Classifications

• • 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
  • 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
  • A61K31/4995—Pyrazines or piperazines forming part of bridged ring systems
• • 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
  • A61K31/517—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with carbocyclic ring systems, e.g. quinazoline, perimidine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• Ecteinascidin-743 (ET-743, Trabectedin, Yondelis®) is a natural marine-based compound derived from the Caribbean tunicate Ecteinascidia turbinata (the sea squirt). Extracts from this organism were shown to have potent cytotoxic activity in the late 1960s, which led to the purification and isolation of individual compounds in the early 1990s.
• One of these compounds, ET-743 displays potent anti-tumor activity in vitro in a variety of tumor cell lines derived from lung, prostate, ovarian, breast and skin cancers.
• ET-743 was selected by the NCI for clinical development in 1993 and is currently in Phase El and Phase I combination clinical trials for solid tumors in the US and Europe. Remarkably, ET-743 has shown extraordinary, low dose activity in patients. However, despite considerable data that has accumulated regarding the activities of ET-743, the unique and seemingly novel mechanism(s) of action of this drug are not yet fully elucidated.
• ET-743 can undergo covalent interactions with the minor groove of DNA, and that this binding has the unique effect of eliciting bending of the DNA towards the major groove.
• Studies of the mechanism of action for ET-743 are disclosed in K. Scotto and R. Johnson, "Transcription of the Multidrug Resistance Gene MDRl: A Therapeutic Target," Molecular Interventions, vol. 1, issue 2, pages 117-25 (June 2001); D. Friedman, et al., "Ecteinascidin-743 Inhibits Activated but not Constitutive Transcription," Cancer Research, vol. 62, pages 3377-81 (June 15, 2002); S.
• PARP-I is an abundant nuclear enzyme which is well characterized as an early sensor of DNA damage which assists in recruiting repair enzymes to lesions sites. It is thought to be one of the first sensors of DNA damage, and upon binding to damaged DNA, the catalytic activity of PARP-I becomes fully active.
• the present invention derives from the discovery that the loss of poly (ADP- ribose) polymerase (PARP-I) in a tumor cell population results in increased cellular sensitivity to Ecteinascidin-743 (ET-743).
• PARP-I poly (ADP- ribose) polymerase
• one embodiment includes a method for improving the cytotoxic effect of Ecteinascidin-743 (ET-743) or an analog thereof on a tumor cell population in a patient said method by administering to the patient, sequentially or simultaneously, a therapeutically effective combination of a composition including ET-743 and an amount of a composition including a PARP-I inhibitor effective to increase the cytotoxic effect of ET-743 on the tumor cell population.
• Another embodiment includes an anti-tumor composition including a therapeutically effective combination of ET-743 and an amount of a PARP-I inhibitor effective to increase the cytotoxic effect of ET-743 on the tumor cell population.
• An additional embodiment includes the use of a PARP-I inhibitor in the manufacture of an anti-tumor medicament characterized by a therapeutically effective amount of ET-743 characterized in that the amount of the PARP-I inhibitor is effective to increase the tumor cytotoxicity of the ET-743.
• Another embodiment further includes combining the ET-743 composition and the PARP-I inhibitor composition into a single composition prior to administration to the patient.
• the PARP-I inhibitor is selected from nicotinamide;
• the ET-743 composition further includes a pharmaceutically acceptable carrier.
• the PARP-I inhibitor composition further includes a pharmaceutically acceptable carrier.
• the single composition further includes a pharmaceutically acceptable carrier.
• the PARP-I inhibitor composition is administered two or more times independently selected from before, during, or after the administration of said ET-743 composition.
• the amount of the ET-743 composition is a therapeutically effective amount independent of the amount of said PARP-I inhibitor composition administered. In another embodiment, the amount of the ET-743 composition is not therapeutically effective when administered without said PARP-I inhibitor composition.
• Another object of the present invention is to provide a method for determining the sensitivity of a tumor or normal cell population in a patient to ET-743 by utilizing polymorphisms and/or mutations in PARP, which result in a loss of PARP activity, in the patient to predict the sensitivity of the cell population to ET-743.
• FIG. Ia is a plot of percent cellular viability versus ET-743 concentration
• FIG. Ib is a plot of percent cellular viability versus Zalypsis® concentration
• FIG. 2a is a study of cellular viability in the presence of ET-743 and nicotinamide.
• FIG. 2b is a study of cellular viability in the presence of ET-743 and NU1025.
• ET-743 can inhibit the transcriptional activation of a variety of promoters, without inhibiting their constitutive expression. For example, activation of the MDRl and p21 promoters by a variety of inducers, including the histone deacetylase inhibitor Trichostatin A (TSA), is blocked by treatment with ET-743, while basal levels of transcription from these promoters remains unaffected.
• TSA histone deacetylase inhibitor Trichostatin A
• PARP-I catalyzes the production of ADP-ribose (PAR) polymers, using cellular NAD as a substrate, and adds these highly negatively-charged polymers to acceptor proteins at glutamic acid residues.
• PAR polymers to nuclear protein acceptors causes them to dissociate from DNA through electrostatic repulsion. Such dissociation alleviates a strong steric hindrance which allows repair complexes access to the damaged DNA.
• PARP-I is well known for its role in the DNA damage response
• studies of PARP-I have just recently uncovered its role in gene regulation and other genetic processes under non-pathophysiological conditions. It was recently shown that PARP- l's catalytic activity is potently activated in the presence of nucleosomes as well as bent or cruciform DNA with even greater activation compared to its activation by DNA damage.
• PARP-I is involved in the transcriptional activation, and in some cases inhibition, of a variety of promoters in the absence of DNA damage; indeed PARP-I binding was shown to be an essential step in the formation of RNA polymerase II pre-initiation complexes.
• one embodiment of the present invention includes a method for improving the cytotoxic effect of ET-743 or an analog thereof in a tumor cell population in a patient by administering to the patient a therapeutically effective combination of ET-743 or an analog thereof and an amount of a composition containing a PARP-I inhibitor effective to increase the cytotoxic effect of the ET-743 or analog thereof on the tumor cell population.
• the composition containing the PARP-I inhibitor can be administered before or after the composition containing the ET-743 or analog thereof, or simultaneously therewith. More than one administration of the PARP-I inhibitor can be performed, so that the PARP-I inhibitor is administered before and/or during and/or after administration of the composition containing ET-743 or analog thereof.
• the amount of ET-743 or analog thereof may be therapeutically effective independent of the amount of PARP-I inhibitor administered.
• a subclinical dosage of ET-743 or analog thereof may be administered, for example to reduce side-effects or otherwise improve patient tolerance, and the amount of PARP-I inhibitor administered is effective to provide a therapeutically effective combination in terms of cytotoxic effect on a tumor cell population.
• Suitable PARP-I inhibitors for use in the present invention include, for example, nicotinamide; NU1025; 3-aminobenzamide; 4-amino-l,8-naphthalimide; 1,5-isoquinolinediol; 6(5H)-phenanthriddinone;l,3,4,5,-tetrahydrobenzo(c)(l,6)- and (c)(l,7)-naphthyridin-6-ones; adenosine substituted 2,3-dihydro-lH-isoindol-l-ones; AG14361; AG014699; 2-(4-chlorophenyl)-5-quinoxalinecarboxamide; 5-chloro-2-[3- (4-phenyl-3,6-dihydro-l(2H)-pyridinyl) propyl] -4(3H)-quinazolinone; isoindolinone derivative INO-1001; 4-hydroxyquinazoline; 2-[
• the tumor cell population includes tumor cells selected from lung cancer, prostate cancer, ovarian cancer, breast cancer, skin cancer, and sarcoma.
• Another embodiment includes combining a ET-743 composition and a PARP- 1 inhibitor composition into a single composition prior to administration to a patient.
• the single composition includes a pharmaceutically acceptable carrier.
• the ET-743 composition includes a pharmaceutically acceptable carrier.
• the PARP-I inhibitor composition includes a pharmaceutically acceptable carrier.
• An additional embodiment involves the use of a composition including a
• PARP-I inhibitor in the manufacture of a medicament for improving the cytotoxic effect of ET-743 on a tumor cell population.
• an effective amount or “therapeutically effective amount” means that amount of a compound or agent that will elicit the biological or medical response of a subject that is being sought by a medical doctor or other clinician.
• the "effective amount” or “therapeutically effective amount” of ET-743 or an analog thereof includes quantities that would otherwise be insufficient in the absence of a PARP-I inhibitor.
• the ET-743 composition and/or PARP-I inhibitor composition may be administered in any variety of suitable forms, for example, topically, parenterally, rectally, or orally. More specific routes of administration include intravenous, intramuscular, subcutaneous, intraocular, intrasynovial, colonical, peritoneal, transepithelial including transdermal, ophthalmic, sublingual, buccal, dermal, ocular, nasal inhalation via insufflation, and aerosol.
• the composition(s) may be presented in forms permitting administration by the most suitable route. These compositions may be prepared according to the customary methods, using one or more pharmaceutically acceptable adjuvants or excipients.
• the adjuvants comprise, inter alia, diluents, sterile aqueous media and the various non-toxic organic solvents.
• the compositions may be presented in the form of oral dosage forms, or injectable solutions, or suspensions.
• vehicle and ET-743 and/or PARP-I inhibitors in the vehicle are generally determined in accordance with the solubility and chemical properties of the product, the particular mode of administration and the provisions to be observed in pharmaceutical practice.
• aqueous suspensions When aqueous suspensions are used they may contain emulsifying agents or agents which facilitate suspension. Diluents such as sucrose, ethanol, polyols such as polyethylene glycol, propylene glycol and glycerol, and chloroform or mixtures thereof may also be used.
• the composition(s) may be incorporated into sustained-release preparations and formulations.
• emulsions, suspensions or solutions of the composition(s) according to the invention in vegetable oil for example sesame oil, groundnut oil or olive oil, or aqueous-organic solutions such as water and propylene glycol, injectable organic esters such as ethyl oleate, as well as sterile aqueous solutions of the pharmaceutically acceptable salts, are used.
• the injectable forms must be fluid to the extent that it can be easily syringed, and proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants.
• Prolonged absorption of the injectable compositions can be brought about by use of agents delaying absorption, for example, aluminum monostearate and gelatin.
• the solutions of the salts of the products according to the invention are especially useful for administration by intramuscular or subcutaneous injection.
• Solutions of the composition(s) as a free base or pharmacologically acceptable salt can be prepared in water suitably mixed with a surfactant such as hydroxypropyl-cellulose.
• Dispersion can also be prepared in glycerol, liquid polyethylene glycols, and mixtures thereof and in oils.
• aqueous solutions also comprising solutions of the salts in pure distilled water, may be used for intravenous administration with the proviso that their pH is suitably adjusted, that they are judiciously buffered and rendered isotonic with a sufficient quantity of glucose or sodium chloride and that they are sterilized by heating, irradiation, microfiltration, and/or by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like.
• Sterile injectable solutions are prepared by incorporating the com ⁇ osition(s) in the required amount in the appropriate solvent with various of the other ingredients enumerated above, as required, followed by filtered sterilization.
• dispersions are prepared by incorporating the various sterilized active ingredient into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above.
• a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above.
• the preferred methods of preparation are vacuum drying and the freeze drying technique, which yield a powder of the active ingredient plus any additional desired ingredient from previously sterile-filtered solution thereof.
• Topical administration gels (water or alcohol based), creams or ointments containing the composition(s) may be used.
• the composition(s) may be also incorporated in a gel or matrix base for application in a patch, which would allow a controlled release of compound through a transdermal barrier.
• composition(s) used in the present invention may be varied, it being necessary that it should constitute a proportion such that a suitable dosage shall be obtained. Obviously, several unit dosage forms may be administered at about the same time.
• a dose employed may be determined by a physician or qualified medical professional, and depends upon the desired therapeutic effect, the route of administration and the duration of the treatment, and the condition of the patient.
• the doses are generally from about 0.001 to about 50, preferably about 0.001 to about 5, mg/kg body weight per day by inhalation, from about 0.01 to about 100, preferably 0.1 to 70, more especially 0.5 to 10, mg/kg body weight per day by oral administration, and from about 0.001 to about 10, preferably 0.01 to 10, mg/kg body weight per day by intravenous administration.
• the doses are determined in accordance with the factors distinctive to the patient to be treated, such as age, weight, general state of health and other characteristics, which can influence the efficacy of the compound according to the invention.
• the com ⁇ osition(s) used in the invention may be administered as frequently as necessary in order to obtain the desired therapeutic effect. Some patients may respond rapidly to a higher or lower dose and may find much weaker maintenance doses adequate. For other patients, it may be necessary to have long-term treatments at the rate of 1 to 4 doses per day, in accordance with the physiological requirements of each particular patient. Generally, the composition(s) may be administered 1 to 4 times per day. Of course, for other patients, it will be necessary to prescribe not more than one or two doses per day.
• Example 1 Cytotoxicity assays using Ecteinascidin-743 (ET-743, Trabectedin) or Zalypsis® (an analog of Yondelis®)
• PARP-I +/+ and -/- mouse embryonic fibroblasts were seeded into 96-well plates at a density of 5,000 cells/well. After 24 hours, cells were treated with serially diluted concentrations of ET-743. 72 hours following the initial treatment, an MTS (3-(4,5-dimethylthiazol-2-yl)-5(3-carboxymethonyphenol)-2-(4-sulfophenyl)- 2H-tetrazolium) cytotoxicity assay was performed. Results were plotted as percent cellular viability versus ET-743 or Zalypsis® concentration (FIGS. Ia and Ib, respectively).
• SW620 colon carcinoma cells were pre-treated for 2 hours with either nicotinamide (10 niM) or NU1025 (100 ⁇ M). Following the 2 hour pre-treatment, media was washed out and replaced with fresh media containing serially diluted concentrations of ET-743, along with a second fixed dose of PARP inhibitor. Four hours later, media containing ET-743 and the PARP inhibitor was washed out and replaced with another fixed dose of PARP inhibitor. Finally, 4 hours later, a final fixed dose of PARP inhibitor was added. 72 hours following the initial treatment, an MTS cytotoxicity assay was performed. Results were plotted as percent cellular viability versus ET-743 concentration (FIGS. 2a and 2b).
• IC 50 concentrations were: 2 nM with ET-743 alone and 0.41 nM in combination with nicotinamide (FIG. 2a) and 1.8 nM with ET-743 alone and 0.37 nM in combination with NU1025 (HG. 2b).
• FIG. 2a treatment with nicotinamide,- a general PARP inhibitor, resulted in a 4.9-fold increased sensitization of cells to ET-743.
• Treatment with a new, more potent and specific PARP inhibitor, NU 1025 up to 1,000 times more potent than nicotinamide had a similar effect (HG. 2b) and resulted in a 4.8-fold increase in cellular sensitization to ET-743.
• Nicotinamide treatment alone resulted in -20% cell death.
• treatment with NU 1025 alone the much more potent PARP inhibitor, resulted in no increased level of cytotoxicity above the untreated cells, suggesting that NU1025 is acting synergistically with ET-743 in cell killing.

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• 2006
  • 2006-11-27 CA CA002630900A patent/CA2630900A1/en not_active Abandoned
  • 2006-11-27 ES ES06840026T patent/ES2361566T3/es active Active
  • 2006-11-27 WO PCT/US2006/061254 patent/WO2007062413A2/en not_active Ceased
  • 2006-11-27 DE DE602006020335T patent/DE602006020335D1/de active Active
  • 2006-11-27 AT AT06840026T patent/ATE499098T1/de not_active IP Right Cessation
  • 2006-11-27 AU AU2006318226A patent/AU2006318226A1/en not_active Abandoned
  • 2006-11-27 EP EP06840026A patent/EP1962843B1/en active Active
  • 2006-11-27 JP JP2008542534A patent/JP2009517403A/ja active Pending
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