Chronotherapy of colorectal cancer

Chronobiol Int. 2002 Jan;19(1):207-19. doi: 10.1081/cbi-120002602.

Abstract

Chronotherapy consists of chemotherapy delivery according to circadian rhythms. These genetically based rhythms modulate cellular metabolism and cell proliferation in normal tissues. As a result, both the host tolerance and antitumor efficacy of 5-fluorouracil (5-FU) and oxaliplatin (L-OHP), like 30 other anticancer drugs, vary largely according to the dosing time in laboratory rodents. The transfer of this concept to the clinic is aimed primarily at increasing the dose-intensity of the therapy through adjustment of drug-delivery to 24h rhythms in host tolerance. A specific technology (programmable-in-time infusion pumps) enables administration of chronotherapy to fully ambulatory patients. Phase I-III clinical trials show chronotherapy significantly increases tolerance to high doses of cancer drugs and improves antitumor activity in patients with metastatic colorectal cancer. These safe conditions of drug-delivery led to the first demonstration of the high activity of the 5-FU-leucovorin-L-OHP protocol. Chronotherapy with these three drugs also allows surgical removal of previously unresectable liver and lung metastases. This novel medico-surgical management provides hope for the cure of metastatic disease in patients with unresectable colorectal cancer metastases.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Clinical Trial, Phase III
  • Randomized Controlled Trial

MeSH terms

  • Animals
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives*
  • Carboplatin / administration & dosage
  • Chronotherapy*
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / radiotherapy
  • Colorectal Neoplasms / secondary
  • Colorectal Neoplasms / surgery
  • Fluorouracil / administration & dosage
  • Humans
  • Irinotecan
  • Leucovorin / administration & dosage
  • Mice
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Radiotherapy, Adjuvant
  • Rats

Substances

  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Oxaliplatin
  • Irinotecan
  • Carboplatin
  • Leucovorin
  • Fluorouracil
  • Camptothecin