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Previous studies suggested that early time-of-day administration is associated with better outcomes. We performed a retrospective study in patients treated at a large tertiary cancer centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients receiving ICIs between January 2018 and December 2023 were grouped according to whether they had \u226550% (\u201clate group\u201d) or &lt;50% (\u201cearly group\u201d) of cycles after the median time of all treatments. The endpoint was overall survival (OS). Hazard ratios (HRs) were estimated using Cox models with and without time-dependent variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>2631 patients with advanced\/metastatic lung cancer (45%), melanoma (23%), renal carcinoma (18%), head and neck (9%), and urothelial cancer (5%) were included. Median age was 68.2 years and median infusion time was 12:49\u2009h. At a median follow-up of 32 months, median OS was 13.1 (95% CI 11.8\u201314.4) vs 21.4 (19.8\u201324.5) months for late and early group. Late group was associated with shorter OS on both the standard analysis (HR 1.48, 1.33\u20131.63) and the time-dependent model (HR 1.30, 1.16\u20131.44).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides further evidence in favour of early ICIs administration with a large sample size and a time-dependent model, which reduces the risk of immortal time bias. Data from randomised trials are required to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41416-026-03494-y","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T17:07:11Z","timestamp":1784394431000},"page":"1240-1246","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Overall survival according to timing of immune checkpoint inhibitors administration in patients with advanced cancer: results from a large single-centre cohort analysis"],"prefix":"10.1038","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6202-5041","authenticated-orcid":false,"given":"Tommaso","family":"Bosetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver John","family":"Kennedy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Califano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-3829","authenticated-orcid":false,"given":"Tom","family":"Waddell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Metcalf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Kreft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-2009","authenticated-orcid":false,"given":"Rebecca","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8875-2164","authenticated-orcid":false,"given":"Paul","family":"Lorigan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"3494_CR1","doi-asserted-by":"crossref","unstructured":"Ribas A, Wolchok JD. 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Honoraria - AstraZeneca; Boehringer Ingelheim; Bristol Myers Squibb Foundation; Janssen; Lilly; MSD; Novartis; Pfizer; Roche; Takeda. Consulting or Advisory Role - AstraZeneca; Boehringer Ingelheim; Bristol Myers. Squibb Foundation; Lilly; MSD; Novartis; Pfizer; Roche; Takeda. Speakers\u2019 Bureau - AstraZeneca; Bristol Myers Squibb Foundation; MSD; Novartis; Pfizer; Roche; Takeda. Research Funding - Abbvie; AstraZeneca; Bristol Myers Squibb Foundation; Clovis Oncology; Lilly; MSD; Novartis; Pfizer; Roche; Takeda. Travel, Accommodations, Expenses - Lilly; MSD; Roche; Takeda.\n                      Tom Waddell\n                      Stock and Other Ownership Interests - The Christie Clinic LLP. Honoraria - Bristol-Myers Squibb; EUSA Pharma; Ipsen; Pfizer. Consulting or Advisory Role - Eisai Europe; Ipsen; Merck; Merck Sharp & Dohme; Pfizer. Research Funding - Bristol-Myers Squibb (Inst); Eisai (Inst); Ipsen (Inst); Merck. Sharp & Dohme (Inst); Pfizer (Inst); Roche (Inst). Travel, Accommodations, Expenses - Bristol-Myers Squibb; EUSA Pharma; Ipsen.\n                      Robert Metcalf\n                      Consulting or Advisory Role - Avacta Life Sciences.\n                      Sophia Kreft\n                      Travel, Accommodations, Expenses - Kyowa Kirin International.\n                      Rebecca Lee\n                      Honoraria - Pierre Fabre. Research Funding - AstraZeneca (Inst); Bristol Myers Squibb Foundation (Inst); Pierre Fabre (Inst).\n                      Paul Lorigan\n                      Stock and Other Ownership Interests - Supportive Care; The Christie Private Care. Honoraria - BMS; Iovance Biotherapeutics; MLA Dx. Consulting or Advisory Role - Bristol-Myers Squibb; Iovance Biotherapeutics; Merck Sharp & Dohme; NeraCare GmbH. Speakers\u2019 Bureau - Bristol-Myers Squibb. Research Funding - BMS (Inst); Pierre Fabre (Inst). Travel, Accommodations, Expenses - Bristol-Myers Squibb; Merck Sharp & Dohme.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"This study was performed in accordance with the Declaration of Helsinki. The study was approved by the Quality Improvement and Clinical Audit Committee at The Christie NHS Foundation Trust (project approval number: reference 4191). As no patient identifiable data was included in the analysis, individual patient consent was not required for this study.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}}]}}