Chronotherapy: It’s About Time
Emerging evidence has shown that specifically timing patients’ course of treatment to align with each person’s internal body clock, known as chronotherapy, could have beneficial results.
The circadian clock is a system within the body that regulates the timing and cycling of distinct processes, such as hormone release, cell regeneration, gene activation, and sleep patterns. By adjusting the scheduling of treatments and medication delivery to the body’s timing of gene activation, specifically the ones involved in encoding the targets for drugs, the success of the treatments and medications could be maximized. Previous research has suggested that cancer treatment drugs and, even, everyday heartburn medications work more efficiently when given at times of day in accordance to a patient’s circadian rhythm. Although several clinical studies have shown promising results, there are many factors — including practicality, costs, and reliability — that still have researchers questioning the effectiveness of chronotherapy.
The circadian clock is a system within the body that regulates the timing and cycling of distinct processes, such as hormone release, cell regeneration, gene activation, and sleep patterns. By adjusting the scheduling of treatments and medication delivery to the body’s timing of gene activation, specifically the ones involved in encoding the targets for drugs, the success of the treatments and medications could be maximized. Previous research has suggested that cancer treatment drugs and, even, everyday heartburn medications work more efficiently when given at times of day in accordance to a patient’s circadian rhythm. Although several clinical studies have shown promising results, there are many factors — including practicality, costs, and reliability — that still have researchers questioning the effectiveness of chronotherapy.
Syncing patients’ course of treatment to each person’s individual circadian clock could yield more successful results.
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In a clinical trial nine years ago, a patient, Carole Godain, signed up for chronotherapy after her colon cancer spread rapidly despite her initial treatment. Francis Lévi, the doctor who treated Godain, had been at the forefront of several chronotherapy clinical trials. Although Godain is currently completely cancer-free, not all of Lévi’s patients have been as successful. However, the recent surge of interest in the field of circadian rhythms and personalized medicine could yield promising implications for the future of chronotherapy and reveal the reasoning behind the inconsistencies of the clinical trials. In a clinical trial led by Joshua Rubin, a neuro-oncologist at Washington University School of Medicine in St. Louis, the daily rhythm of glioblastoma, a deadly brain tumor, was investigated and exploited. The researchers began treating the tumor cells with drugs at different timepoints during the cells’ cycle and found that the drugs were most effective when given at the time of day that corresponded to the cells’ peak expression. The results of this trial has promising implications for the future chronotherapy treatment for other types of cancers that also follow a daily rhythm.
Although there have been encouraging breakthroughs in the field of chronotherapy research, many people are still hesitant. Before chronotherapy can be fully put into practice, more information must be gathered on the specific biomarkers that clinicians can use to pinpoint successfully the most advantageous treatment times. Current research is focused on developing ways to track each individual's rhythms precisely, such as temperature sensors, wearable devices, smartphone apps, and blood and saliva samples. In Godain’s case, she wore a watch-like device that monitored her circadian rhythm. Lévi noted that Godain had very regular sleep-wake cycles, which probably contributed to the success of her treatment. Furthermore, many drug companies are uncertain about the prospects of chronotherapy because of the difficulty in delivery. Patients are already usually inconsistent about taking any medications, and adding the time-specific restrictions required for chronotherapy could be difficult to abide by. Additionally, there are many drugs that already make a lot of money. Therefore, these drug companies lack incentive to invest more time and funds into researching time specific dosages for these already profitable drugs.
While there are still many hurdles to overcome, chronotherapy has promising implications for the future of cancer treatment and drug delivery. By syncing the delivery of drugs and scheduling of treatments to the body’s internal clock, the outcomes of patients could be significantly changed, and many lives could be improved.
Although there have been encouraging breakthroughs in the field of chronotherapy research, many people are still hesitant. Before chronotherapy can be fully put into practice, more information must be gathered on the specific biomarkers that clinicians can use to pinpoint successfully the most advantageous treatment times. Current research is focused on developing ways to track each individual's rhythms precisely, such as temperature sensors, wearable devices, smartphone apps, and blood and saliva samples. In Godain’s case, she wore a watch-like device that monitored her circadian rhythm. Lévi noted that Godain had very regular sleep-wake cycles, which probably contributed to the success of her treatment. Furthermore, many drug companies are uncertain about the prospects of chronotherapy because of the difficulty in delivery. Patients are already usually inconsistent about taking any medications, and adding the time-specific restrictions required for chronotherapy could be difficult to abide by. Additionally, there are many drugs that already make a lot of money. Therefore, these drug companies lack incentive to invest more time and funds into researching time specific dosages for these already profitable drugs.
While there are still many hurdles to overcome, chronotherapy has promising implications for the future of cancer treatment and drug delivery. By syncing the delivery of drugs and scheduling of treatments to the body’s internal clock, the outcomes of patients could be significantly changed, and many lives could be improved.
Featured Image Source: geralt
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