Hi Kevin,
Thanks for sharing!
If I am reading this correctly, the groups were before 3 pm and after 3 pm.
We don't give inpatient IO (formulary restriction) and this patient population is almost exclusively treated outpatient for us. Our infusion centers are not open very late and if a patient is getting 3 drugs with the IO first followed by chemo, I would guess that 97-100% of our patients are already getting IO well before 3 pm (probably before noon).
I could see that with the adoption of SQ IO, patients who want to work full days and swing by the infusion center after work may be getting treatment after 3 pm in the maintenance phase but these patients are likely picking an infusion time that fits into their life (and many patients need to work to have health insurance and support families).
I don't see this changing our practice much right now.
In regards to the study, I am kind of shocked that there was such a large difference between the groups in the mPFS. This study appears to have been done exclusively in China and if the theory is that matching IO to circadian rhythms and gut microbiome rhythms improves outcomes I wonder how applicable the results are to the US where lifestyle, environmental factors, and diet are so different.
Stefanie Houseknecht, PharmD, BCOP
Thoracic Oncology Clinical Pharmacy Specialist
Johns Hopkins Hospital and Bayview Medical Center
Original Message:
Sent: 6/4/2025 9:16:00 AM
From: Kevin Chen
Subject: ICI Timing
Hi All,
Wanted to see if y'all saw this study from ASCO regarding ICI timing: https://ascopubs.org/doi/abs/10.1200/JCO.2025.43.16_suppl.8516?af=R
What do you think of this data? Have you talked to your providers about it? How could this be implemented in practice?
-Kevin
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Kevin Chen PharmD, MS, BCOP
Thoracic Oncology and Sarcoma Clinical Pharmacist
UNC Medical Center
Chapel Hill NC
(984) 974-9116
KevinChen
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