{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:43:32Z","timestamp":1790383412847,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emerging evidence suggests that circadian timing influences the efficacy of immune checkpoint inhibitors (ICI), with morning infusions associated with improved therapeutic outcomes across various malignancies. However, the impact of ICI infusion timing on extensive\u2010stage small cell lung cancer (ES\u2010SCLC), a disease with poor prognosis and limited therapeutic advancements, remains unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective study (LungTime\u2010R02) analyzed 397 patients with ES\u2010SCLC who received first\u2010line anti\u2013PD\u2010L1 (atezolizumab or durvalumab) plus chemotherapy at our center between May 2019 and October 2023. The time of day of administration (ToDA) was calculated as the median infusion time for each patient\u2019s first four ICI treatment cycles. To assess its prognostic relevance, hazard ratios (HRs) of earlier progression or death were estimated across multiple ToDA thresholds (11:00\u201316:30). Propensity score matching (1:2) was applied to balance baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Of the 397 patients, the optimal ToDA cutoff for maximizing progression\u2010free survival (PFS) benefit was identified as 15:00, with the lowest HR for PFS observed at this threshold. Patients who received immunochemotherapy before 15:00 exhibited significantly longer PFS and overall survival compared to those treated later, with results consistent across pooled and propensity score matching cohorts. Multivariable analysis confirmed early ToDA as an independent prognostic factor for both PFS (adjusted HR, 0.483; 95% CI, 0.357\u20130.654) and overall survival (adjusted HR, 0.373; 95% CI, 0.265\u20130.526).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides real\u2010world evidence supporting the survival benefit of earlier immunochemotherapy administration in patients with ES\u2010SCLC. These findings add to the growing body of knowledge on the clinical relevance of circadian timing in cancer treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL TRIAL REGISTRATION<\/jats:title>\n                    <jats:p>Not applicable<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70126","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T08:01:06Z","timestamp":1765180866000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Overall survival according to time\u2010of\u2010day of immunochemotherapy for extensive\u2010stage small cell lung cancer"],"prefix":"10.1002","volume":"131","author":[{"given":"Zhe","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Lung Cancer and Gastrointestinal Unit Hunan Cancer Hospital\/The Affiliated Cancer Hospital of Xiangya School of Medicine Central South University  Changsha China"},{"name":"Department of Pathology School of Basic Medical Science Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Lung Cancer and Gastrointestinal Unit Hunan Cancer Hospital\/The Affiliated Cancer Hospital of Xiangya School of Medicine Central South University  Changsha China"},{"name":"Third Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shidong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Lung Cancer and Gastrointestinal Unit Hunan Cancer Hospital\/The Affiliated Cancer Hospital of Xiangya School of Medicine Central South University  Changsha China"},{"name":"Department of Pathology School of Basic Medical Science Central South 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