CN109381451A - 用于治疗肿瘤的苏糖酸镁及其组合物 - Google Patents
用于治疗肿瘤的苏糖酸镁及其组合物 Download PDFInfo
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Abstract
本发明涉及苏糖酸镁在肿瘤治疗,尤其是恶性肿瘤治疗中的用途及其组合物。
Description
技术领域
本发明涉及肿瘤,尤其是恶性肿瘤治疗领域。
背景技术
近年来,尽管在用于对肿瘤的治疗已经取得了重要的进展,但是恶性肿瘤(即癌症)仍然是人类难以忍受的疼痛和苦难。虽然经过主要手段手术切除、化疗和放疗能有效地控制肿瘤,但上述治疗后,很多病人肿瘤复发、向周围组织器官浸润甚至全身转移,导致病情恶化和死亡。目前,为了开发适于癌症的治疗及症状减轻的治疗方法,一直在进行大量研究。
肺癌是肺组织内细胞生长失去控制而导致的一种疾病。在过去的半个多世纪中,肺癌的发病率和死亡率逐年增加,已经从20世纪初的一种罕见疾病发展为当今的全球头号癌症杀手。根据世界卫生组织(WHO)定期公布的资料,肺癌的发病率和死亡率在世界各国尤其是发达国家呈明显的上升趋势,已经成为许多发达国家最常见的肿瘤,位列男性常见恶性肿瘤第一位和女性常见恶性肿瘤第二位,并且成为恶性肿瘤中最常见的死亡原因。
根据肺癌细胞的分化程度和形态特征,临床上将其分为小细胞肺癌和非小细胞肺癌两类,其中非小细胞肺癌占到85%左右。根据预后情况,几种非小细胞肺癌又可以归为三类:鳞状细胞癌、肺腺癌和大细胞肺癌。尽管诊断方法和治疗手段都有了很大的进步,70%的NSCL患者在初次确诊时大多已处于III B/Ⅳ期,其中约40%的患者失去手术治疗的机会,5年生存率往往低于5%。因此,针对该疾病分子起源和疾病发生发展过程的研究,对其预防和治疗具有重要意义。
脑胶质瘤是常见的危害人类健康的恶性疾病,是由神经外胚叶衍化而来的胶质细胞及星型胶质细胞、少突胶质细胞和室管膜胶质细胞等发生的肿瘤。脑胶质瘤是颅内肿瘤中最常见的一种,约占颅内肿瘤45%。胶质细胞瘤的生长特点为浸润性生长,与正常脑组织无明显界限,恶性者瘤体生长快,病程短。目前,对于胶质瘤治疗以外科手术辅助放疗和化疗治疗为主。外科手术切除主要达到减少胶质瘤细胞数量、缓解荷瘤症状、暂时降低颅内压。放射治疗几乎是各型胶质瘤的常规治疗,除髓母细胞瘤对放疗高度敏感,室管膜瘤中度敏感外,其他类型对放疗均不敏感,有研究认为术后接受放疗患者与非放疗患者预后相同。由于高效低毒化疗药品种有限和肿瘤耐药性等因素,术后辅助经静脉系统化疗的疗效有限。总之,脑胶质瘤术后复发率高,致残、致死率较高;恶性胶质细胞瘤患者的术后中位生存期不足1年。
外科手术切除、化学疗法和放射线疗法是治疗肿瘤的三大手段。外科手术对患者在精神、体力上造成巨大压力,还可能引起后遗症或并发症。此外,某些部位的癌症不适合外科切除。化疗药物,如抗生素、代谢拮抗物、烷化剂、激素剂等,不仅攻击癌细胞,对正常细胞也有毒性,因此,引起呕吐、恶心、食欲不振、脱发等副作用,可使患者的QOL显著降低。因此,期望安全性更高、副作用小的新型的抗肿瘤剂的开发。放射线疗法具有作为急性反应及晚期反应的副作用,放射线对正常细胞与癌细胞同时给予损伤,因此,有可能引起疲倦感、食欲不振、皮肤红斑、消化器官的出血、白细胞等的减少、脱发等多种副作用。
另一方面,在化学疗法的领域,作为对癌细胞有效的抗肿瘤剂发现了抗生素、代谢拮抗物、烷化剂、激素剂等。但是,这些抗肿瘤剂不仅攻击癌细胞,而且对正常细胞也起作用,因此,引起呕吐、恶心、食欲不振、脱发等副作用,产生使患者的QOL显著降低的问题。因此,期望安全性更高、副作用小的新型的抗肿瘤剂的开发。
发明概述
镁在许多细胞功能如能量代谢,蛋白质和DNA合成起关键作用。增殖细胞含有比静止细胞更多的镁,减少细胞镁可降低细胞增殖速率。因此认为细胞内高镁有利于肿瘤细胞的生长。整体动物实验发现,给荷瘤小鼠饲喂无镁饮食,使血镁浓度从1.03降低到0.25mmol/L可抑制肿瘤的生长。
但是,流行病学研究发现镁缺乏症是某些类型癌症的危险因素。镁摄入与结直肠癌风险的逆关联(Larsson,S.C.,Bergkvist,L.,and Wolk,A.(2005).Magnesium intakein relation to risk of colorectal cancer in women.Jama 293,86-89)。高镁摄入量可降低结肠直肠癌的风险(Ma,E.,Sasazuki,S.,Inoue,M.,Iwasaki,M.,Sawada,N.,Takachi,R.,and Tsugane,S.(2010).High dietary intake of magnesium may decreaserisk of colorectal cancer in Japanese men.J Nutr 140,779-785)。膳食镁摄入量较高与结肠直肠肿瘤的风险降低有关(Wark,P.A.,Lau,R.,Norat,T.,and Kampman,E.(2012).Magnesium intake and colorectal tumor risk:a case-control study andmeta-analysis.Am J Clin Nutr.,96(3),622-631)。
综上所述,目前镁与恶性肿瘤的关系尚不明确(Wolf,F.I.,Cittadini,A.R.,andMaier,J.A.(2009).Magnesium and tumors:ally or foe?Cancer Treat Rev 35,378-382;Castiglioni,S.,and Maier,J.A.(2011).Magnesium and cancer:a dangerousliason.Magnes Res 24,S92-100;Finnema,S.J.,Nabulsi,N.B.,Eid,T.,Detyniecki,K.,Lin,S.F.,Chen,M.K.,Dhaher,R.,Matuskey,D.,Baum,E.,Holden,D.,et al.(2016).。苏糖酸镁(L-TAMS)是一种新型镁化合物,与氯化镁、柠檬酸镁、葡萄糖酸镁和甘氨酸镁相比,其吸收率高约54%,保留率高约67%,是唯一能够通过血脑屏障,进入大脑,有效提高大脑中镁水平,进而改善相关功能的镁化合物。但是,并没有报道苏糖酸镁可以直接抑制肿瘤细胞生长、迁移、侵袭和粘附等效果。
现已发现单独给予苏糖酸镁可以抑制肿瘤细胞生长、迁移、侵袭和粘附,从而治疗肿瘤,但是常规的镁化合物如MgSO4并不具有类似生物活性。而且还发现苏糖酸镁可以与抗癌药物(化疗药物)联用,不仅能够起到抑制肿瘤细胞生长、迁移、侵袭和粘附,治疗肿瘤的效果,而且还能够将降低通常患者化疗所引起的副作用,如体重下降、脱毛或生长延缓等等。
具体地,本发明涉及苏糖酸镁用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤,涉及含苏糖酸镁的药物组合物和试剂盒。
优选地,所述肿瘤为恶性肿瘤。肿瘤为恶性肿瘤;优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤;优选地,所述恶性肿瘤选自肺癌;优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌;优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
发明详述
在一些实施方案中,本发明涉及苏糖酸镁在制备用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的药物中的用途。
优选地,所述肿瘤为恶性肿瘤。
优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
优选地,所述恶性肿瘤选自肺癌。
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌。
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
在一些实施方案中,本发明涉及苏糖酸镁用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的用途。
优选地,所述肿瘤为恶性肿瘤。
优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
优选地,所述恶性肿瘤选自肺癌。
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌。
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
在一些实施方案中,本发明涉及用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的苏糖酸镁。
优选地,所述肿瘤为恶性肿瘤。
优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
优选地,所述恶性肿瘤选自肺癌。
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌。
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
在一些实施方案中,本发明苏糖酸镁用作肿瘤患者中化疗辅助用药的用途。
优选地,所述肿瘤为恶性肿瘤。
优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
优选地,所述恶性肿瘤选自肺癌。
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌。
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
在一些实施方案中,本发明涉及一种抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的方法,其包括给药苏糖酸镁。
优选地,所述肿瘤为恶性肿瘤。
优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
优选地,所述恶性肿瘤选自肺癌。
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌。
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
在一些实施方案中,本发明涉及药物组合物,其包含苏糖酸镁和抗肿瘤药物,以及任选地药学上可接受的赋形剂。
优选地,所述抗肿瘤药物选自抗增殖药物、细胞生长抑制剂、抗浸润剂、生长因子功能抑制剂、抗血管生成剂、血管损伤剂、内皮素受体拮抗剂、反义治疗中使用的药剂、基因治疗方法中使用的药剂或免疫治疗方法中使用的药剂。
优选地,所述抗肿瘤药物选自烷化剂、抗代谢物、抗肿瘤抗生素、抗有丝分裂剂或拓扑异构酶抑制剂。
优选地,所述抗肿瘤药物选自顺铂、奥沙利铂、卡铂、环磷酰胺、氮芥、美法仑、苯丁酸氮芥、白消安、替莫唑胺、亚硝基脲、长春新碱、长春碱、长春地辛、长春瑞滨、紫杉醇或泰索帝。
优选地,所述抗肿瘤药物选自紫杉醇、奥沙利铂或长春新碱。
在另外实施方案中,本发明涉及用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的药物组合物,其包含苏糖酸镁和抗肿瘤药物。
在另外实施方案中,本发明涉及上述药物组合物在制备用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的药物中的用途。
在另外实施方案中,本发明涉及上述药物组合物用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的用途。
在另外实施方案中,本发明涉及一种抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的方法,其包括给予上述的药物组合物。
优选地,所述肿瘤为恶性肿瘤。
优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
优选地,所述恶性肿瘤选自肺癌。
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌。
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
在另外实施方案中,本发明还涉及苏糖酸镁在制备用于上述药物组合物中的用途。
在一些实施方案中,本发明涉及用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的组合,其包含苏糖酸镁和抗肿瘤药物。
优选地,所述抗肿瘤药物选自抗增殖药物、细胞生长抑制剂、抗浸润剂、生长因子功能抑制剂、抗血管生成剂、血管损伤剂、内皮素受体拮抗剂、反义治疗中使用的药剂、基因治疗方法中使用的药剂或免疫治疗方法中使用的药剂。
优选地,所述抗肿瘤药物选自烷化剂、抗代谢物、抗肿瘤抗生素、抗有丝分裂剂或拓扑异构酶抑制剂。
优选地,所述抗肿瘤药物选自顺铂、奥沙利铂、卡铂、环磷酰胺、氮芥、美法仑、苯丁酸氮芥、白消安、替莫唑胺、亚硝基脲、长春新碱、长春碱、长春地辛、长春瑞滨、紫杉醇或泰索帝。
优选地,所述抗肿瘤药物选自紫杉醇、奥沙利铂或长春新碱。
在另外实施方案中,本发明涉及上述组合在制备用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的药物中的用途。
在另外实施方案中,本发明涉及上述组合用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的用途。
在另外实施方案中,本发明涉及一种抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的方法,其包括给予上述的组合。
优选地,所述肿瘤为恶性肿瘤。
优选地,所述恶性肿瘤选自:来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
优选地,所述恶性肿瘤选自肺癌。
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌。
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌。
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
在另外实施方案中,本发明还涉及苏糖酸镁在制备用于上述组合中的用途。
在一些实施方案中,本发明还涉及试剂盒,其包含:i)苏糖酸镁;ii)抗肿瘤药物;和iii)用于指示治疗肿瘤或抑制肿瘤细胞迁移、侵袭和粘附的说明书。
优选地,所述抗肿瘤药物选自抗增殖药物、细胞生长抑制剂、抗浸润剂、生长因子功能抑制剂、抗血管生成剂、血管损伤剂、内皮素受体拮抗剂、反义治疗中使用的药剂、基因治疗方法中使用的药剂或免疫治疗方法中使用的药剂。
优选地,所述抗肿瘤药物选自烷化剂、抗代谢物、抗肿瘤抗生素、抗有丝分裂剂或拓扑异构酶抑制剂。
优选地,所述抗肿瘤药物选自顺铂、奥沙利铂、卡铂、环磷酰胺、氮芥、美法仑、苯丁酸氮芥、白消安、替莫唑胺、亚硝基脲、长春新碱、长春碱、长春地辛、长春瑞滨、紫杉醇或泰索帝。
优选地,所述抗肿瘤药物选自紫杉醇、奥沙利铂或长春新碱。
在一些实施方案中,本发明还涉及苏糖酸镁在制备用于预防或降低化疗引起的副作用的药物中的用途。优选地,所述副作用为体重下降、毛发脱落或生长停滞。换句话说,本发明发现了苏糖酸镁可以用作化疗辅助用药,从而减轻化疗引起的副作用。
在一些实施方案中,本发明还涉及一种预防或降低化疗引起的副作用的方法,其包括给予苏糖酸镁。优选地,所述副作用为体重下降、毛发脱落或生长停滞。
在另一些实施方案中,本发明中前述实施方案中提到的苏糖酸镁或含苏糖酸镁的组合物可以通过任一适宜的剂型给予,包括但不限于,液体剂型,如芳香水剂、溶液剂、注射剂、合剂、洗剂、搽剂等;气体剂型,如气雾剂、喷雾剂等;固体剂型,如散剂、丸剂、片剂、膜剂等;半固体剂型,如软膏剂、栓剂、糊剂等;其可以通过速释或控释剂型给予。优选地,通过控释剂型给予。
附图说明
图1:苏糖酸镁(L-TAMS)在裸鼠(BALB/C-nu)中抑制U87细胞的生长并增加裸鼠的生存率。A:在所示各组中肿瘤体积随时间的变化情况。单独给予苏糖酸镁也抑制了肿瘤的生长。注意:在苏糖酸镁组中,肿瘤体积逐渐降低,但在长春新碱组中,肿瘤体积快速下降。B:各组中的体重变化情况。C:苏糖酸镁增加了裸鼠的生存率。在实验开始时,每组n=10。D:不同组治疗15天后得到的肿瘤。
图2:苏糖酸镁抑制H460和H1703细胞的迁移。将H460或H1703细胞(2x 105)接种于6-孔板中并粘附。利用10微升移液管刮擦,然后将细胞在无血清培养基中于37℃培养24h。在显微镜下于0h、6h、12h和24h观察到的图像。
图3:苏糖酸镁抑制PC9和U87细胞的迁移。
图4:苏糖酸镁抑制H1703、PC9和U87细胞的侵袭。本发明中所使用的Transwell如图4所示。将癌细胞点板在BD BioCoat入侵室(Invasion Chambers)上部腔室的聚碳酸酯Transwell过滤器(带Matrigel)的顶侧,在37℃培养24h,然后用棉签去除上部腔室内的细胞。将下膜表面上的迁移和侵入细胞固定在1%多聚甲醛中,用苏木精染色,并在显微镜下计数。箭头表示侵入的细胞,箭头指向细胞迁移的小孔,癌症细胞通过该小孔迁移。
图5:不同处理组中的毛发脱落状况。
图6:不同处理组中的体重状况。
具体实施方式
可以理解:除非另外暗示或明示地理解或指明,在本文中以单数形式出现的单词涵盖其复数对应形式,且在本文中以复数形式出现的单词涵盖其单数对应形式。此外,可以理解:除非另外暗示或明示地理解或指明,对于本文所描述的任何给定组分,针对该组分列出的任何可能的候选物或替代物通常可以单独地或彼此任意组合使用。此外,可以理解:除非另外暗示或明示地理解或指明,这样的候选物或替代物的任何列表只是说明性的,而非限制性的。更进一步地,可以理解:除非另外暗示或明示地理解或指明,无论是否使用“包含性的”等,本文提出的任何数字或数值或量均是近似的,并且任何数值范围包括限定该范围的最小数值和最大数值。通常,除非另外暗示或明示地理解或指明,涉及数字或数值或量的术语“近似”或“约”或符号“约”包括落入该数字或数值或量的±5%的范围的数值。再进一步地,可以理解:为方便起见采用的任何标题并非限制性的。此外,可以理解:除非另外暗示或明示地理解或指明,任何许可的、开放的或末端开放的语言分别包含任何从相对许可的到限制性的语言、较少开放的到封闭式的语言或较少末端开放的到末端封闭的语言。仅仅通过举例的方式,词语“包含”可以涵盖“包含”-、“基本上由...组成”-和/或“由...组成”-型的语言。
通常,术语“治疗”是指在疾病、病症或障碍的治疗或改善或预防中任何成功的标志,包括任何客观的或主观的参数,例如减缓、缓和、减轻症状或使患者对该疾病病症更加耐受,减缓恶化或衰退速度或者使得恶化的终点不那么使人虚弱。治疗或改善症状可基于客观的或主观的参数,包括医生的检查结果。
术语“治疗”还指患者体内的病原体数量的任何减少或是病原体的任何改变,即使是短暂的时间。当病原体具有多种形式(包括细胞外形式),病原体的至少一种形式的减少或改变均被认为是治疗效果。如果该病原体可能存在于患者体内的多个器官中,在至少一个器官中病原体数量的减少或病原体的改变均被认为是治疗效果。
因此,术语“治疗”包括给药本发明组合物以预防或推迟、减轻、或阻止或抑制与本文所述的疾病、病症或障碍有关的症状或病症的发展。术语“治疗性的”是指在受试者中至少部分减少、消除或预防该疾病、该疾病的症状或该疾病的副作用。
通常,涉及向受试者身体施用两种或更多种施用项目如组分、试剂、物质、材料、组合物和/或类似物质的术语“同时施用”“共施用”或“与…一起施用”是指使用一个或多个剂量和一个或多个时间间隔进行施用,以使得所述施用项目以最小量在某一时间间隔内一起存在于受试者身体内或受试者身体的作用部位处。例如,时间间隔可以是任何合适的时间间隔,如适当的数分钟、数小时、数天或数周的间隔。例如,施用项目可以一起施用,如作为单一组合物的部分,或以其他方式施用。施用项目可以基本上同时施用(例如,相互之间间隔在小于或等于约5分钟、约3分钟或约1分钟内),或在彼此之间间隔的短时间之内施用(例如,彼此之间间隔在小于或等于约1小时、30分钟或10分钟内,或在超过约5分钟至最多约1小时内)。如此施用的施用项目可以认为是在基本上相同的时间施用。本领域普通技术人员将能够确定向受试者身体施用所述施用项目的适当剂量和时间间隔,使得施用项目以大于最低水平的水平存在于受试者体内和/或以有效浓度存在于受试者体内。
当施用项目同时施用于受试者身体时,任何这样的施用项目可以是低于其单独施用时可能使用的有效量的有效量。本文进一步描述的术语“有效量”包括这种较低的有效量和通常的有效量,以及事实上有效引起特定状态、效应和/或响应的任何量。因此,任何这样的同时施用项目的剂量可以低于其单独施用时可能使用的剂量。任何这样的施用项目的一种或多种效应可能是叠加的或协同的。任何这样的施用项目可以施用多于一次。
通常,关于活性剂的术语“有效量”是指活性剂足以引起特定的生物状态、效应和/或响应的量。例如,在这种方式中有效的特定药剂的绝对量可根据各种因素如所需的生物终点、药剂本身、受试者或其目标部分和/或类似因素而变化。可以以单一剂量或多个剂量施用活性剂的有效量。组分在本文中可以描述为至少具有有效量或至少具有例如与特定的目标或目的如本文所描述的任何目标或目的相关的有效的量。
术语“药学上可接受的”是指在合理的医学判断范围内,适于与人和动物的组织接触而没有过度的毒性、刺激性、过敏反应或其他问题并发症的具有合理的益处/风险比的那些溶剂、化合物、原料、组合物或剂型。
受试者
本文所述的使用苏糖酸镁的方法、组合或组合物可用于治疗患有一种或多种类型的癌症的受试者。所述受试者可以是患有癌症的任何受试者,例如,所述受试者可以是真核生物受试者,诸如动物,例如,狗、猫、马、鸟、鱼、兔、豚鼠、绵羊、山羊、牛、鸡。在一些实施方案中,所述受试者可以是冷血动物、温血动物、哺乳动物、家养哺乳动物或灵长类动物。在一些情况下,所述受试者可以是脊椎动物或哺乳动物,例如,人。
人类受试者可以是任何年龄,包括高龄。人类受试者可以是儿童(例如,新生儿、幼儿、学步儿童和青春期前儿童)、青少年、青春期青年或成人(例如,早期成人、中年成人、老年人)。人类受试者可以是约0个月至约120岁。人类受试者可以是约0个月至约12个月龄;人类受试者可以是约0至12岁;人类受试者可以是约13岁至19岁;例如,约13、14、15、16、17、18或19岁。人类受试者可以是约20至约39岁;例如,约20、21、22、23、24、25、26、27、28、29、30、31、32、33、34、35、36、37、38或39岁。人类受试者可以是约40至约59岁;例如,约40、41、42、43、44、45、46、47、48、49、50、51、52、53、54、55、56、57、58或59岁。人类受试者可以大于59岁;例如,约60、61、62、63、64、65、66、67、68、69、70、71、72、73、74、75、76、77、78、79、80、81、82、83、84、85、86、87、88、89、90、91、92、93、94、95、96、97、98、99、100、101、102、103、104、105、106、107、108、109、110、111、112、113、114、115、116、117、118、119或120岁。人类受试者可以是约45岁或年龄更大。人类受试者可以是55岁或年龄更大。人类受试者可以包括男性受试者和/或女性受试者。在一些情况下,人类受试者可以是将向其施用组合物用于实验、诊断、营养和/或治疗目的的个人或患者。受试者或患者可以是具有正常的、良好的或者极佳的健康、精神状态、认知和/或营养状态,或具有受损的健康、精神状态、认知和/或营养状态,包括具有不正常的、较差的、损害的、不健康的、受损的、患病的和/或营养缺乏状态的受试者或患者。
恶性肿瘤类型
在一些实施方案中,本文所述的使用苏糖酸镁的方法、组合或组合物,它们可用于治疗患有一种或多种类型的恶性肿瘤的受试者。
在一些实施方案中,所述恶性肿瘤选自来源于上皮组织的恶性肿瘤,也称为癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌。在一些实施方案中,所述恶性肿瘤选自淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤。在一些实施方案中,所述恶性肿瘤选自骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病。在一些实施方案中,所述恶性肿瘤选自间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤。在一些实施方案中,所述恶性肿瘤选自中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤。
在一些实施方案中,所述恶性肿瘤选自其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤。
在一些实施方案中,所述一种或多种类型的恶性肿瘤(亦即癌症)可以是实体瘤或囊性肿瘤。在一些实施方案中,所述实体瘤或囊性肿瘤可以处于良性、恶变前或恶性状态。受试者可能患有的一种或多种类型的癌症包括但不限于,棘皮瘤、腺泡细胞癌、听神经瘤、肢端雀斑样痣性黑色素瘤、顶端螺旋瘤、急性嗜酸性粒细胞性白血病、急性淋巴细胞性白血病、急性巨核细胞性白血病、急性单核细胞白血病、急性成髓细胞性白血病的成熟、急性骨髓树突状细胞性白血病、急性骨髓性白血病、急性早幼粒细胞性白血病、釉质瘤、腺癌、腺样囊性癌、腺瘤、腺瘤样牙源性肿瘤、肾上腺皮质癌、成人T细胞白血病、攻击性NK细胞白血病、AIDS相关的癌症、腺泡状软组织肉瘤、成釉细胞纤维瘤、肛门癌、间变性大细胞淋巴瘤、间变性甲状腺癌、血管免疫母细胞T细胞淋巴瘤、血管肌脂瘤、血管肉瘤、附录癌、星形细胞瘤、非典型畸胎横纹肌样瘤、基底细胞癌、基底样癌、B细胞白血病、B细胞淋巴瘤、比里尼导管癌、胆道癌、膀胱癌、母细胞瘤、骨癌、骨肿瘤、脑干神经胶质瘤、脑肿瘤、乳腺癌、勃勒纳瘤、支气管肿瘤、细支气管肺泡癌、棕色瘤、伯基特淋巴瘤、原发性不明原因癌、类癌肿瘤、癌、原位癌、阴茎癌、对原发灶不明癌、癌肉瘤、卡斯尔曼病、中心癌症神经系统胚胎瘤、小脑星形细胞瘤、脑星形细胞瘤、宫颈癌、胆管癌、软骨瘤、软骨肉瘤、脊索瘤、绒毛膜癌、脉络丛乳头状瘤、慢性淋巴细胞白血病、慢性单核细胞白血病、慢性骨髓性白血病、慢性骨髓增殖性障碍、慢性中性粒细胞白血病、在清细胞瘤、结肠癌、直肠癌、颅咽管瘤、皮肤T细胞淋巴瘤、恶性萎缩性丘疹病、隆突性皮肤纤维肉瘤、皮样囊肿、促纤维增生性小圆细胞瘤、弥漫性大B细胞淋巴瘤、胚胎发育不良性神经上皮瘤、胚胎癌、内胚窦瘤、子宫内膜癌、子宫内膜子宫癌、子宫内膜瘤、肠病相关性T细胞淋巴瘤、室管膜母细胞瘤、室管膜瘤、上皮样肉瘤、红白血病、食管癌、嗅神经母细胞、尤文家族肿瘤、尤文氏家庭肉瘤、尤因氏肉瘤、颅外生殖细胞肿瘤、性腺外生殖细胞瘤、肝外胆管癌、乳房外佩吉特病、输卵管癌、胎中胎、纤维瘤、纤维肉瘤、滤泡性淋巴瘤、滤泡甲状腺癌、胆囊癌、胆囊肿瘤、神经节神经胶质瘤、神经节细胞瘤、胃癌、淋巴瘤、消化道肿瘤、胃肠道类癌肿瘤、胃肠间质瘤、胃肠道间质瘤、胚细胞瘤、生殖细胞瘤、妊娠绒毛膜癌、妊娠滋养细胞肿瘤、骨巨细胞瘤、胶质母细胞瘤、胶质瘤、脑胶质瘤、血管球瘤、胰高血糖素瘤、性腺母细胞瘤、颗粒细胞瘤、毛细胞白血病、毛细胞白血病、头颈癌、头颈部肿瘤、心脏肿瘤、血管母细胞瘤、血管外皮细胞瘤、血管肉瘤、恶性血液疾病、肝细胞癌、肝脾T细胞淋巴瘤、遗传性乳腺癌、卵巢癌综合征、霍奇金淋巴瘤、霍奇金淋巴瘤、下咽癌、下丘脑神经胶质瘤、炎性乳腺癌、眼内黑色素瘤、胰岛细胞癌、胰岛细胞瘤、少年骨髓单核细胞性白血病、肉瘤、卡波济氏肉瘤、肾癌、肝门部胆管肿瘤、Krukenberg瘤、喉癌、喉癌、恶性雀斑样痣黑色素瘤、白血病、白血病、唇及口腔癌肉瘤、脂肪肉瘤、肺癌、黄体瘤、淋巴管瘤、淋巴管肉瘤、淋巴上皮瘤、淋巴性白血病、淋巴瘤、巨球蛋白血症、恶性纤维组织细胞瘤、恶性纤维组织细胞瘤、骨恶性纤维组织细胞瘤、恶性神经胶质瘤、恶性间皮瘤、恶性周围神经鞘瘤、恶性横纹肌样瘤、恶性蝾螈瘤、MALT淋巴瘤、外套细胞淋巴瘤、肥大细胞白血病、纵隔胚细胞瘤、纵隔肿瘤、甲状腺髓样癌、髓母细胞瘤、髓母细胞瘤、髓上皮瘤、黑色素瘤、黑色素瘤、脑膜瘤、默克尔细胞癌、间皮瘤、间皮瘤、隐匿原发性转移性鳞状颈癌、转移性尿路上皮癌、苗勒管混合瘤、单核细胞白血病、口腔癌、粘液性肿瘤、多发性内分泌腺瘤综合征、多发性骨髓瘤、多发性骨髓瘤、蕈样肉芽肿、蕈样肉芽肿、骨髓异常增生症、骨髓增生异常综合征、骨髓性白血病、骨髓瘤、骨髓增生性疾病、粘液瘤、鼻腔癌、鼻咽癌、鼻咽癌、肿瘤、神经鞘瘤、神经母细胞瘤、神经母细胞瘤、神经纤维瘤、神经瘤、结节性黑色素瘤、非霍奇金淋巴瘤、非霍奇金淋巴瘤、非黑色素瘤皮肤癌、非小细胞肺癌、眼肿瘤、寡星状细胞瘤、少枝胶质细胞、嗜酸粒细胞腺瘤、视神经鞘脑膜瘤、口腔癌、口腔癌、口咽癌、骨肉瘤、骨肉瘤、卵巢癌、卵巢癌、卵巢上皮性癌、卵巢生殖细胞肿瘤、卵巢低度恶性潜能的肿瘤、乳腺佩吉特病、肺上沟瘤、胰腺癌、胰腺癌、甲状腺乳头状癌、乳头状瘤、副神经节瘤、鼻窦癌、甲状旁腺癌、阴茎癌、血管周围上皮样细胞瘤、咽癌、嗜铬细胞瘤、松果体瘤、成松果体细胞瘤、垂体细胞瘤、垂体腺瘤、垂体瘤、浆细胞肿瘤、胸膜肺母细胞瘤、多胚瘤、前体T淋巴母细胞淋巴瘤、原发性中枢神经系统淋巴瘤、原发性渗出性淋巴瘤、原发性肝癌、原发性肝癌、原发性腹膜癌、原始神经外胚层瘤、前列腺癌、腹膜假性粘液瘤、直肠癌、肾细胞癌、与第15号染色体上的NUT基因相关的呼吸道癌、视网膜母细胞瘤、横纹肌瘤、横纹肌肉瘤、Richter转化、骶尾部畸胎瘤、唾液腺癌、肉瘤、神经鞘瘤病、皮脂腺癌、继发肿瘤、精原细胞瘤、浆液性肿瘤、男性细胞瘤、性索间质肿瘤、塞扎里综合征、印戒细胞癌、皮肤癌、小蓝圆形细胞瘤、小细胞癌、小细胞肺癌、小细胞淋巴瘤、小肠肿瘤、软组织肉瘤、生长抑素瘤、煤烟疣、脊髓肿瘤、脊髓肿瘤、脾边缘区淋巴瘤、鳞状细胞癌、胃癌、浅表扩散性黑色素瘤、幕上原始神经外胚层瘤、表面上皮-间质瘤、滑膜肉瘤、T细胞急性淋巴细胞性白血病、T-细胞大颗粒淋巴细胞性白血病、T细胞白血病、T细胞淋巴瘤、T细胞幼淋巴细胞白血病、畸胎瘤、终端淋巴肿瘤、睾丸癌、卵泡膜细胞瘤、喉癌、胸腺癌、胸腺瘤、甲状腺癌、肾盂和输尿管的移行细胞癌、移行细胞癌、脐尿管癌、尿道癌、泌尿生殖系统肿瘤、子宫肉瘤、眼色素层黑色素瘤、阴道癌、维尔纳莫里森综合征、疣状癌、视觉通路胶质瘤、外阴癌、瓦尔登斯特伦巨球蛋白血症、沃辛瘤、肾母细胞瘤或它们的任意组合。
在一些实施方案中,本文所述的使用苏糖酸镁的方法、组合或组合物,可用于治疗患有实体瘤的受试者。实体瘤包括各个器官系统的恶性肿瘤(例如,肉瘤、腺癌和癌),诸如肺、乳房、淋巴、胃肠(例如结肠)和泌尿生殖(例如,肾、尿路上皮或睾丸肿瘤)道、咽、前列腺和卵巢的那些恶性肿瘤。示例性的腺癌包括结肠直肠癌、肾细胞癌、肝癌、非小细胞肺癌和小肠癌。另外的示例性实体瘤包括:纤维肉瘤、粘液肉瘤、脂肪肉瘤、软骨肉瘤、骨原性肉瘤、脊索瘤、血管肉瘤、内皮肉瘤、淋巴管肉瘤、淋巴管内皮肉瘤、滑膜瘤、间皮瘤、尤因氏瘤、平滑肌肉瘤、横纹肌肉瘤、胃肠系统癌、结肠癌、胰腺癌、乳腺癌、泌尿生殖系统癌、卵巢癌、前列腺癌、鳞状细胞癌、基底细胞癌、腺癌、汗腺癌、皮脂腺癌、乳头状癌、乳头状腺癌、囊腺癌、髓样癌、支气管癌、肾细胞癌、肝癌、胆管癌、绒毛膜癌、精原细胞瘤、胚胎性癌、维尔姆斯瘤、宫颈癌、内分泌系统癌、睾丸肿瘤、肺癌、小细胞肺癌、非小细胞肺癌、膀胱癌、上皮癌、胶质瘤、星形细胞瘤、髓母细胞瘤、颅咽管瘤、室管膜瘤、松果体瘤、成血管细胞瘤、听神经瘤、少突神经胶质瘤、脑膜瘤、黑色素瘤、成神经细胞瘤和视网膜母细胞瘤。
癌症诊断
可通过医学领域中已知的一种或多种癌症诊断和/或其他检查将受试者鉴定或诊断为患有一种或多种类型的癌症。为了准确地鉴定患有癌症的受试者,可能需要对受试者的病史、身体检查连同一种或多种诊断或检查的全面评估。可进行一种或多种癌症诊断或检查来确定受试者是否患有癌症或者另一状况,诸如感染是否正在模仿癌症的症状。癌症诊断或检查可用于确认或消除状况(例如,癌症)的存在,监测状况过程,进行状况的预后,制定癌症治疗学和治疗的策略,并评估对受试者治疗的效力。在一些情况下,当受试者的状况已发生改变或正在改变时,可重复诊断或检查,如果从受试者采集的生物样品的质量不够好,或可能需要确认异常测试结果。癌症诊断或检查的实例可包括但不限于,成像、实验室测试(包括肿瘤标志物的测试)、肿瘤活检、内窥镜检查、手术或基因检测。
可通过成像将受试者诊断或鉴定为患有癌症。成像可用于检测实体瘤,以检测身体组织的异常,确定疾病的程度或评估治疗的效力。成像也可以与手术操作同时使用或用以获得活检组织。可用于癌症诊断以鉴定患有癌症的受试者的成像类型包括:透射成像、反射成像和/或发射成像。透射成像的非限制性实例包括:X-射线、计算机断层扫描(CT扫描)、荧光镜检查法、骨扫描、淋巴管X射线照片(LAG)和乳房X射线照片。反射成像的非限制性实例包括超声或超声波检查法。发射成像的非限制性实例包括磁共振成像(MRI)和正电子发射断层成像(PET)。
可通过对从受试者获得的生物样品进行实验室检验将该受试者诊断或鉴定为患有癌症。实验室检验使用化学或生化过程来测定体液和组织中的化学或生物组分的水平。可在实验室检验中使用的生物样品或样本包括但不限于血液和尿。可使用一个或多个检验来检测和测定生物样品或样本中的一种或多种类型的化学和生物组分。化学或生物组分可以包括血糖、电解质、酶、激素、脂质(脂肪)、其他代谢物质和蛋白质。实验室检验的非限制性实例包括血液试验、尿分析以及肿瘤生物标志物分析。
血液检验可以包括一个或多个不同的测量或检验,以检查血液样本中不同物质的水平。根据测量的不同物质的水平,可以鉴定诸如癌症的状况。可以测量的物质包括但不限于,废产物如肌酸酐或血液尿素氮(BUN),对身体的健康运转至关重要的电解质,或全血计数。血液检验可以是凝血研究,从而确定血液凝结成块有多快。血液检验还可以是全血计数(CBC)。在CBC中,测量特定体积的血液中的不同血细胞(例如,红细胞、白细胞、血小板)的大小、数目以及成熟度。CBC的血红蛋白部分测量红细胞的携氧能力,而红细胞压积测量红细胞在血液中的百分比。
可进行尿分析以检查尿中药物、血液、蛋白质或其他物质的存在和水平。基于尿中物质的异常存在或水平,可以鉴定诸如癌症的状况。尿中的血液(血尿)可能是良性(非癌性)状况的结果。尿中的高水平蛋白质(蛋白尿)可能指示肾脏或心血管问题。
可测定受试者的生物样品或样本中的肿瘤生物标志物,以鉴定受试者是否患有癌症。肿瘤生物标志物可以是由癌细胞释放入血液或尿中的物质。肿瘤生物标志物还可以是由身体响应于癌细胞而产生的物质。肿瘤生物标志物的非限制性实例包括前列腺特异性抗原(PSA)、前列腺酸性磷酸酶(PAP)、CA125、癌胚抗原(CEA)、α-胎蛋白(AFP)、人绒毛膜促性腺激素(HCG)、CA 19-9、CA 15-3、CA 27-29,乳酸脱氢酶(LDH)和神经元特异性烯醇化酶(NSE)。
可通过进行肿瘤活检将受试者诊断或鉴定为患有癌症。在肿瘤活检期间,从受试者的身体中取出或收获生物样品或样本诸如一块组织或细胞以用于在实验室中分析。可进行用于测量基因表达的细胞总体形态学、免疫组织化学、组织学或聚合酶链反应,以鉴定癌症起源。肿瘤活检的非限制性实例包括骨髓活检、内窥镜活检(例如,膀胱镜检查、支气管镜检、结肠镜检查)、针吸活检(例如,细针抽吸、芯针活检、真空辅助活检、图像引导活检、肝活检)、皮肤活检(例如,刮取活检、钻取活检、切除活检、切开活检)和手术活检(例如,切开活检、切除活检)。
可进行内窥镜检查以诊断或鉴定患有癌症的受试者。用内窥镜进行内窥镜检查,该内窥镜可用于窥视食管、胃十二指肠、结肠或直肠。内窥镜还可用于从身体中取出组织或拍摄身体内部的彩色照片。内窥镜检查的非限制性实例包括结肠镜检查、内窥镜逆行胰胆管造影术(ERCP)、食道-胃-十二指肠镜检查(也称为EGD或上消化道内窥镜检查)、乙状结肠镜检查或膀胱镜检查(也称为膀胱尿道镜检查)。
癌症治疗
本文所述的使用苏糖酸镁和/或包含苏糖酸镁的方法、组合或组合物,可以用于治疗肿瘤,特别是恶性肿瘤(癌症)患者。癌症治疗可以是针对患者所患有的特定类型的癌症的治疗。可用于医学领域中公知的任何癌症治疗,如由美国癌症协会在2013年1月31日可访问的www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/index上公开的。当患有一种或多种类型的癌症的受试者正在进行癌症治疗或用癌症治疗进行治疗时,可将苏糖酸镁施用于该受试者。可以与施用苏糖酸镁一起或分开地用癌症治疗来治疗受试者。可用一种或多种癌症治疗一起或单独地治疗受试者。
可以提供给患有一种或多种类型的癌症的受试者的癌症治疗的类型可以是本领域中公知的任何癌症治疗。这样的癌症治疗的非限制性实例包括手术、化学治疗、放射治疗、靶向治疗、免疫治疗、热疗、干细胞移植、光动力治疗、激光治疗或其他替代方法。各种药剂、设备或程序可与任何癌症治疗方法组合使用。
在一些实施方案中,癌症治疗可以是手术。在一些情况下,手术可用于诊断、治疗或者甚至帮助预防癌症。例如,可鉴定的实体瘤可通过手术去除。在一些实施方案中,癌症治疗可以是化学治疗。化学治疗或化疗是使用一种或多种抗肿瘤剂/抗癌剂来治疗癌症。抗癌剂可以包含在含有苏糖酸镁的同一组合物中,或者可以单独施用。抗癌剂可以通过干预、抑制、促进或参与与癌症相关的各种信号转导途径来治疗癌症。在一些实施方案中,癌症治疗可以是放射治疗。放射治疗采用高能粒子或波来毁坏或破坏癌细胞。它是对于癌症最常见的治疗之一(单独或与其他形式的治疗一起)。在一些实施方案中,癌症治疗可以是靶向治疗。靶向治疗是较新类型的癌症治疗,其使用药物或其他物质来更精确地识别和攻击癌细胞,而通常对正常细胞的损伤较小。在一些实施方案中,癌症治疗可以是免疫治疗。免疫治疗是利用身体自身的免疫系统来帮助对抗癌症的治疗。在一些实施方案中,癌症治疗可以是热疗,热疗是递送热量来治疗癌症。在一些实施方案中,癌症治疗可以是干细胞移植,诸如外周血骨髓和脐带血移植。在一些实施方案中,癌症治疗是光动力治疗。光动力治疗或PDT是使用特殊药物(称为光敏剂)与光一起来杀死癌细胞的治疗。这些药物仅在它们被某些波长的光活化后才起作用。在一些实施方案中,癌症治疗可以是激光治疗。在一些实施方案中,癌症治疗可以是血液制品捐献和输血。
在一些实施方案中,癌症治疗可以是用于癌症处置的替代方法。用于癌症处置的替代方法的类型可以是本领域中公知的任何类型(美国癌症协会(American CancerSociety),Complementary and Alternative Methods for Cancer Management,2011年5月18日公开)。可以使用用于癌症处置的替代方法来代替主流癌症治疗。替代方法可能未经证实,还未经科学测试或已被推翻。对用于治疗某种类型的癌症的替代方法的选择可能随受试者的不同而不同,并且可能依赖于受试者自己的意愿或偏好。用于癌症处置的替代方法可以是针刺治疗、芳香治疗、艺术治疗、生物反馈、迷宫行走、按摩治疗、冥想、音乐治疗、祈祷和灵性、太极拳或瑜伽。
抗肿瘤剂/抗癌剂
本文所述的使用苏糖酸镁和/或包含苏糖酸镁的方法、组合或组合物也可以与施用由于其对正在治疗的癌症的特定用途而被选择的其他公知的抗肿瘤剂/抗癌剂或治疗剂一起用于治疗患有一种或多种癌症的受试者。抗癌剂或治疗剂可以是信号途径中将细胞表面生长因子受体连接至引发细胞增殖的核信号的部分的其他抑制剂。在一些实施方案中,有效量的苏糖酸镁可以与一种或多种抗癌剂一起施用于受试者,以支持采用一种或多种抗癌剂的癌症治疗。待用于治疗患有癌症的受试者的本文所述的包含苏糖酸镁的组合物可进一步包含一种或多种抗癌剂或治疗剂。
本文中描述了可与苏糖酸镁联合使用的此类已知的抗癌剂和/或治疗剂。抗癌剂和/或治疗剂可包括其他抗增殖药物及其组合、细胞生长抑制剂、抗浸润剂、生长因子功能抑制剂、抗血管生成剂、血管损伤剂、内皮素受体拮抗剂、反义治疗剂、基因治疗剂或免疫治疗剂。
抗癌剂和/或治疗剂可以是其他抗增殖药物或其组合。非限制性实例包括烷基化剂(例如,顺铂、奥沙利铂、卡铂、环磷酰胺、氮芥、美法仑、苯丁酸氮芥、白消安、替莫唑胺和亚硝基脲);抗代谢物(例如,吉西他滨和抗叶酸剂诸如氟嘧啶如5-氟尿嘧啶和替加氟、雷替曲塞、甲氨蝶呤、阿糖胞苷和羟基脲);抗肿瘤抗生素(例如,蒽环类如阿霉素、博来霉素、多柔比星、道诺霉素、表阿霉素、伊达比星、丝裂霉素C、更生霉素和光神霉素);抗有丝分裂剂(例如,长春花生物碱如长春新碱、长春碱、长春地辛和长春瑞滨和紫杉烷如紫杉酚和泰索帝和多Polo激酶抑制剂);以及拓扑异构酶抑制剂(例如,表鬼臼毒素如依托泊苷和替尼泊苷、安吖啶、托泊替康和喜树碱)。
在一个优选的实施方案中,本发明组合或药物组合物中的抗肿瘤药物可以是紫杉醇、奥沙利铂或长春新碱。其中,紫杉醇(taxol)别名红豆杉醇,泰素,紫素,特素,是目前已发现的最优秀的天然抗癌药物,现已可人工合成。其在临床上已经广泛用于乳腺癌、卵巢癌和部分头颈癌和肺癌的治疗。奥沙利铂(Oxaliplatin,CAS:61825-94-3)属于铂类抗癌药,其中铂原子与1,2-二氨环己烷(DACH)和一个草酸基结合。常用于转移性结直肠癌治疗,或辅助治疗原发性肿瘤完全切除后三期结肠癌。长春新碱(Vincristine,CAS:57-22-7)是夹竹桃科植物长春花中提取出的生物碱,因抗肿瘤作用良好,目前其制剂作为临床抗肿瘤药物。
抗癌和/或治疗剂可以是细胞生长抑制剂如抗雌激素(例如,他莫昔芬、氟维司群、托瑞米芬、雷洛昔芬、屈洛昔芬)、抗雄激素(例如,比卡鲁胺、氟他胺、尼鲁米特和醋酸环丙孕酮)、LHRH拮抗剂或LHRH激动剂(例如,戈舍瑞林、亮丙瑞林和布舍瑞林)、孕激素(例如,醋酸甲地孕酮)、芳香酶抑制剂(例如,如阿那曲唑、来曲唑、伏氯唑和依西美坦)以及5a-还原酶抑制剂如非那雄胺。
抗癌和/或治疗剂可以是抗浸润剂。抗浸润剂的非限制性实例包括c-Src激酶家族抑制剂如4-(6-氯-2,3亚甲基二氧苯胺基)-7-[2-(4-甲基哌嗪-l-基)乙氧基]-5-四氢吡喃-4基氧基喹唑啉(AZD0530;国际专利申请WO 01/94341)、N-(2-氯-6-甲基苯基)-2-{6-[4-(2-羟基乙基)哌嗪-1-基]-2-甲基嘧啶-4基氨基}噻唑-5-甲酰胺(达沙替尼,BMS-354825;J.Med.Chern.,2004,47,66586661)和波舒替尼(SKL-606),以及金属蛋白酶抑制剂如马立马司他、尿激酶纤维蛋白溶酶原激活剂受体功能抑制剂或乙酰肝素酶的抗体。
抗癌和/或治疗剂可以是生长因子功能抑制剂。该抑制剂的非限制性实例包括生长因子抗体和生长因子受体抗体(诸如抗erbB2抗体曲妥单抗[HerceptinTM]、抗EGFR抗体帕尼单抗、抗erbB 1抗体西妥昔单抗[Erbitux,C225]以及由Stem等人.Critical reviews inoncology/haematology,2005,Vol.54,pp 11-29公开的任何生长因子或生长因子受体抗体)、酪氨酸激酶抑制剂(例如,表皮生长因子家族抑制剂(例如,EGFR家族酪氨酸激酶抑制剂诸如N-(3-氯-4-氟苯基)-7-甲氧基-6-(3-吗啉基丙氧基)喹唑啉-4-胺(吉非替尼,ZD1839)、N-(3-乙炔基苯基)-6,7-双(2-甲氧基乙氧基)喹唑啉-4-胺(厄洛替尼,OSI-774)和6-丙烯酰基酰胺基-N-(3-氯-4-氟苯基)-7-(3-吗啉基丙氧基)-喹唑啉-4-胺(CI1033)),erbB2酪氨酸激酶抑制剂诸如拉帕替尼)、肝细胞生长因子家族抑制剂、胰岛素生长因子家族抑制剂、血小板衍生的生长因子家族抑制剂诸如伊马替尼和/或尼洛替尼(AMN107)、丝氨酸/苏氨酸激酶抑制剂(例如,Ras/Raf信号转导抑制剂诸如法呢基转移酶抑制剂,例如索拉非尼(BAY43-9006)、替吡法尼(RI15777)和洛那法尼(SCH66336))、通过MEK和/或AKT激酶的细胞信号传导的抑制剂、c-kit抑制剂、abl激酶抑制剂、P13激酶抑制剂、Plt3激酶抑制剂、CSF-IR激酶抑制剂、IGF受体(胰岛素样生长因子)激酶抑制剂、极光激酶抑制剂(例如,AZD1152、PH739358、VX-680、MLN8054、R763、MP235、MP529、VX-528和AX39459)以及细胞周期蛋白依赖性激酶抑制剂诸如CDK2和/或CDK4抑制剂。
抗癌和/或治疗剂可以是抗血管生成剂,诸如抑制血管内皮生长因子的作用的那些。非限制性实例包括抗血管内皮细胞生长因子抗体贝伐单抗(AvastinTM)和VEGF受体酪氨酸激酶抑制剂如凡德他尼(ZD6474)、伐他拉尼(PTK787)、舒尼替尼(SU1l248)、阿西替尼(AG-013736)、帕唑帕尼(GW 786034)和4·{4-氟-2-甲基吲哚-5-基氧基)-6-甲氧基-7-(3吡咯烷-1-基丙氧基)喹唑啉(AZD2l7l;WO 00/47212中的实施例240),化合物如在国际专利申请WO 97/22596、WO 97/30035、WO 97/32856和WO 98/13354中公开的那些化合物以及通过其他机理起作用的化合物(例如,利诺胺、整合蛋白av~3功能抑制剂和血管抑素)。
抗癌和/或治疗剂可以是血管损伤剂如考布他汀A4和在国际专利申请WO 99/02166、WO 00/40529、WO 00/41669、WO 01/92224、WO 02/04434和WO 02/08213中公开的化合物。
抗癌和/或治疗剂可以是内皮素受体拮抗剂,例如齐泊腾坦(ZD4054)或阿曲生坦。
抗癌和/或治疗剂可以是在反义治疗中使用的任何药剂,例如针对上述列出的靶标的那些药剂,诸如ISIS 2503(一种抗ras反义剂)。
抗癌和/或治疗剂可以是在基因治疗方法中使用的任何药剂,该基因治疗方法包括,例如用于替换异常基因如异常的p53或异常的BRCA1或BRCA2的方法,GDEPT(基因导向酶前药治疗)方法如使用胞嘧啶脱氨酶、胸苷激酶或细菌硝基还原酶的那些方法,以及用于提高受试者对化学治疗或放射治疗的耐受性的方法如多药耐药基因治疗。
抗癌和/或治疗剂可以是在免疫治疗方法中使用的任何药剂,该免疫治疗方法包括,例如用于提高受试者的肿瘤细胞的免疫原性的体外和体内方法如用诸如白介素2、白介素4或粒细胞-巨噬细胞集落刺激因子等细胞因子进行的转染,用于降低T细胞的能量的方法,使用诸如细胞因子转染的树突细胞等转染的免疫细胞的方法,使用细胞因子转染的肿瘤细胞株的方法以及使用抗独特型抗体的方法。
在某些实施方案中,治疗剂可以选自紫杉醇、硼替佐米、达卡巴嗪、吉西他滨、曲妥珠单抗、贝伐珠单抗、卡培他滨、多西紫杉醇、厄洛替尼、芳香酶抑制剂如AROMASINTM(依西美坦)和雌激素受体抑制剂如FASLODEXTM(氟维司群)。
给药剂量
在一些实施方案中,苏糖酸镁或含苏糖酸镁的组合物可以以多种剂量施用。本领域已知,由于在化合物药物动力学上受试者间的变化性,给药方案的个体化对于最佳治疗是必要的。苏糖酸镁和抗癌剂的给药可以根据本发明通过常规实验得到。
确定将苏糖酸镁或含苏糖酸镁的组合物施用于受试者的合适的剂量可以考虑多种因素中的任何因素,诸如刚提到的那些,例如,任何一种(多种)潜在的或实际的副作用和/或施用苏糖酸镁组合物的目的,诸如营养或预防目的、疾病或病理状况治疗目的和/或为此可将苏糖酸镁或含苏糖酸镁的组合物施用于患有一种或多种类型的癌症的受试者的其他一种(多种)目的。确定合适的剂量可以考虑这些因素中的任何因素、任何其他合适的一种(多种)因素、任何一种(多种)副作用、动物研究模型、人体研究模型、临床研究模型、药物研究模型和在其间的任何平衡。
在一些实施方案中,苏糖酸镁或含苏糖酸镁的组合物是单一或单位剂型。在一些情况下,苏糖酸镁或含苏糖酸镁的组合物可以是多个剂型。苏糖酸镁组合物可以以单次剂量或多次剂量施用。
预期将苏糖酸镁或含苏糖酸镁的组合物施用于受试者的剂量可以是,约10mg/kg体重/天至约60mg/kg体重/天,优选地,约20mg/kg体重/天至约35mg/kg体重/天。例如,预期将苏糖酸镁或含苏糖酸镁的组合物施用于受试者的剂量可以是,10mg/kg体重/天、15mg/kg体重/天、20mg/kg体重/天、25mg/kg体重/天、30mg/kg体重/天、35mg/kg体重/天、40mg/kg体重/天、45mg/kg体重/天、50mg/kg体重/天、60mg/kg体重/天的苏糖酸镁化合物以用于一个(多个)癌症和/或病理状况治疗目的,诸如抗癌治疗。例如,这样的量可以适合于人类受试者。在一些实施方案中,该剂量可以小于10mg/kg体重/天。在一些实施方案中,该剂量可以大于60mg/kg体重/天。
如上述提到的,这样的剂量可基于任何合适的一个(多个)因素,诸如关于受试者(例如人类受试者)的临床试验的结果进行确定、修改和/或完善。在一些实施方案中,例如,合适的剂量可以基于用于合适的动物模型的合适的剂量的确定,基于实验研究或测试,例如以及这样的合适的动物剂量到合适的人类剂量的转换,基于一个(多个)合适的转换因子,诸如任何合适的一个(多个)已确定的转换因子进行确定、修改和/或完善。进一步举例而言,例如,预期任何这样的合适的人类剂量可以基于涉及人类受试者的临床试验来进一步确定、修改和/或完善。该剂量可以根据预期的施用途径来确定。
在一些实施方案中,根据本发明的苏糖酸镁或含苏糖酸镁的组合物中提供的苏糖酸镁化合物的浓度可以小于100%、90%、80%、70%、60%、50%、40%、30%、20%、19%、18%、17%、16%、15%、14%、13%、12%、11%、10%、9%、8%、7%、6%、5%、4%、3%、2%、1%、0.5%、0.4%、0.3%、0.2%、0.1%、0.09%、0.08%、0.07%、0.06%、0.05%、0.04%、0.03%、0.02%、0.01%、0.009%、0.008%、0.007%、0.006%、0.005%、0.004%、0.003%、0.002%、0.001%、0.0009%、0.0008%、0.0007%、0.0006%、0.0005%、0.0004%、0.0003%、0.0002%或0.0001%w/w、w/v或v/v。
在一些实施方案中,根据本发明的苏糖酸镁或含苏糖酸镁的组合物中苏糖酸镁的浓度可以大于90%、80%、70%、60%、50%、40%、30%、20%、19.75%、19.50%、19.25%、19%、18.75%、18.50%、18.25%、18%、17.75%、17.50%、17.25%、17%、16.75%、16.50%、16.25%、16%、15.75%、15.50%、15.25%、15%、14.75%、14.50%、14.25%、14%、13.75%、13.50%、13.25%、13%、12.75%、12.50%、12.25%、12%、11.75%、11.50%、11.25%、11%、10.75%、10.50%、10.25%、10%、9.75%、9.50%、9.25%、9%、8.75%、8.50%、8.25%、8%、7.75%、7.50%、7.25%、7%、6.75%、6.50%、6.25%、6%、5.75%、5.50%、5.25%、5%、4.75%、4.50%、4.25%、4%、3.75%、3.50%、3.25%、3%、2.75%、2.50%、2.25%、2%、1.75%、1.50%、125%、1%、0.5%、0.4%、0.3%、0.2%、0.1%、0.09%、0.08%、0.07%、0.06%、0.05%、0.04%、0.03%、0.02%、0.01%、0.009%、0.008%、0.007%、0.006%、0.005%、0.004%、0.003%、0.002%、0.001%、0.0009%、0.0008%、0.0007%、0.0006%、0.0005%、0.0004%、0.0003%、0.0002%或0.0001%w/w、w/v或v/v。
在一些实施方案中,根据本发明的苏糖酸镁或含苏糖酸镁的组合物中苏糖酸镁化合物的量可以等于或小于10g、9.5g、9.0g、8.5g、8.0g、7.5g、7.0g、6.5g、6.0g、5.5g、5.0g、4.5g、4.0g、3.5g、3.0g、2.5g、2.0g、1.5g、1.0g、0.95g、0.9g、0.85g、0.8g、0.75g、0.7g、0.65g、0.6g、0.55g、0.5g、0.45g、0.4g、0.35g、0.3g、0.25g、0.2g、0.15g、0.1g、0.09g、0.08g、0.07g、0.06g、0.05g、0.04g、0.03g、0.02g、0.01g、0.009g、0.008g、0.007g、0.006g、0.005g、0.004g、0.003g、0.002g、0.001g、0.0009g、0.0008g、0.0007g、0.0006g、0.0005g、0.0004g、0.0003g、0.0002g或0.0001g。在一些实施方案中,组合物中苏糖酸镁化合物的量小于1.5g。
在一些实施方案中,苏糖酸镁化合物的量大于0.0001g、0.0002g、0.0003g、0.0004g、0.0005g、0.0006g、0.0007g、0.0008g、0.0009g、0.001g、0.0015g、0.002g、0.0025g、0.003g、0.0035g、0.004g、0.0045g、0.005g、0.0055g、0.006g、0.0065g、0.007g、0.0075g、0.008g、0.0085g、0.009g、0.0095g、0.01g、0.015g、0.02g、0.025g、0.03g、0.035g、0.04g、0.045g、0.05g、0.055g、0.06g、0.065g、0.07g、0.075g、0.08g、0.085g、0.09g、0.095g、0.1g、0.15g、0.2g、0.25g、0.3g、0.35g、0.4g、0.45g、0.5g、0.55g、0.6g、0.65g、0.7g、0.75g、0.8g、0.85g、0.9g、0.95g、1g、1.5g、2g、2.5、3g、3.5、4g、4.5g、5g、5.5g、6g、6.5g、7g、7.5g、8g、8.5g、9g、9.5g或10g。在一些实施方案中,本发明中的组合或组合物中苏糖酸镁化合物的量大于0.01g。
在一些实施方案中,苏糖酸镁的量在0.00005-5g、0.0001-4g、0.0005-3g、0.001-2.5g、0.005-2g或0.01-1.5g的范围内。
在一些实施方案中,苏糖酸镁在宽剂量范围内有效。例如,在成年人的治疗中,每天0.0005至3g、0.001至2.5g、0.005至2g以及每天0.01至1.5g的剂量是可以使用的剂量的实例。准确的剂量将依赖于施用途径、施用化合物的形式、待治疗的受试者、待治疗的受试者的体重、将伴随施用的抗癌剂的类型以及主治医师的偏好和经验。
在一些实施方案中,在本发明的含苏糖酸镁的组合或组合物中,苏糖酸镁和抗肿瘤药可以以任一比例存在,例如1:1000至1000:1、1:950至950:1、1:900至900:1、1:850至550:1、1:800至800:1、1:750至750:1、1:700至700:1、1:650至650:1、1:600至600:1、1:550至550:1、1:500至500:1、1:450至450:1、1:400至400:1、1:350至350:1、1:300至300:1、1:250至250:1、1:200至200:1、1:150至150:1、1:100至100:1、1:50至50:1、1:40至40:1、1:30至30:1、1:20至20:1、1:10至10:1、1:9至9:1、1:8至8:1、1:7至7:1、1:6至6:1、1:5至5:1、1:4至4:1、1:3至3:1、1:2至2:1等。准确的比例或含量将依赖于施用途径、施用化合物的形式、待治疗的受试者、待治疗的受试者的体重、将伴随施用的抗癌剂的类型以及主治医师的偏好和经验。
施用途径
适于施用于受试者的苏糖酸镁、组合或组合物可以以任何合适的方式施用。这样的施用可以是口服和/或任何其他合适的施用,诸如,经皮、静脉内注射、动脉内注射、吸入、气雾剂、肌内注射、阴道、直肠、皮下、舌下、肠胃外、眼、肺、透粘膜、耳、鼻吹入、咽施用和局部施用。苏糖酸镁组合物的组分,诸如苏糖酸镁和一种或多种抗癌剂可以同时,诸如以本文所述的和/或在美国专利申请公开号US 2006/0089335 A1中的同时施用的任何方式施用于受试者。此外,仅举例而言,肠胃外递送包括肌内、皮下、静脉内、髓内注射,以及鞘内、直接心室内、腹膜内、淋巴管内和鼻内注射。
药物组合物
下文描述了非限制性的示例性组合物和用于制备该组合物的方法。
在一些实施方案中,本发明提供了包含苏糖酸镁和适合于口服施用的药物赋形剂的用于口服施用的药物组合物。在一些实施方案中,本发明提供了用于口服施用的固体或液体药物组合物,该药物组合物包含:(i)苏糖酸镁;(ii)抗肿瘤药;和(iii)药学上可接受的赋形剂。
由于水可以促进一些化合物的降解,因此本发明进一步包括包含活性成分的无水药物组合物和剂型。例如,在药学领域中可添加水(例如,5%)作为模拟长期储存的手段,以便确定诸如保存期或制剂随时间的稳定性等特征。本发明的无水药物组合物和剂型可以使用无水或低水分含量成分以及低水分或低湿度条件进行制备。如果预期在制备、包装和/或储存期间与水分和/或湿度存在大量接触,则含有乳糖的本发明的药物组合物和剂型可制成无水的。可制备和储存无水药物组合物以使得其无水性质得到保持。因此,无水组合物可以使用已知防止暴露于水的材料进行包装,以使得它们可被包含在合适的制剂试剂盒中。合适的包装的实例包括但不限于密封的箔、塑料等,单位剂量容器、泡罩包装和条带包装。
活性成分可根据常规的药物复合技术与药物载体组合成紧密的混合物。该载体可以采取很多种形式,这取决于施用所需的制剂形式。在一些不使用乳糖的实施方案中,在制备口服剂型的组合物时,任何常用的药物介质均可用作载体,例如,在口服液体制剂(诸如,悬浮液、溶液和酏剂)情况下的水、乙二醇、油、醇、牛奶、调味剂、防腐剂、着色剂等;或者可在口服固体制剂的情况下使用的载体如淀粉、糖、微晶纤维素、稀释剂、成粒剂、润滑剂、粘合剂以及崩解剂。例如,对于固体口服制剂,合适的载体包括粉末、胶囊和片剂。如果需要,片剂可以通过标准的水性或非水性技术进行包衣。
适合用于药物组合物和剂型的粘合剂包括但不限于,玉米淀粉、马铃薯淀粉或其他淀粉、明胶、天然和合成树胶如阿拉伯胶、藻酸钠、藻酸、其他藻酸盐、粉末黄蓍胶、瓜尔胶、纤维素及其衍生物(例如,乙基纤维素、醋酸纤维素、羧甲基纤维素钙、羧甲基纤维素钠)、聚乙烯吡咯烷酮、甲基纤维素、预糊化淀粉、羟丙基甲基纤维素、微晶纤维素及其混合物。
用于本文公开的药物组合物和剂型的合适的填充剂的实例包括但不限于,滑石、碳酸钙(例如,颗粒或粉末)、微晶纤维素、粉状纤维素、葡萄糖结合剂、高岭土、甘露糖醇、硅酸、山梨糖醇、淀粉、预糊化淀粉以及它们的混合物。
崩解剂可用于本发明的组合物以提供在暴露于水性环境时崩解的片剂。太多的崩解剂可能产生可在瓶中崩解的片剂。太少可能不足以发生崩解从而可改变一种(多种)活性成分从剂型中释放的速率和程度。因此,既不太少也不太多到不利地改变一种(多种)活性成分的释放的足够量的崩解剂可以用于形成本文公开的化合物的剂型。所用的崩解剂的量可以基于制剂的类型和施用方式而变化,并且对于本领域普通技术人员可以是容易辨别的。可以在药物组合物中使用约0.5至约15重量%的崩解剂,或约1至约5重量%的崩解剂。可用于形成本发明的药物组合物和剂型的崩解剂包括但不限于:琼脂、藻酸、碳酸钙、微晶纤维素、交联羧甲基纤维素钠、交聚维酮、波拉克林钾、羧甲基淀粉钠、马铃薯或木薯淀粉、其他淀粉、预糊化淀粉、其他淀粉、粘土、其他藻胶、其他纤维素、树胶或它们的混合物。
可用于形成本发明的药物组合物和剂型的润滑剂包括但不限于,硬脂酸钙、硬脂酸镁、矿物油、轻质矿物油、甘油、山梨糖醇、甘露糖醇、聚乙二醇、其他二醇、硬脂酸、月桂基硫酸钠、滑石、氢化植物油(例如,花生油、棉籽油、葵花油、芝麻油、橄榄油、玉米油和大豆油)、硬脂酸锌、油酸乙酯、月桂酸乙酯、琼脂或它们的混合物。另外的润滑剂包括,例如,硅胶、合成二氧化硅的凝聚型气溶胶或它们的混合物。润滑剂可任选地以低于药物组合物的约1重量%的量添加。
当针对口服施用需要水性悬浮液和/或酏剂时,其中的活性成分可以与各种甜味剂或调味剂、着色物质或染料以及(如果需要的话)乳化剂和/或悬浮剂连同诸如水、乙醇、丙二醇、甘油和它们的各种组合等稀释剂组合。
片剂可以是未包衣的,或通过已知技术进行包衣以延迟在胃肠道中的崩解和吸收,从而提供在较长时间段的持续作用。例如,可采用时间延迟材料如单硬脂酸甘油酯或双硬脂酸甘油酯。口服使用的制剂还可以作为硬明胶胶囊(其中活性成分与惰性固体稀释剂,例如,碳酸钙、磷酸钙或高岭土混合),或者作为软明胶胶囊(其中活性成分与水或油介质,例如,花生油、液体石蜡或橄榄油混合)呈现。
可用于形成本发明的药物组合物和剂型的表面活性剂包括但不限于,亲水性表面活性剂、亲脂性表面活性剂以及它们的混合物。即,可以使用亲水性表面活性剂的混合物,可以使用亲脂性表面活性剂的混合物,或者可使用至少一种亲水性表面活性剂和至少一种亲脂性表面活性剂的混合物。
合适的亲水性表面活性剂通常可具有至少10的HLB值,而合适的亲脂性表面活性剂通常可具有小于约10的HLB值。用于表征非离子两亲性化合物的相对亲水性和疏水性的经验参数是亲水亲油平衡值(“HLB”值)。具有较低HLB值的表面活性剂更亲脂或疏水,且在油中具有较大的溶解度,而具有较大HLB值的表面活性剂更亲水,并且在水溶液中具有较大的溶解度。亲水性表面活性剂通常被认为是HLB值大于约10的那些化合物,以及HLB范围通常不适用的阴离子、阳离子或两性离子化合物。类似地,亲脂性(即疏水性)表面活性剂是HLB值等于或小于约10的化合物。然而,表面活性剂的HLB值仅仅是通常用于实现制剂的工业、药物和化妆品乳液的配制的粗略指导。
亲水性表面活性剂可以是离子型或非离子型的。合适的离子型表面活性剂包括但不限于:烷基铵盐;夫西地酸盐;氨基酸的脂肪酸衍生物、寡肽和多肽;氨基酸的甘油酯衍生物、寡肽和多肽;卵磷脂和氢化卵磷脂;溶血卵磷脂和氢化溶血卵磷脂;磷脂及其衍生物;溶血磷脂及其衍生物;肉碱脂肪酸酯盐;烷基硫酸盐的盐;脂肪酸盐;多库酯钠;酰基乳酸盐;单-和二-甘油酯的单-和二-乙酰化酒石酸酯;琥珀酰单-和二-甘油酯;单-和二-甘油酯的柠檬酸酯;以及它们的混合物。
在上述组中,离子型表面活性剂举例而言包括:卵磷脂、溶血卵磷脂、磷脂、溶血磷脂及其衍生物;肉碱脂肪酸酯盐;烷基硫酸盐的盐;脂肪酸盐;多库酯钠;酰基乳酸盐;单-和二-甘油酯的单-和二-乙酰化酒石酸酯;琥珀酰单-和二-甘油酯;单-和二-甘油酯的柠檬酸酯;以及它们的混合物。
离子型表面活性剂可以是卵磷脂、溶血卵磷脂、磷脂酰胆碱、磷脂酰乙醇胺、磷脂酰甘油、磷脂酸、磷脂酰丝氨酸、溶血磷脂酰胆碱、溶血磷脂酰乙醇胺、溶血磷脂酰甘油、溶血磷脂酸、溶血磷脂酰丝氨酸、PEG-磷脂酰乙醇胺、PVP-磷脂酰乙醇胺、脂肪酸的乳酸酯、硬脂酰-2-乳酸酯、硬脂酰乳酸酯、琥珀酸单甘油酯、单/二甘油酯的单/二乙酰化酒石酸酯、单/二甘油酯的柠檬酸酯、胆酰肌氨酸、己酸酯、辛酸酯、癸酸酯、月桂酸酯、肉豆蔻酸酯、棕榈酸酯、油酸酯、蓖麻酸酯、亚油酸酯、亚麻酸酯、硬脂酸酯、月桂烷硫酸酯、十四烷基硫酸酯、多库酯、月桂酰肉碱、棕榈酰肉碱、肉豆蔻酰肉碱及其盐和它们的混合物的离子化形式。
亲水性非离子型表面活性剂可包括但不限于,烷基葡萄糖苷;烷基麦芽糖苷;烷基硫代葡萄糖苷;月桂基聚乙二醇甘油酯;聚氧化烯烷基醚如聚乙二醇烷基醚;聚氧化烯烷基酚诸如聚乙二醇烷基酚;聚氧化烯烷基酚脂肪酸酯如聚乙二醇脂肪酸单酯和聚乙二醇脂肪酸二酯;聚乙二醇甘油脂肪酸酯;聚甘油脂肪酸酯;聚氧化烯失水山梨糖醇脂肪酸酯如聚乙二醇失水山梨糖醇脂肪酸酯;多元醇与选自甘油酯、植物油、氢化植物油、脂肪酸和甾醇中的至少一个成员的亲水性酯交换产物;聚氧乙烯甾醇、其衍生物和类似物;聚氧乙烯化维生素及其衍生物;聚氧乙烯-聚氧丙烯嵌段共聚物;以及它们的混合物;聚乙二醇失水山梨糖醇脂肪酸酯以及多元醇与选自甘油三酯、植物油和氢化植物油中的至少一个成员的亲水性酯交换产物。所述多元醇可以是甘油、乙二醇、聚乙二醇、山梨糖醇、丙二醇、季戊四醇或糖。
其他的亲水性非离子型表面活性剂包括但不限于,PEG-10月桂酸酯、PEG-12月桂酸酯、PEG-20月桂酸酯、PEG-32月桂酸酯、PEG-32二月桂酸酯、PEG-12油酸酯、PEG-15油酸酯、PEG-20油酸酯、PEG-20二油酸酯、PEG-32油酸酯、PEG-200油酸酯、PEG-400油酸酯、PEG-15硬脂酸酯、PEG-32二硬脂酸酯、PEG-40硬脂酸酯、PEG-100硬脂酸酯、PEG-20二月桂酸酯、PEG-25三油酸甘油酯、PEG-32二油酸酯、PEG-20月桂酸甘油酯、PEG-30月桂酸甘油酯、PEG-20硬脂酸甘油酯、PEG-20油酸甘油酯、PEG-30油酸甘油酯、PEG-30月桂酸甘油酯、PEG-40月桂酸甘油酯、PEG-40棕榈仁油、PEG-50氢化蓖麻油、PEG-40蓖麻油、PEG-35蓖麻油、PEG-60蓖麻油、PEG-40氢化蓖麻油、PEG-60氢化蓖麻油、PEG-60玉米油、PEG-6癸酸/辛酸甘油酯、PEG-8癸酸/辛酸甘油酯、聚甘油-10月桂酸酯、PEG-30胆固醇、PEG-25植物甾醇、PEG-30大豆甾醇、PEG-20三油酸酯、PEG-40失水山梨糖醇油酸酯、PEG-80失水山梨糖醇月桂酸酯、聚山梨酯20、聚山梨酯80、POE-9月桂基醚、POE-23月桂基醚、POE-10油基醚、POE-20油基醚、POE-20硬脂基醚、生育酚PEG-100琥珀酸酯、PEG-24胆固醇、聚甘油10油酸酯、吐温40、吐温60、蔗糖单硬脂酸酯、蔗糖单月桂酸酯、蔗糖单棕榈酸酯、PEG 10-100壬基酚系列、PEG 15-100辛基酚系列和泊洛沙姆。
合适的亲脂性表面活性剂仅举例而言包括:脂肪醇;甘油脂肪酸酯;乙酰化甘油脂肪酸酯;低级醇脂肪酸酯;丙二醇脂肪酸酯;失水山梨糖醇脂肪酸酯;聚乙二醇失水山梨糖醇脂肪酸酯;甾醇和甾醇衍生物;聚氧乙烯化甾醇和甾醇衍生物;聚乙二醇烷基醚;糖酯;糖醚;单-和二-甘油酯的乳酸衍生物;多元醇与选自甘油酯、植物油、氢化植物油、脂肪酸和甾醇中的至少一个成员的疏水性酯交换产物;油溶性维生素/维生素衍生物;以及它们的混合物。在该组中,优选的亲脂性表面活性剂包括甘油脂肪酸酯、丙二醇脂肪酸酯和它们的混合物,或者是多元醇与选自植物油、氢化植物油和甘油三酯中的至少一个成员的疏水性酯交换产物。
在一些实施方案中,该组合物可包含增溶剂以确保本发明化合物的良好的增溶和/或溶解并最小化此类化合物的沉淀。这对于非口服使用的组合物,例如,注射用组合物可能尤其重要。也可添加增溶剂以提高亲水性药物和/或其他组分,诸如表面活性剂的溶解度,或者维持组合物作为稳定或均一的溶液或分散体。
合适的增溶剂的实例包括但不限于以下物质:醇和多元醇,诸如乙醇、异丙醇、丁醇、苄醇、乙二醇、丙二醇、丁二醇及其异构体、甘油、季戊四醇、山梨糖醇、甘露糖醇、卡必醇、二甲基异山梨糖醇酐、聚乙二醇、聚丙二醇、聚乙烯醇、羟丙基甲基纤维素和其他纤维素衍生物、环糊精和环糊精衍生物;平均分子量为约200至约6000的聚乙二醇的醚,诸如四氢糠醇PEG醚(四氢呋喃聚乙二醇醚)或甲氧基PEG;酰胺和其他含氮化合物,诸如2-吡咯烷酮、2-哌啶酮、ε-己内酰胺、N-烷基吡咯烷酮、N-羟基烷基吡咯烷酮、N-烷基哌啶酮、N-烷基己内酰胺、二甲基乙酰胺和聚乙烯吡咯烷酮;酯,诸如丙酸乙酯、柠檬酸三丁酯、乙酰柠檬酸三乙酯、乙酰柠檬酸三丁酯、柠檬酸三乙酯、油酸乙酯、辛酸乙酯、丁酸乙酯、甘油三乙酸酯、丙二醇单乙酸酯、丙二醇二乙酸酯、ε-己内酯及其异构体、δ-戊内酯及其异构体、β-丁内酯及其异构体;以及本领域中已知的其他增溶剂,诸如二甲基乙酰胺、二甲基异山梨糖醇酐、N-甲基吡咯烷酮、单辛酸甘油酯、二乙二醇单乙醚和水。
也可以使用增溶剂的混合物。实例包括但不限于,甘油三乙酸酯、柠檬酸三乙酯、油酸乙酯、辛酸乙酯、二甲基乙酰胺、N-甲基吡咯烷酮、N-羟基乙基吡咯烷酮、聚乙烯吡咯烷酮、羟丙基甲基纤维素、羟丙基环糊精、乙醇、聚乙二醇200-100、四氢呋喃聚乙二醇醚、卡必醇、丙二醇和二甲基异山梨糖醇酐。特别优选的增溶剂包括山梨糖醇、甘油、甘油三乙酸酯、乙醇、PEG-400、四氢呋喃聚乙二醇醚和丙二醇。
可包含的增溶剂的量没有特别的限制。可将给定的增溶剂的量限制为生物可接受的量,其可以由本领域技术人员容易地确定。在一些情况下,可能有利的是包含远超过生物可接受量的量的增溶剂,例如以最大化药物的浓度,其中在向受试者提供组合物之前使用常规技术诸如蒸馏或蒸发除去过量的增溶剂。因此,如果存在的话,增溶剂可为按重量计基于药物和其他赋形剂的总重量的10%、25%、50%、100%或高达约200%的重量比。如果需要,也可以使用非常少量的增溶剂,诸如5%、2%、1%或甚至更少。通常,增溶剂可以以按重量计约1%至约100%,更典型约5%至约25%的量存在。
所述组合物可以进一步包含一种或多种药学上可接受的添加剂和赋形剂。这样的添加剂和赋形剂包括但不限于,防粘剂、防沫剂、缓冲剂、聚合物、抗氧化剂、防腐剂、螯合剂、粘度调节剂、张力调节剂、调味剂、着色剂、增味剂、遮光剂、悬浮剂、粘合剂、填充剂、增塑剂、润滑剂以及它们的混合物。
此外,酸或碱可掺入组合物中以有利于加工,增强稳定性,或基于其他原因。药学上可接受的碱的实例包括氨基酸、氨基酸酯、氢氧化铵、氢氧化钾、氢氧化钠、碳酸氢钠、氢氧化铝、碳酸钙、氢氧化镁、硅酸镁铝、合成硅酸铝、合成水滑石、氢氧化镁铝、二异丙基乙胺、乙醇胺、乙二胺、三乙醇胺、三乙胺、三异丙醇胺、三甲胺、三(羟甲基)氨基甲烷(TRIS)等。同样合适的是为药学上可接受的酸的盐的碱,该药学上可接受的酸诸如乙酸、丙烯酸、己二酸、藻酸、烷基磺酸、氨基酸、抗坏血酸、苯甲酸、硼酸、丁酸、碳酸、柠檬酸、脂肪酸、甲酸、富马酸、葡糖酸、氢醌磺酸、异抗坏血酸、乳酸、马来酸、草酸、对溴苯磺酸、丙酸、对甲苯磺酸、水杨酸、硬脂酸、琥珀酸、鞣酸、酒石酸、巯基乙酸、甲苯磺酸、尿酸等。也可以使用多元酸的盐,诸如磷酸钠、磷酸氢二钠和磷酸二氢钠。当所述碱为盐时,阳离子可为任何方便的且药学上可接受的阳离子,诸如铵、碱金属、碱土金属等。实例可以包括但不限于,钠、钾、锂、镁、钙和铵。
合适的酸为药学上可接受的有机或无机酸。合适的无机酸的实例包括盐酸、氢溴酸、氢碘酸、硫酸、硝酸、硼酸、磷酸等。合适的有机酸的实例包括乙酸、丙烯酸、己二酸、藻酸、烷基磺酸、氨基酸、抗坏血酸、苯甲酸、硼酸、丁酸、碳酸、柠檬酸、脂肪酸、甲酸、富马酸、葡糖酸、氢醌磺酸、异抗坏血酸、乳酸、马来酸、甲磺酸、草酸、对溴苯磺酸、丙酸、对甲苯磺酸、水杨酸、硬脂酸、琥珀酸、鞣酸、酒石酸、巯基乙酸、甲苯磺酸、尿酸等。
在一些实施方案中,本发明提供了含有苏糖酸镁和适于注射的药物赋形剂的注射用药物组合物。组合物中的组分和试剂的量如本文所述。
可掺入本发明的组合物用于注射施用的示例形式包括水性或油性悬浮液或乳液(具有麻油、玉米油、棉子油或花生油),以及酏剂,甘露糖醇、右旋糖或无菌水溶液,以及类似的药物媒介物。
在盐水中的水溶液也通常用于注射。也可以采用乙醇、甘油、丙二醇、液体聚乙二醇等(及其合适的混合物)、环糊精衍生物和植物油。可以如下维持适当的流动性,例如,通过使用包衣如卵磷脂,在分散体的情况下维持需要的颗粒大小,以及通过使用表面活性剂。可通过各种抗细菌剂和抗真菌剂,例如对羟基苯甲酸酯、氯丁醇、苯酚、山梨酸、硫柳汞等,来防止微生物的作用。
可通过以下方法制备无菌可注射溶液:根据需要将在合适溶剂中的所需量的本发明化合物与如上述所列举的各种其他成分合并,随后过滤灭菌。通常,通过将各种灭菌活性成分掺入至包含碱性分散介质和来自上文列举的那些的所需其他成分的灭菌媒介物中来制备分散体。在用于制备无菌可注射溶液的无菌粉末的情况下,某些理想的制备方法是产生活性成分加上来自其先前灭菌过滤的溶液的任何另外的所需成分的粉末的真空干燥和冷冻干燥技术。
用于吸入或吹入的组合物包含在药学上可接受的水性或有机溶剂或其混合物中的溶液和悬浮液以及粉末。液体或固体组合物可包含如上文所述的合适的药学上可接受的赋形剂。优选地,组合物通过口服或鼻呼吸途径施用以实现局部或全身作用。在优选的药学上可接受的溶剂中的组合物可通过使用惰性气体进行雾化。可从雾化装置直接吸入雾化溶液,或者可将喷雾装置附接至面罩幕或间歇式正压呼吸机。可以以合适的方式从递送制剂的装置优选经口或鼻施用溶液、悬浮液或粉末组合物。
还可以由本文所述的组分以及适于舌下、颊、直肠、骨内、眼内、鼻内、硬膜外或脊柱内施用的一种或多种药学上可接受的赋形剂来制备药物组合物。此类药物组合物的制备是本领域中公知的。参见,例如,Anderson,Philip O.;Knoben,James E.;Troutman,William G,编著.,Handbook of Clinical Drug Data,第十版,McGraw-Hill,2002;Pratt和Taylor编著.,Principles of Drug Action,第三版,Churchill Livingston,New York,1990;Katzung编著.,Basic and Clinical Pharmacology,第九版,McGraw Hill,20037ybg;Goodman和Gilman编著.,The Pharmacological Basis of Therapeutics,第十版,McGraw Hill,2001;Remingtons Pharmaceutical Sciences,20th Ed.,LippincottWilliams&Wilkins.,2000;Martindale,The Extra Pharmacopoeia,第三十二版(ThePharmaceutical Press,London,1999);所有这些文献均通过引用全文并入本文。
剂型
本发明的苏糖酸镁或含苏糖酸镁的组合物可以为任一适宜的剂型给药,包括但不限于,液体剂型,如芳香水剂、溶液剂、注射剂、合剂、洗剂、搽剂等;气体剂型,如气雾剂、喷雾剂等;固体剂型,如散剂、丸剂、片剂、膜剂等;半固体剂型,如软膏剂、栓剂、糊剂等;其可以通过速释或控释剂型给予。优选地,通过控释剂型给予。
本发明范围内的控释可指任意一种缓释剂型。缓释剂型的非限制性的例子在Heaton等的2005/0129762的美国专利申请公开和Edgren等的2007/0128279的美国专利申请公开中有描述,其在此通过参考被引入。缓释制剂在本领域是已知的,其部分在Sawada等的2006/0292221的美国专利申请公开中有描述,在此通过参考被引入。出于本发明的目的,下列术语被认为与控释实质上相同:改进释放、连续释放、控制释放、延迟释放、贮库、逐步释放、长期释放、程序释放、延长释放、成比例释放、推迟释放、储库、延滞、缓慢释放、间隔释放、持续释放、缓释包衣、定时释放、延迟作用、延长作用、分层缓慢作用、长效、延迟作用、重复作用、缓慢作用、持续作用、持续作用的药物和延缓释放。对这些术语的进一步讨论可参见Lesczek Krowczynski,Extended-Release Dosage Forms,1987(CRC Press,Inc.)。各种控释技术涵盖了非常广泛的剂型。控释技术包括但不限于物理体系和化学体系。
本发明提供的控释剂型可采用各种形式。在一些实施方式中,本发明的苏糖酸镁或含苏糖酸镁的组合物以口服剂型施用,包括液体剂型(例如悬浮液或浆液)和口服固体剂型(例如片剂或散装粉末)。在一些实施方式中,剂型以片剂提供。本文使用的术语“片”通常指片剂、囊片、胶囊(包括软明胶胶囊)和锭剂。控释片剂通常分为三种类型:骨架、贮库和渗透体系。尽管这三种体系中的任一种都适用于本发明,但后两种体系具有包封相对大质量的更优化的性能,这可能是本发明所希望的。本发明的苏糖酸镁或含苏糖酸镁的组合物,其被配制用来延缓或控制释放,以提供在理想的时间段内足够高的生理有效的血清或血浆浓度,但速率又低至足以避免与高水平镁相关的不良事件。与高Mg含量有关的副作用包括腹泻。镁的控制释放对于降低和延迟血浆峰水平的同时维持生物利用度是十分理想的。因此,在将与制剂的立即释放有关的副作用最小化的同时,达到了生理有效的水平。此外,由于获得血清或血浆峰水平的时间延迟,以及治疗有效的血清或血浆水平时间延长,剂量频率减少到例如每天一次或两次剂量,从而增加受试者的顺应性和依从性。例如,通过使用延长体内达峰浓度时间的控释制剂,可减轻与施用镁相关的包括腹泻在内的副作用的严重程度和频率,从而减少镁浓度随时间的变化。减少浓度变化还降低了活性成分在其最大值时间点的浓度,并在给定时间内为治疗受试者提供了更为稳定量的镁,其可进一步实现用于适应症的增加剂量。
实验部分
通过参考本申请下列详细描述和包括在其中的实施例,能够更容易地理解本申请。这些实施例的目的是示例性性说明本申请而非将其限制至它们的内容。
实施例1:苏糖酸镁(L-TAMS)抑制肿瘤的生长、预防化疗药物引起的体重下降,提高裸鼠的生存率
实验方法:
裸鼠(BALB/C-nu)皮下接种U87细胞系(人类恶性胶质瘤)。成瘤后(肿瘤体积>50mm3)随机分为以下四组(每组10只裸鼠):溶剂对照组(Veh),引用纯净水;长春新碱(VCR)组,饮用纯净水,腹腔注射VCR(0.2mg/kg,每天,给予10天);苏糖酸镁(L-TAMS)组,饮用含L-TAMS的纯净水;L-TAMS+VCR组,L-TAMS和VCR联合使用。
图1中的A示出了各组中肿瘤体积随时间的变化情况。单独给予苏糖酸镁也抑制了肿瘤的生长。注意:在苏糖酸镁组中,肿瘤体积逐渐降低,但在长春新碱组中,肿瘤体积快速下降。图1中的B示出了各组动物中的体重变化情况。图1中的C表明了苏糖酸镁增加了裸鼠的生存率。在实验开始时,每组n=10。图1中的D示出了不同组治疗15天后获得的肿瘤。
上述结果表明,1)单独使用苏糖酸镁就有显著的抑制肿瘤作用。2)苏糖酸镁不影响VCR的效果(图1中的A)。3)L-TAMS和Veh组之间体重无差别,VCR组的体重略低于L-TAMS+VCR组。但长期实验结果显示,口服L-TAMS可明显减少了VCR引起的体重下降(图6)。4)生存曲线表明L-TAMS能提高模型鼠的生存率(图1中的C)。
实施例2:苏糖酸镁抑制肿瘤细胞的迁移和侵袭
引起肿瘤病人病情恶化和死亡的主要原因是肿瘤细胞向周围健康组织的侵袭和全身转移。我们发现,在离体培养的肺癌和胶质瘤细胞系,L-TAMS可显著抑制肿瘤细胞迁移和侵袭,而硫酸镁(MgSO4)的效果不佳。
实验方法:
我们采用划痕实验(图2、3)和Transwell室实验(图4)分别研究了苏糖酸镁对肿瘤细胞的迁移和侵袭。本发明中所使用的Transwell如图4所示。将癌细胞点板在BD BioCoat入侵室(Invasion Chambers)上部腔室的聚碳酸酯Transwell过滤器(带Matrigel)的顶侧,在37℃培养24h,然后用棉签去除上部腔室内的细胞。将下膜表面上的迁移和侵入细胞固定在1%多聚甲醛中,用苏木精染色,并在显微镜下计数。箭头表示侵入的细胞,箭头指向细胞迁移的小孔,癌症细胞通过该小孔迁移。
结果显示,苏糖酸镁抑制非小细胞肺癌细胞(H460)、人肺鳞癌细胞(H1703)、人肺腺癌细胞(PC9)和人恶性胶质瘤细胞(U87)的迁移(图2和图3)。同样也在H460、H1703和PC9细胞系检测了硫酸镁的作用,发现其效果不如苏糖酸镁。苏糖酸镁抑制H1703、PC9和U87细胞的侵袭(图4)。这些细胞实验的结果提示苏糖酸镁有抑制肿瘤侵袭和转移的作用。
实施例3:苏糖酸镁抑制化疗药物长春新碱引起的副作用如体重下降、毛发脱落和生长延缓
化疗病人由于化疗药物的副作用,常见体重下降、脱发、身体虚弱、状况极差。我们发现口服苏糖酸镁可以抑制长春新碱引起的大鼠脱毛、减少了长春新碱引起的体重下降(图5)。另外,口服苏糖酸镁可明显纠正长春新碱注射导致大鼠的生长缓慢副作用(图6)。
应该认为先前的描述仅仅是说明性的本发明原理。进一步的,由于许多改进和变化对本领域技术人员是显而易见的,所以不希望本发明被上述显示的精确构成和方法所限制。相应地,可以认为,所有合适的改进和等效内容在下述权利要求书所定义的本发明范围之内。
Claims (10)
1.苏糖酸镁在制备用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的药物中的用途。
2.苏糖酸镁在抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤中的用途。
3.用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的苏糖酸镁。
4.苏糖酸镁用作肿瘤患者中化疗辅助用药的用途。
5.一种抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的方法,其包括向有此需要的患者给予苏糖酸镁。
6.权利要求1-5中任一项的用途或方法,其中所述肿瘤为恶性肿瘤;
优选地,所述恶性肿瘤选自:癌,其包括膀胱癌、乳腺癌、结肠癌、间皮瘤、肾癌、肝癌、肺癌、头颈癌、食道癌、胆囊癌、卵巢癌、胰腺癌、胃癌、宫颈癌、甲状腺癌、前列腺癌和皮肤癌;淋巴系的造血肿瘤,其包括白血病、急性淋巴细胞白血病、急性成淋巴细胞白血病、B细胞淋巴瘤、T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、毛状细胞淋巴瘤、套细胞淋巴瘤、骨髓瘤和伯克特淋巴瘤;骨髓系的造血肿瘤,其包括急性和慢性骨髓性白血病、骨髓增生异常综合征和早幼粒细胞白血病;间充质来源的肿瘤,其包括纤维肉瘤和横纹肌肉瘤;中枢和周围神经系统的肿瘤,其包括星形胶质细胞瘤、成神经细胞瘤、神经胶质瘤和神经鞘瘤;以及其他肿瘤,其包括黑色素瘤、精原细胞瘤、畸胎癌、骨肉瘤、着色性干皮症、角化棘皮瘤、甲状腺滤泡癌和卡波西肉瘤;
优选地,所述恶性肿瘤选自肺癌;
优选地,所述恶性肿瘤选自小细胞肺癌或非小细胞肺癌;
优选地,所述恶性肿瘤选自肺鳞癌或肺腺癌;
优选地,其中所述脑肿瘤为脑肿瘤,优选地为脑胶质瘤。
7.药物组合物,其包含苏糖酸镁和抗肿瘤药物,以及任选地药学上可接受的赋形剂;
优选地,所述抗肿瘤药物选自抗增殖药物、细胞生长抑制剂、抗浸润剂、生长因子功能抑制剂、抗血管生成剂、血管损伤剂、内皮素受体拮抗剂、反义治疗中使用的药剂、基因治疗方法中使用的药剂或免疫治疗方法中使用的药剂;
优选地,所述抗肿瘤药物选自烷化剂、抗代谢物、抗肿瘤抗生素、抗有丝分裂剂或拓扑异构酶抑制剂;
优选地,所述抗肿瘤药物选自顺铂、奥沙利铂、卡铂、环磷酰胺、氮芥、美法仑、苯丁酸氮芥、白消安、替莫唑胺、亚硝基脲、长春新碱、长春碱、长春地辛、长春瑞滨、紫杉醇或泰索帝;
优选地,所述抗肿瘤药物选自紫杉醇、奥沙利铂或长春新碱。
8.用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的组合,其包含苏糖酸镁和抗肿瘤药物;
优选地,所述抗肿瘤药物选自抗增殖/抗肿瘤药物、细胞生长抑制剂、抗浸润剂、生长因子功能抑制剂、抗血管生成剂、血管损伤剂、内皮素受体拮抗剂、反义治疗中使用的药剂、基因治疗方法中使用的药剂或免疫治疗方法中使用的药剂;
优选地,所述抗肿瘤药物选自烷化剂、抗代谢物、抗肿瘤抗生素、抗有丝分裂剂或拓扑异构酶抑制剂;
优选地,所述抗肿瘤药物选自顺铂、奥沙利铂、卡铂、环磷酰胺、氮芥、美法仑、苯丁酸氮芥、白消安、替莫唑胺、亚硝基脲、长春新碱、长春碱、长春地辛、长春瑞滨、紫杉醇或泰索帝;
优选地,所述抗肿瘤药物选自紫杉醇、奥沙利铂或长春新碱。
9.权利要求7的组合物或权利要求8的组合在制备用于抑制肿瘤细胞生长、迁移、侵袭和粘附或治疗肿瘤的药物中的用途。
10.试剂盒,其包含:
i)苏糖酸镁;
ii)抗肿瘤药物;
优选地,所述抗肿瘤药物选自抗增殖药物、细胞生长抑制剂、抗浸润剂、生长因子功能抑制剂、抗血管生成剂、血管损伤剂、内皮素受体拮抗剂、反义治疗中使用的药剂、基因治疗方法中使用的药剂或免疫治疗方法中使用的药剂;
优选地,所述抗肿瘤药物选自烷化剂、抗代谢物、抗肿瘤抗生素、抗有丝分裂剂或拓扑异构酶抑制剂;
优选地,所述抗肿瘤药物选自顺铂、奥沙利铂、卡铂、环磷酰胺、氮芥、美法仑、苯丁酸氮芥、白消安、替莫唑胺、亚硝基脲、长春新碱、长春碱、长春地辛、长春瑞滨、紫杉醇或泰索帝;
优选地,所述抗肿瘤药物选自紫杉醇、奥沙利铂或长春新碱;和
iii)用于指示治疗肿瘤或抑制肿瘤细胞迁移、侵袭和粘附的说明书。
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