CA2101572C - Benzoxazinones as inhibitors of hiv reverse transcriptase - Google Patents

Abstract

Certain benzoxazinones of the general formula I are useful in the inhibition of HIV
reverse transcriptase (including its resistant varieties), the prevention or treatment of infection by HIV and the treatment of AIDS, either as compounds, pharmaceutically acceptable salts, pharmaceutical composition ingredients, whether or not in combination with other antivirals, immunomodulators, antibiotics or vaccines. Methods of treating AIDS and methods of preventing or treating infection by HIV
are also described.

FORMULA I

Description

TITLE OF THE INVENTION
BENZOXAZINONES AS INHIBITORS OF HIV REVERSE
TRANSCRIPTASE
BACKGROUND OF THE INVENTION
A retrovirus designated humammmunodeficiency virus i o (HN) is the etiological agent of the complex disease that includes progressive destruction of the immune system (acquired immune deficiency syndrome; AIDS) and degeneration of the central and peripheral nervous system. This virus was previously known as LAV, HTLV-III, or ARV. A common feature of retrovirus replication is 15 reverse transcription of the RNA genome by a virally encoded reverse transcriptase to generate DNA copies of HIV sequences, a required step in viral replication. It is known that some compounds are reverse transcriptase inhibitors and are effective agents in the treatment of AIDS and similar diseases, e.g., azidothymidine or AZT.
Nucleotide sequencing of HIV shows the presence of a Col gene in one open reading frame [Ratner, L. et al., Nature, 313, 277 (1985)]. Amino acid sequence homology provides evidence that the Col sequence encodes reverse transcriptase, an endonuclease and an HIV
protease [Toh, H. et al., EMBO J. 4, 1267 (1985); Power, M.D. et al., 2 s Science, 231, 1567 ( 1986); Pearl, L.H. et al., Nature 329, 351 ( 19$7)].
Applicants demonstrate that the compounds of this invention are inhibitors of HIV reverse transcriptase. The particular advantages of the present compounds are their demonstrated inhibition of resistant HIV reverse transcriptase.
BRIEF DESCRIPTION OF THE INVENTION
Compounds of formula I, as herein defined, are disclosed.
These compounds are useful in the inhibition of HIV reverse transcriptase (and its resistant varieties), the prevention of infection by ~t r t - 2 - 1 ~793IA
HIV, the treatment of infection by HIV and in the treatment of AIDS
and/or ARC, either as compounds, pharmaceutically acceptable salts (when appropriate), pharmaceutical composition ingredients, whether or not in combination with other antivirals, anti-infectives, s immunomodulators, antibiotics or vaccines. Methods of treating AIDS, methods of preventing infection by HIV, and methods of treating infection by HIV are also disclosed.
DETAILED DESCRIPTION OF THE INVENTION AND
to pREFERRED EMBODIMENTS
This invention is concerned witr~ compounds of formula I, combinations thereof, or pharmaceutically acceptable salts thereof, in the inhibition of HIV reverse transcriptase ar.~d its resistant varieties, the prevention or treatment of infection by HIV .and in the treatment of the 1 s resulting acquired immune deficiency syndrome (AIDS). Compounds of formula I are defined as follows:

X / O
N Z
H
wherein:
2s X is halo, X 1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is 3 0 (a) C 1 _g alkyl, unsubstituted or substituted with A, and A is halo, C3_6 cycloalkyl, CN, hydroxy, Cl_4 alkoxy, C2_4 alkynyl-Cl_4 alkoxy, aryloxy, C1_q, alkylcarbonyl, vitro, di(C 1 _2 alkyl)amino, C 1 _q, alkylamino-C 1 _2 alkyl, heterocycle, or arylthio;
(b) C2_4 alkenyl, unsubstituted or substituted with .r r r ,~
~.~I~ ~~2 - 3 - 1 ~793IA
(i) A, or (ii) aryl, unsubstituted or substituted with A;
(c) C2_5 alkynyl, unsubstituted or substituted with (i) A, or (ii) aryl, unsubstituted or substituted with A; or (d) C3_q, cycloalkyl, unsubstituted or substituted with (i) A, or (ii) aryl, unsubstituted or substituted with A, l o or pharmaceutically acceptable salt thereof.
This invention also encompasses a pharmaceutical composition useful for inhibiting HIV reverse transcription, comprising an effective amount of a compound of Formula II, X' R
I I
N Z
and a pharmaceutically acceptable Garner, wherein X is halo;
X 1 is trihalomethyl; pentahaloethyl; C,Z_5 alkyl;
C2_5 alkynyl;
C3_5 cycloalkyl; or aryl;
Z is O or S;
3 o R is (a) C 1 _g alkyl; unsubstituted or substituted with A, and A is halo, C3_6 cycloalkyl, CN,hydroxy, C 1 _4 alkoxy, CZ_4 alkynyl-Cl_4 alkoxy, aryloxy, CI_4 alkylcarbonyl, vitro, di(C 1 _2 alkyl)amino, C 1 _q~ alkylamino-C 1 _2 alkyl, heterocycle, or arylthio;

;, - 4 - 1 ~793IA
(b) C2_4 alkenyl, unsubstituted or substituted with (i) A, or (ii) aryl, unsubstituted or substituted with A;
(c) C2_5 alkynyl, unsubstituted or substituted with (i) A, or (ii) aryl, unsubstituted or substituted with A; or (d) C3_4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) aryl, unsubstituted or substituted with A, io or pharmaceutically acceptable salt thereof.
Preferred compounds include Compounds 37.2, 4, 2, 5 and i 5 24 of Table I below, in order of descending degree of preference.
These compounds have the following structure:
Compound 37.2:
CI ~ ~ O
(-) ( i N O
(-) 6-Chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, the most preferred;

i!i' ., i Compound 4:
CI
H
to (-) 6-chloro-4-phenylethynyl-4-trifluorometlayl-1, 4-dihydro-2H--3,1-benzoxazin-2-one;
Compound 2:
FsC ~~ CN
CI / O
20, (+/-) N O
H
(+/-) 6-chloro-4-(2-cyanophenyl)ethynyl-4-( 1,1,1-trifluoromethyl)-1,4-2 5 dlhydro-2H-3,1-benzoxazin-2-one;
Compound 5:
(+~-) N~ ~ O
H

,, ', . ,~,~, - 6 - 1 ~793IA
(+/-) 4-( 1-chloro-1,1-difluoromethyl)-4-(2-phenyl-ethynyl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one;
Compound 24:

-N
'C H3 CI / _ C+/_) \
N O
H
(+/-) 4-(2-[dimethylaminomethyl]ethynyl)-4~-trifluoromethyl-6-chloro-1 s 1,4-dihydro-2H-3,1-benzoxazin-2-one;
or a pharmaceutically acceptable salt thereof..
The compounds of the present irwention are specifically 2~ illustrated in Tables I and II below:
TAB LE I
25 X~ R
CI / O
N C) H

i i~
~~~~.~)~~
U_ ~ N N
U o n T
°o ~°c~ ~ O o U ~ ~ ~ c~ c°
~ o co ta7 N N 00 U
cfl r~- a c~ 00 0 _ NN TT

U
W i u"
U U U U
GA
H
U
O

E
0 0 0~ o ,z U o c c * *
a~
c c~
a~
°o.. T N C,~ d' E
O
U

U_ U

~ ~

o O ( I
~ ~ p O d-' * ~ ~ d U ~ c~a ,- M o0 o o ~ c o * ( N

U r r n U , ~ ~ W n ~ co o 'd' r n _ T o o a o r T N N ~ ~ T T

T T

U

U U U U

N

e~ ~ ~_ ~i ~
. ~i~ ~,~ . ~,~ . ~i~

C

ao U

i i;
s y * o~ c tc7 U ~ N
U cs~
* '° ~ ~ ~ app U ~ N c~ N N
* ~ C~ 00 tD N
U ~ ~ ~ r~ r T
U , , , 00 r O O Lf7 CO M ~
O ~ ~ O
T T T T ~ ~ r T
T~ T

U
_ ti uWi ii U U U U
xl GA
E
O
0 0, ,o * * *

O T N

T T T

U

i:i~
O

m O

~ O

*

U_ U

O
* 0 0 o 0 '~ ~ T T
U ~ A ~ n * ~ ~ C'0~7 ~ c~ T T
U

U , r Wit' ~n 0 0 co cfl N
t~

f~ I~ CO C'~ ~"~
CO ~t M
-1~ T T CV N ' T T

U

W

W

u' yi ' _ , U U U U U

c~

Z

U

N

o U

z ~
z ~

oil o~

o z U

c Cfl T
T T

T

U

I I I ' a 2~.~1~~72 U o _ U

~c o 0 E ~ ~ o 0 * ~n ~'~ wi N T ~ c~
U

* ~ ~i ~t ~ o U I T N

T

00 O C4 I~ N d' ~L7 Cfl O T
b ~ ~ ~' M C'7 C~ CO ~ d' lf7 In T T T T T T T T T T
U
W
M
U U U U
I
O

*
* I

OTO ~ N T N
N

O

U

* °' o U_ o U T

c o ~ o uy v. '~ o n U ~ o ~ _ ~ n n - c n y n c ms ' I

s o U
-U

CO 1~ N d' ~ ~ M
ch N N N N O
O

T T T T T T N N N
N

U

W

W

~1 i Wi "

_ ~ u U u _ XI U U U

Z/

O

ii ~

* i iii iii i ii * i i i c N N

N N N

O

U

!ili i *~ o U o U T
c * u°~ ~ ~r O O N
U -a T n M ~r *°.~~ o a°y o o d°-U c~ T
b U ~ ~ ~ '.c? Wn O ~-' ~ N CO CO O O O T
T T T T T T ~ ~ T T
I

m C~ n *i II
~ *I *
Q n0 O O T
N N M C~ M
O
U

~~~~.~~ i'~
U_ U
E
U

U I v ~

c U

N

U

.

c~
~

U

W

W

_ X U
~

Ew~ o L

* Q

M

-a c o_ U

c * cps =

c~

c ~ .-a~

o .c ~ o o ~

U

~ i ~, m U_ U

c p p o ~

E o o o o * ~ n ~ ~ r U n n - n C O
o m n o 0 V ~ ~ o =d ''"' U
U ~ r~ ~c~ W n ~=N c~~
N N ~ r ~ 00 l(7 In 00 00 W
Io 0 *.
> > II

m U

i i ~.
o> C
U o U
o c c 0 0 °o U ~ o °o °o M
n A

U m c~
T
U
00 ~~ o~°oo~'o N N T T T 1~
H

>>

U

I'II
U_ U
c c c * ~° ~ p ~ 0 O
U ~ o 0 0 0 N A
n A
,°n ~ O O
o ~ o ~ o r ~ ~ T r CO
'b O o , , ~ ap O
~O
n ~ c~ COr7 ~ T N N 00 00 r r r r r H
H
W
*
*
x C

O

~7 ~ ~ N M
~t d' O

U

2~~~. ~~"~~

The compounds of the present invention may have asymmetric centers and may occur, except when specifically noted, as racemates, racemic mixtures or as individual diastereomers, or enantiomers, with all isomeric forms being included in the present invention. The term (+/-) is intended to encompass (+) optical isomers or (-) optical isomers or mixtures thereof.
When any variable (e.g., R) occurs more than one time in any constituent or in formula I, its definition on each occurrence is independent of its definition at every other occurrence. Also, to combinations of substituents and/or variables are permissible only if such combinations result in stable compounds.
As used herein except where noted, "alkyl" is intended to include both branched- and straight-chain saturated aliphatic hydrocarbon groups having the specified number of carbon atoms;
1 s '~alkenyl" is intended to cover both branched- and straight chain alkyl groups with at least one carbon-carbon double bond; "alkynyl" is intended to cover both branched- and straight chain alkyl groups with at least one carbon-carbon triple bond. "Halogen" or "halo" as used herein, means fluoro, chloro, bromo and iodo.
2 o As used herein, with exceptions as noted, "aryl" is intended to mean phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl or acenaphthyl.
The term heterocycle or heteroc,yclic, as used herein except where noted, represents a stable 5- to 7-membered monocyclic or stable 2s ~_ to 11-membered bicyclic heterocyclic ring; which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, and including any bicyclic group in which any of the above-defined heterocyclic rings is fused to a benzene ring. The heterocyclic ring may be attached at any heteroatom or carbon atom which results in the creation of a stable strucl:ure. Examples of such heterocyclic elements include piperidinyl, piperazinyl, 2-oxopiper-azinyl, 2-oxopiperidinyl, 2-oxopyrrolidinyl, 2-oxoazepinyl, azepinyl, - 20 - 1$793IA
pyrrolyl, 4-piperidonyl, pyrrolidinyl, pyrazolyl, pyrazolidinyl, imidazolyl, imidazolinyl, imidazolidinyl, py:ridyl, pyrazinyl, pyrimidinyl, pyridazinyl, oxazolyl, oxazolidiinyl, isoxazolyl, isoxazolidinyl, morpholinyl, thiazolyl, thiazolidinyl, isothiazolyl, quinuclidinyl, isothiazolidinyl, indolyl, quinolinyl, isoquinolinyl, benzirnidazolyl, thiadiazoyl, benzopyranyl, benzothiazolyl, benzoxazolyl, furyl, tetrahydrofuryl, benzofuranyl, tetrahydropyranyl, thienyl, benzothienyl, thiamorpholinyl, thiamorpholinyl sulfoxide, thiamorpholinyl sulfone, and oxadiazolyl.
1 a The compounds of the present invention can be synthesized by the following methods.

I I!

SCHEME I
CI CI
\ pivaloyl chloride I \
-~
methylene chloridE~
NH2 aqueous Na2C03 HN O
_1 to 1. 2 eq. n-BuLi/THF/0°C CI ~~
( C F3 2. CF3COOEt/0°C ~~ NH2 3. 3N HCl/reflux R-MgBr Fs~J'/R
CI \ ~OH
THF/O°C to RT I

1,1'-carbonyldiimidazole F33C 'R
CI \ O
THF/50°C I
H O

r In the synthesis of the benzoxazines of the present invention, the general method typically involves cyclization on a benzene nucleus as a final step. See Scheme I. The amino group of parachloroaniline is first protected with, e.g. pivaloyl chloride, to give 2. Other less preferable amino protecting groups include t-butox:y-carbonyl, acetate or isovaleroyl groups. About 2 equivalents of an alkyllithium are then reacted with 2, preferably n-butyl lithium. No other organo metallic compounds are suitable for this metalation step.
Subsequently, reaction with CF3COOEt followed by quenching gives 3.
i o The synthesis of the tertiary carlbinol 4 follows, by Grignard addition at the ketone of 3. The Grignard reagent must: be a salt of a divalent cation, e.g. Mg++ or Zn++. Monovalent cations are found unsuitable, such as Li+ or Na+. Suitable solvents include but are not limited to THF or ether. A wide range of temperature conditions i 5 are allowed between about 0°C and about room temperature.
Ring closure to produce the compounds of the present invention 5 is accomplished with condensing agents such as 1,1'-carbonyldiimidazole, phosgene, dimethylcarbonate, diphenylcarbonate, or di-(paranitrophenyl)carbonate. Cyclizatio:n can be accomplished with 20 ~y of these compounds, as well as a wide variety of others.
A specific instance of Scheme I is provided in Scheme IA.
It charts the synthesis of L-741,211, which is a racemate of Compound 37.2, as further provided in Example 6.
SCHEME IA
CI CI
t-g~cocl I w / NaOHIH~O

NH2 ~ NH
(100%) 1. 2 n-BuLiITHF O
-78°C->0°C/1 h CI~ ~ CF3 2. EtOOCCF3/0°c NH2 3. 3N HCI reflux (60%) A
1. EtMgBrITHF CI
50°C/1 h 2. A/1.5h/RT mn2 (73-74%) CI
1,1'-CDIITHF I ~ ~ ~O
(99%) / wN~
H O
(L-741,211 ) SCHEME II
CI ~3C
1. n-BuLi then ZnCl2 N 2. (Ph3F')4Pd/Cul/
H O 2-iodocyanobenzene CI. F3C~~ CN
~( N~
H O

Scheme II provides one method for derivatizing acetylene substitutions at the 4-position of the benzoxazine nucleus. By way of 2o illustration, Compound 6 is metalized, then a zinc salt is added. In the Heck reaction the catalyst tetrakis (triphenylphosphine)palladium(0) complexed with CuI is employed to give 7.
SCHEME III
N
Pyrrolidine, paraformaldehyde Cul F C
CI
N O
H

Scheme III illustrates substitution of a 4-acetylene group with an N-containing heterocycle. The Mar~r~ich reaction involves a condensation reaction of formaldehyde with the heterocycle, e.g.
pyrrolidine. Substitution on the terminal carbon follows in the presence of CuI as catalyst.
SCHEME IV
1 o O
CI O
COCI
H " Et3N/4-~DMAPICH2C12 t+/-) 1. Chromatography on Silica Gel 2. K2C03/H20/2-propanol Scheme IV illustrates the resolution of optical isomers of 3 o the compounds of Formula I or Formula IL In this example, (-) camphanic acid is the resolving agent. A wide variety of other resolving agents are suitable, including O-methyl mandelic acid chloride or Mosher s reagent. It is apparent to the skilled artison how to separate such isomers.

21~.~7~

Scheme IVA is specifically adapted to the resolution of L-741,211 in the isolation of L-743,726. Sef; Scheme IVA, and Example 6.
SCHEME IVA

CI (-)-Camphanyl chloride 4-DM,AP/Et3N/CHC13 N p H
(L-741,211 ) Crystallization from n I-lexane (90°,io recovery) CI
~ \ O
N~O n-BuOH/1 N HC1/60°C
to O
CI
(-) I \
N
H O
L-743,726 Compound 37.2 ~'~.0~~i'~~

SCHEME V
O PC15 CI CI t_guOK/DMSO
(42G/o) Cyclopropyl acetylene is preparE:d by Scheme V in accordance with published procedures, e.g. C. E. Hudson et al., J. Am.
Chem. Soc. 94, 1158 (1972) and W. Schoberth et al., Synthesis, 703 to (1972).
The compounds of this invention are useful in the preparation and execution of screening assays for antiviral compounds.
For example, the compounds of this invention are useful for isolating enzyme mutants, which are excellent screening tools for more powerful antiviral compounds. Furthermore, the compounds of this invention are useful in establishing or determining the binding site of other antivirals to HIV reverse transcriptase, e.g., by competitive inhibition. Thus the compounds of this invention axe commercial products to be sold for these purposes.
The compounds of the present irAVentions are useful in the inhibition of HIV reverse transcriptase, the prevention or treatment of infection by human immunodeficiency virus (HIV) and the treatment of consequent pathological conditions such as A117S. Treating AIDS or preventing or treating infection by HIV is defined as including, but not limited to, treating a wide range of states of HIV infection: AIDS, ARC
(AIDS related complex), both symptomatic a~c~d asymptomatic, and actual or potential exposure to HN. For example, the compounds of this invention are useful in treating infection lby HIV after suspected past exposure to HIV by e.g., blood transfusion, exchange of body fluids, 3 o bites, accidental needle stick, or exposure to patient blood during surgery.
The particular advantage of the compounds of this invention is their potent inhibition against HIV reverse transcriptase rendered resistant to other antivirals, such as L-697,661, which is 3-([(4,7-dichloro-1,3-benzoxazol-2-yl)methyl]-.amino)-5-ethyl-6-methyl-pyridin-2( 1 H)-one; or L-696,229, which is 3 -(2-( 1,3-benzoxazol-2-yl)ethyl]-5-ethyl-6-methyl-pyridin-2(1 H)-one; or AZT.
For these purposes, the compounds of the present invention may be administered orally, parenterally (inc;luding subcutaneous injections, intravenous, intramuscular, intrasternal injection or infusion techniques), by inhalation spray, or rectally, in dosage unit formulations containing conventional non-toxic pharmaceutically-acceptable carriers, adjuvants and vehicles.
Thus, in accordance with the prf;sent invention there is further provided a method of treating and a pharmaceutical composition for treating HIV infection and AIDS. The treatment involves administering to a patient in need of such treatment a pharmaceutical composition comprising a pharmaceutical carrier and a therapeutically-effective amount of a compound of the present invention.
i 5 These pharmaceutical compositions may be in the form of orally-administrable suspensions or tablets; nasal sprays; sterile injectable preparations, for example, as sterile injectable aqueous or oleagenous suspensions or suppositories.
When administered orally as a suspension, these 2o compositions are prepared according to techniques well-known in the art of pharmaceutical formulation and may contain microcrystalline cellulose for imparting bulk, alginic acid or sodium alginate as a suspending agent, methylcellulose as a viscosity enhancer, and sweeteners/flavoring agents known in the art. As immediate release 25 tablets, these compositions may contain microcrystalline cellulose, dicalcium phosphate, starch, magnesium stearate and lactose and/or other excipients, binders, extenders, disintegrants, diluents and lubricants known in the art.
When administered by nasal aerosol or inhalation, these 3 o compositions are prepared according to techniques well-known in the art of pharmaceutical formulation and may be prepared as solutions in saline, employing benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, fluorocarbons, and/or other solubilizing or dispersing agents known in the art.

,..

The injectable solutions or suspensions may be formulated according to known art, using suitable non-toxic, parenterally-acceptable diluents or solvents, such as mannitol, 1,3-butanediol, water, Ringer's solution or isotonic sodium chloride solution, or suitable s dispersing or wetting and suspending agents, such as sterile, bland, fixed oils, including synthetic mono- or diglycerides, and fatty acids, including oleic acid.
When rectally administered in tlhe form of suppositories, these compositions may be prepared by mixing the drug with a suitable 1 o non-irritating excipient, such as cocoa butter, synthetic glyceride esters or polyethylene glycols, which are solid at ordinary temperatures, but liquidify and/or dissolve in the rectal cavity to release the drug.
The compounds of this invention can be administered orally to humans in a dosage range of 1 to 100 mg/kg body weight in divided i s doses. One preferred dosage range is 0.1 to 10 mg/kg body weight orally in divided doses. Another preferred dosage range is 0.1 to 20 mg/kg body weight orally in divided doses. For combination therapy with nucleoside analogs, a preferred dosage range is 0.1 to 20 mg/kg body weight for the compounds of this invention administered orally in ao divided doses, and 50 mg to 5 g/kg body weight for nucleoside analogs administered orally in divided doses. It will be understood, however, that the specific dose level and frequency of dosage for any particular patient may be varied and will depend upon .a variety of factors including the activity of the specific compound employed, the metabolic 2s stability and length of action of that compound, the age, body weight, general health, sex, diet, mode and time of administration, rate of excretion, drug combination, the severity of the particular condition, and the host undergoing therapy.
The present invention is also directed to combinations of the HIV reverse transcriptase inhibitor compounds with one or more agents useful in the treatment of A117S. For example, the compounds of this invention may be effectively administered, whether at periods of pre-exposure and/or post-exposure, in combination with effective IIII
- 31 - 1$793IA
amounts of the AmS antivirals, immunomodulators, antiinfectives, or vaccines, such those in the following as Table.

TABLE

ANTIVIRALS

Drug Name Manufacturer Indication AL-721 Ethigen ARC, PGL

(Los Angeles, CA) HIV positive, AmS

i o Recombinant Human AIDS, Kaposi's Triton Biosciences Interferon Beta (Almeda, CA) sarcoma, ARC

Acemannan Carrington Labs ARC (See also i 5 (Irving, TX) immunomodulators) Cytovene Syntex sight threatening CMV

Ganciclovir (Palo Alto, CA) peripheral CMV

retiniti s d4T Bristol-Myers AIDS, ARC

Didehydrodeoxy- (New York, NY) thymidine ddI Bristol-Myers AmS, ARC

Dideoxyinosine (New York, NY) EL 10 Elan Corp, PLC HIV infection (Gainesville, GA) (See also immunomodulators) Drug Name Manufacturer Indication Trisodium Astra Pharm. CMV retinitis, HIV

Phosphonoformate Products, Inc. infection, other CMV

(Westborough, MA) infections Dideoxycytidine; Hoffman-La Roche; Aff~S, ARC

ddC (Nutley, NJ) to Novapren Novaferon Labs, Inc. HIV inhibitor (Akron, OH) Diapren, Inc.

(Roseville, MN, marketer) Peptide T Peninsula Labs AIDS

Octapeptide (Belmont, CA) Sequence 2 Zidovudine; AZT Burroughs Wellcorne AIDS, adv, ARC
o (Rsch. Triangle Park, pediatric AID S, NC) Kaposi's sarcoma, asymptomatic :HIV

infection, less severe HIV disease, neurological involvement, in combination with 3 therapies.
o Illi Dru Name Manufacturer Indication Ansamycin LM 427 Adria Laboratories ARC

(Dublin, OH) Erbamont (Stamford, CT) Dextran Sulfate Ueno Fine Chem. AmS, ARC, HIV

Ind. Ltd. positive asymptomatic i o (Osaka, Japan) Virazole Viratek/ICN asymptomatic HIV

Ribavirin (Costa Mesa, CA) positive, LAS, ARC

15 Alpha Interferon Burroughs Wellcome Kaposi's sarcoma, HIV

(Rsch. Triangle in combination Park, NC) w/Retrovir Acyclovir Burroughs Wellcome AIDS, ARC, asymptomatic HIV
positive, in combination with AZT.
2s Antibody which Advanced Biotherapy AIDS, ARC
neutralizes pH labile Concepts alpha aberrant Rockville; MD) Interferon in an immuno-adsorption COlUI11I1 iii Dru Name Manufacturer Indication L-697,661 Merck (Rahway, I~fJ) AmS, ARC, asymptomatic HIV

positive, also in combination with AZT.

L-696,229 Merck AmS, ARC, (Rahway, NJ) asymptomatic HIV

positive, also in combination with AZT.

L-735,524 Merck (Rahway, NJ) AmS, ARC, asymptomatic HIV

positive, also in combination with AZT.

IMMUNO-MODULATORS
Dru Name Manufacturer Indication AS-101 Wyeth-Ayerst Labs. AIDS
(Philadelphia, PA) 2s gropirimine Upjohn advanced AmS
(Kalamazoo, MI) Acemannan Carrington Labs, Inc. AmS, ARC
3 0 (Irving, TX) (See also antivirals) ~~0~~'~~

Dru Name Manufacturer Indication CL246,738 American Cyanamid AIDS, Kaposi's (Pearl River, NY) sarcoma Lederle Labs (Wayne, NJ) EL 10 Elan Corp, PLC HIV infection (Gainesville, GA) (See also antivirals) io Gamma Interferon Genentech ARC, in combination (S. San Francisco, CA) w/TNF (tumor necrosis factor) Granulocyte Genetics Institute AIDS
Macrophage Colony (Cambridge, MA) Stimulating Factor Sandoz (East Hanover, NJ) 2 o Granulocyte Hoeschst-Roussel AIDS
Macrophage Colony (Somerville, NJ) Stimulating Factor Immunex (Seattle, WA) 2s Granulocyte Schering-Plough AIDS
Macrophage Colony (Madison, NJ) Stimulating Factor AIDS, in combination w/AZT
3o HIV Core Particle Rorer seropositive HIV
Immunostimulant (Ft. Washington, PA) Dru Name Manufacturer Indication IL-2 Hoffman-La Roche AIDS, ARC, HIV, in Interleukin-2 (Nutley, NJ) combination w/AZT

Immunex Immune Globulin Cutter Biological pediatric AIDS, in Intravenous (human) (Berkeley, CA) combination w/AZT

to IMREG-1 Imreg AIDS, Kaposi's New Orleans, LA) sarcoma, ARC, PGL

IMREG-2 Imreg AIDS, Kaposi"s i s (New Orleans, LA;) sarcoma, ARC, PGL

Imuthiol Diethyl Merieux Institute AIDS, ARC

Dithio Carbamate (Miami, FL) Alpha-2 Schering Plough Kaposi's sarcoma 2o Interferon (Madison, NJ) w/AZT: AIDS

Methionine- TNI Pharmaceutical AIDS, ARC

Enkephalin (Chicago, IL) MTP-PE Ciba-Geigy Corp. Kaposi's sarcoma Muramyl-Tripeptide (Summit, NJ) Granulocyte Amgen A>DS, in combination 3 o Colon Stimulatin y g (Thousand Oaks, C.A) w/AZT
Factor r,""..

Dru Name Manufacturer Indication rCD4 Genentech AIDS, ARC
Recombinant (S. San Francisco, CA) Soluble Human CD4 Rocombinant Biogen AIDS, ARC
Soluble Human CD4 (Cambridge, MA) to Interferon Hoffman-La Roche: Kaposi's sarcoma Alfa 2a (Nutley, NJ) AIDS, ARC, in combination w/AZT
SK&F106528 Smith, Kline & French HIV infection Soluble T4 Laboratories (Philadelphia, PA) Thymopentin Immunobiology ~ HIV infection 2 0 Research Institute (Annandale, NJ) Tumor Necrosis Genentech ARC, in combination Factor; TNF (S. San Francisco, CA) w/gamma Interferon ANTI-INFECTIVE;S
3 o Dru Name Manufacturer Indication Clindamycin with Upjohn pCp Primaquine (Kalamazoo, MI) Fluconazolec Pfizer cryptococcal (New York, NY) meningitis, candidiasis 2~.~~.r~7~
- 3 ~ - 18793IA
Pastille Squibb Corp prevention of oral Nystatin Pastille (Princeton, NJ) candidiasis Ornidyl Merrell Dow PCP
Eflornithine (Cincinnati, OH) Pentamidine LyphoMed PCP treatment Isethionate (IM & IV) (Rosemont, IL) to Piritrexim Burroughs Wellcome PCP treatment (Rsch: Triangle Park, NC) Pentamidine Fisons Corporation PCP prophylaxis isethionate for (Bedford, MA) inhalation 2o SPiramycin Rhone-Poulenc cryptosporidial Pharmaceuticals diarrhea (Princeton, NJ) Intraconazole- Janssen Pharm. histoplasmosisa 851211 (Piscataway, NJ) cryptococcal meningitis Trimetrexate Warner-Lambent PCP

OTHER

Dru Name Manufacturer ' Indication Recombinant Human Ortho Pharm. Corp. severe anemia assoc.

Erythropoietin (Raritan, NJ) with AZT therapy Dru Name Manufacturer Indication Megestrol Acetate Bristol-Myers treatment of anorexia (New York, NY) assoc.w/A117S
Total Enteral Norwich Eaton diarrhea and Nutrition Pharmaceuticals malabsorption related (Norwich, NY) to Aff~S
io It will be understood that the scope of combinations of the compounds of this invention with AIDS antivirals, immunomodulators, anti-infectives or vaccines is not limited to the list in the above Table, but includes in principle any combination with any pharmaceutical i s composition useful for the treatment of AIDS. For example, a compound of Formula I or Formula II may b~e suitably administered in combination with a nucleoside analog having known biological activity against HIV reverse transcriptase: Appropriate nucleoside analogs are generally chain terminators and include AZT, ddC, ddI, D4T, HEPT
2o and 3'-fluoro-2',3'-dideoxythymidine.
AZT is synthesized by the methods of J.P. Horwitz et al., J.
Org. Chem. 29, 2076 (1964); R.P. Glinski et al., J. Org. Chem. 3~, 4299 (1973); C.K. Chu et al., Tetrahedron Letters 29, 5349 (1980.
Application of AZT -as a therapeutic drug in the treatment of AIDS is 2s disclosed in U.S. 4,724,232.
The compound ddC is synthesized by the methods of J.P.
Horwitz et al., J. Org. Chem. 32, 817 ( 1967); R. Marumoto, Chem.
Pharm. Bull. 22, 128 (1974); and T.-S. Lin et al., J. Med. Chem. 30, 440 (1987).
3 o D4T is synthesized by the methods of Herdewijn, P. et al., J. Med. Chem. 30, 1270 ( 1987).
HEPT is synthesized by the methods of Miyasaka, T. et. al.
J. Med. Chem. 32, 2507 (1989); and A. Rosowsky, J. Med. Chem. 24, 1177 ( 1981 ). The synthesis of ddC, ddI and AZT are also described in EPO 484071.

The compound 3'-fluoro-2',3'-dideoxythymidine is synthesized by the procedures of Herdewijn, P. et al., J. Med. Chem. 30, 1270 (1987). The compound L-735,524 is N-(2(R)-hydroxy-1 (S)-indanyl)-2(R)-phenylmethyl-4-(S)-hydroxy-5-( 1-(4-(3-pyridylmethyl)-s 2(S)-N'-(t-butylcarboxamido)-piperazinyl))-pentaneamide, or pharmaceutically acceptable salt thereof. L-697,661 or '661' is 3-((4,7-dichloro-1,3-benzoxazol-2-yl)methyl)-amino)-5-ethyl-ethyl-6-methyl-pyridin-2( 1 H)-one; L-696,229 is 3-[2-( 1,3-benzoxazol-2-yl)-ethyl]-5-ethyl-6-methyl-pyridin-2( 1 H)-one. The synthesis of L-697,661 and L-to 696,229 is described in EPO 484071, and EPO 462800.
Preferred combinations are simultaneous, intermittent, or alternating treatments of L-743,726 with or without an inhibitor of HIV
protease. An optional third component in the combination is a nucleoside inhibitor of HIV reverse transcriptase, such as AZT, ddC or ddI. A preferred inhibitor of HIV protease is L-735,524. Other preferred inhibitors of HIV reverse transcriptase include L-697,661.
These combinations may have synergistic effects on limiting the spread of HIV. Preferred combinations include the following: ( 1 ) L-743,726 2 o with L-735,524, and, optionally any of L-697,661, AZT, ddI or ddC;
(2) L-743,726 and any of L-697,661, AZT, ddI or ddC.
Pharmaceutically acceptable salts of these combinations are also included.

(+/-) 4-( 1,1,1,-trifluoromethyl)-4-( 1-buten-4-yl)-6-chloro-1,4-dihydro-2H-3.1-benzoxazin-2-one' Compound 15~
3o Step A: N-(4-chlorophenyl)-2 2-dimeth ly_nropanamide To a SL 3 necked round bottomed flask with an overhead stirrer was added 4-chloroaniline (127.57 g, 1 mole), 1200 mL of CHC13, and 1200 mL of saturated aqueous Na2C03 solution. An addition funnel was attached to the flask and charged with 2,2-dimethylpropanoyl chloride ( 129 mL, 1.05 mole). The acid chloride was added dropwise to the vigorously stirred mixture over lh. T'he resulting mixture was stirred at ambient temperature for an additional 23h. Some of the product separated from the mixture as white crystals.
These crystals were collected by filtration. 'fhe filtrate was transferred to a separatory funnel and the layers were separated. The chloroform layer was washed with water and brine. Drying (MgS04), filtration, and removal of the solvent in vacuo gave additional product. The; two portions of product were combined and recr,~stallized from boiling 1 o EtOAc-hexanes to give 185.6 g of N-(4-chlorophenyl)-2,2-dimethyl propanamide as a white crystalline solid.
Step B: 1-(2-amino-5-chloro~hen~l]-2.2.2-trifluoroethanone To an oven dried, 3L, 3 necked round bottomed flask with 1 s an overhead stirrer, argon inlet, and a 500 mL oven dried addition funnel was added N-(4-chlorophenyl)-2,2-dirnethylpropanamide ( 100 g, 472 mmol) and dry THF ( 1 L). This solution was cooled in an ice bath to 0°C and the addition funnel was charged v~rith n-butyllithium (387 mL
of a 2.5 M solution in hexanes, 968 nunol). 'The n-butyllithium solution 20 was added dropwise to the amide solution slowly over lh, maintaining the temperature below +5°C. The resulting solution was aged at 0°C for lh during which time an orange precipitate formed. To this mixture was added ethyl 1,1,1-trifluoroacetate ( 115 mL, 968 mmol), dropwise over lh. The resulting clear solution was aged an additional 30 min.
25 The reaction was quenched with 5% aqueous HCI. The mixture was diluted with 1 L of EtOAc and the layers were separated. The organic phase was washed with brine, dried (MgS04;), filtered and concentrated in vacuo, to give 160 g of a yellow oil. This material was suspended in 1 L of 3N aqueous HCl and the solution was heated at reflux for 24h.
3 o The cooled solution was diluted with 1 L of EtOAc and the mixture was made basic with concentrated NH40H. The payers were separated and the organic phase was washed with brine, dried (MgS04), filtered, concentrated in vacuo, and chromatographed on 1.5 kg of silica gel using 15% EtOAc in hexane as eluant. The c;hromatographed material 2~~..~'~~' was recrystallized from boiling hexane to give 57 g (54%) of pure 1-(2-amino-5-chlorophenyl)-2,2,2-trifluoroethanone as bright yellow crystals, mp: 91-92°C. 1H NMR (CDC13): Fi 6.46 (br s, 2H), 6.69 (d, 1 H, J=9.2 Hz), 7.32 (dd, 1 H, J=2.4, 9.2 Hz), 7.70 (d, 1 H, J=2.4 Hz).
Step C: (+/-) 2-(2-Amino-5-chlorophenyl)-1,1,1-trifluoro-S-hexen-2-0l To a 300 mL oven dried 3 necked, round bottomed flask 1 o Wth a stirring bar, argon inlet, addition funnel and a reflux condenser was added magnesium (turnings, 3.03 g, 125 mmol) and dry THF (75 mL). To this wel l stirred mixture was added 4-bromo-1-butene ( 12.0 mL, 11$.21 mmol) at such a rate as to maim<~in a gentle reflux. ~Nhen the addition was complete, the mixture was aged 30 min then cooled to i s 0°C m an ice bath. To this well stirred solution was added a solution of 1-(2-amino-5-chlorophenyl)-2,2,2-trifluoroethanone (5.00 g, 22.36 mmol) in THF (35 mL), dropwise over 30 min. The cooling bath was allowed to expire and the mixture was stirred 20 h at ambient temperature. The reaction was diluted with EtOAc and 10% aqueous 2 o citric acid. This mixture was stirred for 4 h. The layers were separated and the organic phase was washed with aqueous NaHCO3 and brine. Drying (MgS04), filtration, removal of the solvent in vacuo, and chromatography on 300g of silica gel using 15% EtOAc in hexane as eluant gave 4.80 g of (+/-) 2-(2-amino-5-chlorophenyl)- l , l , l -25 trifluoro-5-hexen-2-of as a yellow solid.
Step D: (+/-) 4-( 1,1,1,-trifluoromethyl)-~4-( 1-buten-4-yl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin.-2-one To a 200 mL round bottomed flask with a stirring bar, 3 o argon inlet and a reflux condenser was addedl (+/-) 2-(2-Amino-5-chlorophenyl)- l , l , l -trifluoro-5-hexen-2-of (4.80 g, 17.16 mmol), 1,1'-carbonyldiimidazole (13.91 g, 85.81 mmol) and dry THF (75 mL).
This mixture was heated at 60°C for 18h. The cooled reaction mixture was diluted with EtOAc and washed with H20 (3X 200 mL) and brine (250 mL). Drying (MgS04), filtration, removal of the solvent in ~~.Q.~'~2 vacuo, followed by recrystallization from boiling EtOAc-hexane gave 3.22g of (+/-) 4-( 1,1,1,-trifluoromethyl)-4( 1. -buten-4-yl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one as a white crystalline solid, rnp: 165-166°C. 1 H NMR (CDC13): $ 1.99 (m, 1 H), 2.09-2.40 (m, 3H), 5.00 (d, s 1 H, J=1.4 Hz), 5.03 (dd, 1 H, J=1.4, 7.9), 5.78 (m, 1 H), 6.85 (d, 1 H, J=8.6 Hz), 7.21 (br s, 1 H), 7.35 (dd, 1 H, J=2.2, 8.6 Hz), 9.63 (br s, 1 H).

to (+/-) 6-Chloro-4-ethynyl-4-( 1,1,1-trifluoromethyl)-1,4-dihydro-2H-3,1-benzoxazin-2-one (Compound 26) Step A: 2-(2-amino-5-chlorophenyl)-1,1,1-trifluoro-3-butyn-2-of i s A 500 ml 3-neck round bottom :flask fitted with an addition funnel, argon inlet, stirring bar and digital thermometer was charged with ethynyl magnesium bromide (0.5M in l:~exane; 268 mL, 134 mmol) then chilled to -78°C. Dropwise addition of a solution of 1-(2-amino-5-chlorophenyl)-2,2,2-trifluororethanone (6.0 g, 26.8 mmol) in 50 mL
2o T~ was completed after 15 minutes keeping the temperature <_ -55°C.
The reaction mixture was stirred for 16 h after slowly warming to room temperature. The dark red solution was quenched at -5°C by dropwise addition of saturated aqueous ammonium chloride solution (60 mL). Ethyl acetate extraction followed by washes of 10% citric acid, 2s saturated sodium bicarbonate, water and brine afforded 8.5 g crude product after drying over sodium sulfate, filtration, and evaporation of solvent. Purification via flash chromatography using 15-20% ethyl acetate : hexane afforded pure 2-(2-amino-5~-chlorophenyl)- l , l , l -trifluoro-3-butyn-2-of (5 g light brown oil, 75% yield).
Step B: (+/-) 6-Chloro-4-ethynyl-4-( 1,1,1-trifluoromethyl)- n ,4-dihydro-2H-3,1-benzoxazin-2-one A THF solution of 2-(2-amino-_'i-chlorophenyl)-1,1,1-trifluoro-3-butyn-2-of (5.0 g, 20.0 mmol in 225 mL THF) was treated with l , l'-carbonyldiimidazole ( 13.0 g, 80.0 rnmol) and heated in an oil ~~.0~.~ ~~i~

bath at 60°C for 17 h. The THF was remove;d in vacuo, the residue dissolved in ethyl acetate then washed with 10% citric acid, sodium bicarbonate, water and brine before drying over sodium sulfate.
Following filtration and evaporation in vacuy the crude product was isolated (3.6 g) and recrystallized from ethyl acetate : hexane. The product (+/-) 6-chloro-4-ethynyl-4-( 1,1,1-trifluoromethyl)-1,4-dihydro-2H-3,1-benzoxazin-2-one was isolatf:d as a white crystalline solid (3.22 g, 58.4% yield): mp 226-227°C. 1H-NMR (CDC13 + trace DMSO): 8 3.16 (s, 1 H), 6.98 (d, J=3.3 Hz, 1 H), 7.35 (m, 1 H), 7.,51 (s, to 1 H), 10.66 (s, 1 H).

i 5 (+/-) 6-Chloro-4-( 1,1,1-trifluoromethyl)-4-[(3-( 1-pyrrolidinyl))-1-prop~nyll-1.4-dihydro-2H-3 1-benzoxazin-2-one (Compound 7) A dioxane solution of (+/-) 6-chloro-4-ethynyl-4-( 1,1,1-trifluoromethyl)-1,4-dihydro-2H-3,1-benzoxazin-2-one ( 150 mg, 0.544 mmol), pyrrolidine (52.2 ~.L, 0.626 mmol), paraformaldehyde (20.5 2o mg~ 0.681 mmol), acetic acid (31.1 pL, 0.544 mmol) and copper (I) chloride (20.5 mg, 0.207 mmol in 3.5 ml dio:~ane) was heated to 50°C
in an oil bath for approximately 2 h. The reaction mixture was quenched into 2N HCl and extracted with ethyl acetate. The aqueous layer was neutralized with solid potassium carbonate and extracted with 25 ethyl acetate (3x). The combined extracts were washed with water and brine before drying over sodium sulfate to of ford 140 mg crude product. Chromatographic purification on silica gel and recrystallization from ethyl acetate : hexane afforded crystalline (+/-) 6-chloro-4-( 1,1,1-trifluoromethyl)-4-[(3-( 1-pprrolidinyl))-1-propynyl]-1,4-dihydro-2H-3,1-benzoxazin-2-one (89 m~;, 46% yield): MP 160-161°C (dec). 1H-NMR (CDC13): 8 1.85-1.89 (m, 4H), 2.68-2.71 (m, 4H), 3.67 (s, 1 H), 6.88 (d, J= 8.55 Hz, 1 H), 7.40 (dd, J= 2.19, 8.54 Hz, 1 H), 7.55 (s, 1 H), 9.45 (s, 1 H).

~~.0~.~~F~

(+/-.) 6-Chloro-4-(2-cyanophenyl)ethynyl-4-( 1,1,1-trifluoromethyl)-1,4-dihvdro-2H-3,1-benzoxazin-2-one (Compound 2) A solution of 6-Chloro-4-ethynyl-4-( 1,1,1-trifluoro-methyl)-1,4-dihydro-2H-3,1-benzoxazin-2-one (138 mg, 0.5 mmol) in 3 mL of dry THF was stirred at -78°C. To this solution was added 0.4 mL (1.0 mmol) of n-butyllithium, 2.5 M in hexane. The anion was aged for 10 minutes at -78°C then 1 mL of 2:nC12(1 M in ether) solution was added. The reaction mixture was allowf:d to stir at -78°C for 15 minutes, the ice bath was removed and the rr.~ixture slowly warmed to l 0 0°C over 30 min. To the reaction mixture was added a solution of 2-iodobenzonitrile (149 mg, 0.65 mmol) in 2 mL THF, followed by tetrakis(triphenylphosphine)palladium(0) (56~ mg, 0.05 mmol). The reaction was allowed to warm to r.t. and continued to stir over l.'~
hours. The reaction mixture was quenched with 10 mL of 2N HCI, i s extracted with 2x200 mL EtOAc and the combined extracts were washed with H20, brine and dried over MgS04. The solvent was removed to give 195 mg of an oil which was flashed chromatographed on silica gel (20% EtOAc in hexane) to afford 60 mg of the unreacted starting material and 35 mg of the coupled product. The latter was 2o t~~rated with ether to yield 25 mg of (+/-) 6-Chloro-4-(2-cyanophenyl)ethynyl-4-( 1,1,1-trifluoromethyl)-1,4-dihydro-2H-3,1-benzoxazin-2-one. mp: 245-246°C FAB. MS M+1=377 m/e.
1 H NMR (CDCl3 ): 8 6.82-6.85 (d, J=8.5 Hz, 1 H); 7.40-7.44 (dd, J=2.1, 2 s 8-5 Hz, 1 H); 7.56-7.79 (m, SH); 8.00 (s, 1 H).

(+/-) 4-( 1-Chloro-1,1-difluoromethyl)-4-(2-p~henylethynyl)-6-chloro-3 0 1.4-dihydro-2H-3,1-benzoxazin-2-one (Compound SO
Ste~A: 1-(2-amino-5-chlorophen ly )-2-clhloro-2,2-difluoroeW anone To an oven dried, 300 mL, 3 necked round bottomed flask with a magnetic stirring bar, argon inlet, and a 100 mL oven dried addition funnel was added N-(4-chlorophenyl)-2,2-dimethyl-2~~~.'~'~~

propanamide (10 g, 47.2 mmol) and dry THF (100 mL). This solution was cooled in an ice bath to 0°C and the addiction funnel was charged with n-butyllithium (38.7 mL of a 2.5 M solnation in hexanes, 96.8 mmol). The n-butyllithium solution was added dropwise to the amide solution slowly over 1 h, maintaining the temperature below +5°C. The resulting solution was aged at 0°C for lh during which time an orange precipitate formed. To this mixture was addled ethyl 1-chloro- l , l -difluoroacetate (10:2 mL, 96.8 mmol), dropwise over 15 min. The resulting clear solution was aged an additional 30 min. The reaction 1 o was quenched with 5% aqueous HCI. The mixture was diluted with 1 L
of EtOAc and the layers were separated. The organic phase was washed with brine, dried (MgS04), filtered and concentrated in vacuo, to give 160 g of a yellow oil. This material was suspended in 200 mL of 3N
aqueous HCl and the solution was heated at reflux for 24h. The cooled i 5 solution was diluted with 500 mL of EtOAc and the mixture was made basic with concentrated NH40H. The layers were separated and t:he organic phase was washed with brine, dried (MgS04), filtered, concentrated in vacuo, and chromatographed on 350 g of silica gel using 15% EtOAc in hexane as eluant. The chrom;atographed material was 2 o recrystallized from boiling hexane to give 5.:5 g of pure 1-(2-amino-5-chlorophenyl)-2-chloro-2,2-difluoroethanone as bright yellow crystals, mp: 55-56°C. 1H NMR (CDCl3): 8 6.43 (br s, 2H), 6.69 (d, 1H, J=9.0 Hz), 7.31 (dd, 1 H, J=2.4, 9.0 Hz), 7.80 (d, 1 H, J=2.4 Hz).
Ste~B: (+/-) 2-(2-amino-5-chlorophenyll)-4-phenyl-1-chloro-1,1-difluoro-3-butyn-2-of To a 100 mL, 3 necked, oven dried round bottomed flask, with a stirring bar, argon inlet, reflux condenser, and a septum was 3 o added ethynyl benzene (2.13 g, 20.83 mmol)., dry THF (50 mL) and ethyl magnesium bromide (6.94 mL of a 3.Orv_I solution in ether). This mixture was aged 2h at ambient temperature then a solution of 1-(2-amino-5-chlorophenyl)-2-chloro-2,2-difluoroethanone ( 1.00 g, 4.17 mmol) in THF (6 mL) was added with a syringe. The resulting orange-red solution was stirred at ambient temperature for 2l.Sh. The reaction was quenched by addition of 1N HCl (50 mL) then diluted with EtOAc.
The solution was then made basic with concentrated NIH40H and the layers were separated. The organic phase w<~s washed with water and brine. Drying (MgS04), filtration, removal of the solvent in vacuo, s and chromatography on silica gel using 20% EtOAc in hexane as eluant gave 1.02 g of (+/-) 2-(2-amino-5-chlorophe:nyl)-4-phenyl-1-chloro-1,1-difluoro-3-butyn-2-of as an off white solid. 1 H NMR (CDC13): b 4.42 (br s, 2H), 5.10 (br s, 1 H), 6.65 (d, 1 H, J=8.5 Hz), 7.15 (dd, 1 H, o J=2.4, 8.5 Hz), 7.38 (m, 3H), 7.55 (m, 2H), '7.70 (d, J=2.4 Hz).
Step C: (+/-) 4-( 1-Chloro-1,1-difluorom~ethyl)-4-(2-phenyl-ethynyl)-6-chloro-1,4-dih, d~H-3, 1-benzoxazin-2-one To a 100 mL round bottomed flask with a stirring bar, i s reflux condenser, and an argon inlet was addled (+/-) 2-(2-amino-5-chlorophenyl)-4-phenyl-1-chloro-1,1-difluoro-3-butyn-2-of (0.81 g, 2.37 mmol), dry THF (25 mL), and 1,1'-carbonyldiimidazole ( 1.919 g, 11.84 mmol). This solution was heated at 60°C for 20h. The cooled reaction mixture was diluted with EtOAc anf~ washed with O.SN HCI, H20, and brine. Drying (MgS04), filtration, and removal of the solvent in vacuo gave 890 mg of an oil. This material was chromatographed on 80 g of silica gel using :ZO% EtOAc in hexane as eluant. The chromatographed material was recrystallized from boiling EtOAc-hexanes to give 507 mg, (58%) of (+/-) 4-( 1-chloro-1,1-2 s difluoromethyl)-4-(2-phenylethynyl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one as white needles, mp: 154-155°C. 1H NMR (CDC13):
8 6.89 (d, 1 H, J=8.4 Hz), 7.35-7.48 (m, 4H), 7.56 (m,2H), 7.64 (br s, 1 H), 9.19 (br s, 1 H).
3 o EXAMPLE 5 (-) 6-Chloro-4-phenylethynyl-4-trifluorometllyl-1,4-dihydro-2H-:3,1-benzoxazin-2-one (Compound 4) Step A: 2-(2-Amino-5-chlorophenyl)-4-phenyl-1,1,1-trifluoro-3-butyn-2-of A solution of lithio phenylacetylide, prepared from 4.83 rnL of phenylacetylene (0.044 mol) and 17.2 mL of a 2.5 N solution of n-butyllithium in hexane (0.043 mol) in 50 nriL of THF at -78°C, was treated with 11.4 g of magnesium bromide etherate (0.044 mol) over 5 minutes. The mixture was allowed to warm to -20°C and stirring under argon was continued for 30 minutes. The mixture was then cooled to -60°C and a solution containing 2.5 g (0.011 mol) of l-(2-amino-5-1 o chloro)-2,2,2-trifluoromethylethanone, previously complexed with an equivalent (2.8 g, 0.011 mol) of magnesium bromide etherate in 25 mL
of THF, was added. The reaction mixture was allowed to stir at 15° for one hour before being cooled to 0°C and treated dropwise with a mixture of 30 mL each of saturated aqueous ammonium chloride solution and water. The mixture was extracted with 2 x 100 mL
portions of ethyl ether, the combined organic: phases were washed with brine and dried over MgS04. Removal of the drying agent and solvents left 6 g of an oil which was flash chromatographed on silica gel, eluting with 20% EtOAc in hexane, to afford 2.5 g of 2-(2-amino-5-chloro-2 o phenyl)-4-phenyl-1,1,1-trifluoro-3-butyn-2-ol. 1 H-NMR (CDC13): 8 4.63 (br s, 3H), 6.69 (d, J=8.5 Hz, 1 H), 7.15 (d, J= 2 Hz, 1 H), 7. ll 7 (d, J=2 Hz, 1 H), 7.35-7.44 (m, 3H), 7.53-7.56 (rn, 2H), 7.66 (d, J=2 Hz, 1 H). FAB MS M+H = 326 m/e.
Step B: (~) 6-Chloro-4-phenylethynyl-4-trifluoromethyl-1.4-dihydro-2H-3,1-benzoxazin-2-one (Compound 12) A solution of 2-(2-amino-5-chlo~rophenyl)-4-phenyl-l,l,l-trifluoro-3-butyn-2-of (2.0 g, 6.1 mmol) and 11.0 g ( 12.0 mmol) of 3 0 1,1'-carbonyldiimidazole in 300 mL of dry THF was stirred under argon at SS°C for 24 hours. The solvent was removed on a rotary evaporator and the residue was partitioned between 200 mL of ether and 400 mL of water. The layers were separated and the aqueous extracted once more with ether. The combined ether extracts were washed with 2 x 200 mL 10% citric acid and then with brine before 2~0~.~s'~~

drying over MgS04. Removal of the drying agent and solvent provided 1.5 g (70%) of the crude title compound as a.n oil. Trituration with ether-hexane afforded 875 mg of (~) 6-chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one as a white solid, partial melt at 137°, clear at I47°C. 1 H-NMItZ (CDC13): 8 6.92 (d, J=8 Hz, I H), 7.30-7.49 (m, 4H), 7.58-7.65 (m, 3la), 8.99 (s, 1 H).
Step C: 6-Chloro-1-( 1 S)-camphanoyl-4-phenylethynyl-4-trifluoro-1 o methyl-1,4-dihvdro-2H-3 1-benzoxazin-2-one To a solution containing (~) 6-clhloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxa;zin-2-one (2.24 g, 6.37 mmol), 4-dimethylaminopyridine (0.10 g, 0.8 mmol), and (-) camphanic acid chloride (2.07 g, 9.55 mmol) in 60 mL of dry 1 s dichloromethane, stirred under argon in an ice bath, was added triethylamine (2.22 mL, 15.9 mmol). The cooling bath was removed and the reaction was allowed to proceed at room temperature. When the reaction was complete by thin layer chromatography (Si02, 4%
EtOAc in CHC13), the solution was diluted with 200 mL of CHC13 and 2 o washed twice with 10% citric acid, then with brine. Upon drying (MgS04) the solvent was removed on a rotary evaporator and the foamy reside was subjected to flash chromatography, eluting with CHC13. There was obtained 575 mg of diastereomer I of 6-chloro-(1S)-camphanoyl-4-phenylethynyl-4-trifluorometh~yl-1,4-dihydro-2H-3,1-2s benzoxazin-2-one as an oil, IH-NMR (CDCI's): 8 0.85 (s, 3H), 1.08 (s, 3H), 1.22 (s, 3H), 1.73-1.85 (m, I H), 1.92-2.08 (m, 1 H), 2.50-2.67 (m, 2H), 7.30-7.79 (m, 8H). This was followed b~y 1.52 g of mixed fractions (diastereomers I and II). Continued elution afforded 680 mg of the slower-moving diastereomer (II) of the title compound which, 3 o upon trituration with an ether/hexane mixture, gave clumps of white needles, mp 177-178.5°C; 1H-NMR (CDC13;): 8 0.83 (s, 3H), 1.12 (s, 3H), I .23 (s, 3H), 1.73-1.86 (m, 1 H), 1.93-2.06 (m, 1 H), 2.50-2.63 (m, 2H), 7.38-7.51 (m, 4H), 7.49-7.62 (m, 2H), 7,.72 (d, J=9 Hz, 1 H), 7.76 (d, J=2 Hz, 1 H).

The 1.52 g of isomer mixture from the flash chromatography was dissolved in 75 mL of ether, the solution diluted with 50 mL of hexane, and then seeded with a crystal of isomer II.
Slow crystallization afforded an additional 385 mg of isomer II which was recrystallized from ether/hexane to give >96% diastereomerically pure material by HPLC.
Step D: (-) 6-Chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3 , l -benzoxazin-2-one 1 o The crystalline diastereomer(II) of 6-chloro-1-( 1 S)-camphanoyl-4-phenylethynyl-4-trifluorometlhyl-1,2-dihydro-4(H)-3,1-benzoxazin-2-one (53 mg, 0.10 mmol) was dissolved in 8 mL of 2-propanol at 45°C under an atmosphere of argon. To the solution was added 0.27 mL of a 10% aqueous solution of K2C03. Stirring was 15 continued for 10 min., by which time all of the starting material had been consumed (TLC, Si02, 4% EtOAc in CHC13). The solution was concentrated in vacuo and the residue taken rap in ether. After washing with 0. I N HCl and brine, the ether solution was dried (MgS04), filtered and evaporated in vacuo to an oily solid which was purified by Si02 2o chromato ra h eluant 5% 2 ro anol in hexane.
g P Y~ -P p (-) 6-Chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3, I -benzoxazin-2-one was obtained as white needles from ether/hex;ane, m.p. 178-179°C;
[a]D20 = - 92.5° (CHC13, c=0.0012 g mL-I ),; I H-NMR (CDCl3): 8 6.87 2 s (d, J=8.5 Hz, 1 H), 7.37-7.50 (m, 4H), 7.56-7.63 (m, 3H), 8.60 (s, 1 H).
Step E: (+) 6-Chloro-4-phenylethynyl-4-trifluoromethyl 1,4-dihydro-2H-3,1-benzoxazin-2-one (Compound 37 (+) 6-Chloro-4-phenylethynyl-4-trifluoromethyl-1,4-3 o dihydro-2H-3,1-benzoxazin-2-one was prepared from the non-crystalline product of Step C, diasteromer I, in a manner according to Step D: m.p. 178-179°C; [a]D20=+ 87.6° (CHCl3, c=0.0050 g mL-l;
1H-NMR(CDC13): 8 6.87 (d, J=8.5 Hz, 1H), 7.37-7.50 (m, 4H), 7.56-7.63 (m, 3H), 8.60 (s, 1H).

(-) 6-Chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one(L- 743,726, Compound 37.2) and (+) 6-Chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-~dihydro-2H-3,1-benzoxazin-2-one (L- 743 725) Step A: 2-(2-Amino-5-chlorophenyl)-4-cyclopropyl-1,1,1-trifluoro-3-butyn-2-of 1 o A solution of bromomagnesium cyclopropylacetylide, was prepared from 23 g of cyclopropylacetylene (0.348 mol) in 250 mL of THF by dropwise addition of 116 mL of a 3.0 M solution of ethylmagnesium bromide in ether (0.348 mol) over 1 h. This solution was maintained at 0°C for lh, then at 40°C for 3h. To this solution, i5 recooled to 0°C, 15.56 g of 1-(2-amino-5-chlorophenyl)-2,2,2-trifluoromethylethanone (0.0696 mol), was added as a solid, portionwise over 5 min. The reaction mixture was allowed to stir at 0°
for 1.5 hours. The reaction was quenched at 0°C by dropwise addition of 700 mL of saturated aqueous ammonium chloride solution. The 2 o mixture was extracted with 2 x 400 mL portions of ethyl acetate, the combined organic phases were washed with hrine and dried over MgS04. Removal of the drying agent and solvents left a yellow solid.
This material was recrystallized from boiling: hexanes (100 mL final volume) to afford 14.67 g of 2-(2-amino-5-chlorophenyl)-4-2 5 cyclopropyl-1,1,1-trifluoro-3-butyn-2-ol. A second cro 2.1 p ( g) was obtained from concentrating the mother liquors. mp: 153-154°C. 1H-NMR (CDC13) : 8 0.84 (m, ZH), 0.90 (m, 2~t), 1.38 (m,lH), 4.50 (br s, 3H), 6.69 (d, J = 8.5 Hz, 1 H), 7.13 (dd, J = 2.5, 8.5 Hz, 1 H), 7.55 (d, J
= 2.5 Hz, 1 H).
Step B: (~) 6-Chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4 dihydro-2H-3,1-benzoxazin-2-one (L-741,211 A solution of 2-(2-amino-5-chlorophenyl)-4-cyclopropyl-1,1,1-trifluoro-3-butyn-2-of ( 15.00 g, 0.0518 mol) and 41.98 g (0.259 mol) of 1,1'-carbonyldiimidazole in 250 mL of dry THF was stirred under argon at 55°C for 24 hours. The solvent was removed on a rotary evaporator arid the residue was partitioned between 500 mL of ethyl acetate and 400 mL of water. The layers were separated and the aqueous phase was extracted once more with ethyl acetate. The combined ethyl acetate extracts were washed with 2 x 200 mL of 2%
aqueous HCI, saturated aqueous NaHC03, aald brine. Drying over MgS04, filtration, and removal of the solvent in vacuo provided 16.42 g of the title compound as a solid.. Recrystallization from ethyl acetate-1 o hexane afforded 12.97 g of analytically pure (~) 6-chloro-4-cyclo-propylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one as a white crystals. mp: 178-180°C. 1H-NMfR (CDC13) : 0.85 (rn, 2H), 0.94 (m, 2H), 1.40 (m, 1 H), 6.81 (d, J = 8.5 :Hz, 1 H), 7.37 (dd, J = 2.5, 8.5 Hz, 1 H), 7.49 (d, J = 2.5 Hz, 1 H), 8.87 (br s, 1 H).
St. ep C: 6-Chloro-1-( 1 S)-camphanoyl-4-cyclopropylethynyl-4-trifluoromethyl-1.4-dihydro-2H-3 1-benzoxazin-2-one To a solution containing (~) 6-chloro-4-cyclopropyl-ethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one ( 12.97 g, 0.041 mol), 4-dimethylaminopyridine (1.02 g, 0.0083 mol), and (-) camphanic acid chloride ( 14.22 g, 0.06556 rr~ol) in 350 mL of dry dichloromethane, stirred under argon in an ice bath, was added triethylamine (22.84 mL, 0.164 mol). The cooling bath was removed and the reaction was allowed to proceed at room temperature. After 75 min. the reaction was judged complete by thin layer chromatography (Si02, 4% EtOAc in CHCl3), and the solution was diluted with 500 mL
of CHCl3 then washed with 10% citric acid (2X), water ( 1 X), and brine (1X). Drying (MgS04), filtration, and removal of the solvent _in _vacuo left a colorless foam. This material was triturated with 200 mL of 3 o boiling hexane. On cooling to room temperature the desired diastereomeric camphanate imide precipitated.. The solid was collected on a frit, washed with a little cold hexanes and dried in vacuo to give 7.79g of 6-chloro-1-( 1 S)-camphanoyl-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one as white crystals.

mp: 164-165°C. HPLC purity: 99.2% ~a 254 nm. 1H-NMR (CDC13) ~ 0.77 (s, 3H), 0.86-0.96 (m, 4H), 1.08 (s, 3:H), 1.19 (s, 3H), 1.44 (m, 1 H), 1.76 (m, 1 H); 1.95 (m, I H), 2.5 I (m, 2H), 7.42 (dd, J = 2:4,9.0 Hz, 1 H), 7.63 (m, 2H).
Step D: (-) 6-Chloro-4-cyclopropylethy:nyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one (L-743,726, Compound 37.2 a o 6-chloro-1-( I S)-camphanoyl-4-c:yclopropylethynyl-4-trifluoromethyl-1,2-dihydro-4(H)-3,1-benzo;cazin-2-one (7.50 g, 0.01512 mol) was dissolved in 150 mL of n-butanol at 60°C under an atmosphere of argon. To this solution was added 10 mL of 1 N HCI.
This solution was maintained at 60°C for 72h. The mixture was neutralized with aqueous NaHC03 and the n~-butanol was removed in vacuo. The residue was dissolved in 150 mL, of THF and treated with 50 mL of 2N LiOH for 3h at room temperature. This mixture was diluted with ethyl acetate and washed with tvvo portions of water and one of brine. Drying (MgS04), filtration and removal of the solvent in 2o vacuo gave a white solid. This material was recrystallized from hot hexane to give 3.43 g of (-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3, I -benzoxa:zin-2-one as white crystals., m.p. 131-132°C; [a]D20 = _ 84,7° (CHCl3, c=0.005 g mL-1);
1 H-NMR (CDCl3): 8 0.85 (m, 2H), 0.94 (m, 2H), 1.40 (m, 1 H), 6.81 2 5 (d' J = 8.5 Hz, 1 H), 7.37 (dd, J = 2.5, 8.5 Hz, 1 H), 7.49 (d, J = 2.5 Hz, 1 H), 8.87 (br s, 1 H).
Step E: (+) 6-Chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihvdro-2H-3,1-benzoxazin-2-one (L-743,725) 3 o The mother liquors from Step C above were purified by column chromatography on silica gel using liD% ethyl acetate in hexanes as eluant. The pure, undesired diastereomer (a colorless foam) was hydroylzed according to Step D. The enantiomeric benzoxazinone, (+) 6-Chloro-4-cyclopropylethynyl-4-trifluorom~ethyl- I ,4-dihydro-2H-3,1-benzoxazin-2-one, was obtained as white crystals. m.p. 131-132°C;

[ac]D20 =+ g4.4° (CHC13, c=0.005 g mL-1); 1H-NMR (CDC13): 8 0.85 (m, 2H), 0.94 (m, 2H), 1.40 (m, 1 H), 6.81 (d, J = 8.5 Hz, 1 H), 7.37 (dd, J = 2.5, 8.5 Hz, 1 H), 7.49 (d, J = 2.5 Hz, 1 H), 8.87 (br s, 1 H).
REVERSE TRANSCRIPTASE ASSAY
The assay measures the incorporation of tritiated deoxyguanosine monophosphate by recombinant HN reverse transcriptase (HIV RTR) (or other RT) into acid-precipitable cDNA at 1 o the Km values of dGTP and poly r(C)~oligo d(G) The inhibitors 12-18~
of the present invention inhibit this incorporation.
The assays were carried out in 55 mM Tris (pH 8.2)-30 mM KCl-30 mM MgCl2-1 mM dithiothreitol-20 ~.g of rC:dGl2-18 is (Pharmacia) per ml-8 mM [3H]dGTP (New England Nuclear)-0.01%
TritonTM X-100-50 mM ethylene glycol-bis(13-amino-ethyl ether)-N,N,N',N'-tetraacetic acid (EGTA)-1 mg of bovine serum albumin per ml. After 60 min of incubation at 37°C, acid-precipitable material was collected onto glass fiber filters by using a semiautomatic cell harvester.
2o Bacterial cell extracts containing RT were diluted to within the linear range of the assay, and activity was determined in the presence and absence of inhibitor. Purified HIV-1 RT heterodimer produced in E.
coli also served as a control. Results are determined as inhibitor concentration to give 50% inhibition (IC50 wt), in nanomoles/liter.
2 s For the double mutant assay (dm), A 17 RT was employed in the assay. A 17 RT is resistant to various aminopyridones, as described in Nunberg, J.H. et al., J. Virol. 65, 4887 (1991). Results are measured as IC50 dm in nanomoles/liter.
3o CELL SPREAD ASSAY
Inhibition of the spread of HIV in cell culture was measured according to Nunberg, J. H. et al., J. Virol. 65, 4887 (1991).
In this assay, MT-4 T-lymphoid cells were infected with HIV-1 (wild-type, unless otherwise indicated) by using a predetermined inoculum, and cultures were incubated for 24h. At this time, < 1 % of the cells were positive by indirect immunofluorescence. Cells were then extensively washed and distributed into 96-well culture dishes. Serial twofold dilutions of inhibitor were added to the wells, and cultures were continued for 3 additional days. At 4 days postinfection, 100% of the cells in control cultures were infected. HIV-:l p24 accumulation was directly correlated with virus spread. The cell culture inhibitory concentration was defined as the inhibitor concentration in nanomoles/liter which reduced the spread of infection by at least 95%, or CIC95.

SUMMARY OF RESULTS FOR COMPOUND 37.2 A. Reverse Transcriptase Assay and Cell Spread Assay:
WT K103N* Y181C DM RT-2 IC50(~M) 0.002 0.030 0.008 0.085 80.8 to CIC95(p.M) <0.006(N=2) 0.100 <:0.025 0.400 N.D.
B. Pharmacological L>ata:
Rhesus: 1 mg kg -1 I.V.al~2=Z1 O min.
10 mg kg '1 p.o. (methocel): Cmax=4.4pM [7 2h (p U.C.) 5 C24h=1.1 EII~VI
Protein Binding: 98.0% Normal Human Plasma (HPLC Method) 2 0 * Mutants K 103N and Y 181 C are drug-resistant HIV-1 reverse transcriptases. DM is the double mutant, <~s discussed in the reverse transcriptase assay. RT-2 is the reverse transcriptase of HIV-2.
SYNERGISTIC EFFECTS
A. Preparation of HIV-infected MT-4 cell Suspension MT cells were infected at Day 0 at a concentration of 250,000 per ml with a 1:1000 dilution of HIV-1 strain IIIb stock (final 125 pg p24/ml; sufficient to yield <_ 1 % infected cells on day 1 and 25-100% on day 4). Cells were infected and grown in the following medium: RPMI 1640 (Whittaker BioProducta), 10% inactivated fetal bovine serum, 4 mM glutamine (Gibco Labs) and 1:100 Penicillin-Streptomycin (Gibco Labs).

- 57 - 1 ~793IA
The mixture was incubated overnight at 37°C in 5% C02 atmosphere.
B. Treatment with Inhibitors A matrix of nanomolar range concentrations of the pairwise combinations (see Table S) was prepared. At Day 1, aliquots of 125 ~.1 of inhibitors were added to equal volumes of HIV-infected MT-4 cells (50,000 per well) in a 96-well microtiter cell culture plate.
Incubation was continued for 3 days at 37°C in 5% C02 atmosphere.
io C. Measurement of Virus Spread Using a multichannel pipettor, the settled cells were resuspended and 125 ~l harvested into a separate microtiter plate.. The supernatant was assayed for HN p24 antigen.
15 The concentration of HIV p24 a~ltigen was measured by an enzyme immunoassay, described as follows. Aliquots of p24 antigen to be measured were added to microwells coated with a monoclonal antibody specific for HIV core antigen. The microwells were washed at this point, and at other appropriate steps that follow. Biotinylated HIV-2o specific antibody was then added, followed by conjugated strepavidin-horseradish peroxidase. A color reaction occurs from the added hydrogen peroxide and tetramethylbenzidine substrate. Color intensity is proportional to the concentration of HIV p24 antigen.
Calculation of Degree of Svnergv_ Pairwise combinations of inhibitors (see Table 5) were found to exhibit markedly enhanced inhibition of virus spread, in comparison to each inhibitor alone, or in connparison to merely additive inhibition of each inhibitor. Thus, for example, the pairwise combination of 726 and AZT was found to e:~chibit markedly enhanced inhibition of virus spread, in comparison to ',~26 alone or AZT alone, or in comparison to the sum of 726 inhibition and AZT inhibition.
This data was processed as follows:

fractional inhibitory concentration ratios (FIC) were calculated according to Elion, et. al. J. Biol. Chem., 208 477 (1954). The minimum sum of FICS, which is the maximum synergy, was determined for various pairwise combinations. Alternatively, an average sum of the FICS is calculated, which is the average synergy. See Table S.
These results indicate substantial synergy in the inhibition of virus spread. The smaller the number, the greater' the synergy.
io TABLE S
Pairwise Combinations* ,Average Synergy 726 + ddI 0.81 726 + AZT 0.62 726 + 524 0.65 726 + 524 + AZT
524 is L-735,524. Other compounds are also defined in Table C above.
2 0 file the foregoing specification teaches the principles of the present invention, with examples provided for the purpose of illustration, it will be understood that the practice of the invention encompasses all of the usual variations, adaptions, or modifications, as come within the scope of the following claims and its equivalents.

Claims (30)

1. A compound of the formula:

wherein:

X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated°or unsaturated; and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;

(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, or a pharmaceutically acceptable salt thereof.

2. A pharmaceutical composition useful for inhibiting HIV reverse transcriptase, comprising an effective amount of a compound of Formula I, and a pharmaceutically acceptable carrier, wherein X is halo;
X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, or a pharmaceutically acceptable salt thereof.

3. A compound, which is (-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin -2-one, (-) 6-chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (+/-) 6-chloro-4-(2-cyanophenyl)ethynyl-4-(1,1,1-trifluoromethyl)-1,4-dihydro-2H-3,1-benzoxazin-2-one, (+/-) 4-(1-chloro-1,1-difluoromethyl)-4-(2-phenylethynyl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or (+/-) 4-(2-[dimethylaminomethyl]ethynyl)-4-trifluoromethyl-6-chloro-1,4-dihydro- 2H-3,1-benzoxazin-2-one, or a pharmaceutically acceptable salt thereof.

4. A pharmaceutical composition useful for inhibiting HIV reverse transcriptase, comprising an effective amount of a compound as in any of claims 1 or 3, and a pharmaceutically acceptable carrier.

5. A pharmaceutical composition useful for treating infection of HIV or for treating AIDS or ARC, comprising an effective amount of a compound of claim 1, 2 or 3, and a pharmaceutically acceptable carrier.

6. A use of a pharmaceutically acceptable carrier and an effective amount of a compound of Formula I:

or a pharmaceutically acceptable salt thereof, wherein:
X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino- C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;

(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, or a compound of Formula II:

or a pharmaceutically acceptable salt thereof, wherein:
X is halo;
X1 is trihalomethyl; pentahaloethyl; C2-5 alkyl;
C2-5 alkynyl;
C3-5 cycloalkyl; or phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl;
Z is O or S;and R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;

(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A
for inhibiting HIV reverse transcriptase in a mammal.

7. A use of a pharmaceutically acceptable carrier and an effective amount of a compound of Formula I:

or a pharmaceutically acceptable salt thereof, wherein:
X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino- C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;

(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, or a compound of Formula II:

or a pharmaceutically acceptable salt thereof, wherein:

X is halo;
X1 is trihalomethyl; pentahaloethyl; C2-5 alkyl;
C2-5 alkynyl;
C3-5 cycloalkyl; or phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl;
Z is O or S; and R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;

(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A
for the production of a medicament for inhibiting HIV reverse transcriptase in a mammal.

8. A use of a pharmaceutically acceptable carrier and an effective amount of a compound selected from the group consisting of:
(-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (-) 6-chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (+/-) 6-chloro-4-(2-cyanophenyl)ethynyl-4-(1,1,1-trifluoromethyl)-1,4-dihydro-2H-3,1-benzoxazin-2-one, (+/-) 4-(1-chloro-1,1-difluoromethyl)-4-(2-phenylethynyl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or (+/-) 4-(2-[dimethylaminomethyl]ethynyl)-4-trifluoromethyl-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or a pharmaceutically acceptable salt thereof;
for inhibiting HIV reverse transcriptase in a mammal.

9. A use of a pharmaceutically acceptable carrier and an effective amount of a compound selected from the group consisting of:
(-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (-) 6-chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (+/-) 6-chloro-4-(2-cyanophenyl)ethynyl-4-(1,1,1-trifluoromethyl)-1,4-dihydro-2H-3 ,1-benzoxazin-2-one, (+/-) 4-(1-chloro-1,1-difluoromethyl)-4-(2-phenylethynyl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or (+/-) 4-(2-[dimethylaminomethyl]ethynyl)-4-trifluoromethyl-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or a pharmaceutically acceptable salt thereof;
for the production of a medicament for inhibiting HIV reverse transcriptase in a mammal.

10. A use of a pharmaceutically acceptable carrier and an effective amount of a compound of Formula I:

or a pharmaceutically acceptable salt thereof, wherein:
X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino- C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, or a compound of Formula II:

or a pharmaceutically acceptable salt thereof, wherein:
X is halo;
X' is trihalomethyl; pentahaloethyl; C2-5 alkyl;
C2-5 alkynyl;
C3-5 cycloalkyl; or phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl;
Z is O or S;
R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A
for preventing infection of HIV, or for treating infection of HIV, or for treating AIDS or ARC in a mammal.

11. A use of a pharmaceutically acceptable carrier and an effective amount of a compound of Formula I:

or a pharmaceutically acceptable salt thereof, wherein:
X is halo, X' is trihalomethyl, or pentahaloethyl;
Z is O;
R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino- C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, or a compound of Formula II:

or a pharmaceutically acceptable salt thereof, wherein:
X is halo;
X' is trihalomethyl; pentahaloethyl; C2-5 alkyl;
C2-5 alkynyl;
C3-5 cycloalkyl; or phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl;
Z is O or S;
R is:
(a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A
for the production of a medicament for preventing infection of HIV, or for treating infection by HIV, or for treating AIDS or ARC in a mammal.

12. A use of a pharmaceutically acceptable carrier and an effective amount of a compound selected from the group consisting of:
(-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (-) 6-chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (+/-) 6-chloro-4-(2-cyanophenyl)ethynyl-4-(1,1,1-trifluoromethyl)-1,4-dihydro-3,1-benzoxazin-2-one, (+/-) 4-(1-chloro-1,1-difluoromethyl)-4-(2-phenylethynyl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or (+/-) 4-(2-[dimethylaminomethyl]ethynyl)-4-trifluoromethyl-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or a pharmaceutically acceptable salt thereof, for preventing infection of HIV, or for treating infection of HIV or for treating AIDS or ARC in a mammal.

13. A use of a pharmaceuticlaly acceptable carrier and an effective amount of a compound selected from the group consisting of:
(-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (-) 6-chloro-4-phenylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, (+/-) 6-chloro-4-(2-cyanophenyl)ethynyl-4-(1,1,1-trifluoromethyl)-1,4-dihydro-3,1-benzoxazin-2-one, (+/-) 4-(1-chloro-1,1-difluoromethyl)-4-(2-phenylethynyl)-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or (+/-) 4-(2-[dimethylaminomethyl]ethynyl)-4-trifluoromethyl-6-chloro-1,4-dihydro-2H-3,1-benzoxazin-2-one, or a pharmaceutically acceptable salt thereof, for the production of a medicament for preventing infection of HIV, or for treating infection by HIV or for treating AIDS or ARC in a mammal.

14. A pharmaceutical composition comprising an effective amount of a compound of the Formula wherein:
X is halo, X' is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, in admixture with an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase, or a pharmaceutically acceptable salt of any of the above.

15. A pharmaceutical composition comprising the compound in admixture with the compound and, optionally, one or more of a HIV reverse transcriptase inhibitor selected from the group consisting of AZT, ddI and ddC, or a pharmaceutically acceptable salt of any of the above.

16. A pharmaceutical composition comprising the compound in admixture with one or more of a HIV reverse transcriptase inhibitor selected from the group consisting of AZT, ddI and ddC, or a pharmaceutically acceptable salt of any of the above.

17. A use of an effective amount of a compound of Formula I:

wherein:
X is halo, X' is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4alkoxy, C1-4 alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, and an effective amount of one or more of an agent selected from the group consisting of:
an AIDS antiviral, immunomodulator, antiinfective and vaccine;
for treating infection by HIV or for treating AIDS or ARC in a mammal.

18. A use of an effective amount of a compound of Formula I:

wherein:
X is halo, X' is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A, and an effective amount of one or more of an agent selected from the group consisting of:
an AIDS antiviral, immunomodulator, antiinfective and vaccine;
for the production of a medicament for treating infection by HIV or for treating AIDS or ARC in a mammal.

19. A use of an effective amount of a compound of Formula:

and an effective amount of one or more of an agent selected from the group consisting of:
an AIDS antiviral, immunomodulator, antiinfective and vaccine;
for treating infection by HIV or for treating AIDS or ARC in a mammal.

20. A use of an effective amount of a compound of Formula:

and an effective amount of one or more of an agent selected from the group consisting of:
an AIDS antiviral, immunomodulator, antiinfective and vaccine;
for the production of a medicament for treating infection by HIV or for treating AIDS or ARC in a mammal.

21. A use of an effective amount of a compound of Formula I:

wherein:
X is halo, X' is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
an effective amount of an HIV protease inhibitor, and optionally, an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase or a pharmaceutically acceptable salt of any of the above;
for treating infection by HIV or for treating AIDS or ARC in a mammal.

22. A use of an effective amount of a compound of Formula I:

wherein:
X is halo, X' is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
an effective amount of an HIV protease inhibitor, and optionally, an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase or a pharmaceutically acceptable salt of any of the above;

for the production of a medicament for treating infection by HIV or for treating AIDS or ARC in a mammal.

23. A use of an effective amount of a compound of Formula I:
wherein:
X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase, and, optionally, an effective amount of an HIV protease inhibitor or a pharmaceutically acceptable salt of any of the above;
for treating infection by HIV or for treating AIDS or ARC in a mammal.

24. A use of an effective amount of a compound of Formula I:
wherein:
X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase, and, optionally, an effective amount of an HIV protease inhibitor or a pharmaceutically acceptable salt of any of the above;
for the production of a medicament for treating infection by HIV or for treating AIDS or ARC in a mammal.

25. A use of an effective amount of a compound of Formula I:
wherein:
X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;
(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
an effective amount of an HIV protease inhibitor, and an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase or a pharmaceutically acceptable salt of any of the above;
for treating infection by HIV or for treating AIDS or ARC in a mammal.

26. A use of an effective amount of a compound of Formula I:
wherein:
X is halo, X1 is trihalomethyl, or pentahaloethyl;
Z is O;
R is (a) C1-8 alkyl, unsubstituted or substituted with A, and A is halo, C3-6 cycloalkyl, CN, hydroxy, C1-4 alkoxy, C2-4 alkynyl-C-1-4 alkoxy, aryloxy, C1-4 alkylcarbonyl, nitro, di(C1-2 alkyl)amino, C1-4 alkylamino-C1-2 alkyl, a stable 5- to 7-membered monocyclic or stable 8- to 11-membered bicyclic heterocyclic ring which is either saturated, partially unsaturated or unsaturated, and which consists of carbon atoms and from one to four heteroatoms selected from the group consisting of N, O
and S, and wherein the nitrogen and sulfur heteroatoms may optionally be oxidized, or arylthio;

(b) C2-4 alkenyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
(c) C2-5 alkynyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A; or (d) C3-4 cycloalkyl, unsubstituted or substituted with (i) A, or (ii) phenyl, naphthyl, tetrahydronaphthyl, biphenyl, phenanthryl, anthryl, or acenaphthyl, unsubstituted or substituted with A;
an effective amount of an HIV protease inhibitor, and an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase or a pharmaceutically acceptable salt of any of the above;
for the production of a medicament for treating infection by HIV or for treating AIDS or ARC in a mammal.

27. The use of an effective amount of a compound of Formula:
an effective amount of an HIV protease inhibitor, and an effective amount of a nucleoside analog having biological activity against HIV reverse transcriptase or a pharmaceutically acceptable salt of any of the above; for treating infection by HIV or for treating AIDS or ARC in a mammal.

28. A compound of claim 3, which is (-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1-benzoxazin-2-one, or a pharmaceutically acceptable salt thereof.

29. A pharmaceutical composition of claim 4, wherein the compound is (-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1 -benzoxazin-2-one, or a pharmaceutically acceptable salt thereof.

30. A pharmaceutical composition of claim 5, wherein the compound is (-) 6-chloro-4-cyclopropylethynyl-4-trifluoromethyl-1,4-dihydro-2H-3,1 -benzoxazin-2-one, or a pharmaceutically acceptable salt thereof.