JP5745678B2 - Pi3k阻害剤とmek阻害剤の併用 - Google Patents
Pi3k阻害剤とmek阻害剤の併用 Download PDFInfo
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- JP5745678B2 JP5745678B2 JP2014202819A JP2014202819A JP5745678B2 JP 5745678 B2 JP5745678 B2 JP 5745678B2 JP 2014202819 A JP2014202819 A JP 2014202819A JP 2014202819 A JP2014202819 A JP 2014202819A JP 5745678 B2 JP5745678 B2 JP 5745678B2
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- Heterocyclic Carbon Compounds Containing A Hetero Ring Having Oxygen Or Sulfur (AREA)
Description
相乗作用を計算するChou及びTalalay(1984)法を利用するプログラムであるCalcusynを使用して、併用指数を計算し、よって相乗作用のレベルを決定した(図1)。≦0.3の併用指数値によって示される強い相乗作用が、大半のメラノーマ細胞株(その内の約60%がBRAFに発癌性変異を有する)において観察された。≦0.7の併用指数値によって示される相乗作用、又は強い相乗作用が、一つを除く全てのNSCLC細胞株(その内の約半分がKRASに発癌性変異を有する)において観察された。
これらのモデルの双方は単剤としてのGDC−0973又はGDC−0941に対して中程度の感受性を示す;しかし、何れの単独の薬剤にも優れた感受性を有しておらず、腫瘍成長の遅延を生じるが、静止又は退縮を生じない。従って、MEK及びPI3Kの双方に対する経路活性は各モデルにおいて明らかであり、これらの関連モデルを作製してMEK及びPI3K阻害剤の組み合わせを試験する。NCI−H2122腫瘍を有する動物をGDC−0973(5mg/kg、一日)、GDC−0941(50mg/kg、一日)又は組み合わせで治療した。NCI−H2122腫瘍は単剤GDC−0973に対して感受性を示し、5mg/kg QDアームで57%の腫瘍増殖阻害(ビヒクルコントロールに対するTGI)であった(図2)。同様に、NCI−H2122腫瘍はまた単剤GDC−0941に感受性であり、30mg/kgアームで73%のTGIであった(図2)。GDC−0973及びGDC−0941の組合せは、双方の用量レベルで何れの単剤に対しても顕著な効果の改善を示し、98%のTGI、又は腫瘍静止を生じた(図2)。二つの薬剤の組み合わせに対して中程度の用量のGDC−0973又はGDC−0941を比較するスチューデントt検定は、抗腫瘍効果が統計的に有意であったことを明らかにしている(21日目にそれぞれスチューデントt検定p=0.032、p=0.046;図2)。GDC−0973及びGDC−0941は、単独で、及び併用で投与されたとき、1日10mg/kgのGDC−0973と1日100mg/kgのGDC−0941の高用量においてさえ十分に耐容性を示した(データは示さず)。これらのデータは、GDC−0973及びGDC−0941が組み合わせて使用される場合、NCI−H2122 NSCLC異種移植モデルにおける腫瘍成長に有意な影響を有していることを示している。
NCI−H2122と同様に、A2058腫瘍は単剤GDC−0973に対して中程度の感受性を示し、6mg/kgで41%、10mg/kgで62%のTGIであった(それぞれ図3A及びB)。同様に、A2058腫瘍は単剤 GDC−0941に対してまた中程度の感受性であり、30mg/kgで18%、100mg/kgで56%のTGIであった(それぞれ図3A及びB)。GDC−0973及びGDC−0941の併用は何れの単剤に対しても顕著な効果の改善を生じ、低用量で69%のTGI、高用量で90%のTGIの改善を生じ、腫瘍静止に近づいている(ぞれぞれ図3A及びB)。二つの薬剤の組み合わせに対して中程度の用量のGDC−0973又はGDC−0941を比較するスチューデントt検定は、抗腫瘍効果が統計的に有意であったことを明らかにしている(17日目にそれぞれp=0.048、p=0.008)。同様に、組み合わせに対して高用量のGDC−0973又はGDC−0941の比較は有意差を明らかにした(17日目にそれぞれp=0.001、p=0.004のスチューデントt検定)。GDC−0973及びGDC−0941の組合せはマウスに対して如何なる明らかな副作用も生じなかった。
FaDu腫瘍は、41%の腫瘍増殖阻害パーセント(%TGI)で1日5mg/kgのGDC−0973に対して中程度の感受性を示す(図4A)。同様に、FaDu腫瘍は、33%の%TGIで100mg/kgのGDC−0941に対して中程度の応答性を示す(図4A)。これらの同じ用量のGDC−0973及びGDC−0941の組合せは何れかの単剤に対して顕著な効果の改善を生じ、96%TGIまでの%TGIの改善を生じる(図4A)。改善された併用の効果は単剤GDC−0973及びGDC−0941に対して統計的に有意であった(18日目にそれぞれp=0.0281及びp=0.0034)。
SKOV−3腫瘍は、51%の%TGIで100mg/kgのGDC−0941に対して中程度の応答を示す(図4B)。これらの同じ用量のGDC−0973及びGDC−0941の組合せは何れかの単剤に対して顕著な効果の改善を生じ、91%TGIまでの%TGIの改善を生じる(図4B)。改善された併用の効果は単剤GDC−0973及びGDC−0941に対して統計的に有意であった(22日目にそれぞれp=0.0017及びp=0.0283)。
MOLM−16腫瘍は、57%の腫瘍増殖阻害パーセント(%TGI)で10mg/kgの単剤GDC−0973に対して感受性を示す(図5)。同様に、MOLM−16腫瘍は、40%の%TGIで100mg/kgのGDC−0973に対して中程度の応答を示す(図5)。これらの同じ用量のGDC−0973及びGDC−0941の組合せは何れかの単剤に対して顕著な効果の改善を生じ、96%TGIまでの%TGIの改善を生じる(図5)。改善された併用の効果は単剤GDC−0973及びGDC−0941に対して統計的に有意であった(11日目にそれぞれp=0.0381及びp=0.0158)。
この研究では、RAS/RAF野生型、変異、又は未知である局所進行又は転移性固形腫瘍の患者において、組み合わせて投与されるGDC−0973(5mg又は25mgカプセル)及びGDC−0941(15mg又は50mgカプセル)の毎日の経口投与を21日間、続いて研究薬剤なしの7日が続く。アーカイブ腫瘍標本が全ての患者から得られ、BRAF、NRAS又はKRAS変異状態及びPI3K変異/PI3K増幅/PTENタンパク質状態が確認又は決定される。全ての患者はPDバイオマーカー及び抗腫瘍活性の潜在的な初期の読み取りとして連続的FDG−PET画像診断を受ける。治療は、1年間まで、又は疾患進行、許容できない毒性又は任意の他の中断基準を満たすまで継続する。同時のGDC−0973及びGDC−0941投与は、図6a及び6bの次の投薬スキームの一つに従って28日サイクルの連続21日の間、QD(1日1回)である。交互投薬レジメン及びスケジュールは、GDC−0973及びGDC−0941双方で14日と続いて14日GDC−0973及びGDC−0941双方を止め又は間欠投与スケジュール(例えばQ2D(2日毎)及びQ4D(4日毎)でありうる。表1−A及び1−Bは、GDC−0973及びGDC−0941の同時の経口投与に対する別の治療スケジュールを示す。
Claims (5)
- 上記式(I)の化合物と上記式(III)の化合物とを含む、請求項1に記載の組成物。
- 上記式(I)の化合物を80mg、100mg、130mg又は180mg含み、上記式(III)の化合物を20mg、40mg、又は60mg含む、請求項1又は2に記載の組成物。
- 上記患者に連続21日間投与され、次の7日間は投与されない28日サイクルで投与される請求項1から3の何れか一項に記載の組成物。
- 上記患者に連続14日間投与され、次の14日間は投与されない28日サイクルで投与される請求項1から3の何れか一項に記載の組成物。
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ES2609767T3 (es) | 2017-04-24 |
MA33974B1 (fr) | 2013-02-01 |
US20110086837A1 (en) | 2011-04-14 |
BR112012008483A2 (pt) | 2019-09-24 |
JP2015038110A (ja) | 2015-02-26 |
PE20121816A1 (es) | 2013-01-02 |
WO2011054620A1 (en) | 2011-05-12 |
RU2012118974A (ru) | 2013-11-20 |
CN102740851B (zh) | 2013-12-18 |
CN102740851A (zh) | 2012-10-17 |
NZ599939A (en) | 2014-02-28 |
KR101489045B1 (ko) | 2015-02-02 |
CO6531463A2 (es) | 2012-09-28 |
CL2012000913A1 (es) | 2012-09-14 |
AU2010314287A1 (en) | 2012-05-03 |
EP2488178B1 (en) | 2016-11-16 |
AR078588A1 (es) | 2011-11-16 |
MX345155B (es) | 2017-01-18 |
KR20120064132A (ko) | 2012-06-18 |
ZA201202618B (en) | 2014-10-29 |
AU2010314287A2 (en) | 2012-07-12 |
CA2776944A1 (en) | 2011-05-12 |
EP2488178A1 (en) | 2012-08-22 |
CR20120173A (es) | 2012-07-04 |
IL219105A0 (en) | 2012-06-28 |
TWI428336B (zh) | 2014-03-01 |
TW201118082A (en) | 2011-06-01 |
HK1175125A1 (en) | 2013-06-28 |
MX2012004286A (es) | 2012-05-22 |
RU2563193C2 (ru) | 2015-09-20 |
JP2013507415A (ja) | 2013-03-04 |
ECSP12011865A (es) | 2012-06-29 |
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