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Karaboué A, Innominato PF, Wreglesworth NI, Duchemann B, Adam R, Lévi FA. Why does circadian timing of administration matter for immune checkpoint inhibitors' efficacy? Br J Cancer 2024:10.1038/s41416-024-02704-9. [PMID: 38834742 DOI: 10.1038/s41416-024-02704-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/26/2024] [Accepted: 04/24/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Tolerability and antitumour efficacy of chemotherapy and radiation therapy can vary largely according to their time of administration along the 24-h time scale, due to the moderation of their molecular and cellular mechanisms by circadian rhythms. Recent clinical data have highlighted a striking role of dosing time for cancer immunotherapy, thus calling for a critical evaluation. METHODS Here, we review the clinical data and we analyse the mechanisms through which circadian rhythms can influence outcomes on ICI therapies. We examine how circadian rhythm disorders can affect tumour immune microenvironment, as a main mechanism linking the circadian clock to the 24-h cycles in ICIs antitumour efficacy. RESULTS Real-life data from 18 retrospective studies have revealed that early time-of-day (ToD) infusion of immune checkpoint inhibitors (ICIs) could enhance progression-free and/or overall survival up to fourfold compared to late ToD dosing. The studies involved a total of 3250 patients with metastatic melanoma, lung, kidney, bladder, oesophageal, stomach or liver cancer from 9 countries. Such large and consistent differences in ToD effects on outcomes could only result from a previously ignored robust chronobiological mechanism. The circadian timing system coordinates cellular, tissue and whole-body physiology along the 24-h timescale. Circadian rhythms are generated at the cellular level by a molecular clock system that involves 15 specific clock genes. The disruption of circadian rhythms can trigger or accelerate carcinogenesis, and contribute to cancer treatment failure, possibly through tumour immune evasion resulting from immunosuppressive tumour microenvironment. CONCLUSIONS AND PERSPECTIVE Such emerging understanding of circadian rhythms regulation of antitumour immunity now calls for randomised clinical trials of ICIs timing to establish recommendations for personalised chrono-immunotherapies with current and forthcoming drugs.
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Affiliation(s)
- Abdoulaye Karaboué
- UPR "Chronotherapy, Cancer and Transplantation", Medical School, Paris-Saclay University, 94800, Villejuif, France
- Medical Oncology Unit, GHT Paris Grand Nord-Est, Le Raincy-Montfermeil, 93770, Montfermeil, France
| | - Pasquale F Innominato
- North Wales Cancer Centre, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, LL57 2PW, UK
- Cancer Chronotherapy Team, Division of Biomedical Sciences, Medical School, Warwick University, Coventry, CV4 7AL, UK
| | - Nicholas I Wreglesworth
- North Wales Cancer Centre, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, LL57 2PW, UK
- School of Medical Sciences, Bangor University, Bangor, LL57 2PW, UK
| | - Boris Duchemann
- UPR "Chronotherapy, Cancer and Transplantation", Medical School, Paris-Saclay University, 94800, Villejuif, France
- Thoracic and Medical Oncology Unit, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, 93000, Bobigny, France
| | - René Adam
- UPR "Chronotherapy, Cancer and Transplantation", Medical School, Paris-Saclay University, 94800, Villejuif, France
- Hepato-Biliary Center, Paul Brousse Hospital, Assistance Publique-Hopitaux de Paris, 94800, Villejuif, France
| | - Francis A Lévi
- UPR "Chronotherapy, Cancer and Transplantation", Medical School, Paris-Saclay University, 94800, Villejuif, France.
- Gastro-intestinal and Medical Oncology Service, Paul Brousse Hospital, 94800, Villejuif, France.
- Department of Statistics, University of Warwick, Coventry, UK.
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2
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Wang C, Zeng Q, Gül ZM, Wang S, Pick R, Cheng P, Bill R, Wu Y, Naulaerts S, Barnoud C, Hsueh PC, Moller SH, Cenerenti M, Sun M, Su Z, Jemelin S, Petrenko V, Dibner C, Hugues S, Jandus C, Li Z, Michielin O, Ho PC, Garg AD, Simonetta F, Pittet MJ, Scheiermann C. Circadian tumor infiltration and function of CD8 + T cells dictate immunotherapy efficacy. Cell 2024; 187:2690-2702.e17. [PMID: 38723627 DOI: 10.1016/j.cell.2024.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/02/2024] [Accepted: 04/16/2024] [Indexed: 05/26/2024]
Abstract
The quality and quantity of tumor-infiltrating lymphocytes, particularly CD8+ T cells, are important parameters for the control of tumor growth and response to immunotherapy. Here, we show in murine and human cancers that these parameters exhibit circadian oscillations, driven by both the endogenous circadian clock of leukocytes and rhythmic leukocyte infiltration, which depends on the circadian clock of endothelial cells in the tumor microenvironment. To harness these rhythms therapeutically, we demonstrate that efficacy of chimeric antigen receptor T cell therapy and immune checkpoint blockade can be improved by adjusting the time of treatment during the day. Furthermore, time-of-day-dependent T cell signatures in murine tumor models predict overall survival in patients with melanoma and correlate with response to anti-PD-1 therapy. Our data demonstrate the functional significance of circadian dynamics in the tumor microenvironment and suggest the importance of leveraging these features for improving future clinical trial design and patient care.
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Affiliation(s)
- Chen Wang
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland.
| | - Qun Zeng
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Zeynep Melis Gül
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Sisi Wang
- Translational Research Centre in Onco-Hematology (CRTOH), Geneva 1211, Switzerland
| | - Robert Pick
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Phil Cheng
- Department of Oncology and Precision Oncology Service, Geneva University Hospitals, University of Geneva, Geneva 1211, Switzerland
| | - Ruben Bill
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; AGORA Cancer Research Center, Lausanne 1011, Switzerland; Center for Systems Biology, Massachusetts General Hospital Research Institute and Harvard Medical School, Boston, MA 02114, USA
| | - Yan Wu
- Key Laboratory of Carcinogenesis and Translational Research, Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Stefan Naulaerts
- Laboratory of Cell Stress & Immunity, Department of Cellular & Molecular Medicine, KU Leuven, Leuven 3000, Belgium
| | - Coline Barnoud
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Pei-Chun Hsueh
- Department of Fundamental Oncology, University of Lausanne, Lausanne 1066, Switzerland; Ludwig Institute for Cancer Research, Lausanne 1005, Switzerland
| | - Sofie Hedlund Moller
- Department of Fundamental Oncology, University of Lausanne, Lausanne 1066, Switzerland; Ludwig Institute for Cancer Research, Lausanne 1005, Switzerland
| | - Mara Cenerenti
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Mengzhu Sun
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Ziyang Su
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Stéphane Jemelin
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Volodymyr Petrenko
- Division of Thoracic and Endocrine Surgery, Department of Surgery, Geneva University Hospitals, Geneva 1205, Switzerland; Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland; Diabetes Center, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland; Institute of Genetics and Genomics of Geneva (iGE3), Geneva 1211, Switzerland
| | - Charna Dibner
- Division of Thoracic and Endocrine Surgery, Department of Surgery, Geneva University Hospitals, Geneva 1205, Switzerland; Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland; Diabetes Center, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland; Institute of Genetics and Genomics of Geneva (iGE3), Geneva 1211, Switzerland
| | - Stéphanie Hugues
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; Translational Research Centre in Onco-Hematology (CRTOH), Geneva 1211, Switzerland; Geneva Centre for Inflammation Research (GCIR), Geneva 1211, Switzerland
| | - Camilla Jandus
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; Translational Research Centre in Onco-Hematology (CRTOH), Geneva 1211, Switzerland; Ludwig Institute for Cancer Research, Lausanne 1005, Switzerland; Geneva Centre for Inflammation Research (GCIR), Geneva 1211, Switzerland
| | - Zhongwu Li
- Key Laboratory of Carcinogenesis and Translational Research, Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Olivier Michielin
- Translational Research Centre in Onco-Hematology (CRTOH), Geneva 1211, Switzerland; Department of Oncology and Precision Oncology Service, Geneva University Hospitals, University of Geneva, Geneva 1211, Switzerland
| | - Ping-Chih Ho
- Department of Fundamental Oncology, University of Lausanne, Lausanne 1066, Switzerland; Ludwig Institute for Cancer Research, Lausanne 1005, Switzerland
| | - Abhishek D Garg
- Laboratory of Cell Stress & Immunity, Department of Cellular & Molecular Medicine, KU Leuven, Leuven 3000, Belgium
| | - Federico Simonetta
- Translational Research Centre in Onco-Hematology (CRTOH), Geneva 1211, Switzerland; Division of Hematology, Department of Oncology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Mikaël J Pittet
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; Translational Research Centre in Onco-Hematology (CRTOH), Geneva 1211, Switzerland; AGORA Cancer Research Center, Lausanne 1011, Switzerland; Ludwig Institute for Cancer Research, Lausanne 1005, Switzerland; Geneva Centre for Inflammation Research (GCIR), Geneva 1211, Switzerland
| | - Christoph Scheiermann
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; Translational Research Centre in Onco-Hematology (CRTOH), Geneva 1211, Switzerland; Institute of Genetics and Genomics of Geneva (iGE3), Geneva 1211, Switzerland; Geneva Centre for Inflammation Research (GCIR), Geneva 1211, Switzerland; Biomedical Center (BMC), Institute for Cardiovascular Physiology and Pathophysiology, Walter Brendel Center for Experimental Medicine (WBex), Faculty of Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Planegg-Martinsried 82152, Germany.
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3
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Hirata T, Uehara Y, Hakozaki T, Kobayashi T, Terashima Y, Watanabe K, Yomota M, Hosomi Y. Brief Report: Clinical Outcomes by Infusion Timing of Immune Checkpoint Inhibitors in Patients With Locally Advanced NSCLC. JTO Clin Res Rep 2024; 5:100659. [PMID: 38596201 PMCID: PMC11001639 DOI: 10.1016/j.jtocrr.2024.100659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/21/2024] [Accepted: 03/03/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Previous studies reported an association between immune checkpoint inhibitor infusion timing and the treatment effect in metastatic NSCLC. The present study assessed the association between durvalumab infusion timing and survival outcomes in patients with locally advanced NSCLC. Methods Patients receiving durvalumab after chemoradiotherapy for locally advanced NSCLC at a single institution were retrospectively analyzed, and the association of the proportion of durvalumab infusions greater than or equal to 20% versus less than 20% after 3 PM with progression-free survival (PFS) and overall survival was assessed. Results A total of 82 patients were included, with a median age of 69 years (interquartile range, 62-74 years); of these, 67 patients (82%) were of male sex, and 78 patients (95%) had a history of smoking. The median number of durvalumab infusions per patient was 16 (interquartile range, 8-24). Patients with at least 20% of their durvalumab infusions after 3 PM (n = 12/82, 15%) had a significantly shorter PFS than those who did not (median: 7.4 mo versus not available [NA]; hazard ratio [HR], 2.43; 95% confidence interval [CI]: 1.11-5.34, p = 0.027), whereas overall survival was shorter among the former compared with the latter group (median: 22.4 versus NA; HR, 1.80; 95% CI: 0.73-4.42, p = 0.20). In addition, both backward stepwise multivariable analysis and propensity score-matching analysis revealed that receiving at least 20% of durvalumab infusions after 3 PM was significantly associated with worse PFS (HR, 2.54; 95% CI: 1.03-5.67, p = 0.047; and HR, 4.64; 95% CI: 1.95-11.04; p < 0.001, respectively). Conclusions The time of day of durvalumab infusions may impact survival outcomes in patients with locally advanced NSCLC.
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Affiliation(s)
- Tsuyoshi Hirata
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yuji Uehara
- Department of Precision Cancer Medicine, Center for Innovative Cancer Treatment, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Taiki Hakozaki
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Takayuki Kobayashi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yuto Terashima
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kageaki Watanabe
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Makiko Yomota
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
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4
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Landré T, Karaboué A, Buchwald ZS, Innominato PF, Qian DC, Assié JB, Chouaïd C, Lévi F, Duchemann B. Effect of immunotherapy-infusion time of day on survival of patients with advanced cancers: a study-level meta-analysis. ESMO Open 2024; 9:102220. [PMID: 38232612 PMCID: PMC10937202 DOI: 10.1016/j.esmoop.2023.102220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/09/2023] [Accepted: 12/15/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have become the standard of care for numerous malignancies. Emerging evidence suggests that the time of day (ToD) of ICI administration could impact the outcomes of patients with cancer. The consistency of ToD effects on ICI efficacy awaits initial evaluation. MATERIALS AND METHODS This meta-analysis integrates progression-free survival (PFS) and overall survival (OS) data from studies with a defined 'cut-off' ToD. Hazard ratios (HRs) [95% confidence interval (CI)] of an earlier progression or death according to 'early' or 'late' ToD of ICIs were collected from each report and pooled. RESULTS Thirteen studies involved 1663 patients (Eastern Cooperative Oncology Group performance status 0-1, 83%; males/females, 67%/33%) with non-small-cell lung cancer (47%), renal cell carcinoma (24%), melanoma (20%), urothelial cancer (5%), or esophageal carcinoma (4%). Most patients received anti-programmed cell death protein 1 or anti-programmed death-ligand 1 (98%), and a small proportion also received anti-cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4) (18%). ToD cut-offs were 13:00 or 14:00 (i.e. ICI median infusion time), for six studies, and 16:00 or 16:30 (i.e. reported threshold for weaker vaccination responses) for seven studies. Pooled analyses revealed that the early ToD groups had longer OS (HR 0.50, 95% CI 0.42-0.58; P < 0.00001) and PFS (HR 0.51, 95% CI 0.42-0.61; P < 0.00001) compared with the late ToD groups. CONCLUSIONS Patients with selected metastatic cancers seemed to largely benefit from early ToD ICI infusions, which is consistent with circadian mechanisms in immune-cell functions and trafficking. Prospective randomized trials are needed to establish recommendations for optimal circadian timing of ICI-based cancer therapies.
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Affiliation(s)
- T Landré
- Hôpitaux Universitaires Paris Saint-Denis, UCOG, Assistance Publique - Hôpitaux de Paris, Sevran
| | - A Karaboué
- Medical Oncology Unit, GHT Paris Grand Nord-Est, Le Raincy-Montfermeil, Montfermeil; UPR 'Chronotherapy, Cancer and Transplantation', Paris-Saclay University Medical School, Villejuif, France
| | - Z S Buchwald
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | - P F Innominato
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor; Cancer Research Centre, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - D C Qian
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | - J B Assié
- Pneumology Service, CHI Créteil, Créteil; Inserm U955, UPEC, IMRB, Créteil
| | - C Chouaïd
- Pneumology Service, CHI Créteil, Créteil; Inserm U955, UPEC, IMRB, Créteil
| | - F Lévi
- UPR 'Chronotherapy, Cancer and Transplantation', Paris-Saclay University Medical School, Villejuif, France; Cancer Research Centre, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK; Gastro-intestinal and Medical Oncology Service, Paul-Brousse Hospital, Assistance Publique - Hôpitaux de Paris, Villejuif
| | - B Duchemann
- Thoracic and Medical Oncology Unit, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France.
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Coleman M, Mascialino SJ, Panjwani A, Edwards E, Sukhatme VV, Gavegnano C, Sukhatme VP. Readily available drugs and other interventions to potentially improve the efficacy of immune checkpoint blockade in cancer. Front Immunol 2024; 14:1281744. [PMID: 38299150 PMCID: PMC10827885 DOI: 10.3389/fimmu.2023.1281744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024] Open
Abstract
To improve the efficacy of immune checkpoint inhibitors (ICIs) for cancer treatment, various strategies, including combination therapies with repurposed drugs, are being explored. Several readily available interventions with potential to enhance programmed death 1 (PD-1) blockade have been identified. However, these interventions often remain overlooked due to the lack of financial incentives for their development, making them financial orphans. This review summarizes current knowledge regarding off-label drugs, supplements, and other readily available interventions that could improve the efficacy of PD-1 blockade. The summary of each intervention includes the proposed mechanism of action for combination with checkpoint inhibitors and data from animal and human studies. Additionally, we include summaries of common interventions to be avoided by patients on PD-1 blockade. Finally, we present approaches for conducting further studies in patients, with the aim of expediting the clinical development of these interventions. We strive to increase awareness of readily available combination therapies that may advance cancer immunotherapy and help patients today.
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Affiliation(s)
- Merissa Coleman
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States
- Center for the Study of Human Health, Emory University, Atlanta, GA, United States
| | - Sophia J. Mascialino
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States
- Center for the Study of Human Health, Emory University, Atlanta, GA, United States
| | - Anusha Panjwani
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States
- Center for the Study of Human Health, Emory University, Atlanta, GA, United States
| | - Emily Edwards
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States
- Center for the Study of Human Health, Emory University, Atlanta, GA, United States
- College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Vidula V. Sukhatme
- Morningside Center for Innovative & Affordable Medicine, Emory University, Atlanta, GA, United States
- GlobalCures, Inc, Newton, MA, United States
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Christina Gavegnano
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States
- Center for the Study of Human Health, Emory University, Atlanta, GA, United States
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, United States
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
- Center for Bioethics, Harvard Medical School, Boston, MA, United States
- Department of Medicine, Emory University, Atlanta, GA, United States
| | - Vikas P. Sukhatme
- Morningside Center for Innovative & Affordable Medicine, Emory University, Atlanta, GA, United States
- GlobalCures, Inc, Newton, MA, United States
- Department of Medicine, Emory University, Atlanta, GA, United States
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, United States
- Winship Cancer Institute, Emory University, Atlanta, GA, United States
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Hughes BR, Shanaz S, Ismail-Sutton S, Wreglesworth NI, Subbe CP, Innominato PF. Circadian lifestyle determinants of immune checkpoint inhibitor efficacy. Front Oncol 2023; 13:1284089. [PMID: 38111535 PMCID: PMC10727689 DOI: 10.3389/fonc.2023.1284089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/07/2023] [Indexed: 12/20/2023] Open
Abstract
Immune Checkpoint Inhibitors (ICI) have revolutionised cancer care in recent years. Despite a global improvement in the efficacy and tolerability of systemic anticancer treatments, a sizeable proportion of patients still do not benefit maximally from ICI. Extensive research has been undertaken to reveal the immune- and cancer-related mechanisms underlying resistance and response to ICI, yet more limited investigations have explored potentially modifiable lifestyle host factors and their impact on ICI efficacy and tolerability. Moreover, multiple trials have reported a marked and coherent effect of time-of-day ICI administration and patients' outcomes. The biological circadian clock indeed temporally controls multiple aspects of the immune system, both directly and through mediation of timing of lifestyle actions, including food intake, physical exercise, exposure to bright light and sleep. These factors potentially modulate the immune response also through the microbiome, emerging as an important mediator of a patient's immune system. Thus, this review will look at critically amalgamating the existing clinical and experimental evidence to postulate how modifiable lifestyle factors could be used to improve the outcomes of cancer patients on immunotherapy through appropriate and individualised entrainment of the circadian timing system and temporal orchestration of the immune system functions.
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Affiliation(s)
- Bethan R. Hughes
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom
- School of Medical Sciences, Bangor University, Bangor, United Kingdom
| | - Sadiq Shanaz
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom
| | - Seline Ismail-Sutton
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom
| | - Nicholas I. Wreglesworth
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom
- School of Medical Sciences, Bangor University, Bangor, United Kingdom
| | - Christian P. Subbe
- School of Medical Sciences, Bangor University, Bangor, United Kingdom
- Department of Acute Medicine, Ysbyty Gwynedd, Bangor, United Kingdom
| | - Pasquale F. Innominato
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom
- Cancer Chronotherapy Team, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Research Unit ‘Chronotherapy, Cancers and Transplantation’, Faculty of Medicine, Paris-Saclay University, Villejuif, France
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7
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Zhu H, Chen J, Wen Z, Li J, Yu Q, Liao W, Luo X. The role of circadian clock genes in colorectal carcinoma: Novel insights into regulatory mechanism and implications in clinical therapy. Life Sci 2023; 333:122145. [PMID: 37797685 DOI: 10.1016/j.lfs.2023.122145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/23/2023] [Accepted: 10/02/2023] [Indexed: 10/07/2023]
Abstract
Colorectal cancer (CRC) is a lethal malignancy with limited treatment strategies. Accumulating evidence indicates that CRC tumorigenesis, progression and metastasis are intimately associated with circadian clock, an inherent 24-h cycle oscillation of biochemical, physiological functions in almost every eukaryote. In the present review, we summarize the altered expression level of circadian genes in CRC and the prognosis associated with gene abundance switch. We illustrate the function and potential mechanisms of circadian genes in CRC pathogenesis and progression. Moreover, circadian based-therapeutic strategies including chronotherapy, therapeutics targeting potential circadian components, and melatonin treatment in CRC are also highlighted.
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Affiliation(s)
- Haodong Zhu
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, PR China; Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China
| | - Jiawei Chen
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, PR China; Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China
| | - Zeqin Wen
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410078, PR China
| | - Jinfei Li
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, PR China; Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China
| | - Qinyang Yu
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, PR China; Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China
| | - Weihua Liao
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, PR China
| | - Xiangjian Luo
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, PR China; Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China; Key Laboratory of Biological Nanotechnology of National Health Commission, Central South University, Changsha, Hunan 410078, PR China; Hunan Key Laboratory of Oncotarget Gene, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410078, PR China; Molecular Imaging Research Center of Central South University, Changsha, Hunan 410078, PR China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410078, PR China.
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