Medical research

According to a study on metastasis, the time of day has an impact on cancer diagnosis and therapy.

Your sleeping pattern is just one aspect of your circadian rhythm; it can also affect how cancer grows, gets diagnosed, and is treated. Researchers describe how we could better time when patients are tested for cancer and when they receive therapies to improve diagnostic accuracy and treatment success in a review paper that was published in the journal Trends in Cell Biology. The paper also discusses the role of circadian rhythms in the progression and spread of tumors.

The authors, molecular oncologists Zoi Diamantopoulou, Ana Gvozdenovic, and Nicola Aceto from the ETH Zurich in Switzerland, write, “The circadian rhythm governs most of the cellular functions implicated in cancer progression, and therefore its exploitation opens new promising directions in the fight against metastasis.”

“Since the circadian rhythm drives most of the cellular functions implicated in cancer progression, harnessing it opens up new promising avenues in the battle against metastasis,”

The authors, molecular oncologists Zoi Diamantopoulou,

Our bodies use our circadian rhythms to coordinate a variety of activities throughout the day, such as gene expression, immune function, and cell repair. We have long known that irregular sleep patterns, jet lag, shift work, or other chronic disruptions to our circadian rhythms can put us at risk for a variety of health problems, including cancer. Recent research has demonstrated that circadian rhythms are not only involved in the onset of tumors but also control the progression of cancer and metastasis, or the colonization of secondary sites within the body.

In cancer patients, metastasis is the leading cause of death. In order for metastasis to occur, cells must break away from the primary tumor, enter the bloodstream, and then travel to a new organ and infiltrate it.

Cancer cells break away from the primary tumor and enter the bloodstream at different times throughout the day, according to studies, but the timing of this rhythm varies by type. For instance, breast disease is bound to metastasize at night while we’re sleeping, though prostate malignant growth and various myelomas peak at different times during the day.

According to the authors, we could make use of this data when administering chemotherapy and immunotherapy to precisely target tumor cells at the right time. Chronotherapy is the practice of administering medication and immune therapies at specific times of the day.

According to the authors, “circadian rhythm-based metastasis formation should be seen as an opportunity to intervene in the most timely and effective way.” In the fight against cancer, chronotherapy has the potential to be a useful alternative treatment option.

Chronotherapy has been shown in clinical studies to have an impact on the effectiveness of treatment as well as a reduction in the severity of side effects experienced by patients.

For instance, the authors talk about a recent study that found that patients with melanoma who received immunotherapy before 4:30 p.m. had nearly twice the chance of surviving compared to patients who received the treatment later in the day. The authors also note that the clinical benefits of chronotherapy may be affected by factors such as the patient’s sex and genetic background. The optimal timing varies for various cancer types and therapeutics.

Additionally, understanding the circadian rhythms of cancer cells could aid in their diagnosis. Throughout the day, cancer cells produce proteins at varying rates, and some of these proteins are utilized as diagnostic molecular markers. By collecting and testing biopsies at the time of day when the concentration of these proteins is highest, we could reduce the likelihood of making an incorrect diagnosis for a patient.

According to the authors, “to fully unleash its potential on the clinical side, more mechanistic understanding of these processes will be required.” In additional types of cancer, defining the circadian-rhythm-controlled timing of the proliferation and release of circulating tumor cells into the bloodstream may assist in determining the ideal time frame for the administration of therapy.

More information: Zoi Diamantopoulou et al, A new time dimension in the fight against metastasis, Trends in Cell Biology (2023). DOI: 10.1016/j.tcb.2023.02.002

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