ideasIdea
Give immunotherapy in the morning
Several studies found patients infused with checkpoint inhibitors earlier in the day lived longer. If a randomised trial confirms it, it is a free improvement available everywhere tomorrow.
Retrospective cohorts (Lancet Oncology 2021, multiple follow-ups) and the small randomised MEMOIR signal associate morning infusions with better survival, plausibly via circadian T-cell trafficking.
Hypothesis
Scheduling checkpoint-inhibitor infusions before midday improves overall survival compared with afternoon infusions, with an effect size large enough to change infusion-unit scheduling.
Rationale
Consistent direction across cohorts, mechanistic backing in mouse immunology, zero drug cost, and trivial implementation.
What would test it
Large pragmatic randomised trial of morning vs afternoon infusion in first-line PD-1 therapy for NSCLC and melanoma, endpoint OS; embedded immune-trafficking biomarkers.
Maturity
early clinical