Application of Chronotherapy to the Treatment of Cancer: Can Changing the Timing of Drug Administration Influence Efficacy and Toxicity?

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Chronotherapeutics is the administration of drugs based on circadian rhythms to either optimize therapy or minimize toxicity. Application of this concept to the treatment of cancer is a very plausible idea. Positive results have been seen in patients with acute lymphoblastic leukemia, ovarian cancer, endometrial uterine cancer, metastatic colorectal cancer, metastatic transitional cell carcinoma, bladder cancer, progressive metastatic renal cell carcinoma, breast carcinoma, lung carcinoma, hormone-refractory metastatic prostate cancer and genitourinary tract cancer treated with chronotherapy based chemotherapy regimens. The development of programmable drug delivery devices that allowed ambulatory automatic chrono-modulated delivery of the chemotherapy is a critical step for the clinical and potential application of chronotherapeutics to the treatment of cancer.

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