A robust negative association between estimated tumour circadian clock function and survival in early stage breast cancer

Recent studies have established that the circadian clock influences onset, progression and therapeutic outcomes in a number of chronic conditions including cardio-metabolic diseases and cancer. For the latter, they also suggest that chronotherapy offers the potential to refine current treatments and improve the development of future anti-cancer medicines. Therefore, there is a need for tools to measure the functional state of the tumoural circadian clock in patients. We have previously developed a model-led machine-learning algorithm called TimeTeller which has the potential to provide such a tool. Here we demonstrate its potential for clinical relevance by a study of 1286 breast cancer patients in which we characterise the nature of the circadian clock disruption in their tumours and demonstrate a strong nonlinear association between 10-year survival and TimeTellers tumoural clock disfunction score {Theta}. We find that good tumour clock function is antagonistic to survival.