JP2017526662A - 多発性骨髄腫を治療するための薬物の組み合わせ - Google Patents
多発性骨髄腫を治療するための薬物の組み合わせ Download PDFInfo
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Abstract
Description
本出願は、2014年8月5日に出願の米国出願第62/033,386号に対する優先権を主張する。上記出願の内容全体が、参照によって本明細書に組み込まれる。
本発明は、癌の治療、詳細には、多発性骨髄腫の治療のための、カボザンチニブ及びプロテアソーム阻害剤の組み合わせに関する。
R1は、ハロであり、
R2は、ハロであり、及び
Qは、CHまたはNである。
上記のとおり、本開示は、癌の治療、具体的には、多発性骨髄腫の治療を目的とした、プロテアソーム阻害剤及びC−Met阻害剤を含む医薬的な組み合わせに関する。
R1は、ハロであり、
R2は、ハロであり、及び
Qは、CHまたはNである。
・100mg以下の化合物1が投与されるか、
・95mg以下の化合物1が投与されるか、
・90mg以下の化合物1が投与されるか、
・85mg以下の化合物1が投与されるか、
・80mg以下の化合物1が投与されるか、
・75mg以下の化合物1が投与されるか、
・70mg以下の化合物1が投与されるか、
・65mg以下の化合物1が投与されるか、
・60mg以下の化合物1が投与されるか、
・55mg以下の化合物1が投与されるか、
・50mg以下の化合物1が投与されるか、
・45mg以下の化合物1が投与されるか、
・40mg以下の化合物1が投与されるか、
・35mg以下の化合物1が投与されるか、
・30mg以下の化合物1が投与されるか、
・25mg以下の化合物1が投与されるか、
・20mg以下の化合物1が投与されるか、
・15mg以下の化合物1が投与されるか、
・10mg以下の化合物1が投与されるか、または
・5mg以下の化合物1が投与される。
本発明は、下記の非限定である実施形態によってさらに定義される。
R1は、ハロであり、
R2は、ハロであり、及び
Qは、CHまたはNである。
1−(4−フルオロフェニルカルバモイル)シクロプロパンカルボン酸(化合物A−1)の調製
N−(4−{[6,7−ビス(メチルオキシ)キノリン−4−イル]オキシ}フェニル)−N’−(4−フルオロフェニル)シクロプロパン−1,1−ジカルボキサミド及びその(L)−リンゴ酸塩の調製に使用することができる合成経路をスキーム1に示す。
6.7−ジメトキシ−キノリン−4−オール(47.0kg)及びアセトニトリル(318.8kg)を反応器に順次詰めた。得られた混合物を約60℃まで加熱し、オキシ塩化リン(POCl3、130.6kg)を添加した。POCl3を添加した後、反応混合物の温度を約77℃まで上昇させた。高速液体クロマトグラフィー[HPLC]分析によって反応の進行を測定し、出発物質の残存率が3%を下回った時点で反応完了とした(約13時間)。反応混合物を約2〜7℃まで冷却した後、ジクロロメタン(DCM、482.8kg)、26%のNH4OH(251.3kg)、及び水(900L)を含む冷却溶液へと注ぎ入れて反応を停止した。得られた混合物を約20〜25℃まで温め、相を分離させた。有機相をAW hyflo super−cel NF(Celite、5.4kg)床に通して濾過し、DCM(118.9kg)で濾過床を洗浄した。統合した有機相をブライン(282.9kg)で洗浄してから水(120L)と混合した。相を分離させてから、減圧蒸留によって溶媒を除去しながら有機相を濃縮した(残存体積約95L)。有機相を含む反応器にDCM(686.5kg)を詰めてから、減圧蒸留によって溶媒を除去しながら濃縮した(残存体積約90L)。その後、メチルt−ブチルエーテル(MTBE、226.0kg)を詰め、混合物の温度を調節して−20〜−25℃とし、2.5時間保持することで、個体沈殿物を生じさせた。その後、当該沈殿物を濾過し、n−ヘプタン(92.0kg)で洗浄してから窒素雰囲気下、約25℃で、フィルター上で乾燥させることで、表題化合物(35.6kg)を得た。
4−クロロ−6,7−ジメトキシキノリン(35.3kg)、ナトリウムt−ブトキシド(21.4kg)、及びDMA(167.2kg)を含む20〜25℃の反応器に対して、4−アミノフェノール(24.4kg)を溶解したN,N−ジメチルアセトアミド(DMA、184.3kg)を詰めた。その後、この混合物を100〜105℃まで加熱し、約13時間保持した。反応の進行をHPLCによって分析し、反応完了を決定(出発物質の残存率が2%未満)した後、反応器の内容物を15〜20℃に冷却し、15〜30℃の温度を維持する速度で水(2〜7℃に予冷、587L)を負荷した。得られた固体沈殿物を濾過し、水(47L)及びDMA(89.1kg)の混合物で洗浄してから、最終的に水(214L)で洗浄した。その後、フィルター上のケーキをそのまま約25℃で乾燥することで、4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニルアミンの粗生成物(湿重量59.4kg、乾燥重量41.6kg、乾燥重量は検出限界(limit of detection)に基づく計算値であり、本明細書ではこれ以後、検出限界を「LOD」と記す)。テトラヒドロフラン(THF、211.4kg)及びDMA(108.8kg)の混合物中で、4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニルアミンの粗生成物を約1時間還流(約75℃)した後、0〜5℃まで冷却し、約1時間そのままにした。その後、固体を濾過し、THF(147.6kg)で洗浄してから約25℃の減圧下、フィルター上で乾燥することで、4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニルアミン(34.0kg)を得た。
4−クロロ−6,7−ジメトキシキノリン(34.8kg)、4−アミノフェノール(30.8kg)、及びナトリウムtert−ペントキシド(1.8当量)88.7kg、THF中35重量%)を反応器に詰めたた後、N,N−ジメチルアセトアミド(DMA、293.3kg)を詰めた。その後、この混合物を105〜115℃まで加熱し、9時間保持した。反応の進行をHPLCによって分析し、反応完了を決定(出発物質の残存率が2%未満)した後、反応器の内容物を15〜25℃に冷却してから、温度を20〜30℃に維持しながら、2時間かけて水(315kg)を添加した。その後、反応混合物を20〜25℃でさらに1時間撹拌した。濾過によって粗生成物を回収し、88kgの水及び82.1kgのDMAの混合物で洗浄した後、175kgの水で洗浄した。生成物をフィルター上で53時間乾燥した。LODは、1%w/w未満であった。
THF(96.1kg)及びN,N−ジメチルホルムアミド(DMF、0.23kg)の混合物中に1−(4−フルオロ−フェニルカルバモイル)−シクロプロパンカルボン酸(22.8kg)を含む溶液に対して、バッチの温度が25℃を超えないような速度で塩化オキサリル(12.6kg)を添加した。さらに処理することなく、この溶液を次の段階に使用した。
1−(4−フルオロ−フェニルカルバモイル)−シクロプロパンカルボン酸(35kg)、DMF(344g)、及びTHF(175kg)を反応器に詰めた。反応混合物を12〜17℃に調整した後、反応混合物に19.9kgの塩化オキサリルを1時間かけて詰めた。12〜17℃で反応混合物の撹拌を3〜8時間継続した。さらに処理することなく、この溶液を次の段階に使用した。
THF(245.7kg)及び水(116L)中に4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニルアミン化合物(23.5kg)及び炭酸カリウム(31.9kg)を含む混合物に対して、バッチの温度が30℃を超えないような速度で、1−(4−フルオロ−フェニルカルバモイル)−シクロプロパンカルボニルクロリドを含む、上記段階の溶液を添加した。反応完了時(約20分後)に、水(653L)を添加した。混合物を20〜25℃で約10時間撹拌することで、生成物の沈殿を生じさせた。濾過によって生成物を回収し、THF(68.6kg)及び水(256L)で予め調製した溶液で洗浄してから、最初に、窒素雰囲気下、約25℃で、フィルター上で乾燥した後、減圧下、約45℃で乾燥することにより、表題化合物(41.0kg、LODに基づく計算では38.1kg)を得た。
4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニルアミン(35.7kg、1当量)を反応器に負荷した後、THF(412.9kg)を負荷した。反応混合物に対して、水中(169kg)にK2CO3(48.3kg)を含む溶液を負荷した。4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニルアミンを含む反応器に、温度を20〜30℃に維持しながら、前述の1−(4−フルオロ−フェニルカルバモイル)−シクロプロパンカルボニルクロリドの代替手順による調製において記載した酸クロリド溶液を最低でも2時間かけて移した。反応混合物を20〜25℃で最低でも3時間撹拌した。その後、反応温度を30〜25℃に調整し、混合物を撹拌した。撹拌を停止し、混合物の相をそのまま分離させた。下の水相を除去して廃棄した。残存する上の有機相に水(804kg)を添加した。15〜25℃で撹拌したまま最低でも16時間反応を継続した。
シクロプロパン−1,1−ジカルボン酸[4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニル]−アミド(4−フルオロ−フェニル)−アミド(13.3kg)、L−リンゴ酸(4.96kg)、メチルエチルケトン(MEK、188.6kg)、及び水(37.3kg)を反応器に詰め、混合物を加熱して約2時間還流(約74℃)した。反応器の温度を50〜55℃まで下降させてから反応器の内容物を濾過した。類似量のシクロプロパン−1,1−ジカルボン酸[4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニル]−アミド(4−フルオロ−フェニル)−アミド(13.3kg)、L−リンゴ酸(4.96kg)、MEK(198.6kg)、及び水(37.2kg)を使用して開始し、上記のこうした逐次段階をさらに2回繰り返した。統合した濾液を、MEK(1133.2kg)を使用して大気圧下、約74℃で共沸的に乾燥させた(残存体積約711L、KF<0.5%w/w)。反応器の内容物の温度を20〜25℃まで下降させ、約4時間保持することで、固体沈殿物を生じさせた。当該沈殿物を濾過し、MEK(448kg)で洗浄してから、減圧下、50℃で乾燥することで、表題化合物(45.5kg)を得た。
シクロプロパン−1,1−ジカルボン酸[4−(6,7−ジメトキシ−キノリン−4−イルオキシ)−フェニル]−アミド(4−フルオロ−フェニル)−アミド(47.9kg)、L−リンゴ酸(17.2kg)、メチルエチルケトン(658.2kg)、及び水(129.1kg)を反応器に詰めた。混合物を50〜55℃で約1〜3時間加熱した後、55〜60℃でさらに4〜5時間加熱した。混合物を、1μmのカートリッジに通して濾過することによって清澄化した。反応器の温度を20〜25℃に調整してから、ジャケットの最大温度を55℃とし、150〜200mmHgの減圧下で減圧蒸留することで、体積範囲を558〜731Lとした。
カボザンチニブは、MET、VEGFR2、RET、ならびにTAMファミリーのキナーゼであるTYRO3、AXL、及びMERを含むチロシンキナーゼの阻害剤である。カボザンチニブは、去勢術耐性前立腺癌及び骨転移を伴う他の固形腫瘍を有する患者において臨床活性を有することが明らかとなっている。多発性骨髄腫(MM)は、2番目に多い一般的な血液系腫瘍であり、癌による死において全体の約2%を占めるものである。MMは、モノクローナルB細胞(形質細胞)腫瘍であり、骨痛、病的骨折、及び高カルシウム血症を引き起こす複数の溶骨性病変を示す臨床特徴を有するものである。MM患者においては、HGF及びVEGFの循環レベルが上方制御されており、HGF−METシグナル伝達経路による、形質細胞−骨芽細胞コミュニケーションの制御が、こうした患者における溶解性骨疾患の発症に関係づけられてきた。したがって、本研究の主要目的は、A)同系5TGM1マウスMMモデルにおける骨病変及び腫瘍負荷に対するカボザンチニブ(cabo)の活性の決定(試験1)、及びB)単独投与またはボルテゾミブとの組み合わせ投与の際に、こうしたマウスの全生存期間に対するカボザンチニブの影響の検討(試験2)である。
Claims (21)
- 化合物1が、医薬的に許容可能なL−リンゴ酸塩、D−リンゴ酸塩、DLリンゴ酸塩、またはそれらの混合物である、請求項1〜3に記載の組成物。
- 前記プロテアソーム阻害剤が、エピガロカテキン−3−ガレート、サリノスポラミドA、カルフィルゾミブ、ボルテゾミブ、オプロゾミブ、イキサゾミブ、マリゾミブ、またはデランゾミブである、請求項1〜3に記載の組成物。
- 前記C−Met阻害剤が、化合物1または医薬的に許容可能なその塩であり、前記プロテアソーム阻害剤が、ボルテゾミブである、請求項1〜3に記載の組成物。
- 前記C−Met阻害剤が、化合物1または医薬的に許容可能なその塩であり、前記プロテアソーム阻害剤が、カルフィルゾミブである、請求項1〜3に記載の組成物。
- 対象における増殖性障害の治療方法であって、対象に対する、有効量の請求項1〜3に記載の組成物の投与を含む前記方法。
- 前記増殖性障害が、癌である、請求項10に記載の方法。
- 前記癌が、結腸直腸癌、結腸癌、頭頸部癌、乳癌、非小細胞肺癌、前立腺癌、腎細胞癌、膵癌、卵巣癌、腹膜癌、直腸癌、腎癌、ホジキンリンパ腫、膀胱癌、肝細胞癌、胃癌、扁平上皮癌、子宮頸癌、子宮癌、慢性リンパ性白血病、リンパ腫、骨髄腫、多発性骨髄腫、固形腫瘍、血液腫瘍、または消化管間質腫瘍(GIST)である、請求項11に記載の方法。
- 前記癌が、非小細胞肺癌、結腸癌、多発性骨髄腫、または頭頸部癌である、請求項10に記載の方法。
- 前記癌が、多発性骨髄腫である、請求項11に記載の方法。
- 前記多発性骨髄腫が、再発したものであるか、または難治性である、請求項12に記載の方法。
- 前記対象がヒトである、請求項10〜13のいずれか1項に記載の方法。
- 癌を有する対象の治療方法であって、前記対象に対する、有効量のプロテアソーム阻害剤と、有効量の化合物1または医薬的に許容可能なその塩と、の投与を含み、前記癌が、結腸直腸癌、結腸癌、頭頸部癌、乳癌、非小細胞肺癌、前立腺癌、腎細胞癌、膵癌、卵巣癌、腹膜癌、直腸癌、腎癌、ホジキンリンパ腫、膀胱癌、肝細胞癌、胃癌、扁平上皮癌、子宮頸癌、子宮癌、慢性リンパ性白血病、リンパ腫、骨髄腫、多発性骨髄腫、固形腫瘍、血液腫瘍、または消化管間質腫瘍(GIST)である前記方法
- 前記プロテアソーム阻害剤が、ボルテゾミブまたはカルフィルゾミブである、請求項15に記載の方法。
- 対象における癌細胞または腫瘍細胞の増殖の阻害方法であって、(a)前記細胞と、有効量の、請求項1及び請求項2に定義される式Iの化合物もしくは式IAの化合物、または請求項3に定義される化合物1と、の接触段階、及び(b)有効量のプロテアソーム阻害剤に対する、前記細胞の曝露段階であって、前記プロテアソーム阻害剤が、エピガロカテキン−3−ガレート、サリノスポラミドA、カルフィルゾミブ、ボルテゾミブ、オプロゾミブ、イキサゾミブ、マリゾミブ、またはデランゾミブからなる群から選択される前記曝露段階、を含む前記方法。
- 前記化合物が、化合物1または医薬的に許容可能なその塩であり、前記プロテアソーム阻害剤が、ボルテゾミブまたはカルフィルゾミブである、請求項17に記載の方法。
- 前記組み合わせでの治療下にある患者において、完全な血清学的応答が観測される、請求項1〜18に記載の方法。
- 前記組み合わせでの治療下にある患者において、部分的な血清学的応答が観測される、請求項1〜18に記載の方法。
- 前記組み合わせでの治療下にある患者において、安定疾患(stable disease)が観測される、請求項1〜18に記載の方法。
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CA2957466A1 (en) | 2016-02-11 |
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