JP7469297B2 - チオフェン誘導体 - Google Patents
チオフェン誘導体 Download PDFInfo
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- JP7469297B2 JP7469297B2 JP2021514478A JP2021514478A JP7469297B2 JP 7469297 B2 JP7469297 B2 JP 7469297B2 JP 2021514478 A JP2021514478 A JP 2021514478A JP 2021514478 A JP2021514478 A JP 2021514478A JP 7469297 B2 JP7469297 B2 JP 7469297B2
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- 238000002360 preparation method Methods 0.000 claims description 13
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- 125000001997 phenyl group Chemical group [H]C1=C([H])C([H])=C(*)C([H])=C1[H] 0.000 claims description 12
- 125000000217 alkyl group Chemical group 0.000 claims description 11
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- PMZURENOXWZQFD-UHFFFAOYSA-L Sodium Sulfate Chemical compound [Na+].[Na+].[O-]S([O-])(=O)=O PMZURENOXWZQFD-UHFFFAOYSA-L 0.000 description 24
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- XDCZQCCYSWADBA-UHFFFAOYSA-N 3-(2,5-dichlorothiophen-3-yl)propanoyl chloride Chemical compound ClC=1SC(=CC=1CCC(=O)Cl)Cl XDCZQCCYSWADBA-UHFFFAOYSA-N 0.000 description 6
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- C07D333/50—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom condensed with carbocyclic rings or ring systems
- C07D333/78—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom condensed with carbocyclic rings or ring systems condensed with rings other than six-membered or with ring systems containing such rings
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- A61K31/33—Heterocyclic compounds
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
- A61K31/4025—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil not condensed and containing further heterocyclic rings, e.g. cromakalim
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- A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
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- A61K31/4427—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
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- C07D—HETEROCYCLIC COMPOUNDS
- C07D333/00—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07D—HETEROCYCLIC COMPOUNDS
- C07D409/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07D—HETEROCYCLIC COMPOUNDS
- C07D495/00—Heterocyclic compounds containing in the condensed system at least one hetero ring having sulfur atoms as the only ring hetero atoms
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Description
本発明は、貴重な特性を有する新規化合物、とりわけ医薬の調製のために使用され得るものを見出す目的を有した。
本発明は、HIF-2α(低酸素誘導性因子)を阻害するチオフェン誘導体に関する。したがって、本発明の化合物は、がんなどの疾患を処置することにおいて有用である。
本発明はまた、これらの化合物を調製するための方法、これらの化合物を含む医薬組成物、およびこれらの化合物を含む医薬組成物を利用して疾患を処置する方法を提供する。
HIF-2αタンパク質は、膀胱、乳房、結腸、肝臓、卵巣、膵臓、前立腺、および腎臓の様々なヒトの腫瘍、ならびに腫瘍関連マクロファージにおいて検知されてきた。
本発明に従う化合物およびその塩は、十分な忍容性が認められながら、極めて貴重な薬理学的な特性を有することが見出された。
がんの処置についての他のHIF-2αインヒビターは、WO 2018/031680 A1、WO 2015/035223 A1、WO 2016/145045 A1、WO 2016/145032 A1、WO 2016/144825 A1、WO 2016/144826 A1およびWO 2016/168510 A1に記載されている。
HIF-2αを標的とするアプローチに関するレビューは、S.E. Wilkins ChemMedChem, 2016, 11, 773-786によって記載されている。
本発明は、式I、
式中
R1は、A、Ar、Cyc、Het、COAまたはCNを示し、
R2は、SO2A、SOA、SA、SO2NHA、SO2NA2、S(=NH,=O)A、S(=NH)2A、NO2、Hal、CN、A、Het1、COOHまたはCOOAを示し、
R3は、HまたはHalを示し、
R4は、HまたはHalを示し、
Cycは、3、4、5、6または7個のC原子を有する環状アルキル、
Arは、フェニルを示し、それは、非置換であるか、またはHal、A、[C(R5)2]pOR5、O[C(R5)2]pOR5、[C(R5)2]pN(R5)2、O[C(R5)2]pN(R5)2、[C(R5)2]pHet1、NO2、CN、[C(R5)2]pCOOR5、O[C(R5)2]pCOOR5、CON(R5)2、NR5COA、NR5SO2A、SO2N(R5)2、S(O)2A、COHet1、O[C(R5)2]pHet1、NHCOOA、NHCON(R5)2、NHCOO[C(R5)2]mN(R5)2、NHCOO[C(R5)2]pHet1、NHCONH[C(R5)2]mN(R5)2、NHCONH[C(R5)2]pHet1、OCONH[C(R5)2]mN(R5)2、OCONH[C(R5)2]pHet1、S(O)2Het1、および/もしくはCOAによって単置換、二置換、もしくは三置換されており、
Het1は、1~4個のN、Oおよび/またはS原子を有する単環式または二環式の芳香族、不飽和または飽和ヘテロ環を示し、それは、非置換であるか、またはHal、A、COOA、NH2、NHAおよび/もしくはNA2によって単置換、二置換、もしくは三置換されていてもよく、
R5は、Hまたは1、2、3もしくは4個のC原子を有するアルキルを示し、
Halは、F、Cl、BrまたはIを示し、
nは、1、2または3を示し、
mは、1、2または3を示し、
pは、0、1、2、3または4を示す、
で表される化合物、およびその薬学的に許容し得る塩、互変異性体および立体異性体、ならびにあらゆる比率におけるそれらの混合物に関する。
その上、本発明は、式Iで表される化合物の薬学的に許容し得る誘導体に関する。
本発明はまた、塩の溶媒和物にも関すると理解される。
本明細書に使用されるとき、および他に指し示されない限り、用語「プロドラッグ」は、活性化合物、具体的に式Iで表される化合物を提供するために、加水分解、酸化、またはそうでなければ生物学的条件下(in vitroもしくはin vivo)で反応することができる、式Iで表される化合物の誘導体を意味する。プロドラッグの例は、これらに限定されないが、生物加水分解性アミド、生物加水分解性エステル、生物加水分解性カルバマート、生物加水分解性カーボナート、生物加水分解性ウレイド、および生物加水分解性ホスファート類似体などの生物加水分解性部分を包含する式Iで表される化合物の誘導体および代謝体を包含する。
加えて、「治療的に有効な量」という表現は、この量を投与されていない対応する対象と比較して、以下の結果:
疾患、症候群、状態、愁訴、障害もしくは副作用の、改善された処置、治癒、予防もしくは解消、またはまた、疾患、愁訴もしくは障害の進行の低減
を有する量を示す。
「治療的に有効な量」という表現はまた、正常な生理学的機能を増加させるために有効である量も網羅する。
これらは、具体的に好ましくは、立体異性の化合物の混合物である。
「互変異性体」は、互いに平衡にある化合物の異性体の形態を指す。異性体の形態の濃度は、化合物が見出される環境に依存し、および例えば、化合物が固体であるか、または有機溶液中もしくは水性溶液中にあるかに依存して異なってもよい。
式II
式中R2、R3、R4およびnは、請求項1に指し示された意味を有し、およびXは、F、Cl、BrまたはIである、
で表される化合物と、式III
L-R1 III
式中R1は、請求項1に指し示された意味を有し、
およびLは、H、ボロン酸またはボロン酸エステル基を示す、
で表される化合物とを反応させること、または
式IV
式中R1、R2、R3、R4およびnは、請求項1に指し示された意味を有する、
で表される化合物と、NaBH4とを反応させること、および/あるいは
式Iの塩基または酸を、その塩の1種に変換させること、
を特徴とする、前記プロセスに関する。
Aは、アルキルを示し、これは、非分枝(線状)または分枝であり、および1、2、3、4、5、6、7または8個のC原子を有する。Aは、好ましくは、メチル、エチル、プロピル、イソプロピル、ブチル、イソブチル、sec-ブチルまたはtert-ブチル、また、さらにまた、ペンチル、1-、2-または3-メチルブチル、1,1-、1,2-または2,2-ジメチルプロピル、1-エチルプロピル、ヘキシル、1-、2-、3-または4-メチルペンチル、1,1-、1,2-、1,3-、2,2-、2,3-または3,3-ジメチルブチル、1-または2-エチルブチル、1-エチル-1-メチルプロピル、1-エチル-2-メチルプロピル、1,1,2-または1,2,2-トリメチルプロピル、さらにより好ましくは、例えば、トリフルオロメチルを示す。
その上、Aは、好ましくは、CH2OCH3、CH2CH2OHまたはCH2CH2OCH3を示す。
その上、Aは、好ましくは、1~6個のC原子を有する非分枝または分枝のアルキルを示し、ここで、1~5個のH原子は、OHおよび/またはFによって置き換えられていてもよい。
R2は、好ましくは、SO2Aを示し、最も好ましくは、SO2CH3を示す。
R3は、好ましくは、HまたはFを示す。
R4は、好ましくは、HまたはFを示す。
Cycは、シクロプロリル(cycloprolyl)、シクロブチル、シクロペンチル、シクロヘキシルまたはシクロへプチルを示す。
ヘテロ環のラジカルはまた、部分的または全体的に水素化されていてもよい。
ヘテロ環のラジカルはまた、部分的または全体的に水素化されていてもよい。
Hetは、具体的に好ましくは、ピロリル、ピラゾリル、イミダゾリル、ピリジニルまたはピリミジニルを示し、その各々は、非置換であるか、またはHal、Aおよび/もしくはCNによって単置換、二置換、もしくは三置換されていてもよい。
具体的に好ましい式Iで表される化合物は、以下である。
式Iで表される化合物は、1以上のキラル中心を有してもよく、およびしたがって、様々な立体異性体の形態で出現し得る。式Iは、すべてのこれらの形態を網羅する。
laにおいて、R1は、ArまたはHetを示し;
lbにおいて、R2は、SO2Aを示し;
leにおいて、R3は、HまたはFを示し、
R4は、HまたはFを示し;
lgにおいて、Arは、フェニルを示し、それは、非置換であるか、またはHalおよび/もしくはCNによって単置換、二置換、もしくは三置換されており;
lhにおいて、Hetは、1~4個のN、Oおよび/またはS原子を有する単環式の芳香族ヘテロ環を示し、それは、非置換であるか、またはHal、A、CN、OHおよび/もしくはOAによって単置換、二置換、もしくは三置換されていてもよく;
liにおいて、Hetは、ピロリル、ピラゾリル、イミダゾリル、ピリジニルまたはピリミジニルを示し、その各々は、非置換であるか、またはHal、OH、OA、Aおよび/もしくはCNによって単置換、二置換、もしくは三置換されていてもよく;
R2は、SO2Aを示し、
R3は、HまたはHalを示し、
R4は、HまたはHalを示し、
Aは、1~6個のC原子を有する非分枝または分枝のアルキルを示し、ここで、1~5個のH原子は、OHおよび/またはFによって置き換えられていてもよく、
Arは、フェニルを示し、それは、非置換であるか、またはHalおよび/もしくはCNによって単置換、二置換、もしくは三置換されており、
Hetは、1~4個のN、Oおよび/またはS原子を有する単環式の芳香族ヘテロ環を示し、それは、非置換であるか、またはHal、A、CN、OHおよび/もしくはOAによって単置換、二置換、もしくは三置換されていてもよく、
Halは、F、Cl、BrまたはIを示し、
nは、1、2または3を示す;
およびその薬学的に許容し得る塩、互変異性体および立体異性体、ならびにあらゆる比率におけるそれらの混合物。
式IIおよびIIIで表される出発化合物は、一般に公知である。しかしながら、それらが新規である場合、それらはそれ自体公知の方法によって調製され得る。
式Iで表される化合物は、好ましくは、式IIで表される化合物と式IIIで表される化合物とを反応させることによって得られ得る。
式IIIで表される化合物において、Lは、好ましくはH、
を示す。
本発明に従う該化合物は、それらの最終的な非塩形態において使用され得る。他方、本発明はまた、これらの化合物の、当該技術分野における公知の手順によって様々な有機酸および無機酸ならびに塩基から導き出され得る、それらの薬学的に許容し得る塩の形態における使用を網羅する。式Iで表される化合物の薬学的に許容し得る塩形態は、大部分は、従来の方法によって調製される。式Iで表される化合物がカルボキシル基を含有する場合、その好適な塩の1種は、化合物と好適な塩基とを反応させて、対応する塩基付加塩を与えることによって形成され得る。かかる塩基は、例えば、水酸化カリウム、水酸化ナトリウムおよび水酸化リチウムを包含するアルカリ金属水酸化物;水酸化バリウムおよび水酸化カルシウムなどのアルカリ土類金属水酸化物;例えば、カリウムエトキシドおよびナトリウムプロポキシドのアルカリ金属アルコキシド;ならびに、ピペリジン、ジエタノールアミンおよびN-メチルグルタミンなどの様々な有機塩基である。式Iで表される化合物のアルミニウム塩も同じく包含される。
具体的に好ましいのは、塩酸塩、二塩酸塩、臭化水素酸塩、マレイン酸塩、メシル酸塩、リン酸塩、硫酸塩およびコハク酸塩である。
式Iで表される化合物がその同位体標識された形態を包含することが、さらにまた意図される。式Iで表される化合物の同位体標識された形態は、化合物の1以上の原子が通常天然に存在する原子質量または質量数とは異なる原子質量または質量数を有する原子(単数)または原子(複数)によって置き換えられているという事実は別として、この化合物と同一である。容易に商業的に入手可能であり、および周知の方法によって式Iで表される化合物中へ組み込まれ得る同位体の例は、水素、炭素、窒素、酸素、リン、フッ素および塩素の同位体、例えば、夫々、2H、3H、13C、14C、15N、18O、17O、31P、32P、35S、18Fおよび36CIを包含する。上述の同位体および/または他の原子の他の同位体の1以上を含有する式Iで表される化合物またはその薬学的に許容し得る塩は、本発明の一部であることが意図される。
式Iで表される化合物、およびその薬学的塩、互変異性体および立体異性体はまた、リポソーム送達系、例えば、小さな単層ベシクル、大きな単層ベシクル、および多重膜ベシクルなどの形態で投与され得る。リポソームは、様々なリン脂質、例えばコレステロール、ステアリルアミンまたはホスファチジルコリンなどから形成され得る。
局所投与に適合した医薬化合物は、軟膏、クリーム、懸濁液、ローション、粉末、溶液、ペースト、ゲル、スプレー、エアロゾルまたは油として処方され得る。
目への局所適用に適合した医薬製剤は、点眼剤を包含し、ここで活性成分は、好適な担体、とりわけ水性溶媒中に溶解されるか、または懸濁される。
口における局所適用に適合した医薬製剤は、薬用キャンディー、トローチおよび洗口剤を網羅する。
直腸投与に適合した医薬製剤は、坐薬または浣腸剤の形態で投与され得る。
膣内投与に適合した医薬製剤は、膣坐薬、タンポン、クリーム、ゲル、ペースト、泡体またはスプレー製剤として投与され得る。
(a)有効量の、式Iで表される化合物、および/またはその薬学的に許容し得る塩、互変異性体および立体異性体、ならびにあらゆる比率におけるそれらの混合物、ならびに
(b)有効量のさらなる医薬活性成分
の個別のパックからなるセット(キット)にも関する。
ならびに、有効量の溶解形態または凍結乾燥形態でのさらなる医薬活性成分
を含有する個別のアンプルを含んでもよい。
本化合物は、がんの処置における、哺乳動物のための、とくにヒトのための医薬活性成分として好適である。
本発明は、式Iで表される化合物、および/またはその薬学的に許容し得る塩、互変異性体および立体異性体の、がんの処置または予防のための医薬の調製のための使用を網羅する。
その上、本発明は、がんの処置または予防のための使用のための、式Iで表される化合物、および/またはその薬学的に許容し得る塩、互変異性体および立体異性体を網羅する。
本発明は、具体的に言うと、HIF-2αの阻害のための使用のための、式Iで表される化合物、およびその薬学的に許容し得る塩、互変異性体および立体異性体、ならびにあらゆる比率におけるそれらの混合物に関する。
その上、本発明は、フォンヒッペル・リンダウ(VHL)疾患の処置または予防のための使用のための、式Iで表される化合物、および/またはその薬学的に許容し得る塩、互変異性体および立体異性体を網羅する。
その上、本発明は、心血管疾患の処置または予防のための使用のための、式Iで表される化合物、および/またはその薬学的に許容し得る塩、互変異性体および立体異性体を網羅する。
具体的に好ましい本発明は、疾患ががんである方法に関し、ここで、投与は少なくとも1種の他の活性薬剤の投与と同時、逐次的、または交互である。
開示された式Iで表される化合物は、抗がん剤を包含する他の公知の治療剤と組み合わせて投与され得る。本明細書で使用されるとき、用語「抗がん剤」は、がんを処置する目的でがんを患う患者に投与される任意の剤に関する。
上記に定義された抗がん処置は、単剤治療として適用されてもよく、または本明細書に開示された式Iで表される化合物に加えて、従来の外科手術もしくは放射線治療もしくは薬物治療を含んでもよい。かかる薬物治療、例として化学治療または標的治療は、1以上の、好ましくは1の以下の抗腫瘍剤を包含してもよい。
アルトレタミン、ベンダムスチン、ブスルファン、カルムスチン、クロラムブシル、クロルメチン、シクロホスファミド、ダカルバジン、イホスファミド、インプロスルファン、トシラート、ロムスチン、メルファラン、ミトブロニトール、ミトラクトール、ニムスチン、ラニムスチン、テモゾロミド、チオテパ、トレオスルファン、メクロレタミン、カルボコン;
アパジコン、ホテムスチン、グルホスファミド、パリホスファミド、ピポブロマン、トロホスファミド、ウラムスチン、TH-3024、VAL-0834など;
カルボプラチン、シスプラチン、エプタプラチン、ミリプラチン水和物、オキサリプラチン、ロバプラチン、ネダプラチン、ピコプラチン、サトラプラチン;
ロバプラチン、ネダプラチン、ピコプラチン、サトラプラチンなど;
アムルビシン、ビサントレン、デシタビン、ミトキサントロン、プロカルバジン、トラベクテジン、クロファラビン;
アムサクリン、ブロスタリシン、ピクサントロン、ラロムスチン1、3など;
エトポシド、イリノテカン、ラゾキサン、ソブゾキサン、テニポシド、トポテカン;
アモナフィド、ベロテカン、エリプチニウムアセタート、ボレロキシンなど;
カバジタキセル、ドセタキセル、エリブリン、イクサベピロン、パクリタキセル、ビンブラスチン、ビンクリスチン、ビノレルビン、ビンデシン、ビンフルニン;
フォスブレタブリン、テセタキセルなど;
アスパラギナーゼ3、アザシチジン、レボホリナートカルシウム、カペシタビン、クラドリビン、シタラビン、エノシタビン、フロクスウリジン、フルダラビン、フルオロウラシル、ゲムシタビン、メルカプトプリン、メトトレキサート、ネララビン、ペメトレキセド、プララトレキサート、アザチオプリン、チオグアニン、カルモフール;
ドキシフルリジン、エラシタラビン、ラルチトレキセド、サパシタビン、テガフール2、3、トリメトレキサートなど;
ブレオマイシン、ダクチノマイシン、ドキソルビシン、エピルビシン、イダルビシン、レバミソール、ミルテホシン、マイトマイシンC、ロミデプシン、ストレプトゾシン、バルルビシン、ジノスタチン、ゾルビシン、ダウノルビシン、プリカマイシン;
アクラルビシン、ペプロマイシン、ピラルビシンなど;
アバレリックス、アビラテロン、ビカルタミド、ブセレリン、カルステロン、クロロトリアニセン、デガレリクス、デキサメタゾン、エストラジオール、フルオコルトロン、フルオキシメステロン、フルタミド、フルベストラント、ゴセレリン、ヒストレリン、リュープロレリン、メゲストロール、ミトタン、ナファレリン、ナンドロロン、ニルタミド、オクトレオチド、プレドニゾロン、ラロキシフェン、タモキシフェン、サイロトロピンアルファ、トレミフェン、トリロスタン、トリプトレリン、ジエチルスチルベストロール;
アコルビフェン、ダナゾール、デスロレリン、エピチオスタノール、オルテロネル、エンザルタミド1,3など;
アミノグルテチミド、アナストロゾール、エキセメスタン、ファドロゾール、レトロゾール、テストラクトン;
ホルメスタンなど;
クリゾチニブ、ダサチニブ、エルロチニブ、イマチニブ、ラパチニブ、ニロチニブ、パゾパニブ、レゴラフェニブ、ルキソリチニブ、ソラフェニブ、スニチニブ、バンデタニブ、ベムラフェニブ、ボスチニブ、ゲフィチニブ、アキシチニブ;
アファチニブ、アリサーチブ、ダブラフェニブ、ダコミチニブ、ジナシクリブ、ドビチニブ、エンザスタウリン、ニンテダニブ、レンバチニブ、リニファニブ、リンシチニブ、マシチニブ、ミドスタウリン、モテサニブ、ネラチニブ、オランチニブ、ペリフォシン、ポナチニブ、ラドチニブ、リゴセルチブ、ティピファニブ、チバンチニブ、チボザニブ、トラメチニブ、ピマセルチブ、ブリバニブアラニナート、セジラニブ、アパチニブ4、カボザンチニブS-マラート1,3、イブルチニブ1,3、イコチニブ4、ブパルリシブ2、シパチニブ4、コビメチニブ1,3、イデラリシブ1,3、フェドラチニブ1、XL-6474など;
メトキサレン3;
ポルフィマーナトリウム、タラポルフィン、テモポルフィンなど;
アレムツズマブ、ベシレソマブ、ブレンツキシマブベドチン、セツキシマブ、デノスマブ、イピリムマブ、オファツムマブ、パニツムマブ、リツキシマブ、トシツモマブ、トラスツズマブ、ベバシズマブ、ペルツズマブ2,3;
カツマキソマブ、エロツズマブ、エプラツズマブ、ファーレツズマブ、モガムリズマブ、ネシツムマブ、ニモツズマブ、オビヌツズマブ、オカラツズマブ、オレゴボマブ、ラムシルマブ、リロツムマブ、シルツキシマブ、トシリズマブ、ザルツムマブ、ザノリムマブ、マツズマブ、ダロツズマブ1,2,3、オナルツズマブ1,3、ラコツモマブ1、タバルマブ1,3、EMD-5257974、アベルマブ、ニボルマブ1,3など;
アルデスロイキン、インターフェロンアルファ2、インターフェロンアルファ2a3、インターフェロンアルファ2b2、3;
セルモロイキン、タソネルミン、テセロイキン、オプレルベキン1,3、組換えインターフェロンベータ-1a4など;
デニロイキンジフチトクス、イブリツモマブチウキセタン、イオベングアンI123、プレドニムスチン、トラスツズマブエムタンシン、エストラムスチン、ゲムツズマブ、オゾガマイシン、アフリベルセプト;
シトレデキンベスドトックス、エドトレオチド、イノツズマブオゾガマイシン、ナプツモマブエスタフェナトクス、オポルツズマブモナトックス、テクネチウム(99mTc)アルシツモマブ1,3、ビンタフォリド1,3など;
シプロイセル3;ビテスペン3、エメペピムト-S3、oncoVAX4、リンドペピムト3、troVax4、MGN-16014、MGN-17034など;
アリトレチノイン、ベキサロテン、ボルテゾミブ、エベロリムス、イバンドロン酸、イミキモド、レナリドミド、レンチナン、メチロシン、ミファムルチド、パミドロン酸、ペグアスパルガーゼ、ペントスタチン、シプロイセル3、シゾフィラン、タミバロテン、テムシロリムス、サリドマイド、トレチノイン、ビスモデギブ、ゾレドロン酸、ボリノスタット;セレコキシブ、シレンジチド、エンチノスタット、エタニダゾール、ガネテスピブ、イドロノキシル、イニパリブ、イキサゾミブ、ロニダミン、ニモラゾール、パノビノスタット、ペレチノイン、プリチデプシン、ポマリドミド、プロコダゾール、リダフォロリムス、タスキニモド、テロトリスタット、チマルファシン、チラパザミン、トセドスタット、トラベデルセン、ウベニメクス、バルスポダル、ゲンジシン4、ピシバニール4、レオリシン4、レタスピマイシン塩酸塩1、3、トレバナニブ2,3、ビルリジン4、カーフィルゾミブ1,3、エンドスタチン4、イムコテル4、ベリノスタット3、MGN-17034;
オラパリブ、ベリパリブ。
1Prop. INN(提唱された国際一般名(Proposed International Nonproprietary Name))
2Rec. INN(推奨された国際一般名(Recommended International Nonproprietary names))
3USAN(米国一般名(United States Adopted Name))
4INNなし。
aq(水性)、h(時間)、g(グラム)、L(リットル)、mg(ミリグラム)、MHz(メガヘルツ)、min(分)、mm(ミリメートル)、mmol(ミリモル)、mM(ミリモル)、m.p.(融点)、eq(当量)、mL(ミリリットル)、μL(マイクロリットル)、ACN(アセトニトリル)、AcOH(酢酸)、CDCl3(重水素化クロロホルム)、CD3OD(重水素化メタノール)、c-hex(シクロヘキサン)、DCC(ジシクロヘキシルカルボジイミド)、DCM(ジクロロメタン)、DIC(ジイソプロピルカルボジイミド)、DIEA(ジイソプロピルエチル-アミン)、DMF(ジメチルホルムアミド)、DMSO(ジメチルスルホキシド)、DMSO-d6(重水素化ジメチルスルホキシド)、EDC(1-(3-ジメチル-アミノ-プロピル)-3-エチルカルボジイミド)、ESI(エレクトロスプレーイオン化)、EtOAc(酢酸エチル)、Et2O(ジエチルエーテル)、EtOH(エタノール)、HATU(ジメチルアミノ-([1,2,3]トリアゾロ[4,5-b]ピリジン-3-イルオキシ)-メチレン]-ジメチル-アンモニウムヘキサフルオロホスファート)、HPLC(高速液体クロマトグラフィー)、i-PrOH(2-プロパノール)、K2CO3(炭酸カリウム)、LC(液体クロマトグラフィー)、MeOH(メタノール)、MgSO4(硫酸マグネシウム)、MS(質量分析)、MTBE(メチルtert-ブチルエーテル)、NaHCO3(重炭酸ナトリウム)、NaBH4(水素化ホウ素ナトリウム)、NMM(N-メチルモルホリン)、NMR(核磁気共鳴)、PE(石油エーテル)、PyBOP(ベンゾトリアゾール-1-イル-オキシ-トリス-ピロリジノ-ホスホニウムヘキサフルオロホスファート)、RT(室温)、Rt(保持時間)、SPE(固相抽出)、TBTU(2-(1-H-ベンゾトリアゾール-1-イル)-1,1,3,3-テトラメチルウロニウムテトラフルオロボラート)、TEA(トリエチルアミン)、TFA(トリフルオロ酢酸)、THF(テトラヒドロフラン)、TLC(薄層クロマトグラフィー)、UV(紫外線)、WL(波長)。
1H NMRは、内部標準としての重水素化された溶媒の残余シグナルを使用して、Bruker DPX-300、DRX-400、AVII-400上で、または500MHz分光計上で記録された。化学シフト(δ)は、残余溶媒シグナルと比べてのppmで報告される(DMSO-d6における1H NMRについてδ=2.49ppm)。1H NMRデータは、次のとおり報告される:化学シフト(多重度、カップリング定数、および水素の数)。多重度は、以下のとおり略される:s(一重項)、d(二重項)、t(三重項)、q(四重項)、m(多重項)、br(広い)。
LCMS
方法A
カラム:Chromolith(登録商標) SpeedROD RP18e 50-4.6
移動相:A=水+0.05%HCOOH、B=ACN+0.04%HCOOH
勾配:開始4%B、2.8分後100%B、3.3分後停止
流速:2.4ml/分
波長:220nm
カラム:Shim-pack XR-ODS、3.0*50mm、2.2μm
移動相:A:水/0.05%TFA、B:ACN/0.05%TFA
勾配:2.0分で5%B~100%B、保持0.5分
流速:1.2mL/分
波長:254nm
カラム:Kinetex EVO C18、3.0x50mm、2.6μm
移動相:A:水と0.04%NH4OH、B:ACN
勾配:2.1分で10%B~95%B、保持0.6分
流速:1.2mL/分
波長:254nm
カラム:CORTECSC 18+、2.1x50mm、2.7μm
移動相:A:水と0.1%FA、B:ACNと0.1%FA
勾配:2.0分まで10%B~100%B、2.6分まで保持、2.7分まで100%B~10%B、2.90後停止
流速:1.0mL/分
波長:254nm
カラム:CORTECSC 18+、2.1x50mm、2.7μm
移動相:A:水と0.1%FA、B:ACNと0.1%FA
勾配:3.0分まで10%B~100%B、4.7分まで保持、4.8分まで100%B~10%B、5分後停止
流速:1.0mL/分
波長:254nm
方法A
カラム:Chromolith(登録商標)SpeedROD RP 18e 50-4.6
移動相:A=水+0.01%TFA、B=ACN+0.01%TFA
勾配:開始10%B、3.5分後100%B、4.8分後10%B、5.5分後停止
流速:2.75mL/分
波長:220nm
カラム:Atlantis T3、150x4.6mm
移動相:A=水+0.05%TFA、B=ACN+0.05%TFA
勾配:開始5%B、8分後95%B、10.2分後5%B、12分後停止
流速:1.5mL/分
波長:254nm
カラム:Ascentis Express C18 2.7μm、100x4.6mm
移動相:A=水+0.05%TFA、B=ACN+0.05%TFA
勾配:開始5%B、8分後95%B、10.2分後5%B、12分後停止
流速:1.5mL/分
波長:254nm
カラム:XSELECT HSS T3 100x4.6mm
移動相:A=水+0.05%TFA、B=ACN+0.05%TFA
勾配:開始5%B、8分後95%B、10.2分後5%B、12分後停止
流速:1.2mL/分
波長:254nm
カラム:Atlantis HILIC Silica 3μm 100x4.6mm
移動相:A=水+0.05%TFA、B=ACN+0.05%TFA
勾配:開始5%B、8分後95%B、10.2分後5%B、12分後停止
流速:1.2mL/分
波長:254nm
方法A
HPLC
カラム:Lux Amylose-2
移動相:n-ヘプタン:i-PrOH(20:80)
波長:254nm
流速:1mL/分
SFC
カラム:Lux Amylose-1
移動相:CO2:i-PrOH+0.5%DEA(88:12)
波長:220nm
流速:5mL/分
方法:SFC
カラム:ChiralPak AS-H
移動相:CO2:i-PrOH+0.5%DEA(85:15)
波長:220nm
流速:5mL/分
方法:HPLC
カラム:ChiralPak IA-3
移動相:Hex(0.1%DEA)/EtOH=1:1
波長:254nm
流速:1.0mL/分
方法:HPLC
カラム:ChiralPak IA-3
移動相:Hex(0.1%DEA)/EtOH=4:1
波長:254nm
流速:1.0mL/分
方法:HPLC
カラム:ChiralPak IA-3
移動相:Hex(0.1%DEA)/EtOH=7:3
波長:254nm
流速:1.0mL/分
方法:SFC
カラム:ChiralPak IC、3*100mm、3μm
共溶媒:MeOH+0.1%DEA
波長:220nm
流速:2mL/分
方法A
HPLC
カラム:Lux Amylose-2
移動相:n-ヘプタン:i-PrOH(20:80)
波長:254nm
流速:20ml/分
Alphascreen Protenタンパク質相互作用アッセイ
HIF-2αおよびHIF-1βのPAS Bドメインの相互作用の機能的崩壊の評価のために、AlphaScreenアッセイを設定した。アッセイを、Perkin Elmer社の薄灰色の384ウェルマイクロタイタープレートで、7μlの総体積で実施した。ヒトrec His6Gb1-TEV-GEFKGL-HIF2α(240-350aa)-G (fc 143nM)およびヒトrec ARNT His6Gb1-TEV-GEFKGL-ARNT(356-470aa)-FLAG-E362R(fc 143nM)を、20mM Hepes、150mM NaCl、0.05%Tween 20、2mM DTT、0.1%(w/v)BSA、0.3%DMSO中、23℃で、15分間、pH7.5で、目的の化合物(fc 1nM~30μM)でインキュベートした。タンパク質間相互作用の検出を、AlphaLISA(登録商標)未標識アクセプタービーズ(fc 20μg/ml)およびAlphaScreen(登録商標)ニッケルキレートドナービーズ(fc 9μg/ml)(共にPerkin Elmer社)を添加することによって実施し、反応物を、暗中23℃で、240分間インキュベートした。ドナービーズおよびアクセプタービーズがHIF2アルファ PASBとHIF-1β PAS Bドメインとの相互作用に起因して互いに近接する場合、それは680nmでの励起後に615nmで発光シグナルをもたらす。化合物のPPI崩壊活性を、Alphascreenシグナルの喪失から直接算出した。AlphaScreenシグナルを、Envisionマルチモードリーダー(Perkin Elmer LAS Germany社)で測定した。使用した対照値は、インヒビターを含まない反応であった。使用した薬理学的なゼロ値を、HIF-1βの不在において決定した。阻害性値(IC50)を、GeneData社からのAssay analyserを使用して算出した。
ITC測定を、MicroCal/Malvern社(UK)からのVP-ITCマイクロカロリーメーターで実施した。すべての滴定実験のために、タンパク質および夫々の化合物を30mM HEPES緩衝液 pH7.5、150mM NaClおよび5mM β-メルカプトエタノール中で調合した。タンパク質、HIF2a(240-350)-Gを、組換え過剰発現および多段階クロマトグラフィー精製によって調製した。化合物は、濃縮されたDMSO貯蔵溶液から使用した。注射シリンジ中の最終的なタンパク質濃度は、100μMであった。DMSO中10mMのリガンド貯蔵溶液を、緩衝液で10μM濃度まで希釈し、試料セル中へロードした。すべての緩衝液を、1%(v/v)DMSOの最終的な濃度まで調整した。滴定液および滴定溶液(titrate and titrant solutions)の両方を、カロリーメーターセルおよび注射シリンジをロードするに先立って脱気した。ITC滴定を、303Kの一定温度で実行した。ITCデータ分析を、MicroCal/Malvern社(UK)によって標準的な機械ソフトフェアとして供給されたOrigin 7(OriginLab Cooperation Northampton、USA)系の熱量測定特注品を使用して実施した。統合した熱データを一部位結合モデル(one-site binding model)に適合させ、結合の親和性、エンタルピーおよび化学量論についての見掛けの値を決定した。
このレポーターアッセイを、HIF2α-HIF1β複合体の、生理学的に関係のある細胞株中の低酸素応答エレメント(HRE)と称される特定のDNAフラグメントへの結合をモニターするために設計した。786-O HRE-luc2P細胞は、HRE配列の制御下でルシフェラーゼの発現を駆動するHRE Lucレポーター構築物(pGL4.42 [luc2P/HRE/Hygro] Vector、Promega社、cat no.E4001)の安定した統合によって、786-Oヒト腎細胞腺癌細胞株から導き出された。HREは、低酸素誘導性因子によって制御される様々な遺伝子のプロモーターにおいて存在する。786-O細胞は、HIF2αのみを発現する。結果として、このレポーターアッセイは、生成されたルシフェラーゼの活性を決定することによって、HIF2α-HIF1β活性のモニタリングを可能にする。細胞培養を、10%FBS、ピルビン酸ナトリウム、ペニシリン/ストレプトマイシン、グルタミン、200μg/mlハイグロマイシンゴールドが補充されたRPMI培地において実施した。
一般手順A
HPLC(方法A):純度>99%、Rt=3.66分;LC-MS(方法A):[M+H]+ = 440.8、Rt=3.05分。
(4S)-5,5-ジフルオロ-3-メタンスルホニル-1-フェニル-4H,6H-シクロペンタ[c]チオフェン-4-オール(25a)
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4S)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4S)-5,5-ジフルオロ-3-メタンスルホニル-1-(1-メチル-1H-ピラゾール-5-イル)-4H,5H,6H-シクロペンタ[c]チオフェン-4-オール(47a)
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
(4R)-鏡像異性体を、類似して得た。
例A:注射バイアル
3lの再蒸留水中の100gの式Iの活性成分および5gのリン酸水素二ナトリウムの溶液を2N塩酸を使用してpH6.5まで調整し、滅菌濾過し、注射バイアル中へ移し、滅菌条件下で凍結乾燥させ、滅菌条件下で密封する。各注射バイアルは、5mgの活性成分を含有する。
20gの式Iの活性成分と100gの大豆レシチンおよび1400gのカカオバターの混合物を溶融し、型中に注ぎ、冷却するようにする。各坐薬は、20mgの活性成分を含有する。
溶液を、940mlの再蒸留水中1gの式Iの活性成分、9.38gのNaH2PO4・2H2O、28.48gのNa2HPO4・12H2Oおよび0.1gのベンザルコニウムクロリドから調製する。pHを6.8まで調整し、溶液を最大1lにし、照射によって滅菌する。この溶液は、点眼薬の形態で使用され得る。
500mgの式Iの活性成分を、無菌条件下で99.5gのワセリンと混合した。
1kgの式Iの活性成分、4kgのラクトース、1.2kgのジャガイモデンプン、0.2kgのタルクおよび0.1kgのステアリン酸マグネシウムの混合物を従来のやり方で圧縮することによって、各錠剤が10mgの活性成分を含有するように錠剤が与えられる。
錠剤を、例Eに類似して圧縮し、続いて従来のやり方において、スクロース、ジャガイモデンプン、タルク、トラガラントおよび色素のコーティングで被覆する。
2kgの式Iの活性成分を、従来のやり方において、各カプセルが20mgの活性成分を含有するように、硬質ゼラチンカプセル中に導入する。
60lの再蒸留水中1kgの式Iの活性成分の溶液を滅菌濾過し、アンプル中に移し、滅菌条件下で凍結乾燥させ、滅菌条件下で密封する。各アンプルは、10mgの活性成分を含有する。
Claims (17)
- 式I
R1は、Ar、またはHetを示し、
R2は、SO2A、SOA、SA、SO2NHA、SO2NA2、S(=NH,=O)A、S(=NH)2A、NO2、Hal、CN、A、Het1、COOHまたはCOOAを示し、
R3は、HまたはHalを示し、
R4は、HまたはHalを示し、
Arは、フェニルを示し、それは、非置換であるか、またはHal、A、[C(R5)2]pOR5、O[C(R5)2]pOR5、[C(R5)2]pN(R5)2、O[C(R5)2]pN(R5)2、[C(R5)2]pHet1、NO2、CN、[C(R5)2]pCOOR5、O[C(R5)2]pCOOR5、CON(R5)2、NR5COA、NR5SO2A、SO2N(R5)2、S(O)2A、COHet1、O[C(R5)2]pHet1、NHCOOA、NHCON(R5)2、NHCOO[C(R5)2]mN(R5)2、NHCOO[C(R5)2]pHet1、NHCONH[C(R5)2]mN(R5)2、NHCONH[C(R5)2]pHet1、OCONH[C(R5)2]mN(R5)2、OCONH[C(R5)2]pHet1、S(O)2Het1、および/もしくはCOAによって単置換、二置換、もしくは三置換されており、
Hetは、1~4個のN、Oおよび/またはS原子を有する単環式または二環式の芳香族、不飽和または飽和ヘテロ環を示し、それは、非置換であるか、またはHal、A、NH2、NHA、NA2、COOH、COOA、CONH2、CONHA、CONA2、CONHAr、S(O)mA、NHCH2Ar1、CN、OHおよび/もしくはOAによって単置換、二置換、もしくは三置換されていてもよく、
Aは、1~6個のC原子を有する非分枝または分枝のアルキルを示し、ここで、1~7個のH原子は、OH、F、Clおよび/もしくはBrによって置き換えられていてもよく、ならびに/または、ここで、1または2の非隣接CH2基は、Oおよび/もしくはNH基によって置き換えられていてもよく、
Het1は、1~4個のN、Oおよび/またはS原子を有する単環式または二環式の芳香族、不飽和または飽和ヘテロ環を示し、それは、非置換であるか、またはHal、A、COOA、NH2、NHAおよび/もしくはNA2によって単置換、二置換、もしくは三置換されていてもよく、
Ar1は、非置換であるか、またはHal、A、OHおよび/もしくはOAによって単置換、二置換、もしくは三置換されているフェニルを示し、
R5は、Hまたは1、2、3もしくは4個のC原子を有するアルキルを示し、
Halは、F、Cl、BrまたはIを示し、
nは、1、2または3を示し、
mは、1、2または3を示し、
pは、0、1、2、3または4を示す、
で表される化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - R2が、SO2A、
請求項1に記載の化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - R3が、HまたはFを示し、
R4が、HまたはFを示す、
請求項1または2に記載の化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - Aが、1~6個のC原子を有する非分枝または分枝のアルキルを示し、ここで、1~5個のH原子が、OHおよび/またはFによって置き換えられていてもよい、
請求項1~3のいずれか一項に記載の化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - Arが、フェニルを示し、それが、非置換であるか、またはHalおよび/もしくはCNによって単置換、二置換、もしくは三置換されている、
請求項1~4のいずれか一項に記載の化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - Hetが、1~4個のN、Oおよび/またはS原子を有する単環式の芳香族ヘテロ環を示し、それが、非置換であるか、またはHal、A、CN、OHおよび/もしくはOAによって単置換、二置換、もしくは三置換されていてもよい、
請求項1~5のいずれか一項に記載の化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - Hetが、ピロリル、ピラゾリル、イミダゾリル、ピリジニルまたはピリミジニルを示し、その各々が、非置換であるか、またはHal、OA、OH、Aおよび/もしくはCNによって単置換、二置換、もしくは三置換されていてもよい、
請求項1~6のいずれか一項に記載の化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - R1が、ArまたはHetを示し、
R2が、SO2Aを示し、
R3が、HまたはHalを示し、
R4が、HまたはHalを示し、
Aが、1~6個のC原子を有する非分枝または分枝のアルキルを示し、ここで、1~5個のH原子が、OHおよび/またはFによって置き換えられていてもよく、
Arが、フェニルを示し、それが、非置換であるか、またはHalおよび/もしくはCNによって単置換、二置換、もしくは三置換されており、
Hetが、1~4個のN、Oおよび/またはS原子を有する単環式の芳香族ヘテロ環を示し、それが、非置換であるか、またはHal、A、CN、OHおよび/もしくはOAによって単置換、二置換、もしくは三置換されていてもよく、
Halが、F、Cl、BrまたはIを示し、
nが、1、2または3を示す、
請求項1~7のいずれか一項に記載の化合物、またはその薬学的に許容し得る塩、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。 - 以下の群:
- 請求項1~9に記載の式Iで表される化合物、またはその薬学的に許容し得る塩、溶媒和物、互変異性体または立体異性体の調製のためのプロセスであって、
式II
で表される化合物と、式III
L-R1 III
式中R1が、請求項1に指し示された意味を有し、
およびLが、H、ボロン酸またはボロン酸エステル基を示す、
で表される化合物とを反応させること
を特徴とする、前記プロセス。 - 請求項1~9に記載の式Iで表される化合物、またはその薬学的に許容し得る塩、溶媒和物、互変異性体または立体異性体の調製のためのプロセスであって、
式IV
で表される化合物と、NaBH4とを反応させること
を特徴とする、前記プロセス。 - 請求項1~9に記載の式Iで表される化合物、またはその薬学的に許容し得る塩、溶媒和物、互変異性体または立体異性体の調製のためのプロセスであって、
式Iの塩基または酸を、その塩の1種に変換させること
を特徴とする、前記プロセス。 - 請求項1に記載の式Iで表される化合物、および/またはその薬学的に許容し得る塩、溶媒和物、互変異性体および立体異性体、ならびにあらゆる比率におけるそれらの混合物の少なくとも1種と、任意に薬学的に許容し得る担体、賦形剤またはビヒクルとを含む、医薬。
- がんおよびフォンヒッペル・リンダウ病(VHL)の処置および/または予防のための使用のための、請求項1に記載の式Iで表される化合物、またはその薬学的に許容し得る塩、溶媒和物、互変異性体または立体異性体、またはあらゆる比率におけるそれらの混合物。
- 頭部、頸部、目、口、喉、食道、気管支、喉頭、咽頭、胸部、骨、肺、結腸、直腸、胃、前立腺、膀胱、子宮、子宮頸、乳房、卵巣、精巣または他の生殖器、皮膚、甲状腺、血液、リンパ節、腎臓、肝臓、膵臓、脳、中枢神経系のがん、固形腫瘍および血液由来の腫瘍、膠芽腫、腎細胞癌(RCC)および淡明細胞型腎細胞癌(ccRCC)の群から選択される疾患の処置および/または予防のための使用のための、請求項1~9のいずれか一項に記載の化合物。
- 請求項1に記載の式Iで表される化合物、および/またはその薬学的に許容し得る塩、溶媒和物および立体異性体、ならびにあらゆる比率におけるそれらの混合物の少なくとも1種と、さらなる医薬活性成分の少なくとも1種とを含む、医薬。
- (a)有効量の、請求項1に記載の式Iで表される化合物、および/またはその薬学的に許容し得る塩、溶媒和物、塩または立体異性体、またはあらゆる比率におけるそれらの混合物、ならびに
(b)有効量のさらなる医薬活性成分
の個別のパックからなるセット(キット)。
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