Personalized therapy for metastatic melanoma: Could timing be everything?

Roxana S. Dronca, Alexey A. Leontovich, Wendy K. Nevala, Svetomir N. Markovic

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1401-1406
Number of pages6
JournalFuture Oncology
Issue number11
StatePublished - Nov 2012


  • biorhythms
  • cancer
  • chemotherapy
  • cytokine
  • immunity
  • infradian
  • melanoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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