Document Detail

Cetuximab and cancers of the head and neck: tapping the circadian rhythm.
MedLine Citation:
PMID:  21616603     Owner:  NLM     Status:  MEDLINE    
Proteins in tissue obtained from human skin and oral mucosa have shown a significant circadian rhythm, with the peak expression of p27 at 6:00 AM (early G1-phase marker), p53 at 10:50 AM (late G1-phase marker) and cyclin-E at 2:50 PM (S-phase marker). Patients irradiated in late afternoon/evening have shown a higher grade of mucositis and dermatitis. Studies evaluating the effect of EGFR blockade on cell cycle progression in several human cell types, including A431 squamous epithelial carcinoma cells, suggest that cetuximab leads to cell cycle arrest in G1 phase. On concurrent administration with radiation, mucositis and dermatitis are its main side-effects. So we can hypothesize that cetuximab administration after 11:00 AM would decrease these toxicities. In addition, its administration prior to late afternoon/evening (3:00 PM) can further reduce the radiation associated mucositis and dermatitis due to the occurrence of S-phase during this time and thus increase the therapeutic benefit.
Pragya Shukla; Deepak Gupta; Anusheel Munshi; J P Agarwal
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Publication Detail:
Type:  Journal Article     Date:  2011-05-25
Journal Detail:
Title:  Medical hypotheses     Volume:  77     ISSN:  1532-2777     ISO Abbreviation:  Med. Hypotheses     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-25     Completed Date:  2011-12-21     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  7505668     Medline TA:  Med Hypotheses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-8     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
Department of Radiation Oncology, Tata Memorial Cancer Centre, Mumbai, Maharashtra, India.
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MeSH Terms
Antibodies, Monoclonal / pharmacology*
Antineoplastic Agents / pharmacology
Cell Cycle / drug effects*
Circadian Rhythm / physiology*
Head and Neck Neoplasms / drug therapy*,  radiotherapy*
Radiodermatitis / etiology,  pathology
Radiotherapy / adverse effects,  methods*
Receptor, Epidermal Growth Factor / antagonists & inhibitors
Stomatitis / etiology,  pathology
Time Factors
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antineoplastic Agents; EC, Epidermal Growth Factor; PQX0D8J21J/cetuximab

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