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Seasonal timing of anti–PD-1 therapy and survival outcomes in a real-world pan-cancer cohort
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DOI：10.1080/1744666X.2026.2682180.png)
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Abstract
En 中文
Circannual variation in immune function may influence the efficacy of immune checkpoint inhibitors (ICIs), yet clinical evidence regarding seasonal effects remains limited.
We retrospectively analyzed adults with metastatic solid tumors treated with anti–PD-1 monotherapy at a single center between 2015 and 2024. Seasons were defined by regional daylight patterns: summer (April–October) and winter (November–March). Primary endpoints were overall survival (OS) and progression-free survival (PFS). Kaplan–Meier estimates, log-rank tests, multivariable Cox regression, propensity score matching (PSM), and a 3-month landmark analysis were performed.
Among 430 patients, 245 (57.0%) initiated ICIs in summer and 185 (43.0%) in winter. In the unmatched cohort, summer initiation was associated with longer PFS and OS. After PSM, 181 patients remained in each group, and the survival advantage persisted: median PFS was 6.2 versus 3.6 months (HR 0.72, 95% CI 0.56–0.91) and median OS was 21.5 versus 12.4 months (HR 0.74, 95% CI 0.58–0.94) for summer versus winter, respectively. Landmark and multivariable analyses confirmed these findings.
Initiation of anti–PD-1 therapy during summer was associated with significantly improved survival, suggesting that seasonal modulation of host immunity may influence ICI outcomes.
Keywords:
Environment
immunotherapy
cancer
season
effectiveness
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