MSc(Med. Pharmaceutical Affairs), Faculty of Health Sciences, University of the Witwatersrand, 2009

M. Pharm., Dept. of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, 2011 / Chronotherapy is a form of therapy where treatment is administered according to a schedule that corresponds to an individual’s biological clock. Research demonstrates that the body’s natural processes follow a 24-hour pattern, or circadian rhythm. In addition, symptoms of disease fluctuate according to this 24-hour pattern. These diseases, termed chronotherapeutic disorders may include amongst other disorders, hypertension, cardiovascular disease and asthma. Common therapy for these disorders involves the use of controlled zero-order release formulations. Here, the same quantity of drug is released over a period of time. Although beneficial, these formulations are not ideal in the treatment of chronotherapeutic disorders. Treatment of these disorders aims to release drug at specific periods, only when it is required, such that therapy coincides with the body’s natural rhythm. Ideally, drug should be released in pulses with two or more pulses released from the dosage form. In this manner, the patient is exposed to drug only when required, reducing the number of dosages, reducing side-effects and ultimately increasing patient compliance. Therefore, the aim of this research was to develop a Multi-Layered Multi-Disk Tablet (MLMDT) that incorporates two drug-loaded disks enveloped by three polymeric layers. The proposed system, to be used in the treatment of chronotherapeutic disorders, is designed to provide a lag phase and then two pulses of drug release separated by a ‖switch-off‖ phase. During the ―switch-off‖ phase no drug is released from the system. Initially, preliminary screening studies were performed on various polymeric materials to assess their effectiveness to generate the desired drug release profile. Of the numerous polymer combination and ratios, only a few were relevant and were subsequently tested further. From the preliminary studies it was ascertained that the composition of disk 2 was critical in generating the ―switch-off‖ phase separating the two pulses. Artificial Neural Networks (ANN); a computational technique that simulates the thinking process of the human brain was employed for optimization. Results from this technique outlined the polymer combination suitable for the optimized MLMDT. The optimized formulations were subjected to friability, hardness and uniformity of mass analysis as well as swelling, erosion and magnetic resonance imaging techniques to observe and confirm the performance of the MLMDT during dissolution. In addition, textural analysis, computational modeling and temperature modulated differential scanning calorimetry techniques were used to elucidate any incompatibilities or complexes formed. In vitro drug release analysis revealed that the MLMDT generated a lag phase followed by two pulses of drug release over the 24 hour period. The two pulses were separated by a ―switch-off‖ phase. To confirm data obtained during preclinical in vitro testing, animal studies were undertaken using the Large White Pig model. Pigs were dosed with conventional products and the optimized MLMDT. Blood samples collected over a 24 hour period were analyzed using Ultra Performance Liquid Chromatography to determine the drug concentration in blood. Drug concentration analysis from conventional products revealed increasing plasma concentrations up to 2 hours followed by a steady decline in concentration while the developed MLMDT displayed two pulse drug release separated by a ―switch-off‖ phase.

Made available in DSpace on 2017-07-10T13:59:25Z (GMT). No. of bitstreams: 1 DEFESA_SARAH_M_MARTINS.pdf: 1948811 bytes, checksum: b506b11e5b86370135e564286deabd70 (MD5) Previous issue date: 2015-11-24 / In recent years, the interest of the pharmaceutical industry for new drugs delivery system has been growing, especially aiming the optimization of therapy and reduction of side effects caused by conventional treatments. The multiparticulate systems, besides their techonological and biopharmaceutical advantages when compared to the monolithic systems, allow obtaining different ways of drug delivery, such as the biphasic system, capable of delivering the drug in separate fractions into the bloodstream, and ideal for the treatment of circadian diseases. Thus, this study aimed to obtain a multi particulate system biphasic release, lasting 24 hours, using a combination of polymeric materials hydroxypropyl methylcellulose and ethyl cellulose, as well as a full factorial design 2² to optimize the development stage. Furthermore, it was developed and validated analytical method by UV spectroscopy able to quantify the model drug used, propranolol hydrochloride (PROP) test and the content of dissolution of the dosage form. Using the sugar spheres coating technology, it was possible to obtain the proposed system with a reduced number of experiments. Pellets produced and used in the biphasic formulations showed mechanical characteristics within the expected quality parameters, showing that the technique is robust and can be applied on an industrial scale. The analytical method for the quantification of the proposed drug was linear, precise, accurate, robust against variations in wavelength of mark and sonication solvent in a concentration range of 0.80 - 96 mg L-1 and stable the experimental conditions analyzed, showing a method capable of generating highly reliable results and therefore able to be used in the laboratory routine quality control. / Nos últimos anos, o interesse da indústria farmacêutica por novos sistemas de liberação de fármacos vem crescendo, visando sobretudo a otimização da terapêutica e a diminuição dos efeitos colaterais ocasionados pelos tratamentos convencionais. Os sistemas multiparticulados, além de possuírem vantagens tecnológicas e biofarmacêuticas quando comparadas aos sistemas monolíticos, possibilitam a obtenção de diferentes padrões de liberação de drogas, como por exemplo, o sistema bifásico, capaz de disponibilizar o fármaco em frações distintas para a corrente sanguínea, sendo ideais para o tratamento das doenças circadianas. Desta maneira, o presente trabalho teve como objetivo a obtenção de um sistema multiparticulado de liberação bifásica, com duração de 24 horas, utilizando a combinação dos materiais poliméricos hidroxipropilmetilcelulose e etilcelulose, bem como um planejamento fatorial completo 2² para a otimização da etapa de desenvolvimento. Além disso, foi desenvolvido e validado um método analítico por espectroscopia de UV capaz de quantificar o fármaco modelo utilizado, cloridrato de propranolol (PROP), nos ensaios de teor e dissolução desta forma farmacêutica. Utilizando-se a tecnologia de revestimento de núcleos inertes de sacarose, foi possível a obtenção do sistema proposto com um número reduzido de experimentos. Os péletes produzidos e utilizados nas formulações bifásicas apresentaram características mecânicas dentro dos parâmetros de qualidade esperados, demostrando que a técnica é robusta e pode ser aplicada em escala industrial. O método analítico proposto para a quantificação do fármaco, mostrou-se linear, preciso, exato, robusto em relação a variações no comprimento de onda, marca de solvente e sonicação na faixa de concentração de 0,80 96 μg mL-1 e estável nas condições experimentais analisadas, evidenciando um método capaz de gerar resultados de alta confiabilidade e portanto apto a ser utilizado na rotina laboratorial de controle de qualidade.

Made available in DSpace on 2017-05-12T14:36:22Z (GMT). No. of bitstreams: 1 DEFESA_SARAH_M_MARTINS.pdf: 1948811 bytes, checksum: b506b11e5b86370135e564286deabd70 (MD5) Previous issue date: 2015-11-24 / In recent years, the interest of the pharmaceutical industry for new drugs delivery system has been growing, especially aiming the optimization of therapy and reduction of side effects caused by conventional treatments. The multiparticulate systems, besides their techonological and biopharmaceutical advantages when compared to the monolithic systems, allow obtaining different ways of drug delivery, such as the biphasic system, capable of delivering the drug in separate fractions into the bloodstream, and ideal for the treatment of circadian diseases. Thus, this study aimed to obtain a multi particulate system biphasic release, lasting 24 hours, using a combination of polymeric materials hydroxypropyl methylcellulose and ethyl cellulose, as well as a full factorial design 2² to optimize the development stage. Furthermore, it was developed and validated analytical method by UV spectroscopy able to quantify the model drug used, propranolol hydrochloride (PROP) test and the content of dissolution of the dosage form. Using the sugar spheres coating technology, it was possible to obtain the proposed system with a reduced number of experiments. Pellets produced and used in the biphasic formulations showed mechanical characteristics within the expected quality parameters, showing that the technique is robust and can be applied on an industrial scale. The analytical method for the quantification of the proposed drug was linear, precise, accurate, robust against variations in wavelength of mark and sonication solvent in a concentration range of 0.80 - 96 mg L-1 and stable the experimental conditions analyzed, showing a method capable of generating highly reliable results and therefore able to be used in the laboratory routine quality control. / Nos últimos anos, o interesse da indústria farmacêutica por novos sistemas de liberação de fármacos vem crescendo, visando sobretudo a otimização da terapêutica e a diminuição dos efeitos colaterais ocasionados pelos tratamentos convencionais. Os sistemas multiparticulados, além de possuírem vantagens tecnológicas e biofarmacêuticas quando comparadas aos sistemas monolíticos, possibilitam a obtenção de diferentes padrões de liberação de drogas, como por exemplo, o sistema bifásico, capaz de disponibilizar o fármaco em frações distintas para a corrente sanguínea, sendo ideais para o tratamento das doenças circadianas. Desta maneira, o presente trabalho teve como objetivo a obtenção de um sistema multiparticulado de liberação bifásica, com duração de 24 horas, utilizando a combinação dos materiais poliméricos hidroxipropilmetilcelulose e etilcelulose, bem como um planejamento fatorial completo 2² para a otimização da etapa de desenvolvimento. Além disso, foi desenvolvido e validado um método analítico por espectroscopia de UV capaz de quantificar o fármaco modelo utilizado, cloridrato de propranolol (PROP), nos ensaios de teor e dissolução desta forma farmacêutica. Utilizando-se a tecnologia de revestimento de núcleos inertes de sacarose, foi possível a obtenção do sistema proposto com um número reduzido de experimentos. Os péletes produzidos e utilizados nas formulações bifásicas apresentaram características mecânicas dentro dos parâmetros de qualidade esperados, demostrando que a técnica é robusta e pode ser aplicada em escala industrial. O método analítico proposto para a quantificação do fármaco, mostrou-se linear, preciso, exato, robusto em relação a variações no comprimento de onda, marca de solvente e sonicação na faixa de concentração de 0,80 96 μg mL-1 e estável nas condições experimentais analisadas, evidenciando um método capaz de gerar resultados de alta confiabilidade e portanto apto a ser utilizado na rotina laboratorial de controle de qualidade.

Multiple dose regimens are frequently required to optimize therapy; however, such therapy is frequently undermined by poor patient adherence. In fact, patient adherence is inversely related to the number of doses a patient is asked to take each drug. Consequently, great efforts are under way to develop drug delivery systems that are able to release drugs over an extended time interval; this could offer considerable benefits including reducing administration frequency. This dissertation describes multiple dose platforms designed to deliver a variety of drugs as a single oral administration are described in this dissertation. We believe these drug delivery systems can be used to enhance patient compliance and achieve better therapeutic outcomes. We developed and tested a novel gastroretentive pulsatile drug delivery platform. This platform could deliver multiple unit doses of a drug in a pulsatile pattern and be controlled by dissolution/erosion of a lag-time interval layer. The platform was designed to be retained in the stomach whilst pulsing drug at various timed intervals. This would allow each dose of the drug to release above or within an optimized absorption window over an extended period of time. To assure the robustness and reproducibility of the platform, various in vitro dissolution studies and physical stability tests were performed and evaluated through drug release characteristics, buoyancy, and structural integrity evaluations. The applicability of the novel multiple dose platform was demonstrated by providing repeated release profiles of ciprofloxacin and verapamil in a single, once-daily delivery system. Ultimately, this dissertation demonstrates that a novel multiple dose platform could be a suitable alternative dosing strategy for a variety of drugs to improve patient adherence and treatment efficacy. / text

BMAL1, une protéine centrale de l'horloge circadienne.L’inactivation de BMAL1 (BMAL1-KO) entraîne une perte complète de la rythmicité dans les horloges central et périphérique. Le travail de ma thèse se concentre sur le rôle du gène BMAL1 dans la développement et le traitement des cancers du sein et du côlon.1. Pharmacodynamique in vitro de l’Everolimus en fonction du temps d’administration malgré une horloge circadienne défectueuse ((Zhang et al., 2018) (Zhang, Levi and Chang, 2018)L’everolimus (EV) est un inhibiteur de la mTOR chez les mammifères et il est utilisé pour traiter le cancer du sein positif aux oestrogènes (ER+). Nous avons focalisé nos recherches sur la chronopharmacologie de l’Everolimus administré sur des cellules MCF-7 (ER+). Les MCF-7 présentent une oscillation circadienne de l’activité de mTOR sans mise en évidence d’une oscillation des gènes d’horloge. L’oscillation d’activité de mTOR induirait une oscillation de synthèse et/ou de phosphorylation de protéines importantes dans la progression de la phase G1, notamment la Cycline D1 et RB phosphorylée. Ces variations rythmiques des MCF-7 synchronisées expliquent la chrono-efficacité de l’Everolimus selon des temps différents d’administration.Ce travail a révélé que même dans un système de cellules cancéreuses dont l’horloge était perturbée, l'intégration d'autres rythmes cellulaires dans la chronothérapie pouvait augmenter l'efficacité du médicament. Ce principe peut être appliqué à des traitements du cancer pour optimiser la chronothérapie du cancer.2. Le Knockdown BMAL1 a déclenché différents destins de cellules du carcinome du côlon (CRC) en modifiant l'équilibre délicat entre les voies AKT / mTOR et P21 / P53 (Article soumis)Premièrement, nos résultats ont révélé que le knockdown BMAL1 par le shRNA (BMAL1-KD) avait déclenché une activation plus évidente de l’AKT / mTOR dans deux lignées cellulaires primaires (HCT116 et SW480) que une lignée métastatique de CRC, SW620. De plus, bien que les deux lignées cellulaires primaires de CRC aient présenté une augmentation significative de l'activité de l'AKT/mTOR, elles avaient des statuts différents de P53 (WT ou mutant). Dans ce contexte, les cellules SW480 BMAL1-KD avec P53 mutant présentaient une sénescence accrue, mais les cellules HCT116 BMAL1-KD avec P53 WT présentaient d’abord une apoptose transitoire, puis un taux de prolifération plus élevé.Ainsi, nos travaux ont révélé le rôle crucial de BMAL1 pour équilibrer un régulateur central du métabolisme AKT / mTOR et une voie de réponse au stress P53 / P21 dans des lignées cellulaires de CRC, ce qui met en évidence l’importance de BMAL1 dans le développement de CRC et la progression du vieillissement.3. BMAL1 renforce les propriétés épithéliales et diminue la chimiorésistance des cellules du CRC (article en préparation)La transition épithélo-mésenchymateuse (EMT) est un événement critique dans l'invasion et la métastase des carcinomes, y compris le CRC.Dans ce travail, nous avons étudié comment BMAL1 knockdown (Bmal1-KD) altère l’équilibre délicat entre les propriétés épithéliales et mésenchymateuse de trois lignées cellulaires de CRC (HCT116, SW480 et SW620).Après BMAL1-KD, la diminution de l’expression Twist, un facteur de transcription favorisé l’EMT et des marqueurs mésenchymateux (N-Cadhérine, Vimentine) étaient associées à une expression accrue des marqueurs épithéliaux (E-cadhérine, CK20 et EpCAM). De manière constante, l'augmentation de l'expression de l’E-cadhérine après BMAL1-KD était accompagnée d'une co-localisation membranaire accrue de la β-caténine avec l'E-cadhérine, ainsi que d'une diminution de la localisation nucléaire de la β-caténine, suggérant une diminution de l'activation de la voie Wnt. De plus, les cellules BMAL1-KD ont montré une diminution des capacités de migration et de la résistance aux médicaments.Au total, ces données soulignent l’importance de BMAL1 dans l’EMT des cellules de CRC. / BMAL1 is a core circadian clock protein, forming a heterodimer with CLOCK to initiate the transcription of circadian and output genes. Among canonical clock genes, only BMAL1 knockout results in complete loss of rhythmicity in both the SCN and peripheral tissues. My thesis work focuses on exploring the important role of BMAL1 in human breast and colon cancer progression and treatment. My work is divided into three main parts:1. Dosing time dependent in vitro pharmacodynamics of Everolimus despite a defective circadian clock (Zhang et al., 2018)(Zhang, Levi and Chang, 2018) Everolimus (EV) is an inhibitor of mammalian target of Rapamycin (mTOR) and is used to treat estrogen positive (ER+) breast cancer. Here, we investigated whether EV efficacy varied according to administration timing by using the ER+ breast cancer cell line MCF-7 as a model system. Serum shock synchronization induced a circadian oscillation in mTOR activity in MCF-7 cells, which rhythmically regulated the synthesis or phosphorylation of key G1 progression proteins, such as Cyclin D1 and phosphorylated RB, ultimately resulting in different G0/G1 blockage efficiency according to different EV administration timing. Thus, the different delivery schedule of EV presented different efficacy in G0/G1 phase blockage in serum shocked MCF-7 cells.This investigation revealed that, even in a breast cancer cell system with disrupted circadian organization, modulating drug administration according to other protein rhythms could still increase drug efficacy. This principle may be applied to many other cancer systems and treatment types to optimize cancer chronotherapy.2. Knockdown BMAL1 triggered different colon carcinoma cells fates by altering the delicate equilibrium between AKT/mTOR and P21/P53 pathways (Article in preparation)We tried to evaluate in vitro how knockdown BMAL1 (BMAL1-KD) by shRNA influences human colorectal cancer cell (CRC) behavior.The results revealed that BMAL1-KD triggered different CRC cell fates based on distinct p53 status in different cell lines. First, after BMAL1 knockdown, two primary CRC cell lines (HCT116 and SW480) presented a more evident AKT/mTOR activation than the metastatic colon carcinoma cell line, SW620. Furthermore, although both primary CRC cell lines presented a significant increase of AKT/mTOR activity, they had different P53 status (WT or mutant) and activation pattern. Under these context, SW480 BMAL1-KD cells exhibited increased senescence but HCT116 BMAL1-KD cells showed firstly a transient apoptosis and then higher proliferation rate.Thus, our work uncovered the crucial role of BMAL1 to balance a central metabolism regulator AKT/mTOR and a stress response pathway P53/P21 in CRC cell lines, which highlighted the importance of BMAL1 in CRC development and aging progression.3. BMAL1 knockdown leans epithelial–mesenchymal balance toward epithelial properties and decreased the chemoresistance of colon carcinoma cell (Article in preparation)Epithelial-mesenchymal transition (EMT) is a critical early event in the invasion and metastasis of carcinoma, including colorectal cancer (CRC). In this work, we studied how BMAL1-KD alters the delicate equilibrium between epithelial and mesenchymal properties of three colon carcinoma cell lines (HCT116, SW480 and SW620).The results showed the molecular alterations after BMAL1-KD promote mesenchymal-to-epithelial transition-like changes mostly appeared in two primary CRC cell lines (HCT116 and SW480) compared to the metastatic cell line SW620. Subsequently, BMAL1-KD HCT116 and SW480 cells harbored a decreased migration, invasiveness and drug resistance capacities relative to their scramble counterpart cells. All these data suggested the importance of BMAL1 on EMT inducing in colon carcinoma cells.

L'objectif principal de ma thèse est l’exploration de l’impact clinique d’une perturbation du système circadien chez les patients cancéreux. J’ai démontré une relation robuste entre le rythme d'activité-repos et survie, symptômes et qualité de vie. J’ai mis en évidence et caractérisé la dynamique du système circadien des patients sous chimiothérapie. J’ai montré qu’une bonne tolérance conditionnait l’efficacité de la chronothérapie. Ces résultats me conduisent à proposer de cibler le système circadien pour améliorer les symptômes des patients et l’efficacité des traitements anticancéreux. / The circadian timing system controls several temporal aspects of physiology and behaviour in laboratory animals and humans. The disruption of the circadian timing system results in the occurrence of alterations at various levels of organisation: central coordination, circadian physiology, molecular clocks and signalling pathways. In particular, a circadian disruption induced by long-haul flights across several time-zones or by shift work is associated with the appearance of systemic symptoms, such as fatigue, mood disorders and appetite loss. These symptoms, related to circadian disruption, are also frequently found in cancer patients, as a consequence of their neoplastic disease or its treatment. My PhD work is part of the research regarding the role of the circadian timing system in the development of the symptoms associated with cancer and its treatment, in tumor progression and in patients’ survival. Its perspective is to identify novel therapeutic options. In particular, the general objectives of this thesis consist in the definition of the relationships between symptoms and circadian function of patients before and during chemotherapy, and in the quantification of the clinical impact of circadian disruption on quality of life and survival. I have focused in particular on patients with metastatic colorectal cancer, third cancer for incidence and mortality. These studies confirm the role of the circadian timing system in the occurrence of systemic symptoms in cancer patients, without treatment or during it. This study is currently ongoing in collaboration with the NIH in the United States. In conclusion, this work leads me to propose an innovative therapeutic approach aimed at shielding and/or restoring the integrity of the circadian timing system. This novel strategy should improve the therapeutic index of chemotherapy, by increasing its efficacy and decreasing its toxicity, still reducing the occurrence of symptoms, preserving the quality of life and prolonging the survival of cancer patients. The implementation of this strategy relies on the non-invasive monitoring of biomarkers of the circadian timing system and on the personalization of chronotherapy delivery.

Cette thèse est dédiée au développement d’un modèle mathématique multi-échelle pour la régulation du cycle cellulaire par l’horloge circadienne. Ceci est motivé par le fait que plusieurs études ont montré un lien direct entre certains cancers et un dysfonctionnement du mécanisme de l’horloge circadienne. Le but est de comprendre l’effet des rythmes circadiens et leur perturbation sur la prolifération d’une population de cellules / This thesis is dedicated to the development of a multiscale mathematical model that describes the regulation of the cell cycle by the circadian clock. What motivated this work is the fact that several tumorigenic diseases are linked to circadian rhythms disruption. We would like to understand the effect of circadian rhythms on the proliferation of a cell population and hence give plausible explanation for diseases that arise form circadian clock disruption. The mammalian cell cycle and the circadian clock are two molecular processes that operate in a rhythmic manner and exquisite precision. On one hand, the cell cycle is driven by the rhythmic activity of cyclin dependent kinases which dictate the time a cell must engage mitosis and the time it must divide giving birth to two daughter cells. On the other hand, the circadian clock is a system of transcriptional and translational feedback-loops that generates sustained oscillations of different mRNAs and proteins with a period of approximately 24 h. It turns out that several components of the circadian clock regulates various cyclin-dependent kinases at different stages of the cell cycle. This makes the circadian clock a key player of the temporal organization of the cell cycle and makes these two biological processes act as two tightly coupled oscillators. Our modeling approach consists of using a molecular-structured partial differential equation that describes the proliferation of a cell population. Proliferation depends on the coupled cell cycle-circadian clock molecular state of cells. Due to the large number of molecular components involved in the cell cycle-circadian clock system, the problem becomes of high-dimensionality and specific numerical techniques are needed to solve the equation

L’agence internationale de recherche sur le cancer (IARC) a indiqué que le travail posté qui provoquait une disruption circadienne était probablement cancérogène chez l’Homme. Ainsi, une perturbation expérimentale sévère du système circadien accélère-t elle la progression tumorale et pourrait favoriser la cancérogénèse. Durant ma thèse, j’ai démontré que la disruption circadienne résultant d’une mutation ou d’une mise au silence des gènes de l’horloge Per ou Cry accélérait la cancérogénèse hépatique induite par la diéthylnitrosamine, en favorisant l’instabilité génomique, la prolifération cellulaire, et l’inflammation. J’ai montré que l’alimentation programmée ou la dexaméthasone modifiaient la régulation circadienne de ces trois caractéristiques du cancer, suggérant ainsi qu’une intervention thérapeutique ciblant le système circadien pourrait prévenir la cancérogénèse. J’ai ainsi mis en évidence le contrôle circadien de trois mécanismes moléculaires de la cancérogenèse précoce et proposé deux interventions ciblant l’horloge circadienne dans un but de prévention de la cancérogenèse. / The International Agency for Research on Cancer (IARC) concluded that “shift-work that involves circadian disruption is probably carcinogenic to humans”. Severe disruption alteration accelerated tumor progression and enhanced carcinogenesis. During my PhD, I demonstrated that circadian disruption resulting from mutation of Per and Cry clock genes accelerated liver carcinogenesis induced by diethylnitrosamine through promoting genomic instability, cellular proliferation, and inflammation. I showed that meal timing or dexamethasone altered circadian regulation of these three characteristics of cancer, suggesting a therapeutic intervention targeting the circadian system could prevent carcinogenesis. I have thus demonstrated the circadian control of three molecular mechanisms of early carcinogenesis and proposed two interventions targeting the circadian clock for liver carcinogenesis prevention.

La chronothérapie des cancers administre les médicaments anticancéreux à des moments précis de la journée afin d’en optimiser la tolérance et l’efficacité. Cependant le système circadien qui règle sur 24 h la prolifération et le métabolisme cellulaires peut être altéré par un décalage horaire chronique, la mutation d’un gène de l’horloge, ou un traitement, favorisant ainsi la survenue de pathologies métaboliques, comportementales ou malignes. La disparité des profils circadiens de température corporelle des patients cancéreux ainsi que leurs modifications sous chimiothérapie fournit les bases d’une personnalisation de la chronothérapeutique. La capacité d’un cycle thermique à entraîner sur 24 h l’horloge circadienne de cellules d’hépatocarcinome en culture indique que ce biomarqueur est aussi un effecteur de la synchronisation des cellules cancéreuses, et constitue un repère circadien pour la chronothérapeutique in vitro et in vivo. / Chronotherapy delivers anticancer drugs at specific times of the day to optimize tolerability and efficacy. However, the circadian system that controls cell proliferation and metabolism over 24 h, can be altered by a chronic jet lag, a clock gene mutation, or a xeniobiotic treatment, thus favoring the occurrence of metabolic, behavioral or malignancies. The disparity of circadian body temperature patterns of cancer patients as well as its disruption during the treatment provides a clincher for chronotherapy personalization. The ability of a thermal cycle to drive the circadian clock in cultured hepatocarcinoma cells of 24 h indicates that this biomarker is also an effector of the synchronization of cancer cells, as well as a marker for the circadian in vitro and in vivo chronotherapeutic.