CA2535260A1 - Method for treating cachexia with retinoid ligands - Google Patents

Method for treating cachexia with retinoid ligands Download PDF

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CA2535260A1
CA2535260A1 CA002535260A CA2535260A CA2535260A1 CA 2535260 A1 CA2535260 A1 CA 2535260A1 CA 002535260 A CA002535260 A CA 002535260A CA 2535260 A CA2535260 A CA 2535260A CA 2535260 A1 CA2535260 A1 CA 2535260A1
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carbons
cancer
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lower alkyl
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Guang Liang Jiang
Yang-Dar Yuan
Roshantha A. Chandraratna
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Allergan Inc
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    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
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    • A61K31/343—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having five-membered rings with one oxygen as the only ring hetero atom, e.g. isosorbide condensed with a carbocyclic ring, e.g. coumaran, bufuralol, befunolol, clobenfurol, amiodarone
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    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
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Abstract

The present invention relates to a method of treatment of cachexia in a subject in need of treatment. More specifically, the present invention relates to the use of retinoid compounds that act on retinoid X receptors (RXRs) for the treatment of cachexia in a subject in need of treatment. The cachexia is associated with, in other words a complication of, a primary disease, condition or disorder. Primary diseases, conditions and disorders include, but are not limited to, cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases (e.g., rheumatoid arthritis and systemic lupus erythematosus), tuberculosis, cystic fibrosis, gastrointestinal disorders (e.g., irritable bowel syndrome and inflammatory bowel disease), Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.

Description

METHOD FOR TREATING CACHEXIA
WITH RETINOID LIGANDS
RELATED APPLICATIONS
This application claims the benefit of U.S. Provisional Application No.
601493,138, filed on August 7, 2003 and U.S. Provisional Application No.
60/533,734, filed on December 31, 2003. The entire teachings of the above applications are incorporated herein by reference.
BACKGROUND OF THE INVENTION
Cachexia, which literally means 'bad condition', refers to involuntary weight loss, anorexia (loss of appetite), loss of protein and fat mass, gain in the proportion of body-water, and a variety of metabolic changes, which are associated with a primary disease, condition or disorder. Diseases, conditions or disorders which are typically associated with cachexia include, but axe not limited to, cancer, ATDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases (e.g., rheumatoid arthritis and systemic lupus erythematosus), tuberculosis, cystic fibrosis, gastrointestinal disorders (e.g., irritable bowel syndrome and inflammatory bowel disease), Parkinson's disease, dementia, anorexia nervosa, major depression, an aged condition and sarcopenia. Cachexia is a strong independent risk factor for morbidity and mortality. Cancer cachexia occurs in about half of all cancer patients.
The fact that a large proportion of cancer patients have cachexia, coupled with the demonstrated relationship between cachexia and mortality has provided impetus for the search into underlying mechanisms and therapies that might prevent or reverse cachexia. However, this need has gone largely unmet.
SUMMARY OF THE INVENTION
The present invention relates to a method of treating of cachexia in a subject in need of treatment. More specifically, the present invention relates to the use of retinoid compounds that act on retinoid X receptors (RXRs) for the treating of cachexia in a subject in need of treatment. The cachexia is associated with, in other words a complication of, a primary disease, condition or disorder. Primary diseases, conditions and disorders include, but are not limited to, cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases (e.g., rheumatoid arthritis and systemic lupus erythematosus), tuberculosis, cystic fibrosis, gastrointestinal disorders (e.g., irritable bowel syndrome and inflammatory bowel disease), Parkinson's disease, dementia, major depression, anorexia nervosa, an aged condition and sarcopenia. In one embodiment, the cachexia is associated with one or more of AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia. In another embodiment, the cachexia is associated with one or more of cancer, ASS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia. In yet another embodiment, the cachexia is associated with one or more of ASS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia. In a specific embodiment, the cachexia is associated with cancer. In another specific embodiment, the cachexia is associated with AIDS.
In one embodiment, the method of treating cachexia in a subject in need thereof comprises administering to the subject a therapeutically effect amount of a compound represented by Structural Formula (I):
R~ R~
Z\Y \ \ B
R~ R~ (I)~
where:
Z is represented by Structural Formula (II) or Structural Formula (III) R2 (II) or ~3 (III);
Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R4 groups, or Y is selected from phenyl, pyridyl, thienyl, furyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adjacent caxbons;
X is S, O, or NRS;
n is 1 or 2;
Rl and Ra independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br;
R4 is lower alkyl, fluoroalkyl or halogen;
RS is H or lower alkyl;
R,. i~..
B is hydrogen, -COON or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CHZOH, -CHZORII, -CHZOCORII, -CHO, -CH(ORiz)z, -CHOR130, -COR7, -GR7(ORIZ)z, -CR70R130, or tri(lower alkyl)silyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or Rg is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an allcyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rll is lower alkyl, phenyl or lower alkylphenyl;
Rlz is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
In a particular embodiment, Z is represented by Structural Formula (II) or (III); Y is selected from pyridyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adjacent carbons; X is NRS; n is 1 or 2; Rl and Rz independently are -H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, -Cl or -Br; R4 is lower alkyl, fluoroalkyl or halogen; RS is -H or lower alkyl; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CHzOH, -CHzORII, -CH20COR11, -CHO, -CH(ORIZ)z, -CHOR130, -COR7, -CR7(ORIZ)z, -CR70R130, or tri(lower alkyl)silyl; R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; R$ is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl; Rl l is lower alkyl, phenyl or lower alkylphenyl; RIZ is lower alkyl; and R13 is a divalent alkyl radical of 2 to 5 carbons.
In another particular embodiment, Z is represented by Structural Formula (III); Y is thienyl or furyl, said thienyl or furyl groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRI=CRl-CRl=CRl- groups on adjacent carbons; X is NRS; n is 1 or 2; Rl and Rz ';
independently are -H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, -Cl or -Br; R4 is lower alkyl, fluoroalkyl or halogen; RS is H or lower alkyl; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CH20H, -CHaORII, -CH20COR11, -CHO, -CH(OR12)2, -CHOR130, -COR7, -CR7(OR12)2, -CR70R130, or tri(lower alkyl)silyl; R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; Rg is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl; Rl l is lower alkyl, phenyl or lower alkylphenyl; R12 is lower alkyl; and R13 is a divalent alkyl radical of 2 to 5 carbons.
In yet another particular embodiment, Z is represented by Strucutural Formula (III); Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R4 groups, or Y is selected from phenyl, pyridyl, thienyl, furyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adj acent carbons; X is S or O; n is 1 or 2; Rl and R2 independently are H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, Cl or Br; R4 is lower alkyl, fluoroalkyl or halogen; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CHZOH, -CH20R11, -CHZOCORII, -CHO, -CH(ORIa)2, -CHOR13O, -COR7, -CR~(OR12)2, -CR70R130, or tri(lower allcyl)silyl;
R7 is an alkyl, cycloalkyl or allcenyl group containing 1 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the allcyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rll is lower alkyl, phenyl or lower alkylphenyl; Rla is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
In a further particular embodiment of compounds represented by Structural Formula (I), Z is represented by Structural Formula (II); Y is selected from thienyl or furyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CR1=CR1-CR1=CR1- groups on adjacent carbons; n is 1 or 2; Rl and Rz independently are H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, Cl or Br; R4 is lower alkyl, fluoroalkyl or halogen; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CHzOH, -CH20R11, -CH20COR11, -CHO, -CH(ORIZ)z, -CHOR130, -COR7, -CR7(ORIZ)z, -CR70R130, or tri(lower alkyl)silyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; Rg is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Ril is lower alkyl, phenyl or lower alkylphenyl; Rlz is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
Another group of compounds encompassed by Structural Formula (I) include those where Z is represented by Structural Formula (III); Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R4 groups, or Y is phenyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adj acent carbons; X is NRS; Rl and Rz independently are H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino; cyano, Cl or Br;
R4 is lower alkyl, fluoroalkyl or halogen; RS is -H or lower alkyl; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CHZOH, -CHzORI l, -CHzOCORII, -CHO, -CH(ORiz)za -CHORl30, -COR7, -CR7(ORIZ)z, -CR70R130, or tri(lower alkyl)silyl; R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; R$ is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl; Rl l is lower alkyl, phenyl or lower alkylphenyl; Rlz is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
Yet another group of compounds encompassed by Structural Formula (17 include those where Z is represented by Structural Formula (III); Y is cyclopropyl, said Y group being optionally substituted with one or two R~ groups, and wherein Y
is substituted by the Z and -CRl=CRl-CR1=CRl- groups on adjacent carbons; X is NRS; Rl and Ra independently are H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, Cl or Br; R4 is lower alkyl, fluoroalkyl or halogen; RS is -H or lower alkyl; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CH20H, -CHZORiI, -CHZOCORII, -CHO, -CH(ORia)z, -CHOR130, -COR7, -CR7(ORIZ)a, -CR70R130, or tri(lower alkyl)silyl; R7 is an alkyl of 1 to 5 carbons, cycloalkyl of 3 to 5 carbons or alkenyl group containing 2 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl; R~ 1 is lower alkyl, phenyl or lower alkylphenyl; Rl2 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
In another embodiment, the invention includes a method of treating cachexia in a subject in need of treatment comprising administering a therapeutically effect amount of a compound represented by Structural Formula (IV):
R2o \\H
/~ \\
g (~)~
where R2o is alkyl of 1 to 6 carbons, and B is -COOH, or -COORaI where RZl is alkyl of 1 to 6 carbons, or a pharmaceutically acceptable salt of said compound.
Another aspect of the invention is where a therapeutically effect amount of a compound represented by Structural Formula (V) is used in a method of treating cachexia in a subj ect in need of treatment therefor:

_g_ B
k2 2 where:
Rz is hydrogen or lower alkyl;
R3 is hydrogen or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9RIO, -CH20H, -CHZORIi, -CHZOCORII, -CHO, -CH(ORIZ)z~
-CHOR130, -COR7, -CR7(ORIZ)z, -CR70R130, or tri-lower alkylsilyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rl1 is lower alkyl, phenyl or lower alkylphenyl;
Rlz is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
The invention further includes a method of treating a subject in need thereof for cachexia, comprising administering a therapeutically effective amount of a compound represented by Structural Formula (VI):
B

(VI), where:
n is 1 or 2;

R1 and Rz independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower allcyl, -Cl or -Br;
R4 is H, lower alkyl, fluoroalkyl or halogen;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORS, -CONR9Rio, -CHzOH, -CH20R11, -CHZOCORIl, -CHO, -CH(ORIZ)z, -CHOR130, -COR7, -CR7(ORIZ)z, -CR70R130, or tri-lower alkylsilyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rl1 is lower alkyl, phenyl or lower alkylphenyl;
Rlz is lower alkyl; and i R13 is divalent alkyl radical of 2 to S carbons.
In another embodiment, the method of treating cachexia in a subj ect in need thereof includes administering a therapeutically effective amount of a compound represented by Structural Formula (VII):
B (VII), where:
R4 is lower alkyl of 1 to 6 carbons;
B is -COOH or -COORS; and R8 is lower alkyl of 1 to 6 carbons; and the configuration about the cyclopropane ring is cis, and the configuration about the double bonds in the pentadienoic acid or ester chain attached to the cyclopropane ring is trans in each of said double bonds, or a pharmaceutically acceptable salt thereof.

In yet another embodiment, the compounds administered for treating cachexia in a subject in need thereof are represented by Structural Formula (VIII):
R.. 17 B
(VIII), wherein:
X is S or O; alternatively, X is NRS;
R2 is hydrogen or lower alkyl;
R3 is hydrogen or lower alkyl;
RS is hydrogen or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CH20H, -CH~ORII, -CH20COR11, -CHO, -CH(ORIZ)2, -CHOR130, -COR7, -CR7(ORIa)aa -CR70R130, or tri-lower alkylsilyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, such as an alkyl of 1 to 5 carbons, a cycloalkyl of 3 to 5 carbons or an alkenyl group containing 2 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rl'o independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rll is lower alkyl, phenyl or lower alkylphenyl;
Ri2 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
In a preferred embodiment, compounds of Structural Formula (I) for treating cachexia are represented by Structural Formulas (IX), (X) and (XI):

B
( B
(X) B
~C_ v ~Rs (XI), where:
B is -COOK or -COORS;
R3 is hydrogen, lower alkyl, -Cl or -Br;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; and XisSorO.
Another aspect of the invention involves treating cachexia in a subject in need thereof comprising administering an effective amount of a compound represented by any one of Structural Formulas (XIII), (XIV) or (XV):

R1 '°' (XIII) R2, Y
A

(XIV) J R
v 1 R1 A (XV), where:
X is O, S, or (CR1R1)";
n is 0, 1 or 2;
Y is a bivalent radical having Structural Formula (XVI) or Structural Formula (XVII) where p is an integer from 1 to 4:
CCR1 R1 ~p ~1 C CR1S"
(XVI) X

R1 ~ CR1 (XVII) or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups being unsubstituted, or substituted with 1 to 3 C1_6 alkyl or with 1 to 3 Cl_6 fluoroalkyl groups;
X is O, S or NH;
Rl is independently -H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
Rz is independently -H, lower alkyl of 1 to 6 carbons, -ORI, 1-adamantyl, or lower fluoroalkyl of 1 to 6 carbons, or the two Rz groups jointly represent an oxo group;
R3 is hydrogen, lower alkyl of 1 to 6 carbons, -OR1, fluoro substituted lower alkyl of 1 to 6 carbons or halogen, -NOz, -NHz, -NHCO(C1-C6)alkyl, or -NHCO(C1-C6)alkenyl;
A is hydrogen, COON or a pharmaceutically acceptable salt thereof, -COORB, -CONR9RlO, -CHzOH, -CHzORII, -CHzOCORI l, -CHO, -CH(ORIZ)z, -CH(OR130), -COR7, -CR7(ORIZ)z, -CR7(OR130), or Sl(C1_6 alkyl)3;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the allcyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R~ is phenyl or lower alkylphenyl;
R9 and RlO independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
Rl l is lower alkyl, phenyl or lower alkylphenyl;
RIZ is lower alkyl;
R13 is divalent alkyl radical of 2-5 carbons; and R14 is alkyl of 1 to 10 carbons, fluoro-substituted alkyl of 1 to 10 carbons, alkenyl of 2 to 10 carbons and having 1 to 3 double bonds, alkynyl having 2 to carbons and 1 to 3 triple bonds, carbocyclic aryl selected from the group consisting ofphenyl, C1-CIO-alkylphenyl, naphthyl, C1-ClO-alkylnaphthyl, phenyl-C1-ClO
alkyl, naphthyl-C1-Clo alkyl, C1-Clo-alkenylphenyl having 1 to 3 double bonds, Cl-Clo-alkynylphenyl having 1 to 3 triple bonds, phenyl-Cl-Clo alkenyl having 1 to 3 double bonds, phenyl-C1-Clo alkynyl having 1 to 3 triple bonds, hydroxy alkyl of 1 to 10 carbons, hydroxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, hydroxyalkynyl having 2 to 10 carbons and 1 to 3 triple bonds, acyloxyalkyl of 1 to carbons, acyloxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, or acyloxyalkynyl of 2 to 10 carbons and 1 to 3 triple bonds where the acyl group is represented by CORg, or R14 is a 5 or 6 membered heteroaryl group having 1 to heteroatoms, said heteroatoms being selected from a group consisting of O, S, and 10 N, said heteroaryl group being unsubstituted or substituted with a C1 to Clo alkyl group, with a C1 to Cio fluoroalkyl group, or with halogen, and the dashed line in Structural Formula (XVI) represents a bond or absence of a bond.
A further aspect of the invention is a method of treating cachexia in a subject in need thereof comprising administering a therapeutically effective amount of a compound represented by Structural Formula (XVIII):
R R~

Y~Ra) ~ ~ . R~
R' R~ R1 (XVIII), wherein:
X is O, NR' or S;
R' is alkyl of 1 to 6 carbons;
Y is a bivalent cyclopropyl radical optionally substituted with one or two R4 groups, or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups optionally substituted with 1 to 4 R4 groups;
Rl is independently -H, alkyl of 1 to 6 carbons, or fluoroalkyl of 1 to 6 carbons;
RZ is alkyl of 1 to 8 carbons, or fluoroalkyl of 1 to 8 carbons;
R'2 is alkyl of 1 to 8 carbons, or fluoroalkyl of 1 to 8 carbons;

R3 is hydrogen, alkyl of 1 to 6 carbons, fluoro substituted alkyl of 1 to 6 carbons, halogen, alkoxy of 1 to 8 carbons, or alkylthio of 1 to 6 carbons, -NOa, -NH2, -NHCO(Ci-C6)alkyl, -NHCO(Ci-C6)alkenyl, -NRiH or -N(Rl)Z, benzyloxy or C1-C6 alkyl-substituted benzyloxy;
R4 is -H or alkyl of 1 to 6 carbons, or fluoro substituted alkyl of 1 to 6 carbons;
m is an integer having the values of 0 to 3, and B is -COOH or a pharmaceutically acceptable salt thereof, -COORS, -COOCH2COR7, -CONR9Rio, -CH20H, -CH20R11, -CH20COR11, -CHO, -CH(OR12)Z, -CH(OR130), -COR7, -CR~(ORiz)2, -CR7(OR130), R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
Rs is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a group of 5 to 10 phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
Rl l is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2-5 carbons.
Yet another aspect of the invention is a method of treating cachexia in a subj ect in need thereof with a therapeutically effective amount of a compound represented by Structural Formula (XIX):

~1 J

Ra A

X2 R1~ ( wherein:
Y is a bivalent radical having Formula (a) or Formula (b):

~~ ~ ~R~)p R~C____ CRS RFC CRS
~ (a) ~ ~ (b) or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups being unsubstituted, or substituted with 1 to 3 C1_6 alkyl or with 1 to 3 Cl_6 fluoroalkyl groups;
p is an integer from 1 to 4;
the two Xl groups jointly represent an oxo or thione function, or Xl is independently selected from -H or alkyl of 1 to 6 carbons;
the two X2 groups jointly represent an oxo or a thione function, or X~ is independently selected from -H or alkyl of 1 to 6 carbons, with the proviso that one of the joint Xl grouping or of the joint X2 grouping represents an oxo or a thione function;
W is -H, -O-, -C(Rl)Z-, phenyl, naphthyl, or 5 or 6 membered heteroaryl group having 1 to 3 heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said phenyl, naphthyl or heteroaryl groups being unsubstituted or substituted with a C, to Clo alkyl group, with a C1 to Clo fluoroalkyl group, or with halogen;
Rl is independently -H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
R2 is independently -H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
R3 is hydrogen, lower alkyl of 1 to 6 carbons, -ORI, fluoro substituted lower alkyl of 1 to 6 carbons or halogen, -NOz, -NH2, -NHCO(C1-C6 alkyl, or -NHCO(C1-C6)alkenyl;
A is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CH20H, -CH20Rli, -CH20COR11, -CHO, -CH(ORIZ)a, -CH(OR130), -COR7, -CR7(ORIa)aa -CR7(OR130), or -Si(C1_6 alkyl)3;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R$ is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
Ri 1 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl;
R13 is divalent alkyl radical of 2-5 carbons;
R14 is -H, alkyl of 1 to 10 carbons, fluoro-substituted alkyl of 1 to 10 carbons, alkenyl of 2 to 10 carbons and having 1 to 3 double bonds, allcynyl having 2 to 10 caxbons and 1 to 3 triple bonds, carbocyclic aryl selected from the group consisting of phenyl, Cl-Clo-alkylphenyl, naphthyl, Cl-Clo-alkylnaphthyl, phenyl-Cl-Cio alkyl, naphthyl-Cl-Clo-alkyl, Ci-Clo-alkenylphenyl having 1 to 3 double bonds, C1-Clo-alkynylphenyl having 1 to 3 triple bonds, phenyl-Cl-Coo alkenyl having 1 to 3 double bonds, phenyl-Ci-Clo alkynyl having 1 to 3 triple bonds, hydroxy alkyl of 1 to 10 carbons, hydroxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, hydroxyalkynyl having 2 to 10 carbons and 1 to 3 triple bonds, acyloxyalkyl of 1 to 10 carbons, acyloxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, or acyloxyalkynyl of 2 to 10 carbons and 1 to 3 triple bonds where the acyl group is represented by CORE, or R14 is a 5 or 6 membered heteroaryl group having 1 to 3 heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said carbocyclic aryl and heteroaryl groups being unsubstituted or substituted with a C1 to Clo alkyl group, with a Cl to Clo fluoroalkyl group, or with halogen;
and the dashed line in Formula (a) represents a bond or absence of a bond, provided that when the dashed line represents a bond then there are no Rl substituents on the caxbons connected by said bond.
In another embodiment, the invention is a method of treating cachexia in a subject in need thereof comprising administering a therapeutically effective amount of a compound represented by Structural Formula (XX):

~p~ (R3)m N Y(R2) A B
R~
wherein:
X is O, S, or C(R)z;
R is -H or alkyl of 1 to 6 carbons;
Ri is -H, alkyl of 1 to 10 carbons, alkenyl of 2 to 6 carbons, phenyl-C1-C6 alkyl, or C~-C6-alkylphenyl;
Rz is H, alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, alkoxy of 1 to 6 carbons, or alkylthio of 1 to 6 carbons;
R3 is independently alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, -OH, -SH, alkoxy of 1 to 6 carbons, fluoroalkoxy of 1 to 6 carbons, alkylthio of 1 to 6 carbons, benxyloxy, Ci-C6 alkyl substituted benzyloxy, halogen substituted benzyloxy, phenyloxy, Cl-C6 alkyl substituted phenyloxy, or halogen substituted phenyloxy;
R4 is independently -H, alkyl of 1 to 6 carbons, or -F;
Y is a phenyl or naphthyl group, or heteroaryl selected from a group consisting of pyridyl, thienyl, furyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, imidazolyl and pyrrazolyl, said phenyl and heteroaryl groups being optionally substituted with one or two Rz groups; m is an integer having the values 0 to 3;
p is an integer having the values 0 to 4;
A is - (CHz)q- where q is 0-5, lower branched chain alkyl having 3-6 carbons, cycloalkyl having 3-6 carbons, alkenyl having 2-6 carbons and 1 or 2 double bonds, alkynyl having 2-6 carbons and 1 or 2 triple bonds;
B is hydrogen, -COOH, -COORg, -CONR9RIO, -CHZOH, -CHzORIi, -CHzOCORII, -CHO, -CH(ORiz)z, -CHOR130, -COR7, -CR~(ORIZ)z, -CR70R130, or tri-lower alkylsilyl;
R~ is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R8 is an alkyl group of 1 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl or lower alkylphenyl;
Rl1 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2-5 carbons, and pharmaceutically acceptable salts thereof. , In a further embodiment, the invention is a method of treating cachexia in a subject in need thereof comprising administering a therapeutically effective amount of a compound represented by any one of Structural Formula (XXI), (XXII), (XXIII), (XXIV), (XXV), (XXXVI), (XXXVII), (XXVIIa) or (XXVIIb):
X
a ~a X
R3 ~ (XXII) R.
-) J I X
R3 ~ (XXIII) ~2~~
Rrrr R""
R~ R2 Z"' nt~zC) '''~.
R~ ~ Rs (~XI'~) 7rrs ~n / ,~ ~ x '. t Rao ~n ~s R14 ~ ~..~~92 RI ~a R5 R6 Rya (~STI~
?b ~~n,_.._..~
1'~
i s -..~re (~;.~V II}

R~ Rio ."
Z \ / R~~
Z"
, \ ~Z~
R~ ~ R~2 R~ 3 (XXVIIa) R~ Rio R' R"
Z
Z",~R~~
/Z ~Z"

R $~s R~2 (XXVIIb), wherein:
Rl and R2 each independently is hydrogen or lower alkyl or acyl having 1-4 carbon atoms;
Y is C, O, S, N, CHOH, CO, SO, 502, or a pharmaceutically acceptable salt;
R3 is hydrogen or lower alkyl having 1-4 carbon atoms where Y is C or N;
R4 is hydrogen or lower alkyl having 1-4 carbon atoms when Y is C, R4 does not exist if Y is N, or neither R3 or R4 exist if Y is S, O, CHOH, CO, SO, or SOZ;
R' and R" are hydrogen, lower alkyl or acyl having 1-4 carbon atoms, -OH, alkoxy having 1-4 carbon atoms, thiol or thioether, or amino, or R' or R"
taken together form an oxo(keto), methano, thioketo, HO-N=, NC-N=, (R7R8)N-N=, R170-N=, R17N=, epoxy, cyclopropyl, or cycloalkyl group and wherein the epoxy, cyclopropyl, and cycloalkyl groups are optionally substituted with lower alkyl having 1-4 carbons or halogen;
R"' and R"" are hydrogen, halogen, lower alkyl or acyl having 1-4 carbon atoms, alkylamino, or R"' and R"" taken together form a cycloalkyl group having 3-10 carbons, and wherein the cycloalkyl group can be substituted with lower alkyl having 1-4 carbons or halogen;
RS is hydrogen, a lower alkyl having 1-4 carbons, halogen, nitro, -OR7, -SR7, -NR7R8, or -(CF)"CF3, but RS is not hydrogen if R6, Rlo, R11, Rla and R13 are all _22_ hydrogen, Z, Z', Z", Z"', and Z"" are all carbon, and R' and R" represent -H, -OH, C1-C4 alkoxy or Cl-C4 acyloxy or R' and R" taken together form an oxo, methano, or hydroxyimino group;
R6, Rlo, Rl l, Rla and R13 each independently represent hydrogen, a lower alkyl having 1-4 carbons, halogen, vitro, -OR7, -SR7, -NR7R8 or - (CF)"CF3, and exist only if the Z, Z', Z", Z"', or Z"" from which R6, Rlo, Rin Ria or R13 originates is C, or R6, Rlo, R11, Rm and R13 each independently represent hydrogen or a lower alkyl having 1-4 carbons if the Z, Z', Z", Z"', or Z"" from which R6, Rlo, Rll, Ria or Ri3 originates is N, and where one of R6, Rlo, Rm Rtz ar R13 is X;
R7 represents hydrogen or a lower alkyl having 1-6 carbons;
R8 represents hydrogen or a lower alkyl having 1-6 carbons;
R9 represents a lower alkyl having 1-4 carbons, phenyl, aromatic alkyl, or q-hydroxyphenyl, q-bromophenyl, q-chlorophenyl, q-fluorophenyl, or q-iodophenyl, where q=2-4;
R14 represents hydrogen, a lower alkyl having 1-4 carbons, oxo, hydroxy, acyl having 1-4 carbons, halogen, thiol, or thioketone;
RI7 is hydrogen, lower alkyl having 1-8 carbons, alkenyl optionally substituted with halogen, acyl, -OR7 or -SR7, -R9, alkyl carboxylic acid optionally substituted with halogen, acyl, -OR7 or -SR7, alkenyl carboxylic acid optionally substituted with halogen, acyl, -OR7 or -SR7, alkyl amine optionally substituted with halogen, acyl, -OR7 or -SR7, or alkenyl amine optionally substituted with halogen, acryl, -OR7 or -SR7;
Rl$ represents hydrogen, a lower alkyl having 1-4 carbons, halogen, vitro, -OR7, -SR7, -NR7R8, or -(CF)"CF3;
X is -COOH, tetrazole, -P03H, -S03H, -CHO, -CH2OH, -CONHa, -COSH, -COORS, -COSR9, -CONHR9, or -COOW where W is a pharmaceutically acceptable salt, and wherein X can originate from any C or N on the ring;
Z, Z', Z", Z"' and Z"" each independently is C, S, O, N, or a pharmaceutically acceptable salt, provided that one or more of Z, Z', Z", Z"' and Z"" are not O
or S if Z, Z', Z", Z"' or Z"" is attached by a double bond to one of Z, Z', Z", Z"' or Z"" or if one or more of Z, Z', Z", Z"' or Z"" is attached to one of Z, Z', Z", Z"' or Z"" that is O or S, and provided that one or more of Z, Z', Z", Z"' and Z"" are not N if one of Z, Z', Z", Z"' and Z"" is attached by a single bond to one of Z, Z', Z", Z"' and Z"" that is N;
nisOto3;and the dashed lines are optional double bonds.
The invention also includes the use of the compounds disclosed (e.g., RXR
agonists) herein for the manufacture of a medicament for treating cachexia associated with one or more of the diseases, disorders or conditions named above.
The invention further includes pharmaceutical compositions for treating cachexia comprising a compound (e.g., an RXR agonist) disclosed herein.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a graph showing the actual body weight (in grams) of nude mice bearing H292 xenografts versus days post tumor transplant, with and without treatment by an RXR agonist compound in accordance with the invention.
FIG. 2 is a graph showing the percentage of survival of nude mice bearing H292 xenografts versus days post tumor transplant, with and without treatment by an RXR agonist compound in accordance with the invention.
FIG. 3 is a graph showing the actual body weight of severe combined immunodeficiency (SCE) mice bearing metastatic H446 tumors versus days post transplant, with and without treatment by an RXR agonist compound in accordance with the invention.
FIG. 4 is a graph showing the weight of the right gastrocnemius muscle of mice bearing H292 tumor xenograft 62 days after transplantation, with and without treatment by an RXR agonist compound in accordance with the invention.
FIG. 5 is a graph showing the average food intake of nude mice with and without H292 xenografts, and with and without treatment by an RXR agonist compound (Compound 1) in accordance with the invention.
FIG. 6 is a graph showing the actual body weight (in grams) of nude mice bearing H292 xenografts versus days post tumor transplant, with and without treatment by a RXR agonist compound (Compound 2) in accordance with the invention.

FIG. 7 is a graph showing the average food intake of nude mice bearing H292 xenografts with and without treatment by an RXR agonist compound (Compound 2) in accordance with the invention.
DETAILED DESCRIPTION OF THE INVENTION
CACHEXIA
Cachexia, which literally means 'bad condition', refers to involuntary weight loss, anorexia (loss of appetite), loss of protein and fat mass, gain in the proportion of body-water, and a variety of metabolic changes, which are associated with a primary disease, condition or disorder. The metabolic changes that can occur with cachexia include, for example, an elevation of resting energy expenditures (REEs) (Ann. Surg., 19~: 152 (1983)), glucose intolerance and insulin resistance (Cancer Res., 44: 1718 (1984)), an increase in fat oxidation rates (Metabolism, 35:

15. (1986)) and whole body protein turnover (Cancer Res., 82: 42 (1998)). The pattern of weight loss in cachexia is different from normal starvation. For example, the normal adaptive response to nutrient deprivation is to draw on energy-dense lipid while sparing protein, resulting in loss of fat and relative preservation of lean body mass. In contrast, cachectic patients experience severe and incapacitating muscle wasting with relative sparing of adipose tissue.
Disease, conditions or disorders that are typically associated with cachexia include, but are not limited to, cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases (e.g., rheumatoid arthritis and systemic lupus erythematosus), tuberculosis, cystic fibrosis, gastrointestinal disorders (e.g., irntable bowel syndrome and inflammatory bowel disease), Parkinson's disease, dementia, major depression, anorexia nervosa, an aged condition and sarcopenia. More typically, the disease, conditions or disorders that are associated with cachexia include, but are not limited to, cancer, AIDS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic caxdiac failure, immune system diseases (e.g., rheumatoid arthritis and systemic lupus erythematosus), tuberculosis, cystic fibrosis, gastrointestinal disorders (e.g., irntable bowel syndrome and inflammatory bowel disease), Parkinson's disease, dementia, major depression, anorexia nervosa, an aged condition and sarcopenia. Cachexia is a strong independent risk factor for morbidity and mortality. For example, cancer cachexia occurs in about half of all cancer patients and is more common in patients with lung and upper gastronintestinal cancers (for a more detailed description see the publications: Natur a Reviews Cancer, 2: 862 (2002); Proc. Natl. Acad. Sci.
USA, 100: 5384 (2003); CA Cancer J. Clin., 52: 72 (2002)). Cancer patients with an involuntary 5% weight loss have a shorter median survival rate than patients with stable weight. Cancer patients with weight loss can respond poorly to chemotherapy and also can require increased chemotherapy treatments (Afn. J. Med., 69: 491 (1980)). The fact that a large proportion of cancer patients have cachexia, coupled with the demonstrated relationship between cachexia and mortality, has provided impetus for the search into underlying mechanisms and therapies that might prevent or reverse cachexia and provide a model for identifying additional therapies.
Studies indicate that deregulation of neuroendocrine hormones, particularly catecholamines, glucagon, corticosterone, leptin and growth hormone are involved in the induction of cachexia (for reviews see Int. J. Cardiol., 85: 111 (2002); J.
Nutriti~n, 129: 2905 (1999)). More importantly, inappropriate production and release of cytokines such as TNF-a, interleukin-1, interleukin-6, interferon-~y, leukemia inhibitory factor, and ciliary neurotrophic factor, either alone or in combination, are able to cause the metabolic changes associated with cachexia and finally to induce wasting (for reviews see Drug Discov. Today, 8: 838 (2003);
Izzt. J.
Cardiol., 85: 73 (2002)). Decent studies indicate that the ubiquitin-proteasome proteolytic pathway plays a role in wasting of skeletal muscle and the intracellular events and transcription factors are also involved (Nature-Review-Cancer, 2:862-871 (2002)).
A variety of strategies have been tried to achieve these aims, which include ( 1 ) use of nutritional supplementation with improved diet, (2) administration of agents that can reduce energy expenditures, e.g., (3-adrenergic blockers and nonsteroidal anti-inflammatory drugs such as COX inhibitors, (3) appetite stimulants, e.g., progesterone and cannabinoids, (4) anabolic stimulants, e.g., testosterone and IGF-1, (5) anticytokines, e.g., ,Q-2 agonist such as clenbuterol and analogues, omega-3 fatty acids, melatonin, and thalidomide, and (5) miscellaneous agents, e.g., Ghrelin, anadamide, ponalrestat, ATP, cyclic plasma perfusion, receptor agonist A, IL-15 and decoy nuclear factor KB (Current Ofxcology Reports, 4:264-274 (2002)). There are currently four approved drug products for the treatment of wasting and some of them are used for AIDS-related cachexia:
Oxandrolone, Dronabinol, Megestrol acetate and growth hormone. (for a review, see J. Nutrition, 129: 3035 (1999)).
Oxandrolone is an anabolic steroid being a synthetic derivative of testosterone. The indications for Oxandrolone include use as an adjunctive therapy to promote weight gain following weight loss after extensive surgery, chronic infections, or severe trauma; for patients with unexplained weight loss; and to offset protein catabolism associated with prolonged corticosteroid use. Dronabinol is an orally active cannabinoid first approved for the treatment of nausea and vomiting and were extended in 1992 to the treatment of anorexia associated with AIDS.
The third drug approved for a wasting related indication was megestrol acetate, a synthetic progesterone derivative. It is approved for the treatment of anorexia, cachexia or weight loss in patients with AIDS and hormone-sensitive malignancies.
Growth hormone has been approved for the treatment of ASS wasting and cachexia. This drug received accelerated approval for wasting based on a positive change in lean body mass.
Despite of the numerous efforts in developing treatments for cachexia, few efficacious therapeutic solutions are known. In randomized clinical trials, dietary counseling and use of nutritional supplements have failed to ameliorate the symptoms of cachexia in chronically ill, nonmalignant patients (for reviews, see elm.
.I. Glin. Nutr., 74: 6 (2001); .I. Nutriti~h, 129: 5290 (1999)). Furthermore, artificial and aggressive feeding does not appear to have an impact on the overall survival of advanced cancer patients (J. Glin. Oncol., 2: 534 (1984)) and the global quality of life remains unaffected. Drugs that enhance appetite and anabolic therapies, despite the demonstrated efficacy in randomized clinical trials, do not have a major long-term impact on the vast majority of patients. For example, Dronabinol treatment was associated with improved appetite but had no effect on mood and body weight improvement (.I. Clin. OrZCOI., 20: 567 (2002)). On the other hand, Oxandrolone _27_ treatment resulted in a moderate increase of body weight that might have represented primary edema (Proc. Ana. Soc. Clira. Oncol., 21: 363a (2002)).
Megestrol acetate treatment resulted in body weight gain of at least five pounds in AIDS as well as cancer patients (AIDSRes. Hurn. Retrov., 13: 305 (1997); J.
Clira.
Oncol., 11: 762 (1993); Annals Oncol., 12: 289 (2001)). However, the primary body component that increased was fat, but not lean body mass.
Therefore, taken together, it is difficult to determine the actual clinical relevance, e.g., impact on morbidity, mortality, or quality of life, of the pharmacological therapies in cachectic patients. As such, there is a need for improved methods for the treatment of cachexia. In a preferred embodiment of the invention, the cachexia being treated is associated with one or more diseases, conditions and disorders selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia. In one particularly preferred embodiment, the cachexia is associated with one or more of AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia.
In another particularly preferred embodiment, the cachexia is associated with one or more of cancer, AIDS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia.
In yet another preferred embodiment, the cachexia is associated with one or more of ASS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia. In a specific embodiment, the cachexia is associated with cancer. In another specific embodiment, the cachexia is associated with AIDS.

_28_ CANCER
As used herein, cancer refers to tumors, neoplasms, carcinomas, sarcomas, leukemias, lymphomas and the like. For example, cancers include, but are not limited to, leukemias and lymphomas such as cutaneous T-cell lymphoma (CTCL), non-cutaneous peripheral T-cell lymphoma, lymphomas associated with human T-cell lymphotropic virus (HTLV), for example, adult T-cell leukemia/lyrnphoma (ATLL), acute lymphocytic leukemia, acute nonlymphocytic leukemias, chronic lymphocytic leukemia, chronic myelogenous leukemia, Hodgkin's Disease, non-Hodgkin's lymphomas, and multiple myeloma, childhood solid tumors such as brain tumors, neuroblastoma, retinoblastoma, Wilms' Tumor, bone tumors, and soft-tissue sarcomas, common solid tumors of adults such as head and neck cancers (e.g., oral, laryngeal and esophageal), genitourinary cancers (e.g., prostate, bladder, renal, uterine, ovarian, testicular, rectal and colon), lung cancer, breast cancer, pancreatic cancer, melanoma and other skin cancers, stomach cancer, brain tumors, liver cancer, biliary cancer, gastrointestinal cancers (e.g., small intestinal, gastric) and thyroid cancer.
RETIN~~ X RECEFT~R (RXR) AG~NISTS
There are two main types of retinoid receptors that have been identified in mammals (and other organisms). The two main types or families of receptors are respectively designated the Retinoid Acid Receptors (R.ARs) and Retinoid X
Receptors (RXRs).
The Retinoid X Receptor (RXR) is a member of the nuclear hormone receptor family of proteins. RXR contains two signature domains of nuclear receptor family proteins, the DNA-binding domain and ligand binding domain (LBD). RJR
is a ligand-dependent transcription factor. The endogenous ligand for RXR is 9-cis retinoic acid. RXR plays an important role in many fundamental biological processes such as reproduction, cellular differentiation, bone development, hematopoiesis and pattern formation during embryogenesis (Mangelsdorf, D.J. et al., Cell, 83: 841-850 (1995)). RXR is also implicated in some pathological conditions as neoplastic formation and it is a potential target for cancer therapy (Nagy, L., et al., Cell Death and Diff., 5: 11-19 (1998)).

The mammalian RXR includes at least three distinct genes, RXR~, RXR~ and RXRy (RXR alpha, beta and gamma) which give rise to a large number of protein products through differential promoter usage and alternative splicing.
Compounds useful in treating cachexia can be agonists for the RXR~, RXR~ or RXRy receptor.
Besides acting as a homodimer, RXR plays a central role in regulating the activity of other nuclear hormone receptors by acting as a partner for heterodimers. RXR
forms a functional heterodimer with retinoic acid receptor (RAR), thyroid hormone receptor, vitamin D receptor, NGFI-B and many other nuclear receptors. The different binding partners of the RXR render a different DNA-binding specificity of the heterodimer.
As used herein, RXR refers to naturally occurring RXRs (e.g., mammalian RXRs (e.g., human (Homo sapien) RXRs, marine (e.g., rat, mouse) RXRs) and to proteins having an amino acid sequence which is the same as that of a corresponding naturally occurring RXR (e.g., recombinant proteins). The term includes naturally , occurring variants, such as polymorphic or allelic variants and splice variants.
As used herein, the term an RXR agonist refers to a substance (e.g., a molecule; a compound) which promotes (induces or enhances) at least one function characteristic of an RXR. In one embodiment, the R~~R agonist binds the RJR.
In certain embodiments, the agonist is a partial agonist. Partial agonist, as used herein, refers to an agonist which no matter how high of a concentration is used, is unable to produce maximal activation of the RXR. Some RXR agonists may have mixed agonist-antagonist activity.
An PAR agonist can be identified and activity assessed by any suitable method. For example a ehimeric receptor transactivation assay that tests for agonist-like activity in the RARE, R.AR~, RARy, P~R« receptor subtypes, and that is based on work published by Feigner P. L. and Holm M. Focus, 112, (1989), is described in detail in United States Patent No. 5,455,265, which is hereby incorporated by reference. In addition, a holoreceptor transactivation assay and a ligand binding assay that measure the antagonist/agonist like activity of the compounds of the invention, or their ability to bind to the several retinoid receptor subtypes, respectively, are described in WO 93/11755 (particularly on pages 30-and 37-41) published on June 24, 1993, the content ofwhich is also incorporated herein by reference. A detailed experimental procedure for holoreceptor transactivations has been described by Heyman et al., Cell 68: 397-406, (1992);
Allegretto et al., J. Biol. Chem, 268: 26625-26633, and Mangelsdorf et al., The Retinoids: Biology, Chemistry and Medicine, pp 319-349, Raven Press Ltd., New York, which are incorporated herein by reference. The results obtained in this assay and the chimeric receptor transactivation assay, are expressed as ECso values.
Still another transactivation assay, the "PGR assay" is described in Klein et al., J. Biol.
Glaem. 271: 22692-22696 (1996), which is incorporated herein by reference.
In a particular embodiment, the RXR. agonists are described, for example, in United States Patent Nos. 6,403,638; 6,388,105; 6,313,163; 6,147,224;
6,114,533;
6,048,873; 6,048,873; 6,034,242; 5,917,082; 5,817,836; 5,780,647; 5,675,033;
5,663,367; 6,320,074; 6,162,815; 5,977,125; 5,801,253; 6,326,397 and 6,043,279 the entire contents of which are expressly incorporated herein by reference.
RXR
agonist compounds that can be administered in accordance with the present invention are also described, for example, in the following PCT Published Patent Applications: WO 97/12853; WO 01/19770; WO 00/53562; WO 01/70668 and WO/02/071827, the entire contents of which are expressly incorporated herein by reference.
Preferably, RXR agonists having the structures described in United States Patent Nos. 5,675,033, 5,917,082 and 6,320,074 are used in the pharmaceutical compositions and methods of the present invention. Even more preferably, RXR
agonist compounds of United States Patent Nos. 5,675,033 and 5,917,082 are used.
Examples of RXR agonist compounds disclosed in United States Patent Nos.
5,675,033 and 5,917,082 are represented by Structural Formula (I):
Rq fZ1 z\~ .\ \, (I)~
where:
Z is represented by Structural Formula (II) or Structural Formula (III) R2w J
Rz R2 (II) or (I~) Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R~ groups, or Y is selected from phenyl, pyridyl, thienyl, furyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adjacent carbons; preferably, Y is cyclopropyl, phenyl, pyridyl, thienyl or furyl; more preferably, Y is cyclopropyl or phenyl; and even more preferably, Y is a cyclopropyl substituted with a methyl group at the carbon atom nearest to Z, thereby forming a quaternary carbon;
X is ~, O, or NRS;
n is 1 or 2;
Rl and Rz independently are H, lower alkyl or fluoroalkyl; preferably, Rl is H or methyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, Cl or Br;
R~ is lower alkyl, fluoroalkyl or halogen;
RS is H or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORS, -CONR9R~o, -CHaOH, -CH20R1I, -CHzOCORlI, -CHO, -CH(ORiz)z, -CHOR130, -COR7, -CR7(ORIZ)z, -CR~OR~30, or tri(lower alkyl)silyl; preferably, B
is -COON or a pharmaceutically acceptable salt thereof, -COORS or -CONR9Rlo;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;

R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rl l is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
In one preferred embodiment, Z is represented by Structural Formula (II) and n is 2. In another preferred embodiment, Z is represented by Structural Formula (III) and X is S or O.
In a particular embodiment, Z is represented by Structural Formula (II) or (III); Y is selected from pyridyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adjacent carbons; X is NRS; n is 1 or 2; Rl and R2 independently are -H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br; R4 is lower alkyl, fluoroalkyl or halogen; RS is -H or lower alkyl; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CH20H, -CH20R11, -CHaOCORI, -CHO, -CH(ORIa)a, -CHOR130, -COR7, -CR7(ORI~,)a, -CR7OR130, or tri(lower alkyl)silyl; R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 caxbons, or phenyl or lower alkylphenyl;
Rtl is lower alkyl, phenyl or lower alkylphenyl; Rl~ is lower alkyl; and RI3 is a divalent alkyl radical of 2 to 5 carbons.
In another particular embodiment, Z is represented by Structural Formula (III); Y is thienyl or furyl, said thienyl or furyl groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adjacent carbons; X is NRS; n is 1 or 2; Rl and R~

independently are -H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br; R4 is lower alkyl, fluoroalkyl or halogen; R5 is H or lower alkyl; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9R~o, -CHzOH, -CH20Ru, -CH20CORlu -CHO, -CH(ORia,)a,, -CHOR130, -COR7, -CR7(ORIa)a, -CR70R130, or tri(lower alkyl)silyl; R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R$ is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rll is lower alkyl, phenyl or lower alkylphenyl; Rl~ is lower alkyl; and R13 is a divalent alkyl radical of 2 to 5 carbons.
In yet another particular embodiment, Z is represented by Strucutural Formula (III); Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R~ groups, or Y is selected from phenyl, pyridyl, thienyl, furyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CR1-CRl=CRl- groups on adjacent carbons; X is S or O; n is 1 or ~; Rl and Ra independently are H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, Cl or Br; R4 is lower alkyl, fluoroalkyl or halogen; B is hydrogen, -COON or a pharmaceutically acceptable salt thereof, -COORs, -CONR9RIO, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(ORIa)z, -CHOR130, -COR7, -CR7(ORIa)z, -CR70R~30, or tri(lower alkyl)silyl; R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or Rg is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl; Rl l is lower alkyl, phenyl or lower alkylphenyl; R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
In a further particular embodiment of compounds represented by Structural Formula (I), Z is represented by Structural Formula (II); Y is selected from thienyl or furyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adj acent carbons; n is 1 or 2; Rl and Rz independently are H, lower alkyl or fluoroallcyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, Cl or Br; R4 is lower alkyl, fluoroalkyl or halogen; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CH20H, -CH20R11, -CH20CORn, -CHO, -CH(OR12)z, -CHOR130, -COR7, -CR7(ORia)a, -CR70R130, or tri(lower alkyl)silyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R$ is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rl l is lower alkyl, phenyl or lower alkylphenyl; R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to S carbons.
Another group of compounds represented by Structural Formula (I) include those where Z is represented by Structural Formula (III); Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R4 groups; or Y is phenyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CRl=CRl-CRl=CRl- groups on adjacent carbons; X is NRS; Rl and Rz independently are -H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br; R4 is lower alkyl, fluoroalkyl or halogen; RS is -H or lower alkyl; B is hydrogen, -COON or a pharmaceutically acceptable salt thereof, -COORg, -CONR9Rlo, -CHZOH, -CH20R11, -CH20COR11, -CHO, -CH(ORi2)2, -CHOR130, -COR7, -CR7(OR~2)Z, -CR70R130, or tri(lower alkyl)silyl; R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has I 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl; Rl l is lower alkyl, phenyl or lower alkylphenyl; Rla is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.

Yet another group of compounds represented by Structural Formula (I) include those where Z is represented by Structural Formula (III); Y is cyclopropyl, said Y group being optionally substituted with one or two R4 groups, and wherein Y
is substituted by the Z and -CRl=CRl-CRi=CRl- groups on adjacent carbons; X is NRS; Rl and RZ independently are H, lower alkyl or fluoroalkyl; R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br; R4 is lower alkyl, fluoroalkyl or halogen; RS is -H or lower alkyl; B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR.9Rlo, -CH20H, -CH20R11, -CH20COR11, -CHO, -CH(ORIZ)a, -CHOR130, -COR7, -CR~(ORIa)2, -CR70R13O, or tri(lower alkyl)silyl; R7 is an alkyl of 1 to 5 carbons, cycloalkyl of 3 to 5 carbons or alkenyl group containing 2 to 5 carbons; R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl; Ri 1 is lower alkyl, phenyl or lower alkylphenyl; R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
Still more preferably, compounds of the general structure shown by Structural Formula (IV) are used:
13 (~)~
where Rao is alkyl of 1 to 6 carbons, and B is -COOH, or -COOR21 where R21 is alkyl of 1 to 6 carbons, or a pharmaceutically acceptable salt of said compound.
Compounds 1, 2 and 3, the chemical formulas of which are shown below, are specific examples of RXR agonists that can be used, either as a free acid or as a pharmaceutically acceptable salt, in accordance with the present invention to treat mammals, including human beings, to prevent, inhibit or reduce (partially or completely) cachexia. Among all RXR agonists, Compounds 1 and 2 are presently the most preferred to be used in the present invention. Compounds 1 and 2 are within the scope of Structural Formula (IV).
H
Compound 1 United States Patent No. 5,917,082 H
Compound 2 United States Patent No. 5,917,082 Compound 3 United States Patent No. 6,320,074 Compounds 1 and 2 can be obtained in accordance with the synthetic procedures described in United States Patent Nos. 5,917,082. Compound 3 can be obtained in accordance with the synthetic procedure described in United States Patent No. 6,320,714. The entire contents of both of these patents are expressly incorporated herein by reference.

Further preferred compounds disclosed by U.S. Patent No. 5,917,02 are represented by Structural Formula (V):
R
~B
R2 ~2 (V), where:
RZ is hydrogen or lower alkyl;
R3 is hydrogen or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rio, -CH20H, -CHZORII, -CHaOCORI1, -CHO, -CH(ORIa)a, -CHOR130, -COR7, -CR7(ORIZ)2, -CR70R130, or tri-lower alkylsilyl;
R7 is an allcyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
Rg is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; ' R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rl i is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
Other preferred compounds encompassed by U.S. Patent No. 5,917,02 are represented by Structural Formula (V17:
B

where:

n is 1 or 2;
Rl and Rz independently are H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, -Cl or -Br;
R4 is H, lower alkyl, fluoroalkyl or halogen;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORg, -CONR9Rlo, -CH20H, -CHzORII, -CH20CORu, -CHO, -CH(ORiz)z, -CHOR130, -COR7, -CR7(ORIZ)z, -CR70R130, or tri-lower alkylsilyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rll is lower alkyl, phenyl or lower alkylphenyl;
Rlz is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
Another group of preferred compounds disclosed by U.S. Patent No.
5,917,082 is represented by Structural Formula (VII):
B (vI1)~
where:
R4 is lower alkyl of 1 to 6 carbons;
B is -COOH or -COORS; and R8 is lower alkyl of 1 to 6 carbons; and the configuration about the cyclopropane ring is cis, and the configuration about the double bonds in the pentadienoic acid or ester chain attached to the cyclopropane ring is trans in each of said double bonds, and pharmaceutically acceptable salts thereof.

Yet another group of preferred compounds disclosed by LT.S. Patent No.
5,917,082 is represented by Structural Formula (VIII):
B
(VIII), wherein:
X is S or O; alternatively, X is NRS;
R2 is hydrogen or lower alkyl;
R3 is hydrogen or lower alkyl;
R5 is hydrogen or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORg, -CONR9Rlo, -CHZOH, -CH20R11, -CH20CORm, -CHO, -CH(ORIa)a, -CHOR130, -COR7, -CR7(ORi2)a, -CR70R130, or tri-lower alkylsilyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, such as an alkyl of 1 to 5 carbons, a cycloalkyl of 3 to 5 carbons or an alkenyl group containing 2 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
Rll is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
Particularly preferred compounds encompassed by Structural Formula (I) are represented by Structural Formulas (IX), (X) and (XI):

Ra IX) B
(X
B
(XI)~
where:
B is -COON or -COORS;
R3 is hydrogen, lower alkyl, -Cl or -Br;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R$ is phenyl or lower alkylphenyl; and XisSorO.
When the compound is represented by Structural Formula (IX), R3 is preferably H or methyl and B is preferably -COOH or -COOCH2CH3. Particularly preferred compounds are represented by Structural Formula (IX), wherein R3 is -H, B is -COOH or -COOR, and R is lower alkyl of 1 to 6 carbons, and pharmaceutically acceptable salts thereof.
When the compound is represented by Structural Formula (X), it is preferred that R3 is -H and B is -COOH or -COOCH2CH3.

When the compound is represented by Structural Formula (XI), it is preferred that R3 is -H, B is -COOH or -COOCH2CH3 and X is O or S.
Additional compounds useful for treating cachexia, without limitation to the disease, disorder or condition with the cachexia is associated, are shown below.
One group of compounds useful in treating cachexia is represented by Structural Formulas (XIII), (XIV) or (XV):
R~4 R~
R~
R~ A (XIII) Y
A
R~ R~

R2 (~) R~~.

R2 ~ 1~ ' R~
J R
R2 ~ Ra R
R

R~ A (XV), where:
X is O, S, or (CR1RI)";
n is 0, 1 or 2;

Y is a bivalent radical having Structural Formula (XVI) or Structural Formula (XVII) where p is an integer from 1 to 4:
(CR1 R1 ~p ~1 C CR
(XVI) X
~1 C CR
(XVII) or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups being unsubstituted, or substituted with 1 to 3 Cl_6 alkyl or with 1 to 3 C1_6 fluoroalkyl groups;
X is O, S or NH;
Rl is independently -H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
R2 is independently -H, lower alkyl of 1 to 6 carbons, -ORI, 1-adamantyl, or lower fluoroalkyl of 1 to 6 carbons, or the two RZ groups jointly represent an oxo group;
R3 is hydrogen, lower alkyl of 1 to 6 carbons, -ORI, fluoro substituted lower alkyl of 1 to 6 carbons or halogen, -N02, -NH2, -NHCO(C1-C6)alkyl, or -NHCO(C1-C6)alkenyl;
A is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CHaOH, -CHZORII, -CH20CORl, -CHO, -CH(ORIZ)a~
-CH(OR130), -COR7, -CR7(OR12)2s -CR7(OR130), Or -Si(Cl_6 alkyl)3;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
Rg is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
Rl l is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl;

R13 is divalent alkyl radical of 2-5 carbons; and R14 is alkyl of 1 to 10 carbons, fluoro-substituted alkyl of 1 to 10 carbons, alkenyl of 2 to 10 carbons and having 1 to 3 double bonds, alkynyl having 2 to carbons and 1 to 3 triple bonds, carbocyclic aryl selected from the group consisting of phenyl, C1-Clo-alkylphenyl, naphthyl, C1-Clo-alkylnaphthyl, phenyl-C1-Clo alkyl, naphthyl-C1-Clo alkyl, C1-Clo-alkenylphenyl having 1 to 3 double bonds, C1-Clo-alkynylphenyl having 1 to 3 triple bonds, phenyl-C1-Clo alkenyl having 1 to 3 double bonds, phenyl-C1-Clo alkynyl having 1 to 3 triple bonds, hydroxy alkyl of 1 to 10 carbons, hydroxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, hydroxyalkynyl having 2 to 10 carbons and 1 to 3 triple bonds, acyloxyalkyl of 1 to 10 carbons, acyloxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, or acyloxyalkynyl of 2 to 10 caxbons and 1 to 3 triple bonds where the acyl group is represented by CORE, or R14 is a 5 or 6 membered heteroaryl group having 1 to heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said heteroaryl group being unsubstituted or substituted with a C1 to Clo alkyl group, with ~a C1 to Clo fluoroalkyl group, or with halogen, and the dashed line in Structural Formula (XVI) represents a bond or absence of a bond.
Another group of compounds suitable for treating cachexia is represented by Structural Formula (XVIII):

R' 0 (XVIII), wherein:
XisO,NR'orS;
R' is alkyl of 1 to 6 carbons;
Y is a bivalent cyclopropyl radical optionally substituted with one or two R4 groups, or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups optionally substituted with 1 to 4 R4 groups;

RI is independently -H, alkyl of 1 to 6 carbons, or fluoroalkyl of 1 to 6 carbons;
R2 is alkyl of 1 to 8 carbons, or fluoroalkyl of 1 to 8 carbons;
R'Z is alkyl of 1 to 8 carbons, or fluoroalkyl of 1 to 8 carbons;
R3 is hydrogen, alkyl of 1 to 6 carbons, fluoro substituted alkyl of 1 to 6 carbons, halogen, alkoxy of 1 to 8 carbons, or alkylthio of 1 to 6 carbons, -N02, -NH2, -NHCO(CI-C6)alkyl, -NHCO(C1-C6)alkenyl, -NR1H or -N(Rl)2, benzyloxy or CI-C6 alkyl-substituted benzyloxy;
R4 is -H or alkyl of 1 to 6 carbons, or fluoro substituted alkyl of 1 to 6 carbons;
m is an integer having the values of 0 to 3, and B is -COOH or a pharmaceutically acceptable salt thereof, -COORS, -COOCH2COR7, -CONR9RIO, -CH20H, -CH20RI1, -CHaOCORI1, -CHO, -CH(OR12)z, -CH(OR130), -COR7, -CR7(ORiz)2, -CR7(ORI3O), R7 is an alkyl, cycloalkyl or alkenyl group, containing 1 to 5 carbons;
R$ is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a group of 5 to 10 phenyl or lower alkylphenyl;
R9 and RIO independently are hydrogen, an allcyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
RI1 is lower alkyl, phenyl or lower alkylphenyl;
RIZ is lower alkyl; and RI~ is divalent alkyl radical of 2-5 carbons.
Yet another group of compounds useful for treating cachexia is represented by Structural Formula (XIX):

Y
A

X2 R14 Tv (~~)a wherein:
Y is a bivalent radical having Formula (a) or Formula (b):
~~ ~ 1R1~P
RFC ____ CRS RFC CRS
(a) ~ (b) or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups being unsubstituted, or substituted with 1 to 3 Cl_6 alkyl or with 1 to 3 C1_6 fluoroalkyl groups;
p is an integer from 1 to 4;
the two Xl groups jointly represent an oxo or thione function, or Xl is independently selected from H or alkyl of 1 to 6 carbons;
the two Xz groups jointly represent an oxo or a thione function, or Xz is independently selected from H or alkyl of 1 to 6 carbons, with the proviso that one of the joint Xl grouping or of the joint Xz grouping represents an oxo or a thione function;
W is H, O, C(Rl)z, phenyl, naphthyl, or 5 or 6 membered heteroaryl group having 1 to 3 heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said phenyl, naphthyl or heteroaryl groups being unsubstituted or substituted with a C 1 to C 1 o alkyl group, with a C 1 to C 1 o fluoro alkyl group, or with halogen;
Rl is independently -H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
Rz is independently -H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
R3 is hydrogen, lower alkyl of 1 to 6 carbons, -ORI, fluoro substituted lower alkyl of 1 to 6 carbons or halogen, -NOz, -NHz, -NHCO(C1-C6 alkyl, or vNHCO(C1-C6)alkenyl;
A is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9Rlo, -CHzOH, -CHzORII, -CH20CORl, -CHO, -CH(ORIZ)z, -CH(OR130), -COR7, -CR7(ORIZ)z, -CR7(OR130), or -Si(Ci_6 alkyl)3;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R8 is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
Rll is lower alkyl, phenyl or lower alkylphenyl;
Rla is lower alkyl;
R13 is divalent alkyl radical of 2-5 carbons;
R14 is H, alkyl of 1 to 10 carbons, fluoro-substituted alkyl of 1 to 10 carbons, alkenyl of 2 to 10 carbons and having 1 to 3 double bonds, alkynyl having 2 to carbons and 1 to 3 triple bonds, carbocyclic aryl selected from the group consisting of phenyl, C1-Clo-alkylphenyl, naphthyl, Cl-Clo-alkylnaphthyl, phenyl-Cl-Clo alkyl, naphthyl-Cl-Clo-alkyl, C1-Clo-alkenylphenyl having 1 to 3 double bonds, C1-Clo-alkynylphenyl having 1 to 3 triple bonds, phenyl-C1-Clo alkenyl having 1 to 3 double bonds, phenyl-Cl-Coo allcynyl having 1 to 3 triple bonds, hydroxy alkyl of 1 to 10 carbons, hydroxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, hydroxyalkynyl having 2 to 10 carbons and 1 to 3 triple bonds, acyloxyalkyl of 1 to 10 carbons, acyloxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, or acyloxyalkynyl of 2 to 10 carbons and 1 to 3 triple bonds where the acyl group is represented by CORE, or Rr4 is a 5 or 6 membered heteroaryl group having 1 to heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said carbocyclic aryl and heteroaryl groups being unsubstituted or substituted with a C1 to Clo alkyl group, with a C1 to Clo fluoroalkyl group, or with halogen;
and the dashed line in Formula (a) represents a bond or absence of a bond, provided that when the dashed line represents a bond then there are no Rl substituents on the carbons connected by said bond.
A fiuther group of compounds suitable for treating cachexia is represented by Structural Formula (XX):
Y(R2) A B
R1 (~)a wherein:
X is O, S, or C(R)2;
R is -H or alkyl of 1 to 6 carbons ;
Rl is -H, alkyl of 1 to 10 carbons, alkenyl of 2 to 6 carbons, phenyl-C1-C6 alkyl, or C~-C6-alkylphenyl;
R2 is -H, alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, alkoxy of 1 to 6 carbons, or alkylthio of 1 to 6 carbons;
R3 is independently alleyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, -OH, -SH, alkoxy of 1 to 6 carbons, fluoroalkoxy of 1 to 6 carbons, alkylthio of 1 to 6 carbons, benxyloxy, C1-C6 alkyl substituted benzyloxy, halogen substituted benzyloxy, phenyloxy, Cl-C6 alkyl substituted phenyloxy, or halogen substituted phenyloxy;
R4 is independently -H, alkyl of 1 to 6 carbons, or -F;
Y is a phenyl or naphthyl group, or heteroaryl selected from a group consisting of pyridyl, thienyl, fixryl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, imidazolyl and pyrrazolyl, said phenyl and heteroaryl groups being optionally substituted with one or two R2 groups; m is an integer having the values 0 to 3;
p is an integer having the values 0 to 4;
A is -(CHZ)a- where q is 0-5, lower branched chain alkyl having 3-6 carbons, cycloalkyl having 3-6 carbons, alkenyl having 2-6 carbons and 1 or 2 double bonds, alkynyl having 2-6 carbons and 1 or 2 triple bonds;
B is hydrogen, -COOH, -COORB, -CONRsRIO, -CH20H, -CH20Rln -CHaOCORII, -CHO, -CH(ORIa)2, -CHOR130, -COR7, -CR7(ORIa)2, -CR70R~30, or tri-lower alkylsilyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, Rg is an alkyl group of 1 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 caxbons, or R8 is phenyl or lower alkylphenyl;
R9 and Rlo independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl or lower alkylphenyl;
Rl l is lower alkyl, phenyl or lower alkylphenyl;

_ ~.$ _ R12 is lower alkyl; and R13 is divalent alkyl radical of 2-5 carbons, and pharmaceutically acceptable salts thereof.
Another group of compounds for treating cachexia is represented by Structural Formulas (XXI), (XXII), (XXIII), (XXIV), (XXV), (XXVI), (XXVII), (XXVIIa) or (XXVIIIb):
X
'Z"
,, Z\ X
(XXII) Z", l X
I
Z"

Rs Ra. (XXIII) _ Q.
R,"
R~ R~ ...
n~Na~~ ~ ,,'"~. ~s, '/. z ~~~) ,~c Rio ~x, z, '2 ~''~~~
&~z) .'"..,~ ~, r,,,,- ~,~.~_~. ~"
R~'~ ~ ~ ~ R,~s R~ ~ R~z 81 R1o R'w , R" I
...
Z ~ ~ R11 "
"" , R2 ~ R6~~ \z Z\R12 R1$
R13 (XXVIIa) R1 ~ 10 ''Z",~ R11 R
R12 (~77IIb), wherein:
Rl and R2 each independently is hydrogen or lower alkyl or acyl having 1-4 carbon atoms;
Y is C, O, S, N, CHOH, CO, SO, 502, or a pharmaceutically acceptable salt;
R3 is hydrogen or lower alkyl having 1-~. carbon atoms where Y is C or N;
Rø is hydrogen or lower alkyl having 1-4 carbon atoms when Y is C, R4 does not exist if Y is N, or neither R3 or R4 exist if Y is S, O, CHOH, CO, SO, or 502;
R' and R" are hydrogen, lower alkyl or acyl having 1-4 carbon atoms, -OH, alkoxy having 1-4 carbon atoms, thiol or thioether, or amino, or R' or R"
taken together form an oxo(keto), methano, thioketo, HO-N=, NC-N=, (R7R8)N-N=, R17O-N=, R17N=, epoxy, cyclopropyl, or cycloalkyl group and wherein the epoxy, cyclopropyl, and cycloalkyl groups are optionally substituted with lower alkyl having 1-4 carbons or'halogen;
R"' and R"" are hydrogen, halogen, lower alkyl or acyl having 1-4 carbon atoms, alkylamino, or R"' and R"" taken together form a cycloalkyl group having 3-10 carbons, and wherein the cycloalkyl group can be substituted with lower alkyl having 1-4 carbons or halogen;
RS is hydrogen, a lower alkyl having 1-4 carbons, halogen, nitro, -OR7, -SR7, -NR7R8, or -(CF)"CF3, but RS is not hydrogen if R6, Rlo, R11, Ri2 and R13 are all hydrogen, Z, Z', Z", Z"', and Z"" are all carbon, and R' and R" represent H, OH, Cl Cd alkoxy or C1-C4 acyloxy or R' and R" taken together form an oxo, methano, or hydroxyimino group;
R6, Rlo, R11, Rl2 and R13 each independently represent hydrogen, a lower alkyl having 1-4 carbons, halogen, vitro, -OR7, -SR7, -NR7R8 or - (CF)nCF3, and exist only if the Z, Z', Z", Z"', or Z"" from which R6, Rlo, Ri i, Ri2 or R13 originates is C, or R6, Rlo, R11, Ria and R13 each independently represent hydrogen or a lower alkyl having 1-4 carbons if the Z, Z', Z", Z"', or Z"" from which R6, Rlo, Rl l, R12 or ~
R13 originates is N, and where one of R6, Rlo, Rl l, R12 or R13 is X;
R7 represents hydrogen or a lower alkyl having 1-6 carbons;
R8 represents hydrogen or a lower alkyl having 1-6 carbons;
R9 represents a lower alkyl having 1-4 carbons, phenyl, aromatic alkyl, or q-hydroxyphenyl, q-bromophenyl, q-chlorophenyl, q-florophenyl, or q-iodophenyl, where q=2-4;
R14 represents hydrogen, a lower alkyl having 1-4 carbons, oxo, hydroxy, acyl having 1-4 carbons, halogen, thiol, or thioketone;
R17 is hydrogen, lower alkyl having 1-8 carbons, alkenyl optionally substituted with halogen, acyl, -OR7 or -SR7, -R9, alkyl carboxylic acid optionally substituted with halogen, acyl, -OR7 or -SR7 substituted, alkenyl carboxylic acid optionally substituted with halogen, acyl, -OR7 or -SR7, alkyl amine optionally substituted with halogen, acyl, -OR7 or -SR7, or alkenyl amine optionally substituted with halogen, acryl, -OR7 or -SR7;
Rlg represents hydrogen, a lower alkyl having 1-4 carbons, halogen, vitro, -OR7, -SR7, -NR7R8, or -(CF)"CF3;
X is -COOH, tetrazole, -P03H, -SO3H, -CHO, -CH20H, -CONH~,, -COSH, -COORS, -COSR9, -CONHR9, or -COOW where W is a pharmaceutically acceptable salt, and wherein X can originate from any C or N on the ring;
Z, Z', Z", Z"' and Z"" each independently is C, S, O, N, or a pharmaceutically acceptable salt, provided that one or more of Z, Z', Z", Z"' and Z"" are not O
or S if Z, Z', Z", Z"' or Z"" is attached by a double bond to one of Z, Z', Z", Z"' or Z"" or if one or more of Z, Z', Z", Z"' or Z"" is attached to one of Z, Z', Z", Z"' or Z"" that is O or S, and provided that one or more of Z, Z', Z", Z"' and Z"" are not N if one of Z, Z', Z", Z"' and Z"" is attached by a single bond to one of Z, Z', Z", Z"' and Z"" that is N;
n is 0 to 3; and the dashed lines are optional double bonds.
In a particular embodiment, compounds of Structural Formula (XXI)-(XXVII) are administered to subjects having cachexia associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, an aged condition and sarcopenia.
Described below are additional groups of compounds that can be used in treating cachexia, without limitation as to the primary disease, disorder or condition with which the cachexia is associated.
A first group of compounds useful in treating cachexia is represented by Structural Formula (XXVIII):
R~ R~

(XXVIII), where:
the dotted bond is optional, provided that when:
a) the dotted bond is present, Rl is lower alkyl and RZ is halogen, or Rl and RZ taken together with the caxbon atoms to which they are attached form a 5 to 8 membered carbocyclic ring or a 5 to 8 membered heterocyclic ring containing one sulfur, oxygen or nitrogen atom, wherein when said ring is aromatic, the dotted bond is part of a mesomeric system, and b) the dotted bond is absent, Rl and R2 taken together are methylene, thereby forming a cis-substituted cyclopropyl ring;

R3 is hydroxy or lower alkoxy;
R4, R5, Rg and R7 are, independently, hydrogen or lower alkyl;
X is (>CR8R9)" ;
n is 1,2 or 3;
R8 and R9 are, independently, hydrogen or lower alkyl; and Rlo is hydrogen, alkyl or alkoxy;
and pharmaceutically acceptable salts of carboxylic acids of Structural Formula (XXVIII).
A second group of compounds useful in treating cachexia is represented by Structural Formula (XXIX):

( where:
the dotted bond is either hydrogenated or forms a double bond, provided that:
a) when the dotted bond forms a double bond, Rl is lower alkyl and R2 is hydrogen; and b) when the dotted bond is hydrogenated, Rl and R2 taken together are methylene to form a cis-substituted cyclopropyl ring;
R3 is hydroxy or lower alkoxy;
R4 is alkyl or alkoxy; and RS and R6 are, independently, a 04_12 alkyl or a CS_i2 cycloalkyl substituent containing from 1-3 rings which are either unsubstituted or substituted with from 1-3 lower alkyl groups, with the carbon atom of RS and R6 being linked to the remainder of the molecule to form a quaternary carbon atom; or Rs and R6 are independently a C4_12 alkyl group or a mono- or polycyclic Cs-is hydrocarbon group that axe linked to the phenyl ring through a quaternary carbon atom, and pharmaceutically acceptable salts thereof.
A third group of compounds useful for treating cachexia are represented by Structural Formula (X~~X):
Y ~ R2 / R~
Ar Z ~ X~
wherein:
Rl is a hydrogen atom, a -CH3 radical, a -CHaOR3 radical, a -CHaOCOR4 radical, an -ORs radical, an -O(CHa)m(CO)"R6 radical, a -COR7 radical, a -COORS
radical or an -S(O)pR9 radical;
Ra is a hydrogen atom or a halogen atom, a lower alkyl radical, an -NO2 radical, an -OCOR4 radical, an -OR9 radical or a NR9Rlo radical;
Ar is a radical selected from among those of the following formulae (a)-(e):

i (a) ~N
(b) !/i \\
\O~ ~_~c) n s ca>

X is -O-, -S(O)t- or an -NR9- radical;
Y and Z are each -O-, -S(O)t- or a radical -CR11Ri2;
m is an integer equal to 1, 2 or 3;
n is an integer equal to 0 or 1;
p is an integer equal to 0, 1, 2 or 3;
t is an integer equal to 0, 1 or 2;
R3 is a hydrogen atom or a lower alkyl radical;
R4 is a lower alkyl radical;
RS is a hydrogen atom or a lower alkyl radical;
R6 is a lower alkyl radical or a heterocycle;
R7 is a hydrogen atom, a lower alkyl radical or an NR'R" radical;
R' and R" are identical or different, and are each a hydrogen atom, a lower alkyl radical, a mono- or polyhydroxyalkyl radical, an optionally substituted aryl radical, or an amino acid or peptide or sugar residue, or R' and R" together form, with the nitrogen atom from which they depend, a nitrogen-containing heterocycle;
R8 is a hydrogen atom, a linear or branched alkyl radical having from 1 to 20 carbon atoms, an alkenyl radical, a mono- or polyhydroxyalkyl radical, an optionally substituted aryl or aralkyl radical, or a sugar residue or an amino acid or peptide residue;
R9 is a hydrogen atom or a lower alkyl radical;
Rlo is a hydrogen atom or a lower alkyl radical;
Rl l is a hydrogen atom or a lower alkyl radical;
R12 is a hydrogen atom or a lower alkyl radical, with the proviso that Y and Z
are not simultaneously each an oxygen atom or an -S(O)t- radical.
A fourth group of compounds useful for treating cachexia are represented by Structural Formula (XXXI):
Z-(CR3=CRa)"COORI (~S:XXn where:
Rl is hydrogen or a carboxyl-protecting group;
R2 and R3 are each independently hydrogen atom, halogen, linear lower alkyl, branched lower alkyl, linear lower alkoxy, branched lower alkoxy or aryl;
n is an integer of 1 to 3;
nR2's or nR3's are the same or different from one another; and Z is a group represented by one of the following formulas:
X~ ~ A~D
Y1 B .

~E/F
Y2 , and Xs N' \
~3 A, B and D are each carbon, nitrogen, sulfur or oxygen, where the carbon or nitrogen atoms are optionally substituted;
Xl and Yl are each independently hydrogen, -NR4R5, -CR6R7Rg, -~R9, -SRl°, -S(~)Rll or -S(~)2R12, or alternatively Xl and Yl together with the carbon atoms to which they are bonded form an optionally substituted, saturated or unsaturated ring optionally containing oxygen, sulfur and/or nitrogen, and the substituents on the saturated or unsaturated ring axe optionally united to form a saturated or unsaturated ring optionally containing oxygen, sulfur andlor nitrogen;
R4 and RS are each independently hydrogen, linear lower alkyl, branched lower alkyl or cycloalkyl, or optionally when A or B is a carbon atom optionally bearing a substituent, R4 or RS together with the substituent of A or B form a ring;

R6, R' and R8 are each independently hydrogen, linear lower alkyl or branched lower alkyl; and R9, Rlo, Ri 1 and Rla are each independently hydrogen, linear lower alkyl or branched lower alkyl;
E is a carbon or nitrogen;
F and G are each independently carbon, nitrogen, sulfur or oxygen, where the carbon or nitrogen atoms are optionally substituted;
Xa and YZ are each independently hydrogen, -NR13R14, -CRlsRlsRi7, -ORIS
-SR19, -S(O)R2° or -S(O)ZRZ1, or alternatively Xa and Y2 taken together form an optionally substituted, saturated or unsaturated ring optionally containing oxygen,, sulfur and/or nitrogen;
R13 and R14 are each independently hydrogen, lineax lower allcyl, branched lower alkyl or cycloalkyl;
R15, Rlg and R17 are each independently hydrogen, linear lower alkyl or branched lower alkyl;
Rls, Ri9, Rzo and R21 are each independently hydrogen, linear lower alkyl or branched lower alkyl;
X3 and Y3 are each independently hydrogen, linear or branched lower alkyl, linear or branched lower alkoxy, cycloalkyl, aryl, heteroaryl, fluoroalkyl or halogeno; and the symbol ' ' represents a single bond or a double bond, with the proviso that where. Z is not .~~~o.
C~~
A fifth group of compounds suitable for treating cachexia are represented by Structural Formula (XXXII):

R~
R2 (XXXII), where:
Rl and R2 are each independently hydrogen, lower alkyl, alkenylalkyl, alkynylalkyl, cycloalkyl, cycloalkylalkyl, lower alkoxyalkyl, aryl, heteroaryl or arylallcyl, or alternatively Rl and Ra are united to form a 5- to 7-membered cycloalkyl group which is substituted with a lower alkyl group and optionally contains sulfur, oxygen, sulfinyl, sulfonyl or NR3;
R3 is hydrogen or lower alkyl;
the broken line moiety represents a single bond or a double bond;
A represents R~
R~ ~ R1 or Rs B represents R, /Rs N sN
R~
R7 ~ F

R ; R~

N~~1 N
R~ ~ N

R~
~F
Rb is hydrogen, lower alkyl, alkenylalkyl, alkynylalkyl, cycloalkyl, cycloalkylalkyl, lower alkoxyalkyl, aryl, heteroaryl, arylalkyl or heteroarylalkyl;
R13 is hydrogen, lower alkyl or lower alkoxy;
R7 is -E-C(=O)Rg;
E is aryl, heteroaryl or ~m Rl1 and Rl2 are each hydrogen or lower alkyl;

m is an integer of 1 to 3;
R~ is hydrogen, hydroxyl, lower alkoxy or -NR9Rlo; and R9 and Rlo are each independently hydrogen, hydroxyl, lower alkyl, lower alkoxy, hydroxyalkyl, aryl, hydroxyaryl or heteroaryl, or alternatively R9 and Rlo together with the nitrogen atom to which they are bonded may form a ring optionally containing nitrogen, oxygen or sulfur.
Additional compounds useful for the treatment of cachexia are represented by Structural Formulas (XXXIIn-(XXXVII):

~ 27 X
2s R36~IIII"~, , 'W

m . n R37 ~ i '''', ' ~ ' R38~\\\ 'Y R5 /
\ W
~
COR4~2s ~

R R1 R3o o (~;XXIII) Ras R~
G~R4.o m Rs6~lnm~, ~~

\~~~'.,, R3s\
R (XXXIV) R1 R9 R~
'~~~R2 ' R35 ~ ' Q R55 m R3s~mm" ~-,,"iii ' l '' ' , ~RSG
R37 ~ j R57 / ,, .
R3s ~ ~ ,Z ~ R58 n :.
R3 ~ R1o (~:XXV) R62 R.., ~[~5 R49 Rs: N1 ~~ \ CORq.o ~~~n Rs~ Rs7 (XX~~Vn CORqO
m R3611111m~ ~~
R3~ i ''.,,, R33\

(X~~XVII), where:
Rl through R4 each independently are hydrogen, a C1-C6 alkyl or a C7-Cls arylalkyl or heteroarylalkyl;
Rs is a Cs-Clo alkyl, heteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl, -NR6R7, or -ORB, where R6 and R7 each independently are a C7-Cio alkyl, heteroalkyl, a C7-Cls arylalkyl or heteroarylalkyl, a C3-Clo acyl, provided that only one of R6 or R7 is acyl, or R6 and R7 taken together are C3-C6 cycloalkyl, and where RB is a C7-Clo alkyl, heteroalkyl, aryl, heteroaryl, or a C7-Cls arylalkyl or heteroarylalkyl;
R9 and Rlo each independently are hydrogen, a Cl-Cio alkyl, halogen, heteroarylalkyl, -NRl iRia, - N02 or -OR13, where Rl l and R12 each independently are hydrogen, a C1-Clo alkyl, heteroalkyl, a C7-Cls arylalkyl or heteroarylalkyl, a C1-CB acyl, provided that only one of Rl l or Rl~ is acyl, or Rl l and Rla taken together are a C3-C6 cycloalkyl, and where R13 is hydrogen or a C1-Clo alkyl, heteroalkyl or a C7-Cls arylalkyl or heteroarylalkyl;
R14 and Rls each independently axe hydrogen, a C1-Clo alkyl, a C1-CB acyl, or OR16 where R16 is hydrogen or a C1-Cto alkyl; or R14 and Rls taken together are keto, methano, optionally substituted oxime, optionally substituted hydrazine, optionally substituted epoxy, 1,3-dioxolane, 1,3-dioxane, 1,3-dithiolane, 1,3-dithiane, oxazolidine or:

Ras ~"ORqg Rzo ''\'\'\R2~
N
Rz2 ~~~~~~~~Rzs k where the dashed lines crossing the bonds indicate the attachment bonds to the rings adjacent to R14 and Rls;
R17 and Rl8 each independently are hydrogen, a C1-Clo alkyl, heteroalkyl, aryl, a C7-Cls arylalkyl or heteroarylalkyl or R17 and Rl8 taken together are a C3-C6 cycloalkyl;
R19 is hydrogen, a Cl-Clo alkyl, heteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl;
Rao through R23 each independently are hydrogen, halogen, a C1-Clo alkyl, heteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl, -NR24Rzs, -N02, or -OR26, where R24 and RZS each independently are hydrogen, a C~-Clo alkyl, heteroalkyl, a C7-Cls arylalkyl or heteroarylalkyl or a Cl-C8 acyl, provided that only one of RZa or R2s is acyl, and where R26 is hydrogen or a CI-Clo alkyl, heteroalkyl, aryl, heteroaryl, or a C7-Cls arylalkyl or heteroarylalkyl;
R27 through R31 each independently are hydrogen, a C1-Clo alkyl, heteroalkyl, halogen, -NR32R33, -N02 or -OR34, where R3z and R33 each independently are hydrogen, a Cl-C10 alkyl, a C7-Cls arylalkyl or heteroarylalkyl, a C1-C8 acyl, provided that only one of R3a or R33 is acyl, or R32 and R33 taken together are a C3-C6 cycloalkyl, and where R34 is hydrogen or a C1-Cio alkyl, heteroalkyl or a C7-Cls arylalkyl or heteroarylalkyl and exist only when W is C;
R3s through R38 each independently are hydrogen, a C1-Ca allcyl or -OR39 where R39 is hydrogen or a C1-Clo alkyl, or R35 and R36 or R37 and R3g taken together are keto, or R3s and R36, R37 and R38, R3s and R37 or R36 and R38 taken together are epoxy;
COR4o can originate from any W when the originating W is C,Iand R4o is -OR~1 or -NR42R43, with R41 being hydrogen, a C1-C6 alkyl or a C7-Cls arylalkyl or heteroarylalkyl, and with R4a and R43 each independently being hydrogen, a C1-alkyl, a C7-Cls arylalkyl or heteroarylalkyl, aryl, ortho-, meta, or para-substituted hydroxyarl, or taken together are a C3-C6 cycloalkyl;

R44 and R4s each independently are hydrogen, a C1-C4 alkyl or -CH20R46, where R46 is hydrogen or a C1-C6 alkyl, or R44 and R4s taken together are a C3-cycloalkyl or cycloheteroalkyl;
R47 is hydrogen, a C1-C4 alkyl, or when n=1, R47 taken together with R44 or R4s is a C3-C6 cycloalkyl or cycloheteroalkyl;
R48 and R49 each independently are C1-C4 alkyl;
Rso is a C4-Clo alkyl, keteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl, -NRslRs2, or -ORs3, where Rsl and Rs2 each independently are a C2-Clo alkyl, heteroalkyl, a C7-Cls arylalkyl or heteroarylalkyl, a C3-Clo acyl, provided that only one of Rsl or Rsz is acyl, or Rsl and Rs2 taken together are C3-Cg cycloalkyl, and where Rs3 is a C7-Clo allcyl, heteroalkyl, aryl, heteroaryl, a C3-Cs alkyl, heteroalkyl, aryl or heteroalkyl or a C7-Cls arylalkyl or heteroarylalkyl;
Rs4 represents:
R,~ R,~ R
Rio N
Rio where R9, Rlo, R14, Ris and R4o have the definitions given above;
Rss through Rs8 each independently are hydrogen, halogen, a Cl-Clo alkyl, heteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl, -NRs9R6o or -OR6i, where Rs9 and I~o each independently are hydrogen, a C1-Clo alkyl or heteroalkyl, a C7-Cls arylalkyl or heteroarylalkyl, a Cl-C8 acyl, provided that only one of Rs9 or R6o is acyl, or Rs9 and Rgo taken together are C3-C6 cycloalkyl, and where R61 is hydrogen or a C1-Clo alkyl, heteroalkyl, aryl, heteroaryl, or a C7-Cls arylalkyl or heteroarylalkyl, or where Rss and Rs6 or Rs7 and Rs8 taken together are keto, methano, a C1-Clo alkyl methylene, a C1-Clo dialkylmethylene, C7-Cls arylalkyl or heteroarylalkylmethylene, oxime, O-alkyl oxime, hydrazone, 1,3-dioxolane, 1,3-dioxane, 1,3-dithiolane, 1,3-dithiane, oxazolidine, or Rss and Rs7 or Rs6 and Rs8 taken together are epoxy;

R62 through R64 each independently are hydrogen, aryl, heteroaryl, -CF3, a Ca-C6 alkyl, C2-Cg heteroalkyl or -NRsiRs2, where Rsl and Rs2 have the definitions given above;
R6s is hydrogen, a C1-C2 alkyl or -OR66, where R66 is a Ci-C2 alkyl;
R67 is a C4-Clo alkyl, heteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl, -NRslRs2, or -OR68, where Rsl and Rs2 have the definitions described above, and where R6$ is a C3-Clo alkyl, heteroalkyl, aryl, heteroaryl, or a C7-Cls arylalkyl or heteroarylalkyl;
X and Y each independently represent C, O, S, N, SO or 502, provided, however, that when X or Y are O, S, SO or 502, then either Rl and R2 or R3 and R4, respectively do not exist, and further provided, that when X or Y is N, then one each of Rl and R2 or R3 and R4, respectively, does not exist;
MisNorC;
QisNorC;
Z is O, S, SO, 502, CR.69R7o or NR71, where Rg9 through R71 each independently are hydrogen or a Cl-Clo alkyl, heteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl, or R69 and R7o each independently are -OR71, or R69 and R7o taken together are a cycloalkyl;
each W is independently C, N, S or O, or a pharmaceutically acceptable salt, but is not O or S if attached by a double bond to another W or if attached to another such W which is O or S, and is not N if attached by a single bond to another such W
which is N;
m is 0, 1 or 2 carbon atoms;
n is 0 or 1 carbon atoms;
k is 1 to 5 carbon atoms;
the dashed lines in the structures, other than at RI4 and Rls, represent optional double bonds, provided, however, that the double bonds are not contiguous, and further provided that when such optional double bonds exist then the substitution patterns around such bonds cannot violate double bond valency;
and the wavy lines represent olefin geometry that is either cis (Z) or traps (E), and unless otherwise indicated, for substituents Rl through R71, all olefin geometric isomers (i.e., cis (Z) or traps (E)) of the above compounds are included.

Yet another group of compounds suitable for treating cachexia is represented by Structural Formula (XX~VIII):

R ,. W~ /Raa~ n R36~\~\v" i ., ..
R37~w' ', l R3$ \ R31 W COR4oR2s R1o R3o (~;~VIII), i where:
5 all variables in the structures are as defined above for Structural Formulas (~~X)-(XXXIV), with the exception of new variable R72, which is a C3-Clo alkyl, heteroalkyl, aryl, heteroaryl, a C7-Cls arylalkyl or heteroarylalkyl, NR73R74, or OR75, where R73 and R74 each independently are a C7-Clo alkyl, heteroalkyl, a C7-Cls arylalkyl or heteroarylalkyl, a C3-Clo acyl, provided that only one of R73 or R74 is 10 acyl, or R73 and R74 taken together are C3-C6 cycloalkyl, and where R75 is a CZ-Clo alkyl, heteroalkyl, aryl, heteroaryl, or a C7-C15 arylalkyl or heteroarylalkyl.
A further group of compounds useful for treating cachexia are represented by Structural Formula (XXXIX):
Raa Ray I
R63 ~ W R76 n W~ 1 R6 ~ W
Rs4 (XXXIX), 15 where:
R~ through R47 and R62 through R68, M, W and n each have the definitions given above for Structural Formulas (XXXIII)-(XXXVII), or R62 and R63, R63 and R65, or R65 and R64 taken together are:

R~ \ / R2 R35 . X1-R36~~~~~~~" i ' m R3~ ' .,, R3s R ~Y~ ~
where Rl through R4, R35 through R39, X, Y and m have the definitions given above for Structural Formulas (XXXIII)-(XXXVII) and the dashed lines crossing the bonds adjacent to X and Y indicate the points of attachment at R62 and R63, Rss and R65, or R65 and R6a;
R76 is:
R2~
~~ W / R2s vW
n ~s R3~ W COR4o R2s or 30 where R27 through R34, ~o through R43, R4g, W and n have the same definitions given above for Structural Formulas (XXXIII)-(XXXVII) and the dashed lines crossing the bonds adjacent to R49 and R27/R31 indicate the points of attachment at R76;
other than as indicated above for points of attachment, the dashed lines in the structures represent optional double bonds, provided, however, that the double bonds cannot be contiguous, and further provided that when such optional double bonds exist then the substitution patterns around such bonds cannot violate double bond valency; and the wavy lines represent olefin geometry that is either cis (Z) or traps (E), and unless otherwise indicated, for substituents Rl through R76, all olefin geometric isomers (i.e., cis (Z) or traps (E)) of the above compounds are included.
Yet another group of compounds useful in treating cachexia are represented by Structural Formulas (LX) and (LXI):

(LX) (LXI), where:
Rl is selected from the group of hydrogen, -F, -Cl, -Br, -I, C1-C3 alkyl, C1-haloalkyl, Cz-C3 alkenyl, CZ-C3 haloalkenyl, C2-C3 alkynyl, Ca-C3 haloalkynyl, and Ci-C3 alkoxy, wherein said alkyl, haloalkyl, alkenyl, haloalkenyl, alkynyl, haloalkynyl, and alkoxy groups are optionally substituted;
R~ and R4 are independently selected from the group of hydrogen, -NRIORu, C1-C6 alkyl, Ci-C~ haloalkyl, C3-Cg cycloalkyl, Cz-C6 alkenyl, C2-Cg haloallcenyl, Ca-C6 alkynyl, C2-C6 haloalkynyl, aryl, heteroaryl, C1-C6 alkoxy, and aryloxy, wherein said alkyl, haloalkyl, cycloalkyl, alkenyl, haloalkenyl, alkynyl, haloalkylyl, aryl, heteroaryl, alkoxy, aryloxy groups are optionally substituted;
R3 is selected from the group of hydrogen, Cl-C6 alkyl, C1-C6 haloalkyl, C3-Cg cycloalkyl, C2-C6 alkenyl, C2-C6 haloalkenyl, C2-C6 alkynyl, Ca-C6 haloallcynyl, aryl, heteroaryl, Cl-C6 alkoxy, and aryloxy, wherein said alkyl, haloalkyl, cycloalkyl, alkenyl, haloalkenyl, alkynyl, haloalkynyl, aryl, heteroaryl, alkoxy, aryloxy groups are optionally substituted;
R~ and R6 are independently selected from the group of hydrogen, -F, -Cl, -Br, -I, -CN, -NH2, -OH, -SH, Ci-C6 alkyl, C1-C6 haloallcyl, CZ-C6 alkenyl, C1-haloalkenyl, C1-C6 alkoxy, and aryloxy wherein said alkyl, haloalkyl, alkenyl, haloalkenyl, alkoxy and aryloxy groups are optionally substituted; or RS and R6 taken together form a three- to eight-membered carbocyclic ring, a three- to eight-membered heterocyclic ring, an aryl group or a heteroaryl group, wherein said carbocyclic ring, heterocyclic ring, aryl and heteroaryl groups are optionally substituted;
R7 is selected from the group of C2-C6 allcyl, CZ-C6 alkenyl, and C2-C6 haloalkyl, wherein said alkyl, alkenyl, and haloalkyl groups are optionally substituted;
R8 is selected from the group of hydrogen, -F, -Cl, -Br, - I, -CN, Cl-C6 alkyl, Ci-C6 haloalkyl, Ca-C6 alkenyl, C2-C6 haloalkenyl, C2-C6 alkynyl, C1-C6 alkoxy, and aryloxy, wherein said alkyl, haloalkyl, alkenyl, haloalkenyl, alkynyl, alkoxy, and aryloxy groups are optionally substituted;
R9 is selected from the group of hydrogen, -F, -Cl, -Br, -I, methyl, and optionally substituted methyl;
Rlo and Rll each independently is hydrogen or optionally substituted Cl-C6 alkyl; or Rlo and Rl1 taken together with nitrogen form an optionally substituted five-or six-membered heterocyclic ring;
Y is selected from the group of NR12, O and S; and Rl2 is selected from the group of hydrogen, optionally substituted C1-C6 alkyl, and optionally substituted CI-C6 haloalkyl;
and pharmaceutically acceptable salts thereof.

Additional compounds suitable for treating cachexia are represented by Structural Formula (LXII), including phaarmaceutically acceptable salts, solvates and hydrates thereof R~

'~16 R3 (LXIl' In Structural Formula (LXII), R is selected from the group of hydrogen, -F, -Cl, -Br, -I, C1-C3 alkyl, C~-Cs haloalkyl, Cz-C3 alkenyl, Cz-C3 haloalkenyl, Cz-C3 alkynyl, Cz-C3 haloalkynyl, and CI-C3 alkoxy, wherein said alkyl, haloalkyl, alkenyl, haloalkenyl, alkynyl, haloalkynyl, and alkoxy groups are optionally substituted;
Rl and Rz are each, independently, -H, a halo, a Cl-Clo alkyl, a C3-Cio cycloalkyl, a CS-Cio cycloalkenyl, a 6 to 10 membered aryl, a 5 to 10 membered heteroaryl, an aryl-C1-C6-alkyl, or an amino group represented by the formula -NR14R15, wherein the alkyl, cycloalkyl, cycloalkenyl, aryl, heteroaryl and arylalkyl are optionally substituted with one or more halo, C1-C3 alkyl, C1-C3 haloalkyl or C1-C3 alkoxy; or Rl and Rz taken together with the carbon atoms to which they are attached form a five or six membered carbocyclic ring which is optionally substituted with one or more halo or Cl-C6 alkyl groups. R14 and R15 are each, independently, H, a CI-C6 alkyl, or taken together with the nitrogen they are attached to can form a 5 to 8 heterocycle.
Alternatively, R and Rl taken together with the carbon atoms to which they are attached form an aryl, a heteroaryl, a CS-C8 cycloalkyl or C$-C8 cycloalkenyl ring in which the aryl, heteroaryl, CS-C$ cycloallcyl or CS-C8 cyclollcenyl are optionally substituted with one or more halo, C1-C3 alkyl, C1-C3 haloalkyl or Cl-C3 alkoxy substituents. Preferably, when R and Rl together with the carbon atoms to which they are attached form an aryl or a heteroaryl, the aryl and heteroaryl have from five to six atoms.
R3 is -H, a halo, a C1-Clo alkyl, a C3-Clo cycloalkyl, CS-Clo cycloalkenyl, a to 10 membered aryl, a 5 to 10 membered heteroaryl, an aryl-C1-C6-alkyl, or an amino group represented by the formula NRl4Rls, wherein the alkyl, cycloalkyl, cycloalkenyl, aryl, heteroaryl and arylalkyl are optionally substituted with one or more halo, C1-C3 alkyl, C1-C3 haloalkyl or C1-C3 alkoxy.
R4 is -H, a halo, an aryl-Cl-C6-alkyl, a C1-Clo alkyl or a C1-Clo alkoxy group wherein the arylalkyl, alkyl, and alkoxy are optionally substituted with one or more substituents selected from halo, Ci-C6 alkyl, aryl, heteroaryl, a C1-C6 alkoxy, an amino group represented by the formula -NRl4Ris. Preferably, the aryl and the heteroaryl substituents each, independently, have from five to ten atoms.
Alternatively, R3 and R4 taken together with the carbon atoms to which they are attached form an aryl, a heteroaryl, a Cs-C8 cycloalkyl or a Cs-C8 cycloalkenyl ring wherein the aryl, heteroaryl, cycloalkyl and cycloalkenyl are.optionally substituted with one or more halo, Ci-C3 alkyl, Cl-C3 haloalkyl or C1-C3 alkoxy substituents. Preferably, when R3 and R4 together with the carbon atoms to which they are attached form an aryl or a heteroaryl, the aryl and heteroaryl have from five to ten atoms.
Rs is -H, a halo, or a C1-C3 alkyl group which is optionally substituted with one or more halo.
R6 is =H or halo.
R16 is -OR17, -OCH(R17)OC(O)R18, -NRl9Rzo, or an aminoalkyl.
R17, R19 and R2o are each, independently, -H or a C1-C6 alkyl.
R18 is a C1-C6 alkyl.
Ring A is a heteroaryl group represented by the following structural formula:
O'~01 4~~i In ring A, X1 and Xa are each, independently, O, S, N, NH, or CH.
X3isNorC.
X4 is CH or N.
pis0orl.
However, when Xl is O or S, then X2 is CH or N and p is 0.

Ring A is optionally substituted with one or more substituents selected from a halo, a Ci-C6 alkyl, or a C1-C6 alkoxy.
Additional compounds for use in treating cachexia, without limitation as to the disease, disorder or condition with which it is associated, are disclosed in the following documents: U.S. Patent Nos. 5,770,378, 5,770,382, 5,770,383, 5,917,082, 6,048,873, 6,093,838, 6,403,638, 6,534,545 and 6,624,154; U.S. Patent Application Publication No. 20030166932; Published International Applications WO 93/21146, WO 94/12880, WO 94/17796, WO 97/12853; WO 98/22423, WO 99/06036, WO
99/58486, WO 99/58487, WO 00/020370; WO 01/070662, WO 02/071827 and WO
03/027090; and European Patent Application No. 947496, the contents of which are incorporated herein by reference. Also, the following documents disclose compounds for use in treating cachexia: V.R. Atigadda, et al. Abstracts of Papers, 226th ACS National Meeting, New York, NY, United States, September 7-11, 2003 (2003); P.Y. Michellys, et al., Journal ofMedicinal Chemistry (2003), 46(13), 2696; L.J. Farmer, et al., Bioorganic & Medicinal Chemistry Letters (2003), 13(2), 261-264; B. Dominguez, et al., Bioorganic & Medicinal Chemistry Letters (2002), 12(18), 2607-2609; B.M. Forman, et al., Journal ofBiological Chemistry (2002), 277(15), 12503-12506; M.I. Dawson, et al., Cuf°rentMedicinal Chenaistfy (2002), 9(6), 623-637; V.R. Atigadda, et al., Abstracts of Papers, 223rd ACS National Meeting, Orlando, FL, United States, April 7-11, 2002 (2002); A.M. Standeven, et al., Biochemical Pharmacology (2001), 62(11), 1501-1509; M.M. Faul, et al., ~~ Abstracts of Papers, 222nd ACS National Meeting, Chicago, IL, United States, August 26-30, 2001 (2001); V. Vuligonda, et al., Journal ofMedicinal Chemistry (2001), 44(14), 2298-2303; M. Ebisawa, et al., Chemical & Pharmaceutical Bulletin (2001), 49(4), 501-503; K. Ohta, et al., Chemical e~Z PlZas°naaceutical Bulletin (2000), 48(10), 1504-1513; M.I. Dawson, Bioorgaaaic & Medicinal Chemistry Letters (2000), 10(12), 1311-1313; S.S. Koch, et al., Journal ofMedicinal Claemistry (1999), 42(4), 742-750; S. Hibi, et al., Journal ofMedicinal Claernistry (1998), 41(17), 3245-3252; L.J. Farmer, et al., Bioorganic & Medicinal Chemistry Letters (1997), 7(21), 2747-2752; L.J. Farmer, et al., Bioorganic & Medicinal Chemistry Letters (1997), 7(18), 2393-2398; A.M. Standeven, et al., Biochemical Pharmacology (1997), 54(4), 517-524; R.L. Beard, et al., Journal ofMedicinal Chemistry (1996), _72_ 39(18), 3556-3563; V. Vuligonda, et al., Bioorganic ~ Medicinal ChernistryLetters (1996), 6(2), 213-18; Y. I~atsuta, et al., Chemical & Pharmaceutical Bulletirt (1994), 42(12), 2659-61; M.F. Boehm, et al., .Iournal ofMedicinal Chernistry (1994), 37(18), 2930-41; and M.F. Boehm, et al., .Iou>~rtal ofMedicinal Chemistry (1995), 38(16), 3146-55, the contents of which are incorporated herein by reference.
Examples of compounds disclosed in the documents listed in the above paragraph include:
Bu-t Et 4 g N ~ ~ Cp 2 H
(R ) n ~R ) m ~~1 N-h(R 2 )AB / Me R 1 I Me Me I I
where:
X is O, S, or C(R)a;
R is H or alkyl of 1 to 6 carbons;
Rl is H, alkyl of 1 to 10 carbons, alkenyl of 2 to 6 carbons, phenyl-Cl-C6 alkyl, or C1-C6-alkylphenyl;
Ra is H, alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 caxbons, alkoxy of 1 to 6 carbons, or alkylthio of 1 to 6 carbons;
R3 is independently alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, -OH, -SH, alkoxy of 1 to 6 carbons, fluoroalkoxy of 1 to 6 carbons, alkylthio of 1 to 6 carbons; benxyloxy, C1-C6 alkyl substituted benzyloxy, halogen substituted benzyloxy, phenyloxy, Cl-C6 alkyl substituted phenyloxy, or halogen substituted phenyloxy;
R4 is independently -H, alkyl of 1 to 6 carbons, or -F;

Y is a phenyl or naphthyl group, or heteroaryl selected from a group consisting of pyridyl, thienyl, furyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, imidazolyl and pyrrazolyl, said phenyl and heteroaryl groups being optionally substituted with one or two R2 groups;
m is an integer having the values 0 to 3;
n is an integer having the values 0 to 4;
A is (CHa)q where q is 0-5, lower branched chain alkyl having 3-6 carbons, cycloalkyl having 3-6 carbons, alkenyl having 2-6 carbons and 1 or 2 double bonds, alkynyl having 2-6 carbons and 1 or 2 triple bonds, and B is hydrogen, -COOH, -COORB, -CONR9R1°, -CH2OH, -CH2ORly -CHZOCORI1, -CHO, -CH(OR12)a, -CHOR130, -COR7, -CR7(OR12)z, -CR70R130, or tri-lower alkylsilyl, where R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R8 is an alkyl group of 1 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl, R9 and Rl° independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl or lower alkylphenyl, Rl l is lower alkyl, phenyl or lower alkylphenyl, R12 is lower alkyl, and R13 is divalent alkyl radical of 2-5 carbons, and pharmaceutically acceptable salts.
R
COOH
where the R groups attached directly to the phenyl ring are isopropyl or 1,1-dimethylpropyl and the R group attached to oxygen is methyl, ethyl, 2-fluoroethyl, 2,2-difluoroethyl, 2,2,2-trifluoroethyl, propyl or butyl.

M

Q\
Z~G 20 R G
Z
I II

R, -R~~
i Me Me ~R 19 )Y R~ . . . _ R18 M2- = R...

(R19)z R18 Me ~ R 16 R 17 E
IX ( ~ , ~ ' E
Z~G' 18 D 18 R R
III IV V
Me Me E \ R18 ~M3 v I vII
including salts, solvates, and physiologically functional derivatives thereof, where:

X is CRI or N, where RI is halogen, H, or CH3;
Z is O, S, or NH;
M is N, C, or CR2, when M is N, the ring in which M is located is non-aromatic, when M is C, the ring in which N is located is aromatic, when M is CR2, then Ra is H or Y(CHZ)nR6, and the A ring is non-aromatic;
Y is O or CH2; when n is 0 to 6, R6 is -H, alkyl, or -CF3, but when n is 2 to 5, R6 is H, alkyl, -CF3, -SO2NHR23, -NHSO2R23, or -NR23R24~ where R23 is alkyl, aryl optionally substituted, heteroaryl optionally substituted or combined with R24 to form a ring of 3-7 atoms; and R24 is -H, alkyl, cycloalkyl or combined Wlth R23 to form a ring of 3 to 7 atoms;
G is -COZR7, -SOR7, -PO3R7, -CONHOH, or tR9)Z
J
~R$)v where the broken line represents an optional double bond; J is -CHO, -CO~R7, -S~31~~, -P~3R7a -C~NHOH, ~r J forms a thiazolidinedione ring with R8; R7 is -H or alkyl;
R8 and R9 are independently -H, halogen, alkyl, or -CF3;
y and z are each 0, 1, or 2;
Q is CR4, CR4R5, O, NR, or S, where R4 and RS axe independently H or alkyl, provided that when Q is CR4, the A ring is aromatic;
RI° is alkyl, -CORM, -CONHRII, -COaRII, -CONRIIRIZ, -SOZRII, aryl, or cycloalkyl;
RI I and Rla are independently alkyl or cycloalkyl;
R3 is R', wherein D is CRl3Rla, O, S, NRIS, CHOH, CO, SO,SOa, where Rls and RI4 are independently H, alkyl, or cycloalkyl; and where RIS is H, alkyl, or cycloalkyl; D' is (CHZ)m; RI6 and Ru independently are -H, C1-4 alkyl, cycloalkyl, or together form a carbocyclic ring having from 3 to 7 atoms; RI8 is -H, -OR6, halogen, -CF3, alkenyl, -SRI6, CI_4 alkyl, -COZRI6, -LORI I, or -NR16R1~, where R16 and RI7 are as above defined; m is 0 or 1; or R3 is R", where RIg is as defined above; or R3 is R"', where M~ is C or N, provided however that the optional double bond represented by the broken line is optionally present only when Ma is C;
each R19 is, independently, H or alkyl; y and z are as defined above; or R3 is R"", where each Rl$ is, independently, as defined above; and M3 is C(R16)3 or N(R16)Z, when M3 is N(R16)2, an R16 may combine with an Rl $ to form a 5- or 6-membered ring; and G' and E react to form a bond.

I
in which:
X represents:
(i) either,a divalent radical of following formula:
(a) and Y then represents a divalent radical of following formula:
(b) (ii) or a divalent radical of formula:
~ (c) and Y then represents either a divalent radical corresponding to the divalent radical of formula (b) above or one of the divalent radicals of following formula:

_77_ (d) \NJ ~c) // \\
Z
Z being -O-, -S- or >N-R3;
Rl represents -CH3, -(CH2)p-OR4, -(CH~)p-CORS or -S(O)t-R6, p being 0, 1, 2 or 3, t being 0, 1 or 2, RZ represents H or lower alkyl, R3 represents H, lower alkoxy or -OCOR7, ; R4 represents H, lower alkyl, -COR7, aryl, aralkyl, mono- or polyhydroxyalkyl, or a polyether radical, RS represents H, lower alkyl, -OR8 or Nr'r", R6 represents H or lower alkyl, R7 represents lower alkyl, R8 represents H, alkyl, alkenyl, alkynyl, aryl, aralkyl, mono- or polyhydroxyalkyl, a sugar residue or an amino acid residue, r' and r", identical or different, represent H, lower alkyl, -COR7, aryl, a sugar residue or an amino acid residue or r' and r", taken together, form a heterocycle, and the salts of the compounds of formula (~, when Rl represents a carboxylic acid group, and the geometrical and optical isomers of the compounds of formula (~.

_78_ Me Me Me R
R 1 / x Me Me R2 \ R4 C02H
R 3 = Me I I
where the left hand compound corresponds to Structural Formula (LXIl' above CH ~
Me 3 C
CO ~ H
Me I

Me H
t-Bu / '' Me 'CO 2 R
Bu-t I

Me /~ H
Me ~ Me CO 2 R
Me I I
Me Me H
Me ~ _O_ n ~''~'' Me CO 2 R

where R is -H, a salt of the carboxylic acid or lower alkyl; and Rl is methyl, ethyl or n-prOpyl Me Me OPr-n Me - \ \
a w Me Me Me Me Me CMe 2 \ ~c \
Me CO 2 H
Me Me Z

Me Me Me Me Me R~ R' R' R~~
(CHI) n (, \R5 R 6 CO ~ H
Me Me II
where:
Rl and Ra, each independently, represent hydrogen or lower alkyl or acyl having 1-4 carbon atoms;
Y represents C, O, S, N, CHOH, CO, SO, 502, or a pharmaceutically acceptable salt;
Me Me - ~1 -R3 represents hydrogen or lower alkyl having 1-4 carbon atoms where Y is C
or N;
R4 represents hydrogen or lower alkyl having 1-4 carbon atoms where Y is C, but R4 does not exist if Y is N, and neither R3 or R4 exist if Y is S, O, CHOH, CO, SO, or SOa;
R' and R" represent hydrogen, lower alkyl or acyl having 1-4 carbon atoms, OH, alkoxy having 1-4 carbon atoms, thiol or thio ether, or amino, or R' or R" taken together form an oxo (keto), methano, thioketo, HO-N=, NC-N=, (R7R8)N-N=, epoxy, cyclopropyl, or cycloalkyl group and wherein the epoxy, cyclopropyl, and cycloalkyl groups can be substituted with lower alkyl having 1-4 carbons or halogen;
RS represents hydrogen, a lower alkyl having 1-4 carbons, halogen, vitro, -OR7, -SR7, -NR7R8, or -(CF)nCF3;
R6 represents hydrogen, a lower alkyl having 1-4 carbons, halogen, vitro, -OR7, -SR7, -NR7R8 or -(CF)"CF3;
R7 represents hydrogen or a lower alkyl having 1-6 carbons;
R$ represents hydrogen or a lower alkyl having 1-6 carbons;
X is -COOH, tetrazole, -P03H, -S03H, -CHO, -CH20H, -CONH2, -COSH, -COORg, -COSR9, -CONHR~, or -COOW where R9 represents a lower alkyl having 1-4 carbons, phenyl, aromatic alkyl, or q-hydroxyphenyl, q-bromophenyl, q-chlorophenyl, q- fluorophenyl, or q-iodophenyl, where q=2-4, where W is a pharmaceutically acceptable salt; and n = 0-3.
Me Me g I \
/ N /
Me CO 2 H
s Me Me Me Me Me E
Me Me Me Me Me C- C
Me R2 R 1 _ Me R 3 R '~
i Me O
R 1 / / R 1 Me Me Me I= R 5 = _ _ where:
R is -H, a carboxylic acid salt or lower alkyl;
Ra is methyl, ethyl or propyl;
R3 is methyl, ethyl or propyl;
R4 is lower alkyl; and RS is lower allcyl.

_g3_ Me Me Ma Me Y
Me Me Me Me ~ ~' Z ~ ~ ~ '~ O
OH
\ ~ \
O / II
Me Me I Me Me Me x Me I
/ N \
O
Me Me I I I
where Y is -OH, -OCH3, -NHNHz or -H and Z is -C(O)NH-, -NHC(O)NH- or -N N-.
Me Me n-pr I N
N
N \
CO ~ H
Me Me S

-~4-LR 3J ~R 2~m ~o N-Y(R 2) -A-B

~R 3~ o R 2~m O I N-Y(R 2 ) -A-B

Me Me Me N
O / / CO ~ H
Fr-1 I II
where:
Rl is H, alkyl of 1 to 10 carbons, phenyl, heteroaryl, phenyl-C1-C6 alkyl, C1-C6-alkylphenyl, heteroaryl-C1-C6 alkyl, CI-C6-alkylheteroaryl where heteroaryl is selected from the group consisting of pyridyl, thienyl, furyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, imidazolyl and pyrrazolyl;
R2 is independently H, alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, -~H, -SH, alkoxy of 1 to 6 carbons, or alkylthio of 1 to 6 carbons;
m is an integer having the values of 0 to 3;
R3 is independently -H, alkyl of 1 to 6 carbons, or -F;
o is in an integer having the values of 0 to 4;
Y is a phenyl or naphthyl group, or heteroaryl selected from a group consisting of pyridyl, thienyl, furyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, imidazolyl and pyrrazolyl, said phenyl and heteroaryl groups being optionally substituted with one or two Ra groups;
A is (CHa)g where q is 0-5, lower branched chain alkyl having 3-6 carbons, cycloalkyl having 3-6 carbons, alkenyl having 2-6 carbons and 1 or 2 double bonds, alkynyl having 2-6 carbons and 1 or 2 triple bonds;
B is hydrogen, -COOH, -COORB, -CONR9R1°, -CH2OH, -CH2 ORII, -CH20COR11, -CHO, -CH(OR12)Z, -CHOR130, -COR7, -CR7(OR12)2, -CR70R130, tri-lower alkylsilyl, -OH, -OR8 or -OCOR$ where R' is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R8 is an alkyl group of 1 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl, R9 and Rl°
independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl or lower alkylphenyl, Rl1 is lower alkyl, phenyl or lower alkylphenyl, R12 is lower alkyl, and R13 is divalent alkyl radical of 2-5 carbons, and pharmaceutically acceptable salts thereof.

_g6_ R2 ~ ~ ~ Y
/ ~A
R2 X ~ R1 Rl I

R2 \ Y
~A

R2 ~ ~ Y / / A
RZ ~ I3 R1 Rl RZ R
I II
1 ~ X1 R
Y1 _ Y2 _ Et Me 3 C
H
\ 1 Me g C
Me Iv where:
X is O, S, or (CR1R1)n where n is 0,1 or 2;

_$7_ Y is Yl or Y2 where Z is (CR1R1)o and o is an integer from 1 to 4, or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups being unsubstituted, or substituted with 1 to 3 Cl_6 alkyl or with 1 to 3 C1_6 fluoroalkyl groups;
X is O, S or NH;
Rl is independently -H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
RZ is independently -H, lower alkyl of 1 to 6 carbons, ORI, 1-adamantyl, or lower fluoroalkyl of 1 to 6 carbons, or the two R2 groups jointly represent an oxo (=O) group;
R3 is hydrogen, lower alkyl of 1 to 6 carbons, ORI, fluoro substituted lower alkyl of 1 to 6 carbons or halogen, -N02, -NH2, -NHCO(C1-C6) alkyl, or -NHCO(C1-C6) alkenyl;
A is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COORB, -CONR9R1°, -CH20H, -CH20R11, -CH2OCOR11, -CHO, -CH(ORIa)2, -CH(OR130), -COR7, -CR7(ORl2)Z, -CR7(OR130), or -Si(C1_6alkyl)3, where R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R$ is an alkyl group of 1 to 10 carbons or (trimethylsilyl) alkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R$ is phenyl or lower alkylphenyl, R9 and Rl° independently axe hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl, Rl1 is lower alkyl, phenyl or lower alkylphenyl, Rl2 is lower alkyl, and R13 is divalent alkyl radical of 2-5 carbons, and R14 is alkyl of 1 to 10 carbons, fluoro-substituted alkyl of 1 to 10 carbons, alkenyl of 2 to 10 carbons and having 1 to 3 double bonds, alkynyl having 2 to 10 carbons and 1 to 3 triple bonds, carbocyclic aryl selected from the group consisting of phenyl, C1-Cl°-alkylphenyl, naphthyl, C1-C 1 o-alkylnaphthyl, phenyl-C i -C 1 °alkyl, naphthyl-C 1-C 1 °alkyl, C 1-C 1 °-alkenylphenyl having 1 to 3 double bonds, C1-C1°-alkynylphenyl having 1 to 3 triple bonds, phenyl-C1-Cl°-alkenyl having 1 to 3 double bonds, phenyl-C1-Cl°-alkynyl having 1 to 3 triple bonds, hydroxy alkyl of 1 to 10 carbons, hydroxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, hydroxyalkynyl having 2 to 10 carbons and 1 to 3 triple bonds, acyloxyalkyl of 1 to 10 carbons, acyloxyalkenyl having 2 to 10 carbons _88_ and 1 to 3 double bonds, or acyloxyalkynyl of 2 to 10 carbons and 1 to 3 triple bonds where the acyl group is represented by CORE, or Rl4 is a 5 or 6 membered heteroaryl group having 1 to 3 heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said heteroaryl group being unsubstituted or substituted with a C1 to Clo alkyl group, with a C1 to Cin fluoroalkyl group, or with halogen, and the dashed line in Yl represents a bond or absence of a bond.
Me Me I
HC ~ ~ CO 2 H
Me Me I
Me M a Me COZH
Me I M a Me II
where:
Rl and Rz are independently hydrogen or C1_6 alkyl;
W is C(R3)R4, O, NR3, S, SO or SOz wherein R3 and R4 are independently hydrogen or C1_6 alkyl;
RS is hydrogen, C1_6 alkyl, halogen, -ORII, -SRII, -OCORII, -NHz, -NHRII, -NRllRlz, -NHCORn, -NRII-CORiz where Rll and Riz are independently C1_6 alkyl, phenyl or alkyl phenyl;
X is R~

R6 is hydrogen, or taken together with R7 forms a double bond, or taken together with R' is methylene to form a cyclopropyl ring;
R7 is hydrogen, or taken together with R6 forms a double bond, or taken together with R6 is methylene to form a cyclopropyl ring, or taken together with R9 forms a double bond, or taken together with R9 is methylene to form a cyclopropyl ring;
R8 is hydrogen, or taken together with R9 forms a double bond, or taken together with R9 is methylene to form a cyclopropyl ring;
R9 is hydrogen, hydroxy, -OR13, -OCOR13, or taken together with R7 forms a double bond, or taken together with R7 is methylene to form a cyclopropyl ring, or taken together with R8 forms a double bond, or taken together with Rg is methylene to form a cyclopropyl ring, where R13 is Cl_6 alkyl, phenyl or alkyl phenyl;
Z is -X-Y-Rl°, wherein X is'a valence bond, phenyl or pyridyl, optionally substituted with Cl_3 alkyl, halogen, hydroxy, Cl_3 alkoxy, C1_3 acyloxy, C1_3 alkyl halide, thiol, C1_3 substituted thiol, Y is C1_6-alkyl, Cz_6 alkenyl or C2_6 alkynyl and Rio is _C02H, tetrazole, -P03H, -S03H, -C02Rls, -CONR16R17, -CHZOH, -CHO, -CH2OR18, -CH(OR19)2, -HC(ORZ°O), -CORaI, -CR2°(OR19)z, -CR21(OR2°O), wherein Rls is Cl_6 alkyl, phenyl or alkyl phenyl; or Z is =Y-Rl°, wherein Y is -CR14, -CR14-Ci-s alkyl, -CRl4phenyl, -CRl4pyridyl, -CR14C1_3alkylaryl, -CRl4-Cz-s alkenyl or -CRl4-C2_s alkynyl, wherein R14 is H or C1_3 alkyl and Rl° is -COZH, tetrazole, -P03H, -SO3H, -C02Rls, -CONR16R17, -CHZOH, -CHO, -CHaORlB, -CH OR19 ao zi )a, -HC(OR O), -COR , -CRz°(OR19)z, -CR21(ORa°O), wherein Rls is Cl_6 alkyl, phenyl or alkyl phenyl;
R16 and R17 are independently hydrogen, C1_6-alkyl, Cs_8 cycloalkyl, phenyl or Cl_6-alkyl phenyl; Rl8 is C1_6-alkyl, phenyl or C1_6-alkyl phenyl; R19 is Ci_6 alkyl;
R2° is C2.~ alkyl; R21 is C1_6 alkyl phenyl or C3_6 cycloalkyl;
and salts thereof with a pharmaceutically acceptable acid or base, or any optical isomer or mixture of optical isomers, including a racemic mixture, or any tautomeric forms.

OMe t-Bu CH CH - CO 2 H
t-Bu Me Me where:
Me Me T / Z
T \ R1 / CO ~H I
Z is -C(=Q)- or A
X Y
in which Q, X and Y are each independently ~, S or CH2;
A is -(CR2)ri where n is an integer of from 1 to 3;
T and Tl are each independently 0, S, CH2, or C(CH3)Z; and Rl is hydrogen or C1-C6 alkyl, and pharmaceutically acceptable salts thereof.

s ~Me Me Me Me /
N
~F
R4 a where R4 is methyl, ethyl, n-propyl or n-butyl.

R1 R~ R10 ~ 5 R
.R6 W
~Y / ~ 1 R7 ~I ;.z R $

where:
Rl through R4 each independently are hydrogen, a Ci-C6 alkyl, or a C7-Cls arylalkyl;
Rs through R8 each independently are hydrogen, a Cl-C6 alkyl, or at least two of RS through R8 taken together are a C3-C6 cycloalkyl;
Me Me _92_ R9 and Rl° each independently are hydrogen, a C1-C6 alkyl, -F, -Cl, -Br, -NRllRlz, -NO2 or -ORI3, where Rl1 and Rlz each independently are hydrogen, a C8 alkyl, a C7-Cls arylalkyl, a C1-C$ aryl, provided that only one Rll or R~z can be acyl, or Rl1 and Rlz taken together are a C3-C6 cycloalkyl, and where R~3 is hydrogen or a Cl-C$ alkyl or a C7-Cls arylalkyl;
R~4 represents:
COR15 ~ C~R15 R1s A
N N
COR15 ~~ ~~ COR15 A A
COR15 ~/ COR
10 where Rls is -OR16 or -NR17R18, with R16 being hydrogen, a C1-C~ alkyl or a C7-Cis arylalkyl, aald with R17 and Rl8 each independently being hydrogen, a Cl-C6 alkyl, a C7-Cls arylalkyl, aryl, ortho-, meta-, or para-substituted hydroxyaryl, or taken together are a C3-C6 cycloalkyl, provided that Rlg must be hydrogen when R~~
is aryl or hydroxyaryl, R19 is a C1-C$ alkyl, and A is O, S or NRz°, where Rz° is a hydrogen, 15 C1-C6 alkyl or a C7-Cls arylalky;
W is (CH2)n,;
X and Y each independently represent C, O, S, N, SO or SO2, provided, however, that when X or Y are O, S, SO or 502, then either Rl and Rz or R3 and respectively do not exist, and further provided, that when X or Y is N, then one each of Rl and Rz or R3 and R4 respectively, do not exist;
Z is O, S, CRzzR23 or NRz4, where Rzz through Rz4 each independently are hydrogen or a CI-C6 alkyl or R2z and Rz3 taken together are a C3-C6 cycloalkyl;
V is C or N, provided, however, that when V is N, then no double bond exists adjacent to V;
G is C or N, provided G cannot be C when W is C;

m is 0 or 1 carbon atoms; and n is 0, 1 or 2 carbon atoms;
the dashed lines in the structures represent optional double bonds, provided, however, that the double bonds cannot be contiguous, and further provided that when such optional double bonds exist then one each of RS and R6 or R7 and R$
respectively do not exist; and the wavy lines represent olefin bonds that are either in the cis (Z) or trans (E) configuration.

R12 ~/R2 I R5 X \ W~ _R6 g14 i I / 7 :'w _ i Y Z I R~
R ~ ~ RS

where:
10 Rl through R4 each independently are hydrogen, a Ci-C6 alkyl, or a C7-C1$
axylalkyl;
RS through R$ each independently are hydrogen, a Cl-C6 alkyl, or at least two of RS through R8 taken together are a C3-C6 cycloalkyl;
R9 and Rl° each independently are hydrogen, a C1-C6 alkyl, -F, -Cl, -Br, 15 -NR11R12, -NO2 or -OR13, where Rl1 and Rlz each independently are hydrogen, a C1-C8 alkyl, a C7-C15 arylalkyl, a C1-C8 acyl, provided that only one Rl1 or R12 can be acyl, or Rl l and RI2 taken together are a C3-C6 cycloalkyl, and where R13 is hydrogen or a C1-C$ alkyl or a C7-CIS arylalkyl;
Rll represents:
,,,.
COR~5 ~ ~ CORDS
R~9 N N
COR15 ~~ ~~ COR15 A A
COR15 ,V ~ ~ COR
where Rls is -OR16 or -NR17R18, with R16 being hydrogen, a C1-C6 alkyl or a C7-Cls arylalkyl, and with R17 and Rlg each independently being hydrogen, a C1-C6 alkyl, a 5 C7-Cls arylalkyl, aryl, ortho-, meta-, or para-substituted hydroxyaryl, or taken together are a C3-C6 cycloalkyl, provided that Rl$ must be hydrogen when R17 is aryl or hydroxyaryl, R19 is a Cl-Cs alkyl, and A is O, S or NR2°, where R2° is a hydrogen, Cl-C6 alkyl or a C7-Cls arylalky;
Rl2 through Rls attached to the tricyclic ring each independently are 10 hydrogen or a C1-C6 alkyl, or taken together then one each of Rl~ and R13 or RI4 and Rls respectively, form a carbonyl group;
X and Y each independently represent C, O, S, N, SO or SO2, provided, however, that when X or Y are O, S, SO or 502, then either Rl and RZ or R3 and R~
respectively do not exist, and further provided, that when X or Y is N, then one each 15 of Rl and Ra or R3 and R4 respectively, do not exist;
Z is O, S, CRa2R23 or NR24, where RZZ through R24 each independently are hydrogen or a C1-C6 alkyl or R22 and R23 taken together are a C3-C6 cycloalkyl;
W is N or CR2s, where Rzs is hydrogen or a C1-C6 alkyl;
V is C or N, provided, however, that when V is N, then no double bond exists adjacent to V; and G is C or N, provided G cannot be C when W is C;
the dashed lines in the structures represent optional double bonds, provided, however, that the double bonds cannot be contiguous, and further provided that when such optional double bonds exist then one each of Rs and R6 or R7 and R$
respectively do not exist; and the wavy lines represent olefin bonds that are either in the cis (Z) or trans (E) configuration.

X ~ v~Rl4 W

:.c where:
Ri through R4 each independently are hydrogen, a Cl-C6 alkyl, or a C?-Cls arylallcyl;
R9 and R1° each independently are hydrogen, a C1-C6 alkyl, -F, -C1, -Br, -NRllRlz, -NOz or -OR13, where Rll and R12 each independently are hydrogen, a C8 alkyl, a C7-Cls arylalkyl, a C1-C$ acyl, provided that only one Rl1 or R12 can be acyl, ox Rl l and R12 taken together are a C3-C6 cycloalkyl, and where R13 is hydrogen or a C1-C8 alkyl or a C7-Cls arylalkyl;
R14 represents:
..

~OR15 A
//~ COR15 ~/ N CORIs A A
G G
15 ~/ f>OR
GOR
where Rls is -OR16 or -NR17R1$, with R16 being hydrogen, a CI-C6 alkyl or a C7-Cis 15 arylalkyl, and with R17 and Rl8 each independently being hydrogen, a Cl-C6 alkyl, a C7-Cls arylalkyl, aryl, ortho-, mete-, or pare-substituted hydroxyaryl, or taken together are a C3-C6 cycloalkyl, provided that Rl8 must be hydrogen when R17 is aryl or hydroxyaryl, R19 is a C1-Cs alkyl, and A is O, S or NRa°, where Rz° is a hydrogen, C1-C6 alkyl or a C7-Cls arylalky;

X and Y each independently represent C, O, S, N, SO or SOZ, provided, however, that when X or Y are O, S, SO or 502, then either Rl and RZ or R3 and respectively do not exist, and further provided, that when X or Y is N, then one each of Rl and RZ or R3 and R4 respectively, do not exist;
U is (CHa)" where n is 0, 1 or 2 carbon atoms;
V is C or N, provided, however, that when V is N, then no double bond exists adjacent to V;
W is (CH2)m where m is 0 or 1 carbon atoms G is C or N, provided G cannot be C when W is C;
the dashed lines in the structures represent optional double bonds, provided, however, that the double bonds cannot be contiguous, and further provided that when such optional double bonds exist then one each of RS and R6 or R7 and R8 respectively do not exist; and the wavy lines represent olefin bonds that are either in the cis (Z) or trans (E) configuration.

_ 1 R~ / ~C Y~R I
M a Me \ C~ 2 H

Me Me II
where:
Rl represents:
(i) the radical -CH3, (ii) the radical -CH2-O-R5, (iii) the radical -O-R5, (iv) the radical -CO-R6, RS and R6 having the meanings given below, Y represents a radical chosen from the radicals of formulae (a) and (b) below:

R~
R,7 (a) (b) R7 and R'7 having the meanings given below, Ar represents a radical chosen from the radicals of formulae (c) to (f) below:
Y Rs Y
X~.~~Y X~~~Y
X
O S ~N
X
(c) (d) (e) (~
in which the radical Y is in an ortho or meta position relative to the radical X, X and Y of these formulae corresponding to X and Y represented in formula (I), R$
having the meaning given below, X represents an oxygen or sulphur atom, a radical -SO-, -S02-, -N(R9)- or a radical chosen from the radicals of formulae (g) to (r) below:
(g) (h) ( (i) (1) (k) O ~ H H H OR5 Hs0 CH3 O O S S
'O
N'Z't'ORs n~ n~
(1) (m) (n) (o) (~ ~ (r) H R~2 H NHOH
R5, R9, Rla and n having the meanings given below, R2 and R3, which may be identical or different, are chosen from the group consisting of:

(i) a hydrogen atom, (ii) an alkyl radical having at least 3 carbon atoms, among which the carbon attached to the phenyl radical of formula (I) is substituted with at least two carbon atoms, (iii) a linear or branched alkyl radical, (iv) a radical -ORS, (v) a radical -SRS, (vi) a polyether radical, ' RS having the meaning given below, it being understood that R2 and R3, taken together, can form, with the adjacent aromatic ring, a 5- or 6-membered ring, optionally substituted with methyl groups and/or optionally interrupted by an oxygen or sulphur atom, it being understood that, when R2 and R3 do not form a ring, at least one of the radicals R2 and R3 has a meaning (ii) mentioned above, R4 and R8, which may be identical or different, represent a hydrogen atom, a halogen atom, a linear or branched alkyl radical, or a radical -ORS, a polyether radical, RS represents a hydrogen atom, a lower alkyl radical or a radical -CORi°, Rio having the meaning given below, R6 represents:
(a) a hydrogen atom (b) a lower alkyl radical (c) a radical of formula NR'R", R' and R" having the meanings given below, (d) a radical -ORl l, Ri i having the meaning given below, R7, R'7 and R9, which may be identical or different, represent a hydrogen atom or a lower alkyl radical, n is an integer equal to 0 or 1, Rl° represents a lower alkyl radical, Rl l represents a hydrogen atom, a linear or branched alkyl radical, an alkenyl radical, a mono- or polyhydroxyalkyl radical, an aryl or axalkyl radical, optionally substituted, a sugar residue or an amino acid or peptide residue, R12 represents a lower alkyl radical, R' and R", which may be identical or different, represent a hydrogen atom, a lower alkyl radical, a mono- or polyhydroxyalkyl radical, an optionally substituted aryl radical or an amino acid, peptide or sugar residue, or alternatively, taken together, form a heterocycle, and the optical and geometrical isomers of the said compounds of formula (I), as well as their salts.
Me Me I E
Me Me Me E
COZH
Me Me E
Me Me Me E

Me Me CH ~
Ma ~ CH
Me Me C.
H3 C/ \CH

Co 2 H
Me Me Me Me Me E

Me Me Me Me Me ~ CO 2 H
s Me Me Me Me Me CH = CHCH (Me) = CHCO ~ H
I
Me Me -ia~-Me Me Me Me Me Me Me Me Me S
~S
Me III
CO ZH I~
Me Me M$

~'~~ ~~~'~r Z
~r Me HOC
Me Me Me Me Me Me Me HOZC
Me Me Me E E
~/ ~r\ r O
r Me s Me Me Me Me CH 2 \ ~c \
Me CO 2 H
Me Me Me Me CO ~ H
TREATMENT
Me Me Treating, as used herein, refers to a reduction in (alleviation of) at least one symptom ~of cachexia in a patient suffering from (in need of treatment for) cachexia.
Treating, as used herein, also refers to preventing the onset of at least one symptom of cachexia in a subject at risk of developing cachexia (e.g., a subject suffering from one or more of the diseases, disorders or conditions named above). Treating, as used herein, further refers to inhibiting the progression of at least one symptom of cachexia in a subject. Preferably, as with any multisymptom disorder, a reduction in or inhibition or prevention of more than one symptom is desired. The symptoms of cachexia can include loss of appetite, loss of body weight, elevation of resting energy expenditures, glucose intolerance, insulin resistance, increased fat oxidation rates, increased whole body protein turnover, decreased quality of life (e.g., decreased mobility, energy andlor stamina) and decreased life span. As such, treating of cachexia can include prevention or inhibition of appetite loss or return of appetite, prevention or inhibition of loss of body weight or an increase in body weight (e.g., as a result of preservation or restoration of lean body mass and the energy store of fat and glycogen), improvement in the patients quality of life and increased life span.

Quality of Life can be assessed by objective measurements which include nutritional and metabolic endpoints, physical function (muscle strength) and endurance (exercise tolerance). Quality of Life can also be evaluated by completing patient and caregiver questionnaires, which include standard forms such as the functional living index-cancer (FLIC), functional assessment of cancer therapy index (FACT) and the European Organization for Research and Treatment of Cancer (RORTC). The questionnaires are designed to give information regarding the effect of the drug product from a patient's and caregiver's perspective.
For the prevention or treatment of cachexia (e.g., cachexia resulting from a cancerous condition or other malignancies) it is likely that a compound of the invention is to be administered systemically. Suitable routes of administration include, but are not limited to, orally, intraperitoneally, subcutaneously, intramuscularly, intradermally, transdermally, rectally, sublingually, intravenously, buccally or via inhalation. For intravenous or intraperitoneal administration, the compound will be prepared as a solution or suspension capable of being administered by injection. In certain cases, it may be useful to formulate these compounds in suppository form or as extended release formulation for deposit under the skin or intramuscular injection. Oral admininistration of a compound in accordance with the present invention is presently preferred.
Forms suitable for oral administration include powders, pills, tablets, troches, capsules, elixirs, suspensions, syrups, wafers, chewing gum or the like prepared by art recognized procedures. The amount of active compound in such therapeutically useful compositions or preparations is such that a suitable dosage will be obtained.
The pharmaceutical compositions of the invention preferably contain a pharmaceutically acceptable carnet or diluent suitable for rendering the compound or mixture administrable orally, parenterally, intravenously, intradermally, intramuscularly or subcutaneously, rectally, via inhalation or via buccal administration, or transdermally. The active ingredients may be admixed or compounded with a conventional, pharmaceutically acceptable carrier or diluent. It will be understood by those skilled in the art that any mode of administration, vehicle or carnet conventionally employed and which is inert with respect to the active agent may be utilized for preparing and administering the pharmaceutical compositions of the present invention. Illustrative of such methods, vehicles and carriers are those described, for~example, in Remington's Pharmaceutical Sciences, 18th ed.
(1990), the disclosure of which is incorporated herein by reference.
The formulations of the present invention for use in a subject comprise the agent, together with one or more acceptable carriers or diluents therefor and optionally other therapeutic ingredients. The Garners or diluents must be "acceptable"
in the sense of being compatible with the other ingredients of the formulation and not deleterious to the recipient thereof. The formulations can conveniently be presented in unit dosage form and can be prepared by any of the methods well known in the art of pharmacy. All methods include the step of bringing into association the agent with the carrier or diluent which constitutes one or more accessory ingredients. In general, the formulations are prepared by uniformly and intimately bringing into association the agent with the carriers and then, if necessary, dividing the product into unit dosages thereof.
Formulations suitable for parenteral administration conveniently comprise sterile aqueous preparations of the agents that are preferably isotonic with the blood of the recipient. Suitable Garner solutions include phosphate buffered saline, saline, water, lactated ringers or dextrose (5% in water). Such formulations can be conveniently prepared by admixing the agent with water to produce a solution or suspension, which is filled into a sterile container and sealed against bacterial contamination. Preferably, sterile materials are used under aseptic manufacturing conditions to avoid the need for terminal sterilization.
Such formulations can optionally contain one or more additional ingredients, which can include preservatives such as methyl hydroxybenzoate, chlorocresol, metacresol, phenol and benzalkonium chloride. Such materials are of special value when the formulations are presented in multidose containers.
Buffers can also be included to provide a suitable pH value for the formulation. Suitable buffer materials include sodium phosphate and acetate.
Sodium chloride or glycerin can be used to render a formulation isotonic with the blood.
If desired, a formulation can be filled into containers under an inert atmosphere such as nitrogen and can be conveniently presented in unit dose or multi-dose form, for example, in a sealed ampoule.

Those skilled in the art will be aware that the amounts of the various components of the compositions of the invention to be administered in accordance with the method of the invention to a subject will depend upon those factors noted above.
The compositions of the invention when given orally or via buccal administration can be formulated as syrups, tablets, capsules and lozenges. A
syrup formulation will generally consist of a suspension or solution of the compound or salt in a liquid carrier, for example, ethanol, glycerine or water, with a flavoring or coloring agent. Where the composition is in the form of a tablet, one or more pharmaceutical carriers routinely used for preparing solid formulations can be employed. Examples of such Garners include magnesium stearate, starch, lactose and sucrose. Where the composition is in the form of a capsule, the use of routine encapsulation is generally suitable, for example, using the aforementioned carriers in a hard gelatin capsule shell. Where the composition is in the form of a soft gelatin shell capsule, pharmaceutical carriers routinely used for preparing dispersions or suspensions can be considered, for example, aqueous gums, celluloses, silicates or oils, and are incorporated in a soft gelatin capsule shell.
A typical suppository formulation includes the conjugate or a pharmaceutically acceptable salt thereof which is active when administered in this way, with a binding and/or lubricating agent, for example, polymeric glycols, gelatins, cocoa-butter or other low melting vegetable waxes or fats.
Typical transdermal formulations include a conventional aqueous or non-aqueous vehicle, for example, a cream, ointment, lotion or paste or are in the form of a medicated plastic, patch or membrane.
Typical compositions for inhalation are in the form of a solution, suspension or emulsion that can be administered in the form of an aerosol using a conventional propellant such as dichlorodifluoromethane or trichlorofluoromethane.
A "subject" is typically a human, but can also be an animal in need of treatment, e.g., companion animals (e.g., dogs, cats, and the like), farm animals (e.g., cows, pigs, horses, sheep, goats and the like) and laboratory animals (e.g., rats, mice, guinea pigs and the like).

The therapeutically effective amount of a compound of the invention depends, in each case, upon several factors, e.g., the health, age, gender, size and condition of the subject to be treated, the intended mode of achninistration, and the capacity of the subject to incorporate the intended dosage form, among others.
A
therapeutically effective amount of an active agent is an amount sufficient to have the desired effect for the condition being treated. Desired treatment effects are discussed in detail above. A useful therapeutic or prophylactic concentration may vary with the severity of the condition being treated and the patient's susceptibility to treatment. Accordingly, no single concentration will be uniformly useful, but will require modification depending on the particularities of the disease being treated.
Such concentrations can be arrived at through routine experimentation.
A suitable dose for mammals (e.g., humans or mammals other than humans) can range from about 0.01 to about 100 mg per kg of body weight per day, such as from about 0.1 to about 75 mg per kg of body weight per day, for example, from about 1 to about 50 mg per kg of body weight per day. More preferably, the daily dose can be from about 2 to about 25 mg per kg body weight of the mammal. In a preferred embodiment, the subj ect is a human and a suitable dose is about 10 to about 4000 mg per day per subj ect, such as about 20 to about 2000 mg per day per subject, for example, about 50 to about 1000 mg per day per subject, assuming an average human of about 70 kg. More preferably, a suitable amount is in the range from about 100 to about 500 mg per day per subject.
The method of the invention can further comprise administering an additional therapeutic agent. Preferably, the additional therapeutic agent does not diminish the effects of the primary agents) and/or potentiates the effect of the primary agent(s).
In one embodiment, the additional therapeutic agent can be one that is useful for treating cachexia. For example, the additional therapeutic agent can be an anticachetic agent that has a primary mechanism of action which is different from the RXR agonists described herein. Suitable anticachetic agents include, but are not limited to, progesterone derivatives (e.g., megestrol acetate and medroxyprogesterone acetate), growth hormone (e.g,. Serostim~), growth hormone secretagogues (e.g., ghrelin, GHRP-1, GHRP-2, GHRP-6, NN703, Ipamorelin, Campromorelin, MIA-677 and those described in U.S. Patent Nos. 6,303,620, 6,576,648, 5,977,178, 6,566,337, 6,083,908, 6,274,584 and published International Application No. WO 00/01726), cannabinoids (e.g., dronabinol), anabolic steroids (e.g., oxandrolone), corticosteroids (e.g., dexamethasone), monoclonal antibodies (e.g., entanercept (ENBREL~ and REMICADE~)), ~3-Adrenergic blockers, NSAIDS, anticytokines (e.g., ,Q-2 agonist such as clenbuterol, omega-3 fatty acids, melatonin and thalidomide), metoclopramide, insulin-like growth factor-1 (see WO
96/37216), tumor necrosis factor converting enzyme inhibitors, matrix metalloproteinase inhibitors (see WO 03/090777), appetite stimulants, melanocortin receptors, serotonin receptor inhibitors and hydrazine sulfate.
In another embodiment, the additional therapeutic agent can reduce side effects associated with the administration of the RXR agonist. For example, the additional therapeutic agent can be an antihyperlipidemic agent. Suitable antihyperlipidemic agents include, but are not limited to, bile acid sequestrants (e.g., WELCHOL~, Cholestryramine, Colestipol and Polidexide), Fibrates (e.g., Beclobrate, Bezafibrate, Binifibrate, Ciprofibrate, Clinofibrate, Clofibrate, Clofibric Acid, Etofibrate, Fenofibrate, Genfibrozil, Nicofibrate, Pirifibrate, Ronifibrate, Sirnfibrate and Theofibrate), HMG CoA Reductase Inhibitors (e.g., Atorvastatin, Fluvastatin, Lovastatin, Provastatin and Simvastatin), Nicotinic acid and derivatives (e.g., Acipimox, Aluminum Nicotinate, Niceritrol, Nicoclonate, Nicomol and Oxiniacic Acid), Thyroid Hormone/Analogs (e.g., Etiroxate, Thyropropic Acid and Thyroxine), and others agents such as, Acitran, Azacosterol, Benfluorex, ~i-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, °y Oryzanol, Pantethine, Pentaerythritol Tetraacetate, cx Phenylbutyramide, Pirozadil, Probucol, ,Q-Sitosterol, Sultosilic Acid (Piperazine Salt), Tiadenol, Cholesterol Absorption Inhibitors (Zetia or ezetimibe) Triparanol and Xenbucin.
The term allcyl refers to and covers any and all groups which are known as normal alkyl, branched-chain alkyl and cycloalkyl. The term alkenyl refers to and covers normal alkenyl, branch chain alkenyl and cycloalkenyl groups having one or - 10~ -more sites of unsaturation. Similarly, the term alkynyl refers to and covers normal alkynyl, and branch chain alkynyl groups having one or more triple bonds.
Lower alkyl means the above-defined broad definition of alkyl groups having 1 to 6 carbons in case of normal lower alkyl, and as applicable 3 to 6 carbons for lower branch chained and cycloalkyl groups. Lower alkenyl is defined similarly having 2 to 6 carbons for normal lower alkenyl groups, and 3 to 6 carbons for branch chained and cyclo- lower alkenyl groups. Lower alkynyl is also defined similarly, having 2 to 6 carbons for normal lower alkynyl groups, and 4 to 6 carbons for branch chained lower alkynyl groups.
The term "ester" as used here refers to and covers any compound falling Within the definition of that term as classically used in organic chemistry.
It includes organic and inorganic esters.
Unless stated otherwise in this application, preferred esters are derived from the saturated aliphatic alcohols or acids of ten or fewer carbon atoms or the cyclic or saturated aliphatic cyclic alcohols and acids of 5 to 10 carbon atoms.
Particularly preferred aliphatic esters are those derived from lower alkyl acids and alcohols. Also preferred are the phenyl or lower alkyl phenyl esters.
Amide has the meaning classically accorded that term in organic chemistry.
In this instance it includes the unsubstituted amides and all aliphatic and aromatic mono- and di- substituted amides. Unless stated otherwise in this application, preferred amides are the mono- and di-substituted amides derived from the saturated aliphatic radicals of ten or fewer carbon atoms or the cyclic or saturated aliphatic-cyclic radicals of 5 to 10 carbon atoms. Particularly preferred amides are those derived from substituted and unsubstituted lower alkyl amines. Also preferred are mono- and disubstituted amides derived from the substituted and unsubstituted phenyl or lower alkylphenyl amines. Unsubstituted amides are also preferred.
Acetals and ketals include the radicals of the formula -CK where K is (-OR)Z. Here, R is lower alkyl. Also, K may be -OR70- where R7 is lower alkyl of 2-5 carbon atoms, straight chain or branched.
A pharmaceutically acceptable salt may be prepared for any compounds in this invention having a functionality capable of forming such salt, for example an acid functionality. A pharmaceutically acceptable salt is any salt which retains the activity of the parent compound and does not impart any deleterious or untoward effect on the subj ect to which it is administered and in the context in which it is administered. Pharmaceutically acceptable salts may be derived from organic or inorganic bases. The salt may be a mono or polyvalent ion. Of particular interest are the inorganic ions, sodium, potassium, calcium, and magnesium. Organic salts may by be made with amines, particularly ammonium salts such as mono-, di- and trialkyl amines or ethanol amines. Salts may also be formed with caffeine, tromethamine and similar molecules. Where there is a nitrogen sufficiently basic as to be capable of forming acid addition salts, such may be formed with any inorganic or organic acids or alkylating agent such as methyl iodide. Preferred salts are those formed with inorganic acids such as hydrochloric acid, sulfuric acid or phosphoric acid. Any of a number of simple organic acids such as mono-, di- or tri- acid may also be used.
Certain compounds of the present invention have traps and cis (E and Z) isomers. In addition, the compounds of the present invention may contain one or more chiral centers and therefore may exist in enantiomeric and diastereomeric forms. The scope of the present invention is intended to cover all such isomers. per se, as well as mixtures of cis and traps isomers, mixtures of diastereomers and racemic mixtures of enantiomers (optical isomers) as well. In the present application when no specific mention is made of the configuration (cis, traps or R or S) of a compound (or of an asymmetric carbon) then a mixture of such isomers, or either one of the isomers is intended. In a similar vein, when in the chemical structural formulas of this application a straight line representing a valence bond is drawn to an asymmetric carbon, then isomers of both R and S configuration, as well as their mixtures are intended. A straight horizontal single line or a wavy single line drawn to a carbon with a double bond denotes either cis or traps or both orientations of the substituent on the double_bond. Specific orientation of substituents relative to a double bond is indicated in the name of the respective compound, and/or by specifically showing in the structural formula the orientation of the substituents relative to the double bond.

EXEMPLIFICATION
FIGS. 1-5 comprise charts or graphs disclosing the results of tests obtained with experimental animals that have been inoculated with a xenograft of non-small cell lung cancer cells H292 or with small cell lung cancer cells H446, and which were then orally administered the RXR agonist Compound 1 referred to above.
FIGS. 6 and 7 disclose results of tests obtained with experimental animals that have been inoculated with a xenograft of non-small cell lung cancer cells and which were then orally administered the RXR agonist Compound 2 referred to above.
Specifically, in the experiment shown in FIG. 1 nude mice were subcutaneously transplanted with non-small cell lung cancer cells H292. A
group of the animals was given a daily oral dose of 10 mg per kilogram body weight of Compound 1 in a suitable pharmaceutically acceptable vehicle. A group of the control animals was given the vehicle only. The graph shows the body weight of the animals in grams. It can be seen that the animals treated with Compound 1 have significantly greater body weights than the animals which received the vehicle only.
FIG. 2 shows the percentage of survival of nude mice from a similar experiment as the one described in connection with FIG. 1, and demonstrates significantly better survival rate for the animals that received Compound 1 in a daily oral dose of 10 mg per kg body weight of the animal.
In the experiment shown in FIG. 3, SLID mice were subcutaneously transplanted with small cell lung cancer cells H446. A first group of the animals was given a daily oral dose of 3 mg per kilogram body weight of Compound 1 in a suitable pharmaceutically acceptable vehicle, and a second group was given a daily oral dose of 10 mg per kilogram body,weight in the same vehicle. A group of the control animals was given the vehicle only. The graph shows the body weight of the animals in grams. It can be seen that the animals treated with Compound 1 have significantly greater body weights than the animals that received the vehicle only.
In the experiment shown in FIG. 4 the right gastrocnemius muscle of the control animals and of the animals treated with Compound 1 in a daily dose of mg/kg, as described in connection with FIG. 1, was weighed after the animals had been sacrificed. It can be seen that treatment in accordance with the invention prevents muscle wasting.
In the experiment shown in FIG. 5, the food intake of nude mice with and without H292 xenografts was evaluated. Mice with H292 xenografts had reduced appetite compared with normal control. Mice treated with Compound 1 in a daily dose of 10 mg/kg body weight had equal amount of food intake as normal mice.
Therefore, adminstration of Compound 1 reverses poor appetite in cachectic animals.
In the experiment shown in FIG. 6, nude mice were subcutaneously transplanted with non-small cell lung cancer cells H292. A group of the animals was given a daily oral dose of 50 mg per kilogram body weight of Compound 2 in a suitable pharmaceutically acceptable vehicle. A group of the control animals was given the vehicle only. The graph shows the body weight of the animals in grams. It can be seen that the animals treated with Compound 2 have significantly greater body weights than the animals which received the vehicle only.
In the experiment shown in FIG. 7, the food intake of nude mice bearing H292 xenografts was evaluated. Mice treated with Compound 2 in a daily dose of mg/kg body weight had significantly larger food intake than the tumor bearing mice which received only vehicle. Therefore, adminstration of Compound 2 significantly increases the appetite of tumor bearing animals.
While this invention has been particularly shown and described with references to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention encompassed by the appended claims.

Claims (229)

1. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (I):
wherein:
Z is represented by Structural Formula (II) or Structural Formula (III) Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R4 groups, or Y is selected from phenyl, pyridyl, thienyl, furyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CR1=CR1-CR1=CR1- groups on adjacent carbons;
X is S, O, Or NR5;

n is 1 or 2;
R1 and R2 independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -C1 or -Br;
R4 is lower alkyl, fluoroalkyl or halogen;
R5 is H or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
2. The method of Claim 1, wherein Y is cyclopropyl, phenyl, pyridyl, thienyl or furyl.
3. The method of Claim 2, wherein Y is cyclopropyl or phenyl.
4. The method of Claim 3, wherein Y is
5. The method of Claim 1, wherein R1 is H or methyl.
6. The method of Claim 1, wherein B is -COOH or a pharmaceutically acceptable salt thereof, -COOR8 or -CONR9R10.
7. The method of Claim 1, wherein Z is represented by Structural Formula (II) and n is 2.
8. The method of Claim 1, wherein Z is represented by Structural Formula (III) and X is S or O.
9. The method of Claim 1, wherein the cachexia is associated with cancer.
10. The method of Claim 9, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
11. The method of Claim 1, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
12. The method of Claim 1, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
13. The method of Claim 12, wherein the therapeutically effective amount of the compound is from about 2 to about 25 mg per kg body weight of the subject per day.
14. The method of Claim 1, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
15. The method of Claim 14, wherein the compound is administered to a human subject at a daily dose of from about 100 to about 500 mg.
16. The method of Claim 1, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
17. The method of Claim 16, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic Acid and Derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
18. The method of Claim 1, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
19. The method of Claim 1, wherein the compound is orally administered.
20. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (IV):

wherein:
R20 is alkyl of 1 to 6 carbons;
B is -COOH, or -COOR21; and R21 is alkyl of 1 to 6 carbons, or a pharmaceutically acceptable salt of said compound.
21. The method of Claim 20, wherein the cachexia is associated with cancer.
22. The method of Claim 21, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
23. The method of Claim 20, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
24. The method of Claim 20, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
25. The method of Claim 20, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
26. The method of Claim 20, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
27. The method of Claim 26, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
28. The method of Claim 20, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
29. The method of Claim 20, wherein the compound is orally administered.
30. The method of Claim 20, wherein the compound is represented by the formula:

or a pharmaceutically acceptable salt of said compound.
31. The method of Claim 20, wherein the compound is represented by the formula:

or a pharmaceutically acceptable salt of said compound.
32. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (V):
wherein:
R2 is hydrogen or lower alkyl;
R3 is hydrogen or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;

R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
33. The method of Claim 32, wherein the cachexia is associated with cancer.
34. The method of Claim 33, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
35. The method of Claim 32, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
36. The method of Claim 32, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
37. The method of Claim 32, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
38. The method of Claim 32, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
39. The method of Claim 38, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.- Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
40. The method of Claim 32, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
41. The method of Claim 32, wherein the compound is orally administered.
42. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (VI):
wherein:
n is 1 or 2;
R1 and R2 independently are H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, -Cl or -Br;
R4 is H, lower alkyl, trifluoromethyl or halogen;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2, or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;

R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
43. The method of Claim 42, wherein the cachexia is associated with cancer.
44. The method of Claim 43, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
45. The method of Claim 42, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
46. The method of Claim 42, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
47. The method of Claim 42, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
48. The method of Claim 42, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
49. The method of Claim 42, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
50. The method of Claim 42, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
51. The method of Claim 42, wherein the compound is orally administered.
52. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (VII):
wherein:
R4 is lower alkyl of 1 to 6 carbons;
B is -COOH or -COOR8; and R8 is lower alkyl of 1 to 6 carbons; and the configuration about the cyclopropane ring is cis, and the configuration about the double bonds in the pentadienoic acid or ester chain attached to the cyclopropane ring is trans in each of said double bonds, or a pharmaceutically acceptable salt of said compound.
53. The method of Claim 52, wherein the cachexia is associated with cancer.
54. The method of Claim 53, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
55. The method of Claim 52, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
56. The method of Claim 52, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
57. The method of Claim 52, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
58. The method of Claim 52, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
59. The method of Claim 58, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
60. The method of Claim 52, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
61. The method of Claim 52, wherein the compound is orally administered.
62. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (I):
wherein:
Z is represented by Structural Formula (II) or Structural Formula (III) Y is selected from pyridyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z
and -CR1=CR1-CR1=CR1- groups on adjacent carbons;
X is NR5;
n is 1 or 2;
R1 and R2 independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br;
R4 is lower alkyl, fluoroalkyl or halogen;
R5 is H or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is a divalent alkyl radical of 2 to 5 carbons.
63. The method of Claim 62, wherein the cachexia is associated with cancer.
64. The method of Claim 63, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
65. The method of Claim 62, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
66. The method of Claim 62, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
67. The method of Claim 62, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
68. The method of Claim 62, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
69. The method of Claim 68, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
70. The method of Claim 62, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
71. The method of Claim 62, wherein the compound is orally administered.
72. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (I):
wherein:
Z is represented by Structural Formula (III) Y is thienyl or furyl, said thienyl or furyl groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z
and -CR1=CR1-CR1=CR1- groups on adjacent carbons;
X is NR5;
n is 1 or 2;
R1 and R2 independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br;
R4 is lower alkyl, fluoroalkyl or halogen;
R5 is H or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;

R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is a divalent alkyl radical of 2 to 5 carbons.
73. The method of Claim 72, wherein the cachexia is associated with cancer.
74. The method of Claim 73, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
75. The method of Claim 72, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
76. The method of Claim 72, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
77. The method of Claim 72, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
78. The method of Claim 72, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
79. The method of Claim 78, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha. Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
80. The method of Claim 72, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
81. The method of Claim 72, wherein the compound is orally administered.
82. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (I):
wherein:
Z is represented by Structural Formula (III) Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R4 groups, or Y is selected from phenyl, pyridyl, thienyl, furyl, pyrrolyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, and imidazolyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CR1=CR1-CR1=CR1- groups on adjacent carbons;
X is S or O;
n is 1 or 2;
R1 and R2 independently are H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, Cl or Br;
R4 is lower alkyl, fluoroalkyl or halogen;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
83. The method of Claim 82, wherein the cachexia is associated with cancer.
84. The method of Claim 83, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
85. The method of Claim 82, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
86. The method of Claim 82, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
87. The method of Claim 82, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
88. The method of Claim 82, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
89. The method of Claim 88, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha. Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
90. The method of Claim 82, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
91. The method of Claim 82, wherein the compound is orally administered.
92. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (VIII):
wherein:
X is S or O;
R2 is hydrogen or lower alkyl;
R3 is hydrogen or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
93. The method of Claim 92, wherein the cachexia is associated with cancer.
94. The method of Claim 93, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
95. The method of Claim 92, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
96. The method of Claim 92, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
97. The method of Claim 92, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
98. The method of Claim 92, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
99. The method of Claim 98, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
100. The method of Claim 92, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
101. The method of Claim 92, wherein the compound is orally administered.
102. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of an RXR agonist compound represented by Structural Formula (I):
wherein:
Z is represented by Structural Formula (II) Y is selected from thienyl or furyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z
and -CR1=CR1-CR1=CR1- groups on adjacent carbons;
n is 1 or 2;
R1 and R2 independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br;
R4 is lower alkyl, fluoroalkyl or halogen;

B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
103. The method of Claim 102, wherein the cachexia is associated with cancer.
104. The method of Claim 103, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
105. The method of Claim 102, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
106. The method of Claim 102, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
107. The method of Claim 102, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
108. The method of Claim 102, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
109. The method of Claim 108, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
110. The method of Claim 102, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
111. The method of Claim 102, wherein the compound is orally administered.
112. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (I):
wherein:
Z is represented by Structural Formula (III) Y is cycloalkyl of 3 to 8 carbons or cycloalkenyl of 5 to 8 carbons optionally substituted with one or two R4 groups, or Y is phenyl, said groups being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CR1=CR1-CR1=CR1- groups on adjacent carbons;
X is NR5;
R1 and R2 independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -C1 or -Br;
R4 is lower alkyl, fluoroalkyl or halogen;
R5 is H or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)a Or -CR7OR13O;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
113. The method of Claim 112, wherein the cachexia is associated with cancer.
114. The method of Claim 113, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
115. The method of Claim 112, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
116. The method of Claim 112, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
117. The method of Claim 112, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
118. The method of Claim 112, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
119. The method of Claim 118, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, ,.beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
120. The method of Claim 112, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
121. The method of Claim 112, wherein the compound is orally administered.
122. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (I):
wherein:
Z is represented by Structural Formula (III) Y is cyclopropyl, said Y group being optionally substituted with one or two R4 groups, and wherein Y is substituted by the Z and -CR1=CR1-CR1=CR1- groups on adjacent carbons;
X is NR5;
R1 and R2 independently are -H, lower alkyl or fluoroalkyl;
R3 is hydrogen, lower alkyl, alkylamino, dialkylamino, cyano, -Cl or -Br;
R4 is lower alkyl, fluoroalkyl or halogen;
R5 is -H or lower alkyl;

B is hydrogen, -COON or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl of 1 to 5 carbons, cycloalkyl of 3 to 5 carbons or alkenyl group containing 2 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
123. The method of Claim 122, wherein the cachexia is associated with cancer.
124. The method of Claim 123, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
125. The method of Claim 122, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
126. The method of Claim 122, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
127. The method of Claim 122, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
128. The method of Claim 122, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
129. The method of Claim 128, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, ,.beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
130. The method of Claim 122, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
131. The method of Claim 122, wherein the compound is orally administered.
132. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (VIII):
wherein:

X is NR5;
R2 is hydrogen or lower alkyl;
R3 is hydrogen or lower alkyl;
R5 is hydrogen or lower alkyl;
B is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2 or -CR7OR13O;
R7 is an alkyl of 1 to 5 carbons, cycloalkyl of 3 to 5 carbons or alkenyl group containing 2 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2 to 5 carbons.
133. The method of Claim 132, wherein the cachexia is associated with cancer.
134. The method of Claim 133, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
135. The method of Claim 132, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
136. The method of Claim 132, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
137. The method of Claim 132, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
138. The method of Claim 132, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
139. The method of Claim 138, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
140. The method of Claim 132, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
141. The method of Claim 132, wherein the compound is orally administered.
142. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (IX), (X) or (XI):

wherein:
B is -COOH or -COOR8;
R3 is hydrogen, lower alkyl, Cl or Br;
R8 is an alkyl group of 1 to 10 carbons, a cycloalkyl group of 5 to 10 carbons or trimethylsilylalkyl, where the alkyl group has 1 to 10 carbons, or R8 is phenyl or lower alkylphenyl; and X is S or O.
143. The method of Claim 142, wherein the cachexia is associated with cancer.
144. The method of Claim 143, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
145. The method of Claim 142, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
146. The method of Claim 142, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
147. The method of Claim 142, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
148. The method of Claim 142, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
149. The method of Claim 148, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
150. The method of Claim 142, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
151. The method of Claim 142, wherein the compound is orally administered.
152. The method of Claim 142, wherein the compound is represented by Structural Formula (IX), R3 is H or methyl and B is -COOH or -COOCH2CH3.
153. The method of Claim 142, wherein the compound is represented by Structural Formula (X), R3 is H and B is -COOH or -COOCH2CH3.
154. The method of Claim 142, wherein the compound is represented by Structural Formula (XI), R3 is H, B is -COOH or -COOCH2CH3 and X is O
or S.
155. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (XII):
wherein R is hydrogen or lower alkyl of 1 to 6 carbons, or a pharmaceutically acceptable salt thereof.
156. The method of Claim 155, wherein the cachexia is associated with cancer.
157. The method of Claim 156, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
158. The method of Claim 155, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
159. The method of Claim 155, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
160. The method of Claim 155, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
161. The method of Claim 155, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
162. The method of Claim 161, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma. Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol, Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
163. The method of Claim 155, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
164. The method of Claim 155, wherein the compound is orally administered.
165. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (XIII), (XIV) or (XV):
wherein:
X is O, S, or (CR1R1)n;
n is 0, 1 or 2;
Y is a bivalent radical having Structural Formula (XVI) or Structural Formula (XVII) where p is an integer from 1 to 4:

or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups being unsubstituted, or substituted with 1 to 3 C1-6 alkyl or with 1 to 3 C1-6 fluoroalkyl groups;
X is O, S or NH;
R1 is independently H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
R2 is independently -H, lower alkyl of 1 to 6 carbons, -OR1, 1-adamantyl, or lower fluoroalkyl of 1 to 6 carbons, or the two R2 groups jointly represent an oxo group;
R3 is hydrogen, lower alkyl of 1 to 6 carbons, -OR1, fluoro substituted lower alkyl of 1 to 6 carbons or halogen, -NO2, -NH2, -NHCO(C1-C6)alkyl, or -NHCO(C1-C6)alkenyl;
A is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CH(OR13O), -COR7, -CR7(OR12)2, -CR7(OR13O), or -Si(C1-6 alkyl)3;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl;

R13 is divalent alkyl radical of 2-5 carbons; and R14 is alkyl of 1 to 10 carbons, fluoro-substituted alkyl of 1 to 10 carbons, alkenyl of 2 to 10 carbons and having 1 to 3 double bonds, alkynyl having 2 to 10 carbons and 1 to 3 triple bonds, carbocyclic aryl selected from the group consisting of phenyl, C1-C10-alkylphenyl, naphthyl, C1-C10-alkylnaphthyl, phenyl-C1-C10 alkyl, naphthyl-C1-C10 alkyl, C1-C10-alkenylphenyl having 1 to 3 double bonds, C1-C10-alkynylphenyl having 1 to 3 triple bonds, phenyl-C1-C10 alkenyl having 1 to 3 double bonds, phenyl-C1-C10 alkynyl having 1 to 3 triple bonds, hydroxy alkyl of 1 to 10 carbons, hydroxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, hydroxyalkynyl having 2 to 10 carbons and 1 to 3 triple bonds, acyloxyalkyl of 1 to 10 carbons, acyloxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, or acyloxyalkynyl of 2 to 10 carbons and 1 to 3 triple bonds where the acyl group is represented by COR8, or R14 is a 5 or 6 membered heteroaryl group having 1 to 3 heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said heteroaryl group being unsubstituted or substituted with a C1 to C10 alkyl group, with a C1 to C10 fluoroalkyl group, or with halogen, and the dashed line in Structural Formula (XVI) represents a bond or absence of a bond.
166. The method of Claim 165, wherein the cachexia is associated with cancer.
167. The method of Claim 166, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
168. The method of Claim 165, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
169. The method of Claim 165, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
170. The method of Claim 165, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
171. The method of Claim 165, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
172. The method of Claim 171, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma. Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
173. The method of Claim 165, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
174. The method of Claim 165, wherein the compound is orally administered.
175. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (XVIII):

wherein:
X is O, NR' or S;
R1 is alkyl of 1 to 6 carbons;
Y is a bivalent cyclopropyl radical optionally substituted with one or two R4 groups, or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups optionally substituted with 1 to 4 R4 groups;
R1 is independently H, alkyl of 1 to 6 carbons, or fluoroalkyl of 1 to 6 carbons;
R2 is alkyl of 1 to 8 carbons, or fluoroalkyl of 1 to 8 carbons;
R'2 is alkyl of 1 to 8 carbons, or fluoroalkyl of 1 to 8 carbons;
R3 is hydrogen, alkyl of 1 to 6 carbons, fluoro substituted alkyl of 1 to 6 carbons, halogen, alkoxy of 1 to 8 carbons, or alkylthio of 1 to 6 carbons, -NO2, -NH2, -NHCO(C1-C6)alkyl, -NHCO(C1-C6)alkenyl, -NR1H or -N(R1)2, benzyloxy or C1-C6 alkyl-substituted benzyloxy;
R4 is -H or alkyl of 1 to 6 carbons, or fluoro substituted alkyl of 1 to 6 carbons;
m is an integer having the values of 0 to 3, and B is -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -COOCH2COR7, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CH(OR13O), -COR7, -CR7(OR12)2, -CR7(OR13O), R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons;
R8 is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a group of 5 to 10 phenyl or lower alkylphenyl;

R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2-5 carbons.
176. The method of Claim 175, wherein the cachexia is associated with cancer.
177. The method of Claim 176, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
178. The method of Claim 175, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
179. The method of Claim 175, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
180. The method of Claim 175, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
181. The method of Claim 175, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
182. The method of Claim 181, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma. Oryzanol, Pantethine, Pentaerythritol Tetraacetate, a Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
183. The method of Claim 175, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
184. The method of Claim 175, wherein the compound is orally administered.
185. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (XIX):
wherein:
Y is a bivalent radical having Formula (a) or Formula (b):
or Y is a bivalent aryl or 5 or 6 membered heteroaryl radical having 1 to 3 heteroatoms selected from N, S and O, said aryl or heteroaryl groups being unsubstituted, or substituted with 1 to 3 C1-6 alkyl or with 1 to 3 C1-6 fluoroalkyl groups;
p is an integer from 1 to 4;
the two X1 groups jointly represent an oxo or thione function, or X1 is independently selected from H or alkyl of 1 to 6 carbons;
the two X2 groups jointly represent an oxo or a thione function, or X2 is independently selected from H or alkyl of 1 to 6 carbons, with the proviso that one of the joint X1 grouping or of the joint X2 grouping represents an oxo or a thione function;
W is H, O, C(R1)2, phenyl, naphthyl, or 5 or 6 membered heteroaryl group having 1 to 3 heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said phenyl, naphthyl or heteroaryl groups being unsubstituted or substituted with a C1 to C10 alkyl group, with a C1 to C10 fluoroalkyl group, or with halogen;
R1 is independently H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
R2 is independently H, lower alkyl of 1 to 6 carbons, or lower fluoroalkyl of 1 to 6 carbons;
R3 is hydrogen, lower alkyl of 1 to 6 carbons, -OR1, fluoro substituted lower alkyl of 1 to 6 carbons or halogen, -NO2, -NH2, -NHCO(C1-C6) alkyl, or NHCO(C1-C6)alkenyl;
A is hydrogen, -COOH or a pharmaceutically acceptable salt thereof, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2OCOR11, -CHO, -CH(OR12)2, -CH(OR13O), -COR7, -CR7(OR12)2, -CR7(OR13O), or -Si(C1-6 alkyl)3;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R8 is an alkyl group of 1 to 10 carbons or (trimethylsilyl)alkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl;

R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl, hydroxyphenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl;
R13 is divalent alkyl radical of 2-5 carbons;
R14 is H, alkyl of 1 to 10 carbons, fluoro-substituted alkyl of 1 to 10 carbons, alkenyl of 2 to 10 carbons and having 1 to 3 double bonds, alkynyl having 2 to 10 carbons and 1 to 3 triple bonds, carbocyclic aryl selected from the group consisting of phenyl, C1-C10-alkylphenyl, naphthyl, C1-C10-alkylnaphthyl, phenyl-C1-C10 alkyl, naphthyl-C1-C10-alkyl, C1-C10-alkenylphenyl having 1 to 3 double bonds, C1-C10-alkynylphenyl having 1 to 3 triple bonds, phenyl-C1-C10 alkenyl having 1 to 3 double bonds, phenyl-C1-C10 alkynyl having 1 to 3 triple bonds, hydroxy alkyl of 1 to 10 carbons, hydroxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, hydroxyalkynyl having 2 to 10 carbons and 1 to 3 triple bonds, acyloxyalkyl of 1 to 10 carbons, acyloxyalkenyl having 2 to 10 carbons and 1 to 3 double bonds, or acyloxyalkynyl of 2 to 10 carbons and 1 to 3 triple bonds where the acyl group is represented by COR8, or R14 is a 5 or 6 membered heteroaryl group having 1 to 3 heteroatoms, said heteroatoms being selected from a group consisting of O, S, and N, said carbocyclic aryl and heteroaryl groups being unsubstituted or substituted with a C1 to C10 alkyl group, with a C1 to C10 fluoroalkyl group, or with halogen;
and the dashed line in Formula (a) represents a bond or absence of a bond, provided that when the dashed line represents a bond then there are no R1 substituents on the carbons connected by said bond.
186. The method of Claim 185, wherein the cachexia is associated with cancer.
187. The method of Claim 186, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
188. The method of Claim 185, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
189. The method of Claim 185, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
190. The method of Claim 185, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
191. The method of Claim 185, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
192. The method of Claim 191, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
193. The method of Claim 185, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
194. The method of Claim 185, wherein the compound is orally administered.
195. A method of treating cachexia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (XX):

wherein:
X is O, S, or C(R)2;
R is H or alkyl of 1 to 6 carbons;
R1 is H, alkyl of 1 to 10 carbons, alkenyl of 2 to 6 carbons, phenyl-C1-C6 alkyl, or C1-C6-alkylphenyl;
R2 is H, alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, alkoxy of 1 to 6 carbons, or alkylthio of to 6 carbons;
R3 is independently alkyl of 1 to 6 carbons, -F, -Cl, -Br, -I, -CF3, fluoro substituted alkyl of 1 to 6 carbons, OH, SH, alkoxy of 1 to 6 carbons, fluoroalkoxy of 1 to 6 carbons, alkylthio of 1 to 6 carbons, benxyloxy, C1-C6 alkyl substituted benzyloxy, halogen substituted benzyloxy, phenyloxy, C1-C6 alkyl substituted phenyloxy, or halogen substituted phenyloxy;
R4 is independently -H, alkyl of 1 to 6 carbons, or -F;
Y is a phenyl or naphthyl group, or heteroaryl selected from a group consisting of pyridyl, thienyl, furyl, pyridazinyl, pyrimidinyl, pyrazinyl, thiazolyl, oxazolyl, imidazolyl and pyrrazolyl, said phenyl and heteroaryl groups being optionally substituted with one or two R2 groups; m is an integer having the values 0 to 3;
p is an integer having the values 0 to 4;

A is (CH2)q where q is 0-5, lower branched chain alkyl having 3-6 carbons, cycloalkyl having 3-6 carbons, alkenyl having 2-6 carbons and 1 or 2 double bonds, alkynyl having 2-6 carbons and 1 or 2 triple bonds;
B is hydrogen, -COOH, -COOR8, -CONR9R10, -CH2OH, -CH2OR11, -CH2COR11, -CHO, -CH(OR12)2, -CHOR13O, -COR7, -CR7(OR12)2, -CR7OR13O, or tri-lower alkylsilyl;
R7 is an alkyl, cycloalkyl or alkenyl group containing 1 to 5 carbons, R8 is an alkyl group of 1 to 10 carbons or trimethylsilylalkyl where the alkyl group has 1 to 10 carbons, or a cycloalkyl group of 5 to 10 carbons, or R8 is phenyl or lower alkylphenyl;
R9 and R10 independently are hydrogen, an alkyl group of 1 to 10 carbons, or a cycloalkyl group of 5-10 carbons, or phenyl or lower alkylphenyl;
R11 is lower alkyl, phenyl or lower alkylphenyl;
R12 is lower alkyl; and R13 is divalent alkyl radical of 2-5 carbons, or a pharmaceutically acceptable salt thereof.
196. The method of Claim 195, wherein the cachexia is associated with cancer.
197. The method of Claim 196, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
198. The method of Claim 195, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, diabetes mellitus, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
199. The method of Claim 195, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
200. The method of Claim 195, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
201. The method of Claim 195, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
202. The method of Claim 201, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
203. The method of Claim 195, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
204. The method of Claim 195, wherein the compound is orally administered.
205. A method of treating cachexia associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of an RXR agonist compound.
206. The method of Claim 205, wherein cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of AIDS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
207. The method of Claim 206, wherein cachexia is associated with AIDS.
208. The method of Claim 205, wherein cachexia is associated with cancer.
209. The method of Claim 208, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
210. The method of Claim 205, wherein the RXR agonist compound is a RXR
.alpha.
agonist compound.
211. The method of Claim 205, wherein the RXR agonist compound is a RXR .beta.
agonist compound.
212. The method of Claim 205, wherein the RXR agonist compound is a R.GAMMA.
agonist compound.
213. The method of Claim 205, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
214. The method of Claim 205, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
215. The method of Claim 205, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
216. The method of Claim 215, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
217. The method of Claim 205, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
218. The method of Claim 205, wherein the compound is orally administered.
219. A method of treating cachexia associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Parkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia in a subject in need thereof, the method comprising administering to said subject a therapeutically effective amount of a compound represented by Structural Formula (XXI), (XXII), (XXIII), (XXIV), (XXV), (XXVI), (XXVII), (XXVIIa) or (XXVIIb):

wherein:
R1 and R2 each independently is hydrogen or lower alkyl or acyl having 1-4 carbon atoms;
Y is C, O, S, N, CHOH, CO, SO, SO2, or a pharmaceutically acceptable salt;
R3 is hydrogen or lower alkyl having 1-4 carbon atoms where Y is C
or N;
R4 is hydrogen or lower alkyl having 1-4 carbon atoms when Y is C, R4 does not exist if Y is N, or neither R3 or R4 exist if Y is S, O, CHOH, CO, SO, or SO2;
R' and R" are hydrogen, lower alkyl or acyl having 1-4 carbon atoms, OH, alkoxy having 1-4 carbon atoms, thiol or thioether, or amino, or R' or R"
taken together form an oxo(keto), methano, thioketo, HO-N=, NC-N=, (R7R8)N-N=, R17O-N=, R17N=, epoxy, cyclopropyl, or cycloalkyl group and wherein the epoxy, cyclopropyl, and cycloalkyl groups are optionally substituted with lower alkyl having 1-4 carbons or halogen;
R"' and R"" are hydrogen, halogen, lower alkyl or acyl having 1-4 carbon atoms, alkylamino, or R"' and R"" taken together form a cycloalkyl group having 3-10 carbons, and wherein the cycloalkyl group can be substituted with lower alkyl having 1-4 carbons or halogen;
R5 is hydrogen, a lower alkyl having 1-4 carbons, halogen, nitro, -OR7, -SR7, -NR7R8, or - (CF)n CF3, but R5 is not hydrogen if R6, R10, R11, R12 and R13 are all hydrogen, Z, Z', Z", Z"', and Z"" are all carbon, and R' and R" represent -H, -OH, C1-C4 alkoxy or C1-C4 acyloxy or R' and R" taken together form an oxo, methano, or hydroxyimino group;

R6, R10, R11, R12 and R13 each independently represent hydrogen, a lower alkyl having 1-4 carbons, halogen, nitro, -OR7, -SR7, -NR7R8 or -(CF)n CF3, and exist only if the Z, Z', Z", Z"', or Z"" from which R6, R10, R11, R12 or R13 originates is C, or R6, R10, R11, R12 and R13 each independently represent hydrogen or a lower alkyl having 1-4 carbons if the Z, Z', Z", Z"', or Z"" from which R6, R10, R11, R12 or R13 originates is N, and where one of R6, R10, R11, R12 or R13 is X;
R7 represents hydrogen or a lower alkyl having 1-6 carbons;
R8 represents hydrogen or a lower alkyl having 1-6 carbons;
R9 represents a lower alkyl having 1-4 carbons, phenyl, aromatic alkyl, or q-hydroxyphenyl, q-bromophenyl, q-chlorophenyl, q-florophenyl, or q-iodophenyl, where q=2-4;
R14 represents hydrogen, a lower alkyl having 1-4 carbons, oxo, hydroxy, acyl having 1-4 carbons, halogen, thiol, or thioketone;
R17 is hydrogen, lower alkyl having 1-8 carbons, alkenyl optionally substituted with halogen, acyl, -OR7 or -SR7, -R9, alkyl carboxylic acid optionally substituted with halogen, acyl, -OR7 or -SR7, alkenyl carboxylic acid optionally substituted with halogen, acyl, -OR7 or -SR7, alkyl amine optionally substituted with halogen, acyl, -OR7 or -SR7, or alkenyl amine optionally substituted with halogen, acryl, -OR7 or -SR7;
R18 represents hydrogen, a lower alkyl having 1-4 carbons, halogen, nitro, -OR7, -SR7, -NR7R8, or -(CF)n CF3;
X is -COOH, tetrazole, -PO3H, -SO3H, -CHO, -CH2OH, -CONH2, -COSH, -COOR9, -COSR9, -CONHR9, or -COOW where W is a pharmaceutically acceptable salt, and wherein X can originate from any C or N on the ring;
Z, Z', Z", Z"' and Z"" each independently is C, S, O, N, or a pharmaceutically acceptable salt, provided that one or more of Z, Z', Z", Z"' and Z"" are not O or S if Z, Z', Z", Z"' or Z"" is attached by a double bond to one of Z, Z', Z", Z"' or Z"" or if one or more of Z, Z', Z", Z"' or Z"" is attached to one of Z, Z', Z", Z"' or Z"" that is O or S, and provided that one or more of Z, Z', Z", Z"' and Z"" are not N if one of Z, Z', Z", Z"' and Z""
is attached by a single bond to one of Z, Z', Z", Z"' and Z"" that is N;
n is 0 to 3; and the dashed lines are optional double bonds.
220. The method of Claim 219, wherein the RXR agonist compound is represented by the formula:
or a pharmaceutically acceptable salt of said compound.
221. The method of Claim 219, wherein the cachexia is associated with cancer.
222. The method of Claim 221, wherein the cancer is lung cancer, colorectal cancer, pancreatic cancer, gastrointestinal cancer, liver cancer, biliary cancer, breast cancer, esophageal cancer or leukemia.
223. The method of Claim 219, wherein the cachexia is associated with one or more diseases, disorders or conditions selected from the group consisting of cancer, AIDS, liver cirrhosis, chronic renal failure, chronic obstructive pulmonary disease, chronic cardiac failure, immune system diseases, tuberculosis, cystic fibrosis, gastrointestinal disorders, Farkinson's disease, anorexia nervosa, dementia, major depression, an aged condition and sarcopenia.
224. The method of Claim 219, wherein the therapeutically effective amount of the compound is from about 1 to about 50 mg per kg body weight of the subject per day.
225. The method of Claim 219, wherein the compound is administered to a human subject at a daily dose of from about 10 to about 4000 mg.
226. The method of Claim 219, further comprising administering a therapeutically effective amount of an antihyperlipidemic agent.
227. The method of Claim 226, wherein the antihyperlipidemic agent is selected from the group consisting of bile acid sequestrants, Fibrates, HMG CoA
Reductase Inhibitors, Nicotinic acid and derivatives, Thyroid Hormone/Analogs, Acitran, Azacosterol, Benfluorex, .beta.-Benzalbutyramide, Carnitine, Chondroitin Sulfate, Clomestrone, Detaxtran, Dextran Sulfate Sodium, 5,8,11,14,17-Eicosapentaenoic Acid, Eritadenine, Furazabol, Meflutol, Melinamide, Mytatrienediol, Ornithine, .gamma.-Oryzanol, Pantethine, Pentaerythritol Tetraacetate, .alpha.-Phenylbutyramide, Pirozadil, Probucol, .beta.-Sitosterol, Sultosilic Acid, Tiadenol,Cholesterol Absorption Inhibitors Triparanol and Xenbucin.
228. The method of Claim 219, further comprising administering a therapeutically effective amount of an anticachetic agent, which is not an RXR agonist.
229. The method of Claim 219, wherein the compound is orally administered.
CA002535260A 2003-08-07 2004-08-06 Method for treating cachexia with retinoid ligands Abandoned CA2535260A1 (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US49313803P 2003-08-07 2003-08-07
US60/493,138 2003-08-07
US53373403P 2003-12-31 2003-12-31
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