The Warwick Chronotherapy Group
The Chronotherapy group was founded in April 2014 and includes researchers from various backgrounds ranging from molecular biology to maths and clinical medicine. The Chronotherapy Group staff members include Prof Francis Lévi (medical oncology), Prof David Rand (Maths), Prof Bärbel Finkenstädt (Statistics), Dr Robert Dallmann (molecular chronobiology), Dr Pasquale Innominato (medical oncology) and Dr Annabelle Ballesta (Maths).We also work closely with the Chemistry Department at Warwick (Professor Peter Sadler, Professor Sebastien Perrier), and we are part of the Cancer Research Centre directed by Professor Lawrence Young.
Chronotherapy is an area of study that looks at how to align medical treatment to our circadian rhythms. Focusing on main causes of human mortality, including cancer, cardio-vascular, metabolic, inflammatory, infectious, neurodegenerative or psychiatric diseases, chronotherapy aims to improve treatment tolerability and efficacy.
Our aim is to streamline basic and clinical research on biological clocks, drugs, and diseases, to promote the integration of chronotherapy into drug development and daily medical practice.
A further aim is to prevent diseases through an amelioration of biological rhythm coordination. In this respect, we want to understand the relevance of cross-talks between rhythms of different periodicities for disease outcomes and treatment effects.
Toward these goals, our research encompasses the use of in vitro, in vivo and mathematical models as well as big data and clinical trials. We perform molecular, physiological, pharmacology, mathematical, statistical, translational and clinical research, and contribute to the development of new technologies.
State of the Art
Chronotherapy can improve tolerability of anti-cancer drugs by up to 5-fold and nearly double efficacy in cancer patients. Yet, optimal circadian timing of medications may differ by up to 12 hours among individuals with robust rhythms, according to gender, lifestyle, genetics, and molecular clock.
However, circadian disruption can be found in up to half of the patients, as indicated by poor rest-activity, temperature or cortisol rhythms. Circadian disruption has been strongly associated to poor quality of life and severe systemic symptoms. It is also an independent predictor of poor overall survival in patients with breast, colorectal, lung, ovarian or kidney cancer. Similar data is arising for other pathologies.
The implementation of circadian (and other biological rhythm) concepts in clinical medicine requires dedicated methodologies, technologies and logistics. The latter ones are best supported through an integrated multi-pathology and multi-actor patient-centred e-Health system designated as Domomedicine, which our team is promoting.
Domomedicine involves "all medical procedures and healthcare, sometimes complex, given at the patient's home or during his or her social and professional activities, [...] based on modern technologies. It aims at facilitating patient home support and autonomy as well as promoting biomedical progress" (National Academy of Technology, France).
Domomedicine could be considered as a coordinated set of actions and medical care provided at home, aiming at:
- providing excellence in medicine and healthcare
- complying with patients’ wishes and expectations
- stimulating biomedical progress
- improving the efficiency of the health care system.
As a consequence of such new patient-centred health care sector, new jobs will be developed, with novel specifications and expertise.
We consider cancer chronotherapy research as a driver for similar research in other diseases. We expect that chronotherapy will significantly reduce treatment morbidity and, thus, decrease associated costs, while improving patients’ well being and chronic disease control.
We base such foreseen medical progress on both the major advances in scientific knowledge and methods regarding biological clocks, and the pervasion and awareness of all society levels with information and communication technologies.
Our research is funded by the MRC, Cancer Research UK, the EU (FP7). The Cancer Chronotherapy Team has been selected to become a European Associated Laboratory by INSERM, the National Institute for Health and Medical Research of France.