Toxicity and efficacy of chronomodulated chemotherapy: a systematic review.

Autor:	Printezi MI; Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Kilgallen AB; Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands; Regenerative Medicine Centre, Circulatory Health Laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Bond MJG; Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Štibler U; Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands; Regenerative Medicine Centre, Circulatory Health Laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Putker M; Hubrecht Institute, Utrecht, Netherlands., Teske AJ; Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Cramer MJ; Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Punt CJA; Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Sluijter JPG; Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands; Regenerative Medicine Centre, Circulatory Health Laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., Huitema ADR; Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands; Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Department of Pharmacology, Princess Máxima Centre for Pediatric Oncology, Utrecht, Netherlands., May AM; Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands., van Laake LW; Department of Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands; Regenerative Medicine Centre, Circulatory Health Laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands. Electronic address: l.w.vanlaake@umcutrecht.nl.
Jazyk:	angličtina
Zdroj:	The Lancet. Oncology [Lancet Oncol] 2022 Mar; Vol. 23 (3), pp. e129-e143.
DOI:	10.1016/S1470-2045(21)00639-2
Abstrakt:	Timing chemotherapy on the basis of the body's intrinsic circadian clock-ie, chronomodulated chemotherapy-might improve efficacy and reduce treatment toxicity. This systematic review summarises the available clinical evidence on the effects of chronomodulated chemotherapy from randomised, controlled trials in adult patients with cancer, published between the date of database inception and June 1, 2021. This study complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on the International Prospective Register of Systematic Reviews (CRD42020177878). The protocol was published on Oct 21, 2020, before study initiation. The primary outcome measures comprised toxicity incidence, overall survival, progression-free survival, and objective response rate. Of 1455 identified abstracts, 18 studies including 2547 patients were selected. Studies were heterogeneous in study design, treatment, and population. 14 (77%) of 18 studies reported differences among groups in toxicity. 11 (61%) studies reported that chronomodulated chemotherapy resulted in a significant decrease in toxicity while maintaining anti-cancer activity. Two (11%) studies showed that chronomodulated chemotherapy reduced some toxic effects but increased others, and one (6%) study reported worse toxicity outcomes than standard chemotherapy. Three (17%) studies reported improved efficacy (survival measures, objective response rate, or time to treatment failure) of chronomodulated chemotherapy, and no studies reported a decrease in efficacy. In conclusion, most studies provide evidence of the reduction of toxicity resulting from chronomodulated chemotherapy, while efficacy is maintained. More and larger, carefully designed, randomised, controlled trials are needed to provide recommendations for clinical practice. Competing Interests: Declaration of interests We declare no competing interests. (Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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