The future of precise cancer chronotherapeutics.

We have read with great interest the recent comprehensive systematic review on chronomodulated chemotherapy by Markella Printezi and colleagues. 1 Printezi MI Kilgallen AB Bond MJG et al. Toxicity and efficacy of chronomodulated chemotherapy: a systematic review. Lancet Oncol. 2022; 23: e129-e143 Summary Full Text Full Text PDF Scopus (2) Google Scholar An updated critical revision of available evidence was overdue, given that the previous one was published nearly 30 years ago. 2 Hrushesky WJ Bjarnason GA Circadian cancer therapy. J Clin Oncol. 1993; 11: 1403-1417 Crossref PubMed Scopus (102) Google Scholar Although only a small number of randomised controlled clinical trials involving chronomodulated or circadian-based chemotherapy have been done in the interval between these two systematic reviews, two major developments need to be highlighted. Effect of immunotherapy time-of-day infusion on overall survival among patients with advanced melanoma in the USA (MEMOIR): a propensity score-matched analysis of a single-centre, longitudinal studyOur findings are in line with an increasing body of evidence that adaptive immune responses are less robust when initially stimulated in the evening than if stimulated in the daytime. Although prospective studies of the timing of immune checkpoint inhibitor infusions are warranted, efforts towards scheduling infusions before mid-afternoon could be considered in the multidisciplinary management of advanced melanoma. Full-Text PDF