Cancer is among the most frequent causes of death in humans. To date, established cancer therapies include surgery, radiation, chemo-and immunotherapy as well as hormonal treatments up to stem cell transplantation. In this editorial, we highlight an additional and so far underestimated factor involved in carcinogenesis and prognosis, namely biological clocks, which should be carefully considered to establish future cancer therapies. Disruption of the circadian clock was documented both in host-tissue and in cancer cells, and functional oscillations were associated with cancer prognosis and survival. We summarize recent advances in the field of chronobiology regarding the role of the host's and tumor-intrinsic circadian clock functions in carcinogenesis.The biological circadian clock controls cancer-related pathways A central clock in the hypothalamus and peripheral clocks in almost all organs and tissues altogether regulate physiological processes in a time of day dependent (circadian) manner. The molecular bases of circadian clocks are cellular oscillations generated by a number of rhythmically expressed interconnected clock genes [1]. Highthroughput experiments on murine tissues showed that in any given cell-type or organ, hundreds or thousands of genes are expressed with a circadian rhythm, and led to the estimation that around 50% of all genes oscillate in at least one organ [2]. As a consequence of this, most cellular and physiological processes show 24 h oscillations. This is the case of many aspects of the immune system, including many immune cells and responses of relevance to cancer [3]. Also, major regulators of the cell cycle and tumor suppressor genes were shown to be regulated by the circadian clock, such as WEE1, c-MYC and p21 [4]. Consistently, cell-cycle progression and proliferation show circadian regulation.
Circadian clock disruption is associated with cancerMismatch between the internal clock and the external time disrupts the circadian network, as reported for example in shift workers [5], and has been associated with a wide range of pathologies and disease states including cancer [4]. Mounting evidence from human-based epidemiological studies suggested an effect of circadian disruption during shift work on cancer risk. For example, the risk to develop breast cancer was extensively increased in nurses exposed to long-term rotating night shift work [6]. Similar results were obtained for prostate cancer risk in night shift workers [7]. Out of note, in 2007 an agency of the WHO has classified night shift work leading to circadian disruption as 'probably carcinogenic' to humans [8]. Since then, there has been growing interest in understanding how circadian disruption may play a role in cancer development and progression. In support of human studies, experimental work in rodents documented accelerated tumor growth when mice, engrafted with lung adenocarcinoma or Glasgow osteosarcoma, were exposed to repeated jet lag conditions [9,10]. Similarly, enhanced tumor development has been described in mi...