Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
  • A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/16—Amides, e.g. hydroxamic acids
  • A61K31/17—Amides, e.g. hydroxamic acids having the group >N—C(O)—N< or >N—C(S)—N<, e.g. urea, thiourea, carmustine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/275—Nitriles; Isonitriles
  • A61K31/277—Nitriles; Isonitriles having a ring, e.g. verapamil
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
  • A61K31/34—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having five-membered rings with one oxygen as the only ring hetero atom, e.g. isosorbide
  • A61K31/341—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having five-membered rings with one oxygen as the only ring hetero atom, e.g. isosorbide not condensed with another ring, e.g. ranitidine, furosemide, bufetolol, muscarine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
  • A61K31/42—Oxazoles
  • A61K31/421—1,3-Oxazoles, e.g. pemoline, trimethadione
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
  • A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
  • A61K31/7072—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid having two oxo groups directly attached to the pyrimidine ring, e.g. uridine, uridylic acid, thymidine, zidovudine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
  • A61K31/7076—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines containing purines, e.g. adenosine, adenylic acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P19/00—Drugs for skeletal disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
  • A61P27/16—Otologicals
• • 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
  • A61P35/00—Antineoplastic agents
  • A61P35/02—Antineoplastic agents specific for leukemia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
  • A61P35/04—Antineoplastic agents specific for metastasis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid

Definitions

• the present invention relates to compositions comprising an apoptosis inducing anti-cancer agent and an IMPDH inhibitor. This invention also relates to methods for inducing apoptosis and for treating tumors and cancers .
• nucleotide synthesis in organisms is required for the cells in those organisms to divide and replicate. Nucleotide synthesis in mammals may be achieved through one of two pathways : the de novo synthesis pathway or the salvage pathway. Different cell types use these pathways to a different extent. Inosine-5 ' -monophosphate dehydrogenase (IMPDH;
• EC 1.1.1.205 is an enzyme involved in the de novo synthesis of guanine nucleotides.
• IMPDH catalyzes the NAD-dependent oxidation of inosine-5 ' -monophosphate (IMP) to xanthosine-5 ' -monophosphate (XMP) [Jackson R.C. et . al., Nature, 256, pp. 331-333, (1975)].
• IMPDH is ubiquitous in eukaryotes, bacteria and protozoa [Y. Natsumeda & S.F. Carr, Ann. N.Y. Acad. , 696, pp. 88-93 (1993)].
• the prokaryotic forms share 30-40% sequence identity with the human enzyme.
• IMPDH type I and type II form active tetramers in solution, with subunit molecular weights of 56 kDa [Y. Yamada et . al . , Biochemistry, 27, pp. 2737-2745 (1988) ] .
• IMPDH is an attractive target for selectively inhibiting the immune system without also inhibiting the proliferation of other cells.
• Inhibitors of IMPDH are also known.
• MPA has been demonstrated to block the response of B and T-cells to mitogen or antigen [A. C. Allison et. al . , Ann . N . Y . Acad. Sci., 696, 63, (1993).
• IMPDH inhibitors of different classes have been described in PCT publications WO 97/40028 and WO 98/40381. It is also known that IMPDH plays a role in other metabolic events. Increased IMPDH activity has been observed in rapidly proliferating human leukemic cell lines and other tumor cell lines, indicating IMPDH as a target for anti-cancer as well as immunosuppressive chemotherapy [M. Nagai et. al . , Cancer Res . , 51, pp. 3886-3890, (1991)].
• WO 00/56331 discloses IMPDH inhibitors and compositions thereof for treating inter alia tumors and cancers, including compositions comprising an IMPDH inhibitor and an additional anti-cancer agent. Thus , there remains a need for potent compositions comprising an IMPDH inhibitor with improved pharmacological properties. Such inhibitors would have therapeutic potential as anti-cancer agents.
• the present invention provides pharmaceutical compositions comprising an apoptosis inducing anti-cancer agent, an IMPDH inhibitor, and a pharmaceutically acceptable carrier.
• the present invention also provides methods of inducing apoptosis in a mammal using the compositions of the present invention.
• the present invention also provides methods for treating tumors and cancers in a mammal using the compositions of the present invention.
• halo or halogen refer to a radical of fluorine, chlorine, bromine or iodine.
• IMPDH-mediated disease refers to any disease state in which the IMPDH enzyme plays a regulatory role in the metabolic pathway of that disease.
• treating refers to the alleviation of symptoms of a particular disorder in a patient or the improvement of an ascertainable measurement associated with a particular disorder.
• patient refers to a mammal, including a human.
• compositions comprising:
• apoptosis inducing anti-cancer agent means an agent that acts as an anti-metabolite, induces apoptosis, and is useful in treating cancer. See, e.g., "Induction of Apoptosis by Cancer Chemotherapy," Kaufmann, S. H. and Earnshaw, W. C, Exptal . Cell Res . , 256, 42-49 (2000).
• anti-metabolites include cytarabine, fludarabine, 5- fluro-2 ' -deoxyuridine, gemcitabine, hydroxyurea, and methotrexate . See, ibid, Table 1, p. 43.
• compositions comprising:
• each of R x and R 2 is independently selected from hydrogen; -CF 3 ; - (C ⁇ -C 6 ) -straight or branched alkyl; - (C 2 -C 6 ) -straight or branched alkenyl or alkynyl; - (C ⁇ -C 6 ) -straight or branched alkyl-R 7 ; -[ (C 2 -C 6 ) -straight or branched alkenyl or alkynyl ] -R 7 or -R 7 ; and wherein at least one of Ri or R 2 is - (Ci-C ⁇ ) -straight or branched alkyl-R 7 ; -[ (C 2 -C ⁇ ) -straight or branched alkenyl or alkynyl] -R 7 or -R 7 wherein up to 4 hydrogen atoms in any of said alkyl, alkenyl or alkynyl are optionally and independently replaced by R
• R 4 is selected from hydrogen, - (C ⁇ -C 6 ) -straight or branched alkyl, - (C 2 -C 6 ) -straight or branched alkenyl or alkynyl, -[ (C ⁇ -C 6 ) -straight or branched alkyl] -R 7 , -[ (C 2 -C 6 ) -straight or branched alkenyl or alkynyl] -R , -C(0)- [ (C ⁇ -C 6 ) -straight or branched alkyl], -C (0) - [ (C 2 -C 6 ) - straight or branched alkenyl or alkynyl], -C (0) - [ (C ⁇ -C 6 ) - straight or branched alkyl] -N(R ⁇ ) 2, -C (O) -[ (C 2 -C 6 ) -straight or branched alkenyl or alkyn
• each R 7 is a monocyclic or bicyclic ring system wherein in said ring system: i. each ring comprises 3 to 7 ring atoms independently selected from C, N, 0 or S; ii. no more than 4 ring atoms are selected from N, 0 or S; iii. any CH 2 is optionally replaced with C(0); iv.
• any S is optionally replaced with S(0) or S ( 0 ) 2 ; each R 8 is independently selected from hydrogen or - [C ⁇ -C 4 ] -straight or branched alkyl; wherein in any ring system in said compound up to 3 hydrogen atoms bound to the ring atoms are optionally and independently replaced with halo, hydroxy, nitro, cyano, amino, (C ⁇ -C ) -straight or branched alkyl; 0-(C ⁇ -C )- straight or branched alkyl, (C 2 -C 4 ) -straight or branched alkenyl or alkynyl, or 0- (C 2 -C ) -straight or branched alkenyl or alkynyl; and wherein any ring system is optionally benzofused; R 9 is selected from hydrogen, (R) -methyl, (S) -methyl, (R) - ethyl, (S) -ethyl, (R)
• prodrugs which are formed by esterifying either or both of Ri or R .
• examples of such prodrugs are compounds 143 to 156 in Table 1, set forth below.
• the apoptosis inducing anti-cancer agent is cytarabine, fludarabine, 5-fluro-2 ' -deoxyuridine, or gemcitabine. More preferably, it is cytarabine, fludarabine, or 5- fluro-2 ' -deoxyuridine. Even more preferably, it is fludarabine or cytarabine. Most preferably, it is fludarabine .
• the apoptosis inducing anti-cancer agent is hydroxyurea or methotrexate . More preferably it is hydroxyurea. According to an alternate more preferred embodiment, it is methotrexate.
• monocyclic ring system includes saturated, partially unsaturated and fully unsaturated ring structures.
• bicyclic ring system includes systems wherein each ring is independently saturated, partially unsaturated and fully unsaturated.
• Examples of monocyclic and bicyclic ring systems useful in the compounds of this invention include, but are not limited to, cyclopentane, cyclopentene, indane, indene, cyclohexane, cyclohexene, cyclohexadiene, benzene, tetrahydronaphthalene, decahydronaphthalene, naphthalene, pyridine, piperidine, pyridazine, pyrimidine, pyrazine, 1 , 2 , 3-triazine, 1,2,4 -triazine, 1, 3 , 5-triazine, 1,2,3,4- tetrazine, 1, 2 , 4, 5-tetrazine, 1,2,3,4- tetrahydroquinoline, quinoline, 1,2,3,4- tetrahydroisoquinoline, isoquinoline, cinnoline, phthalazine, quinazoline, quinoxaline, 1, 5-na
• heterocyclic Chemistry Structure, Reactions, Synthesis and Use of Heterocyclic Compounds, Vol. 1-8, " Pergamon Press, NY (1984), the disclosure of which is herein incorporated by reference. It should be understood that heterocycles may be attached to the rest of the compound by any atom of the heterocycle which results in the creation of a stable structure.
• ring atom refers to a backbone atom that makes up the ring. Such ring atoms are selected from C, N, 0 or S and are bound to 2 or 3 other such ring atoms (3 in the case of certain ring atoms in a bicyclic ring system) .
• ring atom does not include hydrogen.
• compositions of the present invention exhibits strong synergistic effect in inducing apoptosis.
• an apoptosis inducing anti-cancer agent such as fludarabine
• composition of the present invention comprises a compound of formula (I) :
• composition of the present invention comprises a compound of formula (IA) : wherein R 9 is selected from (R) -methyl, (S) -methyl, (R) - ethyl, (S) -ethyl, (R) -hydroxymethyl or (S) -hydroxymethyl ; and Ri, R 2 , Rio and Rn are as defined above.
• R 9 is selected from (S) -methyl, (S) -ethyl, or (S) -hydroxymethyl methyl. Most preferably, R 9 is (S) -methyl.
• an (S) oriented moiety at R 9 imparts surprising and unexpectedly increased IMPDH inhibitory activity.
• Rn is selected from 0-methyl, O-ethyl or 0- isopropyl.
• At least one of Ri or R is selected from hydrogen, methyl, ethyl, n-propyl, isopropyl, n-butyl, t-butyl, n-pentyl, phenyl, pyridyl, -CH 2 OCH 3 , -CH 2 CN, -CH 2 OCH 2 CH 2 CN, -CH 2 C (CH 3 ) 2 CH 2 CH 2 CN, -CH 2 C(CH 2 CH 3 ) 2 CH 2 CH 2 CN, -CH 2 CH 2 CN, -CH 2 N (CH 2 CH 2 CN) 2 , -CH 2 N(CH 3 )CH 2 CH 2 CN, -CH (NH 2 ) CH 2 CN, -CH 2 C1, -CH 2 0H, -CH 2 CH 2 OH, -CH 2 CH 2 OH, -CH 2 CH 2 CH 2 CH 2 OH, -CH 2 CH 2 CH 2 CH 2 OH, phenyl, pyr
• Ri or R 2 is selected from hydrogen, ethyl or phenyl; and the other of Ri or R 2 is selected from -CH 2 0H, -CH 2 CN, -CH 2 CH 2 CN or CH 2 N(CH 2 CH 3 ) 2 ; or Ri and R 2 are taken together to form a 3-tetrahydrofuranyl moiety.
• Ri and R 2 are taken together to form a 3- tetrahydrofuranyl moiety that is substituted by -OR ⁇ .
• the compound of formula A is selected from any of those set forth in Table 1, below.
• the present invention provides a composition comprising:
• the present invention provides a composition comprising:
• the compounds of this invention may contain one or more asymmetric carbon atoms and thus may occur as racemates and racemic mixtures, single enantiomers, diastereomeric mixtures and individual diastereomers. All such isomeric forms of these compounds are expressly included in the present invention, unless otherwise indicated.
• Each stereogenic carbon may be of the R or S configuration.
• stable refers to compounds that possess stability sufficient to allow manufacture and maintenance of the integrity for a sufficient period of time to be useful for the purposes detailed herein (e.g., therapeutic or prophylactic administration to a mammal or for use in affinity chromatography applications) .
• such compounds are stable at a temperature of 40°C or less, in the absence of moisture or other chemically reactive conditions, for at least a week.
• the compounds within the compositions of this invention are defined to include pharmaceutically acceptable derivatives or prodrugs thereof.
• a "pharmaceutically acceptable derivative or prodrug” means any pharmaceutically acceptable salt, ester, salt of an ester, or other derivative of a compound of this invention which, upon administration to a recipient, is capable of providing (directly or indirectly) a compound of this invention.
• Particularly favored derivatives and prodrugs are those which increase the bioavailability of the compounds of this invention when such compounds are administered to a mammal (e.g., by allowing an orally administered compound to be more readily absorbed into the blood) or which enhance delivery of the parent compound to a biological compartment (e.g., the brain or lymphatic system) relative to the parent species.
• Preferred prodrugs include derivatives where a group which enhances aqueous solubility or active transport through the gut membrane is appended to the structure of the compounds of this invention.
• Pharmaceutically acceptable salts of the compounds within the compositions of this invention include those derived from pharmaceutically acceptable inorganic and organic acids and bases.
• suitable acid salts include acetate, adipate, alginate, aspartate, benzoate, benzene sulfonate, bisulfate, butyrate, citrate, camphorate, camphor sulfonate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, fumarate, glucoheptanoate, glycerophosphate, hemisulfate, heptanoate, hexanoate, hydrochloride, hydrobromide, hydroiodide, 2- hydroxyethanesulfonate, lactate, maleate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, oxalate, pamoate, pectinate, persulf
• Base salts include ammonium salts, alkali metal salts, such as sodium and potassium salts, alkaline earth metal salts, such as calcium and magnesium salts, salts with organic bases, such as dicyclohexylamine salts, N-methyl-D- glucamine, and salts with amino acids such as arginine, lysine, and so forth.
• the basic nitrogen-containing groups can be quaternized with such agents as lower alkyl halides, such as methyl, ethyl, propyl, and butyl chloride, bromides and iodides; dialkyl sulfates, such as dimethyl, diethyl, dibutyl and diamyl sulfates, long chain halides such as decyl, lauryl, myristyl and stearyl chlorides, bromides and iodides, aralkyl halides, such as benzyl and phenethyl bromides and others. Water or oil-soluble or dispersible products are thereby obtained.
• lower alkyl halides such as methyl, ethyl, propyl, and butyl chloride, bromides and iodides
• dialkyl sulfates such as dimethyl, diethyl, dibutyl and diamyl sulfates
• long chain halides such
• the compounds within the compositions of this invention may be synthesized using conventional techniques.
• these compounds are conveniently synthesized from readily available starting materials.
• the synthetic routes to these compounds, and the syntheses of the specific compounds within Table 1 are disclosed in International PCT Application WO 00/56331, which publication is incorporated herein by reference.
• compositions of this invention may be modified by appending appropriate functionalities to enhance selective biological properties.
• modifications are known in the art and include those which increase biological penetration into a given biological compartment (e.g., blood, lymphatic system, central nervous system) , increase oral availability, increase solubility to allow administration by injection, alter metabolism and alter rate of excretion.
• pharmaceutically acceptable carrier or adjuvant refers to a carrier or adjuvant that may be administered to a patient, together with a compound of this invention, and which does not destroy the pharmacological activity thereof and is nontoxic when administered in doses sufficient to deliver a therapeutic amount of the compound.
• Pharmaceutically acceptable carriers, adjuvants and vehicles that may be used in the pharmaceutical compositions of this invention include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, self-emulsifying drug delivery systems (SEDDS) such as d ⁇ -tocopherol polyethyleneglycol 1000 succinate, surfactants used in pharmaceutical dosage forms such as Tweens or other similar polymeric delivery matrices, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethylcellulose, polyacrylates, waxes, polyethylene-pol
• Cyclodextrins such as ⁇ -, ⁇ -, and ⁇ -cyclodextrin, or chemically modified derivatives such as hydroxyalkylcyclodextrins, including 2- and 3-hydroxypropyl- ⁇ -cyclodextrins, or other solubilized derivatives may also be advantageously used to enhance delivery of compounds of this invention.
• compositions of this invention may be administered orally, parenterally, by inhalation spray, topically, rectally, nasally, buccally, vaginally or via an implanted reservoir. We prefer oral administration or administration by injection.
• the pharmaceutical compositions of this invention may contain any conventional non-toxic pharmaceutically-acceptable carriers, adjuvants or vehicles.
• the pH of the formulation may be adjusted with pharmaceutically acceptable acids, bases or buffers to enhance the stability of the formulated compound or its delivery form.
• parenteral as used herein includes subcutaneous, intracutaneous, intravenous, intramuscular, intra-articular, intraarterial, intrasynovial, intrasternal, intrathecal, intralesional and intracranial injection or infusion techniques.
• the pharmaceutical compositions may be in the form of a sterile injectable preparation, for example, as a sterile injectable aqueous or oleaginous suspension.
• This suspension may be formulated according to techniques known in the art using suitable dispersing or wetting agents (such as, for example, Tween 80) and suspending agents.
• the sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally-acceptable diluent or solvent, for example, as a solution in 1, 3-butanediol .
• suitable vehicles and solvents that may be employed are mannitol, water, Ringer's solution and isotonic sodium chloride solution.
• sterile, fixed oils are conven- tionally employed as a solvent or suspending medium.
• any bland fixed oil may be employed including synthetic mono- or diglycerides .
• Fatty acids, such as oleic acid and its glyceride derivatives are useful in the preparation of injectables, as are natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions.
• These oil solutions or suspensions may also contain a long-chain alcohol diluent or dispersant such as those described in Pharmacopeia Helvetica, Ph. Helv.
• compositions of this invention may be orally administered in any orally acceptable dosage form including, but not limited to, capsules, tablets, emulsions and aqueous suspensions, dispersions and solutions.
• carriers that are commonly used include lactose and corn starch.
• Lubricating agents such as magnesium stearate, are also typically added.
• useful diluents include lactose and dried cornstarch.
• aqueous suspensions and/or emulsions are administered orally, the active ingredient may be suspended or dissolved in an oily phase and combined with emulsifying and/or suspending agents. If desired, certain sweetening and/or flavoring and/or coloring agents may be added.
• compositions of this invention may also be administered in the form of suppositories for rectal administration.
• These compositions can be prepared by mixing a compound of this invention with a suitable non-irritating excipient which is solid at room temperature but liquid at the rectal temperature and therefore will melt in the rectum to release the active components.
• suitable non-irritating excipient include, but are not limited to, cocoa butter, beeswax and polyethylene glycols.
• Topical administration of the pharmaceutical compositions of this invention is especially useful when the desired treatment involves areas or organs readily accessible by topical application.
• the pharmaceutical composition should be formulated with a suitable ointment containing the active components suspended or dissolved in a carrier.
• Carriers for topical administration of the compounds of this invention include, but are not limited to, mineral oil, liquid petroleum, white petroleum, propylene glycol, polyoxyethylene polyoxypropylene compound, emulsifying wax and water.
• the pharmaceutical composition can be formulated with a suitable lotion or cream containing the active compound suspended or dissolved in a carrier with suitable emulsifying agents.
• Suitable carriers include, but are not limited to, mineral oil, sorbitan monostearate, polysorbate 60, cetyl esters wax, cetearyl alcohol, 2-octyldodecanol, benzyl alcohol and water.
• the pharmaceutical compositions of this invention may also be topically applied to the lower intestinal tract by rectal suppository formulation or in a suitable enema formulation. Topically-transdermal patches are also included in this invention.
• compositions of this invention may be administered by nasal aerosol or inhalation.
• Such compositions are prepared according to techniques well-known in the art of pharmaceutical formulation and may be prepared as solutions in saline, employing benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, fluorocarbons, and/or other solubilizing or dispersing agents known in the art.
• Dosage levels of between about 0.01 and about 100 mg/kg body weight per day, preferably between about 0.5 and about 75 mg/kg body weight per day each of fludarabine and the IMPDH inhibitory compound described herein are useful in a monotherapy and/or in combination therapy for the prevention and treatment of IMPDH- mediated disease.
• the pharmaceutical compositions of this invention will be administered from about 1 to about 5 times per day or alternatively, as a continuous infusion. Such administration can be used as a chronic or acute therapy.
• the amount of 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.
• a typical preparation will contain from about 5% to about 95% active compound (w/w) .
• such preparations contain from about 20% to about 80% active compound.
• both, the IMPDH inhibitor and fludarabine should be present at dosage levels of between about 10 to 100%, and more preferably between about 10 to 80% of the dosage normally administered in a monotherapy regimen.
• Fludarabine may be administered separately, as part of a multiple dose regimen, from the IMPDH inhibitory compounds.
• Fludarabine may be part of a single dosage form, mixed together with the compounds of this invention in a single composition.
• a maintenance dose of a compound, composition or combination of this invention may be administered, if necessary. Subsequently, the dosage or frequency of administration, or both, may be reduced, as a function of the symptoms, to a level at which the improved condition is retained when the symptoms have been alleviated to the desired level, treatment should cease. Patients may, however, require intermittent treatment on a long-term basis upon any recurrence of disease symptoms.
• this invention provides methods of treating an IMPDH-mediated disease in a mammal comprising the step of administrating to said mammal any of the pharmaceutical compositions described above.
• Such methods may comprise the additional step of administering to said mammal an agent selected from an anti-inflammatory agent, immunosuppressant, an anticancer agent, an anti-viral agent, or an anti-vascular hyperproliferation compound.
• an agent selected from an anti-inflammatory agent, immunosuppressant, an anticancer agent, an anti-viral agent, or an anti-vascular hyperproliferation compound.
• Such additional agent may be administered to the mammal prior to, concurrently with, or following the administration of a composition of the present invention.
• these methods are useful in suppressing an immune response in a mammal.
• Such methods are useful in treating or preventing diseases, including, transplant rejection (e.g., kidney, liver, heart, lung, pancreas (islet cells) , bone marrow, cornea, small bowel and skin allografts and heart valve xenografts) , graft versus host disease, and autoimmune diseases, such as rheumatoid arthritis, multiple sclerosis, juvenile diabetes, asthma, inflammatory bowel disease (Crohn's disease, ulcerative colitus) , lupus, diabetes, mellitus myasthenia gravis, psoriasis, dermatitis, eczema, seborrhea, pulmonary inflammation, eye uveitis, Grave's disease, Hashimoto As thyroiditis, Behcet's or Sjorgen's syndrome (dry eyes/mouth) , pernicious or immunohaemolytic anaemia,
• transplant rejection
• these methods are useful for treating tumors and cancer in a mammal .
• Such methods are useful in treating or preventing diseases, including, liquid and solid tumors and malignancies, such as lymphoma, leukemia and related disorders, myelodysplastic syndrome, metastatic melanoma, and other forms of cancer, such as breast cancer, colon cancer, pancreatic cancer, and prostate cancer.
• the compounds of the present invention and the compositions of the present invention are useful in treating breast cancer or myelomas, preferably, multiple myeloma.
• the present invention provides a method of treating multiple myeloma comprising the step of administering to a patient in need thereof compound no. 181 or compound no. 169, optionally combined with fludarabine. More preferably, said method of treating multiple myeloma comprises the step of administering to said patient compound no. 181.
• the present invention provides a method of treating breast cancer comprising the step of administering to a patient in need thereof compound no. 181 or compound no. 169, optionally combined with fludarabine. More preferably, said method of treating breast cancer comprises the step of administering to said patient compound no. 181.
• these methods comprise the step of administering to the mammal a composition of this invention.
• this particular method comprises the additional step of administering to said mammal a composition of the present invention wherein said composition contains fluradabine or a derivative or analog thereof .
• More preferred embodiments of the above methods are those that employ the preferred compositions as described above.
• Figure 1 shows the % Apoptosis against the concentration of compound 181 alone, fludarabine alone, and a combination of both. As is evident from Figure 1, the combination of compound 181 and fludarabine results in a much greater % apoptosis due to the synergy therebetween.
• Figure 2 shows the Combination Index against the Effect.

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• 2003
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