title: Personalized therapy for metastatic melanoma: could timing be everything?
abstract: There is ample evidence that immune-related processes in humans are under temporal regulation. The circadian variation of humoral and cellular immunity is well documented and appears to be hormonally modulated via the hypothalamic-pituitary-adrenal axis. In advanced melanoma, it has recently been demonstrated that systemic immunity is repolarized toward a global state of chronic inflammation (Th2 dominance) and appears to be governed by infradian biorhythms of cytokines and immune cell subsets, which extend beyond the 24-h circadian variability reported in healthy volunteers. It is suggested that synchronizing administration of lymphodepleting chemotherapy (temozolomide) with these endogenous (individualized) immune dynamics (biorhythms) in patients with advanced/metastatic melanoma improves clinical outcomes compared with temozolomide used in a conventional 'random delivery' fashion.
authors.affiliation: Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA. dronca.roxana@mayo.edu
authors.forename: Roxana S
authors.initials: RS
authors.lastname: Dronca
authors.forename: Alexey A
authors.initials: AA
authors.lastname: Leontovich
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Nevala
authors.forename: Svetomir N
authors.initials: SN
authors.lastname: Markovic
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002940:Circadian Rhythm / Q000276:immunology; D055870:Drug Chronotherapy; D006801:Humans; D008545:Melanoma / Q000276:immunology / Q000556:secondary* / Q000628:therapy*; D057285:Precision Medicine
chemical_list: D000970:Antineoplastic Agents