Scientists have found that keeping circadian rhythms, the variations in body processes during the course of the day, in mind while administering immunotherapy could hold the key to boosting treatment outcomes in patients with cancer.
The study, which was conducted by teams based at Zhujiang Hospital, Donghai County People’s Hospital and many other national research centers in China, involved conducting an integrated review of recent scientific studies on how circadian rhythms influence the microenvironment within tumors and in turn play a role in the outcomes of immunotherapy treatments, especially therapies aimed at blocking immune checkpoints.
Immunotherapy has transformed cancer care in recent years, but the treatment’s effectiveness varies widely for different patients. Scientists are therefore engaged in finding ways to improve efficacy rates. This particular review focused on finding what role circadian regulation plays in immunotherapy.
These circadian cycles influence angiogenesis, immune system activity, metabolism and tumor growth. When these cycles are disrupted, the responses of the immune system can be suppressed, tumor progression can accelerate and treatment efficacy can diminish.
The study authors explain that their review found that the fluctuations that occur during different times of the day can avail “windows” during which treatment can be most effective. Some of the data they reviewed showed that patients who received their treatments during the morning hours responded better than those who were treated in the afternoon.
Their research provides more credence to an emerging approach in precision oncology referred to as “chronomedicine” in which treatment plans are made to administer medicine at the precise time when an individual is found to be most responsive to that therapy. The research also helps to link immunotherapy to molecular chronobiology.
The study lays the foundation for future clinical research aimed at establishing standardized frameworks to guide time-based administration of cancer treatment. This process is likely to take several years before ample understanding is attained regarding the different mechanisms at play and how patients can be evaluated before a precise protocol for their treatment is designed by their treatment teams.
As it becomes possible to optimize immunotherapy timing to the needs of each patient, there will be a shift from looking at cancer care as a one-size-fits-all intervention to a model that is truly individualized. This could have profound implications for immunotherapies that had been deemed to have low efficacy rates because integrating circadian regulation could make those treatments viable again.
For entities like Calidi Biotherapeutics Inc. (NYSE American: CLDI) that are running R&D programs exploring novel oncolytic virus therapies indicated for various cancers, circadian regulation could offer a new angle from which to test their drug candidates.
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