WO2003039537A1

WO2003039537A1 - Chemoprotectant compositions

Info

Publication number: WO2003039537A1
Application number: PCT/US2002/035437
Authority: WO
Inventors: Alla Shapiro
Original assignee: Alla Shapiro
Priority date: 2001-11-05
Filing date: 2002-11-05
Publication date: 2003-05-15

Abstract

A non-toxic and effective isoflavone chemoprotectant agent for treating or preventing effects and damage due to the administration of chemotherapeutic agents in the treatment of cancer and other conditions and diseases. The isoflavone can be administered orally, subcutaneously, intramuscularly, intravenously, transdermally, intranasally, or rectally. The isoflavone is administered chronically, and/or before, during and/or after administration of the chemotherapeutic agent.

Description

CHEMOPROTECTANT COMPOSITIONS

Field of Invention The present invention relates to the use of compositions that act as protective agents in chemotherapy for cancer and other disease states in human and animal subjects to prevent, reduce, or otherwise ameliorate the toxic side effects of anti-cancer chemotherapeutic compounds in normal body cells while substantially preserving the anti-tumor properties of these compounds in vivo when administered prior to, concomitantly with, or subsequently to administration of such chemotherapeutic compounds.

The present invention further relates to chemotherapeutic protective agents that can be administered as a pharmaceutical preparation and/or as a food supplement. More specifically, the present invention relates to the use of isoflavones, particularly genistein, as protective agents for preventing, reducing or treating toxic sides associated with or resulting from chemotherapy.

Background of the Invention

Despite the decrease in overall cancer incidence and mortality rate in the U.S. since the early 1900's, cancer remains a major public health problem. An estimated 1,268,000 new cases of cancer will be diagnosed in the year 2002, and an estimated 553,400 Americans will die from cancer.

For all sites of cancer, regardless of age and gender, cytotoxic chemotherapy alone or in combination with other treatments (e.g. surgery or radiation) remains the main treatment modality for this disease.

Effective chemotherapy for patients with cancer should include maximal tumor cell killing with minimal injury to normal tissue. Chemotherapy doses that can be delivered without causing severe damage to surrounding normal tissues, can be insufficient to eradicate a tumor. Agents need to be developed to protect normal tissues from the toxicities of chemotherapy. No other group of drugs possesses the frequency, variety and severity of side effects as the anticancer agents do. Toxicities resulting from chemotherapy may not only compromise a patient's quality of life, but also delay drug administration, lower drug intensity, and could ultimately adversely affect outcome. To minimize treatment-related toxicities and to optimize chemotherapy, clinical research has attempted to develop chemoprotectants, also referred to as cytochemoprotectants. These chemoprotectants are drugs with the ability to protect healthy cells, tissues and organs against the deleterious effects of chemotherapeutic agents.

An ideal cell protector from the damaging effect of chemotherapy, i.e. a chemoprotectant or a cytochemoprotectant, should be highly selective for normal tissues in all organs and produce minimal tolerable side effect. Such a chemoprotectant or cytochemoprotectant agent should act to reduce toxicity for the bone marrow, gastrointestinal toxicity, cardiac, renal, neurotoxicity or any toxicities that occurs in other organs without inhibiting the therapeutic effect of the chemotherapeutic agent or agents. In addition, these chemoprotectant agents ideally would allow the use of higher doses of chemotherapy than currently in use. Use of these higher doses of chemotherapeutic agents would enable an increase in the effectiveness of the chemotherapy regimen, in particular an increase the response rate or prolonged survival, without compromising quality of life of the patient undergoing the chemotherapy regimen. The nature of cell damage caused by chemotherapeutic agents seems to be multifactorial and complex. These include generation of highly toxic intracellular cytotoxic free radicals, accumulation of toxic metabolites, glutathion depletion, selective inhibition of gene expression that results in cell loss, and perhaps other, yet unknown. Of all these proposed mechanisms, free radical mediated injury has been the most widely studied and accepted explanation for the pathogenesis of damage for some vital organs caused by chemotherapeutic agents. For example, heart damage resulting from drugs that specifically target heart, such as antrhracyclines,.

One of the most important risk factors associated with chemotherapy is a cumulative lifetime dose of the drag. Therefore, a protective agent with low toxicity profile that can be administered over a prolonged period of time, i.e. chronically, could substantially diminish the deleterious effect of anticancer agents on the normal cells. Chemoprotective agents thus are useful in eliminating or reducing the severity of deleterious cellular effects in normal cells caused by chemotherapy.

Attempts have been made to create chemoprotective agents for administration before, at the time, or after chemotherapy to patients with cancer. However, problems have arisen with the potency, route of administration, selectivity of protecting normal tissues and organs without diminishing of the chemotherapeutic agent's desired effect. Additionally, even when an agent is found to be protective, its side effects can be so severe that clinical applicability is precluded. Furthermore, even among agents that provide protection, the protection may be so inconsistent and/or the side effects so great that they would not be used clinically.

Summary of the Invention

With the present invention, it has now been discovered that isoflavone compounds, in particular genistein, are ideal chemoprotectants. The isoflavones possess desirable and important properties including antioxidant properties (mainly toxic free radical scavenging), antiangiogenic activities, the ability to repair cell damage, and the ability to restore the intracellular glutathione balance.

In addition, isoflavones exhibit superior advantages over known chemoprotectants in their lack of toxicities to the patient, the ability to be administered orally, and in the natural source of these compounds, such as soy, legumens, clover and the like. Accordingly, the present invention provides a method for the prevention, treatment or reduction in damage to the normal tissues and organs caused by chemotherapeutic agents by the administration of isoflavone compounds.

The present invention also provides methods for administering the isoflavone compositions of the present invention, including in the form of pharmaceutical compositions or food supplements, either alone, or in combination with other protectant compositions or chemotherapeutic compositions.

The inventive isoflavone protective agents can be administered prior to, simultaneously with, or subsequently to administration of the chemotherapeutic composition. Combinations of these time periods can also be employed. Further preferred embodiments of the invention include the use of additional therapeutic agent or agents administered in conjunction with the isoflavone chemoprotectant compositions of the present invention. Such agents may include therapeutic hormones, chemotherapeutic agents, monoclonal antibodies, anti- angiogenesis agents, radiolabelled compounds, and mixtures thereof and may also include any pharmaceutical compound useful for the treatments described herein to be delivered in combination with the isoflavone compounds and compositions of the present invention.

Other objects, features and advantages of the present invention will become apparent from the following detailed description. It should be understood, however, that the detailed description and the specific examples, while indicating preferred embodiments of the invention, are given by way of illustration only, since various changes and modifications within the spirit and scope of the invention will become apparent to those skilled in the art from this detailed description.

Detailed Description of the Invention

The present invention is directed to a method for preventing, reducing and/or treating toxicity in a patient undergoing treatment with a chemotherapeutic agent by administering an effective amount of an isoflavone to the patient. The isoflavone chemoprotectant compound of the invention is given to the mammals prior to, during, or immediately after the chemotherapy. Isoflavone compounds particularly useful in the present invention include compounds having the general formula:

wherein R_1? R , R₃ and R₄ are independently selected from the group consisting of hydrogen, hydroxyl and alkoxy. Isoflavone compounds of interest include genistein, genistin, daidzein, daidzin, glycitein, glycitin, biochannin A, formononetin, O-desmethyangolensin, equol and the like, their glucosides and derivatives, and/or mixtures thereof. Of particular importance is genistein, also known as 5,7-dihydroxy-3-(4-hydroxyphenyl)-4H-l benzopyran-4-one or 4',5,7-trihydroxyisoflavone.

These isoflavone compounds exhibit antioxidant properties and estrogenic activity and can act as a tyrosine kinase inhibitor and/or an angiogenesis inhibitor. These isoflavone compounds can also act to lower LDL cholesterol concentration and as a vasodilitory agent. The isoflavone compounds can be derived from any suitable source such as soy, legumes, clover and the like using any of the techniques well known to one of ordinary skill in the art. Preferably the isoflavone compounds used in the present invention are naturally occurring substances which may be found in plants such as legumes, clover, and the root of the kudzu vine (pueraria root). Common legume sources of these isoflavone compounds include soy beans, chick peas, and various other types of beans and peas. Clover sources of these isoflavone compounds include red clover and subterranean clover. Soy beans are a particularly preferred source of the isoflavone compounds (except biochanin A which is not present in soy).

The isoflavone compounds may be isolated from the plant sources in which they naturally occur, or may be synthetically prepared by processes known in the art. For example, daidzein may be isolated from red clover as disclosed by Wong (J. Sci. Food Agr., Vol. 13, p. 304 (1962)) or may be isolated from the mold Micromonospora halophytica as provided by Ganguly and Sarre (Chem. & Ind. (London), p. 201 (1970)), both references of which are incorporated by reference herein. Daidzein may be synthetically prepared by the methods provided by Baker et al (J Chem. Soc, p. 274

(1933)), Wesley et al. (Ber. Vol. 66, p. 685 (1933)), Mahal et al. (J. Chem. Soc, p. 1769 (1934)), Baker et al. (J. Chem. Soc, p. 1852 (1953)), or Farkas (Ber. Vol. 90, p. 2940 (1957)), each reference of which is incorporated herein by reference. The isoflavone glucoside daidzin may be synthetically prepared by the method of Farkas et al. (Ber., Vol. 92, p. 819 (1959)), incorporated herein by reference. The daidzein isoflavone glucoside conjugates 6'-O-Mal daidzin and 6'-O-Ac daidzin can be prepared by a conventional saponification of daidzin with a malonyl or an acetyl anhydride, respectively.

Genistein may be synthetically prepared by the methods provided by Baker et al (J. Chem. Soc, p. 3115 (1928)); Narasimhachari et al. (J. Sci. Ind. Res., Vol. 12, p. 287 (1953)); Yoder et al., (Proc. Iowa Acad. Sci., Vol. 61, p. 271 (1954); and Zemplen et al. (Acta. Chim. Acad. Sci. Hung., Vol. 19, p. 277 (1959)), each reference of which is incorporated herein by reference. The isoflavone glucoside genistin may be synthetically prepared by the method of Zemplen et al. (Ber., Vol 76B, p. 1110 (1943)), incorporated herein by reference. The isoflavone glucoside conjugates of genistein, 6'-O-Mal genistin and 6'-O-Ac genistin, can be prepared by a conventional saponification of genistin with a malonyl or an acetyl anhydride, respectively.

Biochanin A can be synthetically prepared by the method provided by Baker et al. (Nature 169:706 (1952)), incorporated herein by reference. Biochanin A can also be separated from red clover by the method provided by Pope et al. (Chem. & Ind. (London) p.1092 (1953)), incorporated herein by reference. Formononetin can be synthetically prepared by the methods disclosed by Wessely et al. (Ber. 66:685 (1933)) and Kagel et al. (Tetrahedron Letters, p. 593 (1962)), both references of which are incorporated herein by reference. Formononetin can be isolated from soybean meal by the method of Walz (Aim. 489:118 (1931)) or can be isolated from clover species by the method of Bradbury et al. (J. Chem. Soc. p. 3447 (1951)), both references of which are incorporated herein by reference.

The isoflavones useful in the present invention can be extracted from the plant materials in which they naturally occur by any suitable means known to one of skill in the art. Many of the isoflavone compounds are available commercially. For example, genistein, daidzein, and glycitein are commercially available and may be purchased, for example, from Indofme Chemical Company Inc., P.O. Box 473, Somerville, N.J. No. 08876, and biochanin A is available from Aldrich Chemical Company, Inc., 940 West Saint Paul Avenue, Milwaukee, Wis. 53233.

The administration of this compound to the patients with different types of cancer and other diseases treatable with chemotherapeutic agents provides a selective protection of normal (non-cancer) cells from the toxic effects of the chemotherapeutic agent and thus eliminates or reduces the severity of the organ and other damage.

The isoflavone chemoprotectant compositions of the present invention can be administered in conjunction with a chemotherapy regimen used for the treatment of cancer. Such cancers can include, but are not limited to, types of cancer including breast cancer, lung cancer (small and or non-small cell), acute lymphocytic leukemia, acute nonlymphocytic leukemia, chronic lymphocytic leukemia, chronic myelocytic leukemia, hairy cell leukemia, ovary cancer, ovary (germ cell) cancer, melanoma, skin cancer, cervix cancer, ACTH-producing tumors, cancer of the adrenal cortex, bladder cancer, brain cancer, colorectal cancer, cutaneous T-cell lymphoma, endometrial cancer, esophageal cancer, Ewing's sarcoma, gallbladder cancer, head & neck cancer, Hodgkin's lymphoma, Kaposi's sarcoma, kidney cancer, liver cancer, malignant peritoneal effusion, malignant pleural effusion, mesothelioma, multiple myeloma, neuroblastoma, non- Hodgkin's lymphoma, osteosarcoma, pancreatic cancer, penis cancer, prostate cancer, retinoblastoma, soft-tissue sarcoma, squamous cell carcinomas, stomach cancer, testicular cancer, thyroid cancer, trophoblastic neoplasms, cancer of the uterus, vaginal cancer, cancer of the vulva, and Wilm's tumor. The administration of these isoflavone chemoprotectant compositions to patients with different types of cancer and other diseases treatable with chemotherapeutic agents will provide a selective protection of normal (non-cancer) cells from the toxic effects of the chemotherapeutic agents and thus eliminate or reduce the severity of the organ, tissue and other damage.

Chemotherapeutic agents can also be used in some diseases not related to cancer. For example, chemotherapeutic agents can be administered as part of a treatment regimen for a collagen- vascular disease, such as lupus erythematosus, rhematoid arthritis, or the like, inflammatory bowel disease, such as Chron's disease, and temporal arthritis. In such cases the chemotherapeutic agent of choice is azathioprine, which after undergoing cellular metabolism transforms into active but toxic 6-thioquanine (6-TG).

Chemotherapeutic agents are also used in organ transplantation procedures requiring immunosuppression with chemodrugs to prevent the rejection of the transplant. Transplant organs can include the kidney, heart, liver, bone marrow, lung, skin, and the like. In such cases, the chemotherapeutic agent of choice is usually either cyclosporin or methotrexate.

In all of these cases, the use of the isoflavone chemotherapeutic compositions of the present invention confer a protective effect to normal cells and tissues and thus prevent, reduce and/or treat various toxic side effects associated with or resulting from use of the chemotherapeutic agents.

According to the present invention the isoflavone compound of the invention can be administered to a mammal or patient prior to, during, and/or following the chemotherapy. The isoflavone is administered for a time period sufficient to confer a protective effect on normal cells from the chemotherapeutic agent, or to allow a reduction in the severity of the effects, and/or to treat the side effects on normal cells from the chemotherapeutic agent. One of ordinary skill in the art would be able to readily determine a suitable time period taking into account the dosage to be administered, the route of administration, the periodic intervals for administration, the age, weight and health of the patient, the cancer or other disease to be treated, and the like.

In a preferred embodiment of the invention, the isoflavone can be administered chronically to the patient for a suitable time period of from about one month before administration of the chemotherapeutic agent to about one month or longer after administration of the chemotherapeutic agent. Preferably the isoflavone is administered about 5 to 7 days preceding the administration of the chemotherapeutic agent. However, protective effects can still be conferred by administration 1 or 2 days, or even hours or less before administration of the chemotherapeutic agent.

The isoflavone can also be administered concurrently with the administration of the chemotherapeutic agent. Less preferred, but still conferring a protective effect is the administration of the isoflavone after the administration of the chemotherapeutic agent, preferably for a time period from about 5 to 7 days after administration of the chemotherapeutic agent.

The isoflavone compositions of the present invention can be administered by any conventional route known to one of skill in the art, either in a typical pharmaceutical preparation form or as a food supplement. These isoflavone compounds can be administered alone, or in combination with the other drug compounds discussed herein, in the form of the water-soluble acid, free base, or as physiologically acceptable salts, including acid addition salts formed with organic and inorganic acids, for example, hydrochlorides, hydrobromides, sulfates, phosphates, citrates, fumarates, and maleates, and cations such as sodium, potassium, etc. These compounds can be formulated for administration to humans and animals with pharmaceutically acceptable carriers, excipients, and diluents, such as sterile distilled water, Ringer's solution, normal saline, 5% glucose, dextrose, fructose, sucrose, etc., and mixtures thereof, as is well known in the art. Antimicrobial agents, preservatives, etc., can also be included. Compositions for oral administration can include coloring and flavoring agents. Additional methods of formulating compounds of the present invention for administration in the methods described herein can be found, for example, in Remington's Pharmaceutical Sciences, Fifteenth Edition, Mack Publishing Company, Easton, Pa., 1975. For these purposes, the compounds of the present invention may be administered orally, parenterally, by inhalation spray, topically, rectally, nasally, buccally, vaginally or via an implanted reservoir in dosage formulations containing conventional non-toxic pharmaceutically-acceptable carriers, adjuvants and vehicles. The term parenteral as used herein includes subcutaneous, intravenous, intramuscular, intraperitoneally, intrathecally, intraventricularly, and other routes acceptable to one of skill in the art for drag delivery. In addition, administration may be by a single dose, it may be repeated at intervals or it may be by continuous infusion. Where continuous infusion is preferred, pump means often will be particularly preferred for administration.

Unlike known prior art chemoprotectants, the isoflavone chemoprotectant compositions of the present invention are highly suited for administration to the patient as a food supplement. Suitable food supplements include any ingestible preparation containing therapeutically effective amounts of the isoflavone compositions of the present invention which are capable of imparting the desired chemoprotectant agents to the mammal ingesting the food supplement. The food supplement can be freshly prepared, dried, cooked, boiled, lyophilized or baked. Breads, teas, soups, cereals, pills and tablets, are among the vast number of different food products contemplated. The isoflavone chemoprotectant compositions of the present invention can be effectively used in method for treating human and animal patients undergoing treatment with chemotherapeutic agents to prevent or reduce side effects associated therewith and to prolong survival. These methods comprise administering to the patient an appropriate effective amount of an isoflavone chemoprotective agent prior to, simultaneously with, or subsequent to administration of a chemotherapeutic agent. Combinations of these time periods can also be employed.

Dosage levels on the order of about 0.1 mg to about 1,000 mg per kilogram of body weight of the isoflavone active ingredient compound are useful in the treatment of the above conditions, with preferred levels of about 1 mg to about 500 mg per kilogram of body weight, and more preferred amounts of 10 mg to about 400 mg per kilogram of body weight. The amount of isoflavone active ingredient that may be combined with the carrier materials to produce a single dosage form will vary depending upon the host treated and the particular mode of administration. It is understood, however, that a specific dose level for any particular patient will depend upon a variety of factors including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, rate of excretion, drag combination, and the severity of the particular disease being treated and form of administration. Treatment dosages generally may be titrated to optimize safety and efficacy.

Typically, dosage-effect relationships from in vitro initially can provide useful guidance on the proper doses for patient administration. Studies in animal models also generally may be used for guidance regarding effective dosages in accordance with the present invention, hi terms of treatment protocols, it should be appreciated that the dosage to be administered will depend on several factors, including the particular isoflavone that is administered, the route administered, the condition of the particular patient, and the like. Generally speaking, one will desire to administer an amount of the agent that is effective to achieve a serum level commensurate with the concentrations found to be effective in vitro. Determination of these parameters are well within the skill of the art. These considerations, as well as effective formulations and administration procedures are well known in the art and are described in standard textbooks. When administered orally, the isoflavone chemoprotective agent should be given in an amount that will result in a therapeutically effective blood serum level equivalent to that achieved by the parenterally administered doses. Such effective oral doses can easily be determined by one of ordinary skill in the art via conventional in vitro or in vivo methods such as those described in Remington's Pharmaceutical Sciences, Fifteenth Edition, Mack Publishing Company, Easton, Pa., 1975.

Delayed toxic effects due to chemotherapeutic agents have been observed. The protective effects of the present isoflavone chemoprotectant agents can be enhanced by administering them in a supplemental manner during the course of the patient's chemotherapy and/or afterwards as necessary or as desired. Thus, the methods described herein can further comprise daily or weekly parenteral administration of a supplemental amount of isoflavone protective agent in the range of from about 0.1 mg/kg body weight to about 1,000 mg/kg body weight, more preferably from about 1 mg/kg body weight to about 500 mg/kg body weight, and even more preferably from about 10 mg/kg body weight to about 400 mg/kg body weight.

The teachings presented herein permit the design of therapeutic regimens that can be employed to reduce the undesirable side effects of chemotherapeutic agents, increase the dosing of such chemotherapeutic agents to obtain a higher cancer cure rate or treatment rate for non-cancer conditions, and perhaps include weaker patients in treatment protocols employing such chemotherapeutic agents, from which they are currently excluded because they cannot withstand the toxicities associated therewith. The presently disclosed teachings also permit the design of therapeutic regimens useful in preventing or reducing the undesirable decreased patient survival.

The following Formulations 1-5 illustrate pharmaceutical and food supplement formulations incorporating the isoflavone chemoprotectant of the present invention.

Formulation 1 - Food Supplement

An isoflavone is selected from the group consisting of genistein, genistin, daidzein, daidzin, glycitein, glycitin, biochannin A, formononetin, O- desmethylangolensin, and equol, their glucosides and derivatives, and mixtures thereof is admixed with the ingredients for a energy bar formulation and formed into energy bars containing the isoflavone in an amount of 0.1 to 1000 mg per serving size.

Formulation 2 - Gelatin capsules

Hard gelatin capsules are prepared using an isoflavone 0.1-1000 mg/capsule; Starch, NF 0-600 mg/capsule; Starch flowable powder 0-600 mg/capsule; Silicone fluid 350 centistokes 0-20 mg/capsule. The ingredients are mixed, passed through a sieve, and filled into capsules.

Formulation 3 - Tablets Tablets are prepared using isoflavone 0.1-1000 mg/tablet; microcrystalline cellulose 20-300 mg/tablet; starch 0-50 mg/tablet; magnesium stearate or stearate acid 0- 15 mg/tablet; silicon dioxide, fumed 0-400 mg/tablet; silicon dioxide, colloidal 0-1 mg/tablet, and lactose 0-100 mg/tablet. The ingredients are blended and compressed to form tablets.

Formulation 4 - Suspensions

Suspensions are prepared using isoflavone 0.1-1000 mg/5 ml; sodium carboxymethyl cellulose 50-700 mg/5 ml; sodium benzoate 0-10 mg/5 ml; purified water 5 ml; and flavor and color agents as needed.

Formulation 5 - Parenteral Solutions

A parenteral composition is prepared by stirring isoflavone 0.1-1000 mg/5 ml in 10% by volume propylene glycol and water. The solution is made isotonic with sodium chloride and sterilized.

The most effective way of assessing efficacy of isoflavones, and in particular genistein as a chemoprotectant, is the monitoring of acute, as well as cumulative, toxicities caused by different chemotherapeutic agents which would be compared with the cohort of patients who were not pretreated, or did not receive an isoflavone, such as genistein, during or after the chemotherapy course. Measure of toxicity (toxicity criteria) are well established qualitative/quantitative in the scientific and medical community criteria.

hi order to fully illustrate the nature of the invention, the following examples are presented:

Example 1

The standard treatment regimen for patients with breast cancer contains chemotherapeutic agents that cause severe cardiac toxicity. Isoflavones selected from the group consisting of genistein, genistin, daidzein, daidzin, glycitein, glycitin, biochannin A, formononetin, O-desmethylangolensin, and equol, their glucosides and derivatives, and mixtures thereof, are administered daily to a group of patients with breast cancer at time periods starting one month, one week, 5 days, 2 days, and 1 day prior to the beginning of chemotherapy and continued throughout the cycles that comprise particular chemotherapeutic regimen.

The daily estimated dose of the isoflavone, particularly genistein, is varied from about 0.1 mg/kg to about 1,000 mg/kg of body weight per day, with a preferred dose from about 1 mg/kg to about 500 mg/kg of body weight per day, with the most preferred dose from about 10 mg/kg to about 400 mg/kg of body weight per day. The use of genistein results in decreased cardiac toxicity, that allows an increase in drag intensity, shortened delay in drag administration between doses of the chemotherapeutic agent, and reduced side effects.

During/post-treatment cardiac function is assessed by clinically, as well as by changes in ECG, ECHO, cardiac nuclear scans, and other characteristics.

Example 2

The procedure of Example 1 is followed except that the isoflavone is not administered prior to commencement of the chemotherapeutic regimen but only concurrently with the administration of the chemotherapeutic agent. Example 3

The procedure of Example 1 is followed except that for a first group of patients receives the isoflavones only prior to the chemotherapy, a second group only during the chemotherapy, a third group only after the chemotherapy, a fourth group before and during chemotherapy, a fifth group before and after chemotherapy, and a sixth group during and after chemotherapy. The protective effects conferred vary depending upon the dosage, length of treatment and the timing of the treatment.

Example 4 Isoflavones selected from the group consisting of genistein, genistin, daidzein, daidzin, glycitein, glycitin, biochannin A, formononetin, O-desmethylangolensin, and equol, their glucosides and derivatives, and mixtures thereof, are administered to patients with malignant brain tumors at time periods starting one month, one week, 5 days, 2 days, and 1 day prior to the beginning of chemotherapy and continued concomitantly with the chemotherapy drugs regimen. The isoflavones are administered as food supplements and as pharmaceutical preparations with the daily estimated preferred dose of genistein is varied from about 0.1 mg/kg to about 1,000 mg/kg of body weight per day, with a preferred dose from about 1 mg/kg to about 500 mg/kg of body weight per day, with the most preferred dose from about 10 mg/kg to about 400 mg/kg of body weight per day. The use of the isoflavones acts to decrease acute toxicities from the drags used in the treatment regimens in patients with brain tumors. Prolonged or chronic administration of isoflavones, particularly genistein, in a pharmaceutical formulation or in a form of food supplement, prevents the occurrence or delays development of late toxicities by protecting normal brain tissues from the locally (intratumoral) used chemotherapeutic agents.

Example 5

Isoflavones selected from the group consisting of genistein, genistin, daidzein, daidzin, glycitein, glycitin, biochannin A, formononetin, O-desmethylangolensin, and equol, their glucosides and derivatives, and mixtures thereof, are administered to group of patients with prostate cancer. Administration of the isoflavones is commenced at different periods starting at one month, one week, 5 days, 2 days, and 1 day prior to the beginning of chemotherapy and continued concomitantly with the chemotherapy drugs regimen. The isoflavones are administered as food supplements and as pharmaceutical preparations with the daily estimated preferred dose of genistein is varied from about 0.1 mg/kg to about 1 ,000 mg/kg of body weight per day, with a preferred dose from about 1 mg/kg to about 500 mg/kg of body weight per day, with the most preferred dose from about 10 mg/kg to about 400 mg/kg of body weight per day.

Patients with this tumor receive chemotherapy agents that cause toxicities such as nausea, vomiting and suppression of the bone marrow function that results in bleeding and infection.

Administering genistein either in a form of pharmaceutical agent or as a food supplement, will decrease the toxic effects of these chemotherapeutic agents.

Example 6 Isoflavones selected from the group consisting of genistein, genistin, daidzein, daidzin, glycitein, glycitin, biochannin A, formononetin, O-desmethylangolensin, and equol, their glucosides and derivatives, and mixtures thereof, are administered to a group of patients prior to, during, immediately following, or combinations thereof, commencement of the administration of immunosuppressant drags (chemodrugs) prior to transplantation of organs including kidney, heart, liver, lung, skin, and the like. Administration of the isoflavones is commenced at different periods starting at one month, one week, 5 days, 2 days, and 1 day prior to the beginning of the administration of the chemodrugs, during the chemodrug regimen, or for different periods of one month, one week, 5 days, 2 days, and 1 day immediately following the administration of the chemodrug. The chemodrugs may include cyclosporin and methotrexate. The isoflavones are administered as food supplements and as pharmaceutical preparations with the daily estimated preferred dose of genistein is varied from about 0.1 mg/kg to about 1 ,000 mg/kg of body weight per day, with a preferred dose from about 1 mg/kg to about 500 mg/kg of body weight per day, with the most preferred dose from about 10 mg/kg to about 400 mg/kg of body weight per day. Example 7

The procedures of Example 6 is followed as part of a treatment regimen for a collagen- vascular disease such aslupus erythematosus and rhematoid arthritis in which the chemotherapeutic agent may be azathioprine, which after undergoing cellular metabolism transforms into active but toxic 6-thioquanine (6-TG). Isoflavones are administered as noted in Example 6.

Example 8

The procedures of Examples 6 and 7 are followed in conjunction with treatment of an inflammatory bowel disease, including Chron's disease, by administration of a chemotherapeutic agent such as azathioprine, which after undergoing cellular metabolism transforms into active but toxic 6-thioquanine (6-TG).

Example 8 The procedures of Examples 6 and 7 are followed in conjunction with treatment of temporal arthritis by administration of a chemotherapeutic agent such as azathioprine, which after undergoing cellular metabolism transforms into active but toxic 6- thioquanine (6-TG).

All publications and patent applications are herein incorporated by reference to the same extent as if each individual publication or patent application were specifically and individually indicated to be incorporated by reference in its entirety.

Claims

I claim:

1. A method for preventing or treating toxicity in a patient undergoing treatment with a chemotherapeutic agent, comprising administering to said patient an effective amount of an isoflavone.

2. The method of claim 1, wherein said isoflavone is administered prior to administration of said chemotherapeutic agent.

3. The method of claim 1, wherein said isoflavone is administered simultaneously with administration of said chemotherapeutic agent.

4. The method of claim 1, wherein said isoflavone is administered subsequently to administration of said chemotherapeutic agent.

5. The method of claim 1, wherein said effective amount of said isoflavone is administered to said patient in a time period from about one month before administration of said chemotherapeutic agent to about one month after administration of said chemotherapeutic agent.

6. The method of claim 1, wherein said effective amount of said isoflavone is administered to said patient in a time period from about 7 days before administration of said chemotherapeutic agent to about 7 days after administration of said chemotherapeutic agent.

7. The method of claim 1, wherein said effective amount of said isoflavone is administered to said patient in a time period from about 5 days before administration of said chemotherapeutic agent to about 5 days after administration of said chemotherapeutic agent.

8. The method of claim 1, wherein said isoflavone is selected from the group consisting of genistein, genistin, daidzein, daidzin, glycitein, glycitin, biochannin A, formononetin, O-desmethylangolensin, and equol, their glucosides and derivatives, and mixtures thereof.

9. The method of claim 8 wherein said isoflavone is genistein.

10. The method of claim 1, wherein said isoflavone has the formula:

wherein R_l5 R₂, R₃ and R are independently selected from the group consisting of hydrogen, hydroxyl and alkoxy.

11. The method of claim 1, wherein said effective amount of said isoflavone is in the range of from about 0.1 mg/kg body weight to about 1,000 mg/kg body weight.

12. The method of claim 1, wherein said effective amount of said isoflavone is in the range of from about 1 mg/kg body weight to about 500 mg/kg body weight.

13. The method of claim 1, wherein said effective amount of said isoflavone is in the range of from about 20 mg/kg body weight to about 400 mg/kg body weight.

14. The method of claim 1, wherein said isoflavone is administered orally or parenterally.

15. The method of claim 14, wherein said parenteral administration is by slow intravenous infusion.

16. The method of claim 14, wherein said isoflavone is admimstered as a food supplement.

17. The method of claim 1 wherein said chemotherapeutic agent is administered for treatment of cancer.

18. The method of claim 17 wherein said cancer is selected from the group consisting of breast cancer, lung cancer (small and/or non-small cell), acute lymphocytic leukemia, acute nonlymphocytic leukemia, chronic lymphocytic leukemia, chronic myelocytic leukemia, hairy cell leukemia, ovary cancer, ovary (germ cell) cancer, melanoma, skin cancer, cervix cancer, ACTH-producing tumors, cancer of the adrenal cortex, bladder cancer, brain cancer, colorectal cancer, cutaneous T-cell lymphoma, endometrial cancer, esophageal cancer, Ewing's sarcoma, gallbladder cancer, head & neck cancer, Hodgkin's lymphoma, Kaposi's sarcoma, kidney cancer, liver cancer, malignant peritoneal effusion, malignant pleural effusion, mesothelioma, multiple myeloma, neuroblastoma, non- Hodgkin's lymphoma, osteosarcoma, pancreatic cancer, penis cancer, prostate cancer, retinoblastoma, soft-tissue sarcoma, squamous cell carcinomas, stomach cancer, testicular cancer, thyroid cancer, trophoblastic neoplasms, cancer of the uterus, vaginal cancer, cancer of the vulva, and Wilm's tumor.

19. The method of claim 1 wherein said chemotherapeutic agent is administered as part of a treatment regimen for a collagen- vascular disease.

20. The method of claim 19 wherein said collagen- vascular disease is selected from the group consisting of lupus erythematosus and rhematoid arthritis.

21. The method of claim 20 wherein the chemotherapeutic agent is azathioprine, which after undergoing cellular metabolism transforms into active but toxic 6-thioquanine (6- TG).

22. The method of claim 1 wherein said chemotherapeutic agent is administered as part of a treatment regimen for an inflammatory bowel disease.

23. The method of claim 22 wherein said inflammatory bowel disease is Chron's disease.

24. The method of claim 22 wherein the chemotherapeutic agent is azathioprine, which after undergoing cellular metabolism transforms into active but toxic 6-thioquanine (6- TG).

25. The method of claim 1 wherein said chemotherapeutic agent is administered as part of a treatment regimen for temporal arthritis.

26. The method of claim 1 wherein said chemotherapeutic agent is administered as part of a treatment regimen for organ transplantation requiring immunosuppression with chemodrugs to prevent the rej ection of the transplant.

27. The method of claim 26 wherein said organ transplant is selected from the group consisting of kidney, heart, liver, bone marrow, lung, skin, and the like.

28. The method of claim 26 wherein said chemotherapeutic agent is selected from the group consisting of cyclosporin and methotrexate.