Fatigue and weight loss predict survival on circadian chemotherapy for metastatic colorectal cancer.

Background: Chemotherapy-induced neutropenia has been associated with prolonged survival selectively in patients on a conventional schedule (combined 5-fluorouracil, leucovorin, and oxaliplatin [FOLFOX2]) but not on a chronomodulated schedule of the same drugs administered at specific circadian times (chronoFLO4). The authors hypothesized that the early occurrence of chemotherapy-induced symptoms correlated with circadian disruption would selectively hinder the efficacy of chronotherapy.

Methods: Fatigue and weight loss (FWL) were considered to be associated with circadian disruption based on previous data.