Chrono-immunotherapy in genitourinary oncology: From emerging evidence to clinical translation (Review)

Osama Zein Deen1, Xin Ye1, Patsy Lee1

  • 1Department of Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada.

Oncology Letters
|August 14, 2026
PubMed

The intersection of immunotherapy and circadian biology represents a promising translational frontier in genitourinary (GU) oncology. Immunotherapy has reshaped the treatment landscape and markedly influenced patient outcomes in renal cell carcinoma (RCC) and urothelial carcinoma (UC), yet therapeutic responses remain variable, highlighting the necessity for strategies that can further enhance therapeutic efficacy. Notably, the circadian regulation of immune cell trafficking plays a central role in immune function and tumor biology. Retrospective analyses have suggested that earlier time-of-day administration of immunotherapy improves patient outcomes in RCC and UC. To facilitate the translation of chrono-immunotherapy from a theoretical concept to a clinical standard for patients, the present review assesses the biological rationale behind chronotherapy, summarizes clinical and scientific evidence regarding its therapeutic potential and provides a method for the prospective validation of chronotherapy in GU oncology. The present review also identifies current limitations in chrono-immunotherapy data and proposes potential solutions to validate this data and guide its translation into clinical practice.

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