Brandon Luu/X
Jun 30, 2025, 08:44
Brandon Luu: Circadian Biology May be the Next Frontier in Cancer Care
Brandon Luu, Resident Physician in Internal Medicine at University of Toronto, shared a post on X:
“Circadian biology may be the next frontier in cancer care. Patients with lung cancer who got chemo-immunotherapy before 11:30 AM had:
53% lower risk of death
Median overall survival: 33 vs. 19.5 months
Improved treatment response
Let’s break it down
Your body runs on a clock. Cortisol, insulin, immune cells all peak at certain times. Yet most cancer therapy is scheduled without considering circadian rhythms. That’s a problem, especially for immunotherapy, which depends on immune activation
Researchers analyzed patients from France & China with advanced NSCLC. They grouped them by the median time of their first 4 infusions:
Before 11:30 AM
After 11:30 AMSame treatment, different timing, very different outcomes
Key findings:
• OS: 33.0 vs 19.5 months
• PFS: 11.8 vs 7.2 months
• Death risk ↓53% (HR 0.47)
• Response: 62% vs 52%Morning patients lived longer and responded better across both cohorts and most subgroups
Why might this happen?
T-cells are more active in the morning
Drug metabolism is circadian-regulated
Chemo (like platinum and taxanes) may be more effective earlier Circadian biology shapes how the body responds to therapy
This was a retrospective study, causation isn’t proven so randomized trials are needed. But the signal is strong, the biology checks out, and the fix is simple: treat earlier. Chronotherapy could be a low-cost way to boost cancer outcomes
Chronotherapy, aligning treatment with the body’s clock, is a powerful and underrated frontier in personalized medicine. This study shows it may even extend survival in cancer. For the full breakdown, check out the newsletter linked in my bio.”
Samuel Hume, Fellow at The Foulkes Foundation and pursuing PhD in the University of Oxford’s Department of Oncology, shared this post, adding:
“Super interesting – and now supported by evidence from a randomized trial
Blue: each day’s chemo-immunotherapy was started and completed before 3 pm
Red: each day’s therapy was started and completed after 3 pm
Those who received treatment early in the day had better survival.”
More posts featuring Samuel Hume on OncoDaily.
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