WO2007040535A1

WO2007040535A1 - Use of polyamine analogs for treatment and prevention of intestinal polyps

Info

Publication number: WO2007040535A1
Application number: PCT/US2005/035679
Authority: WO
Inventors: Laurence J. Marton
Original assignee: Cellgate, Inc.
Priority date: 2005-10-03
Filing date: 2005-10-03
Publication date: 2007-04-12

Abstract

This disclosure relates to methods of treating and/or preventing intestinal polyps using polyamine analogs, particularly conformationally restricted polyamine analogs. The intestinal polyps to be treated and/or prevented include adenomas. The polyamine analogs and conformationally restricted polyamine analogs can be used as a prophylactic or chemopreventive treatment in individuals at risk of developing intestinal polyps, such as in individuals with familial adenomatous polyposis (FAP).

Description

USE OF POLYAMENE ANALOGS FOR TREATMENT AND PREVENTION

OF INTESTINAL POLYPS

TECHNICAL FIELD

[0001] This application relates to methods of treating or preventing intestinal polyps, such as adenomas, using polyamine analogs, particularly conformationally restricted polyamine analogs.

BACKGROUND

[0002] Polyps of the small and large intestines commonly occur, and are often benign. However, certain polyps may progress to a malignant stage, causing intestinal cancer and colon cancer. Approximately 400,000 people worldwide die of colon cancer each year, with about 1,000,000 new cases diagnosed each year. [0003] A type of polyp known as adenomatous polyps, or adenomas, are of particular concern. It is estimated that about 1 out of every 400 adenomatous polyps will turn cancerous over a given year. Thus, treatment and prevention of such polyps is of great interest in preventing colon cancer.

[0004] Familial Adenomatous Polyposis (FAP) is a condition which predisposes an individual to develop hundreds or even thousands of pre-cancerous polyps. In the United States, FAP affects about 1 in every 30,000 people. The disease can result from a mutation in the APC gene (an autosomal dominant mutation) or in the MUTYH gene (an autosomal recessive mutation). Colon cancer in an individual affected by FAP is virtually inevitable, and colectomy must often be used as a therapeutic or prophylactic intervention. Such individuals still remain susceptible to duodenal polyps and rumors.

[0005] Conformationally-restricted polyamine analogs and methods of synthesizing such analogs have been disclosed in U.S Patent Nos. 5,889,061, 6,392,098, and 6,794,545, United States Patent Application Publication Nos. 2003/0072715, 2003/0195377, and International Patent Applications WO 98/17624, WO 00/66587, WO 02/10142, and WO 03/050072. These compounds have been shown to have anti-cancer effects in vitro or in vivo. [0006] The instant application relates to the use of polyamines and polyamine analogs, such as conformationally-restricted polyamine analogs, for the treatment and prevention of intestinal polyps, such as adenomas.

DISCLOSURE OF THE INVENTION

[0007] The present invention relates to methods of treating and preventing intestinal polyps with polyamine analogs, such as conformational^ restricted polyamine analogs. The methods of the invention embrace the use of polyamine analogs and compositions comprising a polyamine analog for treating and preventing intestinal polyps. In one embodiment, the type of intestinal polyp is an adenoma. In another embodiment, the polyamine analog is administered as a prophylactic measure. In another embodiment, the polyamine analog is administered as a prophylactic measure to an individual with familial adenomatous polyposis, or an individual at risk of developing familial adenomatous polyposis.

[0008] In one embodiment, the only conformational restriction of the polyamine analog is due to a carbon-carbon double bond (an ethenyl group, C=C) in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a cycloalkyl group, such as a cyclopropyl group, in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a macrocyclic group constraining the amino groups relative to one another. In another embodiment, one or more of the conformationally restricted polyamine analogs is covalently bound to a porphyrin. In another embodiment, the porphyrin is mesoporphyrin IX. In another embodiment, the porphyrin is mesoporphyrin IX and the polyamines are attached to the porphyrin via an amide linkage formed between the mesoporphyrin IX carboxy groups and an amino group of the polyamine.

[0009] In one embodiment, the polyamine analog is administered in order to prevent development of intestinal polyps. In another embodiment, the polyamine analog is administered in order to prevent transformation of a benign intestinal polyp into a malignant intestinal polyp. In another embodiment, the polyamine analog is administered in order to treat a malignant intestinal polyp.

[0010] In one embodiment, the polyamine analog is the compound identified herein as SL-11093, or any stereoisomer, salt, solvate or hydrate thereof. In another embodiment, the polyamine analog is the compound identified herein as SL-11217, or any stereoisomer, salt, solvate or hydrate thereof. In another embodiment, the polyamine analog is the compound identified herein as SL-11237, or any stereoisomer, salt, solvate or hydrate thereof.

[0011] In one embodiment, the conformational^ restricted polyamine analog is selected from among compounds of the formula: E-NH-B-A-B-NH-B-A-B-NH-B-A-B-NH-B-A-B-NH-E where A is independently selected from the group consisting of Ci-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, C₃-CO cycloalkyl, C₃-C₆ cycloaryl, and C₃-C₆ cycloalkenyl; B is independently selected from the group consisting of: a single bond, Ci-C₆ alkyl, and C₂-C₆ alkenyl; and E is independently selected from the group consisting of H, Ci-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, C₃-C₆ cycloalkyl, C₃-C₆ cycloaryl, and C₃-C₆ cycloalkenyl; with the proviso that either at least one A moiety is selected from the group consisting OfC₂-C₆ alkenyl, C₂-C₆ alkynyl, C₃-C₆ cycloalkyl, C₃-C₆ cycloaryl, and C₃-C₆ cycloalkenyl, or at least one B moiety is selected from the group consisting Of C₂-C₆ alkenyl; and all salts, hydrates, solvates, and stereoisomers thereof. In one embodiment, the only conformational restriction of the polyamine analog is due to a carbon-carbon double bond (an ethenyl group, C=C) in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a cycloalkyl group, such as a cyclopropyl group, in the molecule. [0012] Specific embodiments of compounds of this type include

and all salts, hydrates, solvates, and stereoisomers thereof. [0013] In another embodiment, the conformationally restricted polyamine analog is selected from among the group of compounds of the formula: E-NH-B-A-B-NH-B-A-B-NH-B-A-B-NH(-B-A-B-NH)_x-E wherein A is independently selected from the group consisting Of Ci-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, C3-C6 cycloalkyl, C₃-C₆ cycloaryl, and C₃-C₆ cycloalkenyl; B is independently selected from the group consisting of a single bond, C1-C₆ alkyl, and C₂-C₆ alkenyl; E is independently selected from the group consisting of H, Ci-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, C₃-C₆ cycloalkyl, C₃-C₆ cycloaryl, and C₃-C₆ cycloalkenyl; and x is an integer from 2 to 16; with the proviso that either at least one A moiety is selected from the group consisting OfC₂-C₆ alkenyl, C₂-C₆ alkynyl, C₃-C₆ cycloalkyl, C₃-C₆ cycloaryl, and C₃-C₆ cycloalkenyl, or at least one B moiety is selected from the group consisting Of C₂-C₆ alkenyl; and all salts, hydrates, solvates, and stereoisomers thereof. In another embodiment, x is 4, 6, 8, or 10. In another embodiment, x is 4. In another embodiment, x is 6. In another embodiment, x is 8. In another embodiment, x is 10. In one embodiment, the only conformational restriction of the polyamine analog is due to a carbon-carbon double bond (an ethenyl group, C=C) in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a cycloalkyl group, such as a cyclopropyl group, in the molecule. [0014] Specific embodiments of compounds of this type include

and

and all salts, hydrates, solvates, and stereoisomers thereof. [0015] In another embodiment, the conformational^ restricted polyamine analog is selected from among the group of compounds of the formula E-NH-B-A-B-NH-B-A-B-NH-B-A-B-NH(-B-A-B-NH)_X-E wherein A is independently selected from the group consisting of Ci-C₆ alkyl, C₂-C₆ alkenyl, C₂-C₆ alkynyl, C₃-C₆ cycloalkyl, C₃-C₆ cycloaryl, and C₃-C₆ cycloalkenyl; B is independently selected from the group consisting of a single bond, Ci-C₆ alkyl, and C₂-C₆ alkenyl; E is independently selected from the group consisting of Ci-C₆ alkyl, Ci-C₆ alkanol, C₃-C₆ cycloalkanol, and C₃-C₆ hydroxyaryl, with the proviso that at least one E moiety be selected from the group consisting of Ci-C₆ alkanol, C₃-C₆ cycloalkanol, and C₃-C₆ hydroxyaryl; and x is an integer from 0 to 16; and all salts, hydrates, solvates, and stereoisomers thereof. In one embodiment, the only conformational restriction of the polyamine analog is due to a carbon-carbon double bond (an ethenyl group, C=C) in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a cycloalkyl group, such as a cyclopropyl group, in the molecule.

[0016] Specific embodiments of compounds of this type include

and all salts, hydrates, solvates, and stereoisomers thereof.

[0017] In another embodiment, the conformationally restricted polyamine analog is selected from among the group of compounds of the formula

E-NH-D-NH-B-A-B-NH-D-NH-E

wherein A is selected from the group consisting OfC₂-C₆ alkene and C₃-C₆ cycloalkyl, cycloalkenyl, and cycloaryl; B is independently selected from the group consisting of a single bond and Ci-C₆ alkyl and alkenyl; D is independently selected from the group consisting of Ci-C₆ alkyl and alkenyl, and C₃-C₆ cycloalkyl, cycloalkenyl, and cycloaryl; E is independently selected from the group consisting of H, Ci-C₆ lkyl and alkenyl; and all salts, hydrates, solvates, and stereoisomers thereof. In one embodiment, the only conformational restriction of the polyamine analog is due to a carbon-carbon double bond (an ethenyl group, C=C) in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a cycloalkyl group, such as a cyclopropyl group, in the molecule.

where Ai, each A₂ (if present), and A₃ are independently selected from Ci-C8 alkyl; where A₄ is selected from Ci-C₈ alkyl or a nonentity; where X is selected from -H, -Z, -CN, -NH₂, -C(0)-Ci-C₈ alkyl, or -NHZ, with the proviso that when A₄ is a nonentity, X is -H, -C(=O)-Ci-C₈ alkyl, or -Z; where Z is selected from the group consisting of an amino protecting group, an amino capping group, an amino acid, and a peptide; where each Y is independently selected from H or Ci-C₄ alkyl; where M is selected from Ci-C₄ alkyl; where k is O, 1, 2, or 3; and where R is selected from C₁- C3₂ alkyl; and all salts, hydrates, solvates, and stereoisomers thereof. In certain embodiments, A₄ is a nonentity. In other embodiments, X is -Z, and -Z is -H. In other embodiments, X is -Z, and -Z is 4-morpholinocarbonyl. In other embodiments, X is -Z and -Z is acetyl. In other embodiments, X is -Z and -Z is t-Boc or Fmoc. In other embodiments, Y is -CH₃. In other embodiments, M is -CH₂-. In still further embodiments, k is 1. In further embodiments, Ai and A₃ are -CH₂CH₂CH₂-. In still further embodiments, -CH₂CH₂CH₂CH₂-. In still further embodiments, R is -Ci₃H₂₇. In yet further embodiments, one or more of the specific limitations on A₄, X, Z, Y, M, k, Ai, A₃, and R are combined.

[0021] In further embodiments of these macrocyclic polyamine analog compounds, A₄ is C1-C₈ alkyl, X is -NHZ, and Z is selected from one of the 20 genetically encoded amino acids (alanine, cysteine, aspartic acid, glutamic acid, phenylalanine, glycine, histidine, isoleucine, lysine, methionine, asparagine, proline, glutamine, arginine, serine, threonine, valine, tryptophan, tyrosine), a peptide of the formula acetyl-SKLQL-, a peptide of the formula acetyl-SKLQ-β-alanine-, or a peptide of the formula acetyl-SKLQ-. In these cases, where Z is an amino acid or peptide, the therapeutic agent to be used is a polyamine-amino acid conjugate or polyamine-peptide conjugate. [0022] In another embodiment, the invention embraces a method of treating or preventing an intestinal polyp, comprising administering one or more polyamine analogs to a subject with one or more intestinal polyps in a therapeutically effective amount. Preferably, the polyamine analog is a conformationally restricted polyamine analog. In one embodiment, the only conformational restriction of the polyamine analog is due to a carbon-carbon double bond (an ethenyl group, C=C) in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a cycloalkyl group, such as a cyclopropyl group, in the molecule.

[0023] The invention also embraces administration of the polyamine analog or conformationally restricted polyamine analog in an amount sufficient to prevent the development of intestinal polyps. The amount of prevention can be either partially or substantially complete.

[0024] The invention also embraces administration of the polyamine analog or conformationally restricted polyamine analog in an amount sufficient to prevent an existing polyp, such as an adenomatous polyp, from becoming malignant. The amount of prevention can be either partially or substantially complete. [0025] In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered as a preventive or prophylactic measure. In one embodiment, the only conformational restriction of the polyamine analog is due to a carbon-carbon double bond (an ethenyl group, C=C) in the molecule. In another embodiment, the only conformational restriction of the polyamine analog is due to a cycloalkyl group, such as a cyclopropyl group, in the molecule. The polyamine analog or conformationally restricted polyamine analog can be administered to patients at risk of developing intestinal polyps, or patients with existing intestinal polyps at risk of developing additional intestinal polyps. Patients at risk of developing intestinal polyps include, but are not limited to, patients with familial adenomatous polyposis (FAP), patients with one or more consanguinous relatives with FAP; patients with a mutation in the APC gene; patients with a mutation in the MUTYH gene; or patients who have previously had colon cancer or precancerous polyps.

[0026] In another embodiment, the polyamine analog or conformationally restricted polyamine analog is present in a formulation suitable for parenteral administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is present in a formulation suitable for oral administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is present in a formulation suitable for rectal administration.

[0027] In one embodiment, the invention embraces administration of a polyamine analog or a conformational^ restricted polyamine analog about once a day for about two to about twelve months. In one embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about every other day for about two to about twelve months. In one embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about twice a week for about two to about twelve months. In one embodiment, the invention embraces administration of a polyamine analog or a conformational^ restricted polyamine analog about once a week for about two to about twelve months. In another embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once every two weeks for about two to about twelve months. In another embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once every three weeks for about two to about twelve months. In another embodiment, the aforementioned administration regimens comprise parenteral administration of the polyamine analog or conformationally restricted polyamine analog. In another embodiment, the aforementioned administration regimens comprise oral administration of the polyamine analog or conformationally restricted polyamine analog. In another embodiment, the aforementioned administration regimens comprise rectal administration of the polyamine analog or conformationally restricted polyamine analog. In another embodiment, the aforementioned administration regimens comprise administration of CGC-11093. In another embodiment, the aforementioned administration regimens comprise administration of CGC-11217. In another embodiment, the aforementioned administration regimens comprise administration of CGC-11237. DETAILED DESCRIPTION OF THE INVENTION

[0028] A "subject" or a "patient" refers to a vertebrate, preferably a mammal, more preferably a human. The polyamine analogs described herein or incorporated by reference herein are used for treatment or prevention in vertebrates, preferably mammals, more preferably humans.

[0029] "Treating" or "to treat" a disease using the methods of the invention is defined as administering one or more polyamine analogs, with or without additional therapeutic agents, in order to palliate, ameliorate, stabilize, reverse, slow, delay, reduce, or eliminate either the disease or the symptoms of the disease, or to retard or stop the progression of the disease or of symptoms of the disease. "Therapeutic use" of the polyamine analogs is defined as using one or more polyamine analogs to treat a disease, as defined above, or to prevent a disease, as defined below. A "therapeutically effective amount" is an amount sufficient to treat a disease, as defined above, or to prevent a disease, as defined below. In the context of this application, an intestinal polyp can be treated with a polyamine analog during a benign phase, in order to palliate, ameliorate, stabilize, reverse, slow, delay, reduce, or eliminate the transformation of the benign polyp into a malignant polyp, or a malignant intestinal polyp can be treated with a polyamine analog in order to palliate, ameliorate, stabilize, reverse, slow, delay, reduce, or eliminate either the polyp or the symptoms of the polyp, or to retard or stop the progression of the polyp or of symptoms of the polyp, or to palliate, ameliorate, stabilize, reverse, slow, delay, reduce, eliminate, retard, or stop metastasis of the malignancy. [0030] "Preventing" or "to prevent" a disease using the methods of the invention is defined as administering one or more polyamine analogs, with or without additional therapeutic agents, in order to prevent, forestall, or delay a disease or the symptoms of the disease, before the disease or symptoms of the disease has occurred. Prevention can be partial or total.

[0031] By "polyamine analog" is meant an organic cation structurally similar but non-identical to naturally occurring polyamines such as spermine and/or spermidine and their precursor, diamine putrescine. By a "polyamine", a term well- understood in the art, is meant any of a group of aliphatic, straight-chain amines derived biosynthetically from amino acids; polyamines are reviewed in Marton et al. (1995) Ann. Rev. Pharm. Toxicol. 35:55-91. Polyamine analogs can be branched or un-branched. Polyamine analogs include, but are not limited to, BE-4444 [1,19-bis (ethylamino)-5,10,15-triazanonadecane]; BE-333 [Nl₃Nl 1-diethylnorspermine; DENSPM; 1,11 -to (ethylamino)-4,8-diazaundecane; thermine; Warner-Parke-Davis]; BE-33 [Nl,N7-to(ethyl) norspermidine]; BE-34 [Nl,N8-to(ethyl) spermidine]; BE- 44 [Nl,N9-to(ethyl) homospermidine]; BE-343 [Nl,N12-to(ethyl) spermine; diethylspermine-Nl-N12; DESPM]; BE-373 [N,N'-to (3-ethylamino) propyl)-l,7- heptane diamine, Merrell-Dow]; BE-444 [Nl,N14-to(ethyl) homospermine; diethylhomospermine-Nl -N 14] ; BE-3443 [1,17-to(ethylamino)-4,9, 14- triazaheptadecane]; and BE-4334 [l,17-to(ethylamino)-5,9,13-triazaheptadecane]; 1,12-Me₂-SPM [1,12-dimethylspermine]. See also Feuerstein et al. (1991); Gosule et al. (1978) J. MoI. Biol. 121:311-326; Behe et al. (1981) Proc. Natl. Acad. ScI USA 78:1619-23; Jain et al. (1989) Biochem. 28:2360-2364; Basu et al. (1990) Biochem. J. 269:329-334; Porter et al. (1988), Advances in Enzyme Regulation, Pergamon Press, pp. 57-79; Frydman et al. (1992) Proc. Natl. Acad. Sci. USA 89:9186-9191; and Fernandez et al. (1994) Cell MoI. Biol. 40: 933-944.

[0032] By "conformationally restricted" is meant that, in a polyamine analog, at least two amino groups in the molecule are locked or limited in spatial configuration relative to each other. The amino groups within the molecule may be primary, secondary, tertiary, or quartenary, and are preferably primary or secondary amino groups, more preferably secondary amino groups. The relative movement of two amino groups can be restricted, for example, by incorporation of a cyclic or unsaturated moiety between them (exemplified, but not limited to, a ring, such as a three-carbon ring, four-carbon ring, five-carbon-ring, six-carbon ring, or a double or triple bond, such as a double or triple carbon bond), or by incorporating the amino groups into a macrocyclic ring structure. Groups restricting conformational flexibility by means of steric hindrance, yet favorable to the therapeutic effects of the compound, can also be used. A conformationally restricted polyamine analog can comprise at least two amino groups which are conformationally restricted relative to each other; a polyamine analog can also further comprise amino groups which are not conformationally restricted relative to other amino groups. Flexible molecules such as spermine and BE-444 can have a myriad of conformations and are therefore not conformationally restricted. Conformationally restricted polyamine analogs include, but are not limited to, the compounds disclosed in International Patent Application WO 98/17624, U.S. Patent No. 5,889,061, and U.S. Patent No. 6,392,098; the compounds disclosed in WO 00/66587 and U.S. Patent No. 6,794,545; and the compounds disclosed in United States Patent Application Publication Nos. 2003/0072715, 2003/0195377, and International Patent Applications WO 02/10142, and WO 03/050072. Several of these compounds are depicted below in Table 1. All of the polyamine analog compounds (both conformationally restricted polyamine analog compounds and non-conformationally restricted polyamine analog compounds) disclosed in those patents or patent applications, including but not limited to the specification, claims, tables, examples, figures, and schemes of those patents or patent applications, are expressly incorporated by reference herein as compounds useful in the invention. The conformationally restricted polyamine analog compounds disclosed in those patents or patent applications, including but not limited to the specification, claims, tables, examples, figures, and schemes of those patents or patent applications, are expressly incorporated by reference herein as preferred compounds useful in the invention.

[0033] In certain embodiments, the saturated oligoamines disclosed in U.S.

Patent Application Publication No. 2003/0130356 can be used for treatment or prevention of intestinal polyps, and all oligoamine compounds disclosed therein, including but not limited to the specification, claims, tables, examples, figures, and schemes of that patent application, are expressly incorporated by reference herein as compounds useful in the invention.

[0034] In certain additional embodiments, the polyamine analog-peptide conjugates disclosed in United States Patent No. 6,649,587 can be used for treatment or prevention of intestinal polyps, and all polyamine analog-peptide conjugates disclosed therein, including but not limited to the specification, claims, tables, examples, figures, and schemes of that patent, are expressly incorporated by reference herein as compounds useful in the invention.

[0035] In certain additional embodiments, the polyamine analog-amino acid conjugates disclosed in International Patent Application WO 02/38105 can be used for treatment or prevention of intestinal polyps, and all polyamine analog-amino acid conjugates disclosed therein, including but not limited to the specification, claims, tables, examples, figures, and schemes of that patent application, are expressly incorporated by reference herein as compounds useful in the invention. [0036] One preferred subset of polyamine analogs and conformationally restricted polyamine analogs are those containing 8, 10, 12, or 14 nitrogen atoms. Such compounds include CGC-11144 and CGC-11150 (also known as SL-11144 and SL-11150, respectively), each of which contains 10 nitrogens. [0037] Another preferred subset of polyamine analogs and conformationally restricted analogs comprises the compounds known as CGC-11093 and CGC-11047 (also known as SL-11093 and SL-11047, respectively), each of which contains 4 nitrogens.

[0038] Another preferred subset of polyamine analogs and conformationally restricted analogs comprises the compounds known as CGC-11217 and CGC-11237 (also known as SL-11217 and SL-11237, respectively), each of which contains 4 nitrogens.

[0039] The invention includes the use of all of the compounds described herein or incorporated by reference herein, including any and all stereoisomers, salts, hydrates and solvates of the compounds described herein or incorporated by reference herein. The invention also includes the use of all compounds described herein or incorporated by reference herein in their non-salt, non-hydrate/non-solvate form. Particularly preferred are pharmaceutically acceptable salts. Pharmaceutically acceptable salts are those salts which retain the biological activity of the free bases and which are not biologically or otherwise undesirable. The desired salt may be prepared by methods known to those of skill in the art by treating the compound with an acid. Examples of inorganic acids include, but are not limited to, hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, and phosphoric acid. Examples of organic acids include, but are not limited to, formic acid, acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, sulfonic acids, and salicylic acid. Salts of the compounds with amino acids, such as aspartate salts and glutamate salts, can also be prepared. [0040] For compounds including a porphyrin ring, the porphyrin can be present without a central cation (i.e., in apo form), or with a central cation bound to one or more of the interior nitrogens of the tetrapyrrole ring. Such cations can be metal ions. Such metal ions can include iron, nickel, zinc, tin, and magnesium ions. [0041] The invention also includes all stereoisomers of the compounds, including diastereomers and enantiomers, as well as mixtures of stereoisomers, including, but not limited to, racemic mixtures. Unless stereochemistry is explicitly indicated in a structure, the structure is intended to embrace all possible stereoisomers of the compound depicted.

[0042] The term "alkyl" refers to saturated aliphatic groups including straight- chain, branched-chain, cyclic groups, and combinations thereof, having the number of carbon atoms specified, or if no number is specified, having up to 12 carbon atoms, with preferred subsets of alkyl groups including C₁-Cj₂, C₁-C_1O, Ci-C₈, C₁-C₆, and Ci-C₄ alkyl groups. "Straight-chain alkyl" or "linear alkyl" groups refers to alkyl groups that are neither cyclic nor branched, commonly designated as "n-alkyl" groups. Examples of alkyl groups include, but are not limited to, groups such as methyl, ethyl, n-propyl, isopropyl, butyl, n-butyl, isobutyl, sec-butyl, t-butyl, pentyl, n-pentyl, hexyl, heptyl, octyl, nonyl, decyl, undecyl, dodecyl, neopentyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, and adamantyl. Cyclic groups can consist of one ring, including, but not limited to, groups such as cycloheptyl, or multiple fused rings, including, but not limited to, groups such as adamantyl or norbornyl. [0043] "Substituted alkyl" refers to alkyl groups substituted with one or more substituents including, but not limited to, groups such as halogen (fluoro, chloro, bromo, and iodo), alkoxy, acyloxy, amino, hydroxyl, mercapto, carboxy, benzyloxy, phenyl, benzyl, cyano, nitro, thioalkoxy, carboxaldehyde, carboalkoxy and carboxamide, or a functionality that can be suitably blocked, if necessary for purposes of the invention, with a protecting group. Examples of substituted alkyl groups include, but are not limited to, -CF₃, -CF₂-CF₃, and other perfluoro and perhalo groups.

[0044] "Hydroxyalkyl" specifically refers to alkyl groups having the number of carbon atoms specified substituted with one -OH group. Thus, "C₃ linear hydroxyalkyl" refers to -CH₂CH₂CHOH-, -CH₂CHOHCH₂-, and -CHOHCH₂CH₂-. [0045] The term "alkenyl" refers to unsaturated aliphatic groups including straight-chain (linear), branched-chain, cyclic groups, and combinations thereof, having the number of carbon atoms specified, or if no number is specified, having up to 12 carbon atoms, which contain at least one double bond (-C=C-). Examples of alkenyl groups include, but are not limited to, -CH₂-CH=CH-CH₃; and -CH₂-CH₂-cyclohexenyl, where the ethyl group can be attached to the cyclohexenyl moiety at any available carbon valence. The term "alkynyl" refers to unsaturated aliphatic groups including straight-chain (linear), branched-chain, cyclic groups, and combinations thereof, having the number of carbon atoms specified, or if no number is specified, having up to 12 carbon atoms, which contain at least one triple bond

(-C≡C-). "Hydrocarbon chain" or "hydrocarbyl" refers to any combination of straight-chain, branched-chain, or cyclic alkyl, alkenyl, or alkynyl groups, and any combination thereof. "Substituted alkenyl," "substituted alkynyl," and "substituted hydrocarbon chain" or "substituted hydrocarbyl" refer to the respective group substituted with one or more substituents, including, but not limited to, groups such as halogen, alkoxy, acyloxy, amino, hydroxyl, mercapto, carboxy, benzyloxy, phenyl, benzyl, cyano, nitro, thioalkoxy, carboxaldehyde, carboalkoxy and carboxamide, or a functionality that can be suitably blocked, if necessary for purposes of the invention, with a protecting group.

[0046] "Aryl" or "Ar" refers to an aromatic carbocyclic group having a single ring (including, but not limited to, groups such as phenyl) or multiple condensed rings (including, but not limited to, groups such as naphthyl or anthryl), and includes both unsubstituted and substituted aryl groups. "Substituted aryls" refers to aryls substituted with one or more substituents, including, but not limited to, groups such as alkyl, alkenyl, alkynyl, hydrocarbon chains, halogen, alkoxy, acyloxy, amino, hydroxyl, mercapto, carboxy, benzyloxy, phenyl, benzyl, cyano, nitro, thioalkoxy, carboxaldehyde, carboalkoxy and carboxamide, or a functionality that can be suitably blocked, if necessary for purposes of the invention, with a protecting group. [0047] "Heteroalkyl," "heteroalkenyl," and "heteroalkynyl" refer to alkyl, alkenyl, and alkynyl groups, respectively, that contain the number of carbon atoms specified (or if no number is specified, having up to 12 carbon atoms) which contain one or more heteroatoms as part of the main, branched, or cyclic chains in the group. Heteroatoms include, but are not limited to, N, S, O, and P; N and O are preferred. Heteroalkyl, heteroalkenyl, and heteroalkynyl groups may be attached to the remainder of the molecule either at a heteroatom (if a valence is available) or at a carbon atom. Examples of heteroalkyl groups include, but are not limited to, groups such as -0-CH₃, -CH₂-O-CH₃, -CH₂-CH₂-O-CH₃, -S-CH₂-CH₂-CH₃, -CH₂-CH(CHs)-S-CH₃, -CH₂-CH₂-NH-CH₂-CH₂-, 1 -ethyl-6-propylpiperidino, 2- ethylthiophenyl, and morpholino. Examples of heteroalkenyl groups include, but are not limited to, groups such as -CH=CH-NH-CH(CH₃)-CH₂-. "Heteroaryl" or "HetAr" refers to an aromatic carbocyclic group having a single ring (including, but not limited to, examples such as pyridyl, thiophene, or furyl) or multiple condensed rings (including, but not limited to, examples such as imidazolyl, indolizinyl or benzothienyl) and having at least one hetero atom, including, but not limited to, heteroatoms such as N, O, P, or S, within the ring. Unless otherwise specified, heteroalkyl, heteroalkenyl, heteroalkynyl, and heteroaryl groups have between one and five heteroatoms and between one and twelve carbon atoms. "Substituted heteroalkyl," "substituted heteroalkenyl," "substituted heteroalkynyl," and "substituted heteroaryl" groups refer to heteroalkyl, heteroalkenyl, heteroalkynyl, and heteroaryl groups substituted with one or more substituents, including, but not limited to, groups such as alkyl, alkenyl, alkynyl, benzyl, hydrocarbon chains, halogen, alkoxy, acyloxy, amino, hydroxyl, mercapto, carboxy, benzyloxy, phenyl, benzyl, cyano, nitro, thioalkoxy, carboxaldehyde, carboalkoxy and carboxamide, or a functionality that can be suitably blocked, if necessary for purposes of the invention, with a protecting group. Examples of such substituted heteroalkyl groups include, but are not limited to, piperazine, substituted at a nitrogen or carbon by a phenyl or benzyl group, and attached to the remainder of the molecule by any available valence on a carbon or nitrogen, -NH-SO₂-phenyl, -NH-(C=O)O-alkyl, -NH-(C=O)O-alkyl-aryl, and -NH-(C=O)-alkyl. If chemically possible, the heteroatom(s) as well as the carbon atoms of the group can be substituted. The heteroatom(s) can also be in oxidized form, if chemically possible.

[0048] The term "alkylaryl" refers to an alkyl group having the number of carbon atoms designated, appended to one, two, or three aryl groups. [0049] The term "alkoxy" as used herein refers to an alkyl, alkenyl, alkynyl, or hydrocarbon chain linked to an oxygen atom and having the number of carbon atoms specified, or if no number is specified, having up to 12 carbon atoms. Examples of alkoxy groups include, but are not limited to, groups such as methoxy, ethoxy, and t-butoxy.

[0050] The term "alkanoate" as used herein refers to an ionized carboxylic acid group, such as acetate (CH₃C(=O)-O^("1)), propionate (CH₃CH₂C(=O)-O^("υ), and the like. "Alkyl alkanoate" refers to a carboxylic acid esterified with an alkoxy group, such as ethyl acetate (CH₃C(=O)-O-CH₂CH₃). "ω-haloalkyl alkanoate" refers to an alkyl alkanoate bearing a halogen atom on the alkanoate carbon atom furthest from the carboxyl group; thus, ethyl ω-bromo propionate refers to ethyl 3- bromopropionate, methyl ω-chloro n-butanoate refers to methyl 4-chloro n-butanoate, etc.

Intestinal polyps

[0054] The invention embraces methods of treating or preventing a variety of intestinal polyps, including, but not limited to, adenomas.

[0055] For preventive use, risk factors which have been identified for intestinal polyps include mutations in the gene APC; mutations in the gene MUTYH; the disease familial adenomatous polyposis; a consanguinous relative with familial adenomatous polyposis; or a previous history of colon cancer. Subjects or patients with these risk factors should be considered for prophylactic therapy using the methods of the invention. Modes of administration

[0056] Compounds useful in the methods of the invention can be administered to a patient or subject (preferably a human patient or subject) via any route known in the art, including, but not limited to, those disclosed herein. Methods of administration include, but are not limited to, systemic, transpleural, intravenous, oral, intraarterial, intramuscular, topical, via inhalation (e.g. as mists or sprays), via nasal mucosa, subcutaneous, transdermal, intraperitoneal, and gastrointestinal. The compounds described or incorporated by reference for use herein can be administered in the form of tablets, pills, powder mixtures, capsules, granules, injectables, creams, solutions, suppositories, emulsions, dispersions, food premixes, and in other suitable forms. The compounds can also be administered in liposome formulations. The compounds can also be administered as prodrugs, where the prodrug undergoes transformation in the subject to a form which is therapeutically effective. Additional methods of administration are known in the art.

[0057] The pharmaceutical dosage form which contains the compounds for use in the invention is conveniently admixed with a non-toxic pharmaceutical organic carrier or a non-toxic pharmaceutical inorganic carrier. Typical pharmaceutically- acceptable carriers include, for example, mannitol, urea, dextrans, lactose, potato and maize starches, magnesium stearate, talc, vegetable oils, polyalkylene glycols, ethyl cellulose, poly(vinylpyrrolidone), calcium carbonate, ethyl oleate, isopropyl myristate, benzyl benzoate, sodium carbonate, gelatin, potassium carbonate, silicic acid, and other conventionally employed acceptable carriers. The pharmaceutical dosage form can also contain non-toxic auxiliary substances such as emulsifying, preserving, or wetting agents, and the like. A suitable carrier is one which does not cause an intolerable side effect, but which allows the compound(s) to retain its pharmacological activity in the body. Formulations for parenteral and nonparenteral drug delivery are known in the art and are set forth in Remington: The Science and Practice of Pharmacy, 20th Edition, Lippincott, Williams & Wilkins (2000). Solid foπns, such as tablets, capsules and powders, can be fabricated using conventional tableting and capsule-filling machinery, which is well known in the art. Solid dosage forms, including tablets and capsules for oral administration in unit dose presentation form, can contain any number of additional non-active ingredients known to the art, including such conventional additives as excipients; desiccants; colorants; binding agents, for example syrup, acacia, gelatin, sorbitol, tragacanth, or polyvinylpyrollidone; fillers, for example lactose, sugar, maize-starch, calcium phosphate, sorbitol or glycine; tableting lubricants, for example magnesium stearate, talc, polyethylene glycol or silica; disintegrants, for example potato starch; or acceptable wetting agents such as sodium lauryl sulfate. The tablets can be coated according to methods well known in standard pharmaceutical practice. Liquid forms for ingestion can be formulated using known liquid carriers, including aqueous and non-aqueous carriers such as sterile water, sterile saline, suspensions, oil-in-water and/or water-in-oil emulsions, and the like. Liquid formulations can also contain any number of additional non-active ingredients, including colorants, fragrance, flavorings, viscosity modifiers, preservatives, stabilizers, and the like. For parenteral administration, the compounds for use in the invention can be administered as injectable dosages of a solution or suspension of the compound in a physiologically acceptable diluent or sterile liquid carrier such as water, saline, or oil, with or without additional surfactants or adjuvants. An illustrative list of carrier oils would include animal and vegetable oils (e.g., peanut oil, soy bean oil), petroleum-derived oils (e.g., mineral oil), and synthetic oils.

[0058] For injectable unit doses, sterile liquids such as water, saline, phosphate-buffered saline, aqueous dextrose and related sugar solutions are preferred liquid carriers.

[0059] The pharmaceutical unit dosage chosen is preferably fabricated and administered to provide a defined final concentration of drug either in the blood, or in the intestinal tract or tissues associated with the intestinal tract. The optimal effective concentration of the compounds of the invention can be determined empirically and will depend on the type and severity of the disease, route of administration, disease progression and health, mass and body area of the patient. Such determinations are within the skill of one in the art. Examples of dosages which can be used for systemic administration (including oral or parenteral) include, but are not limited to, an effective amount within the dosage range of about 0.1 μg/kg to about 300 mg/kg, or within about 1.0 μg/kg to about 40 mg/kg body weight, or within about 10 μg/kg to about 20 mg/kg body weight, or within about 0.1 mg/kg to about 20 mg/kg body weight, or within about 1 mg/kg to about 20 mg/kg body weight, or within about 0.1 mg/kg to about 10 mg/kg body weight, or within about within about 1 mg/kg to about 10 mg/kg body weight, or within about 0.1 μg/kg to about 10 mg/kg body weight. Examples of dosages which can be used for systemic administration (including oral and parenteral) when based on body surface area (expressed in square meters, or m²) include, but are not limited to, an effective amount within the dosage range of about 0.1 μg/m² to about 300 mg/m² body surface area, or within about 10 μg/m² to about 300 mg/m² body surface area, or within about 100 μg/m² to about 300 mg/m² body surface area, or within about 1 mg/m² to about 300 mg/m² body surface area, or within about 10 mg/m² to about 300 mg/m² body surface area, or within about 10 mg/m² to about 200 mg/m² body surface area, or within about 10 mg/m² to about 120 mg/m² body surface area, or within about 40 mg/m² to about 120 mg/m² body surface area, or within about 60 mg/m² to about 100 mg/m² body surface area. The dosages may be administered in a single daily dose, or the total daily dosage may be administered in divided dosage of two, three or four times daily. Dosages may also be administered less frequently than daily, for example, six times a week, five times a week, four times a week, three times a week, twice a week, about once a week, about once every two weeks, about once every three weeks, about once every four weeks, about once every six weeks, about once every two months, about once every three months, about once every four months, or about once every six months. [0060] In one embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once a day for about two to about twelve months. In one embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about every other day for about two to about twelve months. In one embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about twice a week for about two to about twelve months. In one embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once a week for about two to about twelve months. In another embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once every two weeks for about two to about twelve months. In another embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once every three weeks for about two to about twelve months. In another embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once a month for about two to about twelve months. In another embodiment, the invention embraces administration of a polyamine analog or a conformationally restricted polyamine analog about once a day, about once every two days, about once every three days, about twice a week, about once a week, about once every two weeks, about once every three weeks, about once a month, about once every two months, about once every three months, about once every four months, about once every five months, about or once every six months, for an indefinite period of time, or until particular clinical endpoints are met. In another embodiment, the aforementioned administration regimens comprise parenteral administration of the polyamine analog or conformationally restricted polyamine analog. In another embodiment, the aforementioned administration regimens comprise oral administration of the polyamine analog or conformationally restricted polyamine analog. In another embodiment, the aforementioned administration regimens comprise rectal administration of the polyamine analog or conformationally restricted polyamine analog. In another embodiment, the aforementioned administration regimens comprise administration of CGC-11093. In another embodiment, the aforementioned administration regimens comprise administration of CGC-11217. In another embodiment, the aforementioned administration regimens comprise administration of CGC- 11237.

[0061] In one embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 10% compared to the number of polyps that would occur without administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 20% compared to the number of polyps that would occur without administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 30% compared to the number of polyps that would occur without administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 40% compared to the number of polyps that would occur without administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 50% compared to the number of polyps that would occur without administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 60% compared to the number of polyps that would occur without administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 70% compared to the number of polyps that would occur without administration. In another embodiment, the polyamine analog or conformationally restricted polyamine analog is administered in an amount sufficient to reduce the number of polyps that occur in a subject or patient by at least about 80% compared to the number of polyps that would occur without administration.

[0062] In one embodiment of the invention, the dosages may be administered in a sustained release formulation or a sustained release implant, such as in an implant which gradually releases the compounds for use in the invention over a period of time, and which allow for the drug to be administered less frequently, such as about once a month, about once every 2-6 months, about once every year, or even a single administration which need not be repeated. The sustained release implants, devices or formulations (such as pellets, microspheres, and the like) can be administered by topical application, by injection, or can be surgically implanted in various locations. [0063] The compounds for use in the invention can be administered as the sole active ingredient, or can be administered in combination with another active ingredient. In one embodiment, D,L-α-difluoromethyl-ornithine is used as another active ingredient. In another embodiment, L-α-difluoromethyl-ornithine is used as another active ingredient. In another embodiment, D-α-difluoromethyl-ornithine is used as another active ingredient. In another embodiment, a non-steroidal antiinflammatory drug (NSAID) is used as another active ingredient. In another embodiment, a COX-2 inhibitor is used as another active ingredient. In another embodiment, sulindac is used as another active ingredient. Kits

[0064] The invention also provides articles of manufacture and kits containing materials useful for treating or preventing intestinal polyps. The article of manufacture comprises a container with a label. Suitable containers include, for example, bottles, vials, and test tubes. The containers may be formed from a variety of materials such as glass or plastic. The container holds a composition having an active agent which is effective for treating or preventing an intestinal polyp. The active agent in the composition is one or more conformationally restricted polyamine analogs, preferably one or more of the conformationally restricted polyamine analogs disclosed herein or incorporated by reference herein. The label on the container indicates that the composition is used for treating or preventing intestinal polyps, and may also indicate directions for use.

[0065] The invention also provides kits comprising any one or more of a conformationally restricted polyamine analog. In some embodiments, the kit of the invention comprises the container described above. In other embodiments, the kit of the invention comprises the container described above and a second container comprising a buffer. It may further include other materials desirable from a commercial and user standpoint, including other buffers, diluents, filters, needles, syringes, and package inserts with instructions for performing any methods described herein (methods for treating or preventing intestinal polyps).

[0066] In other aspects, the kits may be used for any of the methods described herein, including, for example, to treat a patient or subject with an intestinal polyp or for prophylactic administration to a patient or subject at risk of developing an intestinal polyp. The kits may include instructions for practicing any of the methods described herein.

[0067] The following example is provided to illustrate various embodiments of the invention, and is not intended to limit the invention in any manner.

EXAMPLE

[0068] APC/Min mice (n= 72) were randomized to oral gavage or intraperitoneal administration of sulindac and/or the polyamine analog drugs SLl 1217 or SLl 1237 or SLl 1093 from age 30 days until sacrifice at age 80 days. Tumors in the colons and 4-cm segments of small intestines were examined at 10x magnification after formalin fixation and staining with 0.2% methylene blue. [0069] Table 2 presents the total tumor multiplicity in Min mice administered polyamine analogs CGC-11217 (SL-11217), CGC-11237 (SL-11237), or CGC-11093 (SL-11093) at the indicated dosages and routes of administration:

[0071] Table 4 presents total tumor multiplicity in Min mice administered with polyamine analogs CGC-11217 (SL-11217) or CGC-11093 (SL-11093) (values are presented as mean ± std. error (%control)) at the indicated dosages and routes of administration:

[0073] The disclosures of all publications, patents, patent applications and published patent applications referred to herein by an identifying citation are hereby incorporated herein by reference in their entirety.

[0074] Although the foregoing invention has been described in some detail by way of illustration and example for purposes of clarity of understanding, it is apparent to those skilled in the art that certain minor changes and modifications will be practiced. Therefore, the description and examples should not be construed as limiting the scope of the invention.

Claims

and all stereoisomers, salts, hydrates, and solvates thereof.

8. The method of any of claims 1 to 6, wherein the one or more conformationally restricted polyamine analogs is:

and all stereoisomers, salts, hydrates, and solvates thereof.

9. The method of any of claims 1 to 6, wherein the one or more conformationally restricted polyamine analogs is:

and all stereoisomers, salts, hydrates, and solvates thereof.

10. The method of any of claims 1 to 9, wherein the one or more conformationally restricted polyamine analogs is administered via parenteral administration.

11. The method of any of claims 1 to 9, wherein the one or more conformationally restricted polyamine analogs is administered via oral administration.

12. The method of any of claims 1 to 9, wherein the one or more conformationally restricted polyamine analogs is administered via rectal administration.

13. The method of claim 2, wherein the number of polyps developed by a subject is reduced by about 50% over the number of polyps that would have developed without administration of the conformationally restricted polyamine analog.

14. The method of claim 2, wherein the number of polyps developed by a subject is reduced by about 80% over the number of polyps that would have developed without administration of the conformationally restricted polyamine analog.