REBECCA ROBBINS2026年6月26日《自然-医学》撤回了一项研究，该研究发现癌症治疗若在上午进行，疗效将大幅提升。 Jenny Kane/Associated PressEarly this year, a medical journal article caught the attention of cancer patients and doctors worldwide because of its extraordinary conclusion. Simply changing the time of day that immunotherapy was administered appeared to produce a stunning benefit for lung cancer patients.今年初，一篇发表在医学期刊上的文章因其惊人的结论引起了全球癌症患者和医生的关注。仅仅改变免疫疗法的给药时间，似乎就能为肺癌患者带来意想不到的巨大益处。Those who received IV infusions in the morning had their cancer kept at bay for twice as long as those who got it in the afternoon, according to the results from a clinical trial in China and published in the journal Nature Medicine in February. The study also reported that the patients lived nearly twice as long.根据在中国进行的一项临床试验结果，上午接受静脉输注的患者癌症得到控制的时间是下午接受输注患者的两倍。该研究于今年2月发表在《自然-医学》期刊上。研究还指出，这些患者的存活时间也延长了近两倍。Several oncologists said that in recent months they and their hospitals had received a flurry of calls from patients inquiring about switching to morning infusions.几位肿瘤科医生表示，近几个月来，他们和各自所在医院接到了大量患者的电话，咨询是否可以改在上午进行输注。But on Wednesday, Nature Medicine retracted the study, citing a list of inconsistencies and irregularities in the trial’s design and results.但在周三，《自然-医学》撤回了该研究，理由是其试验设计和结果存在一系列矛盾和不规范之处。“It was too good to be true,” said Dr. Toni Choueiri, an oncologist at the Dana-Farber Cancer Institute in Boston who helped conduct the post-publication review that led to the retraction.“好得让人不敢相信是真的，”波士顿丹娜-法伯癌症研究所的肿瘤科医生托尼·肖埃里博士说，他协助进行了导致此次撤稿的发表后审查。Among the issues that the journal cited in its retraction notice: Records that were supposed to be locked before the study started were changed midway through. There were discrepancies between the Chinese version of the study’s plan and the translated version. Every patient remained treated and tracked in the study’s first year, and no one dropped out because of side effects — highly unusual in an oncology study. And unusual patterns were found in the timing of follow-up scans.该期刊在其撤稿声明中列举的问题包括：原本应该在研究开始前锁定的记录在进行到一半时被修改了；该研究计划的中文版本与翻译版本之间存在差异；所有患者在研究的第一年都接受了治疗和随访，没有人因副作用而退出——这在肿瘤学研究中极为罕见；此外，随访扫描的时间安排也发现了异常模式。“Due to the amount and nature of the problems identified, the editors no longer have confidence in the integrity of the results,” the journal said.该期刊表示：“鉴于所发现问题的数量及其性质，编辑们对结果的可靠性失去信心。”Most of the study’s 28 authors were in China, with several collaborators in Europe. The study was funded by the Chinese government.该研究的28位作者大多在中国，还有几位欧洲的合作者。该研究由中国政府资助。China has been pumping money into its hospitals and drug companies, fueling a surge of patents, publications and new clinical trials. In just a few years, the country has rapidly transformed into a powerhouse in drug development, a shift that some U.S. officials, doctors and executives see as a threat to longstanding American dominance in the field.中国一直在向其医院和制药公司注入资金，推动了专利、出版物和新临床试验的激增。在短短几年内，该国已迅速转型为药物研发的核心力量，一些美国官员、医生和高管将这一转变视为对美国在该领域长期主导地位的威胁。China’s critics often question the reliability of its biomedical research. Experts said that, similar to studies in the United States, China’s research output spans a wide range in quality: Some Chinese scientists run their studies at the most meticulous standards. Others were said to cut corners.批评人士常质疑中国生物医学研究的可靠性。专家表示，与美国的研究类似，中国的研究产出在质量上差异很大：一些中国科学家以最严谨的标准开展研究，而另一些人则被指走捷径。Dr. Yongchang Zhang, the study’s senior author, said in a statement that an internal review had “confirmed that part of the study execution and manuscript preparation might not reach the standards for publication in a high-impact journal.”该研究的资深作者张永昌博士在一份声明中表示，内部审查“确认了部分研究执行和手稿准备工作可能未达到在高影响因子期刊上发表的标准”。Dr. Zhang, a researcher at the Chinese hospital where the study was conducted, added: “We acknowledge these shortcomings and sincerely apologize for any inconvenience caused to the journal and its readers.” He did not provide an explanation for the problems cited by the journal.这位供职于该医院的研究员还表示：“我们承认这些不足，并对给期刊及其读者带来的任何不便深表歉意。”他没有对期刊提出的问题做出解释。The study had enrolled 210 patients with advanced lung cancer at Hunan Cancer Hospital in Changsha, a city in south-central China. Patients were randomly assigned to receive infusions of an immunotherapy — Merck’s blockbuster drug Keytruda or Tyvyt, which is not approved in the United States — either before or after 3 p.m.该研究在中国中南部城市长沙的湖南省肿瘤医院招募了210名晚期肺癌患者。患者被随机分配在下午3点之前或之后接受免疫疗法输注——使用的是默克公司的重磅药物可瑞达(Keytruda)，或未在美国获批的达伯舒(Tyvyt)。The study reported that tumors did not progress for 11 months in patients who received the earlier infusions, compared with six months for those given the later infusions. Patients receiving the earlier infusions lived for 28 months, compared with 17 months for those infused later in the day.研究报告称，接受较早输注的患者肿瘤在11个月内没有进展，而接受较晚输注的患者肿瘤进展时间为六个月。接受较早输注的患者存活了28个月，而当天较晚接受输注的患者存活了17个月。Those “were numbers we usually associate with new blockbuster drugs, not scheduling decisions,” wrote Dr. Gilberto Lopes, an oncologist at the University of Miami. And rescheduling a patient “costs nothing,” he noted.迈阿密大学的肿瘤科医生吉尔伯托·洛佩斯博士写道，这些“通常是我们与新的重磅药物联系在一起的数字，而不是日程安排的决定”。他还指出，重新调整患者的日程“不需要任何成本”。Dr. Anil Makam, an epidemiologist and health services researcher at the University of California, San Francisco, said such a drastic benefit, if real, would have prompted infusion clinics to overhaul staffing and scheduling to shift appointments to earlier in the day.加利福尼亚大学旧金山分校的流行病学和卫生服务研究员阿尼尔·马卡姆博士表示，这种巨大的益处如果是真实的，将会促使输注诊所彻底改革人员配置和日程安排，将预约时间提前。“If we believed the effects, it would be malpractice not to,” he said.“如果我们相信这些效果，不这样做就是失职，”他说。But within days after the study’s publication in Nature Medicine, online sleuths and physicians like Dr. Makam began raising concerns on social media and in blog posts. Less than three weeks after the study was published, the journal published an editor’s note saying it was investigating the issues.但在研究发表于《自然-医学》后的几天内，网络侦探和像马卡姆博士这样的医生开始在社交媒体和博客文章中提出质疑。在研究发表后不到三周，该期刊发表了一份编辑说明，表示正在对这些问题展开调查。In a statement on Thursday, Dr. João Monteiro, chief editor of Nature Medicine, which is published by Springer Nature, said, “We are grateful to the research community for bringing these concerns to our attention.”由施普林格·自然出版的《自然-医学》的主编若昂·蒙泰罗博士在周四的一份声明中表示：“我们感谢研究界向我们提出这些担忧。”Some scientists have long been intrigued by the idea of harnessing the body’s circadian rhythms to try to make drugs more effective or less toxic. For example, enzymes that the body uses to break down certain medicines are more abundant at certain times of day.长期以来，一些科学家一直对利用人体的昼夜节律来试图让药物更有效或降低毒性的想法很感兴趣。例如，人体用来分解某些药物的酶在一天中的某些时间段更为丰富。But critics of the Chinese study argued that immunotherapy works very differently from fast-acting drugs like Tylenol. The drug Keytruda lingers in the body and takes effect over several weeks. The study did not identify a biological reason for a difference in treatment timing that would produce such a significant benefit.但对这项中国研究的批评者认为，免疫疗法的工作原理与泰诺等速效药物非常不同。可瑞达会残留在体内，并在几周内持续发挥作用。该研究并未找出治疗时间差异能产生如此显著益处的生物学原因。“There wasn’t any sound scientific rationale behind it,” said Dr. Roy Herbst, the incoming director of the Dartmouth Cancer Center in New Hampshire and Vermont.“这背后没有任何合理的科学依据，”新罕布什尔州和佛蒙特州达特茅斯癌症中心候任主任罗伊·赫伯斯特博士说。In March, a team led by European researchers reported the findings of an analysis that looked at whether more than 3,000 cancer patients across eight studies had received immunotherapy in the morning or the afternoon. Their study, funded by the drugmaker Roche, which sells a number of cancer drugs, concluded that timing was “unlikely to be a critical determinant” of how well patients did.3月份，一个由欧洲研究人员领导的团队报告了一项分析结果，该分析调查了八项研究中3000多名癌症患者是在上午还是下午接受免疫疗法的。他们的研究由销售多种癌症药物的制药商罗氏资助，结论是时间安排“不太可能是决定患者预后好坏的关键因素”。Other studies looking back at outcomes have found an association between the time of day that patients receive a cancer immunotherapy and how well they fare. But the why remains unclear.其他回顾过往结果的研究也发现患者接受癌症免疫疗法的时间与他们的预后之间存在某种关联。但其中的原因仍不清楚。Doctors said it was possible that more energetic, healthier patients might opt for morning slots. Poorer or rural patients who live far from an infusion center — and tend to fare worse — might ask for afternoon slots because they need to spend the morning traveling to their appointment.医生们表示，这有可能是精力更充沛、更健康的患者会选择上午的时间段。而住在远离输注中心、且往往预后较差的贫困或农村患者可能会要求选择下午的时间段，因为他们需要花整个上午的时间在赶往预约的路上。Rebecca Robbins是《纽约时报》记者，报道制药业。她自2015年以来一直从事健康和医学方面的报道。翻译：纽约时报中文网点击查看本文英文版。