TW201819923A - 基於PHLDA1或PIK3C2B表現之PIK3/AKT/mTOR抑制劑之治療效果的預測方法 - Google Patents
基於PHLDA1或PIK3C2B表現之PIK3/AKT/mTOR抑制劑之治療效果的預測方法 Download PDFInfo
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- TW201819923A TW201819923A TW106134940A TW106134940A TW201819923A TW 201819923 A TW201819923 A TW 201819923A TW 106134940 A TW106134940 A TW 106134940A TW 106134940 A TW106134940 A TW 106134940A TW 201819923 A TW201819923 A TW 201819923A
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- phenyl
- imidazo
- amino
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- pi3k
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- 102000010400 1-phosphatidylinositol-3-kinase activity proteins Human genes 0.000 title claims abstract description 88
- 108091007960 PI3Ks Proteins 0.000 title claims abstract description 88
- 229940124302 mTOR inhibitor Drugs 0.000 title claims abstract description 81
- 239000003628 mammalian target of rapamycin inhibitor Substances 0.000 title claims abstract description 81
- 239000003197 protein kinase B inhibitor Substances 0.000 title claims abstract description 80
- 102100030887 Pleckstrin homology-like domain family A member 1 Human genes 0.000 title claims abstract description 74
- 101000721645 Homo sapiens Phosphatidylinositol 4-phosphate 3-kinase C2 domain-containing subunit beta Proteins 0.000 title claims abstract description 72
- 230000014509 gene expression Effects 0.000 title claims abstract description 71
- 102100025059 Phosphatidylinositol 4-phosphate 3-kinase C2 domain-containing subunit beta Human genes 0.000 title claims abstract description 67
- 238000000034 method Methods 0.000 title claims abstract description 57
- 229940126638 Akt inhibitor Drugs 0.000 title claims abstract description 45
- 230000001225 therapeutic effect Effects 0.000 title claims abstract description 39
- 101000583692 Homo sapiens Pleckstrin homology-like domain family A member 1 Proteins 0.000 title claims abstract description 17
- 206010028980 Neoplasm Diseases 0.000 claims abstract description 76
- 201000011510 cancer Diseases 0.000 claims abstract description 67
- 239000002246 antineoplastic agent Substances 0.000 claims abstract description 46
- 238000002512 chemotherapy Methods 0.000 claims abstract description 38
- 210000004881 tumor cell Anatomy 0.000 claims abstract description 22
- 239000012472 biological sample Substances 0.000 claims abstract description 15
- 125000001997 phenyl group Chemical group [H]C1=C([H])C([H])=C(*)C([H])=C1[H] 0.000 claims description 66
- KTHXBEHDVMTNOH-UHFFFAOYSA-N cyclobutanol Chemical compound OC1CCC1 KTHXBEHDVMTNOH-UHFFFAOYSA-N 0.000 claims description 60
- -1 LY-2780301 Chemical compound 0.000 claims description 31
- 125000001424 substituent group Chemical group 0.000 claims description 20
- 150000001875 compounds Chemical class 0.000 claims description 18
- 239000003795 chemical substances by application Substances 0.000 claims description 17
- 125000002887 hydroxy group Chemical group [H]O* 0.000 claims description 15
- 125000004435 hydrogen atom Chemical group [H]* 0.000 claims description 12
- 125000004191 (C1-C6) alkoxy group Chemical group 0.000 claims description 11
- 125000003277 amino group Chemical group 0.000 claims description 11
- 125000003917 carbamoyl group Chemical group [H]N([H])C(*)=O 0.000 claims description 11
- ZAHRKKWIAAJSAO-UHFFFAOYSA-N rapamycin Natural products COCC(O)C(=C/C(C)C(=O)CC(OC(=O)C1CCCCN1C(=O)C(=O)C2(O)OC(CC(OC)C(=CC=CC=CC(C)CC(C)C(=O)C)C)CCC2C)C(C)CC3CCC(O)C(C3)OC)C ZAHRKKWIAAJSAO-UHFFFAOYSA-N 0.000 claims description 10
- 229960002930 sirolimus Drugs 0.000 claims description 10
- QFJCIRLUMZQUOT-HPLJOQBZSA-N sirolimus Chemical compound C1C[C@@H](O)[C@H](OC)C[C@@H]1C[C@@H](C)[C@H]1OC(=O)[C@@H]2CCCCN2C(=O)C(=O)[C@](O)(O2)[C@H](C)CC[C@H]2C[C@H](OC)/C(C)=C/C=C/C=C/[C@@H](C)C[C@@H](C)C(=O)[C@H](OC)[C@H](O)/C(C)=C/[C@@H](C)C(=O)C1 QFJCIRLUMZQUOT-HPLJOQBZSA-N 0.000 claims description 10
- RAXXELZNTBOGNW-UHFFFAOYSA-N imidazole Natural products C1=CNC=N1 RAXXELZNTBOGNW-UHFFFAOYSA-N 0.000 claims description 9
- 125000004169 (C1-C6) alkyl group Chemical group 0.000 claims description 8
- 229940124640 MK-2206 Drugs 0.000 claims description 8
- ULDXWLCXEDXJGE-UHFFFAOYSA-N MK-2206 Chemical compound C=1C=C(C=2C(=CC=3C=4N(C(NN=4)=O)C=CC=3N=2)C=2C=CC=CC=2)C=CC=1C1(N)CCC1 ULDXWLCXEDXJGE-UHFFFAOYSA-N 0.000 claims description 8
- JOGKUKXHTYWRGZ-UHFFFAOYSA-N dactolisib Chemical compound O=C1N(C)C2=CN=C3C=CC(C=4C=C5C=CC=CC5=NC=4)=CC3=C2N1C1=CC=C(C(C)(C)C#N)C=C1 JOGKUKXHTYWRGZ-UHFFFAOYSA-N 0.000 claims description 8
- 238000005259 measurement Methods 0.000 claims description 8
- 125000002915 carbonyl group Chemical group [*:2]C([*:1])=O 0.000 claims description 7
- 125000002496 methyl group Chemical group [H]C([H])([H])* 0.000 claims description 7
- 150000003839 salts Chemical class 0.000 claims description 7
- RGHYDLZMTYDBDT-UHFFFAOYSA-N 2-amino-8-ethyl-4-methyl-6-(1H-pyrazol-5-yl)-7-pyrido[2,3-d]pyrimidinone Chemical compound O=C1N(CC)C2=NC(N)=NC(C)=C2C=C1C=1C=CNN=1 RGHYDLZMTYDBDT-UHFFFAOYSA-N 0.000 claims description 6
- GYLDXIAOMVERTK-UHFFFAOYSA-N 5-(4-amino-1-propan-2-yl-3-pyrazolo[3,4-d]pyrimidinyl)-1,3-benzoxazol-2-amine Chemical compound C12=C(N)N=CN=C2N(C(C)C)N=C1C1=CC=C(OC(N)=N2)C2=C1 GYLDXIAOMVERTK-UHFFFAOYSA-N 0.000 claims description 6
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- GDCJHDUWWAKBIW-UHFFFAOYSA-N n-[4-[4-[2-(difluoromethyl)-4-methoxybenzimidazol-1-yl]-6-morpholin-4-yl-1,3,5-triazin-2-yl]phenyl]-2-(dimethylamino)ethanesulfonamide Chemical compound FC(F)C1=NC=2C(OC)=CC=CC=2N1C(N=1)=NC(N2CCOCC2)=NC=1C1=CC=C(NS(=O)(=O)CCN(C)C)C=C1 GDCJHDUWWAKBIW-UHFFFAOYSA-N 0.000 claims description 6
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- BLGWHBSBBJNKJO-UHFFFAOYSA-N serabelisib Chemical compound C=1C=C2OC(N)=NC2=CC=1C(=CN12)C=CC1=NC=C2C(=O)N1CCOCC1 BLGWHBSBBJNKJO-UHFFFAOYSA-N 0.000 claims description 6
- 125000006619 (C1-C6) dialkylamino group Chemical group 0.000 claims description 5
- 125000001495 ethyl group Chemical group [H]C([H])([H])C([H])([H])* 0.000 claims description 5
- 125000004433 nitrogen atom Chemical group N* 0.000 claims description 5
- 125000004076 pyridyl group Chemical group 0.000 claims description 5
- URLYINUFLXOMHP-HTVVRFAVSA-N tcn-p Chemical compound C=12C3=NC=NC=1N(C)N=C(N)C2=CN3[C@@H]1O[C@H](COP(O)(O)=O)[C@@H](O)[C@H]1O URLYINUFLXOMHP-HTVVRFAVSA-N 0.000 claims description 5
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- 239000003153 chemical reaction reagent Substances 0.000 claims description 4
- 229910052801 chlorine Inorganic materials 0.000 claims description 4
- 125000001309 chloro group Chemical group Cl* 0.000 claims description 4
- 125000001559 cyclopropyl group Chemical group [H]C1([H])C([H])([H])C1([H])* 0.000 claims description 4
- 229910052731 fluorine Inorganic materials 0.000 claims description 4
- 125000001153 fluoro group Chemical group F* 0.000 claims description 4
- 125000000623 heterocyclic group Chemical group 0.000 claims description 4
- 125000004458 methylaminocarbonyl group Chemical group [H]N(C(*)=O)C([H])([H])[H] 0.000 claims description 4
- 125000003226 pyrazolyl group Chemical group 0.000 claims description 4
- GRZXWCHAXNAUHY-NSISKUIASA-N (2S)-2-(4-chlorophenyl)-1-[4-[(5R,7R)-7-hydroxy-5-methyl-6,7-dihydro-5H-cyclopenta[d]pyrimidin-4-yl]-1-piperazinyl]-3-(propan-2-ylamino)-1-propanone Chemical compound C1([C@H](C(=O)N2CCN(CC2)C=2C=3[C@H](C)C[C@@H](O)C=3N=CN=2)CNC(C)C)=CC=C(Cl)C=C1 GRZXWCHAXNAUHY-NSISKUIASA-N 0.000 claims description 3
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- YOVVNQKCSKSHKT-HNNXBMFYSA-N (2s)-1-[4-[[2-(2-aminopyrimidin-5-yl)-7-methyl-4-morpholin-4-ylthieno[3,2-d]pyrimidin-6-yl]methyl]piperazin-1-yl]-2-hydroxypropan-1-one Chemical compound C1CN(C(=O)[C@@H](O)C)CCN1CC1=C(C)C2=NC(C=3C=NC(N)=NC=3)=NC(N3CCOCC3)=C2S1 YOVVNQKCSKSHKT-HNNXBMFYSA-N 0.000 claims description 3
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- BEUQXVWXFDOSAQ-UHFFFAOYSA-N 2-methyl-2-[4-[2-(5-methyl-2-propan-2-yl-1,2,4-triazol-3-yl)-5,6-dihydroimidazo[1,2-d][1,4]benzoxazepin-9-yl]pyrazol-1-yl]propanamide Chemical compound CC(C)N1N=C(C)N=C1C1=CN(CCOC=2C3=CC=C(C=2)C2=CN(N=C2)C(C)(C)C(N)=O)C3=N1 BEUQXVWXFDOSAQ-UHFFFAOYSA-N 0.000 claims description 3
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- JDUBGYFRJFOXQC-KRWDZBQOSA-N 4-amino-n-[(1s)-1-(4-chlorophenyl)-3-hydroxypropyl]-1-(7h-pyrrolo[2,3-d]pyrimidin-4-yl)piperidine-4-carboxamide Chemical compound C1([C@H](CCO)NC(=O)C2(CCN(CC2)C=2C=3C=CNC=3N=CN=2)N)=CC=C(Cl)C=C1 JDUBGYFRJFOXQC-KRWDZBQOSA-N 0.000 claims description 3
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Abstract
本發明之課題係以對癌症患者提供,使用顯示優良抗腫瘤效果之PI3K/AKT/mTOR抑制劑的化學療法為目的。 解決手段係,一種預測化學療法之治療效果的方法,該化學療法係基於自癌症患者所採取之包含腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B的表現量,對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑者。
Description
本申請案係主張2013年6月20日提申之日本特願2013-129591號說明書(透過參照其之整體被引用於本說明書中)之優先權的利益者。
本發明係關於對使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑之化學療法預測治療效果的方法、抗腫瘤劑及套組。
PI3K/AKT/mTOR訊息傳遞途徑係控制細胞增生、細胞凋亡抗性、糖代謝等各種各樣重要的細胞機能,已知在廣泛的惡性腫瘤中訊息傳遞途徑的活性會亢進(非專利文獻1)。作為抗腫瘤劑,多數的PI3K/AKT/mTOR抑制劑(PI3K抑制劑、AKT抑制劑、mTOR抑制劑或PI3K-mTOR雙重抑制劑等)的臨床試驗在進行中,但特別係在以PI3K或AKT為標靶的抑制劑以單劑所使用的臨床試驗中,尚未顯示充分的臨床效果(非專利文獻2)。
一般地,如PI3K/AKT/mTOR抑制劑般之分子標 靶藥,對其標靶分子係高表現或高活性的腫瘤細胞有顯示強烈效力的狀況,而預先透過治療效果預測標記物來將可期待奏效的患者群予以分層一事則變得重要(非專利文獻3)。就PI3K/AKT/mTOR抑制劑而言,在臨床上PIK3CA變異或PTEN缺失等正作為藥效預測標記物被檢證(非專利文獻4)。
如以上,正積極地開發種種的PI3K/AKT/mTOR抑制劑,但在整體癌症患者中該治療效果並非係能令人滿意的,又,就PI3K/AKT/mTOR抑制劑而言,仍然未發現能夠將顯示充分治療效果的癌症患者予以分層的治療效果預測標記物。
非專利文獻1 自然綜述癌症(Nature Reviews Cancer)2,489-501(2002)
非專利文獻2 自然綜述癌症(Nature Reviews Cancer)9,550-562(2009)
非專利文獻3 自然綜述臨床腫瘤學(Nature Reviews Clinical Oncology)8,587-596(2011)
非專利文獻4 柳葉刀腫瘤學(Lancet Oncology)12,594-603(2011)
本發明的目的係提供對癌症患者使用顯示優良抗腫瘤效果之PI3K/AKT/mTOR抑制劑的化學療法。
本發明人等,深入研究了種種的基因表現與PI3K/AKT/mTOR抑制劑之治療效果的關係,發現就PHLDA1的表現量低,或者PIK3C2B的表現量高的癌症患者而言,PI3K/AKT/mTOR抑制劑(特別係反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇)顯示顯著地強烈的抗腫瘤效果,而至完成本發明。
再者,針對PHLDA1及PIK3C2B之任一者,與PI3K/AKT/mTOR抑制劑的關連完全未有報告。
即,本發明係提供以下方法、抗腫瘤劑及套組者。
[1]一種預測化學療法之治療效果的方法,該化學療法係基於癌症患者之腫瘤細胞之PHLDA1及/或PIK3C2B之表現量,對該癌症患者使用含有PI3K/AKT/mTOR抑制劑的抗腫瘤劑。
[2]如[1]記載之方法,包含下述步驟(1)及(2):(1)測定步驟,測定包含自該患者所採取之腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B之表現量,及(2)預測步驟,當在上述步驟(1)所獲得之PHLDA1的表現量係預先設定之截點(cut-off point)以下的狀況,或者在上述步驟(1)所獲得之PIK3C2B的表現量係預先設定之截點 以上的狀況,預測對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高。
[3]如[1]或[2]記載之方法,其中PI3K/AKT/mTOR抑制劑係咪唑并化合物或其藥學上可容許的鹽,或者係AMG-319、AZD-6482、BYL-719、柯潘利西柏(Copanlisib)(BAY-80-6946)、GDC-0032、GDC-0084、GSK-1059615、GSK-2126458、GSK-2636771、意德拉利西柏(Idelalisib)(CAL-101)、IPI-145、MLN-1117(INK-1117)、PA-799(CH-5132799)、皮克替利西柏(Pictilisib)(GDC-0941)、匹拉若利西柏(Pilaralisib)(XL-147)、SF-1126、索諾利西柏(Sonolisib)(PX-866)、沃克斯它利西柏(Voxtalisib)(SAR-245409、XL-765)、鹽酸阿弗色替波(Afuresertib hydrochloride)(GSK-2110183)、ARQ-092、AZD5363、鹽酸恩扎啕林(Enzastaurin hydrochloride)、GDC-0068、GSK-2141795、GSK690693、LY-2780301、MK-2206、哌立福新(Perifosine)、磷酸曲西瑞賓(Triciribine phosphate)(VQD-002)、AZD-2014、AZD-8055、CC-115、CC-223、DS-3078、依維莫司(Everolimus)、替西羅莫司(Temsirolimus)、ME-344、MLN-0128(INK-128)、OSI-027、PWT-33597、地磷莫司(Ridaforolimus)、西羅莫司(Sirolimus)、達克托利西柏(Dactolisib)(BEZ235)、DS-7423、GDC-0980、NVP-BGT-226、PF-04691502、PF-05212384(PKI-587)或PWT-33597; 該咪唑并化合物係以通式(I)所表示:
(式中,A、B、C及D分別係表示C-R1a、C-R1b、C-R1c、及C-R1d,或者表示前述A、B、C、D中任一者或兩者被取代為N原子;R1a、R1b、R1c、R1d中至少兩者表示氫原子,其它分別表示:鹵素原子;氰基;可具有羥基作為取代基之C1-6烷基;C1-6烷氧基;具有羥基、胺基、可具有取代基之單或二(C1-6烷基)胺基或者單或二(C1-6烷氧基)胺基之任一者作為取代基之羰基;不飽和雜環基;R2表示苯基、吡啶基或噻吩基;R3表示氫原子、甲基、乙基或環丙基;R4表示氫原子或羥基)。
[4]如[3]記載之方法,其中以通式(I)所表示之咪唑并化合物,係下述之化合物:A、B、C及D分別係表示C-R1a、C-R1b、C-R1c及C-R1d,或者表示前述A、B、C、D中任一者或兩者被取代為N原子, R1a、R1b、R1c、R1d中至少二者係表示氫原子,其它分別係表示氯原子、氟原子、氰基、甲基、羥甲基、甲氧基、乙氧基、羧基、胺甲醯基、甲胺基羰基、乙胺基羰基、羥乙胺基羰基、乙氧基胺基羰基、吡唑基;R2係表示苯基、吡啶基或噻吩基;R3係表示氫原子、甲基、乙基或環丙基;R4係表示氫原子或羥基。
[5]如[3]或[4]記載之方法,其中以通式(I)所表示之咪唑并化合物係下述(a)~(t)之任一化合物:(a)反式-3-胺基-1-環丙基-3-(4-(10-氟-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇;(b)反式-3-胺基-1-環丙基-3-(4-(10-氟-3-(吡啶-4-基)-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇;(c)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇;(d)反式-3-胺基-1-環丙基-3-(4-(10-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇;(e)反式-3-胺基-1-環丙基-3-(4-(9-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇;(f)反式-3-胺基-1-環丙基-3-(4-(8-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇;(g)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[2,3-e][1,3]-2-基)苯基)環丁醇;(h)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c] 吡啶并[2,3-e][1,3]-2-基)苯基)環丁醇;(i)反式-3-胺基-1-乙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[2,3-e][1,3]-2-基)苯基)環丁醇;(j)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇;(k)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇;(l)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[4,3-e][1,3]-2-基)苯基)環丁醇;(m)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[4,3-e][1,3]-2-基)苯基)環丁醇;(n)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,2-e][1,3]-2-基)苯基)環丁醇;(o)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡并[2,3-e][1,3]-2-基)苯基)環丁醇;(p)反式-3-胺基-3-(4-(9-(羥甲基)-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)-1-甲基環丁醇;(q)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-9-甲腈;(r)反式-3-胺基-1-甲基-3-(4-(3-苯基-9-(1H-吡唑-5-基)-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇;(s)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-N-甲基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-8-甲醯胺;(t)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-N-乙 氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-8-甲醯胺。
[6]如[1]~[5]中任1項記載之方法,其中PI3K/AKT/mTOR抑制劑係MK-2206、BEZ235、GDC-0941、西羅莫司、反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇。
[7]一種含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑,其係用以治療腫瘤細胞之PHLDA1的表現量係預先設定之截點以下,或者腫瘤細胞之PIK3C2B的表現量係預先設定之截點以上的癌症患者。
[8]一種含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑,該抗腫瘤劑之特徵在於,透過包含下述步驟(1)及(2)之方法,對被預測為使用該抗腫瘤劑之化學療法顯示充分治療效果之可能性高的癌症患者進行投予:(1)測定步驟,測定包含自該患者所採取之腫瘤細胞的生物試樣之PHLDA1及/或PIK3C2B的表現量;(2)預測步驟,當在上述步驟(1)所獲得之PHLDA1的表現量係預先設定之截點以下的狀況,或者在上述步驟(1)所獲得之PIK3C2B的表現量係預先設定之截點以上的狀況,預測對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高。
[9]一種含有測定PHLDA1及/或PIK3C2B的表現量之試劑的套組,其係用以透過包含下述步驟(1)及(2)之方法,來預測對癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑之化學療法的治療效果: (1)測定步驟,測定包含自該患者所採取之腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B的表現量;及(2)預測步驟,當於上述步驟(1)所獲得之PHLDA1的表現量係預先設定之截點以下的狀況,或者在上述步驟(1)所獲得之PIK3C2B的表現量係預先設定之截點以上的狀況,預測對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高。
[10]一種癌症患者的治療方法,包含對透過[1]~[6]中任1項記載之方法被預測為使用含有PI3K/AKT/mTOR抑制劑之腫瘤劑的化學療法顯示充分治療效果之可能性高的癌症患者,投予該抗腫瘤劑。
[11]一種含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑,其係使用來用以治療透過[1]~[6]中任1項記載之方法被預測為使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高之癌症患者。
本發明進一步亦包含以下的態樣。
[12]一種檢查化學療法之治療效果的方法,其係基於癌症患者之腫瘤細胞中PHLDA1及/或PIK3C2B的表現量,來檢查對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法之治療效果。
[13]如[12]記載之方法,包含下述步驟(1)及(2):(1)測定步驟,測定包含自該患者所採取之腫瘤細胞的生物試樣之PHLDA1及/或PIK3C2B的表現量;(2)判定步驟,當於上述步驟(1)所獲得之PHLDA1的表 現量係預先設定之截點以下的狀況,或者在上述步驟(1)所獲得之PIK3C2B的表現量係預先設定之截點以上的狀況,判定對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高。
依據本發明,提供在癌症患者中對於PI3K/AKT/mTOR抑制劑之治療效果的新穎預測法。即,本發明之預測方法係基於PHLDA1及/或PIK3C2B的表現,而能夠預測對PI3K/AKT/mTOR抑制劑會顯著地顯示敏感度的癌症患者。藉此,可在癌症治療中選擇適當的藥劑以至於可避免無用的投藥,而擬定適當之投予計劃(administration schedule)及變更為適當的投予計劃係成為可能。
圖1顯示PHLDA1或PIK3C2B的表現量,與對於PI3K/AKT/mTOR抑制劑之敏感度的相關性。
圖2顯示PHLDA1基因減弱(gene knockdown)、蛋白質的表現量及磷酸化狀態的分析結果。
圖3顯示因PIK3C2B基因減弱所致之對於PI3K/AKT/mTOR抑制劑之敏感度變化的分析結果。
圖4顯示在PI3K/AKT/mTOR抑制劑治療效果預測性中,迄今之法PIK3CA變異/PTEN缺失測定與PHLDA1/PIK3C2B表現量測定的比較。
本發明的預測方法係基於包含自癌症患者所採取之腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B的表現量,來預測或檢查對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑之化學療法的治療效果者。
作為本發明之對象的癌症,具體而言,可舉:頭頸部癌(Head and Neck cancer)、消化器癌(食道癌、胃癌、十二指腸癌、肝癌、膽道癌(膽囊/膽管癌等)、胰臟癌(勝臓癌)、小腸癌、大腸癌(結腸直腸癌、結腸癌、直腸癌等)等)、肺癌(非小細胞肺癌、小細胞肺癌等)、乳癌、卵巢癌、子宮癌(子宮頸癌、子宮體癌等)、腎癌、膀胱癌(移行上皮癌)、前列腺癌等。再者,於此處,就癌而言,不僅包含原發灶,亦包含經轉移至其它臓器(肝臓等)的癌。又,於此處,癌症患者不僅係實際具有腫瘤細胞之患者,亦包含藉由外科手術及化學療法等而腫瘤細胞係消失或變得無法確認的患者。
本發明中所謂「PI3K/AKT/mTOR抑制劑」係具有抑制在PI3K/AKT/mTOR訊息傳遞途徑中信號傳導亢進之活性的藥劑的話則未被特別限制,可舉對於選自於由PI3K、AKT及mTOR構成之群組之1或2種以上之標靶分子的抑制劑。較佳係PI3K抑制劑、AKT抑制劑、mTOR抑制劑或PI3K-mTOR雙重抑制劑。再者,此等抑制劑亦可兼具對PI3K、AKT及mTOR以外之標靶分子的抑制活性。於此處「抑制劑」不僅係包含抑制標靶分子活性的藥劑,亦包含抑 制標靶分子表現的藥劑。又,作為PI3K/AKT/mTOR抑制劑的態樣,未特別限制,可舉:低分子化合物、抗體、反意寡核苷酸(antisense oligonucleotide)、siRNA及適配體等。
於本發明的1個較佳實施形態中,作為具體的PI3K/AKT/mTOR抑制劑,可舉以通式(I)所表示之咪唑并 化合物或其鹽。以通式(I)所表示之咪唑并化合物作為AKT的酵素抑制劑係有用的。
通式(I)中,分別地,A、B、C及D分別係表示C-R1a、C-R1b、C-R1c及C-R1d,或者表示前述A、B、C、D之中任一者或兩者被取代為N原子。
作為以R1a、R1b、R1c或R1d所表示之鹵素原子,可例示:氯原子、溴原子、氟原子、碘原子,較佳係氯原子或氟原子。
以R1a、R1b、R1c或R1d所表示之「可具有羥基作為取代基之C1-6烷基」之C1-6烷基係表示碳數1~6之直鏈狀或者分枝狀的烷基,表示甲基、乙基、正丙基、異丙基、正丁基、異丁基、二級丁基、三級丁基、戊基、己基等,較佳係C1-3烷基,更佳係甲基。羥基(取代基)的個數係0個~2個,較佳係0個或1個。
以R1a、R1b、R1c或R1d所表示之「C1-6烷氧基」係表示碳數1~6的直鏈狀或分枝狀的烷氧基,表示甲氧基、乙氧基、正丙氧基、異丙氧基、正丁氧基、異丁氧基、三級丁氧基等,較佳係C1-3烷氧基,更佳係甲氧基或乙氧基。
以R1a、R1b、R1c或R1d所表示之「具有羥基、胺 基、可具有取代基之單或二(C1-6烷基)胺基或者單或二(C1-6烷氧基)胺基之任一者作為取代基之羰基」係意味具有羥基作為取代基之羰基(即,羧基)、具有胺基作為取代基之羰基(即,胺甲醯基)、亦可具有取代基之單或二(C1-6烷基)胺基羰基、單或二(C1-6烷氧基)胺基羰基。
以R1a、R1b、R1c或R1d所表示之「具有羥基、胺基、可具有取代基之單或二(C1-6烷基)胺基或者單或二(C1-6烷氧基)胺基之任一者作為取代基之羰基」之「可具有取代基之單或二(C1-6烷基)胺基羰基」之單或二(C1-6烷基)胺基羰基係表示具有1或2個上述之C1-6烷基之胺基羰基,較佳係單或二(C1-3烷基)胺基羰基,更佳係甲胺基羰基、二甲胺基羰基、乙胺基羰基。作為取代基較佳係羥基。當具有取代基的狀況時,取代基的個數宜為1個。
又,單或二(C1-6烷氧基)胺基羰基係表示具有1或2個上述之C1-6烷氧基的胺基羰基,較佳係單或二(C1-3烷氧基)胺基羰基,更佳係乙氧基胺基羰基。
作為以R1a、R1b、R1c或R1d所表示之「具有羥基、胺基、可具有取代基之單或二(C1-6烷基)胺基或者單或二(C1-6烷氧基)胺基之任一者作為取代基之羰基」,特佳係羧基、胺甲醯基、甲胺基羰基、乙胺基羰基、羥乙胺基羰基、乙氧基胺基羰基。
作為以R1a、R1b、R1c或R1d所表示之「不飽和雜環基」,係表示具有1~4個N、S、O之任一雜原子之單環性或雙環性之5~10員的不飽和雜環基,例如可例示:咪唑基、 噻吩基、呋喃基、吡咯基、唑基、異唑基、噻唑基、異噻唑基、吡唑基、三唑基、四唑基、吡啶基、吡基、嘧啶基、嗒基、吲哚基、異吲哚基、吲唑基、苯并呋喃基、苯并咪唑基、苯并唑基、苯并噻唑基、嘌呤基、喹啉基、異喹啉基、喹唑啉基、喹啉基(quinoxalyl)等,較佳係表示吡唑基。
進一步,作為以通式(I)所表示之咪唑并化合物較佳的具體例,亦可為記載於下面(a)~(t)之任一者的化合物。
(a)反式-3-胺基-1-環丙基-3-(4-(10-氟-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇、(b)反式-3-胺基-1-環丙基-3-(4-(10-氟-3-(吡啶-4-基)-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇、(c)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇、(d)反式-3-胺基-1-環丙基-3-(4-(10-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇、(e)反式-3-胺基-1-環丙基-3-(4-(9-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇、(f)反式-3-胺基-1-環丙基-3-(4-(8-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇、(g)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[2,3-e][1,3]-2-基)苯基)環丁醇、(h)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c] 吡啶并[2,3-e][1,3]-2-基)苯基)環丁醇、(i)反式-3-胺基-1-乙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[2,3-e][1,3]-2-基)苯基)環丁醇、(j)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇、(k)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇(以下,稱為化合物-I。)、(l)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[4,3-e][1,3]-2-基)苯基)環丁醇、(m)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[4,3-e][1,3]-2-基)苯基)環丁醇、(n)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,2-e][1,3]-2-基)苯基)環丁醇、(o)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡并[2,3-e][1,3]-2-基)苯基)環丁醇、(p)反式-3-胺基-3-(4-(9-(羥甲基)-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)-1-甲基環丁醇、(q)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-9-甲腈、(r)反式-3-胺基-1-甲基-3-(4-(3-苯基-9-(1H-吡唑-5-基)-5H-苯并[e]咪唑并[1,2-c][1,3]-2-基)苯基)環丁醇、(s)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-N-甲基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-8-甲醯胺、 (t)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-N-乙氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3]-8-甲醯胺,作為以通式(I)所表示之咪唑并化合物之藥學上可容許的鹽,可舉:與鹽酸、氫溴酸、氫碘酸、硫酸、硝酸、磷酸等無機酸,或甲酸、乙酸、丙酸、草酸、丙二酸、琥珀酸、延胡索酸、馬來酸、乳酸、蘋果酸、檸檬酸、酒石酸、碳酸、苦味酸、甲烷磺酸、對甲苯磺酸、麩胺酸等有機酸的酸加成鹽;與鈉、鉀、鎂、鈣、鋁等無機鹼,或甲胺、乙胺、美洛明(meglumine)、乙醇胺等有機鹼,或者離胺酸、精胺酸、鳥胺酸等鹼性胺基酸之鹽或銨鹽。又,在以通式(I)所表示之咪唑并化合物,亦包含光學異構物,亦包含水合物。
再者,此等以通式(I)所表示之咪唑并化合物或其藥學上可容許的鹽係可準據記載於WO2012/137870的方法來製造。
在本發明之其它的較佳實施形態中,就具體的PI3K/AKT/mTOR抑制劑而言,作為PI3K抑制劑可舉:AMG-319、AZD-6482、BYL-719、柯潘利西柏(BAY-80-6946)、GDC-0032、GDC-0084、GSK-1059615、GSK-2126458、GSK-2636771、意德拉利西柏(CAL-101)、IPI-145、MLN-1117(INK-1117)、PA-799(CH-5132799)、皮克替利西柏(GDC-0941)、匹拉若利西柏(XL-147)、SF-1126、索諾利西柏(PX-866)、沃克斯它利西柏(SAR-245409、XL-765)等;作為AKT抑制劑,可舉:鹽酸阿弗色替波(GSK-2110183)、 ARQ-092、AZD5363、鹽酸恩扎啕林、GDC-0068、GSK-2141795、GSK690693、LY-2780301、MK-2206、哌立福新、磷酸曲西瑞賓(VQD-002)等;作為mTOR抑制劑可舉:AZD-2014、AZD-8055、CC-115、CC-223、DS-3078、依維莫司、替西羅莫司、ME-344、MLN-0128(INK-128)、OSI-027、PWT-33597、地磷莫司、西羅莫司等;作為PI3K-mTOR雙重抑制劑,可舉;達克托利西柏(BEZ235)、DS-7423、GDC-0980、NVP-BGT-226、PF-04691502、PF-05212384(PKI-587)、PWT-33597等。再者,此等抑制劑係市售的,或能夠藉由通常已知的方法來製造。
上述PI3K/AKT/mTOR抑制劑之中,從因PHLDA1及/或PIK3C2B所致之分層的效果的觀點來看,較佳係MK-2206、BEZ235、GDC-0941、西羅莫司或反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇,特佳係反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3]-2-基)苯基)環丁醇。
在本發明中對含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的投予形態沒有特別限制,因應PI3K/AKT/mTOR抑制劑的種類自通常已知的投予形態適宜選擇,具體而言可例示:口服劑(錠劑、包覆錠劑、散劑、顆粒劑、膠囊劑、液劑等)、注射劑、栓劑、貼劑、軟膏劑等。又,該抗腫瘤劑係可因應投予形態來使用藥理學上可容許的載體,藉由通常已知的方法來調製。作為這樣的載體,可例示於通常 的藥劑所通用之各種的物品,例如:賦形劑、結合劑、崩解劑、潤滑劑、稀釋劑、助溶劑、懸浮劑、張力劑、pH值調整劑、緩衝劑、穩定劑、著色劑、矯味劑、矯臭劑等。
在本發明中所謂「使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法」係意味至少投予含有本發明之PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法,係不僅包含單獨地使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法,亦包含併用了含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑與其它之抗腫瘤劑的化學療法者。
於抗腫瘤劑中所含有之PI3K/AKT/mTOR抑制劑的量,依應應用其之患者的症狀,或依其之劑型等而非固定,一般地每投予單位形式,理想的係口服劑係令為約0.05~1,000mg,注射劑係令為約0.01~500mg,栓劑係令為約1~1,000mg。又,具有上述投予形態之藥劑每1日的投予量雖依患者的症狀、體重、年齡、性別等而異無法一概地決定,通常成人(體重50kg)每1日令為約0.05~5,000mg,較佳係令為0.1~1,000mg即可,宜將其1日1次或是分為2~3次左右來投予。
該化學療法的投予日程係依PI3K/AKT/mTOR抑制劑的種類、併用藥劑的有無、既往治療歷程、病期、轉移的有無、患者的年齡、性別等條件來適宜選擇。
再者,該化學療法係不論於其實施期間中,或者於實施期間的前後,有無切除腫瘤之手術。可係不伴隨主要以延命效果為目的之腫瘤之摘除的化學療法,可係在主 要係以腫瘤縮小效果為目的的化學療法之後進行已變小之腫瘍的摘除的術前輔助性化學療法,亦可係主要以復發/轉移抑制效果為目的之在摘除腫瘍後預防性地進行化學療法的術後輔助性化學療法。
於本發明中「治療效果」係,如上述,可藉由腫瘤縮小效果、復發/轉移抑制效果、延命效果等來評價。所謂「對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果」,係稱與PHLDA1高表現患者或PIK3C2B低表現患者之治療效果相比較,PHLDA1低表現患者或PIK3C2B高表現患者之治療效果係具有統計上有意義程度的差異而顯著地優良。
作為本發明之生物試樣,係自癌症患者採取者且包含腫瘤細胞之生物試樣則未被特別限定,可例示:體液(血液、尿、頭髪等)、組織(活檢樣本、摘除的臓器等)、其萃取物及培養物等。又,生物試樣的採取方法係可因應生物試樣的種類來適宜選擇。
於本發明為指標之所謂PHLDA1(普列克底物蛋白同源物樣域家族A成員1(Pleckstrin homology-like domain family A member 1)),係帶有普列克底物蛋白同源域(pleckstrin homology domain)之核蛋白質的一種,被報告參與類胰島素生長因子的抗細胞凋亡作用。再者,對PI3K/AKT/mTOR途徑的參與係未知。
於本發明為指標之PIK3C2B(磷脂酸肌醇-4-磷酸3-激酶(phosphatidylinositol-4-phosphate 3-kinase),催化性 次單元2β型(catalytic subunit type 2 beta))雖係包含於PI3K超家族,但與被報告與PI3K/AKT/mTOR抑制劑之關連的PIK3CA係不同,係PI3K class II家族的1個,不帶有調節性次單元。
在本發明之預測方法中表現量的測定對象係能夠定量的或半定量地測定表現量者則未特別限制,可舉:mRNA的表現量、DNA的拷貝數、蛋白質的表現量等。
令mRNA之表現量為測定對象的狀況時,可使用會與PHLDA1或PIK3C2B之mRNA專一性地雜交的探針或引子,藉由北方墨點法、RT-PCR法、即時PCR法、DNA微陣列法、原位雜交法等通常慣用之mRNA表現量的測定法來測定。
令DNA拷貝數為測定對象的狀況時,可使用會與PHLDA1或PIK3C2B之DNA專一性地雜交的探針,藉由原位雜交法、陣列CGH法、DNA微陣列法、南方墨點法等通常慣用之DNA拷貝數的測定法來測定。
令蛋白質之表現量為測定對象的狀況時,可使用會專一性地辨識PHLDA1或PIK3C2B之蛋白質的抗體,藉由ELISA法、西方墨點法、免疫組織化學染色法等通常慣用之免疫學的測定法來測定。
本發明中之引子及探針係基於已知之人類PHLDA1或人類PIK3C2B之DNA或mRNA的鹼基序列資訊(人類PHLDA1 DNA:基因銀行(GenBank)ID NC_000012.11,mRNA:基因銀行ID NM_007350;人類PIK3C2B DNA:基 因銀行ID NC_000001.10,mRNA:基因銀行ID NM_002646),透過通常已知的手法所製作,作為會與人類PHLDA1或人類PIK3C2B之DNA或mRNA專一性地雜交的聚核苷酸。該引子之鹼基長係10鹼基長~50鹼基長,較佳係15~50鹼基長,更佳係18~35鹼基長。該引子之鹼基長係15鹼基長~全鹼基長,較佳係20~全鹼基長,更佳係30~全鹼基長。
再者,該引子及探針係會與PHLDA1或PIK3C2B之DNA或者mRNA專一性地雜交者,則不需要係完全地互補的。這樣的引子及探針,與對應的鹼基序列比較則係具有70%以上,較佳80%以上,更佳90%以上,又更佳係95%以上,特佳係98%以上之同一性的聚核苷酸。
再者,於本發明中所謂「會專一性地雜交」,係稱在嚴苛的雜交條件下形成專一的雜交體,而不形成非專一的雜交體。嚴苛的雜交條件係可按照通常已知的方法,基於形成雜交體之核酸的熔化溫度(Tm)等來決定。就能夠維持雜交狀態之具體的洗淨條件而言,可舉通常係「1×SSC、0.1%SDS、37℃」左右的條件,較嚴格的係「0.5×SSC、0.1%SDS、42℃」左右的條件,更嚴格的係「0.1×SSC、0.1%SDS、65℃」左右的條件。
又,該探針或引子,為了能夠容易地檢測,亦能夠以通常慣用的放射性物質、螢光物質、化學發光物質,或酵素予以標記。
本發明中之抗體係會專一性地辨識PHLDA1或PIK3C2B之蛋白質者,則未被特別限制,可係單株抗體及 多株抗體之任一者,亦可係Fab片段及F(ab’)2片段等抗體片段。又,該抗體係可基於已知之人類PHLDA1或人類PIK3C2B之蛋白質的胺基酸序列資訊(人類PHLDA1基因銀行ID NP_031376;人類PIK3C2B基因銀行ID NP_002637),按照通常已知的方法來製造(例如,最新版分子生物學實驗操作指南(Current Protocols in Molecular Biology edit.)Ausubel et al.(1987),Publish.John Wiley and Sons.Section 11.12-11.13)。又,亦可使用市售的抗體。例如,作為抗人類PHLDA1抗體,可使用Abcam公司cat.# ab67849、Abnova公司cat.# H00022822-B01P,而作為抗人類PIK3C2B抗體,可使用Abcam公司cat.# ab55589、Abgent公司cat.# AP3309a等。
就本發明之預測方法而言,在癌症患者腫瘤細胞中PHLDA1的表現量低的狀況時,及/或PIK3C2B的表現量高的狀況時,係預測該癌症患者對於使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高者。
於此處,所謂「PHLDA1的表現量低」,係指該癌症患者之PHLDA1的表現量,與癌症患者整體中PHLDA1的表現量相比較係相對地低的狀況,更具體而言,係指PHLDA1的表現量係預先設定之截點以下的狀況。
於此處,就截點而言,由於係依測定對象及測定方法的種類等諸條件而變動者,在本發明中,廣闊地包含使用因該等此等諸條件能變動之任意的截點的發明,未被 限定於特定的值。具體的截點,可由已預先測定之癌症患者中PHLDA1的表現量,藉由種種的統計分析手法而求得。例如,可例示:癌症患者中PHLDA1表現量的平均值及中位數;係切分PHLDA1之低表現群與高表現群之截點,且在PHLDA1之低表現群與高表現群的治療效果(存活期等)中在卡方檢定下,成為P值成為最小時之值及P值成為低於一定標準時之值(例如,P值成為低於0.1時之值,P值成為低於0.05時之值)之值。此中,宜為癌症患者中PHLDA1之表現量的平均值及中位數,較佳係癌症患者中PHLDA1之表現量的平均值。
又,所謂「PIK3C2B的表現量高」係指,該癌症患者之PIK3C2B的表現量,與癌症患者整體中PIK3C2B的表現量相比較係相對地高的狀況,更具體而言,係指PIK3C2B的表現量係已預先設定之截點以上的狀況。於此處,作為截點,可與上述PHLDA1的表現量的截點同樣地求得,但宜為癌症患者中PIK3C2B的表現量的平均值及中位數,較佳係癌症患者中PIK3C2B的表現量的平均值。
本發明,又,亦提供含有PI3K/AKT/mTOR抑制劑的抗腫瘤劑,其係用以治療,經藉由本發明之預測方法被預測或判定為使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯充分治療效果的可能性高的癌症患者者。
本發明亦提供,這般之本發明抗腫瘤劑的使用形態。
進一步,本發明之抗腫瘤劑亦可包含:記載了用以實施本發明預測方法之程序等的操作說明書、程序手冊 等。
本發明,又,亦提供一種套組,其係用以預測或檢查對癌症患者中使用本發明抗腫瘤劑之化學療法的治療效果。本發明之套組係適宜地使用來用以,藉由上述之本發明預測方法來預測或者檢查化學療法的治療效果。
針對DNA或mRNA來測定在包含自癌症患者所採取之腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B的表現量的狀況時,本發明的套組係能夠包含會與人類PHLDA1或人類PIK3C2B之DNA或mRNA專一性地雜交之聚核苷酸的引子及/或探針。
就蛋白質(酵素)來測定在包含自癌症患者所採取之腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B的表現量的狀況時,本發明之套組能夠包含相對於PHLDA1及/或PIK3C2B(酵素)之抗體、相對於該抗體(一次抗體)之二次抗體,二次抗體宜藉由螢光酵素標記、放射性標記、螢光標記、酵素標記等所標記。
進一步,本發明之套組亦可包含記載了用以實施本發明預測方法之程序等的操作說明書、程序手冊。
以下,基於實施例更詳細地說明本發明,但不言自明的係本發明未被限定於此等實施例。
使用源自人類乳癌之37個細胞株(AU565、BT20、BT474、BT549、CAMA-1、DU4475、HCC1187、HCC1419、HCC1428、HCC1500、HCC1569、HCC1599、HCC1806、HCC1937、HCC1954、HCC202、HCC2218、HCC38、HCC70、MDA-MB-157、MDA-MB-175、MDA-MB-231、MDA-MB-361、MDA-MB-415、MDA-MB-436、MDA-MB-453、MDA-MB-468、UACC-812、UACC-893(以上,取得自美國菌種保存中心(American Type Culture Collection)(ATCC))、MCF-7、SK-BR-3、T47D、ZR-75-1(以上,取得自大日本住友製藥股份有限公司)、KPL-1、KPL-3C、KPL-4(由紅林博士(川崎醫大)提供)),如以下進行了細胞毒性試驗。各細胞株係接種150μL至96孔平底微孔盤,在37℃、含有5%碳酸氣的培養器中培養1日。將經以二甲亞碸來連續稀釋之PI3K/AKT/mTOR抑制劑(AKT抑制劑:化合物-I,MK-2206;PI3K-mTOR雙重抑制劑:BEZ235;PI3K抑制劑:GDC-0941;mTOR抑制劑:西羅莫司)及紫杉醇,或者僅二甲亞碸,添加至各細胞株的培養基。將其添加50μL至先前敘述的96孔平底微孔盤的各孔,使得藥劑的最終濃度分別成為10000、3000、1000、300、100、30、3、1nM。又,將另行準備之、已將各細胞株培養了一日的96孔平底微孔盤放置於室溫30分鐘後,自各孔各除去上清液50μL,使得殘留100μL的細胞培養液。對殘留的細胞培養液100μL,將等量的CellTiter-Glo發光法細胞活力檢測(Luminescent Cell Viability Assay)(Promega,Cat #:G7573)添加至各孔。 經放置於暗處10分鍾後,以微孔盤儀(PerkinElmer,ARVOsx)來測定藥劑添加時之源自孔之活細胞的發光量。添加了藥劑或者僅添加了二甲亞碸之細胞株係在37℃,含有5%碳酸氣的培養器中進一步培養了3日。培養後,於室溫放置30分鐘,自各孔各除去上清液100μL,使得殘留100μL的細胞培養液。對殘留的細胞培養液100μL,添加了等量的CellTiter-Glo發光法細胞活力檢測。經放置於暗處10分鍾後,以微孔盤儀測定了源自各孔之活細胞的發光量。就源自人類乳癌的37個細胞株,藉由以下的式子算出細胞增生率,求得了細胞增生率為50%的濃度,即,50%抑制細胞增生之各藥劑的濃度(GI50值(μM))。
細胞增生率(%)=(T-C0)/(C-C0)×100;T≧C0的狀況
細胞增生率(%)=(T-C0)/C0×100;T<C0的狀況
C0:藥劑添加時孔的發光量(每秒計數(count per second))
C:僅添加了二甲亞碸之孔的發光量(每秒計數)
T:添加了受測藥劑之孔的發光量(每秒計數)
接著,測定了在源自人類乳癌之37個細胞株中PHLDA1及PIK3C2B的表現量。各細胞株係在10cm細胞培養皿培養直至成為50~80%匯合(confluent)程度之後,使用RNeasy Mini Kit(QIAGEN,Cat # 74106)按照手冊萃取了總RNA(total RNA)。經萃取之總RNA係使用分光光度計(Nanodrop 1000,Thermo Fisher Scientific)來確認了濃度及純度。又,使用Agilent 2100 Bioanalyzer(Agilent Technologies)確認了分解度。使用GeneChip 3’IVT Express Kit(Affymetrix),將經萃取之總RNA反轉錄為cDNA,進一步進行了向生物素化cRNA的轉錄反應。接著,將經擴增的生物素化cRNA(20μg)片段化。再者,各操作按照於套組附加之說明書的記載進行。令所獲得之源自各細胞株的生物素化cRNA為檢體,添加至GeneChip人類基因組U-133 plus 2.0陣列(GeneChip Hunman Genome U-133 Plus 2.0 Array)(Affymetrix,PIK3C2B探針組ID:204484_at,PHLDA1探針組ID:217997_at),移至GeneChip雜交烘箱640(GeneChip Hybridization Oven 640)(Affymetrix),在45℃、60rpm的條件下進行雜交16時間。雜交後,使用GeneChip應用流體工作站450(GeneChip Fluidic Station 450)(Affymetrix)來進行洗淨並進行螢光標記,使用GeneChip掃描儀3000 7G(GeneChip Scanner 3000 7G)(Affymetrix)來掃描而取得了微陣列資料。微陣列資料的分析係使用了MATLAB(MathWorks)。基因表現量係藉由RMA法(鲁棒的多陣列平均(Robust Multiarray Average)法)計算。
將由以上所獲得之各藥劑之GI50值之對數與PHLDA1及PIK3C2B表現量之對數的皮爾森相關,顯示於圖1。
其結果顯明,探討了的全部的PI3K/AKT/mTOR抑制劑,與PHLDA1的表現量係統計上有意義地正相關,又,與PIK3C2B的表現量係統計上有意義地負相關。另一方面,紫杉醇,與PHLDA1或PIK3C2B的表現量則未顯示出相關性。 即,顯示了PIK3C2B及PHLDA1的表現量,係對於廣泛的PI3K/AKT/mTOR抑制劑之敏感度預測標記物。
又,就以肺癌、腎癌、肝癌、胰腺癌、大腸癌、膀胱癌、乳癌、頭頸部癌、前列腺癌、皮膚癌、血液癌症、惡性淋巴瘤等各種各樣的癌種所構成之240個細胞株組(OncoPanelTM,Ricerca Biosciences)而言,亦檢證了PHLDA1或PIK3C2B表現量,與對於PI3K/AKT/mTOR抑制劑之敏感度是否相關。其結果確認了,就240個細胞株組而言,與源自人類乳癌的37個細胞株同樣地,廣泛的PI3K/AKT/mTOR抑制劑(化合物-I、MK-2206、BEZ235、GDC-0941、西羅莫司)之GI50值的對數,與PHLDA1及PIK3C2B之表現量的對數係有意義地相關。
在經減弱(knockdown)PHLDA1基因之狀況時,藉由確認AKT的磷酸化狀態,檢證了PHLDA1與PI3K/AKT/mTOR訊息傳遞途徑的關係。
PHLDA1係比較上高表現之乳癌細胞株3株(HCC38、HCC1806、HCC1937,任一者皆係取得自美國菌種保存中心(ATCC))係利用包含10% FBS之RPMI培養基(Life Technologies Corp.,Cat # A104910-01)來培養。
對各細胞株,調製陰性控制組siRNA(ON-TARGET Plus control pool,Thermo Fisher Scientific,Cat # D-001810-10-20)或PHLDA1-siRNA (ON-TARGET Plus siRNA Human PHLDA1,Thermo Fisher Scientific,Cat # J-012389-08)使得終濃度成為10nM,使用Lipofectamine RNAiMAX(Life Technologies,Cat # 13778-150),按照手冊將siRNA導入細胞內,實施了基因減弱。經減弱3日後,將各細胞株以冷PBS(Life Technologies,Cat # 10010-023)清洗2次,加入增溶緩衝液(添加了PhosSTOP(Roche,Cat # 4906837)及Complete,EDTA-free(Roche,Cat # 1873580)之Pierce RIPA緩衝液(Pierce RIPA Buffer)(Thermo Fisher Scientific,Cat # 89901)),冰冷卻30分鍾來增溶。經增溶的萃取液係以4℃、15000rpm進行30分鐘離心分離,回收上清液獲得蛋白萃取液。所獲得之蛋白萃取液係使用BCA蛋白質分析試劑(BCA Protein Assay Reagent)(Thermo Fisher Scientific,Cat # 23225),按照手冊測定了蛋白濃度。蛋白萃取液係藉由添加還原緩衝液(ImmunoPure Lane Maker Reducing Sample Buffer(Thermo Fisher Scientific,Cat # 39000))並煮沸而使之變性。在Criterion TGX預鑄膠片(Criterion TGX Precast Gels)(Biorad,Cat # 567-1084)每1泳道上樣20μg之經還原的蛋白萃取液進行了SDS-PAGE。
SDS-PAGE終了後,使用轉印裝置(blotting device)(Trans-Blot Turbo Transfer System,Biorad)來轉錄至PVDF膜(Trans-Blot Turbo Midi PVDF Transfer Pack,Biorad,Cat # 170-4157)。轉錄膜係Blocking One-P(Nacalai,Cat # 05999-84)在室溫下孵育1時間進行阻斷。隨後,利用藉由添 加了5%BSA及0.05%Tween20之TBS緩衝液(以下,略記為TBS-T)而經稀釋1000倍的抗人類PHLDA1山羊抗體(Santacruz,Cat # sc-6142)、經稀釋2000倍之抗人類磷酸化AKT兔抗體(S473)(Cell Signaling Technology,Cat # 4060),在4℃下,使反應一晚。PVDF膜係以TBS-T在室溫、10分鍾,洗淨3次後,利用經以5%脫脂牛乳/TBS-T稀釋了2000倍的二次抗體(山葵過氧化酶(HRP)標記之抗山羊抗體(Santacruz,Cat # sc-2020)及抗兔抗體(GE Healthcare,Cat # NA9340V))在室溫,使反應1小時。PVDF膜係利用TBS-T在室溫、10分鐘,洗淨3次後,使用ECL Prime西方點墨法檢測試劑(ECL Prime Western Blotting Detection Reagent)(GE Healthcare,Cat # RPN2232),並使用LAS-3000(FujiFilm)檢測了化學發光。將其結果顯示於圖2。
如圖2,在PHLDA1係高表現的乳癌細胞3株,進行了PHLDA1基因減弱之結果,AKT磷酸化(S473)亢進,確認到PI3K/AKT/mTOR訊息傳遞途徑的活化。AKT的磷酸化(S473)水平,由於係與對於PI3K抑制劑之活體外及體內的抗腫瘤效果係相關的緣故(癌症研究(Cancer Reserach)70,4982-4994(2010)),顯示了PHLDA1的表現量能參與對於PI3K/AKT/mTOR抑制劑之治療效果。
人類卵巢癌細胞株OVCAR-3(取得自ATCC)係利用包 含20% FBS、0.01mg/mL牛胰島素(bovine insulin)(Sigma-Aldrich,Cat # I0516)之RPMI培養基(Life Technologies Corp.,Cat # A104910-01)來培養。人類乳癌細胞株HCC1187(取得自ATCC)係利用包含10% FBS之RPMI培養基(Life Technologies Corp.,Cat # A104910-01)來培養。
準據實施例1,使用各細胞株,進行了對於PI3K/AKT/mTOR抑制劑(AKT抑制劑:化合物-I、PI3K抑制劑:GDC-0941)及紫杉醇的細胞毒性試驗。令經培養3日之控制組(添加二甲亞碸)的細胞數為100,令無細胞為0,將測定各濃度之藥劑處理後之相對細胞數之結果顯示於圖3。
如圖3,在OVCAR-3及HCC1187細胞株而言,經PIK3C2B基因減弱之結果,對於為PI3K/AKT/mTOR抑制劑之化合物-I及GDC-0941的敏感度係降低了。另一方面,對於非PI3K/AKT/mTOR抑制劑之紫杉醇的敏感度係沒有變化。即,在癌細胞而言,顯示了PIK3C2B係能單獨地控制對於PI3K/AKT/mTOR抑制劑之敏感度的決定因子。
從在臨床上作為藥效預測標記物被檢證之PIK3CA變異或PTEN缺失,與針對PHLDA1或PIK3C2B表現量對於PI3K/AKT/mTOR抑制劑之敏感度之相關性的觀點來比 較。
於實施例1顯示之源自人類乳癌之細胞株37株之中,除了KPL-3C的36株,PIK3CA變異及PTEN缺失資訊係已知。於此36株中,於圖4顯示因PIK3CA變異(E545K或H1047R)或PTEN缺失之有無所致之對於化合物-I之GI50值(μM)。無法確認到PTEN缺失(8株)對於化合物-I之敏感度的相關性。又,PIK3CA變異(10株)雖然顯示了與對於化合物-I之高敏感度係相關的傾向,但並非係有意義的(P=0.051)。同樣地,在源自人類乳癌之細胞株37株,檢證了PHLDA1或PIK3C2B表現量與對於化合物-I之敏感度的關連性。作為例子,於圖4顯示令PHLDA1或PIK3C2B表現量的平均值為截點,分別分為2群的狀況時之,對於化合物-I之GI50值(μM)的分布。PHLDA1或PIK3C2B表現量與分別對於化合物-I之敏感度,顯示了強烈的相關性(P=0.00061或者0.0060)。
較迄今之法之PIK3CA變異或PTEN缺失,PHLDA1或PIK3C2B表現量,與對於化合物-I之敏感度的相關性明顯地高,在臨床上作為藥效預測標記物係有用的。
Claims (11)
- 一種預測化學療法之治療效果的方法,該化學療法係基於自癌症患者採取之腫瘤細胞之PHLDA1及/或PIK3C2B之表現量,對該癌症患者使用含有PI3K/AKT/mTOR抑制劑的抗腫瘤劑。
- 如請求項1之方法,包含下述步驟(1)及(2):(1)測定步驟,測定包含自該患者所採取之腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B之表現量,及(2)預測步驟,當在上述步驟(1)所獲得之PHLDA1的表現量係預先設定之截點(cut-off point)以下的狀況,或者在上述步驟(1)所獲得之PIK3C2B的表現量係預先設定之截點以上的狀況,預測對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高。
- 如請求項1之方法,其中PI3K/AKT/mTOR抑制劑係咪唑并 化合物或其藥學上可容許的鹽,或者係AMG-319、AZD-6482、BYL-719、柯潘利西柏(Copanlisib)(BAY-80-6946)、GDC-0032、GDC-0084、GSK-1059615、GSK-2126458、GSK-2636771、意德拉利西柏(Idelalisib)(CAL-101)、IPI-145、MLN-1117(INK-1117)、PA-799(CH-5132799)、皮克替利西柏(Pictilisib)(GDC-0941)、匹拉若利西柏(Pilaralisib)(XL-147)、SF-1126、索諾利西柏(Sonolisib)(PX-866)、沃克斯它利西柏(Voxtalisib)(SAR-245409、XL-765)、鹽酸阿弗色替波(Afuresertib hydrochloride)(GSK-2110183)、ARQ-092、AZD5363、鹽酸恩扎啕林(Enzastaurin hydrochloride)、GDC-0068、GSK-2141795、GSK690693、LY-2780301、MK-2206、哌立福新(Perifosine)、磷酸曲西瑞賓(Triciribine phosphate)(VQD-002)、AZD-2014、AZD-8055、CC-115、CC-223、DS-3078、依維莫司(Everolimus)、替西羅莫司(Temsirolimus)、ME-344、MLN-0128(INK-128)、OSI-027、PWT-33597、地磷莫司(Ridaforolimus)、西羅莫司(Sirolimus)、達克托利西柏(Dactolisib)(BEZ235)、DS-7423、GDC-0980、NVP-BGT-226、PF-04691502、PF-05212384(PKI-587)或PWT-33597;該咪唑并 化合物係以通式(I)所表示:
- 如請求項3之方法,其中以通式(I)所表示之咪唑并 化合物,係下述之化合物:A、B、C及D分別係表示C-R 1a、C-R 1b、C-R 1c及C-R 1d,或者表示前述A、B、C、D中任一者或兩者被取代為N原子,R 1a、R 1b、R 1c、R 1d中至少2者係表示氫原子,其它分別係表示氯原子、氟原子、氰基、甲基、羥甲基、甲氧基、乙氧基、羧基、胺甲醯基、甲胺基羰基、乙胺基羰基、羥乙胺基羰基、乙氧基胺基羰基、吡唑基;R 2係表示苯基、吡啶基或噻吩基;R 3係表示氫原子、甲基、乙基或環丙基;R 4係表示氫原子或羥基。
- 如請求項3之方法,其中以通式(I)所表示之咪唑并 化合物係下述(a)~(t)之任一化合物:(a)反式-3-胺基-1-環丙基-3-(4-(10-氟-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -2-基)苯基)環丁醇;(b)反式-3-胺基-1-環丙基-3-(4-(10-氟-3-(吡啶-4-基)-5H-苯并[e]咪唑并[1,2-c][1,3] -2-基)苯基)環丁醇;(c)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-苯并[e]咪 唑并[1,2-c][1,3] -2-基)苯基)環丁醇;(d)反式-3-胺基-1-環丙基-3-(4-(10-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -2-基)苯基)環丁醇;(e)反式-3-胺基-1-環丙基-3-(4-(9-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -2-基)苯基)環丁醇;(f)反式-3-胺基-1-環丙基-3-(4-(8-甲氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -2-基)苯基)環丁醇;(g)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[2,3-e][1,3] -2-基)苯基)環丁醇;(h)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[2,3-e][1,3] -2-基)苯基)環丁醇;(i)反式-3-胺基-1-乙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[2,3-e][1,3] -2-基)苯基)環丁醇;(j)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3] -2-基)苯基)環丁醇;(k)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3] -2-基)苯基)環丁醇;(l)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[4,3-e][1,3] -2-基)苯基)環丁醇;(m)反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[4,3-e][1,3] -2-基)苯基)環丁醇;(n)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,2-e][1,3] -2-基)苯基)環丁醇;(o)反式-3-胺基-1-環丙基-3-(4-(3-苯基-5H-咪唑并 [1,2-c]吡 并[2,3-e][1,3] -2-基)苯基)環丁醇;(p)反式-3-胺基-3-(4-(9-(羥甲基)-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -2-基)苯基)-1-甲基環丁醇;(q)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -9-甲腈;(r)反式-3-胺基-1-甲基-3-(4-(3-苯基-9-(1H-吡唑-5-基)-5H-苯并[e]咪唑并[1,2-c][1,3] -2-基)苯基)環丁醇;(s)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-N-甲基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -8-甲醯胺;(t)2-(4-(反式-1-胺基-3-羥基-3-甲基環丁基)苯基)-N-乙氧基-3-苯基-5H-苯并[e]咪唑并[1,2-c][1,3] -8-甲醯胺。
- 如請求項1之方法,其中PI3K/AKT/mTOR抑制劑係MK-2206、BEZ235、GDC-0941、西羅莫司、反式-3-胺基-1-甲基-3-(4-(3-苯基-5H-咪唑并[1,2-c]吡啶并[3,4-e][1,3] -2-基)苯基)環丁醇。
- 一種含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑,其係用以治療腫瘤細胞之PHLDA1的表現量係預先設定之截點以下,或者腫瘤細胞之PIK3C2B的表現量係預先設定之截點以上的癌症患者。
- 一種含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑,該抗腫瘤劑之特徵在於,透過包含下述步驟(1)及(2)之方法,對被預測為使用該抗腫瘤劑之化學療法顯示充分治療 效果之可能性高的癌症患者進行投予:(1)測定步驟,測定包含自該患者所採取之腫瘤細胞的生物試樣之PHLDA1及/或PIK3C2B的表現量;及(2)預測步驟,當在上述步驟(1)所獲得之PHLDA1的表現量係預先設定之截點以下的狀況,或者在上述步驟(1)所獲得之PIK3C2B的表現量係預先設定之截點以上的狀況,預測對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高。
- 一種含有測定PHLDA1及/或PIK3C2B的表現量之試劑的套組,其係用以透過包含下述步驟(1)及(2)之方法,來預測對癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑之化學療法的治療效果:(1)測定步驟,測定包含自該患者所採取之腫瘤細胞的生物試樣中PHLDA1及/或PIK3C2B的表現量;及(2)預測步驟,當於上述步驟(1)所獲得之PHLDA1的表現量係預先設定之截點以下的狀況,或者在上述步驟(1)所獲得之PIK3C2B的表現量係預先設定之截點以上的狀況,預測對該癌症患者使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高。
- 一種癌症患者的治療方法,包含對透過請求項1~6中任1項之方法被預測為使用含有PI3K/AKT/mTOR抑制劑之腫瘤劑的化學療法顯示充分治療效果之可能性高的癌症患者,投予該抗腫瘤劑。
- 一種含有PI3K/AKT/mTOR抑制劑之抗腫瘤 劑,其係使用來用以治療透過請求項1~6中任1項之方法被預測為使用含有PI3K/AKT/mTOR抑制劑之抗腫瘤劑的化學療法顯示充分治療效果的可能性高之癌症患者。
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JP2019512003A (ja) * | 2016-02-01 | 2019-05-09 | バイエル ファーマ アクチエンゲゼルシャフト | コパンリシブバイオマーカー |
US11883404B2 (en) | 2016-03-04 | 2024-01-30 | Taiho Pharmaceuticals Co., Ltd. | Preparation and composition for treatment of malignant tumors |
KR20240014585A (ko) | 2016-03-04 | 2024-02-01 | 다이호야쿠힌고교 가부시키가이샤 | 악성 종양 치료용 제제 및 조성물 |
SG10201912456RA (en) | 2016-06-24 | 2020-02-27 | Infinity Pharmaceuticals Inc | Combination therapies |
WO2018112122A1 (en) * | 2016-12-16 | 2018-06-21 | Drexel University | Methods of identifying and treating tumors with sigma1 inhibitors |
WO2019181876A1 (ja) | 2018-03-19 | 2019-09-26 | 大鵬薬品工業株式会社 | アルキル硫酸ナトリウムを含む医薬組成物 |
AU2020297166A1 (en) * | 2019-06-21 | 2022-02-17 | Taiho Pharmaceutical Co., Ltd. | Method for treating malignant tumor |
RU2766662C1 (ru) * | 2021-05-18 | 2022-03-15 | Федеральное государственное бюджетное учреждение "Национальный медицинский исследовательский центр онкологии имени Н.Н. Петрова" Министерства здравоохранения Российской Федерации | Способ определения лекарственной чувствительности немелкоклеточного рака легкого in vitro |
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US8445198B2 (en) * | 2005-12-01 | 2013-05-21 | Medical Prognosis Institute | Methods, kits and devices for identifying biomarkers of treatment response and use thereof to predict treatment efficacy |
WO2010087497A1 (ja) * | 2009-02-02 | 2010-08-05 | 財団法人ヒューマンサイエンス振興財団 | 医薬組成物、および、腫瘍の治療用医薬剤 |
CN102473202B (zh) * | 2009-07-08 | 2015-11-25 | 环球创新网络公司 | 用于预测药物在患者中的疗效的方法 |
MY163187A (en) | 2011-04-06 | 2017-08-15 | Taiho Pharmaceutical Co Ltd | Novel imidazo-oxazine compound or salt thereof |
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TW201537174A (zh) | 2015-10-01 |
AU2014282179A1 (en) | 2016-01-28 |
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HUE053322T2 (hu) | 2021-06-28 |
US20160102366A1 (en) | 2016-04-14 |
EP3012327A4 (en) | 2017-03-22 |
KR20160021836A (ko) | 2016-02-26 |
PL3543355T3 (pl) | 2021-05-31 |
HUE053611T2 (hu) | 2021-07-28 |
JP6289459B2 (ja) | 2018-03-07 |
RU2016101364A (ru) | 2017-07-26 |
EP3543355B1 (en) | 2020-12-23 |
WO2014203959A1 (ja) | 2014-12-24 |
DK3543355T3 (da) | 2021-03-01 |
EP3012327A1 (en) | 2016-04-27 |
DK3012327T3 (da) | 2021-01-25 |
PL3012327T3 (pl) | 2021-04-19 |
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