CA2304000A1 - Vitronectin receptor antagonist - Google Patents

Vitronectin receptor antagonist Download PDF

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CA2304000A1
CA2304000A1 CA002304000A CA2304000A CA2304000A1 CA 2304000 A1 CA2304000 A1 CA 2304000A1 CA 002304000 A CA002304000 A CA 002304000A CA 2304000 A CA2304000 A CA 2304000A CA 2304000 A1 CA2304000 A1 CA 2304000A1
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William E. Bondinell
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SmithKline Beecham Corp
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D401/00Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
    • C07D401/02Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
    • C07D401/12Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a chain containing hetero atoms as chain links
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00Drugs for skeletal disorders
    • A61P19/08Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A61P19/10Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • A61P35/04Antineoplastic agents specific for metastasis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/10Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis

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  • Orthopedic Medicine & Surgery (AREA)
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  • Pain & Pain Management (AREA)
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  • Urology & Nephrology (AREA)
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  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
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  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Abstract

A compound of formula (I) is disclosed which is a vitronectin receptor antagonist and is useful in the treatment of osteoporosis, or a pharmaceutically acceptable salt thereof.

Description

TITLE
Vitronectin Receptor Antagonist FIELD OF THE INVENTION
This invention relates to a pharmaceutically active compound which inhibits the vitronectin receptor and is useful for the treatment of inflammation, cancer and cardiovascular disorders, such as atherosclerosis and restenosis, and diseases wherein bone resorption is a factor, such as osteoporosis.
BACKGROUND OF THE INVENTION
Integrins are a superfamily of cell adhesion receptors, which are transmembrane glycoproteins expressed on a variety of cells. These cell surface adhesion receptors include gpIIb /IIIa (the fibrinogen receptor) and avB3 (the vitronectin receptor). The fibrinogen receptor gpIIb /IIIa is expressed on the platelet surface, and mediates platelet aggregation and the formation of a hemostatic clot at the site of a bleeding wound.
Philips, et al., Blood., 1988, 71, 831. The vitronectin receptor avBg is expressed on a number of cells, including endothelial, smooth muscle, osteoclast, and tumor cells, and, thus, it has a variety of functions. The a~B3 receptor expressed on the membrane of osteoclast cells mediates the adhesion of osteoclasts to the bone matrix, a key step in the bone resorption process. Ross, et al., J. Biol. Chem., 1987, 262, 7703. A disease characterized by excessive bone resorption is osteoporosis. The avBg receptor expressed on human aortic smooth muscle cells mediates their migration into neointima, a process which can lead to restenosis after percutaneous coronary angioplasty. Brown, et al., Cardiovascular Res., 1994, 28, 1815.
Additionally, Brooks, et al., Cell,1994, 79, 1157 has shown that an a"Bg antagonist is able to promote tumor regression by inducing apoptosis of angiogenic blood vessels.
Thus, agents that block the vitronectin receptor would be useful in treating diseases, such as osteoporosis, restenosis and cancer.
The vitronectin receptor is now known to refer to three different integrins, designated avBl, avB3 and avBS. Horton, et al., Int. J. Exp. Pathol., 1990, 71, 741. avBi binds fibronectin and vitronectin. avBg binds a large variety of ligands, including fibrin, fibrinogen, laminin, thrombospondin, vitronectin, von Willebrand's factor, osteopontin and bone sialoprotein I. av(3g binds vitronectin. The vitronectin receptor avBs has been shown to be involved in cell adhesion of a variety of cell types, including microvascular endothelial cells, {Davis, et al., J. Cell. Biol., 1993, S1, 206), and its role in angiogenesis has been confirmed. Brooks, et al., Science,1994, 264, 569. This integrin is expressed on blood vessels in human wound granulation tissue, but not in normal skin.
-i-The vitronectin receptor is known to bind to bone matrix proteins which contain the tri-peptide Arg-Gly-Asp (or RGD) motif. Thus, Norton, et al., Exp. Cell Res.
1991, 195, 368, disclose that RGD-containing peptides and an anti-vitronectin receptor antibody (23C6) inhibit dentine resorption and cell spreading by osteoclasts. In addition, Sato, et al., J. Cell Biol. 1990, Ill, 1713 discloses that echistatin, a snake venom peptide which contains the RGD sequence, is a potent inhibitor of bone resorption in tissue culture, and inhibits attachment of osteoclasts to bone.
It has now been discovered that a certain compound is a potent inhibitor of the avLi3 and av(3g receptors. In particular, it has been discovered that such a compound is a more potent inhibitor of the vitronectin receptor than the fibrinogen receptor.
SUA~IMARY OF THE INVENTION
This invention comprises a compound of the formula (I) as described hereinafter, which has pharmacological activity for the inhibition of the vitronection receptor and is useful in the treatment of inflammation, cancer and cardiovascular disorders, such as atherosclerosis and restenosis, and diseases wherein bone resorption is a factor, such as osteoporosis.
This invention is also a pharmaceutical composition comprising a compound according to formula {I) and a pharmaceutically carrier.
This invention is also a method of treating diseases which are mediated by the vitronectin receptor. In a particular aspect, the compound of this invention is useful for treating atherosclerosis, restenosis, inflammation, cancer and diseases wherein bone resorption is a factor, such as osteoporosis.
DETAILED DESCRIPTION
This invention comprises a novel compound which is a more potent inhibitor of the vitronectin receptor than the fibrinogen receptor. The novel compound comprises a benzazepine core in which a nitrogen-containing substituent is present on the aromatic six-membered ring of the benzazepine and an aliphatic substituent containing an acidic moiety is present on the seven-membered ring of the benzazepine. The benzazepine ring system is believed to interact favorably with the vitronectin receptor and to orient the substituent sidechains on the six and seven membered rings so that they may also interact favorably with the receptor. It is preferred that about twelve to fourteen intervening covalent bonds via the shortest intramolecular path will exist between the acidic group on the aliphatic substituent of the seven-membered ring of the benzazepine and the nitrogen of the nitrogen-containing substituent on the aromatic six-membered ring of the benzazepine.
This invention comprises a compound of formula (I):
F F
N\ N \/~/ O / N ~ ~ F
O
,~'4-- COzH
(I) or a pharmaceutically acceptable salt thereof. This compound is (S)-8-[3-(pyridin-2-ylamino)-I-propyloxyj-3-oxo-2-(2,3,4-trifluorobenzyl)-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetic acid.
The compound of formula (I) inhibits the binding of vitronectin and other RGD-containing peptides to the vitronectin receptor. Inhibition of the vitronectin receptor on osteoclasts inhibits osteoclastic bone resorption and is useful in the treatment of diseases wherein bone resorption is associated with pathology, such as osteoporosis and osteoarthritis.
In another aspect, this invention is a method for stimulating bone formation which comprises administering a compound of formula (I) which causes an increase in osteocalcin release. Increased bone production is a clear benefit in disease states wherein there is a IS deficiency of mineralized bone mass or remodeling of bone is desired, such as fracture healing and the prevention of bone fractures. Diseases and metabolic disorders which result in loss of bone structure would also benefit from such treatment. For instance, hyperparathyroidism, Paget's disease, hypercalcemia of malignancy, osteolytic lesions produced by bone metastasis, bone loss due to immobilization or sex hormone deficiency, Beh~et's disease, osteomalacia, hyperostosis and osteopetrosis, could benefit from administering a compound of this invention.
Additionally, since the compound of the instant invention inhibits vitronectin receptors on a number of different types of cells, said compound would be useful in the treatment of inflammatory disorders, such as rheumatoid arthritis and psoriasis, and cardiovascular diseases, such as atherosclerosis and restenosis. The compound of formula (I) of the present invention may be useful for the treatment or prevention of other diseases including, but not limited to, thromboembolic disorders, asthma, allergies, adult respiratory distress syndrome, graft versus host disease, organ transplant rejection, septic shock, eczema, contact dermatitis, inflammatory bowel disease, and other autoimmune diseases.
The compound of the present invention may also be useful for wound healing.
The compound of the present invention is also useful for the treatment, including prevention, of angiogenic disorders. The term angiogenic disorders as used herein includes conditions involving abnormal neovascularization. Where the growth of new blood vessels is the cause of, or contributes to, the pathology associated with a disease, inhibition of angiogenisis will reduce the deleterious effects of the disease. An example of such a disease target is diabetic retinopathy. Where the growth of new blood vessels is required to support growth of a deleterious tissue, inhibition of angiogenisis will reduce the blood supply to the tissue and thereby contribute to reduction in tissue mass based on blood supply requirements. Examples include growth of tumors where neovascularization is a continual requirement in order that the tumor grow and the establishment of solid tumor metastases. Thus, the compound of the present invention inhibit tumor tissue angiogenesis, thereby preventing tumor metastasis and tumor growth.
Thus, according to the methods of the present invention, the inhibition of angiogenesis using the compound of the present invention can ameliorate the symptoms of the disease, and, in some cases, can cure the disease.
Another therapeutic target for the compound of the .instant invention are eye diseases chacterized by neovascularization. Such eye diseases include corneal neovascular disorders, such as corneal transplantation, herpetic keratitis, luetic keratitis, pterygium and neovascular pannus associated with contact lens use. Additional eye diseases also include age-related macular degeneration, presumed ocular histoplasmosis, retinopathy of prematurity and neovascular glaucoma.
This invention further provides a method of inhibiting tumor growth which comprises administering stepwise or in physical combination a compound of formula (I) and an antineoplastic agent, such as topotecan and cisplatin.
Also included in this invention are prodrugs of the compounds of this invention.
Prodrugs are considered to be any covalently bonded carriers which release the active parent drug according to formula (I) in vivo. Thus, in another aspect of this invention are novel prodrugs, which are also intermediates in the preparation of the formula (I) compound, of formula (II):
F F
-_ NCO / N ~ / F
~ ~ o ,~'~-- C02Cj_salkyl (II) or a pharmaceutically acceptable salt thereof.
In yet another aspect of this invention are novel intermediates of formula (III):
F F
O-~N+ N~ p / N ~F
w ~ ~o ,~'~--- C02C~.salkyl (III) or a pharmaceutically acceptable salt thereof.
Abbreviations and symbols commonly used in the peptide and chemical arts are used herein to describe the compounds of this invention. In general, the amino acid abbreviations follow the IUPAC-IUB Joint Commission on Biochemical Nomenclature as described in Eur. J. Biochem., 158, 9 (1984).
C~_6atkyl as applied herein means an optionally substituted alkyl group of 1 to 6 carbon atoms, and includes methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, t-butyl, n-pentyl, isopentyl, neopentyl and hexyl and the simple aliphatic isomers thereof.
Certain reagents are abbreviated herein. DCC refers to dicyclohexylcarbodiimide, DMAP refers to dimethylaminopyridine, DIEA refers to diisopropylethyl amine, EDC
refers to 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide, hydrochloride. HOBt refers to 1-hydroxybenzotriazole, THF refers to tetrahydrofuran, DIEA refers to diisopropylethylamine, DEAD refers to diethyl azodicarboxylate, PPh3 refers to triphenylphosphine, DIAD refers to diisopropyl azodicarboxylate, DME refers to dimethoxyethane, DMF refers to dimethylformamide, NBS refers to N-bromosuccinimide, Pd/C refers to a palladium on carbon catalyst, PPA refers to polyphosphoric acid, DPPA
refers to diphenylphosphoryl azide, BOP refers to benzotriazol-1-yloxy-tris(dimethyl-amino)phosphonium hexafluorophosphate, HF refers to hydrofluoric acid, TEA
refers to triethyiamine, TFA refers to trifluoroacetic acid, PCC refers to pyridinium chlorochromate.
Compounds of the formula (I) are generally prepared by the methods described in Bondinell, et al., PCT application WO 93/00095, published January 7, 1993 and Bondinell, et al., PCT application WO 94/14776, the entire disclosures of which are incorporated herein by reference.
Additionally, the compound of formula (I) is prepared by the methods detailed in the scheme hereinbelow.
Scheme I
H
HO
O a \ -_ '~--C02CH3 ---COZH
N+ NCO N H
\ ~ \ ~ O b ,~~--C02CH3 F F
O ' 8oc ~N+ N ~/ O / ~ ~ F
O c ~ ~~--COZCH3 O-,N+ NCO F
d \ ~' F
j NCO / N ~ ~ F
\ ~ \ ( O e,f ---~~~-C02CH3 ' F
N N,~O / N ~ ~ F
\ f \ I O
''-"'C.U2(i~"'13 a) 2-[N-(3-hydroxy-I-propyl)-N-(tent-butoxycarbonyl)aminojpyridine-N-oxide, DEAD, (Ph)3P, DMF; b) L1HMDS, 2,3,4-trifluorobenzyl bromide, DMF; c) HCl/dioxane; d) cyclohexene, IO~Io Pd/C, MeOH; e) 1.0 N NaOH, MeOH; f) TFA.
Compound I-1, prepared by the general procedures described in Bondinell, et al., PCT application WO 93/00095, published January 7, 1993 and Bondinell, et al., PCT
application WO 94/14776, is reacted with 2-[N-(3-hydroxy-i-propyl)-N-(tert-butoxycarbonyl)aminojpyridine-N-oxide in a Mitsunobu-type coupling reaction (Organic Reactions 1992, 42, 335-656; Synthesis 19$1, I-28) to afford I-2. The reaction is mediated by the complex formed between diethyl azodicarboxylate and triphenylphosphine, and is conducted in an aprotic solvent, for instance THF, CH2C12, or DMF. The resulting product, I-2, can be alkylated at position 2 (benzazepine numbering) under standard alkylation conditions well-known to those of skill in the art. Far example, I-2 can be treated with a base, such as sodium hydride, LDA, or lithium hexamethyldisiiazide, in an appropriate solvent, usually THF, DMF, DME, or mixtures thereof, to effect deprotonation of the amide N-H. Treatment of the resulting anionic species with an appropriate electrophiie, for instance 2,3,4-trifluorobenzyl bromide, results in N-alkylation to afford the product I-3. Removal of the tert-butoxycarbamate (Boc) group from I-3 to afford I-4 can be accomplished under standard acidic conditions. Such conditions are well-known to those of skill in the art, and are described in appropriate reference volumes, for instance in Greene, "Protective Groups in Organic Synthesis" (published by Wiley-Interscience). The pyridine-N-oxide moiety of I-4 is reduced to the corresponding pyridine I-5 under transfer hydrogenation conditions using a palladium catalyst, preferably palladium metal on activated carbon, in an inert solvent, for instance methanol, ethanol, or 2-propanol.
Cyclohexene, 1,4-cyclohexadiene, formic acid, and salts of formic acid, such as potassium formate or ammonium formate, are commonly used as the hydrogen transfer reagent in this type of reaction. The methyl ester of I~5 is hydrolyzed using aqueous base, for example, LiOH in aqueous THF or NaOH in aqueous methanol or ethanol, and the intermediate carboxylate salt is acidified with a suitable acid, for instance TFA or HCI, to afford the carboxylic acid I-6. Alternatively, the intermediate carboxylate salt can be isolated, if desired, or a carboxylate salt of the free carboxylic acid can be prepared by methods well-known to those of skill in the art.
Acid addition salts of the compound are prepared in a standard manner in a suitable solvent from the parent compound and an excess of an acid, such as hydrochloric, hydrobromic, hydrofluoric, sulfuric, phosphoric, acetic, trifluoroacetic, malefic, succinic or methanesulfonic. Cationic salts are prepared by treating the parent compound with an _7-excess of an alkaline reagent, such as a hydroxide, carbonate or alkoxide, containing the appropriate cation; or with an appropriate organic amine. Cations such as Li+, Na'~, K+, Ca++, Mg+~' and NH4~' are specific examples of canons present in pharmaceutically acceptable salts.
This invention also provides a pharmaceutical composition which comprises a compound according to formula (I) and a pharmaceutically acceptable earner.
Accordingly, the compound of formula (I) may be used in the manufacture of a medicament. Pharmaceutical compositions of the compound of formula (I) prepared as hereinbefore described may be formulated as solutions or lyophilized powders for parenteral administration. Powders may be reconstituted by addition of a suitable diluent or other pharmaceutically acceptable carrier prior to use. The liquid formulation may be a buffered, isotonic, aqueous solution. Examples of suitable diluents are normal isotonic saline solution, standard 5% dextrose in water or buffered sodium or ammonium acetate solution. Such formulation is especially suitable for parenteral administration, but may also 1S be used for oral administration or contained in a metered dose inhaler or nebulizer for insufflation. It may be desirable to add excipients such as polyvinylpyrrolidone, gelatin, hydroxy cellulose, acacia, polyethylene glycol, mannitol, sodium chloride or sodium citrate.
Alternately, the compound may be encapsulated, tableted or prepared in a emulsion or syrup for oral administration. Pharmaceutically acceptable solid or liquid carriers may be added to enhance or stabilize the composition, or to facilitate preparation of the composition. Solid carriers include starch, lactose, calcium sulfate dihydrate, terra alba, magnesium stearate or stearic acid, talc, pectin, acacia, agar or gelatin.
Liquid carriers include syrup, peanut oil, olive oil, saline and water. The carrier may also include a sustained release material such as glyceryt monostearate or glyceryl distearate, atone or with a wax. The amount of solid carrier varies but, preferably, will be between about 20 mg to about 1 g per dosage unit. The pharmaceutical preparations are made following the conventional techniques of pharmacy involving milling, mixing, granulating, and compressing, when necessary, for tablet forms; or milling, mixing and filling for hard gelatin capsule forms. When a liquid carrier is used, the preparation will be in the form of a syrup, elixir, emulsion or an aqueous or non-aqueous suspension. Such a liquid formulation may be administered directly p.o. or filled into a soft gelatin capsule.
For rectal administration, the compound of this invention may also be combined with excipients such as cocoa butter, glycerin, gelatin or polyethylene glycols and molded into a suppository.
The compound described herein is an antagonist of the vitronectin receptor, and is useful for treating diseases wherein the underlying pathology is attributable to ligand or cell _g_ which interacts with the vitronectin receptor. For instance, this compound is useful for the treatment of diseases wherein loss of the hone matrix creates pathology. Thus, the instant compound is useful for the treatment of ostoeporosis, hyperparathyroidism, Paget's disease, hypercalcemia of malignancy, osteolytic lesions produced by bone metastasis, bone loss due to immobilization or sex hormone deficiency. The compound of this invention is also believed to have utility as an antitumor, anti-angiogenic, antiinflammatory and anti-metastatic agent, and be useful in the treatment of atherosclerosis and restenosis.
The compound is administered either orally or parenterally to the patient, in a manner such that the concentration of drug is sufficient to inhibit bone resorption, or other such indication. The pharmaceutical composition containing the compound is administered at an oral dose of between about 0.1 to about 50 mg/kg in a manner consistent with the condition of the patient. Preferably the oral dose would be about 0.5 to about 20 mg/kg.
For acute therapy, parenteral administration is preferred. An intravenous infusion of the peptide in 5% dextrose in water or normal saline, or a similar formulation with suitable excipients, is most effective, although an intramuscular bolus injection is also useful.
Typically, the parenteral dose will be about 0.01 to about 100 mg/kg;
preferably between 0.1 and 20 mg/kg. The compound is administered one to four times daily at a level to achieve a total daily dose of about 0.4 to about 400 mg/kg/day. The precise level and method by which the compound is administered is readily determined by one routinely skilled in the art by comparing the blood level of the agent to the concentration required to have a therapeutic effect.
This invention further provides a method for treating.osteoporosis or inhibiting bone loss which comprises administering stepwise or in physical combination a compound of formula (I) and other inhibitors of bone resorption, such as bisphosphonates (i.e., allendronate), hormone replacement therapy, anti-estrogens, or calcitonin. In addition, this invention provides a method of treatment using a compound of this invention and an anabolic agent, such as the bone morphogenic protein, iproflavone, useful in the prevention of bone loss and/or to increase bone mass.
Additionally, this invention provides a method of inhibiting tumor growth which comprises administering stepwise or in physical combination a compound of formula (I) and an antineoplastic agent. Compounds of the camptothecin analog class, such as topotecan, irinotecan and 9-aminocamptothecin, and platinum coordination complexes, such as cisplatin, ormaplatin and tetraplatin, are well known groups of antineoplastic agents. Compounds of the camptothecin analog class are described in U.S.
Patent Nos.
5,004,758, 4,604,463, 4,473,692, 4,545,880 4,342,776, 4,513,138, 4,399,276, EP
Patent Application Publication Nos . 0 418 099 and 0 088 642, Wani, et al., J. Med.
Chem., 1986, 29, 238, Wani, et al., J. Med. Chem., 1980, 23, 554, Wani, et al., J. Med.
Chem., 1987, 30, 1774, and Nitta, et al., Proc. l4th International Congr. Chemotherapy., 1985, Anticancer Section l, 28, the entire disclosure of each which is hereby incorporated by reference. The platinum coordination complex; cisplatin, is available under the name Platinol~ from Bristol Myers-Squibb Corporation. Useful formulations for cisplatin are described in U.S.
Patent Nos. 5,562,925 and 4,310,515, the entire disclosure of each which is hereby incorporated by reference.
In the method of inhibiting tumor growth which comprises administering stepwise or in physical combination a compound of formula (I) and an antineoplastic agent, the platinum coordination compound, for example cisplatin, can be administered using slow intravenous infusion. The preferred carrier is a dextroseJsaline solution containing mannitol. The dose schedule of the platinum coordination compound may be on the basis of from about 1 to about 500 mg per square meter (mg/m2) of body surface area per course of treatment. Infusions of the platinum coordiation compound may be given one to two times weekly, and the weekly treatments may be repeated several times. Using a compound of the camptothecin analog class in a parenteral administration, the course of therapy generally employed is from about 0.1 to about 300.0 mg/m2 of body surface area per day for about five consecutive days. Most preferably, the course of therapy employed for topotecan is from about 1.0 to about 2.0 mg/m2 of body surface area per day for about five consecutive days. Preferably, the course of therapy is repeated at least once at about a seven day to about a twenty-eight day interval.
The pharmaceutical composition may be formulated with both the compound of formula (I) and the antineoplastic agent in the same container, but formualtion in different containers is preferred. When both agents are provided in solution form, they can be contained in an infusion/injection system for simultaneous administration or in a tandem arrangement.
For convenient administration of the compound of formula (I) and the antineoplastic agent at the same or different times, a kit is prepared, comprising, in a single container, such as a box, carton or other container, individual bottles, bags, vials or other containers each having an effective amount of the compound of formula (I) for parenteral administration, as described above, and an effective amount of the antineoplastic agent for parenteral administration, as described above. Such kit can comprise, for example, both pharmaceutical agents in separate containers or the same container, optionally as lyophilized plugs, and containers of solutions for reconstitution. A variation of this is to include the solution for reconstitution and the lyophilized plug in two chambers of a single container, which can be caused to admix prior to use. With such an arrangement, the antineoplastic agent and the compound of this invention may be packaged separately, as in two containers, or lyophilized together as a powder and provided in a single container.

When both agents are provided in solution form, they can be contained in an infusion/injection system for simultaneous administration or in a tandem arrangement. For example, the compound of formula (I) may be in an i.v. injectable form, or infusion bag linked in series, via tubing, to the antineoplastic agent in a second infusion bag. Using such S a system, a patient can receive an initial bolus-type injection or infusion of the compound of formula (I) followed by an infusion of the antineoplastic agent.
The compound may be tested in one of several biological assays to determine the concentration of compound which is required to have a given pharmacological effect.
Inhibition of vitronectin binding Solid-Phase j3HJ-SK&F-!07260 Binding to a,,,li3: Human placenta or human platelet avj33 (0.1-0.3 mg/mL) in buffer T (containing 2 mM CaCl2 and 1 %
octylglucoside) was diluted with buffer T containing I mM CaCl2, 1 mM MnCl2, 1 mM MgCl2 (buffer A) and O.OS% NaN3, and then immediately added to 96-well ELISA plates (Corning, New York, 1S NY} at 0.1 mL per well. 0.1 - 0.2 Ng of ocv(33 was added per well. The plates were incubated overnight at 4°C. At the time of the experiment, the wells were washed once with buffer A and were incubated with 0.1 mL of 3.S% bovine serum albumin in the same buffer for 1 hr at room temperature. Following incubation the wells were aspirated completely and washed twice with 0.2 mL buffer A.
Compounds were dissolved in 100% DMSO to give a 2 mM stock solution, which was diluted with binding buffer (1S mM Tris-HCl (pH 7.4), 100 mM NaCI, 1 mM
CaCl2, 1 mM MnCl2, 1 mM MgCl2) to a final compound concentration of 100 pM. This solution is then diluted to the required final compound concentration. Various concentrations of unlabeled antagonists (0.001 - 100 l.~M) were added to the wells in triplicates, followed by 2S the addition of S.0 nM of (3H]-SK&F-107260 (6S - 86 Ci/mmol).
The plates were incubated for 1 hr at room temperature. Following incubation the wells were aspirated completely and washed once with 0.2 mL of ice cold buffer A in a well-to-well fashion. The receptors were solubilized with 0.1 mL of 1 % SDS
and the bound [3H]-SK&F-107260 was determined by liquid scintillation counting with the addition of 3 mL Ready Safe in a Beckman LS Liquid Scintillation Counter, with 40%
efficiency. Nonspecific binding of [3H]-SK&F-107260 was determined in the presence of 2 l.~M SK&F-107260 and was consistently less than 1% of total radioligand input. The ICSO (concentration of the antagonist to inhibit SO% binding of [3H]-SK&F-107260) was determined by a nonlinear, least squares curve-fitting routine, which was modified from the 3S LUNDON-2 program. The Ki (dissociation constant of the antagonist) was calculated according to the equation: Ki = ICSp/( 1 + L/Kd), where L and Kd were the concentration and the dissociation constant of [3H]-SK&F-107260, respectively.

The compound of the present invention inhibits vitronectin binding to SK&F
107260 at a concentration of about 0.003 micomolar.
The Compound of this invention is also tested for in vitro and in vivo bone resorption in assays standard in the art for evaluating inhibition of bone formation, such as the pit formation assay disclosed in EP 528 587, which may also be performed using human osteoclasts in place of rat osteoclasts, and the ovarectomized rat model, described by Wronski et al., Cells and Materials 1991, Sup. I, 69-74.
Vascular smooth muscle cell migration assay Rat or human aortic smooth muscle cells were used. The cell migration was monitored in a Transwell cell culture chamber by using a polycarbonate membrane with pores of 8 um (Costar). The lower surface of the filter was coated with vitronectin. Cells were suspended in DMEM supplemented with 0.2% bovine serum albumin at a 1 S concentration of 2.5 - 5.0 x 106 cells/mL, and were pretreated with test compound at various concentrations for 20 min at 20°C. The solvent alone was used as control. 0.2 mL
of the cell suspension was placed in the upper compartment of the chamber. The lower compartment contained 0.6 mL of DMEM supplemented with 0.2% bovine serum albumin.
Incubation was carried out at 37°C in an atmosphere of 95% air/5% C02 for 24 hr. After incubation, the non-migrated cells on the upper surface of the filter were removed by gentle scraping. The filter was then fixed in methanol and stained with 10% Giemsa stain.
Migration was measured either by a) counting the number of cells that had migrated to the lower surface of the filter or by b) extracting the stained cells with 10%
acetic acid followed by determining the absorbance at 600 nM.
Thyroparathyroidectomized rat model Each experimental group consists of 5-6 adult male Sprague-Dawley rats (250-400g body weight). The rats are thyroparathyroidectomized (by the vendor, Taconic Farms) 7 days prior to use. All rats receive a replacement dose of thyroxine every 3 days. On receipt of the rats, circulating ionized calcium levels are measured in whole blood immediately after it has been withdrawn by tail venipuncture into heparinized tubes. Rats are included if the ionized Ca level (measured with a Ciba-Corning model 634 calcium pH analyzer) is <1.2 mM/L.
Each rat is fitted with an indwelling venous and arterial catheter for the delivery of test material and for blood sampling respectively. The rats are then put on a diet of calcium-free chow and deionized water.
Baseline Ca levels are measured and each rat is administered either control vehicle or human parathyroid hormone 1-34 peptide (hPTH I-34, dose 1.25 ug/kg/h in saline/0.1 %
bovine serum albumin, Bachem, Ca) or a mixture of hPTHI-34 and test material, by continuous intravenous infusion via the venous catheter using an external syringe pump. The calcemic response of each rat is measured at two-hourly intervals during the infusion period of 6-8 hours.
Human osteoclast resorption and adhesion assays Pit resorption and adhesion assays have been developed and standardized using normal human osteoclasts derived from osteoclastoma tissue. Assay 1 was developed for the measurement of osteoclast pit volumes by laser confocal microscopy. Assay 2 was developed as a higher throughput screen in which collagen fragments (released during resorption) are measured by competitve ELISA.
Assay 1 (using laser confocal microscopy) ~ Aliquots of human osteoclastoma-derived cell suspensions are removed from liquid nitrogen strorage, warmed rapidly at 37oC and washed xl in RPMI-1640 medium by centrifugation ( I OOOrpm, 5 mins at 4oC).
~ The medium is aspirated and replaced with murine anti-I-iLA-DR antibody then diluted 1:3 in RPMI-1640 medium. The suspension is incubated for 30 mins on ice and mixed frequently.
~ The cells are washed x2 with cold RPMI-1640 followed by centrifugation (1000 rpm, S mins at 4oC) and the cells are then transferred to a sterile 15 ml centrifuge tube.
The number of mononuclear cells are enumerated in an improved Neubauer counting chamber.
~ Sufficient magnetic beads (5 / mononuclear cell), coated with goat anti-mouse IgG
(Dynal, Great Neck, NY) are removed from their stock bottle and placed into 5 ml of fresh medium (this washes away the toxic azide preservative). The medium is removed by immobilizing the beads on a magnet and is replaced with fresh medium.
~ The beads are mixed with the cells and the suspension is incubated for 30 mins on ice. The suspension is mixed frequently.
~ The bead-coated cells are immobilized on a magnet and the remaining cells (osteociast-rich fraction) ace decanted into a sterile 50 ml centrifuge tube.
~ Fresh medium is added to the bead-coated cells to dislodge any trapped osteoclasts.
This wash process is repeated x 10. The bead-coated cells are discarded.
~ The viable osteoclasts are enumerated in a counting chamber, using fluorescein diacetate to label live cells. A large-bore disposable plastic Pasteur pipet is used to add the sample to the chamber.
~ The osteoclasts are pelleted by centrifugation and the density adjusted to the appropriate number in EMEM medium (the number of osteoclasts is variable from tumor to tumor), supplemented with 10% fetal calf serum and 1.7g/liter of sodium bicarbonate.
~ 3m1 aliquots of the cell suspension (per compound treatment) are decanted into 15m1 centrifuge tubes. The cells are pelieted by centrifugation.
~ To each tube, 3m1 of the appropriate compound treatment are added (diluted to 50 uM in the EMEM medium). Also included are appropriate vehicle controls, a positive control (anti-vitronectin receptor murine monoclonal antibody [87MEM1] diluted to 100 ug/ml) and an isotype control (IgG~ diluted to 100 ug/ml). The samples are incubated at 37oC for 30 mins.
~ 0.5m1 aliquots of the cells are seeded onto sterile dentine slices in a 48-well plate and incubated at 37oC for 2 hours. Each treatment is screened in quadruplicate.
~ The slices are washed in six changes of warm PBS (10 ml / well in a 6-well plate) and then placed into fresh medium containing the compound treatment or control samples. The samples are incubated at 37oC for 48 hours.
Tartrate resistant acid phosphatase (TRAP) procedure (selective stain for cells of the osteoclast lineage) ~ The bone slices containing the attached osteoclasts are washed in phosphate buffered saline and fixed in 2°!o gluteraldehyde (in 0.2M sodium cacodylate) for 5 mins.
~ They are then washed in water and are incubated for 4 minutes in TRAP buffer at 37oC (0.5 mg/ml naphthol AS-BI phosphate dissolved in N,N-dimethylformamide and mixed with 0.25 M citrate buffer (pH 4.5), containing 10 mM sodium tartrate.
~ Following a wash in cold water the slices are immersed in cold acetate buffer (0.1 M, pH 6.2) containing 1 mg/ml fast red garnet and incubated at 4oC for 4 minutes.
~ Excess buffer is aspirated, and the slices are air dried following a wash in water.
~ The TRAP positive osteoclasts (brick red/ purple precipitate) are enumerated by bright-field microscopy and are then removed from the surface of the dentine by sonication.
~ Pit volumes are determined using the Nikon/Lasertec ILM21 W confocal microscope.
Assay 2 (using an ELISA readout) The human osteoclasts are enriched and prepared for compound screening as described in the initial 9 steps of Assay I . For clarity, these steps are repeated hereinbelow.
~ Aliquots of human osteoclastoma-derived cell suspensions are removed from liquid nitrogen strorage, warmed rapidly at 37oC and washed xl in RPMI-1640 medium by centrifugation ( IOOOrpm, 5 mins at 4oC).

The medium is aspirated and replaced with murine anti-HLA-DR antibody then diluted 1:3 in RPMI-1640 medium. The suspension is incubated for 30 mins on ice and mixed frequently.
~ The cells are washed x2 with cold RPMI-1640 followed by centrifugation (1000 rpm, 5 mins at 4oC) and the cells are then transferred to a sterile 15 ml centrifuge tube.
The number of mononuclear cells are enumerated in an improved Neubauer counting chamber.
~ Sufficient magnetic beads (5 / mononuclear cell), coated with goat anti-mouse IgG
(Dynal, Great Neck, NY) are removed from their stock bottle and placed into 5 ml of fresh medium (this washes away the toxic azide preservative). The medium is removed by immobilizing the beads on a magnet and is replaced with fresh medium.
~ The beads are mixed with the cells and the suspension is incubated for 30 mins on ice. The suspension is mixed frequently.
~ The bead-coated cells are immobilized on a magnet and the remaining cells (osteoclast-rich fraction) are decanted into a sterile 50 ml centrifuge tube.
~ Fresh medium is added to the bead-coated cells to dislodge any trapped osteoclasts.
This wash process is repeated x10. The bead-coated cells are discarded.
~ The viable osteoclasts are enumerated in a counting chamber, using fluorescein diacetate to label live cells. A large-bore disposable plastic pasteur pipet is used to add the sample to the chamber.
~ The osteoclasts are pelleted by centrifugation and the density adjusted to the appropriate number in EMEM medium (the number of osteoclasts is variable from tumor to tumor), supplemented with 10% fetal calf serum and 1.7g/liter of sodium bicarbonate.
In contrast to the method desribed above in Assay 1, the compounds are screened at 4 doses to obtain an ICS", as outlined below:
~ The osteoclast preparations are preincubated for 30 minutes at 37°C
with test compound (4 doses) or controls.
~ They are then seeded onto bovine cortical bone slices in wells of a 48-well tissue culture plate and are incubated for a further 2 hours at 37°C.
The bone slices are washed in six changes of warm phosphate buffered saline (PBS), to remove non-adherent cells, and are then returned to wells of a 48 well plate containing fresh compound or controls.
~ The tissue culture plate is then incubated for 48 hours at 37°C.
~ The supernatants from each well are aspirated into individual tubes and are screened in a competitive ELISA that detects the c-telopeptide of type I
collagen which is released during the resorption process. This is a commercially available ELISA

(Osteometer, Denmark) that contains a rabbit antibody that specifically reacts with an 8-amino acid sequence (Glu-Lys-Ala-His- Asp-Gly-GIy-Arg) that is present in the carboxy-terminal telopeptide of the al-chain of type I collagen. The results are expressed as % inhibition of resorption compared to a vehicle control.
Human osteoclast adhesion assay The human osteociasts are enriched and prepared for compound screening as described above in the inital 9 steps of Assay 1. For clarity, these steps are repeated hereinbelow.
~ Aliquots of human osteoclastoma-derived cell suspensions are removed from liquid nitrogen strorage, warmed rapidly at 37oC and washed xl in RPMI-1640 medium by centrifugation ( I OOOrpm, 5 mins at 4oC).
~ The medium is aspirated and replaced with murine anti-HLA-DR antibody then diluted 1:3 in RPMI-1640 medium. The suspension is incubated for 30 mins on ice and mixed frequently.
~ The cells are washed x2 with cold RPMI-1640 followed by centrifugation (1000 rpm, 5 mins at 4oC) and the cells are then transferred to a sterile 15 ml centrifuge tube.
The number of mononuclear cells are enumerated in an improved Neubauer counting chamber.
~ Sufficient magnetic beads (5 / mononuclear cell), coated with goat anti-mouse IgG
(Dynai, Great Neck, NY) are removed from their stock bottle and placed into 5 ml of fresh medium (this washes away the toxic azide preservative). The medium is removed by immobilizing the beads on a magnet and is replaced with fresh medium.
~ The beads are mixed with the cells and the suspension is incubated for 30 mins on ice. The suspension is mixed frequently.
~ The bead-coated cells are immobilized on a magnet and the remaining cells (osteoclast-rich fraction) are decanted into a sterile 50 ml centrifuge tube.
Fresh medium is added to the bead-coated cells to dislodge any trapped osteoclasts.
This wash process is repeated x10. The bead-coated cells are discarded.
~ The viable osteoclasts are enumerated in a counting chamber, using fluorescein diacetate to label live cells. A large-bore disposable plastic pasteur pipet is used to add the sample to the chamber.
~ The osteoclasts are pelleted by centrifugation and the density adjusted to the appropriate number in EMEM medium (the number of osceoclasts is variable from tumor to tumor), supplemented with 10% fetal calf serum and 1.7g/liter of sodium bicarbonate.

~ Osteoclastoma-derived osteoclasts are preincubated with compound (4 doses) or controls at 37"C for 30 minutes.
~ The cells are then seeded onto osteopontin-coated slides (human or rat osteopontin, 3.5ug/ml) and incubated for 2 hours at 37"C.
~ Non adherent cells are removed by washing the slides vigorously in phosphate buffered saline and the cells remaining on the slides are fixed in acetone.
~ The osteoclasts are stained for tartrate-resistant acid phosphatase (TRAP), a selective marker for cells of this phenotype (see steps 15 -17), and are enumerated by light microscopy. The results are expressed as % inhibition of adhesion compared to a vehicle control.
Celt Adhesion Assay Cells and Cell Culture Human embryonic kidney cells ( HEK293 cells) were obtained from ATCC
(Catalog No. CRL 1573). Cells were grown in Earl's minimal essential medium (EMEM) medium containing Earl's salts, 10% fetal bovine serum. 1 % glutamine and 1 %
Penicillin-Steptomycin.
Constructs and Transfections A 3.2 kb EcoRI-KpnI fragment of the av subunit and a 2.4 kb XbaI- XhoI
fragment of the (33 subunit were inserted into the EcoRI - EcoRV cloning sites of the pCDN vector (Aiyar et al., 1994 ) which contains a CMV promoter and a 6418 selectable marker by blunt end ligation. For stable expression, 80 x 10 6 HEK 293 cells were electrotransformed with av+~i3 constructs (20 ftg DIVA of each subunit) using a Gene Pulser (HensIey et al., 1994 ) and plated in 100 mm plates (5x 105 cells/plate). After 48 hr, the growth medium was supplemented with 450 ltg/mL Geneticin (G418 Sulfate, GIBCO-BRL, Bethesda, MD).
The cells were maintained in selection medium until the colonies were large enough to be assayed.
Immunocytocl:emical analysis of transfected cells To determine whether the HEK 293 transfectants expressed the vitronectin receptor, the cells were immobilized on glass microscope slides by centrifugation, fixed in acetone for 2 min at room temperature and air dried. Specific reactivity with 23C6, a monoclonal antibody specific for the av(33 complex was demonstrated using a standard indirect immunofluorescence method.
Cell Adhesion Studies Corning 96-well ELISA plates were precoated overnight at 4oC with 0.1 mL of human vitronectin (0.2 ~tg/mL in RPMI medium). At the time of the experiment, the plates were washed once with RPbII medium and blocked with 3.5% BSA in RPMI medium for 1 hr at room temperature. Transfected 293 cells were resuspended in RPMI medium, supplemented with 20 mM Hepes, pH 7.4 and 0.1 % BSA at a density of 0.5 x 106 cells/mL.
0.1 mL of cell suspension was added to each well and incubated for 1 hr at 37°C, in the presence or absence of various av(33 antagonists. Following incubation, 0.025 mL of a 10% formaldehyde solution, pH 7.4, was added and the cells were fixed at room temperature for 10 min. The plates were washed 3 times with 0.2 mL of RPMI
medium and the adherent cells were stained with 0.1 mL of 0.5% toluidine blue for 20 min at room temperature. Excess stain was removed by extensive washing with deionized water. The toluidine blue incorporated into cells was eluted by the addition of 0.1 mL of 50% ethanol containing 50 mM HCI. Cell adhesion was quantitated at an optical density of 600 nm on a microtiter plate reader (Titertek Multiskan MC, Sterling, VA).
Solid-Phase oc~,(ig Binding Assay:
The vitronectin receptor a~(35 was purified from human placenta. Receptor preparation was diluted with 50 mM Tris-HCI, pH 7.5, 100 mM NaCI, 1 mM CaCl2, 1 mM
MnCh, 1 mM MgCl2 (buffer A) and was immediately added to 96-well ELISA plates at O.I
ml per well. 0.1-0.2 Ng of a~(33 was added per well. The plates were incubated overnight at 4°C. At the time of the experiment, the wells were washed once with buffer A and were incubated with 0.1 ml of 3.5% bovine serum albumin in the same buffer for 1 hr at room temperature. Following incubation the wells were aspirated completely and washed twice with 0.2 ml buffer A.
In a [3H]-SK&F-107260 competition assay, various concentrations of unlabeled antagonists (0.001-100 liM) were added to the wells, followed by the addition of 5.0 nM of [3H]-SK&F-107260. The plates were incubated for 1 hr at room temperature.
Following incubation the wells were aspirated completely and washed once with 0.2 ml of ice cold buffer A in a well-to-well fashion. The receptors were solubilized with 0.1 ml of 1 % SDS
and the bound [3H]-SK&F-107260 was determined by liquid scintillation counting with the addition of 3 ml Ready Safe in a Beckman LS 6800 Liquid Scintillation Counter, with 40%
efficiency. Nonspecific binding of [3H]-SK&F-107260 was determined in the presence of 2 pNI SK&F-107260 and was consistently less than 1 % of total radioligand input.
The ICgo (concentration of the antagonist to inhibit 50% binding of [3H]-SK&F-107260) was determined by a nonlinear, least squares curve-fitting routine, which was modified from the LUNDON-2 program. The K; (dissociation constant of the antagonist) was calculated according to Cheng and Prusoff equation: K; = ICgp/ ( 1 + L/ICa), where L and Kd were the concentration and the dissociation constant of [3H]-SK&F-1072b0, respectively.
Inhibition of RGD-mediated GPIIb-IIIa binding Purification of GPIIb-IIIa Ten units of outdated, washed human platelets (obtained from Red Cross) were lyzed by gentle stirring in 3% octylglucoside, 20 mM Tris-HCI, pH 7.4, 140 mM
NaCI, 2 mM CaCh at 4°C for 2 h. The lysate was centrifuged at 100,OOOg for 1 h.
The supernatant obtained was applied to a 5 mL lentil lectin sepharose 4B column (E.Y. Labs) preequilibrated with 20 mM Tris-HCI, pH 7.4, 100 mM NaCI, 2 mM CaCl2, 1%
octylglucoside (buffer A). After 2 h incubation, the column was washed with 50 mL cold buffer A. The lectin-retained GPIIb-IIIa was eluted with buffer A containing 10% dextrose.
All procedures were performed at 4°C. The GPIIb-IIIa obtained was >95%
pure as shown by SDS polyacrylamide gel electrophoresis.
Incorporation of GPIIb-IIIa in Liposomes.
A mixture of phosphatidylserine (70%) and phosphatidylcholine (30%) (Avanti Polar Lipids) were dried to the walls of a glass tube under a stream of nitrogen. Purified GPIIb-IIIa was diluted to a final concentration of 0.5 mg/tnL and mixed with the phospholipids in a protein:phospholipid ratio of 1:3 (w:w). The mixture was resuspended and sonicated in a bath sonicator for 5 min. The mixture was then dialyzed overnight using 12,000-14,000 molecular weight cutoff dialysis tubing against a 1000-fold excess of 50 mM Tris-HCI, pH 7.4, 100 mM NaCI, 2 mM CaCl2 (with 2 changes). The GPIIb-IIIa-containing liposomes wee centrifuged at 12,0008 for 15 min and resuspended in the dialysis buffer at a final protein concentration of approximately 1 mglmL. The liposomes were stored at -70C until needed.
Competitive Binding to GPIIb-IIIa The binding to the fibrinogen receptor (GPIIb-IIIa) was assayed by an indirect competitive binding method using [3H]-SK&F-107260 as an RGD-type ligand. The binding assay was performed in a 96-well filtration plate assembly (Millipore Corporation, Bedford, MA) using 0.22 um hydrophilic durapore membranes. The wells were precoated with 0.2 mL of 10 ltg/mL polylysine (Sigma Chemical Co., St. Louis, MO.) at room temperature for 1 h to block nonspecific binding. Various concentrations of unlabeled benzazepines were added to the wells in quadruplicate. [3H]-SK&F-107260 was applied to each well at a final concentration of 4.5 nM, followed by the addition of 1 Irg of the purified platelet GPIIb-IIIa-containing liposomes. The mixtures were incubated for 1 h at room temperature. The GPIIb-IIIa-bound [3H]-SK&F-107260 was seperated from the unbound by filtration using a Millipore filtration manifold, followed by washing with ice-cold buffer (2 times, each 0.2 mL). Bound radioactivity remaining on the filters was counted in 1.5 mL
Ready Solve (Beckman Instruments, Fullerton, CA) in a Beckman Liquid Scintillation Counter (Model LS6800), with 40% efficiency. Nonspecific binding was determined in the presence of 2 pM unlabeled SK&F-107260 and was consistently less than 0.14% of the total radioactivity added to the samples. All data points are the mean of quadruplicate determinations.
Competition binding data were analyzed by a nonlinear least-squares curve fitting procedure. This method provides the IC50 of the antagonists (concentration of the antagonist which inhibits specific binding of [3H]-SK&F-107260 by 50% at equilibrium).
The IC50 is related to the equilibrium dissociation constant (Ki) of the antagonist based on the Cheng and Prusoff equation: Ki = IC50/(1+L/Kd), where L is the concentration of [3HJ-SK&F-107260 used in the competitive binding assay (4.5 nM), and Kd is the dissociation constant of [3H]-SK&F-107260 which is 4.5 nM as determined by Scatchard analysis.
The compound of this invention has an affinity for the vitronectin receptor relative to the fibrinogen receptor of greater than 10:1. This compound has a ratio of activity of greater than 100:1.
The efficacy of the compound of formula (I) alone or in combination with an antineoplastic agent may be determined using several transplantable mouse tumor models.
See U. S. Patent Nos. 5,004,758 and 5,633,Oi6 for details of these models The examples which follow are intended in no way to limit the scope of this invention, but are provided to illustrate how to make and use the compound of this invention. Many other embodiments will be readily apparent to those skilled in the art.
EXAMPLES
General I H nuclear magnetic resonance (NMR) spectra were recorded at either 250 or MHz. Chemical shifts are reported in parts per million (8) downfield from the internal standard tetramethylsilane (TMS). Abbreviations for NMR data are as follows:
s=singlet, d=doublet, t=triplet, q=quartet, m=multiples, dd=doublet of doublets, dt=doublet of triplets, app=apparent, br=broad. J indicates the NMR coupling constant measured in Hertz.

CDCl3 is deuteriochloroform, DMSO-d6 is hexadeuteriodimethylsulfoxide, and CD30D is tetradeuteriomethanol. Infrared (IR) spectra were recorded in transmission mode, and band positions are reported in inverse wavenumbers (cm-1). Mass spectra were obtained using electrospray (ES) ionization techniques. Eiementai analyses were performed by Quantitative Technologies Inc., Whitehouse, NJ. Melting points were taken on a Thomas-Hoover melting point apparatus and are uncorrected. All temperatures are reported in degrees Celsius. Analtech Silica Gel GF and E. Merck Silica Gel 60 F-254 thin layer plates were used for thin layer chromatography. Both flash and gravity chromatography were carried out on E. Merck Kieselgel 60 (230-400 mesh) silica gel. Analytical and preparative HPLC were carried out on Rainin or Beckman chromatographs. ODS refers to an octadecylsilyl derivatized silica gel chromatographic support. 5 a Apex-ODS
indicates an octadecylsilyi derivatized silica gel chromatographic support having a nominal particle size of 5 N, made by Jones Chromatography, Littleton, Colorado. YMC ODS-AQ~ is an ODS
chromatographic support and is a registered trademark of YMC Co. Ltd., Kyoto, Japan.
PRP-1~ is a polymeric (styrene-divinylbenzene) chromatographic support, and is a registered trademark of Hamilton Co., Reno, Nevada. Celite~ is a filter aid composed of acid-washed diatomaceous silica, and is a registered trademark of Manville Corp., Denver, Colorado.
Example 1 Preparation of Preparation of (S)-3-oxo-8-f3-(pyridin-2-,~lamino) 1 propyloxx 2 f2 3 4 trifluorobenzvl)-2,3,4.5-tetrahydro-1H-2-benzazepine-4-acetic acid Preparation I
Preparation of methyl (~)-8-hvdroxv-3-oxo-~ 3 4 5-tetrahvdro-1H-2 benzazepine 4 acetate a) 4-Bromo-3-bromomethylanisole A mixture of 2-bromo-5-methoxytoluene (20 g, 0.10 mol), N-bromosuccinimide (19.6 g, 0.11 mol), benzoyl peroxide (1 g, 4 mmol), and methylene chloride {200 mL) was irradiated for 18 hr with a flood lamp to effect gentle reflux. The mixture was then cooled to -10°C for several hr and the solution was decanted away from the precipitated succinimide. The solution was concentrated and the residue was crystallized from chloroform/hexane to give the title compound (19.7 g, 70%) as pale yellow prisms: 1H
NMR {CDC13) 8 7.45 (d, J = 8.9 Hz, 1 H), 6.99 (d, J = 3 Hz, 1 H), 6.74 (dd, J
= 8.9, 3 Hz, 1 H), 4.55 (s, 2 H) 3.80 (s, 3 H).

b) 3-Bis(tert-butoxycarbonyl)aminomethyl-4-bromoanisole A mixture of 4-bromo-3-bromomethylanisole (24 g, 86 mmol) and potassium di-tert-butyl iminodicarboxylate (24 g, 94 mmol) in dimethylformamide (200 mL) was stirred under argon at room temperature for 18 hr. The reaction was then concentrated under vacuum and the residue was partitioned between ethyl acetate and water. The organic phase was washed with water and brine, dried(MgS04), and concentrated. The residue was recrystallized from hexane to give the title compound (IS g, 42%) as a white solid: 1H
NMR (CDC13) 8 7.40 (d, J = 8.6 Hz, 1 H)), 6.68 (m, 2 H), 4.81 (s, 2 H), 3.74 (s, 3 H), 1.44 (s, 18 H).
c) Methyl (~)-3-carbomethoxy-4-[2-bis(tert-butoxycarbonyl)aminomethyl-4-methoxyphenyl]-3-butenoate A 500 mL flask was charged with 3-bis(tert-butoxycarbonyl)aminomethyl-4-bromoanisole(15 g, 36 mmol), dimethyl itaconate (7.5 g, 47 mmol), tri-o-tolylphosphine (1 g, 3 mol), palladium acetate (0.4 g, 2 mmol), diisopropylethylamine (12.8 mL, 72 mmol), and propionitrile (150 mL). The mixture was purged with argon (several evacuation/argon flush cycles), then was heated to reflux under argon for I hr. The reaction was allowed to cool to RT, then was poured into ice-cold ethyl ether (500 mL). The resulting precipitate was removed by filtration and the filtrate was concentrated. The residue was purified by chromatography on silica gel ( 10% - 20% ethyl acetate in hexane) to give the title compound (11.8 g, 66%) as a pale yellow oil: IH NMR (CDC13) 8 7.94 (s, 1 H), 7. i5 (d, J
= 8.1 Hz. 1 H)), 6.77 (d, J = 8.1 Hz, 1 H), 6.76 (s, 1 H), 4.73 (s, 2 H), 3.81 (s, 3 H), 3.79 (s, 3 H), 3.71 (s, 3 H), 3.38 (s, 2 H), 1.45 (s, 18 H).
d) Methyl (~)-3-carbomethoxy-4-[2-bis(ten-butoxycarbonyl)aminomethyl-4-methoxyphenyl]butanoate A pressure vessel charged with methyl (~)-3-carbomethoxy-4-[2-bis(tert-butoxycarbonyl)aminomethyl-4-methoxyphenylJ-3-butenoate (I i.8 g), ethyl acetate (120 mL), and l0% palladium on charcoal (1 g) was shaken under 45 psi of hydrogen for 18 hr.
The mixture was then filtered and the filtrate was concentrated to give the title compound ( 12 g, 100%) as a colorless oil: I H NMR (CDCI3) 8 7.00 (d, J = 8.2 Hz, 1 H), 6.71 (m, 2 H), 4.81 (s, 2 H), 3.75 (s, 3 H), 3.66 (s,3 H), 3.63 (s, 3 H), 3.05 (m, 2 H), 2.73 (m, 2 H), 2.42 (dd, J = 16.0, 4.8 Hz, 1 H), 1.44 (s, i8 H).
e) Methyl (t)-3-carbomethoxy-4-[2-(aminomethyl)-4-methoxyphenyl]butanoate A solution of methyl (-~)-3-carbomethoxy-4-[2-bis(tert-butoxycarbonyl)aminomethyl-4-methoxyphenyl]butanoate {12 g) in chloroform (100 mL) and trifluoroacetic acid (50 mL) was stirred under argon at room temperature for 4 hr. The solution was then concentrated under vacuum to give the title compound { 10 g, 100%) as a viscous oil: MS (ES) m/e 296.2 (M + H)+.
f) Methyl (~)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate A solution of methyl (~)-3-carbomethoxy-4-[2-(aminomethyl)-4 methoxyphenyl]butanoate (10 g, 24 mmol) and triethylamine (17 mL, 120 mmol) in toluene ( 100 mL) was heated at reflux for 18 hr. The reaction was then concentrated and the residue was partitioned between ethyl acetate and water. The aqueous layer was extracted twice with ethyl acetate and the combined organic extracts were washed with brine, dried (M~S04), and concentrated to afford the title compound (4.8 g, 76%) as tan solid: MS
(ES) m/e 264.2 (M + H)+.
g) Methyl (~)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate Anhydrous aluminum chloride (7.6 g, 57 mmoi) was added portionwise to a stirred solution of methyl (~)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate (3.0 g, 11 mmol) and ethanethiol (4.2 mL, 57 mmol) in methylene chloride (100 mL) at 0°C
under argon. The resulting mixture was allowed to warm to room temperature and stir overnight, then was concentrated. The residue was triturated with ice-water, and the resulting solid was collected by filtration and dried to give the title compound (2.64 g, 91 %) as an off white solid: MS (ES) m/e 250.2 (M + H)+.
Preparation 2 HPLC separation of the enantiomers of methyl (+)-8-hydroxy-3-oxo ~ 3 4 5 tetrahydro 1H
2-benzazepine-4-acetate a) Methyl (R)-(+)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate and methyl (S)-(-)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate Methyl (~)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate was resolved into its enantiomers by chiral HPLC using the following conditions:
Diacel Chiralpak ASS column {21.2 x 250 mm)., EtOH mobile phase, 7 mL/min flowrate, uv detection at 254 nm, 70 mg injection; tR for methyl (R)-(+)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate = 21.5 min; tR for methyl (S)-(-)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate = 39.1 min.

Preparation 3 HPLC separation of the enantiomers of methyl (+)-8-methoxy-3-oxo-2 3 4 5 tetra~dro I H-2-benzazepine-4-acetate a) Methyl (R)-(+)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate and methyl (S)-(-)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate Methyl (~)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate was resolved into its enantiomers by chiral HPLC using the following conditions:
Diacel Chiralpak ASS column (21.2 x 250 mm), CH3CN mobile phase, 15 mL/min flowrate, uv detection at 254 nm, 500 mg injection; tR for methyl {R)-(+)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-1 H-2-benzazepine-4-acetate = 10.2 min; tR for methyl (S}-(-)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-1 H-2-benzazepine-4-acetate = 19.0 min.
Preparation 4 Demethvlation of methyl (S)-8-methoxv-3-oxo-2 3 4 5-tetrahydro-1H-2-benzazepine 4 acetate a) Methyl (S)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate A solution of methyl (S)-8-methoxy-3-oxo-2,3,4,5-tetrahydro-lH-2-benzazepine-4-acetate { 15.0 g, 0.057 mole) in CHCl3 (160 mL) was added dropwise over 30 min to a solution of boron tribromide (20.53 mL, 0.217 mole) in CHCl3 (160 mL) at -8 °C under argon, maintaining the temperature between -5 °C and 0 °C. The reaction mixture was stirred at ca. -8 °C for 30 min and then MeOH (200 mL) was added, dropwise initially, maintaining the temperature at ca. 0 °C. The reaction mixture was concentrated to give a viscous oil which was reconcentrated from MeOH (100 mL). The oil was dissolved in H20/MeOH and a small amount of dark solid was removed by filtration. The filtrate was neutralized (to pH 7) with 50 % sodium hydroxide, depositing a white solid.
The suspension pH was adjusted to 4.5 by the addition of a small amount of acetic acid and the solid was collected and dried in vacuum to give afford the title compound (9.7 g, 68 %).
The product was assayed for chiral purity by HPLC: Chiralpak ASS column (4.6 x mm), 100% EtOH mobile phase, 0.5 mL/min flow rate, uv detection at 215 nm; tR
= 7.5 min (S-enantiomer, 99 Cloy; tR = 4.4 min (R-enantiomer, 1%).

Preparation 5 Preaaration of 2-fN-(3-hvdroxv-I-oropvi)-N-(tert-butoxycarbonyl)aminolpyridine N oxide a) 2-[(3-Hydroxy-I-propyl)amino]pyridine-N-oxide A mixture of 2-chloropyridine-N-oxide ( 16.6 g, 0.1 mole), 3-amino-1-propanol ( 15.3 mL, 0.2 mole), NaHC03 (42 g, 0.5 mole), and tert-amyl alcohol ( 100 mL) was heated to reflex. After 21 hr, the reaction was cooled, diluted with CH2Cl2 (300 mL), and suction filtered to remove insoluble materials. The filtrate was concentrated and reconcentrated from toluene to leave a yellow oil. Silica gel chromatography ( 20%
MeOH/CHCI3) gave the title compound { I 5.62 g, 93%) as a yellow solid: TLC (20% MeOH/CHCI3) R
f 0.48;
1H NMR (250, CDC13) b 8.07 (dd, J = 6.6, 1.2 Hz, 1 H), 7.34 (br t, 1 H), 7.10 -7.30 (m, 1 H), 6.64 (dd, J = 8.5, 1.4 Hz, I H), 6.40 - 6.60 (m, I H), 4.49 (br s, I H), 3.65 - 3.90 (m, 2 H), 3.35 - 3.60 (m, 2 H), 1.75 - 2.00 (m, 2 H); MS (ES) m/e 169 (M+ H)+.
b) 2-[N-(3-hydroxy-1-propyl)-N-(tent-butoxycarbonyl)amino]pyridine-N-oxide A solution of 2-[(3-hydroxy-I-propyl)amino]pyridine-N-oxide (8.0 g, 47.6 mmol) in tert-BuOH (80 mL) was treated with di-tert-butyl Bicarbonate (i 1.4 g, 55.3 mmol).
After 18h, the solution was concentrated and the residue was triturated with hexane. The resulting solid was dried in vacuo to give the title compound (12.5 g, 98%) as an off-white solid: MS (ES) m/e 269.3 {M + H)+.
Preparation 6 Preparation of (S)-3-oxo-8-f 3-(pyridin-2-ylamino)-I-propyloxyl-2-(2 3 4-trifluorobenzyl) 2 3 4 5-tetrahvdro-I H-2-benzazepine-4-acetic acid a) Methyl (S)-8-[3-[N-( 1-oxopyridin-2-yl)-N-(tert-butoxycarbonyl)amino]-1-propyloxy]-3-oxo-2,3,4,5-tetrahydro- I H-2-benzazepine-4-acetate A solution of 2-[N-(3-hydroxy-I-propyl)-N-(tent-butoxycarbonyl)amino]pyridine-N-oxide (1.8 g, 6.84 mmole) and diethyl azodicarboxylate (1.19 g, 6.84 mmole) in anhydrous DMF (22.5 mL) was added dropwise over 10 minutes to a solution of (S)-8-hydroxy-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate (0.65 g, 2.75 mmole) and triphenylphosphine { 1.94 g, 7.4 mmole) in anhydrous DMF (13.5 mL) at RT. A
ter 16 hr, the solution was evaporated to a brown oil which was partitioned between ethyl acetate (500 mL) and water ( I OU mL). The organic layer was washed with water (2 x 100 mL) and brine ( 100 mL), dried (Na2S04), and concentrated to give a pale brown oil.
Purification by silica gel chromatography (5% MeOH/CH2Cl2) gave the title compound (0.85 g, 60%).
MS (ES) m/e 500.3 (M + H)+.
b) Methyl (S)-8-[3-[N-( 1-oxopyridin-2-yl)-N-(tert-butoxycarbonyl)amino]-1-propyloxy]-2-(2.3,4-trifluorobenzyl)-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate A 1.0 M solution of lithium bis(trimethysilyl) amide (1.0 mL, 1.0 mmole) was added dropwise to a solution of methyl (S)-8-[3-[N-(1-oxopyridin-2-yl)-N-(tert-butoxycarbonyl)amino]- I -propyloxy)-3-oxo-2,3,4,5-tetrahydro-1 H-2-benzazepine-4-acetate (0.470 g, 0.94 mmole) in anhydrous DMF (10.0 mL) at -15° under argon. After 10 minutes, a solution of 2,3,4-trifluorobenzyl bromide (0.22 g, 0.96 mmoIe) in anhydrous THF (5.0 mL) was added dropwise. The solution was allowed to warm to RT over 2 hr.
After 18 hr, the solution was evaporated and the residue was partitioned between ethyl acetate (200 mL) and water (30 mL). The organic layer was washed with water (2 x 25 mL) and brine (30 mL), dried (Na2S04), and concentrated to give a pale yellow solid.
Purification by silica gel chromatography (5% MeOH/CH2CI2) gave the title compound (0.45 g, 75%). MS (ES) m/e 644. I (M + H)+.
c) Methyl (S)-8-[3-[N-(I-oxopyridin-2-yl)amino]-1-propyloxy]-2-(2,3,4-trifluorobenzyl)-3-oxo-2,3,4,5-tetrahydro- I H-2-benzazepine-4-acetate Methyl (S)-8-[3-[N-(I-oxopyridin-2-yl)-N-(tert-butoxycarbonyl)amino]-I-propyloxy]-2-{2,3,4-trifluorobenzyl)-3-oxo-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate (0.39, 0.61 mmole) was dissolved in a solution of 4.0 M hydrogen chloride in 1,4-dioxane (20 mL), and the reaction was kept at RT for 16 hr. Removal of the solvent left an oil which solidified upon trituration with ether. This material was dissolved in methylene chloride (80 mL) and washed with saturated NaHC03 ( 10 mL) The organic layer was dried (Na2S04) and concentrated to give the title compound (0.33 g, 98%). MS
(ES) m/e 544.1 (M + H)+.
d) Methyl (S)-3-oxo-8-[3-(pyridin-2-ylamino)-I-propyloxy]-2-(2,3,4-trifluorobenzyl}-2,3,4,5-tetrahydro-IH-2-benzazepine-4-acetate A solution of methyl (S)-8-[3-[N-(1-oxopyridin-2-yl)amino]-1-propyloxy]-2-(2,3,4-trifluorobenzyl)-3-oxo-2,3,4,5-tetrahydro-IH-2-benzazepine-4-acetate (0.28 g, 0.52 mmole) and cyclohexene (0.28 g, 3.35 mmole) in methanol (15 mL) containing 10%
Pd/C
(0.270 g) was heated at reflex for 16 hr, cooled, and filtered through celiteCJ. The filtrate was concentrated to give the title compound (0.27 g, 99%). MS (ES) m/e 528.1 (M + H)+.

e} (S)-3-Oxo-8-[3-(pyridin-2-yiamino)-1-propyloxy]-2-(2,3,4-trifluorobenzyl}-2,3,4,5-tetrahydro-IH-2-benzazepine-4-acetic acid A solution of methyl (S)-3-oxo-8-[3-(pyridin-2-ylamino)-1-propyloxy]-2-(2,3,4 trifluorobenzyl)-2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetate (0.27 g, 0.52 mmole) in a mixture of methanol (15 mL) and 0.5 N NaOH (3.0 mL) was heated at 50°C.
After 2 hr, the reaction was cooled to RT, treated with TFA (0.50 mL), and concentrated to give a pale yellow solid. Purification by semi-preparative HPLC (YMC ODS-AQ, 10 um, 120 A, mm x 250 mm, 40% CH3CN/H20 containing 0.1 % TFA) gave the title compound, (0.210 g, 67%). MS (ES) m/e 514.4 (M + H)+. Anal. Calcd for C27H26F3N304 ~ 1.3 CF3C02H:
C, 53.73: H, 4.16; N, 6.35. Found: C, 53.64; H, 4.11; N, 6.14.
Example 2 Parenteral Dosa,~nit Composition A preparation which contains 20 mg of the compound of Example 1 as a sterile dry powder is prepared as follows: 20 mg of the compound is dissolved in 15 mL of distilled water. The solution is filtered under sterile conditions into a 25 mL mufti-dose ampoule and lyophilized. The powder is reconstituted by addition of 20 mL of S%
dextrose in water (D5W) for intravenous or intramuscular injection. The dosage is thereby determined by the injection volume. Subsequent dilution may be made by addition of a metered volume of this dosage unit to another volume of D5W for injection, or a metered dose may be added to another mechanism for dispensing the drug, as in a bottle or bag for IV
drip infusion or other injection-infusion system.
Example 3 Oral Dosage Unit Composition A capsule for oral administration is prepared by mixing and milling 50 mg of the compound of Example 1 with 75 mg of lactose and 5 mg of magnesium stearate.
The resulting powder is screened and filled into a hard gelatin capsule.

Example 4 Oral Dosage Unit Composition A tablet for oral administration is prepared by mixing and granulating 20 mg of sucrose, 150 mg of calcium sulfate dihydrate and 50 mg of the compound of Example I
with a 10% gelatin solution. The wet granules are screened, dried, mixed with 10 mg starch, 5 mg talc and 3 mg stearic acid; and compressed into a tablet.
IO The above description fully discloses how to make and use the present invention.
However, the present invention is not limited to the particular embodiments described hereinabove, but includes all modifications thereof within the scope of the following claims. The various references to journals, patents and other publications which are cited herein comprises the state of the art and are incorporated herein by reference as though fully set forth.

*rB

Claims (29)

What is claimed is:
1. A compound according to formula (I):
or a pharmaceutically acceptable salt thereof.
2. A pharmaceutical composition which comprises a compound according to claim 1 and a pharmaceutically acceptable carrier.
3. A pharmaceutical composition which comprises a compound according to claim 1, an antineoplastic agent and a pharmaceutically acceptable carrier.
4. The pharmaceutical composition according to claim 3 wherein the antineoplastic agent is topotecan.
5. The pharmaceutical composition according to claim 3 wherein the antineoplastic agent is cisplatin.
6. A method of treating a disease state in which antagonism of the .alpha.v.beta.3 receptor is indicated which comprises administering to a subject in need thereof a compound according to claim 1.
7. A method of treating a disease state in which antagonism of the .alpha.v.beta.5 receptor is indicated which comprises administering to a subject in need thereof a compound according to claim 1.
8. A method of treating osteoporosis which comprises administering to a subject in need thereof a compound according to claim 1.
9. A method for inhibiting angiogenesis which comprises administering to a subject in need thereof a compound according to claim 1.
10. A method for inhibiting tumor growth or tumor metastasis which comprises administering to a subject in need thereof a compound according to claim 1.
11. A method of treating atherosclerosis or restenosis which comprises administering to a subject in need thereof a compound according to claim 1.
12. A method of treating inflammation which comprises administering to a subject in need thereof a compound according to claim 1.
13. A method of inhibiting tumor growth which comprises administering stepwise or in physical combination a compound according to claim 1 and an antineoplastic agent.
14. The method according to claim 13 wherein the antineoplastic agent is topotecan.
15. The method according to claim 13 wherein the antineoplastic agent is cisplatin.
16. A compound according to formula (II):
or a pharmaceutically acceptable salt thereof.
17. A compound according to formula (III):

or a pharmaceutically acceptable salt thereof.
18. A compound according to claim 1 for use as a medicament.
19. The use of a compound of claim 1 in the manufacture of a medicament for the treatment of diseases in which antagonism of the .alpha.v.beta.3 receptor is indicated.
20. The use of a compound of claim 1 in the manufacture of a medicament for the treatment of diseases in which antagonism of the .alpha.v.beta.5 receptor is indicated.
21. The use of a compound of claim 1 in the manufacture of a medicament for the treatment of osteoporosis.
22. The use of a compound of claim 1 in the manufacture of a medicament for the inhibition of angiogenesis.
23. The use of a compound of claim 1 in the manufacture of a medicament for the inhibition of tumor growth or tumor metastasis.
24. The use of a compound of claim 1 in the manufacture of a medicament for the treatment of atherosclerosis or restenosis.
25. The use of a compound of claim 1 in the manufacture of a medicament for the treatment of inflammation.
26. The use of a compound of claim 1 and an antineoplastic agent in the manufacture of a medicament for the inhibition of tumor growth in physical combination or for stepwise administration.
27. The use according to claim 26 wherein the antineoplastic agent is topotecan.
28. The use according to claim 26 wherein the antineoplastic agent is cisplatin.
29. The use of a compound of claim 1 and an inhibitor of bone resorption in the manufacture of a medicament for the treatment of osteoporosis in physical combination or for stepwise administration.
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