JP2020508351A - ファルネシルトランスフェラーゼ阻害剤を用いてがんを治療する方法 - Google Patents
ファルネシルトランスフェラーゼ阻害剤を用いてがんを治療する方法 Download PDFInfo
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Abstract
Description
A.方法
遺伝子のRNAレベルを指すことができる。一部の実施形態では、遺伝子の発現レベルは、遺伝子のタンパク質レベルを指し、本明細書で提供される方法は遺伝子のタンパク質レベルを決定することを含む。
位でのSNVを有しない場合、FTI治療に応答する可能性が高いと予測されるか、又はFTIの治療的有効量が投与される。一部の実施形態では、試料がCXCL12の3’UTRにおいてSNVを有しない場合、ワルデンストレームマクログロブリン血症を有する対象は、FTI治療に応答する可能性が高いと予測されるか、又はFTIの治療的有効量が投与される。
一部の実施形態では、本明細書において、FTI又はFTIを含む医薬組成物を用いて対象を治療する方法が提供される。本明細書に提供される医薬組成物は、治療的有効量のFTI及び薬学的に許容される担体、希釈剤又は賦形剤を含む。一部の実施形態では、FTIはチピファルニブ;アルグラビン;ペリリルアルコール;SCH−66336;L778123;L739749;FTI−277;L744832;R208176;BMS214662;AZD3409;又はCP−609,754である。一部の実施形態では、FTIはチピファルニブである。
一部の実施形態では、本明細書に提供される方法は、治療的有効量の二次活性剤の投与又はサポートケア療法をすることをさらに含む。二次活性剤は化学療法剤であり得る。化学療法剤又は化学療法薬は、細胞内の活性のその様式、例えば、細胞周期に影響を与えるかどうか、どの段階で影響を与えるのかによって分類することができる。或いは、薬剤は、DNAを直接架橋する能力、DNAに挿入する能力、又は核酸合成に影響を与えることにより染色体及び有糸分裂の異常を誘発する能力に基づいて特徴付けることができる。
PTCL患者におけるチピファルニブ臨床研究
チピファルニブの第II相臨床研究は、再発又は難治性の進行性末梢T細胞リンパ腫(PTCL)を有する対象における客観的奏効率(ORR)に関して、チピファルニブの抗腫瘍活性を評価することを主な目的として実施することができる。客観的な腫瘍応答の決定は、修飾された重症度加重評価ツール(mSWAT)に従って、国際ワークショップ基準(IWC)及び/又は測定可能な皮膚疾患によって実行することができる。二次的な目的には、1年での無増悪生存率、反応期間(DOR)、全生存率(OS)におけるチピファルニブの効果;並びにチピファルニブの安全性及び忍容性を利用することを含み得る。
PTCL患者のチピファルニブ臨床研究における活性の証拠
例Iに記載される研究に登録された患者のコホートにおいて臨床活性の証拠を研究した。8人のPTCL患者のうち4人において持続的応答(11か月の中央値)が見られた。
個別のFTI治療の決定
患者が、FTI治療、例えば、チピファルニブ治療に適しているかどうかを決定するために以下の手順をとることができる。
AML患者のチピファルニブ臨床研究における活性の証拠
チピファルニブを用いた以前の臨床研究は、リスクの低いAML(CTEP−20、第2相)又は再発性及び難治性AML(INT−17、第2相)を用いた、高齢患者における新たに診断されたAMLにおいて行われた。これらの研究では、患者の選択は遺伝子マーカーに基づいていなかった。チピファルニブ単剤作用の事例証拠が報告された。しかしながら、患者集団全体の全体的な臨床活動は、チピファルニブの登録を支持しなかった。
PTCL患者のチピファルニブ臨床研究における活性の証拠
この例は、再発性又は難治性のPTCLを有する18人の患者におけるチピファルニブの抗腫瘍活性を調査するために設計された第2相試験(ClinicalTrials.gov Identifier:NCT02464228)、及び本研究の特定の結果を記載する。
Claims (60)
- 対象においてCXCL12を発現するがんを治療する方法であって、対象にファルネシルトランスフェラーゼ阻害剤(FTI)、任意選択でチピファルニブの治療的有効量を投与することを含み、がんが末梢T細胞リンパ腫(PTCL)又は急性骨髄性白血病(AML)である上記方法。
- PTCLが再発性又は難治性のPTCLである、請求項1に記載の方法。
- PTCLがAITLである、請求項1に記載の方法。
- AITLが再発性又は難治性のAITLである、請求項3に記載の方法。
- AMLが新たに診断されたAMLである、請求項1に記載の方法。
- AMLを有する対象が高齢患者であるか、化学療法に不適当であるか、又は低リスクのAMLを有する、請求項1又は5に記載の方法。
- AMLが再発性又は難治性のAMLである、請求項1、5又は6に記載の方法。
- FTI、任意選択でチピファルニブが、参照比より高い、CXCR4の発現レベルに対するCXCL12の発現レベルの比を有する対象に選択的に投与される、請求項1から7までのいずれか一項に記載の方法。
- 参照比が、1/10、1/9、1/8、1/7、1/6、1/5、1/4、1/3、1/2、1、2、3、4、5、6、7、8、9又は10である、請求項8に記載の方法。
- FTI、任意選択でチピファルニブが、さらなる遺伝子の発現レベルが、参照発現レベルより高い対象に選択的に投与される、請求項1から9までのいずれか一項に記載の方法。
- さらなる遺伝子がCXCL13及び/又はPD−1である、請求項10に記載の方法。
- FTI、任意選択でチピファルニブが、CXCL12の3’UTRに単一ヌクレオチド変異(SNV)を有しない対象に選択的に投与される、請求項1から11までのいずれか一項に記載の方法。
- CXCL12の3’UTRにおけるSNVがrs2839695である、請求項12に記載の方法。
- FTI、任意選択でチピファルニブが、SIK3に単一ヌクレオチド変異を有する対象に選択的に投与される、請求項1から13までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、CENPFにR2729Q変異を有する対象に選択的に投与される、請求項1から14までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、体重1kg当たり0.05〜500mgの用量で投与される、請求項1から15までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが1日2回投与される、請求項1から16までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回200〜1200mgの用量で投与される、請求項17に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回100mg、200mg、300mg、400mg、600mg、900mg又は1200mgの用量で投与される、請求項18に記載の方法。
- FTI、任意選択でチピファルニブが、28日治療周期の1〜7日目及び15〜21日目に投与される、請求項1から15までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、28日治療周期の1〜21日目に投与される、請求項1から15までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、28日治療周期の1〜7日目に投与される、請求項1から15までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、少なくとも1周期投与される、請求項22に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回900mgの用量で投与される、請求項21から23までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回600mgの用量で投与される、請求項21から23までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回400mgの用量で投与される、請求項21から23までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回300mgの用量で投与される、請求項21から23までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回200mgの用量で投与される、請求項21から23までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、放射線の前、その間又は後に投与される、請求項1から28までのいずれか一項に記載の方法。
- 第2の活性剤の治療的有効量の投与又はサポートケア療法をすることをさらに含む、請求項1から29までのいずれか一項に記載の方法。
- 対象において血管免疫芽球性T細胞リンパ腫(AITL)を治療する方法であって、対象にファルネシルトランスフェラーゼ阻害剤(FTI)、任意選択でチピファルニブの治療的有効量を投与することを含む上記方法。
- AITLが再発性又は難治性のAITLである、請求項31に記載の方法。
- FTI、任意選択でチピファルニブが、対象がAITL組織像の腫瘍を有することに基づいて対象に選択的に投与される、請求項31又は32に記載の方法。
- AITL組織像が腫瘍細胞構成要素によって特徴付けられる、請求項33に記載の方法。
- 腫瘍細胞構成要素が、ろ胞性ヘルパーT細胞に由来する多形性の中型の新生物細胞を含む、請求項34に記載の方法。
- AITL組織像が非腫瘍細胞構成要素によって特徴付けられる、請求項33に記載の方法。
- 非腫瘍細胞構成要素が顕著な樹枝状の血管を含む、請求項36に記載の方法。
- 非腫瘍細胞構成要素がろ胞性樹状細胞の増殖を含む、請求項36又は37に記載の方法。
- 非腫瘍細胞構成要素が、散在するEBV陽性のB細胞芽球を含む、請求項36から38までのいずれか一項に記載の方法。
- AITLを有する対象がAITLと診断されている、請求項31から39までのいずれか一項に記載の方法。
- AITLの診断が、非腫瘍構成要素の可視化を含む、請求項40に記載の方法。
- AITLの診断が、内皮細静脈の増殖の可視化を含む、請求項40に記載の方法。
- AITLの診断が、以下の腫瘍マーカー:CXCL13、CD10、PD1及びBCL6の1つ以上の存在を検出することを含む、請求項40に記載の方法。
- FTI、任意選択でチピファルニブが、経口的、非経口的、直腸又は局所的に投与される、請求項31から43までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、体重1kg当たり0.05〜500mgの用量で投与される、請求項31から44までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが1日2回投与される、請求項31から45までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回200〜1200mgの用量で投与される、請求項31から46までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回100mg、200mg、300mg、400mg、600mg、900mg又は1200mgの用量で投与される、請求項47に記載の方法。
- FTI、任意選択でチピファルニブが、28日治療周期の1〜7日目及び15〜21日目に投与される、請求項31から44までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、28日治療周期の1〜21日目に投与される、請求項31から44までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、28日治療周期の1〜7日目に投与される、請求項31から44までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、少なくとも1周期投与される、請求項49から51までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回900mgの用量で投与される、請求項49から51までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回600mgの用量で投与される、請求項49から51までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回400mgの用量で投与される、請求項49から51までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回300mgの用量で投与される、請求項49から51までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、1日2回200mgの用量で投与される、請求項49から51までのいずれか一項に記載の方法。
- FTI、任意選択でチピファルニブが、放射線の前、その間又は後に投与される、請求項31から57までのいずれか一項に記載の方法。
- 第2の活性剤の治療的有効量の投与又はサポートケア療法をすることをさらに含む、請求項31から58までのいずれか一項に記載の方法。
- 第2の活性剤がヒストンデアセチラーゼ、抗葉酸剤又は化学療法である、請求項59に記載の方法。
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