JP5697853B2 - 過剰増殖性疾患を治療するための新規な組成物 - Google Patents
過剰増殖性疾患を治療するための新規な組成物 Download PDFInfo
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- JP5697853B2 JP5697853B2 JP2009119925A JP2009119925A JP5697853B2 JP 5697853 B2 JP5697853 B2 JP 5697853B2 JP 2009119925 A JP2009119925 A JP 2009119925A JP 2009119925 A JP2009119925 A JP 2009119925A JP 5697853 B2 JP5697853 B2 JP 5697853B2
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Description
本願は、2008年5月16日に出願された米国仮特許出願第61/127,883号および2009年4月7日に出願された米国仮特許出願第61/212,072号の利益を主張するものであり、それらの内容は、全体が本明細書に参考として援用される。
一態様において、本発明は、(A)抗炎症活性を有する第1の薬剤、またはアセトアミノフェン、フェナセチン、トラマドールなど、(B)酸化的リン酸化阻害剤、イオノフォア、またはアデノシン5’−一リン酸活性化プロテインキナーゼ(AMPK)活性化剤となり得る第2の薬剤、および(C)セロトニン活性を保有または保持する第3の薬剤、を含む組成物を特徴とする。
別の態様において、本発明は、本質的に、抗炎症活性を保有する第1の薬剤またはアセトアミノフェン、フェナセチン、トラマドールなどと、酸化的リン酸化阻害剤、イオノフォア、またはAMPK活性化剤であってもよい第2の薬剤と、セロトニン活性を保有する第3の薬剤と、からなる組成物を特徴とする。本明細書で用いられる用語「本質的に・・・からなる」は、組成物を、その3種の特定の薬剤ならびにその基本的で新規な特徴、即ち本明細書に記載された標的疾患を治療する際の有効性に物質的な影響を与えないもの、に限定している。そのような組成物の一例は、上述の3種薬剤および薬学的に許容され得る担体を含有する。上記の組成物は、第1の薬剤5〜5,000mg(例えば5〜3,000mg、5〜1,500mg、または5〜1,000mg)と、第2の薬剤1〜5,000mg(例えば1〜3,000mg、1〜1,000mg、1〜500mg、または1〜100mg)と、第3の薬剤0.1〜1,000mg(例えば0.1〜100mg、0.1〜50mg、または0.1〜30mg)とを含むか、または上記量に基づいて計算されたものと同比の量を含むことができる。
第1の薬剤の例は、ステロイド系抗炎症薬および非ステロイド系抗炎症薬を含むことができる。ステロイド系抗炎症薬の例としては、グルココルチコイド、ヒドロコルチゾン、コルチゾン、ベクロメタゾン、ジプロピオナート、ベタメタゾン、デキサメタゾン、プレドニゾン、メチルプレドニゾロン、トリアムシノロン、フルオシノロンアセトニド、フルドロコルチゾン、およびプロピオン酸ベクロメタゾンが挙げられる。
セロトニン1Aアゴニスト、例えばアリールピペラジン化合物、複素環縮合ベンゾジオキサンのアザヘテロシクリルメチル誘導体、ブスピロン、3−アミノジヒドロ−[1]−ベンゾピランおよびベンゾチオピラン、(S)−4−[[3−[2−(ジメチルアミノ)エチル]−1H−インドール−5−イル]メチル]−2−オキサゾリジノン(311C90)および8−OH−DPAT、5−カルボキシアミドトリプタミンヘメエタノラートマレイン酸塩、N,N−ジプロピル−5−カルボキシアミドトリプタミンマレイン酸塩、R(+)−UH−301HCl、S15535、ゲピロン、プシロシビン、キサリプロデンHClおよびタンドスピロン;
セロトニン1Bアゴニスト、例えばCGS−12066a、N−メチルキパジン二マレイン酸塩、リザトリプタンおよびナラトリプタン;
セロトニン1Cアゴニスト、例えばデクスノルフェンフルラミン;
セロトニン1A、1B、1Dおよび1Fアゴニスト、例えばスマトリプタンおよび5−カルボキシアミドトリプタミンヘミエタノラートマレイン酸塩;
セロトニン1Bおよび1Dアゴニスト、例えばジヒドロエルゴタミンおよびGR46611;
セロトニン1Aおよび1Dアゴニスト、例えばLY−165、163;
セロトニン1Aおよび1Eアゴニスト、例えばエルゴノビンおよびBRL54443マレイン酸塩;
5−HT2A/2Cアゴニスト、例えばDOI(2,5−ジメトキシ−4−ヨードアンフェタミン)、mCPP(m−クロロフェニルピペラジン)、TFMPP(3−トリフルオロメチルフェニルピペラジン)、メスカリン、DMT、プシロシン、2C−B、ロルカセリン、メチルセロトニンlaleaste塩および1−(3−クロロフェニル)ピペラジンHCl;
セロトニン2Bアゴニスト、例えばBW723C86;
セロトニン受容体2Cモジュレータ、例えばBVT933、DPCA37215、IK264、PNU22394、WAY161503、R−1065、YM348、VER−3323ヘミフマル酸塩、ならびに米国特許第3,914,250、WO01/66548、WO02/10169、WO02/36596、WO02/40456、WO02/40457、WO02/44152、WO02/48124、WO02/51844、およびWO03/033479に開示されたもの(それらの開示は、全体が参考として援用される);
5−HT3アゴニスト、例えばフェニルビグアニド、O−メチルセロトニHCl、SR57227Aおよび1−(3−クロロフェニル)ビグアニドHCl;
5−HT4アゴニスト、例えばシサプリド、クエン酸モサプリド二水和物およびML10302;
5HT7受容体アゴニスト、例えば4−(2−ピリジル)ピペラジン、LP12塩酸塩水和物、LP44およびキノリン誘導体;
セロトニントランスポータ阻害剤、例えばイミプラミン;
セロトニン再取込み阻害剤、例えばアリールピロリジン化合物、フェニルピペラジン化合物、ベンジルピペリジン化合物、ピペリジン化合物、三環式γ−カルボリンデュロキセチン化合物、ピラジノキノキサリン化合物、ピリドインドール化合物、ピペリジインドール化合物、ミルナシプラン、シタロプラム、セルトラリン代謝産物、デメチルセルトラリン、ノルフルオキセチン、デスメチルシタロプラム、エスシタロプラム、1−フェンフルラミン、フェモキセチン、イホキセチン、シアノドチエピン、リトキセチン、ダポキセチン、ネファゾドン、セリクラミン、トラゾドン、ミルタザピン、フルボキサミン、インダルピン、インデロキサジン、ミルナシプラム、パロキセチン、シブトラミン、ジメルジン、塩酸トラゾドン、デクスフェンフラミン、ビシファジン、ビラゾドン、デスベンラファキシン、デュロキセチン、アミトリプチリン、ブトリプチリン、デシピラミン、ドスレピン、ドキセピン、ロフェプラミン、ノルトリプチリン、ピロトリプチリン、トリミピラミン、アモキサピン(amoxapnie)、マプロチリン、アドハイパーフォリン、ブロモフェニラミン、クロロフェニラミン、デクストロメトルファン、ジフェンヒドラミン、ハイパーフォリン、ケタミン、ネファゾドン、ペチジン、フェンシクリジン、フェニラミン、プロポキシフェン、ならびに米国特許第6,365,633、WO01/27060、およびWO01/162341中のもの(それらの開示は、全体が本明細書に参考として援用される)、EPTI、8−OH−DPAT、プロザック(登録商標)(塩酸フルオキセチン)およびゾロフト(登録商標)(塩酸セルトラリン);
セロトニンおよびノルアドレナリン再取込み阻害剤(例えばベンラファキシン、ベンラファキシン代謝産物O−デスメチルベンラファキシン、クロミプラミンおよびクロミプラミン代謝産物デスメチルクロミプラミン);
モノアミン再取込み阻害剤(例えばアミド);
ピリダジノンアルドースリダクターゼ阻害剤(例えばピリダジノン化合物);
セロトニン受容体の刺激剤でもあるセロトニン作動薬(例えばメシル酸エルゴロイドまたはメシル酸ペルゴリド);
セロトニン合成の刺激剤(例えばビタミンB1、ビタミンB3、ビタミンB6、ビオチン、サデノシルメチオニン、葉酸、アスコルビン酸、マグネシウム、コエンザイムQ10、またはピラセタム);
セロトニン受容体アゴニスト、例えばラウオルシン、ヨヒンビン、α−メチル−5−ヒドロキシトリプタミン、1−(1−ナフチル)ピペラジン、メトクロプラミド、HTF−919、R−093877、ゾルミトリプタン、5−メトキシ−N,N−ジメチルトリプタミン、5−MEO−DIPT塩酸塩水和物およびリセルグ酸ジエチルアミド;
セロトニン前駆体、例えばトリプトファン;
神経末端からのセロトニン放出を促進する薬剤、例えばフェンフルラミン、およびノルフェンフルラミン;
上述の化合物全てが、公知の薬物であり、公的に容易に入手できる。薬物の幾つかは、化学品会社、例えばシグマ−アルドリッチ(Sigma−Aldrich)(ミズーリ州セントルイス)から購入することができる。薬物が容易に入手できない場合、特定の実施形態で、化合物を有機的に製造して、許容された規準、例えばメルク・インデックス(Merck Index)、レミントン・ファーマシューティカル・サイエンシーズ(Remington’s Pharmaceutical Sciences)、USP/NF、および外国の刊行物に見出されるものにより同定し得ることは、当業者には理解されよう。特定の実施形態において、これらの薬物化合物を投与するためのレジメンは周知であり、必要に応じて通常の技能を有する臨床医により容易に再構築され得る。有効な用量は、当業者に認識されるとおり、治療される疾患の種類または程度;対象の寸法、体重、年齢、および性別;投与経路;賦形剤の使用;代謝率、排泄率、およびその他の治療処置との可能な併用に応じて変更され得る。特定の実施形態において、その他の薬物の併用投与が、代謝および/または排泄の上昇または低下をもたらすことで、用量の調整が必要となる可能性がある。特定の別の実施形態において、活性剤の1種以上が血漿蛋白質に結合している場合、結合の度合いに影響を与えるその他の薬物の併用投与にも、用量の調整が必要となる場合がある。上記組成物の一日量は、第1の薬剤5〜10,000mg(例えば10〜5,000または10〜3,000mg)、第2の薬剤1〜5,000mg(例えば2〜1,000または2〜3,000mg)、および第3の薬剤0.1〜1,000mg(例えば1〜50mg)であってもよい。
本発明の化合物および方法は、様々な良性腫瘍の治療にも適している。良性腫瘍の例としては、副腎腫瘍、例えば腺腫、副腎褐色細胞腫および副腎神経節細胞腫;脳腫瘍、例えば髄膜腫および腺腫;末梢神経腫瘍、例えば神経線維腫および神経鞘腫;肝臓腫瘍、例えば腺腫;甲状腺腫瘍、例えば濾胞性腺腫;副甲状腺腫瘍、例えば腺腫;胸腺腫瘍、例えば胸腺腫;唾液腺腫瘍、例えば多形性腺腫;小腸腫瘍、例えば繊毛腺腫;結腸腫瘍、例えば腺管繊毛腺腫、結腸の腺腫性ポリープおよび大腸腺腫症、膵臓腫瘍、例えば漿液嚢胞腺腫;膵島腫瘍、例えば膵島細胞腫;上咽頭腫瘍(nasopharyngyl tumors)、例えば鼻血管線維腫;卵巣腫瘍、例えば異型増殖性粘液腫瘍、卵巣のブレンナー腫瘍、粘液嚢胞腺腫、乳頭状嚢胞腺腫、卵巣の皮様嚢腫、卵巣奇形腫、卵巣線維腫、黄体腫および卵巣甲状腺腫;子宮腫瘍、例えば子宮細胞平滑筋腫および平滑筋腫;胎盤腫瘍、例えば繊毛血管腫、部分胞状奇胎、全胞状奇胎;骨腫瘍、例えば海綿状血管腫および巨細胞腫;軟組織腫瘍、例えば海綿状血管腫、デスモイド腫瘍、脂肪腫、骨髄脂肪腫および骨軟骨腫;関節腫瘍、例えば滑膜軟骨腫;肺腫瘍、例えばカルチノイド腫、顆粒細胞腫瘍および血管腫;心筋腫瘍、例えば心房粘液腫;乳房腫瘍、例えば線維腺腫、乳管内乳腺腫および神経鞘腫;腎臓腫瘍、例えば先天性中胚葉性腎腫;皮膚腫瘍、例えば巨大先天性真皮内母斑が挙げられる。
より具体的には本明細書での腫瘍は、良性(癌性でない)または悪性腫瘍のいずれかを指す。
悪性腫瘍
悪性腫瘍の例は、非限定的に、乳癌:
1.胸管癌:A1.非浸潤性乳管癌(DCIS):面皰癌、篩状型、乳頭型、微小乳頭型;A2.浸潤性乳管癌(IDC):管状癌、粘液(コロイド)癌、髄様癌、乳頭癌、化生癌、炎症性癌;
2.小葉癌:B1.非浸潤性小葉癌(LCIS);B2.浸潤性小葉癌;
3.乳首のパジェット病。
子宮頸:子宮頸部上皮内新生物 I期、子宮頸部上皮内新生物 II期、子宮頸部上皮内新生物 III期(非浸潤性扁平上皮癌)、角化型扁平上皮癌、非角化型扁平上皮癌、いぼ状癌、非浸潤性腺癌、子宮頸管型非浸潤性腺癌、類内膜腺癌、明細胞腺癌、腺扁平上皮癌、腺様嚢胞癌、小細胞癌、未分化癌。
膣:扁平細胞癌、腺癌。
男性の生殖器系
陰茎:扁平上皮癌。
精巣:セミノーマ腫瘍、非セミノーマ腫瘍、奇形腫、胎児性癌、黄体嚢腫瘍、繊毛癌。
心臓:肉腫(血管肉腫、線維肉腫、横紋筋肉腫、脂肪肉腫)、粘液腫、横紋筋腫、線維腫、脂肪腫および奇形腫。
喉頭:扁平上皮癌。
胸膜中皮腫:原発性胸膜中皮腫。
肺
1.扁平上皮癌(類上皮癌)、亜分類:紡錘細胞;
2.小細胞癌、中間細胞型他細胞癌、混合型燕麦細胞癌;
3.腺腫:腺房腺癌、乳頭状腺癌、細気管支肺胞癌、粘膜形成を伴う固形癌;
4.大細胞癌:巨細胞癌、明細胞癌、肉腫。
ファーター膨大部:原発性腺癌、カルチノド腫瘍、リンパ腫。
肛門管:腺腫、扁平上皮癌、メラノーマ。
胆嚢:腺癌、腸型腺癌、腺扁平上皮癌、非浸潤性癌、癌NOS、明細胞腺癌、粘液腺癌、乳頭状腺癌、印環細胞癌、小細胞(燕麦細胞)癌、扁平上皮癌、未分化癌。
肝臓:ヘパトーマ(肝細胞癌)、胆管癌、肝芽腫、血管肉腫、肝細胞腺腫、血管腫。
膵外分泌部:導管細胞癌、多形性巨細胞癌、類破骨細胞型巨細胞癌、腺癌、腺扁平上皮癌、粘液(コロイド性)癌、嚢胞腺癌、腺房細胞癌、乳頭癌、混合型小細胞(麦芽細胞)癌、癌NOS、未分化癌、ランゲルハンス島に生じた内分泌細胞腫瘍、カルチノイド。
胃:腺癌、乳頭状腺癌、管状腺癌、粘液腺癌、印環細胞癌、腺扁平上皮癌、扁平上皮癌、小細胞癌、未分化癌、リンパ腫、肉腫、カルチノイド腫瘍。
泌尿器系
腎臓:腎細胞癌、ベリニ管の癌、乳頭状腺癌、管状癌、顆粒細胞癌、明細胞癌(副腎腫)、腎臓の肉腫、腎芽腫。
尿管:移行細胞癌、扁平上皮癌、腺癌。
膀胱:非浸潤性癌、移行尿路上皮癌、乳頭状移行細胞癌、扁平上皮癌、未分化型腺癌。
骨:A.骨形成:骨肉腫、B.軟骨形成:軟骨肉腫、間葉性軟骨肉腫、C.悪性巨細胞腫瘍、D.ユーイング肉腫、E.血管腫:血管上皮腫、血管周囲細胞腫、血管肉腫、F.結合組織腫:線維肉腫、脂質肉腫、悪性間葉細胞腫、未分化肉腫;G.その他の腫瘍:脊索腫、長骨のエナメル上皮腫。
甲状腺:乳頭癌(濾胞性病巣を伴うものなど)、濾胞癌、髄様癌、未分化(退形成)癌、神経芽腫:交感神経芽細胞腫、交感神経産生細胞腫、悪性神経節神経腫、神経節交感神経芽細胞腫、神経節神経腫。
扁平上皮癌、扁平上皮癌の紡錘細胞亜種、基底細胞腫、汗腺または皮脂腺から発症した腺癌、悪性メラノーマ。
結膜:結膜の癌。
眼瞼:基底細胞癌、扁平上皮癌、皮脂腺細胞癌。
眼瞼:眼瞼のメラノーマ。
ぶどう膜:紡錘細胞メラノーマ、混合細胞メラノーマ、類上皮細胞メラノーマ。
網膜芽細胞腫:網膜芽細胞腫。
非腫瘍性過剰増殖疾患の例としては、非限定的に、骨髄異形成疾患:非浸潤性子宮頸癌、家族性腸ポリープ、例えばガードナー症候群;口腔白板症;組織球増殖症;ケロイド;血管腫、炎症性関節炎;多角化症および関節炎を含む丘疹落屑性皮疹が挙げられる。同じく、ウイルス誘発性過剰増殖性疾患、例えばいぼおよびEBV誘発疾患(即ち、伝染性単核症)、瘢痕形成、血管増殖性疾患、例えば再狭窄、アテローム性硬化症、ステント内狭窄、移植血管再狭窄など;線維化疾患;乾癬;糸球体腎炎、黄斑変性疾患;良性増殖性疾患、例えば前立腺肥大および脂肪腫;自己免疫性疾患などが挙げられる。
本発明の組成物は、非限定的に輪状裂(annular−fissures)、髄核のフラグメンテーション(fragmentation)、内包性ヘルニア、椎間板ヘルニア、椎間板変性など、椎間板の欠損または障害の治療に投与することもできる。
その他の実施形態
本明細書に開示された特徴は全て、いずれの組合せで行ってもよい。本明細書に開示された各特徴を、同様の、同等の、または類似の目的を提供する別の特徴に置換してもよい。つまり他に断りがなければ、開示された各特徴は、同等または類似の特徴の一般例に過ぎない。上記記載から当業者は、本発明の本質的な特徴を容易に確認でき、その精神および範囲から逸脱することなく、本発明の様々な変更および改良を施して、それを様々な使用および条件に適用させることができる。つまりその他の実施形態も、以下の特許請求の範囲に含まれる。
Claims (6)
- 過剰増殖性疾患を治療するための組成物であって、前記組成物は、
(i)第1の薬剤として、アスピリン、又はセレコキシブと、
(ii)第2の薬剤として、塩酸メトホルミンと、
(iii)第3の薬剤として、セロトニン・クレアチニン硫酸複合体と、
を含む、組成物。 - 前記組成物は、1−5000mgの第1の薬剤と、5−5000mgの第2の薬剤と、0.1−1000mgの第3の薬剤と、を含む、請求項1に記載の組成物。
- 前記組成物は、1−3000mgの第1の薬剤と、5−1500mgの第2の薬剤と、0.1−500mgの第3の薬剤と、を含む、請求項1に記載の組成物。
- 前記組成物は、1−1000mgの第1の薬剤と、5−1000mgの第2の薬剤と、0.1−100mgの第3の薬剤と、を含む、請求項1に記載の組成物。
- 前記組成物は薬学的に許容される担体を更に含む、請求項1乃至4のいずれか一項に記載の組成物。
- 前記組成物は、同組成物を目的の作用部位へ送達するのに有用な担体物質を更に含む、請求項1乃至5のいずれか一項に記載の組成物。
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