WO2023006993A1

WO2023006993A1 - Fused amino pyridine or pyrimidine derivatives for the treatment of congenital central hypoventilation syndrome

Info

Publication number: WO2023006993A1
Application number: PCT/EP2022/071434
Authority: WO
Inventors: Xénia PROTON DE LA CHAPELLE; Nathan BECKOUCHE; Jean-Philippe Annereau; Luis BRISENO-ROA; Anita RAYAR; Nicolas Pineau
Original assignee: Atmosr; Medetia; INSERM (Institut National de la Santé et de la Recherche Médicale); Assistance Publique - Hôpitaux De Paris (Aphp); Universite Paris Cité; Fondation Imagine
Priority date: 2021-07-30
Filing date: 2022-07-29
Publication date: 2023-02-02

Abstract

The present invention relates to HSP90 inhibitors containing a fused amino pyridine or pyrimidine core useful as inhibitors of HSP90 and their use in the treatment of congenital central hypoventilation syndrome.

Description

FUSED AMINO PYRIDINE OR PYRIMIDINE DERIVATIVES FOR THE TREATMENT OF CONGENITAL CENTRAL HYPOVENTILATION

SYNDROME

FIELD OF INVENTION

[0001] The present invention relates to HSP90 inhibitors containing a fused amino pyridine or pyrimidine core useful as inhibitors of HSP90 and their use in the treatment of congenital central hypoventilation syndrome.

BACKGROUND OF INVENTION

[0002] HSP90s are ubiquitous chaperone proteins that are involved in proper protein folding and stabilization of a wide range of proteins, including key proteins involved in signal transduction, cell cycle control and transcriptional regulation. Their distribution in various cellular compartments underlines their essential roles in cellular homeostasis. HSP90 proteins orchestrate crucial physiological processes such as cell survival, cell cycle control, hormone signaling, and apoptosis. Conversely, HSP90, and its secreted forms, contribute to the development and progress of serious pathologies, including cancer and neurodegenerative diseases.

[0003] Congenital central hypoventilation syndrome (CCHS) also named Ondine’s curse is a life-threatening neurorespiratory disease characterized by a sleep hypoventilation associated with a dysfunction of PHOX2B C0₂/H⁺ sensitive neurons of the retrotrapezoid nucleus/parafacial respiratory group (RTN/pFRG). The patients are thus devoid of the interoceptive alarms that normally trigger awakening in the case of life-threatening hypoxia during sleep. Hypercapnia, acidosis, and hypoxemia resulting from CCHS negatively affect physiological functions and can be life-threatening. [0004] CCHS is caused by heterozygous in frame duplications of the paired-like homeobox 2B gene ( PHOX2B ) that encodes a key transcription factor which plays a role in the development of the autonomic nervous system and the neural structures involved in controlling breathing. In 90% of cases, mutations are tri-nucleotide expansion leading to poly alanine (poly Ala) expansions in the gene product, ranging from +4 to +13 residues of a 20-alanine stretch. Polyalanine expansions induce misfolding of proteins, which are degraded by autophagy and proteasome machinery, this leading to cell death. The severity of the CCHS phenotype correlates with the length of poly Ala expansions, ultimately leading to formation of toxic intracytoplasmic aggregates and impaired PHOX2B mediated transactivation of target gene promoters, such as the Dopamine-beta- Hydroxylase promoter. Ventilatory supports such as tracheostomy, nasal mask or diaphragm pacing represent the only options available for affected. Thus, there is an important need to identify compounds which would be efficient for the treatment of congenital central hypoventilation syndrome. [0005] Recent studies suggest that heat shock proteins (HSPs) play an important role in congenital central hypoventilation syndrome. Bachetti et al. have shown that activation of the heat shock response by the HSP90 inhibitor geldanamycin is efficient both in preventing formation and in inducing clearance of PHOX2B pre-formed polyalanine aggregates in COS-7 cells expressing PHOX2B-GFP fused proteins, and ultimately also in rescuing the PHOX2B ability to transactivate the Dopamine-beta-Hydroxylase promoter (Int J Biochem Cell Biol, 2007, 39(2):327-39). In addition, Di Zanni et al. demonstrated that the HSP90 inhibitor 17-AAG is effective in vitro in both rescuing the nuclear localization and transactivation activity of PHOX2B carrying the largest expansion of poly Ala and promoting the clearance of aggregates of these mutant proteins inducing molecular mechanisms such as ubiquitin-proteasome (UPS), autophagy and heat shock protein (HSP) systems (Neurobiol Dis, 2012, 45(1):508- 18).

[0006] In the present invention, the inventors disclose fused amino pyridine or pyrimidine derivative compounds useful as HSP90 inhibitors and demonstrate that they represent potent drugs for the treatment of congenital central hypoventilation syndrome. SUMMARY

[0007] The present invention relates to a compound of formula (I):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein Ui, U2,V, W, X, Y, Z and Q are as defined hereafter, for use in the treatment of congenital central hypoventilation syndrome (CCHS) in a subject in need thereof.

[0008] The invention also relates to a compound of formula (II):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein Ur, X₂, X5, R₂₁, R₂₂, R₂₃, Mi, M₂, M₃, M₄, X, Y and Z are as defined hereafter, for use in the treatment of congenital central hypoventilation syndrome (CCHS) in a subject in need thereof. [0009] The invention also relates to a compound of formula (III):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein Ur, Xi, X2, X3, X4, X5, Mi, M2, M3, M4, X, Y and Z are as defined hereafter, for use in the treatment of congenital central hypoventilation syndrome (CCHS) in a subject in need thereof. [0010] In one embodiment, Ur is CH. In another embodiment Ur is N.

[0011] In one embodiment, the compound for use is of formula (IV), (V), (V-l), (V-la), (V-2) or (V-2a) as defined hereafter.

[0012] In one embodiment, the compound for use is selected from the compounds delineated in Table A and geometric isomers, enantiomers, diastereomers, racemates, pharmaceutically acceptable salts and solvates thereof.

[0013] In one embodiment, the compound for use is compound-111, also named Debio0932.

[0014] The invention also provides a pharmaceutical composition comprising compound-111 and a pharmaceutical acceptable carrier, for use in the treatment of congenital central hypoventilation syndrome (CCHS) in a subject in need thereof.

DEFINITIONS

[0015] In the present invention, the following terms have the following meanings: [0016] An "aliphatic group" or "aliphatic" refers to a non-aromatic moiety that may be saturated ( e.g single bond) or contain one or more units of unsaturation, e.g., double and/or triple bonds. An aliphatic group may be straight chained, branched or cyclic, contain carbon, hydrogen or, optionally, one or more heteroatoms and may be substituted or unsubstituted. An aliphatic group, when used as a linker, preferably contains between 1 and 24 atoms, more preferably between 4 to 24 atoms, more preferably between 4 to 12 atoms, more typically between 4 and 8 atoms. An aliphatic group, when used as a substituent, preferably contains between 1 and 24 atoms, more preferably between 1 to 10 atoms, more preferably between 1 to 8 atoms, more typically between 1 and 6 atoms. In addition to aliphatic hydrocarbon groups, aliphatic groups include, for example, poly alkoxy alkyls, such as, for example, polyalkylene glycols, polyamines, and polyimines. Such aliphatic groups may be further substituted. It is understood that aliphatic groups include alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl groups described herein.

[0017] The term "acyl" refers to hydrogen, alkyl, partially saturated or fully saturated cycloalkyl, partially saturated or fully saturated heterocycle, aryl, and heteroaryl substituted carbonyl groups. For example, acyl includes groups such as (Ci-C₆)alkanoyl (e.g., formyl, acetyl, propionyl, butyryl, valeryl, caproyl, t-butylacetyl, etc.), (C3-C6)cycloalkylcarbonyl {e.g., cyclopropylcarbonyl, cyclobutylcarbonyl, cyclopentylcarbonyl, cyclohexylcarbonyl, etc.), heterocyclic carbonyl (e.g., pyrrolidinylcarbonyl, pyrrolid-2-one-5-carbonyl, piperidinylcarbonyl, piperazinylcarbonyl, tetrahydrofuranylcarbonyl, etc.), aroyl (e.g., benzoyl) and heteroaroyl (e.g., thiophenyl-2-carbonyl, thiophenyl-3 -carbonyl, furanyl-2-carbonyl, furanyl-3-carbonyl, lH-pyrroyl-2-carbonyl, lH-pyrroyl-3-carbonyl, benzo[b]thiophenyl- 2-carbonyl, etc.). In addition, the alkyl, cycloalkyl, heterocycle, aryl and heteroaryl portion of the acyl group may be any one of the groups described in the respective definitions. When indicated as being "optionally substituted", the acyl group may be unsubstituted or optionally substituted with one or more substituents (typically, one to three substituents) independently selected from the group of substituents listed below in the definition for "substituted" or the alkyl, cycloalkyl, heterocycle, aryl and heteroaryl portion of the acyl group may be substituted as described above in the preferred and more preferred list of substituents, respectively.

[0018] The term "alkyl" embraces linear or branched radicals having one to twenty carbon atoms or, preferably, one to twelve carbon atoms. More preferred alkyl radicals are "lower alkyl" radicals having one to ten carbon atoms, i.e. Ci-Cio alkyl. Most preferred are lower alkyl radicals having one to eight carbon atoms. Examples of such radicals include methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec -butyl, tert-butyl, pentyl, iso-amyl, hexyl and the like.

[0019] The term "alkenyl" embraces linear or branched radicals having at least one carbon-carbon double bond of two to twenty carbon atoms or, preferably, two to twelve carbon atoms. More preferred alkenyl radicals are "lower alkenyl" radicals having two to ten carbon atoms and more preferably two to eight carbon atoms. Examples of alkenyl radicals include ethenyl, allyl, propenyl, butenyl and 4-methylbutenyl. The terms "alkenyl", and "lower alkenyl", embrace radicals having "cis" and "trans" orientations, or alternatively, "E" and "Z" orientations.

[0020] The term "alkynyl" embraces linear or branched radicals having at least one carbon-carbon triple bond of two to twenty carbon atoms or, preferably, two to twelve carbon atoms. More preferred alkynyl radicals are "lower alkynyl" radicals having two to ten carbon atoms and more preferably two to eight carbon atoms. Examples of alkynyl radicals include propargyl, 1-propynyl, 2-propynyl, 1-butyne, 2-butynyl and 1-pentynyl.

[0021] The term "alkoxy" embraces linear or branched oxy-containing radicals each having alkyl portions of one to twenty carbon atoms or, preferably, one to twelve carbon atoms. More preferred alkoxy radicals are "lower alkoxy" radicals having one to ten carbon atoms and more preferably having one to eight carbon atoms. Examples of such radicals include methoxy, ethoxy, propoxy, butoxy and tert-butoxy.

[0022] The term "alkoxyalkyl" embraces alkyl radicals having one or more alkoxy radicals attached to the alkyl radical, that is, to form monoalkoxyalkyl and dialkoxyalkyl radicals.

[0023] The term "aryl", alone or in combination, means a carbocyclic aromatic system containing one, two or three rings wherein such rings may be attached together in a pendent manner or may be fused. The term "aryl" embraces aromatic radicals such as phenyl, naphthyl, tetrahydronaphthyl, indane and biphenyl.

[0024] The term "alkylthio" embraces radicals containing a linear or branched alkyl radical, of one to ten carbon atoms attached to a divalent sulfur atom. Preferred alkylthio radicals have alkyl radicals of one to twenty carbon atoms or, preferably, one to twelve carbon atoms. More preferred alkylthio radicals have alkyl radicals are "lower alkylthio" radicals having one to ten carbon atoms. Most preferred are alkylthio radicals having lower alkyl radicals of one to eight carbon atoms. Examples of such lower alkylthio radicals are methylthio, ethylthio, propylthio, butylthio and hexylthio. [0025] The term "alkylsulfonyl" refers to a -SC -alkyl group, wherein alkyl is as herein defined.

[0026] The terms "aralkyl" or "arylalkyl" embrace aryl-substituted alkyl radicals such as benzyl, diphenylmethyl, triphenylmethyl, phenylethyl, and diphenylethyl. [0027] The term "aryloxy" embraces aryl radicals attached through an oxygen atom to other radicals.

[0028] The terms "aralkoxy" or "arylalkoxy" embrace aralkyl radicals attached through an oxygen atom to other radicals.

[0029] The term "amino" refers to a -Nth group or any group derived thereof by substitution of one or two hydrogen atoms by an organic aliphatic or aromatic group. Preferably, groups derived from -Nth are alkylamino groups, i. e. , N- alkyl groups, comprising monoalkylamino and dialkylamino. According to a specific embodiment, the term "amino" refers to Nth, NHMe or NMe2.

[0030] The term "aminoalkyl" embraces alkyl radicals substituted with amino radicals. Preferred aminoalkyl radicals have alkyl radicals having one to twenty carbon atoms or, preferably, one to twelve carbon atoms. More preferred aminoalkyl radicals are "lower aminoalkyl" that have alkyl radicals having one to ten carbon atoms. Most preferred are aminoalkyl radicals having lower alkyl radicals having one to eight carbon atoms. Examples of such radicals include aminomethyl, aminoethyl, and the like. [0031] The term "alkylamino" denotes amino groups which are substituted with one or two alkyl radicals. Preferred alkylamino radicals have alkyl radicals having one to twenty carbon atoms or, preferably, one to twelve carbon atoms. More preferred alkylamino radicals are "lower alkylamino" that have alkyl radicals having one to ten carbon atoms. Most preferred are alkylamino radicals having lower alkyl radicals having one to eight carbon atoms. Suitable lower alkylamino may be monosubstituted N-alkylamino or disubstituted N,N-alkylamino, such as N-methylamino, N-ethylamino, N,N-dimethylamino, N,N-diethylamino or the like. [0032] The term "alkylcarbonylamino" refers to a -NH-CO-alkyl group, wherein alkyl is as herein defined.

[0033] The term "cycloalkyl" embraces saturated carbocyclic radicals having three to twelve carbon atoms. The term "cycloalkyl" embraces saturated carbocyclic radicals having three to twelve carbon atoms. More preferred cycloalkyl radicals are "lower cycloalkyl" radicals having three to eight carbon atoms. Examples of such radicals include cyclopropyl, cyclobutyl, cyclopentyl and cyclohexyl.

[0034] The term "cycloalkenyl" embraces partially unsaturated carbocyclic radicals having three to twelve carbon atoms. Cycloalkenyl radicals that are partially unsaturated carbocyclic radicals that contain two double bonds (that may or may not be conjugated) can be called "cycloalky ldienyl". More preferred cycloalkenyl radicals are "lower cycloalkenyl" radicals having four to eight carbon atoms. Examples of such radicals include cyclobutenyl, cyclopentenyl and cyclohexenyl.

[0035] The terms "halogen" or "halo" as used herein, refers to an atom selected from fluorine, chlorine, bromine and iodine.

[0036] The terms "heterocyclyl", "heterocycle" "heterocyclic" or "heterocyclo" embrace saturated, partially unsaturated and unsaturated heteroatom-containing ring- shaped radicals, which can also be called "heterocyclyl", "heterocycloalkenyl" and "heteroaryl" correspondingly, where the heteroatoms may be selected from nitrogen, sulfur and oxygen. Examples of saturated heterocyclyl radicals include saturated 3 to 6-membered heteromonocyclic group containing 1 to 4 nitrogen atoms (e.g., pyrrolidinyl, imidazolidinyl, piperidino, piperazinyl, etc.); saturated 3 to 6-membered heteromonocyclic group containing 1 to 2 oxygen atoms and 1 to 3 nitrogen atoms (e.g., morpholinyl, etc.); saturated 3 to 6-membered heteromonocyclic group containing 1 to 2 sulfur atoms and 1 to 3 nitrogen atoms (e.g., thiazolidinyl, etc.). Examples of partially unsaturated heterocyclyl radicals include dihydrothiophene, dihydropyran, dihydrofuran and dihydrothiazole. Heterocyclyl radicals may include a pentavalent nitrogen, such as in tetrazolium and pyridinium radicals. The term "heterocycle" also embraces radicals where heterocyclyl radicals are fused with aryl or cycloalkyl radicals. Examples of such fused bicyclic radicals include benzofuran, benzothiophene, and the like.

[0037] The term "heteroaryl" embraces unsaturated heterocyclyl radicals. Examples of heteroaryl radicals include unsaturated 3 to 6 membered heteromonocyclic group containing 1 to 4 nitrogen atoms, for example, pyrrolyl, pyrrolinyl, imidazolyl, pyrazolyl, pyridyl, pyrimidyl, pyrazinyl, pyridazinyl, triazolyl (e.g., 4H-l,2,4-triazolyl, 1H- 1,2,3- triazolyl, 2H-l,2,3-triazolyl, etc.) tetrazolyl (e.g., lH-tetrazolyl, 2H-tetrazolyl, etc.), etc.; unsaturated condensed heterocyclyl group containing 1 to 5 nitrogen atoms, for example, indolyl, isoindolyl, indolizinyl, benzimidazolyl, quinolyl, isoquinolyl, indazolyl, benzotriazolyl, tetrazolopyridazinyl (e.g., tetrazolo[l,5-b]pyridazinyl, etc.), etc.; unsaturated 3 to 6-membered heteromonocyclic group containing an oxygen atom, for example, pyranyl, furyl, etc.; unsaturated 3 to 6-membered heteromonocyclic group containing a sulfur atom, for example, thienyl, etc.; unsaturated 3- to 6-membered heteromonocyclic group containing 1 to 2 oxygen atoms and 1 to 3 nitrogen atoms, for example, oxazolyl, isoxazolyl, oxadiazolyl (e.g., 1,2,4-oxadiazolyl, 1,3,4-oxadiazolyl, 1,2,5-oxadiazolyl, etc.) etc.; unsaturated condensed heterocyclyl group containing 1 to 2 oxygen atoms and 1 to 3 nitrogen atoms (e.g., benzoxazolyl, benzoxadiazolyl, etc.); unsaturated 3 to 6-membered heteromonocyclic group containing 1 to 2 sulfur atoms and 1 to 3 nitrogen atoms, for example, thiazolyl, thiadiazolyl (e.g., 1,2,4-thiadiazolyl, 1,3,4-thiadiazolyl, 1,2,5-thiadiazolyl, etc.) etc.; unsaturated condensed heterocyclyl group containing 1 to 2 sulfur atoms and 1 to 3 nitrogen atoms (e.g., benzothiazolyl, benzothiadiazolyl, etc.) and the like.

[0038] The term "heterocyclylalkyl" embraces heterocyclyl-substituted alkyl radicals. More preferred heterocyclylalkyl radicals are "lower heterocyclylalkyl" radicals having one to six carbon atoms in the heterocyclylalkyl radicals.

[0039] The term "substituted" refers to the replacement of one or more hydrogen radicals in a given structure with the radical of a specified substituent including, but not limited to: halo, alkyl, alkenyl, alkynyl, aryl, cycloalkyl, heterocyclyl, thiol, alkylthio, oxo, thioxy, arylthio, alkylthioalkyl, arylthioalkyl, alkylsulfonyl, alkylsulfonylalkyl, arylsulfonylalkyl, alkoxy, aryloxy, aralkoxy, carbonyl, aminocarbonyl, alkylaminocarbonyl, arylaminocarbonyl, alkoxy carbonyl, aryloxycarbonyl, haloalkyl, amino, trifluoromethyl, cyano, nitro, azide, haloalkyl, alkylamino, arylamino, alkylaminoalkyl, arylaminoalkyl, aminoalkylamino, hydroxy, alkoxyalkyl, carboxyalkyl, alkoxycarbonylalkyl, aminocarbonylalkyl, acyl, aralkoxycarbonyl, carboxylic acid, sulfonic acid, sulfonyl, phosphonic acid, aryl, heteroaryl, heterocyclic, and aliphatic. It is understood that the substituent may be further substituted.

[0040] The term "substituted carbonyl" includes compounds and moieties which contain a carbon connected with a double bond to an oxygen atom, and tautomeric forms thereof. Examples of moieties that contain a substituted carbonyl include aldehydes, ketones, carboxylic acids, amides, esters, anhydrides, etc. The term "carbonyl moiety" refers to groups such as "alkylcarbonyl" groups wherein an alkyl group is covalently bound to a carbonyl group, "alkenylcarbonyl" groups wherein an alkenyl group is covalently bound to a carbonyl group, "alkynylcarbonyl" groups wherein an alkynyl group is covalently bound to a carbonyl group, "arylcarbonyl" groups wherein an aryl group is covalently attached to the carbonyl group. Furthermore, the term also refers to groups wherein one or more heteroatoms are covalently bonded to the carbonyl moiety. For example, the term includes moieties such as, for example, aminocarbonyl moieties, (wherein a nitrogen atom is bound to the carbon of the carbonyl group, e.g., an amide).

[0041] For simplicity, chemical moieties are defined and referred to throughout can be univalent chemical moieties (e.g., alkyl, aryl, etc.) or multivalent moieties under the appropriate structural circumstances clear to those skilled in the art. For example, an "alkyl" moiety can be referred to a monovalent radical (e.g., CH_3— Cth— ), or in other instances, a bivalent linking moiety can be "alkyl," in which case those skilled in the art will understand the alkyl to be a divalent radical (e.g., —Cth—' Cth— ), which is equivalent to the term "alkylene. " Similarly, in circumstances in which divalent moieties are required and are stated as being "alkoxy", "alkylamino", "aryloxy", "alkylthio", "aryl", "heteroaryl", "heterocyclic", "alkyl" "alkenyl", "alkynyl", "aliphatic", or "cycloalkyl", those skilled in the art will understand that the terms alkoxy", "alkylamino", "aryloxy", "alkylthio", "aryl", "heteroaryl", "heterocyclic", "alkyl", "alkenyl", "alkynyl", "aliphatic", or "cycloalkyl" refer to the corresponding divalent moiety. [0042] The term "compound" is defined herein to include pharmaceutically acceptable salts, solvates, hydrates, polymorphs, enantiomers, diastereoisomers, racemates and the like of the compounds having a formula as set forth herein.

[0043] As used herein, the term "pharmaceutically acceptable salt" refers to those salts which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio. Pharmaceutically acceptable salts are well known in the art. For example, S. M. Berge, et al. describes pharmaceutically acceptable salts in detail in J. Pharmaceutical Sciences, 66: 1-19 (1977). The salts can be prepared in situ during the final isolation and purification of the compounds of the invention, or separately by reacting the free base function with a suitable organic acid or inorganic acid. Examples of pharmaceutically acceptable nontoxic acid addition salts include, but are not limited to, salts of an amino group formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid or with organic acids such as acetic acid, maleic acid, tartaric acid, citric acid, succinic acid lactobionic acid or malonic acid or by using other methods used in the art such as ion exchange. Other pharmaceutically acceptable salts include, but are not limited to, adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptonate, glycerophosphate, gluconate, hemisulfate, heptanoate, hexanoate, hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate, pamoate, pectinate, persulfate, 3-phenylpropionate, phosphate, picrate, pivalate, propionate, stearate, succinate, sulfate, tartrate, thiocyanate, p-toluenesulfonate, undecanoate, valerate salts, and the like. Representative alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like. Further pharmaceutically acceptable salts include, when appropriate, nontoxic ammonium, quaternary ammonium, and amine cations formed using counterions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, alkyl having from 1 to 6 carbon atoms, sulfonate and aryl sulfonate. [0044] As used herein, the term "pharmaceutically acceptable ester" refers to esters which hydrolyze in vivo and include those that break down readily in the human body to leave the parent compound or a salt thereof. Suitable ester groups include, for example, those derived from pharmaceutically acceptable aliphatic carboxylic acids, particularly alkanoic, alkenoic, cycloalkanoic and alkanedioic acids, in which each alkyl or alkenyl moiety advantageously has not more than 6 carbon atoms. Examples of particular esters include, but are not limited to, formates, acetates, propionates, butyrates, acrylates and ethylsuccinates.

[0045] The term "pharmaceutically acceptable prodrugs" as used herein refers to those prodrugs of the compounds of the present invention which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals with undue toxicity, irritation, allergic response, and the like, commensurate with a reasonable benefit/risk ratio, and effective for their intended use, as well as the zwitterionic forms, where possible, of the compounds of the present invention. "Prodrug", as used herein means a compound which is convertible in vivo by metabolic means ( e.g by hydrolysis) to a compound of the invention. Various forms of prodrugs are known in the art, for example, as discussed in Bundgaard, (ed.), Design of Prodrugs, Elsevier (1985); Widder, et al. (ed.), Methods in Enzymology, vol. 4, Academic Press (1985); Krogsgaard-Larsen, et al., (ed). "Design and Application of Prodrugs, Textbook of Drug Design and Development, Chapter 5, 113-191 (1991); Bundgaard, et al., Journal of Drug Deliver Reviews, 8:1-38 (1992); Bundgaard, J. of Pharmaceutical Sciences, 77:285 et seq. (1988); Higuchi and Stella (eds.) Prodrugs as Novel Drug Delivery Systems, American Chemical Society (1975); and Bernard Testa & Joachim Mayer, "Hydrolysis In Drug And Prodrug Metabolism: Chemistry, Biochemistry And Enzymology," John Wiley and Sons, Ltd. (2002).

[0046] The term "solvate" as used herein refers to a molecular complex comprising a compound of the invention and containing stoichiometric or sub-stoichiometric amounts or one or more pharmaceutically acceptable solvent molecule, such as ethanol. The term “hydrate” refers to a solvate when said solvent is water and includes hemihydrate, monohydrate, dihydrate, trihydrate and the like. [0047] The term “congenital central hypoventilation syndrome” or “CCHS” or “Ondine’s curse” or “congenital failure of autonomic control” or “Haddad syndrome” or “Ondine-Hirschsprung disease” as used herein refer to a rare neurocristopathy characterized by absence of adequate autonomic control of respiration with decreased sensitivity to hypoxia and hypercapnia. Congenital central hypoventilation syndrome is characterized by a sleep hypoventilation associated with a dysfunction of PHOX2B C0₂/H⁺ sensitive neurons of the retrotrapezoid nucleus/parafacial respiratory group (RTN/pFRG). The patients are thus devoid of the interoceptive alarms that normally trigger awakening in the case of life-threatening hypoxia during sleep and in more severely affected individuals, during waking periods as well. Congenital central hypoventilation syndrome is associated with a malfunction of the nerves that control involuntary body functions and abnormal development of early embryonic cells that form the spinal cord. Hypercapnia, acidosis, and hypoxemia resulting from CCHS negatively affect physiological functions and can be life- threatening.

[0048] The term "subject" as used herein refers to an animal. Preferably the animal is a mammal. More preferably the mammal is a human. A subject can be male or female. In one embodiment the subject is a mammal, preferably a human, suffering from congenital central hypoventilation syndrome. In one embodiment, a subject may be a “patient”, i.e., a warm-blooded animal, more preferably a human, who/which is awaiting the receipt of, or is receiving medical care or was / is / will be the object of a medical procedure, or is monitored for the development of congenital central hypoventilation syndrome.

[0049] The terms “treating” or “treatment” refer to both therapeutic treatment and prophylactic or preventative measures; wherein the object is to prevent, reduce, alleviate, and/or slow down (lessen) one or more symptoms of congenital central hypoventilation syndrome in a subject in need thereof. Symptoms of congenital central hypoventilation syndrome include, without being limited to, poor breathing or complete lack of spontaneous breathing, especially during sleep, respiratory insufficiency, central hypoventilation, apnea, hypercapnia, hypoventilation, hypoxemia, hyperhidrosis, cognitive impairment, ganglioneuroblastoma, ganglioneuroma, muscular hypotonia, seizure, abnormality of temperature regulation, abnormality of the cardiovascular system, abnormality of the mouth, autosomal dominant inheritance, feeding difficulty due to acid reflux and decreased intestinal motility, aganglionic megacolon, constipation, downslanted palpebral fissures, abnormal pupils, low-set ears, posteriorly rotated ears. In one embodiment, “treating” or “treatment” refers to a therapeutic treatment. In another embodiment, “treating” or “treatment” refers to a prophylactic or preventive treatment. In yet another embodiment, “treating” or “treatment” refers to both a prophylactic (or preventive) treatment and a therapeutic treatment. Those in need of treatment include those already with the disorder as well as those prone to have the disorder or those in whom the disorder is to be prevented. A subject or mammal is successfully “treated” for a disease or condition if, after receiving a therapeutic amount of a therapeutic agent, the patient shows observable and/or measurable reduction in or absence of one or more of the following: relief to some extent, of one or more of the symptoms associated with congenital central hypoventilation syndrome; reduced morbidity and mortality, and improvement in quality-of-life issues. The above parameters for assessing successful treatment and improvement in the disease are readily measurable by routine procedures familiar to a physician.

DETAILED DESCRIPTION [0050] The invention relates to fused amino pyridine or pyrimidine derivatives that are useful as HSP90 inhibitors and their use in the treatment of congenital central hypoventilation syndrome.

Compounds [0051] In a first embodiment, the compounds of the present invention are fused amino pyridine or pyrimidine derivatives of formula (I):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein:

Ui is C or N;

U2 is N or CH; V is hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, which one or more methylenes can be interrupted or terminated by O, S, S(O), SO2 , N(Rs), C(O), substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted heterocyclic; substituted or unsubstituted cycloalkyl; W is absent when Ui is N, or when Ui is C, W is hydrogen, halogen, amino, hydroxy, thiol, alkyl, substituted alkyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO2, CN, N3, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

X is absent, O, S, S(O), S(0)₂, N(R₈), C(O), CF₂, C(R₈), or C₂-C₆ alkyl, C2-C6 alkenyl, C2-C6 alkynyl in which one or more methylene can be interrupted or terminated by O, S, SO, SO2 , N(Rs), C(O); Y is hydrogen, halogen, NO2, CN, or C1-C10 alkyl;

Z is amino, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylcarbonylamino;

Q is aryl, substituted aryl, heteroaryl, substituted heteroaryl, cycloalkyl, or heterocyclylalkyl; and Re is hydrogen, acyl, aliphatic or substituted aliphatic.

[0052] In one embodiment, in formula (I):

Ui is C or N;

U2 is N or CH;

V is hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl; W is absent when Ui is N, or when Ui is C, W is hydrogen, halogen, amino, hydroxy, thiol, alkyl, substituted alkyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

X is O, S, S(O), S(0)₂, N(Rs), or C(O);

Y is hydrogen, halogen, NO2, CN, or C1-C10 alkyl; Z is amino, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylcarbonylamino;

Q is aryl, substituted aryl, heteroaryl, substituted heteroaryl, cycloalkyl, or heterocyclylalkyl; and

Re is hydrogen, acyl, aliphatic or substituted aliphatic. [0053] In one embodiment, in formula (I), Ui is C. In another embodiment, in formula (I), Ui is N.

[0054] In a second embodiment, the compounds of the present invention are compounds of formula (II):

Ur is CH or N;

X2 and X5 are each independently CH or N;

R21, R22 and R23 are each independently selected from the group consisting of hydrogen, halogen, amino, substituted amino, hydroxy, substituted hydroxy, thiol, substituted thiol, alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, substituted carbonyl, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl; or

R22 and R23 can be taken together from the carbon to which they are attached to form a substituted or unsubstituted, saturated or unsaturated, fused 5-8 membered cyclic ring optionally substituted with 0-3 heteroatom;

Mi is absent, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, aryl or heteroaryl;

M2 is absent, O, S, SO, SO₂, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

M4 is hydrogen, halogen, CN, N₃, hydroxy, substituted hydroxy, amino, substituted amino, CF₃, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl, heterocyclic, aryl or heteroaryl; and X, Y, Z and Rs are as previously defined.

[0055] In one embodiment, in formula (II):

Ur is CH or N;

X2 and X5 are each independently CH or N;

R21, R22 and R23 are each independently selected from the group consisting of hydrogen, halogen, amino, hydroxy, thiol, alkyl, substituted alkyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

M2 is absent, O, S, SO, SO₂, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs); M4 is hydrogen, halogen, CN, N₃, hydroxy, amino, CF₃, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl, heterocyclic, aryl or heteroaryl; and X, Y, Z and Rs are as previously defined.

[0056] In one embodiment, in formula (II), Ur is CH. In another embodiment, in formula (II), Ur is N.

[0057] In one embodiment, in formula (II), Ur is CH, X is S; Y is hydrogen; Z is amino; R21-R23, M1-M4 and X2, X5 are as defined above. In one embodiment, in formula (II), Ur is N, X is S; Y is hydrogen; Z is amino; R21-R23, M1-M4 and X2, Xs are as defined above. [0058] In a third embodiment, the compounds of the present invention are compounds of formula (III):

Ur is CH or N;

Xi, X2, X3, X4 and Xs are each independently N or CR₂₁; where R21 is selected from the group consisting of hydrogen, halogen, amino, substituted amino, hydroxy, substituted hydroxy, thiol, substituted thiol, alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, substituted carbonyl, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

Mi is absent, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, aryl or heteroaryl; M2 is absent, O, S, SO, SO₂, N(Rs), or C=0; M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

[0059] In one embodiment, in formula (III):

Ur is CH or N;

Xi, X2, X3, X4 and Xs are each independently N or CR₂₁, where R21 is selected from the group consisting of hydrogen, halogen, amino, hydroxy, thiol, alkyl, substituted alkyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl; Mi is absent, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, aryl or heteroaryl;

M2 is absent, O, S, SO, SO2, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

M4 is hydrogen, halogen, CN, N₃, hydroxy, amino, CF₃, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl, heterocyclic, aryl or heteroaryl; and X, Y, Z and Rs are as previously defined.

[0060] In one embodiment, in formula (III), Ur is CH. In another embodiment, in formula (III), Ur is N.

[0061] In one embodiment, in formula (III), Ur is CH, X is S; Y is hydrogen; Z is amino; and M1-M4 and X1-X5 are as defined above. In one embodiment, in formula (III), Ur is N, X is S; Y is hydrogen; Z is amino; and M1-M4 and X1-X5 are as defined above.

[0062] In a fourth embodiment, the compounds of the present invention are compounds of formula (IV):

Ur is CH or N; X2 and Xs are each independently CH or N;

R21 is selected from the group consisting of hydrogen, halogen, amino, substituted amino, hydroxy, substituted hydroxy, thiol, substituted thiol, alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, substituted carbonyl, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

Cy is a substituted or unsubstituted, saturated or unsaturated, fused 5-8 membered cyclic ring optionally substituted with 0-3 heteroatom;

M2 is absent, O, S, SO, SO₂, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

[0063] In one embodiment, in formula (IV):

Ur is CH or N; X2 and Xs are each independently CH or N;

R21 is selected from the group consisting of hydrogen, halogen, amino, hydroxy, thiol, alkyl, substituted alkyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

Mi is absent, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, aryl or heteroaryl; M2 is absent, O, S, SO, SO₂, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

M4 is hydrogen, halogen, CN, N₃, hydroxy, amino, CF₃, C₁-C₆ alkyl,

C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl, heterocyclic, aryl or heteroaryl; and X, Y, Z and Rs are as previously defined.

[0064] In one embodiment, in formula (IV), Ur is CH. In another embodiment, in formula (IV), Ur is N. [0065] In one embodiment, in formula (IV), X is S; Y is hydrogen; Z is amino; and R21,

M1-M4 and X2, X5 are as defined above.

[0066] In a fifth embodiment, the compounds of the present invention are compounds of formula (V):

Ur is CH or N;

X2 and X5 are each independently CH or N;

R21 is elected from the group consisting of hydrogen, halogen, amino, substituted amino, hydroxy, substituted hydroxy, thiol, substituted thiol, alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, substituted carbonyl, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

Yi and Y3 are each independently O, S, N(Rs), CH(R_2i); n is 1, 2, or 3;

Rio and R20 are each independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl; Mi is absent, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, aryl or heteroaryl;

M2 is absent, O, S, SO, SO₂, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

M4 is hydrogen, halogen CN, N₃, hydroxy, substituted hydroxy, amino, substituted amino, CF₃, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl, heterocyclic, aryl or heteroaryl; and

X, Y, Z and Rs are as previously defined.

[0067] In one embodiment, in formula (V):

Ur is CH or N;

X2 and X5 are each independently CH or N; R21 is selected from the group consisting of hydrogen, halogen, amino, hydroxy, thiol, alkyl, substituted alkyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

Yi and Y3 are each independently O, S, N(Rs), CH(R_2i); n is 1, 2, or 3;

M2 is absent, O, S, SO, SO₂, N(Rs), or C=0; M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

M4 is hydrogen, halogen, CN, N₃, hydroxy, amino, CF₃, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl, heterocyclic, aryl or heteroaryl; and X, Y, Z and Rs are as previously defined. [0068] In one embodiment, in formula (V), Ur is CH. In another embodiment, in formula (V), Ur is N.

[0069] In one embodiment, in formula (V), X is S; Y is hydrogen; Z is amino; n, R21, M1-M4, X2, X5, Yi and Y3 are as defined above.

[0070] In one embodiment, the compounds of the present invention are compounds of formula (V-l):

R21 is amino, substituted amino, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino;

Yi and Y3 are each independently O, S, N(Rs), CH(R_2i);

Rio and R20 are each independently hydrogen or alkyl;

Mi is absent, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl;

M2 is N(Rs), wherein Rs is hydrogen, acyl, aliphatic or substituted aliphatic;

M4 is C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl; and Z is amino, substituted or unsubstituted alkylamino, or substituted or unsubstituted dialkylamino; Rs is hydrogen, acyl, aliphatic or substituted aliphatic.

[0071] In one embodiment, the compounds of the present invention are compounds of formula (V- 1 a) :

la) or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein R21, Mi, M3, M4 and Z are as defined above. [0072] In one embodiment, the compounds of the present invention are compounds of formula (V-2):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein Ur is CH or N;

Mi is ethylene or propylene;

M4 is C1-C6 alkyl; and Y is hydrogen or halogen.

[0073] In one embodiment, the compounds of the present invention are compounds of formula (V-2a):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein R21, Mi, M4 and Y are as defined above.

[0074] Representative compounds according to the invention are those selected from the Table A below or geometric isomers, enantiomers, diastereomers, racemates, pharmaceutically acceptable salts, prodmgs and solvates thereof:

[Table A]

[0075] In a specific embodiment, the compound according to the invention is compound- 111 as defined above, or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt, prodrug or solvate thereof. Compound-111 can also be referred to as Debio 0932:

(Compound- 111; Debio 0932)

[0076] In another specific embodiment, the compound according to the invention is compound- 128 as defined above, or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt, prodrug or solvate thereof. Compound- 128 is the purine analog of compound- 111:

(Compound- 128)

[0077] In one embodiment, the compounds used in the present invention are those described in W02008/115719. [0078] In one embodiment, the compounds used in the present invention are those described in WO2012/138896.

[0079] The compounds of the present invention can be prepared by any process known to be applicable by one skilled in the art, especially the compounds can be prepared as described in W02008/115719 or in WO2012/138896.

[0080] The compounds described herein contain one or more asymmetric centers and thus give rise to enantiomers, diastereomers, and other stereoisomeric forms that may be defined, in terms of absolute stereochemistry, as (R)- or (S)-, or as (D)- or (L)- for amino acids. The present invention is meant to include all such possible isomers, as well as their racemic and optically pure forms. Optical isomers may be prepared from their respective optically active precursors by the procedures described above, or by resolving the racemic mixtures. The resolution can be carried out in the presence of a resolving agent, by chromatography or by repeated crystallization or by some combination of these techniques which are known to those skilled in the art. Further details regarding resolutions can be found in Jacques, et ah, Enantiomers, Racemates, and Resolutions (John Wiley & Sons, 1981). When the compounds described herein contain olefinic double bonds, other unsaturation, or other centers of geometric asymmetry, and unless specified otherwise, it is intended that the compounds include both E and Z geometric isomers and/or cis- and trans-isomers. Likewise, all tautomeric forms are also intended to be included. The configuration of any carbon-carbon double bond appearing herein is selected for convenience only and is not intended to designate a particular configuration unless the text so states; thus, a carbon-carbon double bond or carbon-heteroatom double bond depicted arbitrarily herein as trans may be cis, trans, or a mixture of the two in any proportion. Composition/Pharmaceutical composition/medicament

[0081] The compounds used in the present invention can be used under the form of a composition. Therefore, the present invention provides a composition comprising, consisting essentially of or consisting of at least one compound as described herein. [0082] As used herein, “consisting essentially of’, with reference to a composition, means that the at least one compound according to the present invention is the only one therapeutic agent or agent with a biologic activity within said composition.

[0083] In one embodiment, said composition is a pharmaceutical composition and further comprises at least one pharmaceutically acceptable excipient.

[0084] As used herein, the term "pharmaceutically acceptable carrier or excipient" means a non-toxic, inert solid, semi-solid or liquid filler, diluent, encapsulating material or formulation auxiliary of any type. Some examples of materials which can serve as pharmaceutically acceptable carriers are sugars such as lactose, glucose and sucrose; cyclodextrins such as alpha-(oc), beta-( ) and gamma-(y) cyclodextrins; starches such as com starch and potato starch; cellulose and its derivatives such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; powdered tragacanth; malt; gelatin; talc; excipients such as cocoa butter and suppository waxes; oils such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil and soybean oil; glycols such as propylene glycol; esters such as ethyl oleate and ethyl laurate; agar; buffering agents such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogen-free water; isotonic saline; Ringer's solution; ethyl alcohol, and phosphate buffer solutions, as well as other non-toxic compatible lubricants such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, releasing agents, coating agents, sweetening, flavoring and perfuming agents, preservatives and antioxidants can also be present in the composition, according to the judgment of the formulator.

[0085] Consequently, the present invention provides a pharmaceutical composition comprising, consisting essentially of or consisting of at least one compound according to the present invention. [0086] The invention encompasses pharmaceutical compositions comprising pharmaceutically acceptable salts of the compounds of the invention as described above.

[0087] The invention also encompasses pharmaceutical compositions comprising hydrates of the compounds of the invention [0088] The invention further encompasses pharmaceutical compositions comprising any solid or liquid physical form of the compounds of the invention. For example, the compounds can be in a crystalline form, in amorphous form, and have any particle size. The particles may be micronized, or may be agglomerated, particulate granules, powders, oils, oily suspensions or any other form of solid or liquid physical form.

[0089] The compounds of the invention, and derivatives, fragments, analogs, homologs, pharmaceutically acceptable salts or hydrate thereof can be incorporated into pharmaceutical compositions suitable for administration, together with a pharmaceutically acceptable carrier or excipient. Such compositions, pharmaceutical compositions or medicaments typically comprise a therapeutically effective amount of any of the compounds of the present invention formulated together with one or more pharmaceutically acceptable carriers or excipients.

[0090] By a "therapeutically effective amount" of a compound of the invention is meant an amount of the compound which confers a therapeutic effect on the treated subject, at a reasonable benefit/risk ratio applicable to any medical treatment. The therapeutic effect may be objective {i.e., measurable by some test or marker) or subjective (i.e., subject gives an indication of or feels an effect). An effective amount of the compound described above may range from about 0.1 mg/Kg to about 500 mg/Kg, preferably from about 1 to about 50 mg/Kg. Effective doses will also vary depending on route of administration, as well as the possibility of co-usage with other agents. It will be understood, however, that the total daily usage of the compounds and compositions of the present invention will be decided by the attending physician within the scope of sound medical judgment. The specific therapeutically effective dose level for any particular patient will depend upon a variety of factors including the disorder being treated and the severity of the disorder; the activity of the specific compound employed; the specific composition employed; the age, body weight, general health, sex and diet of the patient; the time of administration, route of administration, and rate of excretion of the specific compound employed; the duration of the treatment; drugs used in combination or contemporaneously with the specific compound employed; and like factors well known in the medical arts. [0091] Another object of the present invention is a medicament comprising, consisting essentially of, or consisting of at least one compound as described herein.

[0092] In one embodiment, the composition, pharmaceutical composition, or medicament of the present invention comprise a therapeutically effective amount of a compound of the present invention formulated together with one or more pharmaceutically acceptable carriers or excipients.

Formulation and administration route

[0093] For use in administration to a subject, the compounds of the invention, composition, pharmaceutical composition or medicament will be formulated. [0094] Compounds of the invention may be administered by any suitable means, including, without limitation, parenteral, intravenous, intramuscular, subcutaneous, implantation, oral, sublingual, buccal, nasal, pulmonary, transdermal, topical, vaginal, rectal, and transmucosal administrations or the like. Topical administration can also involve the use of transdermal administration such as transdermal patches or iontophoresis devices. Pharmaceutical preparations include a solid, semisolid or liquid preparation (tablet, pellet, troche, capsule, suppository, cream, ointment, aerosol, powder, liquid, emulsion, suspension, syrup, injection etc.) containing a compound of the invention as an active ingredient, which is suitable for selected mode of administration.

[0095] The term “parenteral” as used herein includes subcutaneous, intracutaneous, intravenous, intramuscular, intraarticular, intraarterial, intrasynovial, intrasternal, intrathecal, intralesional and intracranial injection or infusion techniques.

[0096] In one embodiment, the pharmaceutical compositions are administered orally, and are thus formulated in a form suitable for oral administration, i.e., as a solid or a liquid preparation. [0097] Suitable solid oral formulations include tablets, capsules, pills, granules, pellets, sachets and effervescent, powders, and the like. In such solid dosage forms, the active compound is mixed with at least one inert, pharmaceutically acceptable excipient or carrier such as sodium citrate or dicalcium phosphate and/or: a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol monostearate, h) absorbents such as kaolin and bentonite clay, and i) lubricants such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof. In the case of capsules, tablets and pills, the dosage form may also comprise buffering agents.

[0098] Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like. [0099] The solid dosage forms of tablets, dragees, lozanges, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art. They may optionally contain opacifying agents and can also be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner. Examples of embedding compositions that can be used include polymeric substances and waxes.

[0100] In one embodiment of the present invention, the composition is formulated in a capsule. In accordance with this embodiment, the compositions of the present invention comprise in addition to the active compound and the inert carrier or diluent, a hard gelatin capsule.

[0101] Any inert excipient that is commonly used as a carrier or diluent may be used in the formulations of the present invention, such as for example, a gum, a starch, a sugar, a cellulosic material, an acrylate, or mixtures thereof. A preferred diluent is microcrystalline cellulose. The compositions may further comprise a disintegrating agent (. e.g ., croscarmellose sodium) and a lubricant (e.g., magnesium stearate), and in addition may comprise one or more additives selected from a binder, a buffer, a protease inhibitor, a surfactant, a solubilizing agent, a plasticizer, an emulsifier, a stabilizing agent, a viscosity increasing agent, a sweetener, a film forming agent, or any combination thereof. Furthermore, the compositions of the present invention may be in the form of controlled release or immediate release formulations.

[0102] Suitable liquid oral formulations include pharmaceutically acceptable solutions, suspensions, dispersions, emulsions, microemulsions, syrups, elixirs, oils and the like.

[0103] For liquid formulations, pharmaceutically acceptable carriers may be aqueous or non-aqueous solutions, suspensions, emulsions or oils. Examples of non-aqueous solvents are propylene glycol, polyethylene glycol, and injectable organic esters such as ethyl oleate. Aqueous carriers include water, alcoholic/aqueous solutions, emulsions or suspensions, including saline and buffered media. Examples of oils are those of petroleum, animal, vegetable, or synthetic origin, for example, peanut oil, soybean oil, mineral oil, olive oil, sunflower oil, and fish-liver oil. Solutions or suspensions can also include the following components: a sterile diluent such as water for injection, saline solution, fixed oils, polyethylene glycols, glycerine, propylene glycol or other synthetic solvents; antibacterial agents such as benzyl alcohol or methyl parabens; antioxidants such as ascorbic acid or sodium bisulfite; chelating agents such as ethylenediaminetetraacetic acid (EDTA); buffers such as acetates, citrates or phosphates, and agents for the adjustment of tonicity such as sodium chloride or dextrose. The pH can be adjusted with acids or bases, such as hydrochloric acid or sodium hydroxide.

[0104] In addition, the compositions may further comprise binders (e.g., acacia, cornstarch, gelatin, carbomer, ethyl cellulose, guar gum, hydroxypropyl cellulose, hydroxypropyl methyl cellulose, povidone), disintegrating agents (e.g., cornstarch, potato starch, alginic acid, silicon dioxide, croscarmellose sodium, crospovidone, guar gum, sodium starch glycolate, Primogel), buffers (e.g., tris-HCL, acetate, phosphate) of various pH and ionic strength, additives such as albumin or gelatin to prevent absorption to surfaces, detergents (e.g., Tween 20, Tween 80, Pluronic F68, bile acid salts), protease inhibitors, surfactants (e.g., sodium lauryl sulfate), permeation enhancers, solubilizing agents ( e.g ., glycerol, polyethylene glycerol), a glidant (e.g., colloidal silicon dioxide), anti-oxidants (e.g., ascorbic acid, sodium metabisulfite, butylated hydroxyanisole), stabilizers (e.g., hydroxypropyl cellulose, hydroxypropylmethyl cellulose), viscosity increasing agents (e.g., carbomer, colloidal silicon dioxide, ethyl cellulose, guar gum), sweeteners (e.g., sucrose, aspartame, citric acid), flavoring agents (e.g., peppermint, methyl salicylate, or orange flavoring), preservatives (e.g., Thimerosal, benzyl alcohol, parabens), lubricants (e.g., stearic acid, magnesium stearate, polyethylene glycol, sodium lauryl sulfate), flow-aids (e.g., colloidal silicon dioxide), plasticizers (e.g., diethyl phthalate, triethyl citrate), emulsifiers (e.g., carbomer, hydroxypropyl cellulose, sodium lauryl sulfate), polymer coatings (e.g., poloxamers or poloxamines), coating and film forming agents (e.g., ethyl cellulose, acrylates, polymethacrylates) and/or adjuvants.

[0105] In one embodiment, the active compounds are prepared with carriers that will protect the compound against rapid elimination from the body, such as a controlled release formulation, including implants and microencapsulated delivery systems. Biodegradable, biocompatible polymers can be used, such as ethylene vinyl acetate, polyanhydrides, polyglycolic acid, collagen, polyorthoesters, and polylactic acid. Methods for preparation of such formulations will be apparent to those skilled in the art. The materials can also be obtained commercially from Alza Corporation and Nova Pharmaceuticals, Inc. Liposomal suspensions (including liposomes targeted to infected cells with monoclonal antibodies to viral antigens) can also be used as pharmaceutically acceptable carriers. These can be prepared according to methods known to those skilled in the art, for example, as described in U.S. Pat. No. 4,522,811.

[0106] It is especially advantageous to formulate oral compositions in dosage unit form for ease of administration and uniformity of dosage. Dosage unit form as used herein refers to physically discrete units suited as unitary dosages for the subject to be treated; each unit containing a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier. The specifications for the dosage unit forms of the invention are dictated by and directly dependent on the unique characteristics of the active compound and the particular therapeutic effect to be achieved, and the limitations inherent in the art of compounding such an active compound for the treatment of individuals.

[0107] The pharmaceutical compositions can be included in a container, pack, or dispenser together with instructions for administration. [0108] The preparation of pharmaceutical compositions that contain an active component is well understood in the art, for example, by mixing, granulating, or tablet forming processes. The active therapeutic ingredient is often mixed with excipients that are pharmaceutically acceptable and compatible with the active ingredient. For oral administration, the active agents are mixed with additives customary for this purpose, such as vehicles, stabilizers, or inert diluents, and converted by customary methods into suitable forms for administration, such as tablets, coated tablets, hard or soft gelatin capsules, aqueous, alcoholic or oily solutions and the like as detailed above.

[0109] Injectable preparations, for example, sterile injectable aqueous or oleaginous suspensions, may be formulated according to the known art using suitable dispersing or wetting agents and suspending agents. The sterile injectable preparation may also be a sterile injectable solution, suspension or emulsion in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution, U.S.P. and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose any bland fixed oil can be employed including synthetic mono- or diglycerides. In addition, fatty acids such as oleic acid are used in the preparation of injectables.

[0110] The injectable formulations can be sterilized, for example, by filtration through a bacterial-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable medium prior to use.

[0111] In order to prolong the effect of a drug, it is often desirable to slow the absorption of the drug from subcutaneous or intramuscular injection. This may be accomplished by the use of a liquid suspension of crystalline or amorphous material with poor water solubility. The rate of absorption of the drug then depends upon its rate of dissolution, which, in turn, may depend upon crystal size and crystalline form. Alternatively, delayed absorption of a parenterally administered drug form is accomplished by dissolving or suspending the drug in an oil vehicle. Injectable depot forms are made by forming microencapsule matrices of the drug in biodegradable polymers such as polylactide- polyglycolide. Depending upon the ratio of drug to polymer and the nature of the particular polymer employed, the rate of drug release can be controlled. Examples of other biodegradable polymers include poly(orthoesters) and poly(anhydrides). Depot injectable formulations are also prepared by entrapping the drug in liposomes or microemulsions that are compatible with body tissues.

[0112] Compositions for rectal or vaginal administration are preferably suppositories which can be prepared by mixing the compounds of this invention with suitable non irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.

[0113] Dosage forms for topical or transdermal administration of a compound of this invention include ointments, pastes, creams, lotions, gels, powders, solutions, sprays, inhalants or patches. The active component is admixed under sterile conditions with a pharmaceutically acceptable carrier and any needed preservatives or buffers as may be required. Ophthalmic formulation, ear drops, eye ointments, powders and solutions are also contemplated as being within the scope of this invention.

[0114] The ointments, pastes, creams and gels may contain, in addition to an active compound of this invention, excipients such as animal and vegetable fats, oils, waxes, paraffins, starch, tragacanth, cellulose derivatives, polyethylene glycols, silicones, bentonites, silicic acid, talc and zinc oxide, or mixtures thereof.

[0115] Powders and sprays can contain, in addition to the compounds of this invention, excipients such as lactose, talc, silicic acid, aluminum hydroxide, calcium silicates and polyamide powder, or mixtures of these substances. Sprays can additionally contain customary propellants such as chlorofluorohydrocarbons.

[0116] Transdermal patches have the added advantage of providing controlled delivery of a compound to the body. Such dosage forms can be made by dissolving or dispensing the compound in the proper medium. Absorption enhancers can also be used to increase the flux of the compound across the skin. The rate can be controlled by either providing a rate controlling membrane or by dispersing the compound in a polymer matrix or gel.

[0117] For pulmonary delivery, a therapeutic composition of the invention is formulated and administered to the patient in solid or liquid particulate form by direct administration e.g., inhalation into the respiratory system. Solid or liquid particulate forms of the active compound prepared for practicing the present invention include particles of respirable size: that is, particles of a size sufficiently small to pass through the mouth and larynx upon inhalation and into the bronchi and alveoli of the lungs. Delivery of aerosolized therapeutics, particularly aerosolized antibiotics, is known in the art (see, for example U.S. Pat. No. 5,767,068 to VanDevanter et ah, U.S. Pat. No. 5,508,269 to Smith et al, and WO 98/43,650 by Montgomery, all of which are incorporated herein by reference). A discussion of pulmonary delivery of antibiotics is also found in U.S. Pat. No. 6,014,969, incorporated herein by reference.

Dosage [0118] Daily administration may be repeated continuously for a period of several days to several years. Oral treatment may continue for between one week and the life of the patient. Preferably the administration may take place for five consecutive days after which time the patient can be evaluated to determine if further administration is required. The administration can be continuous or intermittent, e.g., treatment for a number of consecutive days followed by a rest period. The compounds of the present invention may be administered intravenously on the first day of treatment, with oral administration on the second day and all consecutive days thereafter. [0119] The amount of the compound administered to the patient is less than an amount that would cause toxicity in the patient. In certain embodiments, the amount of the compound that is administered to the patient is less than the amount that causes a concentration of the compound in the patient's plasma to equal or exceed the toxic level of the compound. Preferably, the concentration of the compound in the patient's plasma is maintained at 10 nM. In one embodiment, the concentration of the compound in the patient's plasma is maintained at 25 nM. In one embodiment, the concentration of the compound in the patient's plasma is maintained at 50 nM. In one embodiment, the concentration of the compound in the patient's plasma is maintained at 100 nM. In one embodiment, the concentration of the compound in the patient's plasma is maintained at 500 nM. In one embodiment, the concentration of the compound in the patient's plasma is maintained at 1000 nM. In one embodiment, the concentration of the compound in the patient's plasma is maintained at 2500 nM. In one embodiment, the concentration of the compound in the patient's plasma is maintained at 5000 nM. The optimal amount of the compound that should be administered to the patient in the practice of the present invention will depend on the particular compound used.

[0120] The total daily dose of the compounds of this invention administered to a human or other animal in single or in divided doses can be in amounts, for example, from 0.01 to 50 mg/kg body weight or more usually from 0.1 to 25 mg/kg body weight. Single dose compositions may contain such amounts or submultiples thereof to make up the daily dose. In general, treatment regimens according to the present invention comprise administration to a patient in need of such treatment from about 10 mg to about 1000 mg of the compound(s) of this invention per day in single or multiple doses.

[0121] The compounds of the formulae described herein can, for example, be administered by injection, intravenously, intraarterially, subdermally, intraperitoneally, intramuscularly, or subcutaneously; or orally, buccally, nasally, transmucosally, topically, in an ophthalmic preparation, or by inhalation, with a dosage ranging from about 0.1 to about 500 mg/kg of body weight, alternatively dosages between 1 mg and 1000 mg/dose, every 4 to 120 hours, or according to the requirements of the particular drug. The methods herein contemplate administration of an effective amount of compound or compound composition to achieve the desired or stated effect. Typically, the pharmaceutical compositions of this invention will be administered from about 1 to about 6 times per day or alternatively, as a continuous infusion. Such administration can be used as a chronic or acute therapy. The amount of active ingredient that may be combined with pharmaceutically excipients or carriers to produce a single dosage form will vary depending upon the host treated and the particular mode of administration. A typical preparation will contain from about 5% to about 95% active compound (w/w). Alternatively, such preparations may contain from about 20% to about 80% active compound. [0122] Lower or higher doses than those recited above may be required. Specific dosage and treatment regimens for any particular patient will depend upon a variety of factors, including the activity of the specific compound employed, the age, body weight, general health status, sex, diet, time of administration, rate of excretion, drug combination, the severity and course of the disease, condition or symptoms, the patient's disposition to the disease, condition or symptoms, and the judgment of the treating physician.

[0123] Upon improvement of a patient's condition, a maintenance dose of a compound, composition, pharmaceutical composition or medicament of this invention may be administered, if necessary. Subsequently, the dosage or frequency of administration, or both, may be reduced, as a function of the symptoms, to a level at which the improved condition is retained when the symptoms have been alleviated to the desired level. Patients may, however, require intermittent treatment on a long-term basis upon any recurrence of disease symptoms.

Use for treating congenital central hypoventilation syndrome

[0124] The invention further relates to at least one of the compounds of the invention for use as a medicament, in particular for use for treating congenital central hypoventilation syndrome in a subject in need thereof.

[0125] The present invention further relates to a method for treating congenital central hypoventilation syndrome in a subject in need thereof, comprising administering to the subject a therapeutically effective amount of at least one of the compounds of the invention, or at least one composition, pharmaceutical composition or medicament as described herein.

[0126] The present invention further relates to the use of at least one of the compounds of the invention in the manufacture of a medicament, in particular for the treatment of congenital central hypoventilation syndrome in a subject in need thereof.

[0127] In one embodiment, the compounds of the invention, composition, pharmaceutical composition or medicament can be useful for treating congenital central hypoventilation syndrome.

BRIEF DESCRIPTION OF THE DRAWINGS

[0128] Figure 1 is a histogram showing the immobile fraction analyzed by FRAP on HeLa cells transfected by PHOX2B 5Ala-GFP and treated by different HSP90 inhibitors (17-DMAG, Debio 0932, Ganetespib, KW-2478, Onalespib, TAS-116, XL888, KUNB- 31 or SNX-5422) at ImM, or with DMSO as a control. Statistical analysis was done using an unpaired Mann- Whitney test (where * P < 0.05, ** P < 0.01, *** P < 0.001, **** P < 0.0001) comparing each condition to the control condition (DMSO).

[0129] Figure 2 is a histogram showing the immobile fraction analyzed by FRAP on HeLa cells transfected by PHOX2B 5Ala-GFP and treated by 17-DMAG or Debio 0932 at IOhM, lOOnM or ImM. Statistical analysis was done using an unpaired Mann-Whitney test (where * P < 0.05, ** P < 0.01, *** P < 0.001, **** P < 0.0001) comparing each condition to the control condition (DMSO).

[0130] Figure 3 is a histogram showing the effect of Debio 0932 (IOmM) on response to metabolic acidosis in ex vivo medullary spinal cord preparation. Statistical analysis was done using a non-parametric Friedman test (where ** P < 0.01) comparing the 7h of treatment condition (Debio 0932 (IOmM)) to the control condition (No Drug). [0131] Figure 4 is a histogram showing the immobile fraction analyzed by FRAP on HeLa cells transfected by PHOX2B 5Ala-GFP and treated with Debio 0932 or compound- 128 at ImM, or with DMSO as a control. Statistical analysis was done using an unpaired Mann- Whitney test (where * P < 0.05) comparing each condition to the control condition (DMSO).

EXAMPLES

[0132] The present invention is further illustrated by the following example.

[0133] Abbreviations:

CCHS: congenital central hypoventilation syndrome; DMSO: dimethylsulfoxide;

FRAP: fluorescence recovery after photobleaching;

HSP90: heat shock protein 90;

ROI: region of interest;

SEM: standard error of mean. Example 1: Debio 0932 shows a potent effect in a CCHS in vitro cell model

Purpose

[0134] The purpose of this experiment was to compare the effect of several HSP90 inhibitors in a CCHS in vitro cell model. The ability of several HSP90 inhibitors to improve the impaired mobility of a mutated PHOX2B protein (+5 Alanine mutation, representative of mutations found in CCHS patients) was analyzed using FRAP (fluorescence recovery after photobleaching) microscopy. The effects of the different inhibitors were compared to the one of 17-DMAG.

Materials and Methods

[0135] Tested compounds [0136] The following HSP90 inhibitors were tested:

17-DMAG: also referred to as 17-dimethylaminoethylamino-17- demethoxygeldanamycin, of formula C32H49QN4O8 (CAS number: 467214-21-7, MedChemExpress - reference: HY-12024); compound- 111, also referred to as Debio 0932, of formula 2-((6- (dimethylamino)benzo[d][l,3]dioxol-5-yl)thio)-l-(2-(neopentylamino)ethyl)- lH-imidazo[4,5-c]pyridin-4-amine (CAS number: 1061318-81-7, MedChemExpress - reference: HY-13469);

Ganetespib, of formula C20H20N4O3 (CAS number: 888216-25-9,

MedChemExpress - reference: HY-15205);

- KW-2478, of formula C30H42N2O9 (CAS number: 819812-04-9, MedChemExpress - reference: HY-13468); - Onalespib, of formula C24H31N3O3 (CAS number: 912999-49-6,

MedChemExpress - reference: HY-14463);

TAS-116 of formula C25H26N8O (CAS number: 1260533-36-5, MedChemExpress - reference: HY- 15785);

XL888 of formula C29H37N5O3 (CAS number: 1149705-71-4, MedChemExpress - reference: HY-13313) ;

- KUNB-31 of formula C19H18N2O3 (CAS number: 2220263-80-7, MERCK - reference: SML2273);

- S NX-5422 of formula C25H30F3N5O4 (CAS number: 908115-27-5, Selleckchem - reference: S2656). [0137] Cell culture

[0138] HeLa cells (ATCC® CCL-2™) were obtained from ATCC and cultured at 37°C in a humidified incubator set to 5% CO2, in DMEM (reference: 41965039 - ThermoFisher) with 10% Fetal Bovine Serum (reference: 26140079 - ThermoFisher). Cells were seeded (8.000 cells per cm²) one day prior to transfection in Ibidi m-Slide 8 Well (reference: 80826 - Ibidi). Cells were transfected with plasmid carrying different PHOX2B-GFP constructs (wild-type, +4/+5/+13 Alanine mutants) using Lipofectamine 2000 (reference: 11668019 - ThermoFisher) as recommended by vendor. After transfection, cells were treated by either 1% DMSO (control condition - reference: 85190 - ThermoFisher), or by the different HSP90 inhibitors at ImM (in 1% DMSO). [0139] Microscopy [0140] HeLa cells were used for FRAP experiment 14 to 18 hours after transfection. FRAP experiments were done on a Confocal Leica TCS SP8 SMD microscope with a temperature/C0₂ regulated chamber (37°C and 5% CO2). A 40X oil immersion objective was used, with a 3X additional digital zoom. [0141] FRAP was carried out using the LAS AF application wizard, using the “zoom in” option (to minimize the scan field during photobleaching and apply more light to the ROI). A ROI of 20-22 pm² was defined for each studied fluorescent nucleus. 5 images were taken (using 10% laser power) before bleaching (10 times 0.863 seconds at 100% laser power), and then recording recovery for 100 seconds. [0142] Roughly 10 cells were analyzed per condition for each experiment, and each compound was tested in 2-6 separated experiments. DMSO control was recorded in each experiment to be used for normalization of value within each experiment.

[0143] Data were then analyzed using the LAS AF application wizard data analysis tool (using a single exponential function type to determine ti/2 and immobile fraction for each acquisition).

Results

[0144] The mobility (which is inversely proportional to the immobile fraction) of the mutant protein PHOX2B 5Ala was significantly increased by 17-DMAG treatment at ImM. Overall, most inhibitors had an effect like 17-DMAG. However, surprisingly, Debio 0932 was able to significantly improve PHOX2B-5Ala mobility when compared to 17-DMAG (Figure 1).

[0145] 17-DMAG and Debio 0932 were tested at different doses for their ability to ameliorate PHOX2B 5Ala mobility. Neither 17-DMAG, nor Debio 0932 was able to ameliorate PHOX2B 5Ala mobility at a dose of lOnM. At lOOnM, 17-DMAG was not able to increase PHOX2B 5Ala mobility, while Debio 0932 increased it significantly (Figure 2). At a dose of lOOOnM, both 17-DMAG and Debio 0932 were able to significantly increase PHOX2B 5Ala mobility. These results demonstrate that Debio 0932 is more potent than 17-DMAG to increase PHOX2B 5Ala mobility, since it shows a significant effect at a lower dose than 17-DMAG. These results also suggest that Debio 0932 could be a compound of interest for the treatment of congenital central hypoventilation syndrome.

Example 2: Debio 0932 shows a potent effect in a CCHS ex vivo mouse model Purpose

[0146] The purpose of this experiment was to study the effect of Debio 0932 in a CCHS ex vivo mouse model. The ability of Debio 0932 to restore an hypercapnic response in CCHS mice was evaluated using an electrophysiological approach on ex vivo medullary spinal cord preparations. Materials and Methods

[0147] Tested compound

[0148] The following HSP90 inhibitor was tested: compound-111, also referred to as Debio 0932, of formula 2-((6-(dimethylamino)benzo[d][l,3]dioxol-5-yl)thio)-l-(2- (neopentylamino)ethyl)-lH-imidazo[4,5-c]pyridin-4-amine (CAS number: 1061318-81- 7, MedChemExpress - reference: HY-13469).

[0149] Ex vivo medullary spinal cord preparations

[0150] Newborn CCHS mice (Egr2^Cre/+Phox2b^27ala/+ mice at postnatal day 0 to 3) were placed under deep cold anesthesia and medullary- spinal cord preparations were dissected. The rostral section was made at the level of the eighth cranial nerve exit point. The caudal section was made between the seventh and eighth cervical spinal roots. Preparations were placed in a recording chamber with the ventral surface facing upward. They were continuously superfused at a rate of 10 ml/min, at 26°C, with dioxygenated artificial cerebrospinal fluid (aCSF - 129.0 mM NaCl, 3.35 mM KC1, 1.26 mM CaCl₂2H₂0, 1.15 mM MgCh 6H₂0, 0.58 mM NaH₂P0₄H₂0, 21.0 mM NaHCOs, 30.0 mM D-glucose) saturated with 0₂ and adjusted to pH 7.4 by bubbling with 95% 0₂ and 5% C0₂ (normal pH-aCSF). Central ventilatory drive (CVD) was analyzed by measuring the electrical activity of a fourth cervical ventral nerve root (C4) recorded using a suction electrode, filtered (10-3000 Hz), amplified (x5000), integrated (time constant 100 ms) and digitized by a Spike 2 data analysis system (CED, Cambridge, UK), at a sampling frequency of 2500 Hz. Respiratory frequency (fR) was commonly defined as the burst frequency recorded from C4 over 1 min.

[0151] Debio 0932 pharmacological treatment [0152] After completion of the surgical procedure, ex vivo preparations were recorded following a sequence of different conditions to evaluate their response to hypercapnia (mimicked here by metabolic acidosis) over time. Preparations were first maintained in normal pH-aCSF superfusion for 30 min to stabilize CVD. This was followed by 30 min of metabolic acidosis (0.15 mM NaHCCF, saturated with O2 and adjusted to pH 7.23 by bubbling with 95% O2 and 5% CO2) to determine response to metabolic acidosis before treatment; and then returned to 30 min of normo-pH aCSF. Debio 0932 (IOmM final) was then added to both normo-pH and metabolic acidosis aCSF and preparations were maintained in Debio 0932 aCSF for 7 hours, time at which the normo-pH aCSF was switched for 30 min to metabolic acidosis. Response to metabolic acidosis under Debio 0932 treatment was expressed as a percentage of the response to metabolic acidosis before treatment. The mean values obtained during the last 10 min of each condition were used to evaluate CVD in both normo-pH and metabolic acidosis conditions.

Results

[0153] The ability of Debio 0932 to restore a hypercapnic response in CCHS mice (Egr2^Cre/+Phox2b^27ala/+) was evaluated using an electrophysiological approach on ex vivo medullary spinal cord preparations. Response to metabolic acidosis was recorded before and after 7h of 10 mM Debio 0932 treatment (Figure 3).

[0154] Debio 0932 treatment led to a statistically significant increase in the response to metabolic acidosis after 7h of treatment. These results further suggest that Debio 0932 could be a compound of interest for the treatment of congenital central hypoventilation syndrome. Example 3: Debio 0932 and Compound 128 show a potent effect in a CCHS in vitro cell model

Purpose

[0155] The purpose of this experiment was to compare the effect of Debio 0932 (compound-111) and compound-128 in a CCHS in vitro cell model. The ability of Debio 0932 and compound- 128 to improve the impaired mobility of a mutated PHOX2B protein was analyzed using FRAP microscopy.

Materials and Methods

[0156] Tested compounds [0157] The following HSP90 inhibitors were tested: compound- 111, also referred to as Debio 0932, of formula 2-((6-

(dimethylamino)benzo[d][l,3]dioxol-5-yl)thio)-l-(2-(neopentylamino)ethyl)-lH- imidazo[4,5-c]pyridin-4-amine (CAS number: 1061318-81-7, MedChemExpress - reference: HY- 13469); - compound- 128, according to Table A above, of formula 8-((6-

(dimethylamino)benzo[d][l,3]dioxol-5-yl)thio)-9-(2-(neopentylamino)ethyl)-9H- purin-6-amine. Compound 128 can be prepared as described in WO2012/138896.

[0158] The same experimental procedure as in Example 1 was used to compare the effect of Debio 0932 and compound-128. Results

[0159] The mobility of the mutant protein PHOX2B-5Ala was significantly increased both by Debio 0932 and compound-128. Thus, compound-128 has a similar effect on PHOX2B-5Ala protein mobility when compared to Debio 0932 (Figure 4).

[0160] These results demonstrate that compound-128 is as potent as Debio 0932 to increase PHOX2B-5Ala mobility. These results suggest that both Debio 0932 and compound- 128 could be of interest for the treatment of congenital central hypoventilation syndrome.

Claims

1. A compound of formula (I):

Ui is C or N;

U2 is N or CH;

V is hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl;

W is absent when Ui is N, or when Ui is C, W is hydrogen, halogen, amino, hydroxy, thiol, alkyl, substituted alkyl, substituted or unsubstituted alkoxy, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylthio, substituted or unsubstituted alkylsulfonyl, CF₃, NO₂, CN, N₃, sulfonyl, acyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, heterocyclic, substituted heterocyclic, cycloalkyl, or substituted cycloalkyl;

X is O, S, S(O), S(0)₂, N(Rs), or C(O), wherein Rs is hydrogen, acyl, aliphatic or substituted aliphatic;

Y is hydrogen, halogen, NO₂, CN, or C₁-C₁₀ alkyl;

Z is amino, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylcarbonylamino; and Q is aryl, substituted aryl, heteroaryl, substituted heteroaryl, cycloalkyl, or heterocyclylalkyl; for use in the treatment of congenital central hypoventilation syndrome in a subject in need thereof. 2. A compound of formula (II):

Ur is CH or N;

X2 and X5 are each independently CH or N;

M2 is absent, O, S, SO, SO₂, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

M4 is hydrogen, halogen, CN, N₃, hydroxy, substituted hydroxy, amino, substituted amino, CF₃, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, cycloalkyl, heterocyclic, aryl or heteroaryl;

X is O, S, S(O), S(0)₂, N(Rs), or C(O);

Y is hydrogen, halogen, NO₂, CN, or C₁-C₁₀ alkyl;

Z is amino, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylcarbonylamino; and Rs is hydrogen, acyl, aliphatic or substituted aliphatic; for use in the treatment of congenital central hypoventilation syndrome in a subject in need thereof.

3. A compound of formula (III):

Ur is CH or N;

M2 is absent, O, S, SO, SO₂, N(Rs), or C=0;

M3 is absent, C=0, O, S, SO, SO₂ or N(Rs);

X is O, S, S(O), S(0)₂, N(Rs), or C(O);

Y is hydrogen, halogen, NO₂, CN, or C₁-C₁₀ alkyl; and,

Z is amino, substituted or unsubstituted alkylamino, substituted or unsubstituted dialkylamino, substituted or unsubstituted alkylcarbonylamino; Rs is hydrogen, acyl, aliphatic or substituted aliphatic; for use in the treatment of congenital central hypoventilation syndrome in a subject in need thereof.

4. The compound for use according to claim 2 or claim 3, wherein Ur is CH. 5. The compound for use according to claim 2 or claim 3, wherein Ur is N.

6. The compound for use according to any one of claims 2, 4 or 5, wherein the compound of formula (II) is represented by formula (IV):

Ur, X, Y, Z, X2, X5, R21, Mi, M2, M3 and M4 are as previously defined in claim 2; and

Cy is a substituted or unsubstituted, saturated or unsaturated, fused 5-8 membered cyclic ring optionally substituted with 0-3 heteroatom. 7. The compound for use according to any one of claims 2, or 4 to 6, wherein the compound of formula (II) is represented by formula (V):

Ur, X, Y, Z, X2, X5, Rs. R21, Mi, M2, M3 and M4 are as previously defined in claim 2; and

Yi and Y3 are each independently O, S, N(Rs), CH(R2i); n is 1, 2, or 3; and

Rio and R20 are each independently hydrogen, alkyl, substituted alkyl, aryl or substituted aryl.

8. The compound for use according to claim 7, wherein the compound is of formula

(V-l):

Yi and Y3 are as defined in claim 7

Rio and R20 are each independently hydrogen or alkyl;

Mi is absent, C₁-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl;

M2 is N(Rs), wherein Rs is hydrogen, acyl, aliphatic or substituted aliphatic;

9. The compound for use according to claim 8, wherein the compound is of formula (V-l a):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein R21, Mi, M3, M4 and Z are as defined in claim 8. The compound for use according to claim 7, wherein the compound is of formula

(V-2):

Mi is ethylene or propylene;

M4 is C1-C6 alkyl; and Y is hydrogen or halogen.

11. The compound for use according to claim 10, wherein the compound is of formula (V-2a):

or a geometric isomer, enantiomer, diastereomer, racemate, pharmaceutically acceptable salt or solvate thereof, wherein R21, Mi, M4 and Y are as defined in claim 10.

12. The compound for use according to any one of claims 1 to 11, wherein the compound is selected from the compounds delineated in Table A and geometric isomers, enantiomers, diastereomers, racemates, pharmaceutically acceptable salts and solvates thereof:

[Table A]

13. The compound for use according to claim 12, wherein the compound is compound-

111 of formula:

(Compound- 111) or a pharmaceutically acceptable salt or solvate thereof. 14. A pharmaceutical composition comprising compound- 111 of formula:

(Compound- 111) and a pharmaceutical acceptable carrier, for use in the treatment of congenital central hypoventilation syndrome in a subject in need thereof.