US20050267201A1 - Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same - Google Patents

Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same Download PDF

Info

Publication number
US20050267201A1
US20050267201A1 US11/165,896 US16589605A US2005267201A1 US 20050267201 A1 US20050267201 A1 US 20050267201A1 US 16589605 A US16589605 A US 16589605A US 2005267201 A1 US2005267201 A1 US 2005267201A1
Authority
US
United States
Prior art keywords
taxane
paclitaxel
polyoxyethylated
carrier
meleu
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US11/165,896
Inventor
Jose Gutierrez-Rocca
Janice Cacace
Sami Selim
Robert Testman
J. Rutledge
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Teva Branded Pharmaceutical Products R&D Inc
Original Assignee
Baker Cummins Pharmaceuticals Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US08/608,776 external-priority patent/US5968972A/en
Priority claimed from US08/733,142 external-priority patent/US6245805B1/en
Application filed by Baker Cummins Pharmaceuticals Inc filed Critical Baker Cummins Pharmaceuticals Inc
Priority to US11/165,896 priority Critical patent/US20050267201A1/en
Assigned to BAKER NORTON PHARMACEUTICALS, INC. reassignment BAKER NORTON PHARMACEUTICALS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: TESTMAN, ROBERT, SELIM, SAMI, CACACE, JANICE L., GUTIERREZ-ROCCA, JOSE C., RUTLEDGE, J. MICHAEL
Publication of US20050267201A1 publication Critical patent/US20050267201A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/4841Filling excipients; Inactive ingredients
    • A61K9/4858Organic compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/335Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/335Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/337Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having four-membered rings, e.g. taxol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/04Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/12Cyclic peptides, e.g. bacitracins; Polymyxins; Gramicidins S, C; Tyrocidins A, B or C
    • A61K38/13Cyclosporins
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/10Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/14Esters of carboxylic acids, e.g. fatty acid monoglycerides, medium-chain triglycerides, parabens or PEG fatty acid esters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/22Heterocyclic compounds, e.g. ascorbic acid, tocopherol or pyrrolidones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/36Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
    • A61K47/40Cyclodextrins; Derivatives thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/4841Filling excipients; Inactive ingredients
    • A61K9/4866Organic macromolecular compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/18Drugs for disorders of the alimentary tract or the digestive system for pancreatic disorders, e.g. pancreatic enzymes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00Drugs for disorders of the urinary system
    • A61P13/08Drugs for disorders of the urinary system of the prostate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00Drugs for disorders of the urinary system
    • A61P13/12Drugs for disorders of the urinary system of the kidneys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P33/00Antiparasitic agents
    • A61P33/02Antiprotozoals, e.g. for leishmaniasis, trichomoniasis, toxoplasmosis
    • A61P33/06Antimalarials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P39/00General protective or antinoxious agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/10Dispersions; Emulsions
    • A61K9/107Emulsions ; Emulsion preconcentrates; Micelles
    • A61K9/1075Microemulsions or submicron emulsions; Preconcentrates or solids thereof; Micelles, e.g. made of phospholipids or block copolymers
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

  • the invention relates to compositions for orally administering paclitaxel and related taxanes to human patients, and methods of treatment employing such compositions.
  • Paclitaxel is a natural diterpene product isolated from the Pacific yew tree ( Taxus brevifolia ). It is a member of the taxane family of terpenes. It was first isolated in 1971 by Wani et al. (J. Am. Chem. Soc., 93:2325, 1971), who characterized its structure by chemical and X-ray crystallographic methods.
  • Paclitaxel has been approved for clinical use in the treatment of refractory ovarian cancer in the United States (Markman et al., Yale Journal of Biology and Medicine, 64:583, 1991; McGuire et al., Ann. Intern. Med., 111:273, 1989). It is effective for chemotherapy for several types of neoplasms including breast (Holmes et al., J. Nat. Cancer Inst., 83:1797, 1991) and has been approved for treatment of breast cancer as well. It is a potential candidate for treatment of neoplasms in the skin (Einzig et al., Proc. Am. Soc. Clin. Oncol., 20:46), lung cancer and head and neck carcinomas (Forastire et al. Sem. Oncol., 20:56, 1990). The compound also shows potential for the treatment of polycystic kidney disease (Woo et al, Nature, 368:750, 1994) and malaria.
  • Paclitaxel is only slightly soluble in water and this has created significant problems in developing suitable injectable and infusion formulations useful for anticancer chemotherapy.
  • Some formulations of paclitaxel for IV infusion have been developed utilizing CREMOPHOR ELTM (polyethoxylated castor oil) as the drug carrier because of paclitaxel's aqueous insolubility.
  • CREMOPHOR ELTM polyethoxylated castor oil
  • paclitaxel used in clinical testing under the aegis of the NCI has been formulated in 50% CREMOPHOR ELTM and 50% dehydrated alcohol.
  • CREMOPHOR ELTM when administered intravenously, is itself toxic and produces vasodilation, labored breathing, lethargy, hypotension and death in dogs. It is also believed to be at least partially responsible for the allergic-type reactions observed during paclitaxel administration, although there is some evidence that paclitaxel may itself provoke acute reactions even in the absence of Cremophor.
  • prodrug compounds that are more water soluble than the parent compound and that display the cytotoxic properties upon activation.
  • One important group of such prodrugs includes the 2′-onium salts of paclitaxel and docetaxel, particularly the 2′-methylpyridinium mesylate (2′-MPM) salts.
  • Paclitaxel is very poorly absorbed when administered orally (less than 1%); see Eiseman et al., Second NCI Workshop on Taxol and Taxus (September 1992); Suffness et al. in Taxol Science and Applications (CRC Press 1995). Eiseman et al. indicate that paclitaxel has a bioavailability of 0% upon oral administration, and Suffness et al. report that oral dosing with paclitaxel did not seem possible since no evidence of antitumor activity was found on oral administration up to 160 mg/kg/day. For this reason, paclitaxel has not been administered orally to human patients in the prior art, and certainly not in the course of treating paclitaxel-responsive diseases.
  • Docetaxel N-debenzoyl-N-tert-butoxycarbonyl-10-deacetyl paclitaxel
  • TAXOTERE® Rhone-Poulenc-Rorer S.A.
  • a drug such as paclitaxel after oral administration
  • a membrane-bound P-glycoprotein which functions as an energy-dependent transport or efflux pump to decrease intracellular accumulation of drug by extruding xenobiotics from the cell.
  • This P-glycoprotein has been identified in normal tissues of secretory endothelium, such as the biliary lining, brush border of the proximal tubule in the kidney and luminal surface of the intestine, and vascular endothelial cells lining the blood brain barrier, placenta and testis.
  • P-glycoprotein efflux pump prevents certain pharmaceutical compounds from transversing the mucosal cells of the small intestine and, therefore, from being absorbed into the systemic circulation.
  • a number of known non-cytotoxic pharmacological agents have been shown to inhibit P-glycoprotein, including cyclosporin A (also known as cyclosporine), verapamil, tamoxifen, quinidine and phenothiazines, among others. Many of these studies were aimed at achieving greater accumulation of intravenously administered cytotoxic drugs inside tumor cells. In fact, clinical trials have been conducted to study the effects of cyclosporine on the pharmacokinetics and toxicities of paclitaxel (Fisher et al., Proc. Am.
  • Benet et al. disclose a purported method for increasing the bioavilability of orally administered hydrophobic pharmaceutical compounds. This method comprises orally administering such compounds to the patient concurrently with a bioenhancer comprising an inhibitor of a cytochrome P450 3A enzyme or an inhibitor of P-glycoprotein-mediated membrane transport. Benet et al., however, provide virtually no means for identifying which bioavailability enhancing agents will improve the availability of specific “target” pharmaceutical compounds, nor do they indicate specific dosage amounts, schedules or regimens for administration of the enhancing or target agents. In fact, although the Benet et al.
  • Benet et al. When describing the general characteristics of compounds which can be used as bioenhancers by reduction of P-glycoprotein transport activity, Benet et al. indicate that these are hydrophobic compounds which generally, but not necessarily, comprise two co-planar aromatic rings, a positively charged nitrogen group or a carbonyl group—a class that includes an enormous number of compounds, most of which would not provide the desired absorption enhancing activity in the case of specific target agents. Moreover, the classes of target agents disclosed by Benet et al. include the great majority of pharmaceutical agents listed in the Physicians' Desk Reference. These inclusion criteria are of no value to medical practitioners seeking safe, practical and effective methods of orally administering specific pharmaceutical agents.
  • Benet et al. provides no teaching that could be followed by persons skilled in the medical and pharmaceutical arts to identify suitable bioenhancer/target drug combinations or to design specific treatment regimens and schedules which would render the target agents therapeutically effective upon oral administration to human patients. Benet et al. also provides no direction whatsoever regarding how paclitaxel and other taxanes might be administered orally to humans with therapeutic efficacy and acceptable toxicity.
  • the present invention relates to oral pharmaceutical compositions containing taxane antitumor agents, for example paclitaxel or docetaxel, which, when administered to a mammalian patient, preferably with co-administration of an oral bioavailability enhancing agent, enable sufficient absorption of the taxane agent from the gastrointestinal tract into the bloodstream to provide therapeutically significant blood levels of the active drug.
  • taxane antitumor agents for example paclitaxel or docetaxel
  • compositions of the invention comprise a vehicle including a carrier in which the taxane agent is dissolved or dispersed.
  • vehicle may also include a viscosity-reducing co-solubilizer which renders the vehicle more flowable at body temperature or at least reduces the melting point of the vehicle below body temperature, and may also provide increased taxane solubility.
  • the carrier used in the novel compositions is preferably a non-ionic surface active agent (surfactant) or emusifier having a hydrophilic-lipophilic balance (HLB) value at least about 10.
  • the viscosity-reducing co-solubilizer is selected from, e.g., organic solvents suitable for oral administration, vegetable oils, hydrogenated or polyoxyethylated castor oil, citrate esters and saturated polyglycolized glycerides. Certain saturated polyglycolized glycerides may also serve as carriers in the compositions of the invention.
  • the novel pharmaceutical compositions contain about 2-500 mg/ml or mg/g of taxane, and preferably about 2-50 mg/ml or mg/g of taxane.
  • the therapeutically inactive vehicle comprises at least 30% by weight of carrier and about 0-70% of co-solubilizer, and may also contain conventional pharmaceutical additives and excipients such as flavoring and coloring agents and the like.
  • Another aspect of the invention pertains to methods of treatment of mammalian patients suffering from taxane-responsive disease conditions by the administration to such patients of oral pharmaceutical compositions in accordance with the invention, preferably with co-administration of an oral bioavailability enhancing agent.
  • compositions of the invention contain at least two components: an active agent comprising a taxane, preferably the antitumor agent paclitaxel or docetaxel, and a therapeutically inactive vehicle comprising a pharmaceutically acceptable carrier for said taxane.
  • compositions for oral administration that are liquid or at least flowable form at body temperature (about 37° C.), as generally required for oral bioavailability, it is required in some instances to add an additional component to the vehicle: a viscosity-reducing co-solubilizer which decreases the viscosity and increases the flowability of the vehicle at body temperature, and also may increase the amount of the active agent that can be dissolved or dispersed in the vehicle in comparison with the use of a carrier alone.
  • the novel compositions may comprise more than one taxane as active ingredient and more than one carrier and/or co-solubilizer as inactive vehicle components.
  • the vehicle comprises at least 30% by weight of carrier, preferably 30-90% by weight.
  • Preferred carriers for use in the invention are non-ionic surfactants or emulsifiers having HLB values at least about 10. It has been found that such non-ionic surfactants or emulsifiers are not only compatible carriers for the lipophilic taxanes (which are poorly soluble in water) but also promote absorption of the active ingredient from the gastrointestinal tract into the bloodstream.
  • Preferred carriers for use in the invention include, for example, Vitamin E TPGS (d- -tocopheryl polyethylene glycol 1000 succinate, Eastman Chemical Co., Kingsport Tenn.); saturated polyglycolyzed glycerides such as GELUCIRETM and LABRASOLTM products (Gattefossé Corp., Westwood, N.J.) which include glycerides of C 8 -C 18 fatty acids; CREMOPHORTM EL or RH40 modified castor oils (BASF, Mt.
  • Vitamin E TPGS d- -tocopheryl polyethylene glycol 1000 succinate, Eastman Chemical Co., Kingsport Tenn.
  • saturated polyglycolyzed glycerides such as GELUCIRETM and LABRASOLTM products (Gattefossé Corp., Westwood, N.J.) which include glycerides of C 8 -C 18 fatty acids
  • CREMOPHORTM EL or RH40 modified castor oils BASF, Mt.
  • Preferred viscosity-reducing co-solubilizers include, e.g., PHARMASOLVETM (N-methyl-2-pyrrolidone, International Specialty Products, Wayne, N.J.); MIGLYOLTM glycerol or propylene glycol esters of caprylic and capric acids (Hüls AG, Marl, Germany); polyoxyethylated hydroxystearates (e.g., SOLUTOLTM HS 15); TWEENTM polyoxyethylated sorbitan esters; SOFTIGENTM polyethylene glycol esters of caprylic and capric acids (Hüls AG); modified castor oils (such as CREMOPHORTM EL or RH 40); vegetable oils such as olive oil, polyoxyethylated fatty ethers or modified castor oils; certain saturated polyglycolyzed glycerides (such as a LABRASOLTM) citrate esters such as tributyl citrate, triethyl citrate and
  • the vehicle contains about 0-70% by weight of the co-solubilizer, and preferably about 10-50% by weight. It will be noted that several of the materials identified as carriers have also been found to be effective co-solubilizers, either alone or in combination with other viscosity-reducing agents, for certain other carriers. In general, any solvent in which paclitaxel or other taxanes are at least moderately soluble at body temperature or with gentle heating can be used as a co-solubilizer in the vehicle of the novel compositions. Preferred co-solubilizers are those in which at least 25 mg/ml of paclitaxel or other taxane can be solubilized at about 20-25° C.
  • the concentration of the active taxane ingredient or ingredients in the composition may vary based on the solubility of the active agent in the carrier(s) or carrier(s)/co-solubilizer(s) system and on the desired total dose of taxane to be administered orally to the patient.
  • the concentration of taxane may range from about 2 to about 500 mg/ml or mg/g of vehicle, and preferably from about 2 to about 50 mg/ml or mg/g.
  • compositions of the invention may be prepared by any conventional method known to individuals of skill in the pharmaceutical arts for preparing liquid or other fluid oral formulations containing surfactant carriers and lipophilic active ingredients. Since the majority of the preferred carriers are very viscous at room temperature, and in some cases retain a relatively high viscosity even upon the addition of a minor proportion of co-solubilizer, it is generally preferred in preparing the novel compositions to mix the carriers and co-solubilizers to be used, add the taxane active ingredient, and heat the resulting mixture while stirring, for example to about 40° C. This method enables the preparation of clear solutions. Certain co-solubilizers, however, particularly PHARMASOLVETM, lower the carrier viscosity and enhance taxane solubility to such a degree that the composition can be prepared by stirring at room temperature with no heating.
  • the viscosity of the finished composition not be higher than 40,000 cps at body temperature (approximately 37° C.).
  • compositions of the invention may be in the form of true solutions, emulsions or even suspensions, but solutions of the active taxane ingredient in the carrier or carrier/co-solubilizer system are preferred.
  • the present invention also comprehends methods of treating human patients afflicted with cancers, tumors, Kaposi's sarcoma, malignancies, uncontrolled tissue or cellular proliferation secondary to tissue injury, and any other disease conditions responsive to taxanes such as paclitaxel and docetaxel, and/or prodrugs and derivatives of the foregoing, with the novel orally administered pharmaceutical compositions.
  • taxanes such as paclitaxel and docetaxel, and/or prodrugs and derivatives of the foregoing
  • prodrugs and derivatives of the foregoing.
  • carcinoma which may be treated particularly effectively with oral paclitaxel, docetaxel, other taxanes, and their prodrugs and derivatives, are hepatocellular carcinoma and liver metastases, cancers of the gastrointestinal tract, pancreas, prostate and lung, and Kaposi's sarcoma.
  • non-cancerous disease conditions which may be effectively treated with these active agents administered orally in accordance with the present invention are uncontrolled tissue or cellular proliferation secondary to tissue injury, polycystic kidney disease, inflammatory diseases (e.g., arthritis) and malaria, including chloroquine- and pyrimethamine-resistant malaria parasites (Pouvelle et al., J. Clin. Invest., 44: 413-417, 1994).
  • the preferred method of the invention for treating mammalian patients (particularly human patients) suffering from taxane-responsive disease conditions is to administer the oral compositions containing the taxane target agent concomitantly with the administration of at least one dose of an oral bioavailability enhancing agent.
  • the preferred embodiment of the method of the invention for oral administration to humans of paclitaxel, its derivatives, analogs and prodrugs, and other taxanes comprises the oral administration of an oral absorption or bioavailability enhancing agent to a human patient simultaneously with, or prior to, or both simultaneously with and prior to the oral administration to increase the quantity of absorption of the intact target agent into the bloodstream.
  • the orally administered enhancing agents which may be used in practicing the preferred embodiment of the invention include, but are not limited to, the following:
  • Cyclosporins including cyclosporins A through Z but particularly cyclosporin A (cyclosporine), cyclosporin F, cyclosporin D, dihydro cyclosporin A, dihydro cyclosporin C, acetyl cyclosporin A, PSC-833, SDZ-NIM 811 1 (both from Sandoz Pharmaceutical Corp).
  • the structures of cyclosporins A-Z are described in Table 1 below.
  • SDZ-NIM 811 is (Me-Ile-4)-cyclosporin, an antiviral, non-immunosuppressive cyclosporin.
  • Cyclosporins are a group of nonpolar cyclic oligopeptides (some of which have immunosuppressant activity) produced by the genus, Tolypocladium , including, e.g., Tolypocladium inflatum Gams (formerly designated as Trichoderma Polysporum ), Tolypocladium terricola and other fungi imperfecti.
  • the major component, cyclosporin A (cyclosporine or CsA)
  • CsA cyclosporine
  • a number of synthetic and semi-synthetic analogs have also been prepared. See generally Jergorov et al., Phytochemistry, 38: 403-407 (1995).
  • the present invention comprehends natural, semi-synthetic and synthetic analogs of cyclosporins.
  • Cyclosporins are neutral, lipophilic, cyclic undecapeptides with molecular weights of about 1200. They are used intravenously or orally as immunosuppressants, primarily for organ transplantation and certain other conditions. Cyclosporins, particularly cyclosporine (cyclosporin A), are known inhibitors of the P-glycoprotein efflux pump and other transporter pumps as well as of certain P450 degradative enzymes, but to date no effective regimens for applying this property clinically have been developed to the point of clinical and commercial feasibility or regulatory approval.
  • the dosage range of the enhancing agent to be co-administered with the target agent in accordance with the invention is about 0.1 to about 20 mg/kg of patient body weight.
  • “Co-administration” of the enhancing agent comprehends administration substantially simultaneously with the target agent (either less than 0.5 hr. before, less than 0.5 hr. after or together), from about 0.5 to about 72 hr. before the administration of the target agent, or both, i.e., with one or more doses of the same or different enhancing agents given at least 0.5 hr. before and one dose given substantially simultaneously with (either together with or immediately before of after) the target agent.
  • “co-administration” comprehends administering more than one dose of target agent within 72 hr. after a dose of enhancing agent, in other words, the enhancing agent(s) need not be administered again before or with every administration of target agent, but may be administered intermittently during the course of treatment.
  • the dosage range of orally administered taxane target agents will vary from compound to compound based on its therapeutic index, the requirements of the condition being treated, the status of the subject and so forth.
  • the method of the invention makes it possible to administer paclitaxel and other taxanes orally ranging from about 20 mg/m 2 to about 1000 mg/m 2 (based on patient body surface area) or about 0.5-30 mg/kg (based on patient body weight) as single or divided (2-3) daily doses, and maintain the plasma levels of paclitaxel in humans in the range of 50-500 ng/ml for extended periods of time (e.g., 8-12 hours) after each oral dose.
  • paclitaxel levels are at least comparable to those achieved with 96-hour IV infusion paclitaxel therapy (which causes the patient great inconvenience, discomfort, loss of quality time, infection potential, etc.).
  • plasma levels of paclitaxel are more than sufficient to provide the desired pharmacological activities of the target drug, e.g., inhibition of tubulin disassembly (which occurs at levels of about 0.1 ⁇ M, or about 85 ng/ml) and inhibition of protein isoprenylation (which occurs at levels of about 0.03 ⁇ M, or about 25 ng/ml) which are directly related to its antitumor effects by inhibiting oncogene functions and other signal-transducing proteins that play a pivotal role in cell growth regulation.
  • tubulin disassembly which occurs at levels of about 0.1 ⁇ M, or about 85 ng/ml
  • protein isoprenylation which occurs at levels of about 0.03 ⁇ M, or about 25 ng/ml
  • Two or more different enhancing agents and/or two or more different taxane target agents may be administered together, alternately or intermittently in all of the various aspects of the method of the invention.
  • oral paclitaxel administered alone exhibits near zero bioavailability.
  • the composition must meet the following criterion: when the composition is administered orally to a mammalian subject (e.g., a laboratory rat or a human patient), i.e., is ingested by the subject, one hour after administration of an effective oral dose of an oral bioavailability enhancing agent, the amount of the active ingredient absorbed into the bloodstream is at least 15% of the amount absorbed when the same dose of paclitaxel is administered to the subject intravenously in a standard intravenous vehicle, for example a CREMOPHORTM EL/ethanol vehicle.
  • the relative percentage of absorption is determined by comparing the respective AUC (area under the curve) values of the taxane blood level vs.
  • the preferred bioavailability enhancing agent for use in making the experimental determination of whether a particular oral composition meets the 15% of IV absorption criterion is cyclsoporin A, for example a single oral dose of 5 mg/kg of CsA.
  • compositions may be administered in any known pharmaceutical dosage form.
  • the compositions may be encapsulated in a soft or hard gelatin capsule or may be administered in the form of a liquid preparation.
  • Each dosage form may include, apart from the essential components of the composition (at least one carrier and one taxane active ingredient, and in some instances at least one co-solubilizer), conventional pharmaceutical excipients, diluents, sweeteners, flavoring agents, coloring agents and any other inert ingredients regularly included in dosage forms intended for oral administration (see, e.g., Remington's Pharmaceutical Sciences, 17th Ed., 1985).
  • paclitaxel or other taxane dosage forms may contain sufficient quantities of the target agent to provide a daily dosage of about 20-1000 mg/m 2 (based on mammalian subject or patient body surface area) or about 0.5-30 mg/kg (based on mammalian subject or patient body weight) as single or divided (2-3) daily doses.
  • Preferred dosage amounts are about 50-200 mg/m 2 or about 2-6 mg/kg.
  • Dosing schedules for the treatment method of the present invention can likewise be adjusted to account for the patient's characteristics and disease status.
  • Preferred dosing schedules for administration of oral paclitaxel are (a) the daily administration to a patient in need thereof of 1-3 equally divided doses providing about 20-1000 mg/m 2 (based on body surface area), and preferably about 50-200 mg/m 2 , with said daily administration being continued for 1-4 consecutive days each 2-3 weeks, or (b) administration for about one day each week.
  • the former schedule is comparable to use of a 96-hour paclitaxel infusion every 2-3 weeks, which is considered by some a preferred IV treatment regimen.
  • Oral administration of taxanes in accordance with the invention may actually decrease toxic side effects in many cases as compared with currently utilized IV therapy. Rather than producing a sudden and rapid high concentration in blood levels as is usually the case with an IV infusion, absorption of the active agent through the gut wall (promoted by the enhancing agents), provides a more gradual appearance in the blood levels and a stable, steady-state maintenance of those levels at or close to the ideal range for a long period of time.
  • the oral compositions of the invention may be administered in a two-part medicament system.
  • the carrier may be chemically or physically incompatible with desired adjunctive ingredients such as flavoring or coloring agents.
  • the active ingredient can be administered to the patient as the first part of the medicament in a relatively small volume of any suitable liquid solubilizing vehicle (such as water, CREMOPHORTM or ethanol), which may be sweetened, flavored or colored as desired to mask the unpleasant taste of the vehicle and render it more palatable.
  • the administration of the active ingredient can be followed by administration of the second part of the medicament: a larger volume of fluid, for example 1 to 8 fluid ounces (30-240 ml), containing at least one carrier or a carrier/co-solubilizer system in accordance with the invention.
  • a larger volume of fluid for example 1 to 8 fluid ounces (30-240 ml)
  • a carrier/co-solubilizer system in accordance with the invention.
  • administration of the second, “chaser” formulation a short time after the taxane active ingredient can retard precipitation of the taxane which might otherwise occur upon entry into the gastric fluid and promote oral absorption to a degree comparable to that observed when the taxane is intermixed with the carrier and administered simultaneously.
  • “chaser” formulations which may be used in a two-part oral taxane medicament include:
  • the oral compositions of the invention can contain not only one or more taxane active ingredients but also one or more bioavailability enhancing agents in a combination dosage form.
  • such combination dosage form may contain from about 0.1 to about 20 mg/kg (based on average patient body weight) of one or more of cyclosporins A, D, C, F and G, dihydro CsA, dihydro CsC and acetyl CsA together with about 20 to about 1000 mg/m 2 (based on average patient body surface area), and preferably about 50-200 mg/m 2 , of paclitaxel, docetaxel, other taxanes or paclitaxel or docetaxel derivatives.
  • compositions and methods of the present invention provide many advantages in comparison with prior art intravenous compositions containing paclitaxel and other taxanes and prior art intravenous administration regimens. Apart from the issues of decreased toxicity, patient convenience and comfort, ease of administration and lowered expense, discussed previously, the invention makes it possible to administer powerful taxane antitumor agents to patients with greatly reduced likelihood of allergic hypersensitivity reactions which are common with IV administration. Thus, the need for pre-medication regimens of H-1 and H-2 blockers plus steroids can be eliminated.
  • the present invention also makes it possible to give taxanes, e.g., paclitaxel, in comparatively infrequent daily doses (e.g., about twice/day) and according to schedules that would otherwise not be possible or practical with the intravenous route.
  • taxanes e.g., paclitaxel
  • comparatively infrequent daily doses e.g., about twice/day
  • schedules that would otherwise not be possible or practical with the intravenous route.
  • the use of the bioavailability enhancer e.g., cyclosporin A
  • paclitaxel could be given intermittently as single dose on a fixed schedule (weekly, biweekly, etc.) or chronically, over a period of consecutive days (e.g., 4 days) every 2-4 weeks with the goal of keeping the levels within a safe and effective “window”.
  • Blood samples were collected from each animal at 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours post-dose of paclitaxel. The blood samples were combusted and assayed for total radioactivity.
  • the total blood radioactivity levels (corresponding to concentration in the blood of 3 H-paclitaxel) were plotted on a graph vs. time post-dose. Data for each group of rats were compiled in the form of mean AUC, C max and T max .
  • the percentage of absorption of 3 H-paclitaxel for each group of animals was calculated by comparing the mean AUC value for the group to the corresponding mean AUC of a reference group of rats administered 3 H-paclitaxel (9 mg/kg) intravenously in the form of PAXENETM (Baker Norton Pharmaceuticals, Miami Fla.) which includes CREMOPHORTM EL, ethanol and citric acid.
  • Table 2 lists all carriers and carrier/co-solubilizer combinations which were formulated into oral compositions containing paclitaxel in accordance with the invention, were tested in rats in accordance with the foregoing procedure and were found to yield percentage absorption values in the experimental animals of 15% or greater in comparison with IV paclitaxel.
  • Table 3 lists vehicle formulations including certain POE sorbitan fatty acid esters as carriers for oral paclitaxel, alone or in combination with a co-solubilizer. In formulations where more than one component is present in the vehicle, the respective weight ratios of the components is given. Each of these formulations was tested in the animal model described in Example 1 and found to yield a percentage absorption of paclitaxel upon oral administration greater (in some cases far greater) than 15% of a roughly comparable dose of paclitaxel administered intravenously.
  • the table sets forth the total dose of paclitaxel incorporated into each vehicle as actually administered to the experimental animals, the concentration of paclitaxel in the composition, the HLB value of the carrier, the mean AUC value for the group of rats receiving the formulation and the percentage of paclitaxel absorption in comparison with rats receiving IV administration.
  • TABLE 3 Absorption Results of Polyoxyethylated (POE) Sorbitan Fatty Acid Esters Surfactants as Carriers AUC Dose Conc.
  • Table 4 pertains to vehicle formulations containing POE alkyl ethers as carriers.
  • the data set forth correspond to the data described in the preceding example with respect to Table 3.
  • TABLE 4 Absorption Results of Polyoxyethylated (POE) Alkyl Ethers Surfactants as Carriers AUC Dose Conc.
  • Table 5 pertains to vehicle formulations containing POE stearates as carriers.
  • the data set forth correspond to the data described in Example 2 with respect to Table 3.
  • TABLE 5 Absorption Results of Polyoxyethylated (POE) Stearates as Carriers AUC Dose Conc.
  • Table 6 pertains to vehicle formulations containing ethoxylated-modified triglycerides as carriers.
  • the data set forth correspond to the data described in Example 2 with respect to Table 3.
  • TABLE 6 Absorption Results of Ethoxylated Modified Triglycerides as Carriers AUC Dose Conc. ⁇ g ⁇ eq ⁇ % FORMULATIONS [mg/kg] [mg/ml] HLB hr/ml ABS PEG-20 Almond 9.5 20 10 8.06 27.6 Glycerides (Crovol A-40) PEG-20 Corn 9.6 20 10 7.46 25.3 Glycerides (Crovol M-40)
  • Table 7 pertains to vehicle formulations containing POE 660 hydroxystearates as carriers.
  • the data set forth correspond to the data described in Example 2 with respect to Table 3.
  • TABLE 7 Absorption Results of Polyoxyethylated (POE) 660 Hydroxystearate as Carrier AUC Dose Conc. ⁇ g ⁇ eq ⁇ % FORMULATIONS [mg/kg] [mg/ml] HLB hr/ml ABS POE 660 hydroxystearate 9.1 25 ⁇ 14 10.8 38.4 (Solutol HS 15) Gelucire 44/14 + Solutol 9.3 25 ⁇ 14 6.54 22.8 HS + TPGS (2:1:1)
  • Table 8 pertains to vehicle formulations containing saturated polyglycolyzed glycerides as carriers.
  • the data set forth correspond to the data described in Example 2 with respect to Table 3.
  • TABLE 8 Absorption Results of Saturated Polyglycolized Glycerides as Carriers AUC Dose Conc.
  • Table 9 pertains to vehicle formulations containing Vitamin E TPGS systems as carriers.
  • the data set forth correspond to the data described in Example 2 with respect to Table 3.
  • TABLE 9 Absorption Results of TPGS Systems as Carriers AUC Dose Conc. ⁇ g ⁇ eq ⁇ FORMULATIONS [mg/kg] [mg/ml] hr/ml % ABS* TPGS + Pharmasolve 8.2 25 8.93 35.2 (1.5:1) TPGS + Pharmasolve 9.5 25 8.72 29.8 (1:1) TPGS + Pharmasolve 9.1 25 8.83 31.4 (2:1) TPGS + Propylene 8.5 20 9.65 36.9 glycol (1:1) TPGS + Pharmasolve + 9.0 25 8.31 29.8 PEG 200 (2:1:1) TPGS + Pharmasolve + 8.2 25 6.62 26.3 PEG 400 (2:1:1) TPGS + Pharmasolve + 8.9 25 8.07 29.3 PG (2:1:1) TPGS + Mygliol 810 9.
  • Table 10 pertains to vehicle formulations containing POE and hydrogenated castor oil derivatives as carriers.
  • the data set forth correspond to the data described in Example 2 with respect to Table 3.
  • TABLE 10 Absorption Results of Polyoxyethylated Castor Oil (Cremophor) Derivatives Systems as Carriers Dose Conc.
  • Table 11 pertains to vehicle formulations containing polysorbate 80 as at least one of the carriers.
  • the data set forth correspond to the data described in Example 2 with respect to Table 3.
  • TABLE 11 Absorption Results of Polysorbate 80 (Tween 80) Systems as Carrierts Dose Conc.
  • compositions and methods which achieve the various objects of the invention and which are well adapted to meet the conditions of practical use.

Abstract

Pharmaceutical compositions for oral administration to mammalian subjects comprise a taxane or taxane derivative (e.g., paclitaxel or docetaxel) as active ingredient and a vehicle comprising at least 30% by weight of a carrier for the taxane, said carrier having an HLB value of at least about 10. The compositions may also comprise 0-70% of a viscosity-reducing co-solubilizer. The compositions may be incorporated into conventional oral pharmaceutical dosage forms, or can be in the form of a two-part medicament wherein the first part includes the taxane in a solubilizing vehicle and the second part comprises a carrier for the taxane to promote oral absorption. Methods of treatment of taxane-responsive disease conditions employing the novel compositions are also disclosed, whereby the compositions can be administered alone or in association with an oral bioavailability enhancing agent.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • This application is a continuation of co-pending application Ser. No. 09/055,818, which is a continuation-in-part of co-pending application Ser. No. 08/863,513, abandoned, which is a continuation-in-part of application Ser. No. 08/733,142, filed Oct. 16, 1996, now U.S. Pat. No. 6,245,805, which is a continuation-in-part of application Ser. No. 08/608,776, filed Feb. 29, 1996, now U.S. Pat. No. 5,968,972, which claims the priority of provisional application Ser. No. 60/007,071, filed Oct. 26, 1995.
  • BACKGROUND OF THE INVENTION
  • 1. Field of the Invention
  • The invention relates to compositions for orally administering paclitaxel and related taxanes to human patients, and methods of treatment employing such compositions.
  • 2. Description of the Prior Art
  • Many valuable pharmacologically active compounds cannot be effectively administered by the oral route to human patients because of poor or inconsistent systemic absorption from the gastrointestinal tract. These pharmaceutical agents are, therefore, generally administered via intravenous routes, requiring intervention by a physician or other health care professional, entailing considerable discomfort and potential local trauma to the patient and even requiring administration in a hospital setting with surgical access in the case of certain IV infusions.
  • One of the important classes of cytotoxic agents which are not normally bioavailable when administered orally to humans are the taxanes, which include paclitaxel, its derivatives and analogs. Paclitaxel (currently marketed as TAXOL® by Bristol-Myers Squibb Oncology Division) is a natural diterpene product isolated from the Pacific yew tree (Taxus brevifolia). It is a member of the taxane family of terpenes. It was first isolated in 1971 by Wani et al. (J. Am. Chem. Soc., 93:2325, 1971), who characterized its structure by chemical and X-ray crystallographic methods. One mechanism for its activity relates to paclitaxel's capacity to bind tubulin, thereby inhibiting cancer cell growth. Schiff et al., Proc. Natl. Acad. Sci. USA, 77:1561-1565 (1980); Schiff et al., Nature, 277:665-667 (1979); Kumar, J. Biol. Chem., 256: 10435-10441 (1981).
  • Paclitaxel has been approved for clinical use in the treatment of refractory ovarian cancer in the United States (Markman et al., Yale Journal of Biology and Medicine, 64:583, 1991; McGuire et al., Ann. Intern. Med., 111:273, 1989). It is effective for chemotherapy for several types of neoplasms including breast (Holmes et al., J. Nat. Cancer Inst., 83:1797, 1991) and has been approved for treatment of breast cancer as well. It is a potential candidate for treatment of neoplasms in the skin (Einzig et al., Proc. Am. Soc. Clin. Oncol., 20:46), lung cancer and head and neck carcinomas (Forastire et al. Sem. Oncol., 20:56, 1990). The compound also shows potential for the treatment of polycystic kidney disease (Woo et al, Nature, 368:750, 1994) and malaria.
  • Paclitaxel is only slightly soluble in water and this has created significant problems in developing suitable injectable and infusion formulations useful for anticancer chemotherapy. Some formulations of paclitaxel for IV infusion have been developed utilizing CREMOPHOR EL™ (polyethoxylated castor oil) as the drug carrier because of paclitaxel's aqueous insolubility. For example, paclitaxel used in clinical testing under the aegis of the NCI has been formulated in 50% CREMOPHOR EL™ and 50% dehydrated alcohol. CREMOPHOR EL™ however, when administered intravenously, is itself toxic and produces vasodilation, labored breathing, lethargy, hypotension and death in dogs. It is also believed to be at least partially responsible for the allergic-type reactions observed during paclitaxel administration, although there is some evidence that paclitaxel may itself provoke acute reactions even in the absence of Cremophor.
  • In an attempt to increase paclitaxel's solubility and to develop more safe clinical formulations, studies have been directed to synthesizing paclitaxel analogs where the 2′ and/or 7-position is derivatized with groups that would enhance water solubility. These efforts have yielded prodrug compounds that are more water soluble than the parent compound and that display the cytotoxic properties upon activation. One important group of such prodrugs includes the 2′-onium salts of paclitaxel and docetaxel, particularly the 2′-methylpyridinium mesylate (2′-MPM) salts.
  • Paclitaxel is very poorly absorbed when administered orally (less than 1%); see Eiseman et al., Second NCI Workshop on Taxol and Taxus (September 1992); Suffness et al. in Taxol Science and Applications (CRC Press 1995). Eiseman et al. indicate that paclitaxel has a bioavailability of 0% upon oral administration, and Suffness et al. report that oral dosing with paclitaxel did not seem possible since no evidence of antitumor activity was found on oral administration up to 160 mg/kg/day. For this reason, paclitaxel has not been administered orally to human patients in the prior art, and certainly not in the course of treating paclitaxel-responsive diseases.
  • Docetaxel (N-debenzoyl-N-tert-butoxycarbonyl-10-deacetyl paclitaxel) has become commercially available as TAXOTERE® (Rhone-Poulenc-Rorer S.A.) in parenteral form for the treatment of breast cancer. To date, no reference has been made in the scientific literature to oral absorption of docetaxel in animals or patients.
  • It has been speculated that, in some cases, the poor or non-existent bioavailability of a drug such as paclitaxel after oral administration is a result of the activity of a multidrug transporter, a membrane-bound P-glycoprotein, which functions as an energy-dependent transport or efflux pump to decrease intracellular accumulation of drug by extruding xenobiotics from the cell. This P-glycoprotein has been identified in normal tissues of secretory endothelium, such as the biliary lining, brush border of the proximal tubule in the kidney and luminal surface of the intestine, and vascular endothelial cells lining the blood brain barrier, placenta and testis.
  • It is believed that the P-glycoprotein efflux pump prevents certain pharmaceutical compounds from transversing the mucosal cells of the small intestine and, therefore, from being absorbed into the systemic circulation. A number of known non-cytotoxic pharmacological agents have been shown to inhibit P-glycoprotein, including cyclosporin A (also known as cyclosporine), verapamil, tamoxifen, quinidine and phenothiazines, among others. Many of these studies were aimed at achieving greater accumulation of intravenously administered cytotoxic drugs inside tumor cells. In fact, clinical trials have been conducted to study the effects of cyclosporine on the pharmacokinetics and toxicities of paclitaxel (Fisher et al., Proc. Am. Soc. Clin. Oncol., 13: 143, 1994); doxorubicin (Bartlett et al., J. Clin. Onc. 12:835-842, 1994); and etoposide (Lum et al., J. Clin. Onc. 10:1635-42, 1992), all of which are anti-cancer agents known to be subject to multidrug resistance (MDR). These trials showed that patients receiving intravenous cyclosporine prior to or together with the anti-cancer drugs had higher blood levels of those drugs, presumably through reduced body clearance, and exhibited the expected toxicity at substantially lower dosage levels. These findings tended to indicate that the concomitant administration of cyclosporine suppressed the MDR action of P-glycoprotein, enabling larger intracellular accumulations of the therapeutic agents. For a general discussion of the pharmacologic implications for the clinical use of P-glycoprotein inhibitors, see Lum et al., Drug Resist. Clin. One. Hemat., 9: 319-336 (1995); Schinkel et al., Eur. J. Cancer, 31A: 1295-1298 (1995).
  • In the aforedescribed studies relating to the use of cyclosporine to increase the blood levels of pharmaceutical agents, the active anti-tumor agents and the cyclosporine were administered intravenously. No suggestion was made in these publications that cyclosporine could be orally administered to substantially increase the bioavailability of orally administered anti-cancer drugs and other pharmaceutical agents which are themselves poorly absorbed from the gut without producing highly toxic side effects. None of the published studies provided any regimen for implementing the effective oral administration to humans of poorly bioavailable drugs such as paclitaxel, e.g., indicating the respective dosage ranges and timing of administration for specific target drugs and bioavailability-enhancing agents are best suited for promoting oral absorption of each target drug or class of drugs.
  • In published PCT application WO 95/20980 (published Aug. 10, 1995) Benet et al. disclose a purported method for increasing the bioavilability of orally administered hydrophobic pharmaceutical compounds. This method comprises orally administering such compounds to the patient concurrently with a bioenhancer comprising an inhibitor of a cytochrome P450 3A enzyme or an inhibitor of P-glycoprotein-mediated membrane transport. Benet et al., however, provide virtually no means for identifying which bioavailability enhancing agents will improve the availability of specific “target” pharmaceutical compounds, nor do they indicate specific dosage amounts, schedules or regimens for administration of the enhancing or target agents. In fact, although the Benet et al. application lists dozens of potential enhancers (P450 3A inhibitors) and target drugs (P450 3A substrates), the only combination of enhancer and target agent supported by any experimental evidence in the application is ketoconazole as the enhancer and cyclosporin A as the target drug.
  • When describing the general characteristics of compounds which can be used as bioenhancers by reduction of P-glycoprotein transport activity, Benet et al. indicate that these are hydrophobic compounds which generally, but not necessarily, comprise two co-planar aromatic rings, a positively charged nitrogen group or a carbonyl group—a class that includes an enormous number of compounds, most of which would not provide the desired absorption enhancing activity in the case of specific target agents. Moreover, the classes of target agents disclosed by Benet et al. include the great majority of pharmaceutical agents listed in the Physicians' Desk Reference. These inclusion criteria are of no value to medical practitioners seeking safe, practical and effective methods of orally administering specific pharmaceutical agents.
  • In general, Benet et al. provides no teaching that could be followed by persons skilled in the medical and pharmaceutical arts to identify suitable bioenhancer/target drug combinations or to design specific treatment regimens and schedules which would render the target agents therapeutically effective upon oral administration to human patients. Benet et al. also provides no direction whatsoever regarding how paclitaxel and other taxanes might be administered orally to humans with therapeutic efficacy and acceptable toxicity.
  • In published PCT application WO 97/15269, which corresponds to U.S. patent application Ser. No. 08/733,142 (the grandparent of the present application) and which is commonly owned with this application, it is disclosed that various therapeutically effective pharmaceutical “target agents” which exhibit poor oral bioavailability can be made bioavailable, providing therapeutic blood levels of the active agent, by oral co-administration of certain bioavailability enhancing agents. Preferred examples of such target agents disclosed in WO 97/15269 include the cyclosporins, e.g., cyclosporins A, D and G. Preferred examples of target agents include the taxane class of antineoplastic agents, particularly paclitaxel. Therapeutic regimens and dosage amounts for co-administration for target agents and enhancing agents are also disclosed. All of the disclosures of published application WO 97/15269 are incorporated herein by reference.
  • Neither commonly owned application WO 97/15269 nor any prior art disclosure, however, describes classes of oral formulations or compositions containing the active target agent, e.g., paclitaxel, which are particularly adapted for co-administration with an oral bioavailability enhancing agent to yield therapeutic blood levels of target agents heretofore considered unsuitable for oral administration.
  • SUMMARY OF THE INVENTION
  • The present invention relates to oral pharmaceutical compositions containing taxane antitumor agents, for example paclitaxel or docetaxel, which, when administered to a mammalian patient, preferably with co-administration of an oral bioavailability enhancing agent, enable sufficient absorption of the taxane agent from the gastrointestinal tract into the bloodstream to provide therapeutically significant blood levels of the active drug.
  • The compositions of the invention comprise a vehicle including a carrier in which the taxane agent is dissolved or dispersed. The vehicle may also include a viscosity-reducing co-solubilizer which renders the vehicle more flowable at body temperature or at least reduces the melting point of the vehicle below body temperature, and may also provide increased taxane solubility.
  • The carrier used in the novel compositions is preferably a non-ionic surface active agent (surfactant) or emusifier having a hydrophilic-lipophilic balance (HLB) value at least about 10. The viscosity-reducing co-solubilizer is selected from, e.g., organic solvents suitable for oral administration, vegetable oils, hydrogenated or polyoxyethylated castor oil, citrate esters and saturated polyglycolized glycerides. Certain saturated polyglycolized glycerides may also serve as carriers in the compositions of the invention.
  • The novel pharmaceutical compositions contain about 2-500 mg/ml or mg/g of taxane, and preferably about 2-50 mg/ml or mg/g of taxane. The therapeutically inactive vehicle comprises at least 30% by weight of carrier and about 0-70% of co-solubilizer, and may also contain conventional pharmaceutical additives and excipients such as flavoring and coloring agents and the like.
  • Another aspect of the invention pertains to methods of treatment of mammalian patients suffering from taxane-responsive disease conditions by the administration to such patients of oral pharmaceutical compositions in accordance with the invention, preferably with co-administration of an oral bioavailability enhancing agent.
  • DETAILED DESCRIPTION OF THE INVENTION
  • The oral pharmaceutical compositions of the invention contain at least two components: an active agent comprising a taxane, preferably the antitumor agent paclitaxel or docetaxel, and a therapeutically inactive vehicle comprising a pharmaceutically acceptable carrier for said taxane.
  • In order to produce compositions for oral administration that are liquid or at least flowable form at body temperature (about 37° C.), as generally required for oral bioavailability, it is required in some instances to add an additional component to the vehicle: a viscosity-reducing co-solubilizer which decreases the viscosity and increases the flowability of the vehicle at body temperature, and also may increase the amount of the active agent that can be dissolved or dispersed in the vehicle in comparison with the use of a carrier alone.
  • The novel compositions may comprise more than one taxane as active ingredient and more than one carrier and/or co-solubilizer as inactive vehicle components. The vehicle comprises at least 30% by weight of carrier, preferably 30-90% by weight. Preferred carriers for use in the invention are non-ionic surfactants or emulsifiers having HLB values at least about 10. It has been found that such non-ionic surfactants or emulsifiers are not only compatible carriers for the lipophilic taxanes (which are poorly soluble in water) but also promote absorption of the active ingredient from the gastrointestinal tract into the bloodstream.
  • Preferred carriers for use in the invention include, for example, Vitamin E TPGS (d- -tocopheryl polyethylene glycol 1000 succinate, Eastman Chemical Co., Kingsport Tenn.); saturated polyglycolyzed glycerides such as GELUCIRE™ and LABRASOL™ products (Gattefossé Corp., Westwood, N.J.) which include glycerides of C8-C18 fatty acids; CREMOPHOR™ EL or RH40 modified castor oils (BASF, Mt. Olive, N.J.); MYRJ™ polyoxyethylated stearate esters (ICI Americas, Charlotte, N.C.); TWEEN™ (ICI Americas) and CRILLET™ (Croda Inc., Parsippany, N.J.) polyoxyethylated sorbitan esters; BRIJ™ polyoxyethylated fatty ethers (ICI Americas); CROVOL™ modified (polyethylene glycol) almond and corn oil glycerides (Croda Inc.); EMSORB™ sorbitan diisostearate esters (Henkel Corp., Ambler, Pa.); SOLUTOL™ polyoxyethylated hydroxystearates (BASF); and -cyclodextrin. Only those members of these surfactant families which have HLB values of about 10 or greater may be used as carriers in the subject compositions.
  • Preferred viscosity-reducing co-solubilizers include, e.g., PHARMASOLVE™ (N-methyl-2-pyrrolidone, International Specialty Products, Wayne, N.J.); MIGLYOL™ glycerol or propylene glycol esters of caprylic and capric acids (Hüls AG, Marl, Germany); polyoxyethylated hydroxystearates (e.g., SOLUTOL™ HS 15); TWEEN™ polyoxyethylated sorbitan esters; SOFTIGEN™ polyethylene glycol esters of caprylic and capric acids (Hüls AG); modified castor oils (such as CREMOPHOR™ EL or RH 40); vegetable oils such as olive oil, polyoxyethylated fatty ethers or modified castor oils; certain saturated polyglycolyzed glycerides (such as a LABRASOL™) citrate esters such as tributyl citrate, triethyl citrate and acetyl triethyl citrate; propylene glycol, alone or in combination with PHARMASOLVE™; ethanol; water; and lower molecular weight polyethylene glycols such as PEG 200 and 400.
  • The vehicle contains about 0-70% by weight of the co-solubilizer, and preferably about 10-50% by weight. It will be noted that several of the materials identified as carriers have also been found to be effective co-solubilizers, either alone or in combination with other viscosity-reducing agents, for certain other carriers. In general, any solvent in which paclitaxel or other taxanes are at least moderately soluble at body temperature or with gentle heating can be used as a co-solubilizer in the vehicle of the novel compositions. Preferred co-solubilizers are those in which at least 25 mg/ml of paclitaxel or other taxane can be solubilized at about 20-25° C.
  • The concentration of the active taxane ingredient or ingredients in the composition may vary based on the solubility of the active agent in the carrier(s) or carrier(s)/co-solubilizer(s) system and on the desired total dose of taxane to be administered orally to the patient. The concentration of taxane may range from about 2 to about 500 mg/ml or mg/g of vehicle, and preferably from about 2 to about 50 mg/ml or mg/g.
  • The compositions of the invention may be prepared by any conventional method known to individuals of skill in the pharmaceutical arts for preparing liquid or other fluid oral formulations containing surfactant carriers and lipophilic active ingredients. Since the majority of the preferred carriers are very viscous at room temperature, and in some cases retain a relatively high viscosity even upon the addition of a minor proportion of co-solubilizer, it is generally preferred in preparing the novel compositions to mix the carriers and co-solubilizers to be used, add the taxane active ingredient, and heat the resulting mixture while stirring, for example to about 40° C. This method enables the preparation of clear solutions. Certain co-solubilizers, however, particularly PHARMASOLVE™, lower the carrier viscosity and enhance taxane solubility to such a degree that the composition can be prepared by stirring at room temperature with no heating.
  • It is desirable that the viscosity of the finished composition not be higher than 40,000 cps at body temperature (approximately 37° C.).
  • The oral compositions of the invention may be in the form of true solutions, emulsions or even suspensions, but solutions of the active taxane ingredient in the carrier or carrier/co-solubilizer system are preferred.
  • The present invention also comprehends methods of treating human patients afflicted with cancers, tumors, Kaposi's sarcoma, malignancies, uncontrolled tissue or cellular proliferation secondary to tissue injury, and any other disease conditions responsive to taxanes such as paclitaxel and docetaxel, and/or prodrugs and derivatives of the foregoing, with the novel orally administered pharmaceutical compositions. Among the types of carcinoma which may be treated particularly effectively with oral paclitaxel, docetaxel, other taxanes, and their prodrugs and derivatives, are hepatocellular carcinoma and liver metastases, cancers of the gastrointestinal tract, pancreas, prostate and lung, and Kaposi's sarcoma. Examples of non-cancerous disease conditions which may be effectively treated with these active agents administered orally in accordance with the present invention are uncontrolled tissue or cellular proliferation secondary to tissue injury, polycystic kidney disease, inflammatory diseases (e.g., arthritis) and malaria, including chloroquine- and pyrimethamine-resistant malaria parasites (Pouvelle et al., J. Clin. Invest., 44: 413-417, 1994).
  • Although some of the oral pharmaceutical compositions of the invention may provide therapeutic blood levels of the taxane active ingredient when administered alone, the preferred method of the invention for treating mammalian patients (particularly human patients) suffering from taxane-responsive disease conditions is to administer the oral compositions containing the taxane target agent concomitantly with the administration of at least one dose of an oral bioavailability enhancing agent.
  • The preferred embodiment of the method of the invention for oral administration to humans of paclitaxel, its derivatives, analogs and prodrugs, and other taxanes comprises the oral administration of an oral absorption or bioavailability enhancing agent to a human patient simultaneously with, or prior to, or both simultaneously with and prior to the oral administration to increase the quantity of absorption of the intact target agent into the bloodstream. The orally administered enhancing agents which may be used in practicing the preferred embodiment of the invention include, but are not limited to, the following:
  • Cyclosporins, including cyclosporins A through Z but particularly cyclosporin A (cyclosporine), cyclosporin F, cyclosporin D, dihydro cyclosporin A, dihydro cyclosporin C, acetyl cyclosporin A, PSC-833, SDZ-NIM 8111 (both from Sandoz Pharmaceutical Corp). The structures of cyclosporins A-Z are described in Table 1 below.
    SDZ-NIM 811 is (Me-Ile-4)-cyclosporin, an antiviral, non-immunosuppressive cyclosporin.
    TABLE 1
    Cyclosporins A-Z
    Cyclosporin Aminoacids
    Cy- 1 2 3 4 5 6 7 8 9 10 11
    CyA Mebmt Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyB Mebmt Ala Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyC Mebmt Thr Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyD Mebmt Val Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyE Mebmt Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu Val
    CyF Desoxy- Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    Mebmt
    CyG Mebmt Nva Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyH Mebmt Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu D-Mev
    CyI Mebmt Val Sar MeLeu Val MeLeu Ala D-Ala MeLeu Leu MeVal
    CyK Desoxy- Val Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    Mebmt
    CyL Bmt Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyM Mebmt Nva Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyN Mebmt Nva Sar MeLeu Val MeLeu Ala D-Ala MeLeu Leu MeVal
    CyO MeLeu Nva Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyP Bmt Thr Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyQ Mebmt Abu Sar Val Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyR Mebmt Abu Sar MeLeu Val Leu Ala D-Ala MeLeu Leu MeVal
    CyS Mebmt Thr Sar Val Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyT Mebmt Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu Leu MeVal
    CyU Mebmt Abu Sar MeLeu Val Leu Ala D-Ala MeLeu MeLeu MeVal
    CyV Mebmt Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    CyW Mebmt Thr Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu Val
    CyX Mebmt Nva Sar MeLeu Val MeLeu Ala D-Ala Leu MeLeu MeVal
    CyY Mebmt Nva Sar MeLeu Val Leu Ala D-Ala MeLeu MeLeu MeVal
    CyZ MeAmino Abu Sar MeLeu Val MeLeu Ala D-Ala MeLeu MeLeu MeVal
    octyl
    acid
  • Cyclosporins are a group of nonpolar cyclic oligopeptides (some of which have immunosuppressant activity) produced by the genus, Tolypocladium, including, e.g., Tolypocladium inflatum Gams (formerly designated as Trichoderma Polysporum), Tolypocladium terricola and other fungi imperfecti. The major component, cyclosporin A (cyclosporine or CsA), has been identified along with several other lesser metabolites, for example, cyclosporins B through Z, some of which exhibit substantially less immunosuppressive activity than cyclosporin A. A number of synthetic and semi-synthetic analogs have also been prepared. See generally Jergorov et al., Phytochemistry, 38: 403-407 (1995). The present invention comprehends natural, semi-synthetic and synthetic analogs of cyclosporins.
  • Cyclosporins are neutral, lipophilic, cyclic undecapeptides with molecular weights of about 1200. They are used intravenously or orally as immunosuppressants, primarily for organ transplantation and certain other conditions. Cyclosporins, particularly cyclosporine (cyclosporin A), are known inhibitors of the P-glycoprotein efflux pump and other transporter pumps as well as of certain P450 degradative enzymes, but to date no effective regimens for applying this property clinically have been developed to the point of clinical and commercial feasibility or regulatory approval.
  • The dosage range of the enhancing agent to be co-administered with the target agent in accordance with the invention is about 0.1 to about 20 mg/kg of patient body weight. “Co-administration” of the enhancing agent comprehends administration substantially simultaneously with the target agent (either less than 0.5 hr. before, less than 0.5 hr. after or together), from about 0.5 to about 72 hr. before the administration of the target agent, or both, i.e., with one or more doses of the same or different enhancing agents given at least 0.5 hr. before and one dose given substantially simultaneously with (either together with or immediately before of after) the target agent. Additionally, “co-administration” comprehends administering more than one dose of target agent within 72 hr. after a dose of enhancing agent, in other words, the enhancing agent(s) need not be administered again before or with every administration of target agent, but may be administered intermittently during the course of treatment.
  • The dosage range of orally administered taxane target agents will vary from compound to compound based on its therapeutic index, the requirements of the condition being treated, the status of the subject and so forth. The method of the invention makes it possible to administer paclitaxel and other taxanes orally ranging from about 20 mg/m2 to about 1000 mg/m2 (based on patient body surface area) or about 0.5-30 mg/kg (based on patient body weight) as single or divided (2-3) daily doses, and maintain the plasma levels of paclitaxel in humans in the range of 50-500 ng/ml for extended periods of time (e.g., 8-12 hours) after each oral dose. These levels are at least comparable to those achieved with 96-hour IV infusion paclitaxel therapy (which causes the patient great inconvenience, discomfort, loss of quality time, infection potential, etc.). Moreover, such plasma levels of paclitaxel are more than sufficient to provide the desired pharmacological activities of the target drug, e.g., inhibition of tubulin disassembly (which occurs at levels of about 0.1 □M, or about 85 ng/ml) and inhibition of protein isoprenylation (which occurs at levels of about 0.03 □M, or about 25 ng/ml) which are directly related to its antitumor effects by inhibiting oncogene functions and other signal-transducing proteins that play a pivotal role in cell growth regulation.
  • Two or more different enhancing agents and/or two or more different taxane target agents may be administered together, alternately or intermittently in all of the various aspects of the method of the invention.
  • As indicated above, oral paclitaxel administered alone (e.g., in a solid dosage form or even in a liquid vehicle not containing an oral absorption promoting carrier) exhibits near zero bioavailability. To be considered an orally bioavailable pharmaceutical composition containing paclitaxel or other taxanes for purposes of the present invention, the composition must meet the following criterion: when the composition is administered orally to a mammalian subject (e.g., a laboratory rat or a human patient), i.e., is ingested by the subject, one hour after administration of an effective oral dose of an oral bioavailability enhancing agent, the amount of the active ingredient absorbed into the bloodstream is at least 15% of the amount absorbed when the same dose of paclitaxel is administered to the subject intravenously in a standard intravenous vehicle, for example a CREMOPHOR™ EL/ethanol vehicle. The relative percentage of absorption is determined by comparing the respective AUC (area under the curve) values of the taxane blood level vs. time curve generated upon oral administration and the corresponding curve generated upon intravenous administration.
  • The preferred bioavailability enhancing agent for use in making the experimental determination of whether a particular oral composition meets the 15% of IV absorption criterion is cyclsoporin A, for example a single oral dose of 5 mg/kg of CsA.
  • The novel pharmaceutical compositions may be administered in any known pharmaceutical dosage form. For example, the compositions may be encapsulated in a soft or hard gelatin capsule or may be administered in the form of a liquid preparation. Each dosage form may include, apart from the essential components of the composition (at least one carrier and one taxane active ingredient, and in some instances at least one co-solubilizer), conventional pharmaceutical excipients, diluents, sweeteners, flavoring agents, coloring agents and any other inert ingredients regularly included in dosage forms intended for oral administration (see, e.g., Remington's Pharmaceutical Sciences, 17th Ed., 1985).
  • Precise amounts of each of the target drugs included in the oral dosage forms will vary depending on the age, weight, disease and condition of the patient. For example, paclitaxel or other taxane dosage forms may contain sufficient quantities of the target agent to provide a daily dosage of about 20-1000 mg/m2 (based on mammalian subject or patient body surface area) or about 0.5-30 mg/kg (based on mammalian subject or patient body weight) as single or divided (2-3) daily doses. Preferred dosage amounts are about 50-200 mg/m2 or about 2-6 mg/kg.
  • Dosing schedules for the treatment method of the present invention, for example, the treatment of paclitaxel-responsive diseases with oral paclitaxel dosage forms co-administered with enhancing agents, can likewise be adjusted to account for the patient's characteristics and disease status. Preferred dosing schedules for administration of oral paclitaxel are (a) the daily administration to a patient in need thereof of 1-3 equally divided doses providing about 20-1000 mg/m2 (based on body surface area), and preferably about 50-200 mg/m2, with said daily administration being continued for 1-4 consecutive days each 2-3 weeks, or (b) administration for about one day each week. The former schedule is comparable to use of a 96-hour paclitaxel infusion every 2-3 weeks, which is considered by some a preferred IV treatment regimen.
  • Oral administration of taxanes in accordance with the invention may actually decrease toxic side effects in many cases as compared with currently utilized IV therapy. Rather than producing a sudden and rapid high concentration in blood levels as is usually the case with an IV infusion, absorption of the active agent through the gut wall (promoted by the enhancing agents), provides a more gradual appearance in the blood levels and a stable, steady-state maintenance of those levels at or close to the ideal range for a long period of time.
  • In a further embodiment of the present invention, the oral compositions of the invention may be administered in a two-part medicament system. Thus, for example, there may be certain carriers coming within the scope of the invention which are desirable for use in vehicles for certain taxane agents because of their ability to solubilize the taxane and promote its oral absorption, but the carrier may be chemically or physically incompatible with desired adjunctive ingredients such as flavoring or coloring agents. In such cases, the active ingredient can be administered to the patient as the first part of the medicament in a relatively small volume of any suitable liquid solubilizing vehicle (such as water, CREMOPHOR™ or ethanol), which may be sweetened, flavored or colored as desired to mask the unpleasant taste of the vehicle and render it more palatable. The administration of the active ingredient can be followed by administration of the second part of the medicament: a larger volume of fluid, for example 1 to 8 fluid ounces (30-240 ml), containing at least one carrier or a carrier/co-solubilizer system in accordance with the invention. It has been discovered that administration of the second, “chaser” formulation a short time after the taxane active ingredient can retard precipitation of the taxane which might otherwise occur upon entry into the gastric fluid and promote oral absorption to a degree comparable to that observed when the taxane is intermixed with the carrier and administered simultaneously. Illustrative examples of “chaser” formulations which may be used in a two-part oral taxane medicament include:
      • a) 2-20% (by weight) Vitamin E TPGS+water q.s.;
      • b) 2-25% Vitamin E TPGS+2-25% PHARMASOLVE™+water q.s.;
      • c) 2-20% Vitamin E TPGS+2-25% propylene glycol+water q.s.
  • Pursuant to yet another aspect of the invention, the oral compositions of the invention can contain not only one or more taxane active ingredients but also one or more bioavailability enhancing agents in a combination dosage form. For example, such combination dosage form may contain from about 0.1 to about 20 mg/kg (based on average patient body weight) of one or more of cyclosporins A, D, C, F and G, dihydro CsA, dihydro CsC and acetyl CsA together with about 20 to about 1000 mg/m2 (based on average patient body surface area), and preferably about 50-200 mg/m2, of paclitaxel, docetaxel, other taxanes or paclitaxel or docetaxel derivatives.
  • The compositions and methods of the present invention provide many advantages in comparison with prior art intravenous compositions containing paclitaxel and other taxanes and prior art intravenous administration regimens. Apart from the issues of decreased toxicity, patient convenience and comfort, ease of administration and lowered expense, discussed previously, the invention makes it possible to administer powerful taxane antitumor agents to patients with greatly reduced likelihood of allergic hypersensitivity reactions which are common with IV administration. Thus, the need for pre-medication regimens of H-1 and H-2 blockers plus steroids can be eliminated.
  • The present invention also makes it possible to give taxanes, e.g., paclitaxel, in comparatively infrequent daily doses (e.g., about twice/day) and according to schedules that would otherwise not be possible or practical with the intravenous route. The use of the bioavailability enhancer (e.g., cyclosporin A) promotes oral absorption of paclitaxel for the first dose and if a second paclitaxel dose is to be given later in the day, the use of additional cyclosporin A may not even be needed. Thus, paclitaxel could be given intermittently as single dose on a fixed schedule (weekly, biweekly, etc.) or chronically, over a period of consecutive days (e.g., 4 days) every 2-4 weeks with the goal of keeping the levels within a safe and effective “window”.
  • The following examples illustrate various aspects of the invention. These examples are not intended, however, to limit the invention in any way or to set forth specific active ingredients, carriers, co-solubilizers, enhancing agents, dosage ranges, testing procedures or other parameters which must be used exclusively to practice the invention.
  • EXAMPLE 1 Animal Screening Model
  • Groups of three male rats each were fasted for 16-18 hours prior to dosing with 3H-radiolabeled paclitaxel. Each group of animals received one oral dose of cyclosporin A (5 mg/kg) prior to dosing with experimental oral paclitaxel formulation. One hour subsequent to cyclosporin dosing, each group received approximately 9 mg/kg of paclitaxel orally in the form of a composition according to the invention. Each group received a different oral formulation.
  • Blood samples were collected from each animal at 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours post-dose of paclitaxel. The blood samples were combusted and assayed for total radioactivity.
  • The total blood radioactivity levels (corresponding to concentration in the blood of 3H-paclitaxel) were plotted on a graph vs. time post-dose. Data for each group of rats were compiled in the form of mean AUC, Cmax and Tmax.
  • The percentage of absorption of 3H-paclitaxel for each group of animals was calculated by comparing the mean AUC value for the group to the corresponding mean AUC of a reference group of rats administered 3H-paclitaxel (9 mg/kg) intravenously in the form of PAXENE™ (Baker Norton Pharmaceuticals, Miami Fla.) which includes CREMOPHOR™ EL, ethanol and citric acid.
  • Table 2 lists all carriers and carrier/co-solubilizer combinations which were formulated into oral compositions containing paclitaxel in accordance with the invention, were tested in rats in accordance with the foregoing procedure and were found to yield percentage absorption values in the experimental animals of 15% or greater in comparison with IV paclitaxel.
    TABLE 2
    Carriers and carrier/co-solubilizer combinations which achieved greater than 15% paclitaxel absorption
    Carriers Co-solubilizers
    TPGS Pharmasolve Propylene Mygliols Softigen PEG 200 & Propylene PEG 200 &
    glycol 400 glycol/ 400/
    Pharmasolve Pharmasolve
    Gelucire 44/14 Pharmasolve Mygliols Olive oil/ Olive Olive oil/ Cremophor EL Cremophor
    Brij 97 oil/ TPGS RH 40
    Cremophor
    RH 40
    Gelucire 44/14 Labrasol TPGS/ Tween 80 PEG 400
    Solutol HS
    15
    Gelucire 50/13 Tween 80 PEG 400 Cremophor
    EL
    Cremophor EL Pharmasolve Citrate Ethanol/water Ethanol
    esters
    Cremophor RH 40 Ethanol/water
    Myrj 49 Pharmasolve
    Myrj 52 Pharmasolve Propylene
    glycol
    Myrj 53 Pharmasolve
    Tween 40*
    Tween 60*
    Tween 80* Ethanol Citrate Olive oil PEG 400 Water
    esters
    Crillet 6*
    Emsorb 2726 Pharmasolve
    Solutol HS 15*
    Brij 76 Pharmasolve
    Brij 78 Pharmasolve
    Brij 98 Pharmasolve
    Crovol A-40*
    Crovol M-40*
    .-Cyclodextrin Water

    *Have been demonstrated to work as both solubilizer and carrier

    Note:

    All carriers listed above can solubilize paclitaxel greater than 25 mg/ml at 37□ C.
  • EXAMPLE 2 Polyoxyethylated (POE) Sorbitan Fatty Acid Esters as Carriers
  • Table 3 lists vehicle formulations including certain POE sorbitan fatty acid esters as carriers for oral paclitaxel, alone or in combination with a co-solubilizer. In formulations where more than one component is present in the vehicle, the respective weight ratios of the components is given. Each of these formulations was tested in the animal model described in Example 1 and found to yield a percentage absorption of paclitaxel upon oral administration greater (in some cases far greater) than 15% of a roughly comparable dose of paclitaxel administered intravenously. The table sets forth the total dose of paclitaxel incorporated into each vehicle as actually administered to the experimental animals, the concentration of paclitaxel in the composition, the HLB value of the carrier, the mean AUC value for the group of rats receiving the formulation and the percentage of paclitaxel absorption in comparison with rats receiving IV administration.
    TABLE 3
    Absorption Results of Polyoxyethylated (POE) Sorbitan
    Fatty Acid Esters Surfactants as Carriers
    AUC
    Dose Conc. □g ·
    [mg/ [mg/ eq × hr/ %
    FORMULATIONS kg] ml] HLB ml ABS*
    POE 20 sorbitan 10.2 18 16.7 17.2 54.6
    monolaurate (Tween 20)
    POE 20 sorbitan 10.2 18 15.6 17.6 55.9
    monopalmitate (Tween 40)
    POE 20 sorbitan 8.9 25 14.9 17.1 62.3
    monostearate (Tween 60)
    POE 20 sorbitan 9.4 25 10.5 6.15 21.1
    tristearate (Tween 65)
    POE 20 sorbitan 9.0 18 15.0 11.4 40.9
    monooleate (Tween 80)
    POE 20 sorbitan 9.3 20 14.9 13.6 47.5
    monoisostearate (Crillet 6)
    POE 40 sorbitan 10.2 25  15.0* 7.76 24.6
    diisostearate/Pharmasolve
    (3:1) [Emsorb 2726]

    *Percent absorption versus paclitaxel IV AUC (same for Tables 4-11)
  • EXAMPLE 3 POE Alkyl Ethers as Carriers
  • Table 4 pertains to vehicle formulations containing POE alkyl ethers as carriers. The data set forth correspond to the data described in the preceding example with respect to Table 3.
    TABLE 4
    Absorption Results of Polyoxyethylated (POE)
    Alkyl Ethers Surfactants as Carriers
    AUC
    Dose Conc. □g · eq × %
    FORMULATIONS [mg/kg] [mg/ml] HLB hr/ml ABS
    POE 10 stearyl 10.2 18 12.4* 9.54 30.3
    ether/Pharmasolve
    (3:1) [Brij 76]
    POE 20 stearyl 9.5 18 15.3* 11.4 38.7
    ether/Pharmasolve
    (3:1) [Brij 78]
    POE 20 oleyl 9.6 25 15.3* 5.89 20.9
    ether/Pharmasolve
    (3:1) [Brij 98]

    *Not an actual HLB value of mixture. Numbers represent HLB values of pure surfactants.
  • EXAMPLE 4 POE Stearates as Carriers
  • Table 5 pertains to vehicle formulations containing POE stearates as carriers. The data set forth correspond to the data described in Example 2 with respect to Table 3.
    TABLE 5
    Absorption Results of Polyoxyethylated
    (POE) Stearates as Carriers
    AUC
    Dose Conc. □g · eq × %
    FORMULATIONS [mg/kg] [mg/ml] HLB hr/ml ABS
    POE 20 stearate 9.2 25 15.0* 10.3 36.4
    ester/Pharmasolve
    (3:1) [Myrj 49]
    POE 40 stearate 9.4 18 16.9* 16.2 57.3
    ester/Pharmasolve
    (3:1) [Myrj 52]
    POE 50 stearate 10.0 25 17.9* 7.01 22.3
    ester/Pharmasolve
    (3:1) [Myrj 53]

    *Not an actual HLB value of mixture. Numbers represent HLB values of pure surfactants.
  • EXAMPLE 5 Ethoxylated Modified Triglycerides as Carriers
  • Table 6 pertains to vehicle formulations containing ethoxylated-modified triglycerides as carriers. The data set forth correspond to the data described in Example 2 with respect to Table 3.
    TABLE 6
    Absorption Results of Ethoxylated
    Modified Triglycerides as Carriers
    AUC
    Dose Conc. □g · eq × %
    FORMULATIONS [mg/kg] [mg/ml] HLB hr/ml ABS
    PEG-20 Almond 9.5 20 10 8.06 27.6
    Glycerides
    (Crovol A-40)
    PEG-20 Corn 9.6 20 10 7.46 25.3
    Glycerides
    (Crovol M-40)
  • EXAMPLE 6 POE 660 Hydroxystearates as Carriers
  • Table 7 pertains to vehicle formulations containing POE 660 hydroxystearates as carriers. The data set forth correspond to the data described in Example 2 with respect to Table 3.
    TABLE 7
    Absorption Results of Polyoxyethylated
    (POE) 660 Hydroxystearate as Carrier
    AUC
    Dose Conc. □g · eq × %
    FORMULATIONS [mg/kg] [mg/ml] HLB hr/ml ABS
    POE 660 hydroxystearate 9.1 25 ˜14 10.8 38.4
    (Solutol HS 15)
    Gelucire 44/14 + Solutol 9.3 25 ˜14 6.54 22.8
    HS + TPGS (2:1:1)
  • EXAMPLE 7 Saturated Polyglycolized Glycerides as Carriers
  • Table 8 pertains to vehicle formulations containing saturated polyglycolyzed glycerides as carriers. The data set forth correspond to the data described in Example 2 with respect to Table 3.
    TABLE 8
    Absorption Results of Saturated Polyglycolized
    Glycerides as Carriers
    AUC
    Dose Conc. □g · eq ×
    FORMULATIONS [mg/kg] [mg/ml] hr/ml % ABS
    Gelucire 44/14 + PEG 400 10.3 25 11.9 37.4
    (6:1)
    Gelucire 44/14 + Labrasol 9.3 25 12.1 42.1
    (6:1)
    Gelucire 44/14 + Mygliol 8.7 25 4.75 17.6
    810 (6:1)
    Gelucire 44/14 + Mygliol 10.3 25 8.45 26.6
    818 (6:1)
    Gelucire 44/14 + Mygliol 9.5 25 6.48 22.0
    840 (6:1)
    Gelucire 44/14 + Cremophore 9.5 25 10.7 36.6
    RH 40 (6:1)
    Gelucire 44/14 + Cremophor 9.8 25 11.5 38.1
    EL (6:1)
    Gelucire 44/14 + Solutol 9.3 25 6.54 22.8
    HS + TPGS (2:1:1)
    Gelucire 44/14 + Olive 9.6 20 11.9 39.9
    Oil + Tween 80 (2:1:1)
    Gelucire 44/14 + Olive 9.6 20 9.83 33.2
    Oil + TPGS (2:1:1)
    Gelucire 44/14 + Olive 9.6 20 9.07 30.6
    Oil + POE 10 Oleyl (2:1:1)
    Gelucire 44/14 + Olive 9.1 20 7.73 27.5
    Oil + Cremophor RH
    40 (2:1:1)
    Gelucire 44/14 + Tween 9.7 25 10.05 33.5
    80 (6:1)
    Gelucire 50/13 + Tween 9.4 25 8.21 28.4
    80 (5:2)
    Gelucire 50/13 + PEG 400 9.3 25 6.46 22.5
    (6:1)
    Gelucire 50/13 + Cremophor 9.1 25 8.11 28.9
    EL (6:1)

    Labrasol: Saturated polyglycolyzed C8-C10 glycerides (HLB = 14)

    Mygliols: Neutral oils (saturated coconut and palmkernel fatty acids) mainly C8-C10 fatty acids

    Cremophor EL: Polyoxyl 35 castor oil (HLB 12-14)

    Cremophor RH 40: Polyoxyl 40 Hydrogenated castor oil (HLB 14-16)
  • EXAMPLE 8 Vitamin E TPGS Systems as Carriers
  • Table 9 pertains to vehicle formulations containing Vitamin E TPGS systems as carriers. The data set forth correspond to the data described in Example 2 with respect to Table 3.
    TABLE 9
    Absorption Results of TPGS Systems as Carriers
    AUC
    Dose Conc. □g · eq ×
    FORMULATIONS [mg/kg] [mg/ml] hr/ml % ABS*
    TPGS + Pharmasolve 8.2 25 8.93 35.2
    (1.5:1)
    TPGS + Pharmasolve 9.5 25 8.72 29.8
    (1:1)
    TPGS + Pharmasolve 9.1 25 8.83 31.4
    (2:1)
    TPGS + Propylene 8.5 20 9.65 36.9
    glycol (1:1)
    TPGS + Pharmasolve + 9.0 25 8.31 29.8
    PEG 200 (2:1:1)
    TPGS + Pharmasolve + 8.2 25 6.62 26.3
    PEG 400 (2:1:1)
    TPGS + Pharmasolve + 8.9 25 8.07 29.3
    PG (2:1:1)
    TPGS + Mygliol 810 9.1 25 5.65 20.0
    (1:1)
    TPGS + Softigen 767 10.2 25 8.66 27.5
    (1:1)
    TPGS + PEG 200 (1:1) 8.3 25 7.75 30.4
    TPGS + PEG 400 (1:1) 9.6 25 7.32 24.6

    Softigen 767: PEG-6-Caprylic/Capric Glycerides
  • EXAMPLE 9 POE and Hydrogenated Castor Oil Derivatives as Carriers
  • Table 10 pertains to vehicle formulations containing POE and hydrogenated castor oil derivatives as carriers. The data set forth correspond to the data described in Example 2 with respect to Table 3.
    TABLE 10
    Absorption Results of Polyoxyethylated Castor Oil
    (Cremophor) Derivatives Systems as Carriers
    Dose Conc. AUC
    [mg/ [mg/ □g · eq ×
    FORMULATIONS kg] ml] hr/ml % ABS
    IV Paxene 10.0 6 11.15 37.2
    Cremophor EL + Ethanol + 9.2 1.3 6.07 21.5
    Water (1:1:8)
    IV Paxene + Water (1:1) 8.9 3 8.70 31.8
    IV Paxene + Water (1:5) 9.1 1 10.76 38.5
    Cremophor EL + Pharmasolve 8.6 20 6.74 25.3
    (1:1)
    Cremophor EL + TBC (1:1) 9.0 20 9.35 31.9
    Cremophor EL + Gelucire 9.8 25 11.5 38.1
    44/14 (1:6)
    Cremophor EL + Gelucire 9.1 25 8.11 28.9
    50/13 (1:6)
    Cremophor RH 40 + Ethanol + 9.0 3 7.14 25.7
    Water (1:1:2)
    Cremophor RH 40 + Gelucire 9.5 25 10.7 36.6
    44/14 (1:6)
    Cremophor RH 40 + Gelucire 9.1 20 7.73 27.5
    44/14 + Olive Oil (1:2:1)
  • EXAMPLE 10 Polysorbate 80 Carriers
  • Table 11 pertains to vehicle formulations containing polysorbate 80 as at least one of the carriers. The data set forth correspond to the data described in Example 2 with respect to Table 3.
    TABLE 11
    Absorption Results of Polysorbate
    80 (Tween 80) Systems as Carrierts
    Dose Conc. AUC
    [mg/ [mg/ □g · eq × %
    FORMULATIONS kg] ml] hr/ml ABS
    Polysorbate 80 9.0 18 11.4 40.9
    Polysorbate 80 + Ethanol + Water 8.0 1.2 7.92 31.2
    (1:1:8)
    Polysorbate 80 + Ethanol (3:1) 8.9 18 9.97 36.3
    Polysorbate 80 + Water (3:1) 8.2 18 7.15 28.3
    Polysorbate 80 + TBC (1:1) 9.5 20 9.12 31.2
    Polysorbate 80 + ATEC (1:1) 9.1 20 8.50 30.3
    Polysorbate 80 + Olive oil (3:1) 9.0 20 13.3 43.7
    Polysorbate 80 + PEG 400 (1:1) 9.7 20 9.41 31.5
    Polysorbate 80 + Gelucire 44/14 + 9.6 20 11.9 39.9
    Olive Oil (1:2:1)
    Polysorbate 80 + Gelucire 44/14 9.7 25 10.05 33.5
    (1:6)

    TBC = Tributyl citrate (citrate ester)

    ATEC = Acetyl triethyl citrate (citrate ester)
  • It has thus been shown that there are provided compositions and methods which achieve the various objects of the invention and which are well adapted to meet the conditions of practical use.
  • As various possible embodiments might be made of the above invention, and as various changes might be made in the embodiments set forth above, it is to be understood that all matters herein described are to be interpreted as illustrative and not in a limiting sense.
  • What is claimed as new and desired to be protected by Letters Patent is set forth in the following claims.

Claims (22)

1. A two-part medicament for oral administration to a mammalian subject, the first part of said medicament comprising a taxane or taxane derivative as active ingredient in a solubilizing vehicle for said taxane, and the second part of said medicament comprising at least 30% by weight of a carrier for the taxane, said carrier having an HLB value at least about 10.
2. A two-part medicament according to claim 1 wherein the solubilizing vehicle is capable of solubilizing at least about 25 mg/ml of the taxane at about 20-25° C.
3. A two-part medicament according to claim 1 wherein the solubilizing vehicle comprises water, ethanol or a polyoxyethylated or hydrogenated castor oil.
4. A two-part medicament according to claim 1 wherein the solubilizing vehicle comprises sweetening, flavoring or coloring agents.
5. A two-part medicament according to claim 1 wherein the solubilizing vehicle contains about 2-500 mg/ml or mg/g of the taxane.
6. A two-part medicament according to claim 5 wherein the solubilizing vehicle contains about 2-50 mg/ml or mg/g of the taxane.
7. A two-part medicament according to claim 1 wherein the carrier includes at least one non-ionic surfactant or emulsifier.
8. A two-part medicament according to claim 7 wherein the carrier includes at least one surfactant or emulsifier selected from the group consisting of Vitamin E TPGS, saturated polyglycolyzed glycerides, modified castor oils, polyoxyethylated stearate esters, polyoxyethylated sorbitan esters, polyoxyethylated fatty ethers, modified almond and corn oil glycerides sorbitan diisostearate esters, polyoxyethylated hydroxystearates, and β-cyclodextrin.
9. A two-part medicament according to claim 1 wherein the second part of the medicament comprises about 30-240 ml of fluid.
10. A two-part medicament according to claim 1 wherein the taxane is paclitaxel or docetaxel.
11. A two-part medicament according to claim 10 wherein the taxane is paclitaxel.
12. A method of treating a mammalian subject suffering from a taxane-responsive disease condition comprising the oral administration to the subject of a two-derivative as active ingredient in a solubilizing vehicle for said taxane and the second part of said medicament comprising at least 30% by weight of a carrier for the taxane, said carrier having an HLB value at least about 10.
13. A method according to claim 12 wherein the solubilizing vehicle is capable of solubilizing at least about 25 mg/ml of the taxane at about 20-25° C.
14. A method according to claim 12 wherein the solubilizing vehicle comprises water, ethanol or a polyoxyethylated or hydrogenated castor oil.
15. A method according to claim 12 wherein the solubilizing vehicle comprises sweetening, flavoring or coloring agents.
16. A method according to claim 12 wherein the solubilizing vehicle contains about 2-500 mg/ml or mg/g of the taxane.
17. A method according to claim 12 wherein the solubilizing vehicle contains about 2-50 mg/ml or mg/g of the taxane.
18. A method according to claim 12 wherein the carrier includes at least one non-ionic surfactant or emulsifier.
19. A method according to claim 12 wherein the carrier includes at least one surfactant or emulsifier selected from the group consisting of Vitamin E TPGS, saturated polyglycolyzed glycerides, modified castor oils, polyoxyethylated stearate esters, polyoxyethylated sorbitan esters, polyoxyethylated fatty ethers, modified almond and corn oil glycerides sorbitan diisostearate esters, polyoxyethylated hydroxystearates, and β-cyclodextrin.
20. A method according to claim 12 wherein the second part of the composition comprises about 30-240 ml of fluid.
21. A method according to claim 12 wherein the taxane is paclitaxel or docetaxel
22. A method according to claim 21 wherein the taxane is paclitaxel.
US11/165,896 1995-10-26 2005-06-24 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same Abandoned US20050267201A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US11/165,896 US20050267201A1 (en) 1995-10-26 2005-06-24 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same

Applications Claiming Priority (7)

Application Number Priority Date Filing Date Title
US707195P 1995-10-26 1995-10-26
US08/608,776 US5968972A (en) 1995-10-26 1996-02-29 Method for increasing the oral bioactivity of pharmaceutical agents
US08/733,142 US6245805B1 (en) 1995-10-26 1996-10-16 Method, compositions and kits for increasing the oral bioavailability of pharmaceutical agents
US86351397A 1997-05-27 1997-05-27
US09/055,818 US6964946B1 (en) 1995-10-26 1998-04-06 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same
PCT/US1999/013821 WO2000078247A1 (en) 1995-10-26 1999-06-18 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same
US11/165,896 US20050267201A1 (en) 1995-10-26 2005-06-24 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US09/055,818 Division US6964946B1 (en) 1995-10-26 1998-04-06 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same

Publications (1)

Publication Number Publication Date
US20050267201A1 true US20050267201A1 (en) 2005-12-01

Family

ID=47631112

Family Applications (2)

Application Number Title Priority Date Filing Date
US09/055,818 Expired - Fee Related US6964946B1 (en) 1995-10-26 1998-04-06 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same
US11/165,896 Abandoned US20050267201A1 (en) 1995-10-26 2005-06-24 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US09/055,818 Expired - Fee Related US6964946B1 (en) 1995-10-26 1998-04-06 Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same

Country Status (16)

Country Link
US (2) US6964946B1 (en)
EP (1) EP1221908A4 (en)
JP (1) JP2003502349A (en)
CN (1) CN1361677A (en)
AU (1) AU774060B2 (en)
BR (1) BR9917403A (en)
CA (1) CA2371924A1 (en)
CZ (1) CZ20014589A3 (en)
HU (1) HUP0300836A3 (en)
MX (1) MXPA01013116A (en)
NO (1) NO20016198L (en)
NZ (1) NZ516279A (en)
PL (1) PL196267B1 (en)
SK (1) SK18782001A3 (en)
UA (1) UA77646C2 (en)
WO (1) WO2000078247A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080319048A1 (en) * 2007-06-22 2008-12-25 Scidose Llc Solubilized formulation of docetaxel without tween 80
US7772274B1 (en) 2009-10-19 2010-08-10 Scidose, Llc Docetaxel formulations with lipoic acid
US20110092579A1 (en) * 2009-10-19 2011-04-21 Scidose Llc Solubilized formulation of docetaxel
US20110092580A1 (en) * 2009-10-19 2011-04-21 Scidose Llc Docetaxel formulations with lipoic acid and/or dihydrolipoic acid
US8912228B2 (en) 2009-10-19 2014-12-16 Scidose Llc Docetaxel formulations with lipoic acid

Families Citing this family (31)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6828346B2 (en) * 1999-10-25 2004-12-07 Supergen, Inc. Methods for administration of paclitaxel
US6136846A (en) * 1999-10-25 2000-10-24 Supergen, Inc. Formulation for paclitaxel
KR20030019296A (en) * 1999-10-27 2003-03-06 아이박스 리서치 인코포레이티드 Method and compositions for administering taxanes orally to human patients
US6750246B1 (en) 2000-02-03 2004-06-15 Bristol-Myers Squibb Company C-4 carbonate taxanes
US7115565B2 (en) 2001-01-18 2006-10-03 Pharmacia & Upjohn Company Chemotherapeutic microemulsion compositions of paclitaxel with improved oral bioavailability
CA2434641A1 (en) * 2001-01-18 2002-08-22 Pharmacia And Upjohn Company Chemotherapeutic microemulsion compositions of paclitaxel with improved oral bioavailability
US20040092428A1 (en) * 2001-11-27 2004-05-13 Hongming Chen Oral pharmaceuticals formulation comprising paclitaxel, derivatives and methods of administration thereof
WO2003053350A2 (en) * 2001-12-20 2003-07-03 Bristol-Myers Squibb Company Pharmaceutical compositions of orally active taxane derivatives having enhanced bioavailability
EP1498143A1 (en) * 2003-07-18 2005-01-19 Aventis Pharma S.A. Self-emulsifying and self-microemulsifying formulations for the oral administration of taxoids
EP1510206A1 (en) * 2003-08-29 2005-03-02 Novagali Pharma SA Self-nanoemulsifying oily formulation for the administration of poorly water-soluble drugs
CN1853728A (en) * 2005-04-19 2006-11-01 上海天博生物科技有限公司 Method prescription and use for improving medicine or nutrient oral absorption
AR054215A1 (en) * 2006-01-20 2007-06-13 Eriochem Sa A PHARMACEUTICAL FORMULATION OF A TAXANE, A SOLID COMPOSITION OF A LIOFILIZED TAXAN FROM AN ACETIC ACID SOLUTION, A PROCEDURE FOR THE PREPARATION OF A SOLID COMPOSITION OF A TAXANE, A SOLUBILIZING COMPOSITION OF A LIOFILIZED TAXANE AND AN ELEMENTARY KIT
CZ300677B6 (en) * 2006-05-03 2009-07-15 I.Q.A., A. S. Pharmaceutical composition containing docetaxel and intended for preparation of fusion solution, process of its preparation and use
WO2008058366A1 (en) * 2006-09-28 2008-05-22 Université de Montréal Oil-in-water emulsions, methods of use thereof, methods of preparation thereof and kits thereof
KR101502533B1 (en) * 2007-11-22 2015-03-13 에스케이케미칼주식회사 Stable pharmaceutical composition containing Taxane derivatives, and method of manufacturing the same
KR101478779B1 (en) * 2007-11-22 2015-01-05 에스케이케미칼주식회사 Preparation of lyophilized composition containing Taxane derivatives of which improved properties as a reconstitution time
ES2344674B1 (en) * 2008-08-07 2011-06-29 Gp Pharm, S.A. INJECTABLE PHARMACEUTICAL COMPOSITION OF TAXANOS.
US8362013B2 (en) * 2009-04-30 2013-01-29 Abbvie Inc. Salt of ABT-263 and solid-state forms thereof
US20100280031A1 (en) * 2009-04-30 2010-11-04 Paul David Lipid formulation of apoptosis promoter
US8728516B2 (en) * 2009-04-30 2014-05-20 Abbvie Inc. Stabilized lipid formulation of apoptosis promoter
TWI532484B (en) * 2009-06-08 2016-05-11 艾伯維有限公司 Solid dispersions containing an apoptosis-promoting agent
TWI471321B (en) * 2009-06-08 2015-02-01 Abbott Gmbh & Co Kg Pharmaceutical dosage form for oral administration of a bcl-2 family inhibitor
TW201113266A (en) * 2009-09-02 2011-04-16 Ziopharm Oncology Inc Pharmaceutical formulations for indibulin
US8476310B2 (en) 2009-10-19 2013-07-02 Scidose Llc Docetaxel formulations with lipoic acid
WO2011079127A1 (en) * 2009-12-22 2011-06-30 Abbott Laboratories Abt-263 capsule
NZ603828A (en) 2010-05-03 2015-09-25 Teikoku Pharma Usa Inc Non-aqueous taxane pro-emulsion formulations and methods of making and using the same
UA113500C2 (en) 2010-10-29 2017-02-10 MEL EXTRUSION SOLID DISPERSIONS CONTAINING AN APOPTOSIS-INDUCING AGENT
JO3685B1 (en) 2012-10-01 2020-08-27 Teikoku Pharma Usa Inc Non-aqueous taxane nanodispersion formulations and methods of using the same
TWI752750B (en) * 2015-09-30 2022-01-11 香港商慧源香港創新有限公司 Oral taxane compositions and methods
FR3042498A1 (en) * 2015-10-14 2017-04-21 Naturex NOVEL SOLVENT FOR ORGANIC EXTRACTION AND / OR SOLUBILIZATION, EXTRACTION PROCESS USING SAID SOLVENT, AND EXTRACTS THEREFROM
CN108066774B (en) * 2018-01-11 2023-04-18 比卡生物科技(广州)有限公司 Cabazitaxel composition for injection and preparation method thereof

Citations (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4960790A (en) * 1989-03-09 1990-10-02 University Of Kansas Derivatives of taxol, pharmaceutical compositions thereof and methods for the preparation thereof
US5403858A (en) * 1991-07-08 1995-04-04 Rhone-Poulenc Rorer, S.A. New compositions containing taxane derivatives
US5438072A (en) * 1992-12-02 1995-08-01 Rhone-Poulenc Rorer S.A. Taxoid-based compositions
US5504102A (en) * 1993-09-29 1996-04-02 Bristol-Myers Squibb Company Stabilized pharmaceutical composition and stabilizing solvent
US5565478A (en) * 1994-03-14 1996-10-15 The United States Of America As Represented By The Department Of Health & Human Services Combination therapy using signal transduction inhibitors with paclitaxel and other taxane analogs
US5610173A (en) * 1994-01-07 1997-03-11 Sugen, Inc. Formulations for lipophilic compounds
US5616330A (en) * 1994-07-19 1997-04-01 Hemagen/Pfc Stable oil-in-water emulsions incorporating a taxine (taxol) and method of making same
US5646176A (en) * 1992-12-24 1997-07-08 Bristol-Myers Squibb Company Phosphonooxymethyl ethers of taxane derivatives
US5665386A (en) * 1995-06-07 1997-09-09 Avmax, Inc. Use of essential oils to increase bioavailability of oral pharmaceutical compounds
US5681846A (en) * 1995-03-17 1997-10-28 Board Of Regents, The University Of Texas System Extended stability formulations for paclitaxel
US5716928A (en) * 1995-06-07 1998-02-10 Avmax, Inc. Use of essential oils to increase bioavailability of oral pharmaceutical compounds
US5877205A (en) * 1996-06-28 1999-03-02 Board Of Regents, The University Of Texas System Parenteral paclitaxel in a stable non-toxic formulation
US5972992A (en) * 1992-11-27 1999-10-26 Napro Biotherapeutics, Inc. Injectable composition
US6004927A (en) * 1994-02-02 1999-12-21 Regents Of The University Of California Method for increasing bioavailability of orally administered pharmaceutical compounds
US6096331A (en) * 1993-02-22 2000-08-01 Vivorx Pharmaceuticals, Inc. Methods and compositions useful for administration of chemotherapeutic agents
US6245805B1 (en) * 1995-10-26 2001-06-12 Baker Norton Pharmaceuticals, Inc. Method, compositions and kits for increasing the oral bioavailability of pharmaceutical agents
US20010029264A1 (en) * 1998-03-10 2001-10-11 Mcchesney-Harris Lisa L. Novel methods and compositions for delivery of taxanes
US20020025337A1 (en) * 1995-07-20 2002-02-28 Lisbeth Illum Lipid vehicle drug delivery composition containing vitamin e
US6458373B1 (en) * 1997-01-07 2002-10-01 Sonus Pharmaceuticals, Inc. Emulsion vehicle for poorly soluble drugs

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997023208A1 (en) 1995-12-21 1997-07-03 Genelabs Technologies, Inc. Taxane composition and method
HUP0003546A3 (en) * 1997-05-27 2002-12-28 Baker Norton Pharma Compositions for administering taxanes orally to human patients
BE1011216A3 (en) 1997-06-13 1999-06-01 Thissen En Abrege L T B Lab Pharmaceutical form for the administration of paclitaxel, method of preparation of a composition paclitaxel ready to employment and use thereof.
SK284511B6 (en) 1997-07-29 2005-05-05 Pharmacia & Upjohn Company Self-emulsifying formulations for lipophilic compounds
GB9718903D0 (en) 1997-09-05 1997-11-12 Glaxo Group Ltd Method,compositions and kits for increasing the oral bioavailability of pharmaceutical agents
DE69931617T2 (en) 1998-04-01 2007-05-24 Jagotec Ag TAXAN MICROEMULSIONS

Patent Citations (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4960790A (en) * 1989-03-09 1990-10-02 University Of Kansas Derivatives of taxol, pharmaceutical compositions thereof and methods for the preparation thereof
US5403858A (en) * 1991-07-08 1995-04-04 Rhone-Poulenc Rorer, S.A. New compositions containing taxane derivatives
US5972992A (en) * 1992-11-27 1999-10-26 Napro Biotherapeutics, Inc. Injectable composition
US5438072A (en) * 1992-12-02 1995-08-01 Rhone-Poulenc Rorer S.A. Taxoid-based compositions
US5646176A (en) * 1992-12-24 1997-07-08 Bristol-Myers Squibb Company Phosphonooxymethyl ethers of taxane derivatives
US6096331A (en) * 1993-02-22 2000-08-01 Vivorx Pharmaceuticals, Inc. Methods and compositions useful for administration of chemotherapeutic agents
US5504102A (en) * 1993-09-29 1996-04-02 Bristol-Myers Squibb Company Stabilized pharmaceutical composition and stabilizing solvent
US5610173A (en) * 1994-01-07 1997-03-11 Sugen, Inc. Formulations for lipophilic compounds
US6004927A (en) * 1994-02-02 1999-12-21 Regents Of The University Of California Method for increasing bioavailability of orally administered pharmaceutical compounds
US6028054A (en) * 1994-02-02 2000-02-22 The Regents Of The University Of California Method for increasing bioavailability of oral pharmaceutical compositions
US5565478A (en) * 1994-03-14 1996-10-15 The United States Of America As Represented By The Department Of Health & Human Services Combination therapy using signal transduction inhibitors with paclitaxel and other taxane analogs
US5616330A (en) * 1994-07-19 1997-04-01 Hemagen/Pfc Stable oil-in-water emulsions incorporating a taxine (taxol) and method of making same
US5681846A (en) * 1995-03-17 1997-10-28 Board Of Regents, The University Of Texas System Extended stability formulations for paclitaxel
US5716928A (en) * 1995-06-07 1998-02-10 Avmax, Inc. Use of essential oils to increase bioavailability of oral pharmaceutical compounds
US5665386A (en) * 1995-06-07 1997-09-09 Avmax, Inc. Use of essential oils to increase bioavailability of oral pharmaceutical compounds
US20020025337A1 (en) * 1995-07-20 2002-02-28 Lisbeth Illum Lipid vehicle drug delivery composition containing vitamin e
US6245805B1 (en) * 1995-10-26 2001-06-12 Baker Norton Pharmaceuticals, Inc. Method, compositions and kits for increasing the oral bioavailability of pharmaceutical agents
US6610735B2 (en) * 1995-10-26 2003-08-26 Baker Norton Pharmaceuticals, Inc. Method, compositions and kits for increasing the oral bioavailability of pharmaceutical agents
US5877205A (en) * 1996-06-28 1999-03-02 Board Of Regents, The University Of Texas System Parenteral paclitaxel in a stable non-toxic formulation
US6458373B1 (en) * 1997-01-07 2002-10-01 Sonus Pharmaceuticals, Inc. Emulsion vehicle for poorly soluble drugs
US20010029264A1 (en) * 1998-03-10 2001-10-11 Mcchesney-Harris Lisa L. Novel methods and compositions for delivery of taxanes

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080319048A1 (en) * 2007-06-22 2008-12-25 Scidose Llc Solubilized formulation of docetaxel without tween 80
US7772274B1 (en) 2009-10-19 2010-08-10 Scidose, Llc Docetaxel formulations with lipoic acid
US20110092579A1 (en) * 2009-10-19 2011-04-21 Scidose Llc Solubilized formulation of docetaxel
US20110092580A1 (en) * 2009-10-19 2011-04-21 Scidose Llc Docetaxel formulations with lipoic acid and/or dihydrolipoic acid
US8541465B2 (en) 2009-10-19 2013-09-24 Scidose, Llc Docetaxel formulations with lipoic acid and/or dihydrolipoic acid
US8912228B2 (en) 2009-10-19 2014-12-16 Scidose Llc Docetaxel formulations with lipoic acid

Also Published As

Publication number Publication date
UA77646C2 (en) 2007-01-15
JP2003502349A (en) 2003-01-21
AU774060B2 (en) 2004-06-17
EP1221908A1 (en) 2002-07-17
PL359924A1 (en) 2004-09-06
NO20016198D0 (en) 2001-12-18
US6964946B1 (en) 2005-11-15
CZ20014589A3 (en) 2002-07-17
WO2000078247A1 (en) 2000-12-28
BR9917403A (en) 2002-07-09
HUP0300836A3 (en) 2005-11-28
CA2371924A1 (en) 2000-12-28
NO20016198L (en) 2002-02-05
PL196267B1 (en) 2007-12-31
AU4695599A (en) 2001-01-09
NZ516279A (en) 2004-06-25
CN1361677A (en) 2002-07-31
MXPA01013116A (en) 2002-06-04
HUP0300836A2 (en) 2003-08-28
EP1221908A4 (en) 2002-10-09
SK18782001A3 (en) 2002-09-10

Similar Documents

Publication Publication Date Title
US6964946B1 (en) Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same
US6395770B1 (en) Method and compositions for administering taxanes orally to human patients
US20040127551A1 (en) Taxane-based compositions and methods of use
WO2001072299A1 (en) Taxane-based compositions and methods of use
EP0994706B1 (en) Compositions for administering taxanes orally to human patients and their use
AU2002360816A1 (en) Taxane based compositions and methods of use
AU1104201A (en) Method and compositions for administering taxanes orally to human patients
WO2004091506A2 (en) Taxane-based compositions and methods of use
EP1479382A1 (en) Oral pharmaceutical compositions containing taxanes and methods for treatment employing the same
RU2236226C2 (en) Oral pharmaceutical compositions comprising taxanes and methods for treatment using thereof
AU784159B2 (en) Method and compositions for administering taxanes orally to human patients
KR20020027356A (en) Oral pharmaceutical compositions containing taxanes and methods of treatment employing the same
MXPA99010850A (en) Method and compositions for administering taxanes orally to human patients

Legal Events

Date Code Title Description
AS Assignment

Owner name: BAKER NORTON PHARMACEUTICALS, INC., FLORIDA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:GUTIERREZ-ROCCA, JOSE C.;CACACE, JANICE L.;SELIM, SAMI;AND OTHERS;REEL/FRAME:016538/0967;SIGNING DATES FROM 19980408 TO 19980513

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION