Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
  • A61K38/19—Cytokines; Lymphokines; Interferons
  • A61K38/20—Interleukins [IL]
  • A61K38/204—IL-6
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• interleukin-6 antagonists for the treatment of diseases characterised by high levels of aromatase
• the invention described herein relates to the use of interleukin- 6 (IL-6) antagonists for the preparation of a medicinal agent for the treatment of diseases presenting high aromatase levels.
• IL-6 interleukin- 6
• Aromatase is a regulatory enzyme in oestrogen synthesis.
• Oestrogens are known to play a central role in the growth of breast tumours in a hormone-dependent manner (James VHT, Reed MJ; Prog Cancer Res Ther 1980, 14:471-487). It has been found, however, that the highest incidence of breast tumours develops in postmenopausal women, i.e. at a time when the ovaries have stopped producing oestrogens. The greater frequency of breast tumours precisely during the period when oestrogen production has ceased, and therefore when the tumour risk should be lower, is only apparently paradoxical.
• oestrogens are also present in other body tissues, such as adipose and mammary tissue (James VHT, McNeill JM, Lai LC, Newton CJ, Ghilchik MV, Reed MJ; 1987, 50:269-279).
• body tissues such as adipose and mammary tissue (James VHT, McNeill JM, Lai LC, Newton CJ, Ghilchik MV, Reed MJ; 1987, 50:269-279).
• Cytokines are important regulators in oestrogen synthesis in normal or cancerous mammary tissue (Reed MJ, Purohit A, Endocrine Review 18(5): 701-715).
• the peripheral synthesis of oestrogens derives mainly from the activity of three enzymes, namely, aromatase, oestrone sulphatase or sulphotransf erase), and oestradiol dehydrogenase (Type I) (E2DH).
• the first of these enzyme complexes, aromatase converts adrenocortical androstenedione to oestrone and is widely distributed in muscular and adipose tissue (Longcope C, Pratt JH, Schneider SH, Fineberg SE, 1977, J. Clin. Endocrinol. Metab. 45: 1134-1145).
• Aromatase activity is also detectable in normal mammary tissue and in 40-50% of cancerous mammary tissue.
• the second enzyme, oestrone sulphatase permits the conversion of oestrone, obtained by means of the above-mentioned aromatase activity, to oestrone sulphate (Reed MJ, Purohit A 1993, Rev. Endocr. Relat. Cancer 45:51-62).
• This hormone has been found to be associated with hormone-dependent tumours (Masamura S, Santner SJ, Santen RJ, 1996, J. Steroid Biochem. Mol. Biol 58:425-430).
• the third enzyme, E2DH permits the conversion of oestrone, formed both from androstenedione and from oestrone sulphate, to oestradiol and has been found to be associated with breast cancer
• Cytokines particularly IL-6 and Tumor Necrosis Factor- ⁇ (TNF- ), play a crucial role in the regulation of oestrogen synthesis in breast cancer cells. Both IL-6 and TNF- ⁇ stimulate aromatase activity, E2DH activity, and oestrone sulphatase activity, and, in addition, are capable of acting synergistically to increase the activity of these enzymes.
• 50% of the volume of a breast tumour consists of macrophages and lymphocytes.
• 11-6 to stimulate aromatase activity may be markedly reinforced (20- to 40-fold) by the 11-6 soluble receptor (IL-6 sR).
• IL-6 sR 11-6 soluble receptor
• 11-6 sR is produced by malignant epithelial cells, tumour-derived fibroblasts and, particularly, tumour-associated macrophages (TAMs) and tumour-infiltrating lymphocytes (TILs), but not by normal stromal cells.
• TAMs tumour-associated macrophages
• TILs tumour-infiltrating lymphocytes
• the interleukin-6 receptor (IL-6 R) and/ or IL-6 soluble receptor can interact with the gpl30 protein component of the IL-6 R system. This interaction is required for the induction of the transduction signal deriving from IL-6 bound to its receptor.
• TNF- ⁇ secreted by adipocytes and by cells of the immune system increases the expression of the gpl30 protein component of the IL-6 R signalling system, giving rise to a synergistic effect of IL-6 and TNF- ⁇ in stimulating the production of oestrogen synthesis.
• the complex oestrogen synthesis regulation system in breast tumours is extensively co-ordinated by cytokines. The result of the co-ordinated stimulation of oestrogen synthesis is the cause of the high oestradiol concentrations found in breast cancer (Reed MJ, Purohit A, Endocrine Review 18(5): 701-715).
• BCFs Breast cyst fluids stimulate aromatase and E2DH activity in breast cells cultured in vitro (such cysts are present in many premenopausal women and are associated with an increase in occurrence of breast cancer) .
• BCFs subjected to radioimmunoassay (RIA) analysis have shown the presence of cytokines IL-1 and IL-6, and both these cytokines are capable of stimulating aromatase activity in fibroblasts deriving from breast cancer cells (Duncan L. J., Robinson G.V., Ghilchik M.V., Reed M.J., 1994 Endocr. Relat. Cancer 2:27-35; Reed M. J., Coldham N.J., Patel S.R., Ghilchik M.W., James V.H.T., 1992, J. Endocrinol. 132:R5-R8).
• RIA radioimmunoassay
• IL-6 concentration in BCFs is 1000- fold greater than the IL- 1 concentration in the same fluids and that IL- 6 is the main aromatase activity stimulating factor in BCFs.
• Non-steroidal inhibitors Compounds inhibiting aromatase activity are already known and can be divided into two groups, called non-steroidal inhibitors and steroidal inhibitors, respectively.
• Aminogluthetimide is a non-steroidal aromatase inhibitor and has long been used for the treatment of breast cancer.
• the inhibition of aromatase activity by aminogluthetimide is not selective; this compound, in fact, also inhibits other enzymes involved in the metabolic pathway of steroidogenesis and is therefore not easily utilisable because of its toxicity (Oncologist 1998; 3(2): 129-130).
• Anastrazole is a non-steroidal aromatase inhibitor. This compound is not devoid of drawbacks and , in fact, presents the disadvantage of causing gastrointestinal disorders in patients treated with it (Cancer 1997 Feb. 15;79(4):730-9).
• Letrozole is a non-steroidal aromatase inhibitor capable of reducing aromatase activity only by 5-10% compared to basal levels (Recent Results Cancer Res. 1998; 152:227-84).
• Formestane is a steroidal aromatase inhibitor, it is less toxic than aminogluthetimide, but presents the drawback that it can be administered only intramuscularly (Oncology (Huntingt) 1997 Nov; l l(l l): 1697-703).
• Exemestane is a steroidal aromatase inhibitor. This compound is not devoid of drawbacks. In fact, it causes headache in 45% of treated patients, dizziness in 33%, nausea in 33%, and other side effects (Anticancer Drugs 1998 Sept; 9(8):675-83).
• aromatase activity inhibitors are also known.
• a great deal of effort has been made and continues to be made in the field of aromatase inhibitors aimed at the treatment of hormone-dependent tumours, particularly cancer of the breast.
• aromatase inhibitors aimed at the treatment of hormone-dependent tumours, particularly cancer of the breast.
• aromatase inhibitors aimed at the treatment of hormone- dependent tumours, particularly cancer of the breast.
• there is still a strongly perceived need to find new, increasingly specific aromatase inhibitors which are capable of affording greater inhibition of aromatase activity and are devoid of the unwanted side effects of the above-mentioned known compounds.
• the compounds according to the invention have the following amino acid sequences: SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7 (Sant 7).
• WO 96/34104 tells us that these compounds are human interleukin-6 antagonists totally incapable of binding to gpl30 and that they are useful agents for the treatment of multiple myeloma, rheumatoid arthritis, systemic lupus erythematosus, and osteoporosis.
• the compounds according to the invention possess a substantial ability to inhibit aromatase activity in a highly specific manner as compared to the known compounds and that they can be usefully applied therapeutically in the treatment of hormone-dependent tumours, particularly cancer of the breast.
• oestrogens derives mainly from the activity of three enzymes, namely, aromatase, oestrone sulphatase and oestradiol dehydrogenase (E2DH).
• Aromatase converts corticoadrenal androstenedione to oestrone.
• oestrone is converted to oestradiol and aromatase activity is greater in tumour tissue than in normal mammary tissue.
• Oestrone sulphotransferase permits the conversion of oestrone, obtained by means of the above-mentioned aromatase activity, to oestrone sulphate, and oestrone sulphate is associated with hormone- dependent tumours.
• E2DH allows the conversion of oestrone, formed both from androstenedione and from oestrone sulphate, to oestradiol and oestradiol is associated with breast cancer.
• the compounds according to the invention possess a substantial capacity to inhibit aromatase activity and can be usefully applied therapeutically in the treatment of hormone-dependent tumours, particularly tumours of the breast. Moreover, such compounds are also useful agents for the prevention of onset of breast cancer.
• subjects at high risk of breast cancer such as, for instance, obese persons and/ or subjects with precancerous nodules (breast cysts) can be treated with the compounds according to the invention for the prevention of such diseases.
• the subject of the invention described herein is therefore the use of compounds with an amino acid sequence selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7 (Sant 7) for the preparation of a medicinal agent for the prevention or treatment of diseases mediated by an increase in aromatase activity.
• a further subject of the invention described herein is the use of an amino acid sequence selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7, for the preparation of a medicinal agent for the prevention or treatment of oestrogen- dependent tumours.
• a further subject of the invention described herein is the use of an amino acid sequence selected from the group consisting of SEQ ID NO: 1
• a further subject of the invention described herein is the use of an amino acid sequence selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7, for the preparation of a medicinal agent endowed with antioestrogen activity.
• a further subject of the invention described herein is the use of an amino acid sequence selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7, for the preparation of a medicinal agent with an inhibitory effect on oestrogen synthesis, in which the enzyme catalysing oestrogen synthesis is selected from the group consisting of aromatase, oestrone sulphatase, or oestradiol dehydrogenase .
• a further subject of the invention described herein is the use of a fragment of a compound selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7, which conserves the activity of the sequence it derives from, for the preparation of a medicinal agent useful for the prevention or treatment of diseases mediated by an increase in aromatase activity.
• a further subject of the invention described herein is the use of a fragment of a compound selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7, which conserves the activity of the sequence it derives from, for the preparation of a medicinal agent , for the prevention or treatment of oestrogen-dependent tumours.
• a further subject of the invention described herein is the use of a fragment of a compound selected from the group consisting of SEQ
• SEQ ID NO: 1 SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7, for the prevention or treatment of breast tumours.
• a further subject of the invention described herein is the use of a fragment of a compound selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, or SEQ ID NO: 7, which conserves the activity of the sequence it derives from, for the preparation of a medicinal agent endowed with antioestrogen activity.
• a further subject of the invention described herein is the use of a fragment of a compound selected from the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, o SEQ ID NO: 7, which conserves the activity of the sequence it derives from, for the preparation of a medicinal agent with an inhibitory effect on oestrogen synthesis, in which the enzyme catalysing oestrogen synthesis is selected from the group consisting of aromatase, oestrone sulphatase, or oestradiol dehydrogenase.
• the compounds according to the invention can be administered alone or in combination with one or more pharmacologically acceptable diluents and/ or vehicles and with one or more therapeutic agents, and/ or antioxidants, and/ or vitamins and with other agents useful for support therapy compatible with the compound itself.
• the compounds according to the invention can be suitably administered orally, via oral inhalation or via intranasal inhalation; parenterally, including subcutaneous, transdermal, intradermal, intramuscular and intravenous administration; or rectally.
• formulations according to the invention described herein suitable for oral administration and prepared on the basis of methods known to pharmaceutical technology, may be in the form of capsules, sachets, granules or powders, tablets containing a predetermined amount of active ingredient; or in the form of aqueous or non-aqueous liquid suspensions; or in the form of emulsions; liposomes; or in spray form with a metered-dose inhaler.
• the formulations for parenteral administration include sterile and non- sterile aqueous solutions, which may contain antioxidants, buffers, bacteriostatic agents and/or solutes which make the formulation isotonic; or in lyophilised form. These formulations may also include suspending and/ or disaggregating agents.
• the formulations for parenteral administration may be contained in ampoules or vials containing a sterile liquid, or a sterile powder to be reconstituted, for the preparation of an extempore injectable solution.
• fibroblasts derived from mammary tissue of women undergoing reductive mastectomy were used.
• Aromatase activity was evaluated in primary cultures of these fibroblasts according to the following procedure.
• dexamethasone markedly stimulates aromatase activity in vitro in the presence of fetal calf serum.
• Culture medium containing IL-6 (50 ng/mL); or IL-6 sR (100 ng/mL); or Sant 7 (10 ⁇ g/mL); or IL-6 plus IL-6 sR; or IL-6 plus Sant 7; or IL-6 plus IL-6 sR plus Sant 7 was then added.
• Aromatase activity was evaluated on a single layer of cells by measuring the production of 3 H2 ⁇ by [l ⁇ - 3 H] androstenedione (15-30 Ci/mmol).
• fibroblasts derived from normal tissue - proximal to tumour tissue were used.
• Aromatase activity was evaluated in primary cultures of these fibroblasts according to the following procedure.
• IL-6 sR (100 ng/mL); or Sant 7 (10 ⁇ g/mL); or IL-6 plus IL-6 sR; or IL- 6 plus IL-6 sR plus Sant 7, the last of these being added 3 hours before IL-6 plus IL-6 sR, i.e. with three hours' pretreatment with Sant
• Aromatase activity was evaluated on a single layer of cells by measuring the production of 3 H2 ⁇ by [l ⁇ - 3 H] androstenedione (15-30 Ci/mmol).
• TFs fibroblasts derived from breast tumours
• Aromatase activity was evaluated in primary cultures of these fibroblasts according to the following procedure.
• IL-6 50 ng/mL
• IL-6 50 ng/mL
• IL-6 sR 100 ng/mL
• Sant 7 10 ⁇ g/mL
• IL-6 plus IL-6 sR plus Sant 7 was then added.
• Aromatase activity was evaluated on a single layer of cells by measuring the production of 3 H2 ⁇ by [l ⁇ - 3 H] androstenedione (15-30 Ci/mmol).
• fibroblasts derived from normal tissue proximal to tumour tissue were used.
• Aromatase activity was evaluated in primary cultures of these fibroblasts according to the following procedure.
• Culture medium was then added containing IL-6 (50 ng/mL) plus IL-6 sR (100 ng/mL); or IL-6 (50 ng/mL) plus IL-6 sR (100 ng/mL) plus Sant 7 at doses of 0.1, 0.5, 1.0, 5.0, or 10 ⁇ g/mL, respectively. Cells were incubated for a further 48 hours.
• Aromatase activity was evaluated on a single layer of cells by measuring the production of 3 H2 ⁇ by [l ⁇ - 3 H] androstenedione (15-30
• IL-6 sR markedly stimulate aromatase activity.
• IC50 value that is to say the Sant 7 concentration with which 50% inhibition of aromatase activity is obtained. This value was 0.06 ⁇ g/mL.
• Y may be a base chosen from between C and T

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