WO2008034346A1 - Composition et méthode de traitement de tumeurs - Google Patents
Composition et méthode de traitement de tumeurs Download PDFInfo
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- WO2008034346A1 WO2008034346A1 PCT/CN2007/002671 CN2007002671W WO2008034346A1 WO 2008034346 A1 WO2008034346 A1 WO 2008034346A1 CN 2007002671 W CN2007002671 W CN 2007002671W WO 2008034346 A1 WO2008034346 A1 WO 2008034346A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
- A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
- A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
- A61K47/548—Phosphates or phosphonates, e.g. bone-seeking
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- 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
- A61K31/04—Nitro compounds
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- 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
- A61K31/045—Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
- A61K31/05—Phenols
- A61K31/06—Phenols the aromatic ring being substituted by nitro groups
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- 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
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
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- 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
- A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
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- 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
- A61K31/28—Compounds containing heavy metals
- A61K31/32—Tin compounds
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- 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
- A61K31/53—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with three nitrogens as the only ring hetero atoms, e.g. chlorazanil, melamine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K33/00—Medicinal preparations containing inorganic active ingredients
- A61K33/24—Heavy metals; Compounds thereof
- A61K33/243—Platinum; Compounds thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Definitions
- compositions and methods for treating tumors are provided.
- the present invention relates to compositions and methods for treating tumors in mammals, particularly humans. More particularly, a tumor therapeutic composition for intravenous administration is provided, which includes a tumor-targeting carrier, an anticancer drug, and an agent that enhances an immune inflammatory response. Methods of treating tumors by administering these compositions are also provided.
- Surgery is the traditional method of removing all or part of a tumor from the body. Surgery is generally the only effective way to treat early cancer. However, more than 50% of current cancer patients have become advanced in diagnosis, and they are no longer candidates for effective surgical treatment. Even in patients who can undergo surgery, the operation of the surgical procedure and the squeezing of the tumor may cause the tumor cells to fall off and cause tumor metastasis through blood circulation. Most cancer patients do not die from a tumor at the time of diagnosis or surgery, but die from tumor metastasis and recurrence.
- Radiotherapy is only effective for local cancers in the early and middle stages of cancer, and is not effective for advanced cancers with metastasis.
- Chemotherapy is a common and effective method, but has serious negative effects such as vomiting, leukopenia (WBC), hair loss, weight loss and other toxic effects.
- WBC leukopenia
- Many cancer patients cannot successfully complete the entire chemotherapy process because of severe toxic side effects.
- Quite a few cancer patients die from the toxic side effects of chemotherapy because they are intolerant of the toxic side effects of chemotherapy.
- the great side effects of anticancer drugs are due to the low targeting specificity of anticancer drugs. The drug reaches the majority of the patient's normal organs and the intended target tumor through circulation.
- the characteristics of low targeting specificity only a small part of the drug can correctly act on the target tissue, most of the drugs act on non-target tissues and cause toxic side effects, and also reduce the effectiveness of chemotherapy.
- the effectiveness of chemotherapeutic drugs further reduces the efficacy of anticancer drugs due to their short stagnation time in the target tumor. Therefore, improving the targeting of drugs is the only way to increase the retention rate of tumors and the local killing rate of tumors.
- Immunotherapy a cancer vaccine comprising the use of such autologous vaccines effective tumor load less than 10 8 tumor cells in cancer patients. Immunotherapy is often used as an adjunct therapy in combination with other therapies such as surgery, radiation therapy and chemotherapy to remove any residual tumor cells from the body. Immunotherapy and the use of cancer vaccines have not proven to be effective for tumor cells greater than 5X10 9 to 10 11 tumor cells, which is typical in patients with mild metastatic symptoms.
- autologous tumor vaccination requires complicated procedures and requires the treatment of each patient's tumor specimens, which cannot meet the patient's needs in clinical practice.
- the ideal cancer treatment should be to stimulate the body's immune ability to eradicate systemic microscopic tumors at multiple sites in the body while specifically targeting tumor cells and non-tumor cells, while the carrier-targeted drug is used to treat the primary tumor. It plays a role in the treatment and prevention of tumor metastasis.
- the object of the present invention is to provide such a cancer treatment method.
- the object of the present invention is to provide a vector for the treatment of primary tumors or multiple tumors of the whole body, and to stimulate the in vivo immunity to eradicate systemic microscopic tumors (subclinical foci) at multiple sites in the body, and specifically distinguish tumors. Cancer treatment methods for cells and non-tumor cells.
- the present invention provides a composition comprising: a) an oxidizing or reducing agent; b) a targeting carrier; c) an anticancer drug; and d) a hapten.
- the compositions provided herein may comprise a) an oxidizing agent; b) a targeting carrier agent; c) an anticancer drug; and d) a hapten.
- the compositions provided by the invention may comprise a) a reducing agent; a targeted carrier agent; c) an anticancer drug; and d) a hapten.
- the oxidizing or reducing agent, targeting carrier, anticancer drug and hapten are formulated as a single pharmaceutical composition or each is formulated as a separate pharmaceutical composition.
- the oxidizing agent is selected from the group consisting of stannous chloride (SnCl 2 ); stannous sulfate (SnS0 4 ); stannous sulfite (SnS0 3 ); - tin oxide (SnO); Tin (Sn0 2 ); sodium stannate (Na 2 SnO 3 ) ; sodium stannate (Na 2 Sn0 2 ); stannous chloride (SnCl 2 ); tin tetrachloride (SnCl 4 ); thiostannate (SnS 3 ) ; stannous sulfide (SnS).
- SnCl 2 stannous chloride
- SnS0 4 stannous sulfate
- SnS0 3 stannous sulfite
- SnO - tin oxide
- Tin Sn0 2
- sodium stannate Na 2 SnO 3
- sodium stannate Na 2 Sn0 2
- the reducing agent is selected from the group consisting of a low oxygen content reducing agent and a non-nitrogen compound tirapazamine (SR-4233).
- the low oxygen content reducing agent is nitroimidazole.
- the targeted carrier agent is any carrier capable of carrying a drug to a targeted tissue, Sodium Dimercaptosuccinate (DMSA-III); Sodium Dimercaptosuccinate (DMSA-V); Sodium Pyrophosphate and Stannous Chloride for Injection (PYP); Methylene diphosphonate Injection (MDP) ); polymeric albumin; thioethylglycine; Pentetic Acid and Stannous Chloride (DTP A); sodium sulphate (Sodium Glucoheptonate and Stannous Chloride); stannous cysteine Ethyl (L, L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); Exametazime (HMPAO); Etifenin and Stannous Chloride; Sodium Phytate and Stahnous Chloride; Methoxyisobutyl isocyanide [Cu(MIBI) 4 BF 4 ](MIBI); Methyl-L-tyrosine (a
- the anticancer drug is any drug that can be used to treat cancer, cisplatin, carboplatin, calcium leucovorin, vincristine, methotrexate, fluorouracil, cytarabine , cyclophosphamide, epirubicin, instant doxorubicin, mitomycin, etoposide, pingyangmycin, and so on.
- the hapten is selected from the group consisting of trinitrophenol (TNP), dinitrophenol (DNP), N-iodoacetyl-N, and one (5-sulfonic acid 1-naphthalene) Ethylene diamide (AED), dinitrofluorobenzene (DNFB), Ovabulin (OVA), albumin (album).
- the composition further comprises an anti-tumor agent.
- the anti-tumor in the composition is an anti-angiogenic agent.
- the anti-angiogenic agent is selected from the group consisting of a basement membrane degradation inhibitor, a cell migration inhibitor, an endothelial cell proliferation inhibitor, an inhibitor of three-dimensional structure and potency establishment .
- the anti-angiogenic agent is selected from the group consisting of an angiogenesis inhibitor gene, an angiogenesis chemokine gene, AGM-1470 (T P-470), angiostatin steroid, angiostatin, anti- ⁇ 3 antibody, anti-alkaline fibroblast growth factor antibody, anti-IL-1 antibody, anti-TNF-ot antibody, anti-VEGF antibody, acinolamine, azathiophene, BB-94, BB-2516, basic FGF-soluble Receptor, Carboxyaminotriazole (CAI), Cartilage Derivative Inhibitor (CDI), Chitin, Chloroquine, Cisplatin, CM101, Cortisone/Heparin, Cortisone/hyaluroflan, cortexolone/heparin, CT-2584 , cyclophosphamide, cyclosporin A, dexamethasone, diclofenac/hyaluronic acid glycosamino
- the antitumor agent is selected from the group consisting of a deuteration agent, an antimetabolite, a natural product, a platinum coordination complex, an anthraquinone, a substituted urea, a Indole derivatives, corticosteroid inhibitors, certain hormones and antagonists, anti-cancer polysaccharides and certain herbal extracts such as herbal extracts.
- the anti-tumor agent is an oncogene inhibitor or a tumor suppressor gene or protein.
- the oncogene inhibitor is an anti-oncogene antibody or an anti-oncogene antisense oligonucleotide.
- the oncogene is selected from the group consisting of abl, erbA, erbB, ets, fes(fps), fgr, fins, fos, hst, intl, int2, jun, hit, B-lym, mas, met , mil(rqf), mos, myb, myc, Nm c, neu(ErbB2) , ral(mil) , Ha-ras, Ki-ras, N-ras, rel, ros, sis, src, ski, trk
- the tumor suppressor gene is selected from the group consisting of pl6, p21, p27, p53, RB, WT-1, DCC, NF-1 and APC.
- the composition further comprises a viral vector comprising an oncogene or a tumor suppressor gene sequence.
- the viral vector is selected from the group consisting of an adenoviral vector, a prion vector and a conditionally replicating human immunodeficiency virus vector, a retroviral vector, an SV40 vector, a simple herpesvirus amplicon vector, and a poxvirus Carrier.
- the composition further comprises an accelerator that promotes the binding of the hapten and the tumor antigen of the tumor neoplasm.
- the promoter is a chelating agent or a chemical crosslinking agent.
- the chelating agent is glycyl tyrosyl-(Ne-diethylenetriaminepentaacetic acid)-lysine (GYK-DTPA) or adriamycin adipate- Dihydrazide (ADR-ADH).
- the chemical linker is a carbodiimide.
- the composition further comprises an immunoreceptor potentiator.
- the immunoreceptor synergist is selected from the group consisting of BCG, Bacillus licheniformis, Brucella abortus, dextran, levamisole, tyloron, an enzyme and non-strong virus.
- the composition of the redox agent is SnCl 2
- the targeting vector agent refers to all compounds having organ or tumor targeting.
- the redox agent in the composition is SnCl 2
- anti-cancer drug is meant all compounds having anti-cancer action.
- the redox agent in the composition is from about 0.01% (w/w) to about 35% (w/w), and the targeted carrier agent used is from about 1% (w/w) ) to about 98% (w/w), the anticancer drug used is from about 1 mg/ml to about 80 mg/ml, and the hapten used is from about 1 mg/ml to About 80 mg/ml.
- a kit comprising a composition.
- the composition comprises: a) an oxidizing or reducing agent; b) a targeting carrier; c) an anticancer drug; and d) a hapten.
- an article of manufacture comprising: i) a packaging material; ii) the above composition; iii) and one indicating that the article is a label for treating a tumor.
- the combination therapeutic comprises: a) an oxidizing or reducing agent; b) a targeting carrier; c) an anticancer drug; and d) a hapten.
- the mammal is a human.
- the targeting carrier agent is selected from the group consisting of: Sodium Dimercaptosuccinate (DMSA-III); Sodium Dimercaptosuccinate (DMSA-V) ), - Sodium Pyrophosphate and Stannous Chloride for Injection (PYP); Methylene diphosphonate injection (MDP); polymeric albumin; thioglycide; Pentetie Acid and Stannous Chloride (DTP A); Sodium Glucoheptonate and Stannous Chloride; L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); Exametazime (HMPAO); Etifenin and Stannous Chloride; Sodium Phytate and Stahnous Chloride; methoxyisobutyl isocyanide [Cu(MIBI) 4 BF ](MIBI) ; methyl-L-tyrosine (a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile);
- the anticancer drug is selected from the group consisting of: all drugs useful for the treatment of cancer, cisplatin, carboplatin, calcium leucovorin, vincristine, methotrexate, fluorouracil, cytarabine, Cyclophosphamide, epirubicin, instant doxorubicin, mitomycin, etoposide, pingyangmycin, and the like.
- the hapten is selected from the group consisting of: trinitrophenol (TNP), dinitrophenol (DNP), N-iodoacetyl-N'-(5-sulfonate-1-naphthyl) Ethylene diamide (AED), dinitrofluorobenzene (DNFB), Ovabulin (OVA) and albumin ( Albumin).
- TNP trinitrophenol
- DNP dinitrophenol
- AED N-iodoacetyl-N'-(5-sulfonate-1-naphthyl) Ethylene diamide
- AED dinitrofluorobenzene
- OVA Ovabulin
- Albumin Albumin
- the oxidizing agent is selected from the group consisting of: stannous chloride SnCl 2 ; stannous sulfate SnS0 3 ; — tin oxide SnO; tin dioxide Sn0 2 ; sodium stannate Na 2 SnO 3 ; sodium stannous Na 2 Sn0 2 ; stannous chloride SnCl 2 ; tin tetrachloride SnCl 4; thiostannate SnS 3 ; stannous sulfide SnS.
- the composition further comprises a chelating agent which is glycyl tyrosyl-(Ne-diethylenetriaminepentaacetic acid)-lysine (GYK-DTPA) or adriamycin Adipic acid dihydrazide (ADR ⁇ ADH) o
- a chelating agent which is glycyl tyrosyl-(Ne-diethylenetriaminepentaacetic acid)-lysine (GYK-DTPA) or adriamycin Adipic acid dihydrazide (ADR ⁇ ADH) o
- the composition further comprises a chemical crosslinker which is a carbodiimide.
- the use further comprises the use of an immune response potentiator.
- the immune response potentiator is selected from the group consisting of BCG, Bacillus licheniformis, Brucella abortus extract, dextran, levamisole, tylosonol, enzyme, non-pathogenic sexual viruses, polysaccharides and herbal extracts.
- the enzyme is selected from the group consisting of Vibrio cholerae neuraminidase (VCN), papain, beta-galactosidase and concanavalin A.
- VCN Vibrio cholerae neuraminidase
- papain beta-galactosidase
- beta-galactosidase concanavalin A.
- the redox agent, targeting carrier, anticancer drug and hapten may be formulated as a single pharmaceutical composition, or separately formulated as a composition of each drug.
- the targeting carrier agent may be two or more, and the two or more targeting carrier agents and one anticancer drug may be formulated into a single pharmaceutical composition, or The formulations are separately formulated in the form of a composition of each drug.
- the anticancer drug may be two or more, and the two or more anticancer drugs and a targeting carrier agent may be formulated into a single pharmaceutical composition, or respectively.
- the formulation is formulated in the form of a composition of each drug.
- the oxidizing or reducing agent, the targeting carrier, and the anticancer drug can be formulated together into a single pharmaceutical composition.
- the oxidizing or reducing agent, targeting carrier, and hapten can be formulated together into a single pharmaceutical composition.
- one of the two or more anticancer drugs may be a hapten.
- the hapten is nitroimidazole, trinitrophenol (TOP), dinitrophenol (DNP), N-iodoacetyl-N'-(5-sulfonate 1 Mono-naphthyl)ethylenediamide (AED), dinitrofluorobenzene (DNFB), Ovabulin (OVA) or albumin (albumin).
- the composition further comprises an anti-tumor agent.
- the anti-tumor agent is an anti-angiogenic agent.
- the antitumor agent is selected from the group consisting of an alkylating agent, an antimetabolite, a natural product, a platinum coordination complex, an anthraquinone, a substituted urea , formazan derivatives, corticosteroid inhibitors, hormones and antagonists.
- the anti-tumor agent is an oncogene inhibitor or a tumor suppressor gene or protein.
- the oncogene inhibitor is an anti-oncogene antibody or an anti-oncogene antisense oligonucleotide.
- the oncogene is selected from the group consisting of abl, erbA, erbB. Ets, fesffps), f, fms, fos, hst, intl, int2, jun, hit, B-lym, mas, met, mxl(raf), mos, myb, myc, N-myc, neu(ErbB2), ral (mil), Ha-ras, Ki-ras 'N-ras, reh ros, sis, src, ski, trk and mouth>.
- the tumor suppressor gene is selected from pl6, P 21, p27, p53 , RB, WT- 1, DCC, NF- 1 Wo port APC.
- the composition further comprises a viral vector comprising an oncogene or a tumor suppressor gene sequence.
- the viral vector is selected from the group consisting of an adenoviral vector, a prion vector and a conditionally replicating human immunodeficiency virus vector, a retroviral vector, an SV40 vector, a simple herpesvirus amplicon vector, and a poxvirus Carrier.
- the tumor for treatment is selected from the group consisting of adrenal gland, anus, auditory nerve, bile duct, bladder, bone, bone metastases, brain, breast, central nervous system, cervix, colon, ear, uterine mucosa , esophagus, eyelids, eyelids, fallopian tubes, gastrointestinal bundles, head and neck, heart, kidney, throat, liver, lungs, palate, mandibular jaw, maxilla, mouth, nasopharynx, nose, mouth, ovary, pancreas, parotid gland, Penis, auricle, pituitary, prostate, rectum, retina, salivary gland, skin, small intestine, spinal cord, stomach, testis, thyroid, tonsil, urethra, uterus, vagina, vestibular cochlear nerve, and vulvar tumor, various cancerous lymph nodes and lymph nodes Metastatic disease 'focal and malignant lymphoma.
- the tumor for treatment is a solid tumor, but is not limited to a solid tumor.
- the solid tumor has a size greater than 10 8 cells.
- the solid tumor has a size from about 5 x 109 to about 10 11 cells.
- the composition is administered to a tumor by intravenous or direct injection. In one use of the invention, the composition is administered to a tumor by a combination with a surgical procedure.
- the invention also provides a method of treating a tumor in a mammal comprising administering to the mammal an effective amount of a therapeutic composition comprising: a) an oxidizing or reducing agent; b) a targeting carrier; Cancer drug; and d) hapten.
- a therapeutic composition comprising: a) an oxidizing or reducing agent; b) a targeting carrier; Cancer drug; and d) hapten.
- the therapeutic composition comprises: a) an oxidizing agent; b) a targeting carrier agent; c) an anticancer drug; and d) a hapten
- the therapeutic composition comprises: a) a reducing agent; b) targeting a carrier agent; c) an anticancer drug; and d) a hapten.
- the oxidizing or reducing agent, targeting carrier, anticancer drug and hapten are formulated in a single composition.
- the oxidizing agent or reducing agent, the targeting carrier agent, the anticancer drug, and the hapten are each formulated as separate compositions, and they are used after being combined together before administration.
- the oxidizing or reducing agent, the targeting carrier agent and the anticancer drug are formulated into a single composition, and the oxidizing or reducing agent, the targeting carrier agent and the hapten are It is formulated into another single composition, and the two compositions are combined before being applied.
- the mammal to be treated is a human.
- the tumor to be treated is selected from the group consisting of adrenal gland, anus, auditory nerve, bile duct, Bladder, bone, bone metastases, brain, breast, central nervous system, cervix, colon, ear, uterine mucosa, esophagus, eyelid, eyelid, fallopian tube, gastrointestinal bundle, head and neck, heart, kidney, throat, liver, Lung, upper jaw, mandibular, maxillary, mouth, nasopharynx, nasal, oral, ovary, pancreas, parotid gland, penis, auricle, pituitary, prostate, rectum, retina, salivary gland, skin, small intestine, spinal cord, stomach, testis, Thyroid, tonsil, urethra, uterus, vagina, vestibular cochlear and vulvar and lymphoid and lymph node metastases and malignant lymphoma of various cancers.
- Figure 1 shows the results of flow cytometry, which shows that Bruceantin-Adm-DNP chelate has a significantly better therapeutic effect on mouse tumors compared to the control group (only doxorubicin) (40% vs. 28%) ). See Example 3 below.
- the upper panel in Figure 1 is the control group, and the lower panel in Figure 1 is the treatment group.
- the present invention combines chemotherapy and immunotherapy to provide a systemic targeted therapy for a primary tumor or a systemic multiple tumor, while stimulating in vivo immunity to eradicate systemic microscopic tumors at multiple sites in the body.
- This can be achieved by combining the carrier targeted to the tumor with the chemotherapeutic agent to form a conjugate, and combining the tumor-targeting carrier with the immunoadjuvant to form a conjugate, and the carrier-chemistry
- the drug and the carrier-immunological adjuvant are administered for administration; or, the carrier, the chemotherapeutic drug and the immunological adjuvant can be organically combined to form a conjugate.
- the chemotherapeutic drug and the immunological adjuvant are delivered to the tumor site intravenously (they can At the same time, the tumor site is reached.
- the chemotherapeutic drug kills the tumor, and the immunoadjuvant acts to modify the tumor decomposition product or the tumor to degrade the protein.
- the product thus obtained can be extracted from the major histocompatibility complex (MHC).
- MHC major histocompatibility complex
- the invention can recognize and generate an immune response for immune cells, and thus has the immunological effect of tumor-specific immune antigen.
- the invention plays a role in enhancing the immunogenicity of the tumor, and finally plays the role of immunotherapy, thereby enhancing the anticancer effect.
- reduce the dose and side effects of chemotherapy make up for the lack of chemotherapy, and reduce the recurrence of tumors. Rate, or prevent metastasis of the tumor, it is even possible to treat tumor metastases.
- a redox agent such as stannous chloride (SnCl 2 ) is mainly utilized.
- a pro-tumor compound such as Methylene diphosphonate Injection (MDP) forms a conjugate with an anticancer drug such as cytarabine and an immunoadjuvant DNP.
- MDP Methylene diphosphonate Injection
- the MDP-cytarabine-DNP conjugate can be effectively carried into the bone tumor tissue, thereby allowing the anticancer drug cytarabine to exert an anticancer effect, and the DNP acts as an immunoadjuvant. Modification of antigenic effects.
- an oxidizing agent or a reducing agent-promoted reaction may be carried out at room temperature, for example, at room temperature to form a useful conjugate or chelate, such as a coupling of a carrier and a drug.
- a conjugate or chelate of a substance or chelate, a carrier and a hapten may be carried out at room temperature, for example, at room temperature to form a useful conjugate or chelate, such as a coupling of a carrier and a drug.
- the present invention provides a composition for the treatment of tumors, which can be administered intravenously, including a tumor tissue targeting agent, an agent having a killing effect on tumor tissues, and an inflammatory reaction capable of increasing the mass of the tissue to be killed.
- Reagents preferred are those comprising four components (referred to as four-in-one or FIO), SP, including one or more oxidizing agents and/or reducing agents, tumor tissue agents and anti-drugs.
- FIO four-in-one
- SP including one or more oxidizing agents and/or reducing agents, tumor tissue agents and anti-drugs.
- Cancer preparations as well as haptens.
- These compositions are useful for treating tumors, such as solid tumors. Accordingly, the present invention also provides methods of using these compositions for treatment.
- compositions of the present invention have great applicability in the treatment of a variety of neoplastic tumors, tumors and cancers, particularly solid tumors which are not effectively treated by conventional cancer treatment methods such as surgery, radiation therapy, chemotherapy and immunotherapy.
- the present invention provides methods and compositions for treating malignancies, tumors, and cancer. These methods include the use of a composition comprising one or more oxidizing or reducing agents, a tumor tissue targeting agent and an anti-cancer agent and a hapten that reduces, reduces, ameliorates or prevents neoplastic tumors, tumors and cancer; Or remain in a state of clinical or diagnostically marked relief, clinical symptoms or diagnostic signs associated with neoplastic tumors, tumors, and cancer, especially with traditional cancer treatments such as surgery, radiation therapy, chemotherapy, and immunotherapy. Solid tumor related.
- the composition can be administered alone or in combination with other methods of treating neoplastic tumors, tumors and cancer.
- Treatable neoplastic tumors, tumors and cancers include, but are not limited to, adrenal gland, anus, auditory nerve, bile duct, bladder, bone, brain, breast, bruccal, central nervous system, cervix, colon, ear, endometrium , esophagus, eyelids, eyelids, fallopian tubes, gastrointestinal tract, head and neck, heart, kidney, throat, liver, lungs, mandible, mandibular, maxilla, mouth, nasopharynx, nose, mouth, ovary, pancreas, Parotid gland, penis, auricle, pituitary, prostate, rectum, retina, salivary gland, skin, small intestine, spinal cord, stomach, testis, thyroid, tonsil, urethra, uterus, vagina, vestibular cochlear, vulvar neoplasm, various cancers Lymphatic and lymph node metastases and malignant lymphoma.
- the treated neoplastic tumor, tumor and cancer are solid tumors.
- solid tumors including solid tumors larger than 10 8 cells, such as solid tumors from about 5 x 109 to 10" cells, the composition is particularly effective.
- the compositions of the invention may also be useful for other solid tumors. It is vaild.
- the composition provided can improve the therapeutic effect of cancer treatment in most cancer patients, including visible tumor masses and early cancer patients who are unsuitable candidates for surgical treatment and tumors that have lost the chance of surgery are large or metastatic. Patients with advanced cancer.
- compositions provided herein may be in the form of a single pharmaceutical composition comprising one or more oxidizing and/or reducing agents, a tumor tissue targeting agent and an anticancer agent, and a hapten.
- the components contained, such as oxidizing agents and/or reducing agents, tumor tissue targeting agents, anticancer agents, and haptens, have been mixed together.
- compositions provided by the present invention comprise components such as oxidizing agents and/or reducing agents, tumor tissue targeting agents, anti-cancer agents, and haptens that have been selectively mixed together, for example, a portion of an oxidizing agent and/or The reducing agent has been mixed with the tumor tissue targeting agent and hapten A portion of the oxidizing agent and/or reducing agent has been mixed with the tumor tissue targeting agent and anticancer agent.
- the composition provided by the present invention comprises components such as an oxidizing agent and/or a reducing agent, a tumor tissue targeting agent, an anticancer agent, and a hapten in separate forms, for example, they are separately present in different forms.
- the container may be used after being mixed together immediately before administration, or they may be administered separately at shorter time intervals from each other.
- the interval between each administration is generally less than one day, preferably less than one hour, but may be longer.
- the precise sequence and timing of administration can be determined empirically.
- the dosage of the composition can be determined empirically, but is generally a dose normally used to treat neoplastic tumors, tumors, and cancer in an amount sufficient to further enhance the treatment of other neoplastic tumors.
- the composition can be packaged as a kit.
- Additional immunological agents may also be included in the composition, including, but not limited to, BCG, interferon, or the colony stimulating factor GM-CSF pretreated with a low dose of cyclophosphamide.
- the composition FIO is administered to form a vector targeted therapy that directly kills many tumor cells by an anticancer drug, resulting in shrinkage of the tumor. This reduces the tumor load value and can be used with immunotherapy and tumor vaccine treatment.
- the tumor inflamed area is formed to attract lymphocytes and other inflammatory mediators to reach the targeted tumor site.
- the attracted lymphocytes include tumor antigen presenting cells (APC), macrophages, dendritic cells (DC), and activated B cells. These lymphocytes are exposed to tumor antigens produced by lysis of tumor cells to elicit a tumor-specific immune response.
- Tumor vaccines work. Such tumor vaccines enhance the patient's own tumor immunogenicity, stimulating T lymphocytes to attack live tumor cells in and around the unkilled tumor, and to fully metastasize tumors and small potential tumors. This autologous tumor vaccine plays an important role in preventing tumor metastasis and tumor recurrence.
- additional therapeutic viruses and nucleic acids such as DNA, cDNA
- DNA, cDNA can also be included in the composition.
- these can be encapsulated in a chelate that can be fused or transfected into some retained tumor cells to produce genetically modified tumor vaccines and hybrid vaccines in situ.
- Tumor DNA and RNA obtained from tumor lysis can be transfected into dendritic cells, which directly receive tumor antigen signals.
- the combination of chemically and genetically modified intratumoral tumor vaccines produces potent antigen-specific and antigen-unspecific or costimulatory signals against tumor immune responses.
- the composition may also include other agents such as anti-angiogenic agents, radiosensitizers, and other cancer therapeutics.
- agents such as anti-angiogenic agents, radiosensitizers, and other cancer therapeutics.
- conjugates can also be formed by FIO, and anti-angiogenic agents are slowly released to inhibit the formation of microvessels required for new tumor growth.
- Antitumor (anti-cancer) agents for use in the compositions and methods include, but are not limited to, anti-angiogenic agents, alkylating agents, antimetabolites, natural products, platinum coordination complexes, anthracenediones, substituted Urea, Methyl hydrazine derivatives, adrenal cortex inhibitors, hormones and antagonists, oncogene inhibitors such as anti-cancer gene antibodies or anti-oncogene antisense oligonucleotides, anti-cancer polysaccharides, or herb extracts such as Chinese herbal medicine extract Things.
- Anti-angiogenic agents include, but are not limited to, basement membrane degradation inhibitors, cell migration inhibitors, endothelial cell proliferation inhibitors, three-dimensional tissue and construct potency inhibitors, angiogenesis genes, angiogenesis chemical factor genes, AGM-1470 ( TNP-470), vasopressin steroid, angiostatin, anti-avfi3 antibody, anti-basic fibroblast growth factor antibody, IL-1 antibody, TNF- ⁇ antibody, VEGF antibody, auranofin , azathioprine, BB-94, BB-2156, basic soluble FGF receptor, carboxyaminotriazole (CAI), cartilage-derived inhibitor (CDI), chitin, chloroquine, cisplatin, CM101 , cortisone/heparin, cortisone/hyaluroflan, 11-deoxysitol/heparin, CT-2584, cyclophosphamide, cyclosporin, dexamethasone, diclofe
- the compositions of the present invention comprise a single composition comprising one or more oxidizing and/or reducing agents, a tumor tissue targeting agent and an anti-cancer agent and a hapten, and the resulting composition can be used
- the drug is delivered in the form of an injection, or includes three compositions, one containing an oxidizing agent or a reducing agent, the other containing a tissue-targeting agent and an anticancer drug, and one containing a hapten, each of which is pharmaceutically acceptable.
- the carrier or excipient received is in a form that can be injected, or includes four compositions, one containing an oxidizing or reducing agent, the other containing a tissue-targeting formulation, the other containing an anti-cancer drug, and one containing a hapten. Each is admixed with a pharmaceutically acceptable carrier or excipient to form an injectable form. Specific medical procedures, pharmaceutical compositions and kits are also provided.
- a composition comprising: a) an oxidizing or reducing agent; b) a tissue targeting agent; and c) an anti-tumor (anti-cancer) agent, such as Arc -C, and d) - a hapten DNP or TNP.
- an anti-tumor (anti-cancer) agent such as Arc -C, and d) - a hapten DNP or TNP.
- a method of treating a tumor preferably a solid tumor, in a mammal, preferably a human.
- Including tumor targeting is the administration of an effective amount of a hapten and a medicinal therapeutic that causes inflammatory necrosis of the tumor neoplasm, thereby producing an autoimmune response to the tumor, treating the tumor neoplasm.
- the autoimmune response to a tumor can be a humoral and/or cellular immune response.
- the haptens used in the present invention include, but are not limited to, trinitrophenol (TNP), dinitrophenol (DNP), N-iodoacetyl- ⁇ '- (5-sulfonate-1-naphthyl) Ethylene diamide (AED), dinitrofluorobenzene (DNFB) and Ovabulin (OVA).
- TNP trinitrophenol
- DNP dinitrophenol
- AED N-iodoacetyl- ⁇ '- (5-sulfonate-1-naphthyl) Ethylene diamide
- AED N-iodoacetyl- ⁇ '- (5-sulfonate-1-naphthyl) Ethylene diamide
- DNFB dinitrofluorobenzene
- OVA Ovabulin
- the oxidizing agents used in the present methods and compositions include, but are not limited to, stannous chloride (SnCl 2 ); stannous sulfate (SnS0 4 ); stannous sulfite (SnS0 3 ); - tin oxide (SnO); tin dioxide (Sn0 2 ); sodium stannate (Na 2 SnO 3 ) ; sodium stannate (Na 2 Sn0 2 ); stannous chloride (SnCl 2 ); tin tetrachloride (SnCl 4 ) ; thiostannate ( SnS 3 ); stannous sulfide (SnS).
- the reducing agents used in the present methods and compositions include, but are not limited to, hematoxylin, a low oxygen containing reducing agent such as a nitroimidazole, and a non-nitro compound SR 4233.
- Tissue targeting agents for use in the present compositions and treatments include, but are not limited to, niXSodium Dimercapto succinate (DMSA-III); Sodium Dimercaptosuccinate (DMSA-V) Sodium Pyrophosphate and Stannous Chloride for Injection (PYP); Methylene diphosphonate injection (MDP); polymeric albumin; thioglycide; Sodium Glucoheptonate and Stannous Chloride; L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)) ; Exametazime (HMPAO); Etifenin and Stannous Chloride; Sodium Phytate and Stahnous Chloride; methoxyisobutyl isocyanide [ Cu(MIBI) 4 BF 4 ](MIBI) ; methyl-L-tyrosine (a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile); nitroimidazole (2-nitroimidazole); mono
- the composition also includes an accelerator, the method further comprising administering an accelerator that promotes the attachment of the hapten and the tumor antigen of the tumor neoplasm.
- Promoters include, but are not limited to, chelating agents such as glycyl tyrosyl-(Ne-diethylenetriaminepentaacetic acid)-lysine (GYK-DTPA) or adriamycin adipate-diacyl ⁇ (ADR-ADH), or a chemical crosslinking reagent such as carbodiimide.
- the composition also includes an immune response potentiator, further comprising a method of administering an immune response potentiator on the tumor.
- the immune response potentiator includes, but is not limited to, polysaccharides, herbal extracts such as herbal extracts, BCG, Bacillus licheniformis, an enzyme such as Vibrio cholerae neuraminidase (VCN), papain, beta - Galactosidase and concanavalin A, and non-pathogenic viruses such as non-pathogenic Newcastle disease virus.
- VCN Vibrio cholerae neuraminidase
- papain a neuraminidase
- beta - Galactosidase and concanavalin A
- non-pathogenic viruses such as non-pathogenic Newcastle disease virus.
- a nucleic acid encoding the oncogene or an encoded gene product can also be administered, or included in the composition to increase the immune response.
- oncogenes include, but are not limited to, ab erbA, erbB, ets, fes(fps), fgr, fins, fas, hst, intl, int2, jun, hit, B-lym, mas, met, Mtl(raf), mos, myb, myc, N-myc, neu(ErbB2), ral(mil), Ha-ras, Ki-ras, N-ras, rel, ros, sis, src, ski, rA: and Ys.
- compositions and methods can also be administered simultaneously, sequentially or in combination with chemotherapy, such as further comprising two or more anti-tumor agents or administering the compositions provided herein in a tissue targeting agent composition, and then Preferably, the combination chemotherapy is administered on the same day, the same week, or other cycle.
- the present method is expected to also be combined with gene therapy, e.g., further comprising a tumor suppressor gene such as pl6, p21, P 27, p53 , RB, WT-1, DCC, NF-1 and APC in the composition.
- a tumor suppressor gene such as pl6, p21, P 27, p53 , RB, WT-1, DCC, NF-1 and APC in the composition.
- the tumor suppressor gene is in a viral vector such as an adenoviral vector, a prion vector and a conditionally replicating human immunodeficiency virus vector.
- a specific composition is applied in the treatment, wherein stannous chloride is used as an oxidizing agent, MDP is used as a bone tissue targeting agent, ARC-C is used as an anticancer agent and TOP is used as a hapten, and is used for treating bone cancer. And malignant tumor bone metastasis.
- each component can be present in a variety of different amounts.
- the oxidizing or reducing agent used is from about 0.01% (w/w) to about 35% (w/w)
- the targeting compound used is from about 1% (w/w) to about 98%.
- the chemotherapeutic agent (e.g., anticancer agent) used is from about 1 mg/ml to about 80 mg/ml
- the hapten used is from about 1 mg/ml to about 80 mg/ml.
- the coupling can be formed in a manner known in the art, for example by mixing at, for example, ambient temperature. Coupling can also be performed by some physical method, including low temperature, laser suspected aggregation (ILC), radio frequency induction, and radiation.
- ILC laser suspected aggregation
- the conjugate of the hapten and the anticancer drug to the tissue targeting agent is administered to the tumor neoplasm by injection.
- the hapten and anticancer drug and tissue targeting agent are administered to the tumor neoplasm by a combination with a surgical procedure.
- a method of treating a tumor comprising administering an effective amount of an anti-tumor (anti-cancer) agent, such as Ara-C, a hapten, a redox agent, tissue targeting, in situ.
- an anti-tumor (anti-cancer) agent such as Ara-C, a hapten, a redox agent, tissue targeting, in situ.
- Agent tumor targeting agent, which is capable of targeting tissues that reach the tumor, thereby treating the tumor.
- a method of treating a tumor, particularly a solid tumor, in a mammal, preferably a human comprising administering an effective amount of an anti-tumor (anti-cancer) agent, such as Am-C, in situ, A hapten, a redox agent, Sodium Dimercaptosuccinate (VSA-V), is a tumor tissue targeting agent that can reach soft tissue tumors, thereby treating soft tissue tumors.
- an anti-tumor (anti-cancer) agent such as Am-C
- VSA-V Sodium Dimercaptosuccinate
- a method of treating a tumor, particularly a solid tumor comprising administering an effective amount of an anti-tumor (anti-cancer) agent, such as Am-C, an immunoadjuvant DNP, a redox agent, is provided in situ.
- an anti-tumor (anti-cancer) agent such as Am-C, an immunoadjuvant DNP, a redox agent
- Pentetic Acid and Stannous Chloride (DTPA) acts as a tumor tissue targeting agent and can reach kidney tumors, thereby treating renal tissue tumors.
- a method of treating a tumor comprising administering an effective amount of an anti-tumor (anti-cancer) agent in situ, such as Ara-C, a redox agent, a thiophene medicine
- an anti-tumor agent in situ, such as Ara-C, a redox agent, a thiophene medicine
- the cassette acts as a tumor tissue targeting agent and a DNP immunoadjuvant that can reach the tumor tissue, thereby treating the tumor.
- a method of treating a tumor comprising administering an effective amount of an anti-tumor (anti-cancer) agent, such as Ara-C, a redox agent, sodium phytate (in situ), is provided.
- an anti-tumor (anti-cancer) agent such as Ara-C, a redox agent, sodium phytate (in situ)
- PHY As a liver tissue targeting agent (or lymphatic targeting agent) and a DNP immunoadjuvant, it can reach tumor tissues, thereby treating liver tumors (or malignant tumors of the lymphatic system).
- a method of treating a tumor, particularly a solid tumor comprising administering an effective amount of an anti-tumor (anti-cancer) agent, such as Ara-C, a redox agent, etifenin, is provided by sputum administration.
- an anti-tumor (anti-cancer) agent such as Ara-C
- a redox agent etifenin
- the kit acts as a hepatobiliary system targeting agent and a DNP immunoadjuvant that can reach the hepatobiliary tissue, thereby treating malignant tumors of the hepatobiliary system.
- a method of treating a tumor comprising administering an effective amount of an anti-tumor (anti-cancer) agent, such as Ara-C, a redox agent, a stannous double half, is provided in situ.
- an anti-tumor (anti-cancer) agent such as Ara-C, a redox agent, a stannous double half
- an anti-tumor agent such as Ara-C, a redox agent, a stannous double half
- a method of treating a tumor, particularly a solid tumor, in a mammal, preferably a human comprising injecting an effective amount of a hapten, a tissue targeting agent, an anticancer agent, and An oxidizing agent and/or a reducing agent, thereby producing an autoimmune response to the tumor and treating the tumor.
- the present invention is mainly used for intravenous administration of a tumor for treating a tumor
- 2 The present invention may be a carrier, a drug and an adjuvant integrated, and may be a conjugate or other form of chelation
- 3 In the conjugate of the present invention, the carrier plays its role, carrying the drug to the targeted site (the tumor or the organ where the tumor is located), and the drug and the adjuvant respectively act to achieve the purpose of treatment, and the drug kills the tumor.
- the adjuvant modifies the fragments of the tumor killed by the drug to function as a tumor vaccine
- the redox agent plays a role in forming a conjugate and does not participate in the treatment of the tumor
- the present invention is not limited to the above theoretical mechanism, nor is it limited to any other theoretical mechanism.
- the present invention provides effective methods and materials for treating tumors, and the present invention also extends to the various methods and materials described. These are part of the invention in terms of valence methods and materials.
- the present invention provides compositions and methods for use in systemic tumor-specific chemotherapy-induced immunotherapy involving tumor neoplasms, tumors, and cancer tissues, preferably in combination with intratumoral, gene therapy, radiation therapy.
- systemic immunotherapy is induced, which is to treat these tumors.
- the following vector chemotherapy is an effective method for the treatment of tumors, and at the same time, it can induce a certain immunotherapeutic effect, and simultaneously reach the tumor by the carrier with the hapten and the chemotherapeutic drug.
- the site can; greatly enhance chemotherapy-induced immunotherapy, which has a more positive effect on the treatment of tumor neoplasms, tumors and cancer.
- chemotherapy can also induce structural changes in m-cell surface, extracellular matrix, and cell lysis, releasing components of tumor cells, ie, local inflammation.
- This inflammatory effect together with the added hapten, further produces more complex immunogens, wherein the hapten binds to a tumor-specific antigen produced by lysis of tumor cells by agglomeration.
- Inflamed areas attract different lymphoid cells, such as tumor antigen presenting cells (APCs), macrophages, dendritic cells (DCs), and activated B cells, which accumulate in the inflamed area and interact with tumor antigens, eg, Complex tumor antigens, DNA, RNA and other components released from cell lysis.
- APCs tumor antigen presenting cells
- DCs dendritic cells
- activated B cells activated B cells
- tumor-specific immune responses including humoral, cellular, and complement-mediated responses.
- This localized tumor-specific immune response is further enhanced by the presence of live tumor neoplastic cells that are present in adjacent proximity and that are not killed by the initial coagulation.
- subsequent tumor-specific immune responses enhance the effects of chemotherapy (in situ vaccination) and extend to metastatic tumor neoplasms, preventing tumor cell recurrence and metastasis.
- composition and method can also achieve a therapeutic effect by the action of the carrier on the tissue region including the tumor tissue region and the action of the tumor extracellular matrix (EM).
- EM tumor extracellular matrix
- tumor cells are surrounded by extracellular matrices such as collagen, fibronectin, proteoglycans (proteins/carbohydrates), hyaluronic acid and other high molecular weight substances. It has been shown that tumor cells differ from the extracellular matrix of normal cells.
- the tumor-specific immune response can be enhanced by in situ administration or by a composition comprising a carrier compound, a promoter that promotes binding of the hapten to the tumor antigen, an immunopotentiator, an antitumor agent, an oncogene product, or a combination of any of these.
- the intended treatment can be used alone or in combination with other cancer treatments such as, but not limited to, surgery, radiation therapy, chemotherapy, and conventional immunotherapy.
- other cancer treatments such as, but not limited to, surgery, radiation therapy, chemotherapy, and conventional immunotherapy.
- such treatment can be used with chemotherapy by the addition of various anti-tumor agents, such as anti-angiogenic agents, to the targeted carrier composition.
- This combination therapy is advantageous because the targeting vector increases the time that the anti-tumor agent remains in the tumor mass, exposing the tumor mass to the anti-tumor agent for a longer period of time.
- the carrier acts as a tool to control drug release.
- targeted vector chemotherapy reduces at least some or more than 50% of tumor cells within a target tumor.
- the cells killed or still alive by the antineoplastic agent can be further combined with the hapten to produce an immunotherapeutic effect.
- the treatment can be used with radiation therapy by incorporating a radiation sensitizer into the targeting carrier composition.
- the targeting vector acts as a tool to control drug release, releasing the radiation sensitizer To the still living tumor cells, increase the effect of radiation therapy.
- the treatment can be used prior to surgery.
- the targeting vector composition plays an important role in pre-treatment of the tumor, making the surgery easy to exclude tumor mass and reducing the rate of tumor metastasis.
- the treatment can be used in combination with gene therapy by adding a nucleic acid encoding the desired wild type oncogene, tumor suppressor gene, immune cytokine gene or apoptotic gene to the targeting vector composition.
- a nucleic acid encoding the desired wild type oncogene, tumor suppressor gene, immune cytokine gene or apoptotic gene to the targeting vector composition.
- Such combination therapy is advantageous because the targeting vector facilitates the introduction of these wild-type oncogenes or tumor suppressor genes into living tumor cells.
- an immunological adjuvant such as BCG
- a targeted carrier composition to increase the immune response to tumor cells.
- the immunological adjuvant can be re-injected repeatedly, such as every 2 to 4 weeks.
- Low dose Cyclosphamide such as 200 to 300 mg/m 2
- conjugate means a substance that is joined together by various actions. It includes various compositions, compounds, chelates, linkers such as, but not limited to, a conjugate of a targeting compound and ancillary drugs.
- the conjugate containing the targeting compound is a substance formed by binding the targeting agent to other substances, and the substance bound thereto is also brought into the target while being targeted to the target.
- an oxidation-reduction reaction refers to the reaction of electrons from a donor to a receptor molecule.
- an oxidizing agent refers to a reagent that accepts electrons in an oxidation-reduction reaction.
- a reducing reagent refers to a reagent that provides electrons in an oxidation-reduction reaction.
- a targeting vector refers to a compound that is capable of targeting a transport compound, that is, a compound or biological material that can partially or completely reach a particular tissue.
- a hapten refers to an antibody-specific substance that induces antibody formation unless it is combined with a carrier or molecule. Once the hapten is bound to the carrier/molecule, the antibody produced by the conjugate can recognize the hapten and/or the vector/portion.
- a hapten-carrier/molecular conjugate can also produce a specific cellular immune response.
- anti-tumor therapy refers to any treatment regimen designed to treat tumor neoplasms, tumors or cancer that reduces or ameliorates its symptoms. Prevent or reduce the severity of tumor neoplasms, tumors or cancer The treatment is also considered.
- a tumor neoplasm refers to an abnormal new growth, so synonymous with a tumor, which may be a benign tumor or a malignant tumor. Unlike hyperplasia, the proliferation of tumor neoplasms continues even without initial stimuli.
- cancer refers to a general term for a class of diseases caused by any form of malignancy.
- malignant when used in a tumor, refers to a primary tumor that has the ability to spread and metastasize, while losing growth control and positional control.
- an anti-tumor agent refers to any agent used for anti-tumor therapy.
- agents include, when used alone or in combination with other compounds, which can alleviate, reduce, ameliorate, prevent or adjust or maintain the clinical symptoms associated with neoplastic tumors, tumors or cancer or the mitigating status of diagnostic markers. They can be used in the methods, combinations and compositions provided herein.
- Anti-caries biological tumor agents include, but are not limited to, anti-angiogenic agents, deuteration agents, antimetabolites, some natural products, platinum coordination complexes, anthrones, substituted ureas, formazan derivatives, adrenocortical hormone inhibition , certain hormones and antagonists, anti-cancer polysaccharides and certain herbal extracts such as herbal extracts.
- antitumor agents or anti-tumor or anti-cancer agents
- anti-neoplastic biological tumor treatments do not include compositions containing oxidizing or reducing agents, protein denatus; and haptens, or treatment with them, but All agents and treatment modalities known to those skilled in the art to ameliorate some forms of symptoms of neoplasms, tumors or cancer are known.
- angiogenesis refers to the creation of new blood vessels from the mother's microvasculature. Angiogenesis is tightly regulated by angiogenic stimuli and inhibitor systems. Pathological angiogenesis is caused by movement of the net balance between angiogenic stimuli and inhibitors, such as excessive production of normal or malformed angiogenic mediators, or due to the relative lack of inhibitors in the process.
- uncontrolled angiogenesis refers to pathological angiogenesis in which angiogenic stimuli affect beyond the effects of angiogenesis inhibitors.
- anti-angiogenic therapy or agent is meant to include any therapeutic regimen and compound, when used alone or in combination with other compounds, which may reduce, reduce, ameliorate, prevent or modulate or remain undesirable and/or Or uncontrolled angiogenesis associated with clinical symptoms or diagnostic markers of relief status.
- endothelin inhibitor is not considered to be “anti-angiogenic treatment or anti-angiogenic agent”.
- tumor suppressor gene refers to a gene encoding a product that normally negatively regulates the cell cycle, which must be mutated before the cell undergoes rapid division or otherwise inactive.
- tumor suppressor genes include, but are not limited to, pl6, p21, p53, RB (retinoblastoma), WT-1 (embryonic carcinosarcoma), DCC (deletion in colon cancer), NF-1 ( Neurofibrosarcoma) and APC (colon polypoid adenoma).
- oncogene refers to a variant and/or over-expressed form of a normal gene of an animal cell (proto-oncogene) that, when dominant, causes the cell to detach from normal growth inhibition, thereby acting alone or in combination with The combination of chemicals can transform cells into tumor cells.
- tumor suppressor genes include, but are not limited to, abl, erbB, ets, fes (fps), fgr, fins, fos, hst, intl, int2, jun, hit, B-lym, mas, met, mil (raf ), mos, myb, myc, N-myc, neu (ErbB2), ral (mil), Ha-ras, Ki-ras, N-ras, rel, ros, sis, src, ski, t' and w.
- antisense oligonucleotide refers to a synthetic sequence of a nucleotide base complementary to an intentional strand of mR A or double stranded DNA. Mixtures of intentional and antisense oligonucleotides can result in pairing or hybridization of the two molecules under suitable conditions. When these oligonucleotides are paired (hybridized) with mRNA, hindering protein synthesis (translation) occurs. When these oligonucleotides are paired with double-stranded DNA, inhibition of RNA synthesis (transcription) occurs. The resulting translation and/or transcriptional inhibition results in the inhibition of the synthesis of the protein encoded by the sense strand.
- an antibody includes an antibody fragment, such as a Fab fragment, which consists of the variable regions of the light and heavy chains.
- a humanized antibody refers to an antibody that has been modified to include a "human" amino acid sequence such that it is administered to a human without causing an immune response.
- Methods of preparing these antibodies are known. For example, a hybridoma expressing a monoclonal antibody has been altered by recombinant DNA technology to express the amino acid composition of the constant region therein as a human antibody-based antibody. Computer programs have been designed to determine these areas.
- haptens which promote the binding of a hapten to a tumor antigen
- agents which promote the binding of a hapten to a tumor antigen
- the cross-linking of the hapten with the tumor antigen can be a covalent bond or a non-covalent bond and can be mediated by hydrophobic, polar, ionic electrostatic or other interactions.
- immune response refers to the change in the response of an organism's immune system in response to an antigen; in vertebrates, this may include antibody production, induction of cell-mediated immunity, complement activation or The development of immune tolerance.
- immune response potentiator refers to a substance that enhances the effect of an immune response by an antigen.
- a cytokine is a factor, such as a lymphokine or a monokine, which is produced by a cell and affects the same or other cells.
- a "cytokine” is one of a group of molecules that transmit signals between cells in an immune response. Cytokines are proteins or peptides; some are glycoproteins.
- interleukin refers to a large group of cytokines produced primarily by T cells, although some are produced by mononuclear phagocytic cells or by tissue cells. They have multiple functions, but most are directly involved in guiding other cell division and differentiation. Each interleukin acts on a specific, limited cell that expresses the correct receptor for such a cytokine.
- interleukin-1 refers to an interleukin produced by a tumor antigen presenting cell (APC), which is associated with IL-6 as a costimulatory signal for T cell activation.
- the IL-1 genome includes IL-la, IL- ⁇ and IL-1 receptor antagonists (IL-lRa) (Dinarello, Eur, Cytokine Netw., 5(6): 517-522 (1994)). Each member was first synthesized as a precursor protein; the molecular weight of the IL-1 precursor (ProIL-la, ProIL- ⁇ ) was approximately 31,000 Daltons.
- IL-lRa The precursor has a leader sequence that becomes mature after cleavage and is secreted like most proteins. IL-la and IL- ⁇ are potent agonists, and IL-Ra is a specific receptor antagonist. Moreover, IL-Ra is clearly a pure receptor antagonist with no agonist activity in vitro or in vivo. Although IL-1Ra is a secreted protein, this molecule has another form that remains in the cell. It is called "intracellular" (ic) IL-lRa. ML-lRa is produced by replacing the exon encoding the signal peptide with an mRNA splicing insert of the altered IL-IRa gene. The IL-IRa form is functionally indistinguishable.
- IL-1 includes all proteins encoded by the IL-1 gene family including IL-la, IL-1 ⁇ , IL-1Ra, and icIL-IRa, or other sources or synthetically prepared Equivalent molecule. It is expected that a conserved amino acid will be substituted, but the substitution will not change its activity of IL-1. Those skilled in the art are aware of suitable conservatively substituted amino acids, and such substitutions generally do not alter the biological activity of the resulting molecule.
- amino acids in the various amino acid sequences presented herein are represented by their well-known three-letter or one-letter abbreviation. Nucleotides that occur in a variety of DNA fragments are expressed using standard single letter representations conventionally used in the art.
- therapeutic agent refers to conventional drugs and drug treatments, including vaccines, which are known to those skilled in the art.
- Radioprotectant refers to conventional drugs and drug treatments, including vaccines, which are known to those skilled in the art.
- Radioprotectant refers to conventional drugs and drug treatments, including vaccines, which are known to those skilled in the art.
- Radiotion Therapy agents are also known in the art.
- vaccine refers to any composition for active immunological prevention.
- the vaccine can be used therapeutically to treat the disease, either actively or after infection to prevent the progression of the disease or to reduce the severity of the disease.
- examples of vaccines include, but are not limited to, live bacteria of attenuated strains of bacteria or attenuated (variant or variant) strains, or microorganisms, fungi, plants, protozoa, metazoan derivatives or products. Preparation.
- Vaccine also includes protein/peptide and nucleotide based vaccines.
- cytotoxic cells refers to cells that kill virally infected target cells, target cell expression.
- serum refers to the portion of the blood liquid obtained after removal of fibrin clots and blood cells, which is distinguished from plasma in circulating blood.
- an effective amount of a compound that treats a particular disease is an amount sufficient to ameliorate or somehow reduce the symptoms associated with the disease. This amount can be administered as a single dose or as the case may be, whereby it can be effectively treated.
- the drug dose can cure the disease, but in general, the treatment is to relieve the symptoms of the disease. Repeated administration can achieve the desired symptom relief effect.
- pharmaceutically acceptable salts, esters or other derivatives of such conjugates include any salts, esters or derivatives which can be readily prepared by those skilled in the art using such derivatization methods known to those skilled in the art. They, which produce compounds that are administered to animals or humans without substantial toxic effects, either pharmaceutically active or prodrugs.
- treatment means any way in which the symptoms of one condition, disorder or disease are improved or beneficially altered. Treatment also includes the use of the compositions of the compositions discussed herein.
- an improvement in the symptoms of a particular disorder by administration of a particular pharmaceutical composition means any relief, either permanent or temporary, sustained or transient, and may be classified as or associated with administration of the composition.
- TLC thin layer chromatography
- HPLC high performance liquid chromatography
- a prodrug is a compound that, once in the body, can be metabolized or converted to a compound having a biologically active, pharmaceutically active or therapeutically active form.
- the pharmaceutically active compound is modified such that the active compound can be regenerated by metabolic processes.
- Prodrugs can be designed to alter metabolic stability or the transport properties of the drug, mask the side effects or toxicity of the drug, improve the taste of the drug or alter other characteristics or properties of the drug.
- biological activity refers to the in vivo administration of a compound, composition or other mixture, the activity of the compound in vivo or the physiological response they cause.
- biological activity includes therapeutic effects
- the pharmacological activity of these compounds, compositions and mixtures should be.
- Biological activity can be observed by in vitro systems designed to detect or utilize these activities.
- the biological activity of luciferase is its oxygenase activity, i.e., by oxidizing a substrate.
- a receptor refers to a molecule that has an affinity for a particular ligand.
- the receptor can be a naturally occurring or synthetic molecule.
- Receptors may also be referred to in the art as anti-ligands.
- receptors and anti-ligands are used interchangeably.
- the receptor can be used in its unaltered state or in the formation of aggregates with other types of molecules.
- the receptor may be attached indirectly or via a specific binder or linker, either covalently or non-covalently, or physically bonded to the binding member.
- receptors include, but are not limited to; antibodies, cell membrane receptor surface receptors and internalized receptors, monoclonal antibodies and antisera that interact with specific antigenic determinants [eg viruses, cells, or other substances], Drugs, polynucleotides, nucleic acids, peptides, cofactors, lectins, sugars, polysaccharides, cells, cell membranes, and organelles.
- receptors and applications using these receptors include, but are not limited to:
- a) enzyme a specific transporter or enzyme necessary for the survival of microorganisms, which can be used as a target for the selection of antibiotics [ligands];
- b) antibodies studies to determine the ligand binding site of an antibody molecule that binds to an epitope associated with an antigen; by mimicking the epitope sequence, the development of a vaccine based on one or more of these sequences can be led to Or lead to the development of relevant diagnostic agents or therapeutically useful compounds useful for the treatment of, for example, autoimmune diseases.
- nucleic acid determining a ligand, such as a protein or RNA, binding site;
- a catalytic polypeptide a polymer, preferably a polypeptide, which accelerates a chemical reaction comprising converting one or more reactants into one or more products; these polypeptides generally comprise at least one reactant or reaction intermediate a site of specific binding and an active functional group near the binding site, wherein the functional group is a chemically conjugated reactant [see, e.g., U.S. Patent 5,215,899] ;
- hormone receptors the identification of ligands that bind to the receptor with high affinity is useful for the development of hormone replacement therapy; for example, determining that a ligand that binds to such a receptor can lead to the development of a drug that controls blood pressure;
- Opioid receptors Identifying ligands that bind to opiate receptors in the brain is useful for developing low addictions to replace morphine and related drugs.
- an antibody includes an antibody fragment, such as a Fab fragment, which consists of the variable regions of the light and heavy chains.
- recombinant production the use of recombinant DNA technology refers to the expression of cloned DNA-encoded proteins using well-known molecular biology methods.
- a product that is substantially identical means that the properties are sufficiently similar that the relevant properties are sufficient to remain unchanged so that substantially the same product can be substituted for the product.
- the two sequences discussed encode an amino acid of the same sequence or an equivalent protein.
- the use of “equivalent” means that the two proteins or peptides have essentially the same amino acid sequence, with only conservative amino acid substitutions (see, For example, Table 1 above does not substantially alter the activity or function of a protein or peptide.
- “equivalent” refers to a property, the properties do not need to be to the same extent (e.g., the two peptides may exhibit the same type of enzymatic activity, but have different velocities), but the activities are substantially preferably the same.
- nucleotide sequences are “complementary”
- the two sequences of nucleotides are capable of hybridization, preferably less than 25%, more preferably less than 15%, even more preferably less than 5%, most Preferably there is no mismatch between the opposing nucleotides.
- the two molecules hybridize under highly stringent conditions.
- hybridization stringency to determine the percentage of mismatches is as follows:
- substantially the same or homologous or similar varies within this context, as understood by those skilled in the relevant art, generally meaning at least 70%, preferably at least 80%, more preferably at least 90%, Most preferably at least 95% identity.
- composition refers to any mixture. It can be a solution, a suspension, a liquid, a powder, a paste, an aqueous, a non-aqueous one, or any combination thereof.
- a combination refers to the union of two or more items.
- the combination comprises a composition comprising two or more components in a single mixture; it also includes two separate compositions in question.
- liquid refers to any composition that can flow.
- the liquid therefore comprises a composition in the form of a semi-solid, a paste, a solution, an aqueous mixture, a gel, a lotion, a cream, and the like.
- compositions for use in the treatment of tumors comprising: A) an oxidizing agent and/or a reducing agent; B) a targeting carrier agent; C) an anticancer drug; and D) a hapten.
- the oxidizing or reducing agent, the targeting carrier, the anticancer drug and the hapten may be formulated as a single pharmaceutical composition, or each may be separately formulated into a pharmaceutical composition.
- the oxidizing agent used is stannous chloride (SnCl 2 ); stannous sulfate (SnS0 4 ); stannous sulfite (SnS0 3 ); tin oxide (SnO); tin dioxide ( Sn0 2 ); sodium stannate (Na 2 SnO 3 ); sodium stannate (Na 2 Sn0 2 ); stannous chloride (SnCl 2 ); tin tetrachloride (SnCl 4 ) ; thiostannate (SnS) 3 ); Stannous sulfide (SnS).
- the reducing agent used is hematoxylin, a hypoxic reducing agent such as nitroimidazole or a nitrogen-free compound tirapazamine (SR-4233) (Zhang and Stevens, Melanoma Res. , 8 (6V.510-5 (1998)
- the targeting carrier compounds can be used in the composition.
- the targeting vector used is, but not limited to, Sodium Dimercaptosuccinate (DMSA-III); Sodium Dimercaptosuccinate (Sodium Dimercaptosuccinate (Sodium Dimercaptosuccinate (Sodium Dimercaptosuccinate (S)) DMSA-V)); Sodium Pyrophosphate and Stannous Chloride for Injection (PYP) ; Methylene diphosphonate Inclusion (MDP); Polymerized Albumin; Sulfur Pentetic Acid and Stannous Chloride (DTPA), sodium sulphate (Sodium Glucoheptonate and Stannous Chloride); stannous cysteine ethyl ester (L, L- Ethyl Cysteinate Dimer and Stannous Chloride (ECD) ; Exametazime (HMPAO); Etifenin and Stannous Chloride; Sodium Phytate and Stahnous Chloride; Isobutyl butyl
- the hapten used is trinitrobenzene (TOP) (Dieli et al, Int. Immunol, 9(1): 1-8 (1997)), dinitrobenzene (DNP) (Stjarnkvist et al, J. Pharm. Sci., 80(5 ⁇ : 436-40 (1991)), N-iodoacetyl-N,-(5-sulfo-1-naphthyl)ethylenediamide ( AED) (Mizuochi et al, J. Immunol, 134(2): 673-6 (1985)), Dinitrofluorobenzene (DNFB) (Claman, J. Immunol., 1160 ⁇ : 704-9 (1976)) , Ovabulin ( OVA ) (Katz et al, J. Immunol., 102 (5 ⁇ : 1319-28 (1971)), or albumin ( albumin
- composition further comprises an anti-tumor agent for use in combination with intratumoral therapy and chemotherapy.
- the anti-tumor agent used is an anti-angiogenic agent. More preferably, the anti-angiogenic agent is a basement membrane degradation inhibitor, a cell migration inhibitor, an inhibitor of endothelial cell proliferation, a tissue and an inhibitor of three-dimensional structural potency. Examples of such anti-angiogenic agents are further shown in Table 2 below.
- Subtype instance Basement membrane degrading protease inhibitor plasminogen activator (eg: ⁇ -1, ⁇ -2) metal egg lysis inhibitor white enzyme tissue inhibitors (eg, ⁇ -1 and ⁇ -2) phenylalanyl-propene Base-arginine chloromethylketone-coagulation cartilage-derived inhibitor cartilage-derived inhibitor (CDI)
- Cysteine-rich acidic secretion SPAPC secreted protein, acidic, cysteine-rich (SPAPC) acid
- Platelet activating factor inhibitor Venus venom is targeted at mast cells and macrophages
- lymphocytes solid cyclosporine-like morphine, such as: ⁇ -endorphin or sulfuric acid alcohol, anti-lymphocyte serum, radiation, AGM-1470
- the target is the extracellular matrix: peptide
- Heparin Prostaglandin inhibitors synthesize prostaglandins such as indomethacin and aspirin, ketones, mitoxantrone or bisantrene, alpha aconitate and its derivatives, ampicillin Type instance
- Placental ribonuclease inhibitor ribonuclease ribonuclease, glycine-arginine-glycine-asparagine-serine (GRGDS), actin and an anti-actin antibody inhibitor,
- PECAM-1 platelet endothelial cell adhesion molecule-1
- Endothelial cell fibroblast growth inhibitor FGF closed pit pentosan polysulfate, heparinase, proliferation inhibition protamine, somatostatin analogues, such as octreotide thrombolytics TSP1, TSP2 and TSP3
- Tumor necrosis factor interferon, interleukin TNF, IL-1, IFN- ⁇ IFN-a and macrophage derivatives, hormones and other cytokines endothelial cell inhibitors
- Growth factor antibody bFGF antibody, VEGF antibody, hepatocyte growth factor
- Chloroquine nickel manganese alloy salt, sulfadiazine, several opioids, gold compounds, dimethyl sulfoxide
- TGFpl TGF 2
- TGFp3 TGFp3
- Inhibitor oxazolone MD27032 (4-propyl-5(4-indazinyl-2(3 ⁇ )-oxazolone) basement membrane biosynthesis inhibitor cyclic adenosine monophosphate, cis-hydroxy-valine, Collagen product inhibitor
- endothelial cells are three-dimensionally composed of nicardipine, a phosphokinase C inhibitor, such as the inhibitor calphostin C and staurosporine, an intrinsic toxin, which is a mutant of aFGF fused to a Pseudomonas exotoxin. , IL-lp, IL-6, TGF-P and platelet-derived growth factor-BB, irsogladine, fenietinide, a proline analog, L-adetine-2-carboxy acid, cyclosporine, lactating stimulating hormone 16kDa fragment
- Photodynamic therapy for photocoagulation Therapeutic effects of hyperthermia on hyperthermia can be achieved by killing endothelial cells, inhibiting replication, inhibiting cell migration, or a combination of three mechanisms.
- the anti-angiogenic agent used is AGM-1470 (TNP-470), angiostatin steroid, angiostatin, anti- ⁇ 3 antibody, anti-basic fibroblast growth factor antibody , anti-interleukin-1 antibody, anti-TNF- ⁇ antibody, anti-vascular endothelial growth factor antibody, auranofin, azathioprine, strontium-94, ⁇ -2516, soluble receptor for basic fibroblast growth factor, Carboxamide amide triazoles (CAI), cartilage-derived inhibitors (CDI), chitin, chloroquine, cisplatin, CM10K cortisone/heparin, cortisone/hyaluronic acid, 11-deoxysitol/heparin, CT-2584, cyclophosphamide, cyclosporin A, dexamethasone, diclofenac/hyaluronic acid, eosinophilic major basic protein, fibronectin peptide,
- the anti-angiogenic agent used is an angiogenesis inhibitor such as vasopressin, endostatin, kringle-5, PEX, TIMP TIMP2> TIMP3, TIMP4, endo::angio or endo::PEX, or Is an angiogenesis chemokine gene, such as IP-10, Mig or SDF-lo
- the anti-tumor agent used is a deuteration agent, an anti-implant, a natural product, a platinum coordination complex, an enoxadione, An alternative urea, a methylhydrazine derivative, an adrenocortical hormone inhibitor, a hormone and an antagonist. Examples of such anti-tumor agents are shown in Table 3 below. Chemotherapeutic agent for tumor diseases
- BCNU Dichloroethyl nitrosourea
- CCNU liquid nitrogen mustard
- DTIC dimethyl malignant melanoma
- Hodgkin's disease lymphocholine-sodium pyrrole-carboxylamine
- methotrexate methotrexate
- velvet (hair) membrane cancer anti-metabolite
- Mold disease breast, head, neck, lung, bone
- Fluorouracil (5-fluorouracil, breast, colon, stomach, pancreas, ovary, 5-FU) fluorodeoxyuridine (5-fluorodecapture, local epidermal lesions before bladder cancer)
- Acetaminophen acute granulocyte and acute lymphoid leukemia ⁇ analog ⁇ ( ⁇ ) ⁇ (6-mercaptopurine, 6 - acute lymphoid, acute granulocytes and chronic granules and related inhibition of MP) Preparation of thioguanine (6-thioguanine; TG) acute granulocytes, acute lymphoid and chronic myeloid leukemia
- VLB Vinblastine
- Vinca vinca vincristine acute lymphoblastic leukemia neuroblastic alkali tumor, embryonal carcinosarcoma, rhabdomyosarcoma, Hodgkin's disease, non-Hodgkin's lymphoma, small cell tumor
- Epipodophyllin etoposide Epipodophyllin etoposide, tenipore testis, small cell lung tumor and other lung cancer, breast, Hodgkin's disease, non-Hodgkin's lymphoma, acute neutropenic leukemia, multiple hemorrhagic sarcoma of the skin Velvet (hair) membrane cancer, embryonal carcinosarcoma, rhabdomyosarcoma, testicular, multiple hemorrhagic sarcoma of the skin
- non-Hodgkin's lymphoma acute antibiotic leukemia, breast, genital, thyroid, lung, stomach, neuroblastoma testis, head and neck, skin, esophagus, lung and genitourinary system, Hodgkin Disease, non-Hodgkin's lymphoma,
- Mitomycin (Mitomycin C) stomach, cervix, colon, breast, pancreas, bladder, head and neck
- Biological response to interferon- ⁇ hairy cell leukemia multiple skin gangrostic sarcoma, melanoma, benign tumor, kidney, ovary, bladder, non-Hodgkin's lymphoma, mold (fungi) disease, multiple myeloma, Chronic myeloid leukemia Cisplatin (cis-DDP) testis, ovary, bladder, head and neck, lung, thyroplatin coordination complex
- Hyperplasia Hyperplasia, thrombocytopenia, malignant black agent methyl hydrazine derivative methyl benzamidine (N-methyl hydrazine, hydrazine) Hodgkin's disease
- Adrenal cortex o-chlorobenzene p-chlorophenyldichloroethane adrenal cortex
- Adrenal cortex prednisone (there are several other equivalents of acute and chronic lymphocytic leukemia, non-Hodge steroid preparations, see section 59) Lymphatic disease, Hodgkin's disease, mammary tumor progesterone hydroxyprogesterone, sulphate , medroxyprogesterone, vinegar endometrium, breast tumor
- Antagonist male hormone acetaminophen testosterone, fluoromethyl testicular breast
- the antitumor agent used is a cytosine analog such as cytidine arabinoside (Ara-C), daunorubicin, doxorubicin, methotrexate (MTX).
- Fluorinated pyrimidine such as 5-fluorouracil (5-FU), hydroxyurea, 6-mercaptopurine, plant alkaloids such as vincristine (VCR), VP-16 and vinblastine (VLB); oximation agents such as cyclophosphine Amide tumor cell lysing agent, mesna, melphalan, 1,3-dichloroethylnitrosourea (BCNU), cisplatin, nitrogen mustard (HN2), triamine (HN3), atypical oximation agent Such as procarbazine, bleomycin, mitomycin C, actinomycin D (DACT), or an enzyme such as L-asparaginase.
- the anti-tumor agent used is an oncogene inhibitor.
- the oncogene inhibitor is an anti-oncogene antibody or an anti-oncogene antisense oligonucleotide.
- oligonucleotide antibodies and antisense oligonucleotides listed in Table 4 below can be used in the composition.
- Myc MC29 myeloid tissue increases chicken lymphoma
- N-myc NVT human neuroblast nuclei neu Erb NVT rat neuroblasts TyrPK GFR L
- the anti-tumor agent used is a cell matrix inhibitor. More preferably, the cell matrix inhibitor is an anti-cell matrix antibody or an anti-cell matrix antisense oligonucleotide.
- the cell matrix inhibitor is an anti-cell matrix antibody or an anti-cell matrix antisense oligonucleotide.
- antibodies against the following cell matrix or cell matrix genes and antisense oligonucleotides can be used: caveolin-1, core proteoglycan, cadherin, catenin, integrin. '
- the composition further comprises a tumor suppressor gene for use in combination with intratumoral therapy and gene therapy.
- the tumor suppressor genes used are pl6, p21, p27, p53, RB, WT-1, DCC, NF-1 and APC.
- the composition further comprises a suicide gene such as HSVltk (herpes simplex virus type 1 thymidine kinase), tdk&tmk (thymidine kinase & thymidylate kinase), coda&upp (cytosine deaminase) & uracil phosphoribosyltransferase); a cytolytic gene such as granzyme A, granzyme B, perforin; or an apoptotic gene such as Bak, Bax, Bcl-XL, Bcl-XS, Bik, Sarp-2 , TRAIL.
- HSVltk herpes simplex virus type 1 thymidine kinase
- tdk&tmk thymidine kinase & thymidylate kinase
- coda&upp cytosine deaminase
- the composition further comprises a cytokine gene, such as interleukin 1 beta, interleukin 2, interleukin 4, interleukin 6, interleukin 8, interleukin 10, interleukin 12, interleukin 15, GM-CSF, Interferon alpha, interferon beta, interferon gamma, tumor necrosis factor a, B7.1 or ⁇ 7.2 to enhance the immune response.
- a cytokine gene such as interleukin 1 beta, interleukin 2, interleukin 4, interleukin 6, interleukin 8, interleukin 10, interleukin 12, interleukin 15, GM-CSF, Interferon alpha, interferon beta, interferon gamma, tumor necrosis factor a, B7.1 or ⁇ 7.2 to enhance the immune response.
- Genes that are originals of the gene transfer system can use naked DNA, composite DNA, cDNA, plasmid DNA, RNA or other compositions thereof.
- the tumor suppressor gene is contained in a viral vector.
- Any viral vector suitable for gene therapy can be used in the composition.
- an adenoviral vector U.S. Patent 5,869,305
- a prion vector U.S. Patent 5,962,274
- a conditionally replicating human immunodeficiency virus vector U.S. Patent 5,888,767
- retrovirus SV40
- herpes simplex can be used.
- Viral replicon vector and vaccinia virus vector can be used, wherein the lipids protect DNA or other biological materials from oxidation during agglutination.
- the composition further comprises a radiation sensitizer for use in combination with intratumoral therapy and radiation therapy.
- a radiation sensitizer for use in combination with intratumoral therapy and radiation therapy.
- the radiation sensitizer used is SR2508 (etramide) (Chang et al, Int J Radiat Oncol Biol Phys, 40(l): 65-70 (1998) ⁇ Buthionine sulfoximine ( BSO) (Vahrmeijer et al, Cancer Chemother Pharmacol, 44 ⁇ 2 ⁇ : 1 11-6 (1999))
- the composition further comprises an enhancer that promotes coupling between the semi-antigen and the tumor antigen to enhance an autologous tumor-specific immune response.
- the promoter used is a chelating agent or a chemical crosslinking agent. More preferably, the chelating agent used is glycyl tyrosyl-(Ne-diethylenetriaminepentaacetate)-lysine (GYK-DTPA) or adriamycin adipate-dihydrazide ( ADR-ADH). Also more preferably, the chemical crosslinking agent used is carbodiimide.
- the composition further comprises an immune response potentiator to enhance an autologous tumor-specific immune response.
- the synergist used is BCG (Ratliff, Eur Urol, 2: 17-21 (1992)), Corynebacterium parvum (Lillehoj et al, Avian Dis, 37(3): 371-40 ⁇ 993 )), Brucella abortion extract, dextran, levamisole, tylosonol, an enzyme, a non-toxic virus, a polysaccharide, or a herbal extract such as a herbal extract.
- the enzyme used is cholera myxoinase (VCN) (Seiler and Sedlacek, Recent Results Cancer Res, J ⁇ : 53-60 (1980)); papain (Helting Wo B Nau, Acta Pathol) Microbiol. Immunol. Scand, 92f !: 59-63 (1984); and Hess'Eur J Immunol 6(3): 188-93 (1976)), ⁇ -galactosidase or Concanavalin A .
- the non-toxic virus used is a non-toxic Newcastle disease virus (Meulemans et al, Vet Rec, 14 01): 300-3 (1998); and Adams, Poult Sci, 49(1): 229 -33 (1970)).
- the polysaccharide used is an anti-tumor polysaccharide derived from a liquid cultured mushroom blazei mill mycelium (originally glucoside, the main chain is ⁇ -1, 2-linking- D-mannipyran residue with a side chain of ⁇ -D-glucopyran residue -3-0- ⁇ -D-glucopyran residue) (Mizuno et al., Biochem Mol Biol Int, 47 ⁇ 4 ⁇ : 707-14 (1999)) ; anti-tumor polysaccharide preparation obtained from velvet mushroom (the main chain of polysaccharide mainly contains ⁇ -(1->3)-D-linked glucose, and its molecular weight is about 200KD.
- the composition may also contain an agglutinating lysing agent to enhance the autologous tumor-specific immune response.
- the composition may also contain a cytokine to enhance an autologous tumor-specific immune response.
- the administered cytokine is a lipid raft-embedded interleukin 2 for storing a formula (Krup et al, J Immimother, 22 (6: 525-38 (; 1999 ⁇ ), or a storage formula for granulocyte-macro Phagocytic colony stimulating factor (GMt-CSF) (Leong et al, J Immunoter, 22(2): 166-74 (1999)) o
- the composition may further comprise a Oncogenes enhance their own tumor-specific immune responses.
- the oncogenes listed in Table 4 above can be used.
- the composition can include an attenuated, replicable viral vector to enhance an autologous tumor-specific immune response.
- the attenuated, replicable viral vector used is mutant G207 of herpes simplex virus type 1 (HSV-1), which replicates in human tumor cells and causes cell death, thereby inhibiting tumor growth, but No pathogenicity to normal tissues (Toda et al., Hum. Gene. Ther., 10(3): 385-93 (19991) ⁇
- the composition can include a reporter to monitor the course of treatment.
- the report can be a chemical or an enzyme.
- the reporter enzyme is beta-galactosidase or its gene. Other reporters known in the art can also be used.
- the composition contains hydrogen peroxide as the oxidizing agent and hydrazine as the hapten. It is also possible to contain carbodiimide as a promoter.
- the concentration of the oxidizing or reducing agent to be applied in the composition is from about 0.01% (w/w) to 35% (w/w), and the concentration of the targeting carrier compound is about 1% Cw/w; > to 98% ( w/w), the concentration of the anticancer drug is about 1 mg/ml to 80 mg/ml, and the concentration of the hapten is about 1 mg/ml to 80 mg/ml.
- the invention also provides a kit for intratumoral treatment, the kit comprising such a composition comprising one or more of A) an oxidizing agent and/or a reducing agent; B) a targeting carrier agent; Anticancer agent; and D) hapten.
- the kit also includes a syringe for administering the composition and instructions for administration.
- the invention also provides a manufactured article for use in intratumoral treatment.
- the product of manufacture includes: A) a packaging material; B) one or more oxidizing or reducing agents, a targeting carrier agent, an anticancer agent and a hapten; and C) a label indicating that the article is used to treat a tumor.
- the present invention provides a method for treating a tumor in a mammal by administering an effective amount of a composition to a mammal, the composition comprising a hapten, a chemical drug such as an anticancer agent, a targeting vector
- a composition comprising a hapten, a chemical drug such as an anticancer agent, a targeting vector
- the hapten and/or chemical agent has passed or may form a conjugate or chelate with the targeting carrier by the action of an oxidizing agent and/or a reducing agent, or the hapten, chemical drug, targeting carrier III
- the conjugate or chelate has been formed or may be formed by the action of an oxidizing agent and/or a reducing agent.
- the present invention treats the tumor by producing an autoimmune response to the tumor.
- the mammal being treated is a human.
- the hapten used is trinitrobenzene (TNP), dinitrobenzene (DNP), N-iodoacetyl-N,-(5-sulfo-1-naphthyl)-Asian Diamide (AED), dinitrofluorobenzene (DNFB) and ovabulin (OVA).
- TNP trinitrobenzene
- DNP dinitrobenzene
- AED N-iodoacetyl-N,-(5-sulfo-1-naphthyl)-Asian Diamide
- AED N-iodoacetyl-N,-(5-sulfo-1-naphthyl)-Asian Diamide
- DNFB dinitrofluorobenzene
- OVA ovabulin
- the method of treatment can further comprise administering an enhancer in situ to enhance the tumor-specific autoimmune response by promoting coupling between the hapten and the tumor antigen.
- the accelerator used is a chelating agent or a chemical crosslinking agent. More preferably, the chelating agent used is glycyl tyrosyl-(Ne-diethylenetriaminepentaacetic acid)-lysine (GYK-DTPA) or adriamycin adipate-dihydrazide ( ADR-ADH). Also more preferably, the chemical crosslinking agent used is carbodiimide.
- the method of treatment can further comprise administering an immunological response potentiator in situ to enhance a tumor-specific autoimmune response.
- the immune response potentiator used is BCG (Ratliff, Eur Urol, 2: 17-21 (1992)), Corynebacterium parvum (Lillehoj et al, Avian Dis, 37(3): 371- 40 (1993)).
- the oxidizing or reducing agents, targeting agents, anticancer agents and haptens may be formulated as a pharmaceutical composition, or each may be separately formulated as a pharmaceutical composition.
- the oxidizing agent used is, but not limited to, stannous chloride (SnCl 2 ); stannous sulfate (SnS0 4 ); stannous sulfite (SnS0 3 ); - tin oxide (SnO); Tin dioxide (Sn0 2 ); sodium stannate (Na 2 SnO 3 ) ; sodium stannate (Na 2 Sn0 2 ); stannous chloride (SnCl 2 ); tin tetrachloride (SnCl 4 ); thio tin Acid salt (SnS 3 ); stannous sulfide (SnS:).
- the targeted combination carrier used is, but not limited to, Sodium Dimercaptosuccinate (DMSA-III); Sodium Dimercaptosuccinate (Sodium Dimercaptosuccinate (Sodium Dimercaptosuccinate (Sodium Dimercaptosuccinate (S)) DMSA-V)); Sodium Pyrophosphate and Stannous Chloride for Injection (PYP); Methylene diphosphonate Injection (MDP); Polymerized Albumin; Sulfur B Pentetic Acid and Stannous Chloride (DTP A); Sodium Glucoheptonate and Stannous Chloride; Stannous cysteine ethyl ester (L, L-Ethyl) Cysteinate Dimer and Stannous Chloride (ECD)); Exametazime (HMPAO); Etifenin and Stannous Chloride; Sodium Phytate and Stahnous Chloride; Butyl isocyanide salt [Cu(MIBI) 4 BF 4 ] (MIBI) ; methyl-
- the cancer treatment provided by the present invention can be used alone or in combination with other cancer treatment methods.
- the tumor therapy is administered in combination with chemotherapy, i.e., an anti-tumor agent is further administered.
- the anti-tumor agent used is a 02671 anti-angiogenic agents. More preferably, the anti-angiogenic agent is a basement membrane degradation inhibitor, an inhibitor of cell migration, an inhibitor of endothelial cell proliferation, tissue and an inhibitor of three-dimensional structure construction.
- the anti-angiogenic agent used is AGM-1470 (TNP-470), angiostatin steroid, neovastin, anti-v ⁇ 3 antibody, anti-basic fibroblast growth factor antibody, anti-interleukin-1 antibody , anti-TNF (X antibody, anti-vascular endothelial growth factor antibody, auranofin, azathioprine, BB-94, BB-2516, soluble receptor for basic fibroblast growth factor, carboxyamine triazole Class (CAI), cartilage inhibitor, chitin, chloroquine, cisplatin, CM101, fofu heparin, cortisone/hyaluronic acid, 11-deoxysitol/heparin, CT-2584, cyclophosphine Amide, cyclosporin octapeptide, dexamethasone, diclofenac/hyaluronic acid glycosaminoglycan, eosinophilic major basic protein,
- anti-angiogenic agents described in Section B can also be used.
- the anti-angiogenic agent used is an angiostatin gene such as angiostatin, endostatin, kringle-5, PEX. , TIMP TIMP2. TIMP3, TIMP4, endo::angio, or endo::PEX, or an angiogenesis chemokine gene, such as IP-10, Mig or SDF-la.
- the anti-tumor agent used is a deuteration agent, an antimetabolite, a natural product, a platinum coordination complex, an anthraquinone, a substituted urea A methyl hydrazine derivative, an adrenocortin, a hormone, an antagonist, an anti-cancer polysaccharide, or an herbal extract such as a herbal extract. It is also possible to use additional anti-tumor agents as described in Section B.
- the anti-tumor agent used is an oncogene inhibitor such as an anti-oncogene antibody or an anti-oncogene antisense oligonucleotide.
- an anti-cancer gene antibody or an anti-oncogene antisense oligonucleotide against the following oncogenes can be used: abl, erbA, erbB, ets, fes(fps), fgr, fms, fos, s intl, int2, Jun, Hit, B-lym, mas, met, mil(raf), mos, myb, myc, N-myc, neu(ErbB2), ral(mil), Ha-ras, Ki-ras, i'el, ros, sis , src, ski, trk, and yes.
- intratumoral therapy and gene therapy are used in combination by further injecting a tumor with a tumor suppressor gene sequence.
- the tumor suppressor gene sequences used are pl6, p21, p27, p53, RB, WT-1, DCC, NF-1 and APC.
- the method further comprises administering a suicide gene such as HSVltk (herpes simplex virus 1 thymidine kinase:), tdk&tmk (thymidine kinase & thymidylate kinase), coda&upp (cytosine) in situ.
- HSVltk herpes simplex virus 1 thymidine kinase:
- tdk&tmk thymidine kinase & thymidylate kinase
- coda&upp cytosine
- Aminoase & uracil phosphoribosyltransferase a cytolytic gene such as granzyme A, granzyme B, perforin; or an apoptotic gene such as Bak, Bax, Bcl-XL, Bcl-XB, Bik, Sarp -2, TRAIL.
- the method further comprises administering a cytokine gene in situ, such as interleukin 1 beta, interleukin 2, interleukin 4, interleukin 6, interleukin 8, interleukin 10, interleukin 12, interleukin 15, GM - CSF, interferon alpha, interferon beta, interferon gamma, tumor necrosis factor alpha, B7.1 or sputum 7.2 to enhance the immune response.
- a cytokine gene in situ such as interleukin 1 beta, interleukin 2, interleukin 4, interleukin 6, interleukin 8, interleukin 10, interleukin 12, interleukin 15, GM - CSF, interferon alpha, interferon beta, interferon gamma, tumor necrosis factor alpha, B7.1 or sputum 7.2 to enhance the immune response.
- the gene in the gene delivery system which is a component of the composition can be used in the form of naked DNA, composite DNA, cDNA, and plasmid DNA.
- the tumor suppressor gene sequence is carried by a viral vector.
- Any viral vector suitable for gene therapy can be used in the composition.
- an adenoviral vector U.S. Patent 5,869,305
- a prion vector U.S. Patent 5,962,274
- a conditionally replicating human immunodeficiency virus vector a conditionally replicating human immunodeficiency virus vector
- a poxvirus vector U.S. Patent 5,888,767)
- retrovirus may be employed.
- SV40 a herpes simplex virus amplicon vector expressing a related gene and a poxvirus vector.
- non-viral vector systems such as liposome transporters can be used, wherein the lipid protects DNA or other biological material from oxidation during agglutination.
- the method further comprises administering a radiation sensitizer in situ for the combined use of tumor therapy and radiation therapy.
- the radiation sensitizer used is an antisense deoxyoligonucleotide of raf (Gokhale et al, Antisense Nucleic Acid Drug Dev, 9(2): 191-201 (1999);) SR2508 (etrazine) (Chang et al, Lit J Radiat Oncol Biol Phvs, 40 il: 65-70 (1998) or Butionine sulfoximine (BSO) (Vahrmeijer et al, Cancer Chemother Pharmacol, 44(2): 111-6 ( 1999)).
- the method further comprises administering a cytokine-containing reservoir in situ to enhance an autologous tumor-specific immune response.
- the cytokine-containing reservoir used is a liposome-embedded IL-2 (Krup et al, J Immunother, 22 (6 ⁇ : 525-38 (1999)), or formulated as Granulocyte-macrophage colony-stimulating factor (Leong et al, J Immunother, 22(2): 166-74 (1999).
- the method further comprises administering an oncogene sequence in situ to enhance an autologous tumor-specific immune response.
- an oncogene sequence in situ to enhance an autologous tumor-specific immune response.
- the oncogene sequences shown in Table 4 above can be used.
- the method further comprises administering an attenuated, replicable viral vector in situ to enhance an autologous tumor-specific immune response.
- the attenuated, replicable viral vector used is mutant G207 of herpes simplex virus type 1 (HSV-1), which replicates in human tumor cells and causes cell death, thereby inhibiting tumor growth, but Not pathogenic to normal tissues (Toda et al., Hum Gene Ther, 10 ⁇ : 385-93 ( ⁇ 999) ⁇
- the method further comprises administering a reporter in situ to monitor the course of treatment.
- the reporter can be a chemical or an enzyme.
- the reporter enzyme is beta-galactosidase or its gene. Other reporters known in the art can also be used.
- both guanidine and DNP are used as haptens in therapy.
- the concentration of the oxidizing or reducing agent used in the treatment is from about 0.01% (w/w) to about 35% (w/w), and the concentration of the targeted carrier agent is about about 1% ( w/w) to 99% (w/w), the concentration of the hapten is about 1 mg/ml to 80 mg/ml.
- the autoimmune response produced by the combined action of a hapten and an anticancer agent or treatment is a humoral and/or cellular immune response.
- Any tumor neoplasm, tumor or cancer can be treated by the methods provided herein.
- it can treat tumors in the following areas: adrenal gland, anus, ear nerve, biliary tract, bladder, bone, brain, chest, bru C cal, central nervous system, cervix, colon, ear, endometrium, esophagus, eye, eyelid , fallopian tube, gastrointestinal tract, head and neck, heart, kidney, throat, liver, lung, jaw, mandibular odontoid, maxilla, mouth, nasopharynx, nose, mouth, ovary, pancreas, parotid gland, penis, auricle , pituitary, prostate, rectum, retina, salivary gland, skin, small intestine, spinal cord, stomach, testis, thyroid, tonsil, urethra, uterus, vagina, vestibular cochlear nerve, or vulva, lymphatic and lymph node metastases and malignant lymphatic
- tumors and cancers examples include: breast cancer, lung cancer, colorectal cancer, pancreatic tumor, gallbladder hepatic duct tumor, liver tumor, stomach tumor, esophageal cancer, malignant melanoma, urethra and male genital cancer, Skin cancer, head and neck and thyroid cancer, central nervous system and pituitary cancer, ocular and ocular appendage tumors, bone malignant tumors, soft tissue sarcoma, Hodgkin's disease and non-Hodgkin's disease, multiple myeloma, pediatric solid tumors, women Obstetric cancer.
- Other examples include:
- Endothelial and related tissue vessels angiosarcoma, lymphangioma, synovial tumor, mesothelioma, invasive meningioma.
- squamous cancer, squamous cell or epidermoid carcinoma
- Epithelial lining adenocarcinoma, papillary carcinoma, papillary adenocarcinoma, cystadenocarcinoma, myeloma, undifferentiated adenocarcinoma
- Renal epithelium renal cell carcinoma, adrenal adenoma
- Hepatocytes hepatoma (hepatocellular carcinoma)
- biliary tract cholangiocarcinoma, trichomoniasis angiosarcoma (chlangiocarcinoma)
- Urinary tract epithelium papillary carcinoma, transitional cell carcinoma, squamous cell carcinoma
- Placenta epithelium choriocarcinoma
- Testicular epithelium (blast cells, spermatogonia, embryonal cancer)
- tumors derived from more than one type of tumor cells or more than one germ layer can also be treated.
- the tumor treated is a solid tumor. More preferably, the solid tumor has a size greater than 10 8 cells. Most preferably, the size of the solid tumor is 5 x 10 9 to 10 11 cells.
- MDP methylene diphosphonate
- ARA-C anticancer drug cytarabine
- DNP hapten dinitrophenol
- mice were subcutaneously inoculated with osteoblasts (Osteosarcoma Cells) about 10 ⁇ 10 3 , after the week, the tumor was 1 cm in diameter, methylene diphosphonate (MDP) 100 mg and anticancer drug cytarabine (ARA-C). 50 mg of hapten dinitrophenol (DNP) 0.5 mg was dissolved in 10 ml of saline containing 0.05 mg of stannous chloride SnCl 2 , and after standing for 5 minutes, a MDP-ARCR-DNP chelate was formed.
- Treatment group intravenous chelating 0.2ML, twice a week for three weeks
- control group intravenous injection of only 0.2ML ARCR, twice a week for three weeks.
- the tumor in the treatment group was significantly smaller than the control group (P less than 0.05). Tumor specimens were surgically removed, pathological sections were taken, and CD4 and CD8 immunostaining were performed. MDP-ARCR-DNP chelate was positive for the tumor and negative for the control group. Experiments have shown that this target (MDP) can transport drugs and haptens to tumor sites by chelation, while releasing drugs to kill tumors and release haptens to immunomodulate killed tumor cells or cell debris. , plays a role in tumor vaccines.
- MDP MDP-ARCR-DNP chelate
- C57 mice were subcutaneously inoculated with lymphoma cells 10X10 3 , one week later, the tumor was 1 cm in diameter, 5 ml of Brucinetin and 10 mg of anticancer drug Adria (Adm), hapten dinitrophenol (DNP) 0.5 mg was dissolved in 10 ml of saline containing 0.05 mg of stannous chloride SnCl 2 and allowed to stand for 5 minutes to form a Bruceantin-Adm-DNP chelate.
- Treatment group intravenous injection of 0.2ML, twice a week for three weeks
- control group intravenous injection of only 0.2ML doxorubicin twice a week for three weeks.
- the tumor in the treatment group was significantly smaller than the control group (P less than 0.05). Surgical removal of tumor specimens Pathological sections were subjected to immunostaining for CD4 and CD8. Bmceantin-Adm-DNP chelate was positive for the tumor and negative for the control group. At the same time, the lymph node weight treatment group was found to be heavier than the control group, the spleen was weighed and the flow cytometry was measured with CD4 and CD8 antibodies. The flow cytometry treatment group was: 40%, and the control group: 28%. The result is shown in Figure 1.
- Co-oxidation chemotherapy was performed 4 times, respectively (1) CTX0.8dl.8 DDP20mgdl-5 EPI50mgdl VCRlmgdl; (2) CTX0.8dl.8 DDP20mgdl-5 VCRlmgdl; (3) (4) CTX0.8dl.8 DDP20mgdl -5 EPI40mgdl VCRlmgdl, no obvious digestive tract reaction and myelosuppression, no alopecia, no change in liver and kidney function.
- Add epirubicin (EPI) 40mg) containing 0.05mg of stannous chloride, form a chelate in 10ml of saline, intravenously, 6 times of treatment (due to the patient's multiple arrhythmias in July, to reduce the sub- In the case of sodium pyrophosphate, EPI is associated with heart damage, replaced with methylene diphosphonate.
- the treatment interval is supported by Quansheng, no adverse reactions.
- ECT shows that the sacral tumor and bone metastases are less relieved, chest and ankle.
- CT is significantly better than before, the patient is generally in good condition, appetite. Sleep well, normal bowel movements, can walk without foreign objects, no obvious pain. On January 16, 2006, he was discharged from hospital.
- CT showed no significant changes in chest and ankle CT compared with the last discharge.
- methylene bisphosphonate plus treatment methylene diphosphonate plus Am-c50mg, including Stannous chloride 0.05mg, formed into a chelate in 10ml of saline, intravenously, 4 times in total, sodium stannous pyrophosphate DDP 20mg, containing stannous chloride, in 0.05mg 10ml of saline, forming chelation , intravenous administration).
- the patient can walk, drive, and the tumor shrinks significantly.
- Example 5 Treatment of gastric cancer and liver cancer, combined application of topical therapy.
- Admission diagnosis gastric antrum CaW phase ⁇ 4 ⁇ 1, abdominal lymph node metastasis, pleural effusion, wound healing after gastric perforation surgery. After admission, the anticancer Chinese medicine was taken orally, nutritional support, abdominal incision (5-Fu, hydrogen peroxide) dressing, wound healing in early March.
- the gastric antrum small curved side mass release sustained-release library treatment 5 times, the pancreatic head area tumor sustained-release library treatment 2 times, peritoneal perfusion 6 times, of which 5-Fu + DDP 20mg + interleukin ⁇ 1 million u2 times, duck bilirubin plus Amygdalin Peritoneal perfusion 4 times.
- the main drugs are: DDP 20mg*2 times, 5-Fu0.5*2 times, Ara-c 25!3 ⁇ 4*2 times ⁇ , phytic acid Sodium and efentifenin kits (EHIDA) combined with drug treatment showed abdominal pain, bloating, loss of appetite, and fatigue of night sweats.
- EHIDA phytic acid Sodium and efentifenin kits
- the B-pancreatic head area saw a mass 6.5*6.3*4.6cm solid hypoechoic mass, 3.7*3.5cm behind the stomach, and a mass in the liver 4.0*2.5cm, 1.6* 1.5cm, portal vein embolus 2.0 *1.5cm.
- the gastric small-bend side mass was released twice, the liver sustained-release library was 6 times (including the portal vein embolus), and the gastric antrum mass was treated with a gastroscope sustained-release library.
- Example 6 Treatment of ovarian cancer
- Example 7 Treatment of malignant lymphoma
- B-ultrasound The shape of the liver is normal.
- the left hepatic lobe is about 4.5*1.8CM.
- the solid hypoechoic nodules are irregular in shape, the boundary is clear, the internal echo is uniform, and the right hepatic lobe is about 1.1.1.
- Braceantin, Tetrandrine, thalicarpine, maytansine chelated anticancer drugs are effective in intravenous treatment.
- B-ultrasound The thickness of the small intestine wall in the right lower abdomen is significantly smaller than the previous range, and the thickness of the intestinal wall is about 1.1CM.
- the hypoechoic nodules of cm the boundary is clear, the internal echo is homogeneous, the portal vein and the intrahepatic bile duct are not dilated, and there is no abnormality in the gallbladder, pancreas, spleen and kidneys; retroperitoneal scan: a 0.5*0.7 above the pancreatic body
- the hypoechoic nodules of cm regular shape; the right thoracic cavity exploration and irregular liquid dark area range is about 5.4*3.8cm, the right rib angle is thickened at the pleura, the thickest part is about 1.1cm.
- a solid low echo with a range of about 2.8*L2*2.6cm, border Clear, echoes are all.
- bilirubin chelated anticancer drugs cytarabine, 5-FU, doxorubicin, arsenic trioxide
- CT review report retroperitoneal lymphoma review: right inferior vena cava
- the ipsilateral diaphragm was still thickened.
- the right upper lobe and the left upper lobe were patchy, and the strip was high-density.
- the pleura was locally thickened and partially adhered, the bronchial tubes were unobstructed, the lumen was not narrowed, and the hilar and mediastinum did not show abnormally enlarged lymph nodes.
- the medial soft tissue mass of the internal iliac crest is smaller than before.
- kidney cancer One patient, female, 68 years old, developed pancreatic cancer and invaded the aorta.
- the KPS score is 70, and the sound image shows a tumor size of 4.6 x 5.3 cm, which is irregularly spherical.
- the clinical diagnosis is stage II pancreatic cancer, T3N1M0. She received an intravenous treatment with urinary cytidine for the eschar, and the chelate contained the cysteine and the anticancer drug AraC. After 4 weeks, the tumor shrank to 3.7 x 4.5 cm. The patient is in very good condition and the blood cell count is normal.
- Example 9 Treatment of Kidney Cancer
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Description
用于治疗肿瘤的组合物和方法 发明领域
本发明涉及治疗哺乳动物, 特别是人的肿瘤的组合物和方法。 更特别地, 提 供了用于在静脉给药的肿瘤治疗组合物, 其中包括靶向肿瘤的载体、 抗癌药物和 增强免疫发炎反应的试剂。 也提供了通过施用这些组合物治疗肿瘤的方法。
发明背景
癌症的治疗已经有许多方法, 包括手术、 化疗和辐射。 手术是把全部或部分 肿瘤移出身体的传统方法。 手术一般是治疗早期癌症的唯一有效方法。 但目前癌 症患者中的 50%以上的人而言, 诊断时已经成为晚期,他们不再是有效的手术治 疗的候选人。 即使能手术的病人, 手术过程的操作和挤压肿瘤, 可能使瘤细胞脱 落并通过血液循环而使造成肿瘤的转移。 大多数癌症患者并未死于诊断时或手术 时的肿瘤, 而是死于肿瘤的转移和复发。
别的治疗方法经常是无效的。 放射治疗只对癌症早期和中期的局部癌症有效, 对具有转移的晚期癌症无效。 化疗是有效的常用方法, 但有严重的负作用, 如呕 吐、 白细胞降低(WBC)、脱发、体重降低和别的毒性作用。 因为严重的毒副作用, 许多癌症患者不能成功的完成全部的化疗过程。 相当一些癌症患者由于对化疗的 毒副作用无法耐受而死于化疗的毒副作用。 由于抗癌药物的低靶向特异性而导致 抗癌药物的极大副作用。 药物通过循环到达患者大多数正常的器官和预期的靶肿 瘤。 同时低靶向特异性的特点, 仅有一小部分药物能正确地作用于目标组织, 大 部分药物作用于非目标组织而造成毒副作用, 也降低了化疗的有效性。 化疗药物 的有效性因为抗癌药物在靶肿瘤内的滞溜时间短, 而进一步降低其疗效。 因此提 高药物的靶向性是提高药物肿瘤的存留率和肿瘤局部杀伤率的唯一途径。
免疫疗法, 包括使用癌症疫苗, 如自体疫苗, 对于肿瘤荷载少于 108肿瘤细胞 的癌症患者有效。 免疫疗法经常作为辅助疗法与其它的疗法如手术, 放射疗法和 化疗相结合以清除体内任何残留的肿瘤细胞。 免疫疗法和使用癌症疫苗不能证明 对于肿瘤荷载大于 5X109到 1011肿瘤细胞有效, 其在具有轻微转移症状的患者中 是典型的。 此外, 自体瘤疫苗接种需复杂的程序, 且要求对每一患者的肿瘤标本 进行处理, 临床实践上不能满足病人的需要。
目前, 对于晚期肿瘤患者, 还没有有效的治疗方法。 因为早期肿瘤不易早期 检出, 许多诊断有癌症的患者是处于肿瘤荷载大于 5X109到 1011肿瘤细胞的癌症 晚期, 或肿瘤已经转移到别的组织。 对于这些患者, 传统的癌症治疗如手术、 放 射和化疗可能不再有效和 /或合适。
实验和临床已有一批化合物具有一定的肿瘤靶向性, 有一些已用于临床肿瘤 显像和治疗, 但是用于治疗的靶向药物大多是选用发射性同位素, 效果仍然限于 止痛, 无法达到肿瘤部分和完全缓解。 目前肿瘤的治疗仍然强调是综合治疗, 特 别将免疫治疗与化疗有机的结合起来, 甚至通过化疗起到一定的免疫作用, 有理 论证实化疗和免疫治疗是临床实践的最佳伙伴。
尽管癌症治疗有一些进展, 但有效的治疗方法仍很少。 由于晚期癌症对生命 的危害严重性和广泛性, 临床上很需要有效的治疗的方法。 理想的癌症治疗应是 在载体靶向药物治疗原发肿瘤的同时, 激发人体内在的免疫能力去根除身体内多 个位点的全身性微小肿瘤, 并特异性地区别肿瘤细胞和非肿瘤细胞, 起到治疗和 预防肿瘤转移的作用。
所以, 本发明的目的是提供这样的癌症治疗方法。 特别的, 本发明的目的是 提供载体靶向治疗原发肿瘤或全身多发肿瘤的同时, 激发体内免疫能力根除身体 内多个位点的全身性微小肿瘤 (亚临床灶), 并且特异性区别肿瘤细胞和非肿瘤细 胞的癌症治疗方法。
发明概述
本发明提供了一种组合物, 其中包括: a)氧化剂或还原剂; b)靶向载体剂; c)抗癌药物; 和 d) 半抗原。 也就是, 本发明提供的组合物可以包括 a)氧化剂; b)靶向载体剂; c)抗癌药物; 和 d)半抗原。 或者, 并发明提供的组合物可以包 括 a)还原剂; ) 靶向载体剂; c)抗癌药物; 和 d) 半抗原。
在本发明的一种实施方案中, 所述氧化剂或还原剂、 靶向载体剂、 抗癌药物 和半抗原配成单一的药物组合物或每个配成独立的药物组合物。
在本发明的一种实施方案中, 所述氧化剂选自氯化亚锡 (SnCl2); 硫酸亚锡 (SnS04); 亚硫酸亚锡 (SnS03 ); —氧化锡 (SnO) ; 二氧化锡 (Sn02) ; 锡酸钠 (Na2Sn03 ); 亚锡酸钠 (Na2Sn02); 氯化亚锡 (SnCl2); 四氯化锡 (SnCl4); 硫代 锡酸盐 (SnS3 ); 硫化亚锡 (SnS)。
在本发明的一种实施方案中, 所述还原剂选自一种含氧量低的还原剂和非硝 基化合物替拉扎明 (SR— 4233 )。
在本发明的一种实施方案中, 所述含氧量低的还原剂是硝基咪唑。
在本发明的一种实施方案中, 所述靶向载体剂是一切可以运载药物到靶向组 织的载体, 二巯丁二钠 (III)(Sodium Dimercaptosuccinate (DMSA-III)); 二巯丁二钠 (V)(Sodium Dimercaptosuccinate (DMSA-V)); 注射用亚锡焦磷酸钠(Sodium Pyrophosphate and Stannous Chloride for Injection (PYP)); 注射用亚甲基二膦酸盐 (Methylene diphosphonate Injection (MDP)); 聚合白蛋白; 硫乙甘肽; 亚锡喷替酸 (Pentetic Acid and Stannous Chloride (DTP A)); 亚锡葡庚糖酸钠(Sodium Glucoheptonate and Stannous Chloride); 亚锡双半胱氨酸乙酯 (L,L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); 依沙美肟 (Exametazime)(HMPAO); 亚锡依替
菲宁 (Etifenin and Stannous Chloride); 亚锡植酸钠 (Sodium Phytate and Stahnous Chloride); 甲氧基异丁基异腈盐 [Cu(MIBI)4BF4](MIBI); 甲基 -L-酪氨酸 (a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile); 硝基咪唑类化合物 (2-nitroimidazole) ; 单克隆抗体和肿瘤单克隆抗体; 及中药提取物如鸭胆子素 (Bruceantin).汉防已甲素 (Tetrandrine)、唐松草碱 (thalicarpine)、美登素 (maytansine) 等等。
在本发明的一种实施方案中, 所述抗癌药物是一切可以用于治疗癌症的药物, 顺铂, 卡铂, 亚叶酸钙, 长春新碱, 甲氨蝶呤, 氟尿嘧啶, 阿糖胞苷, 环磷酰胺, 表阿霉素, 速溶阿霉素, 丝裂霉素, 足叶乙甙, 平阳霉素, 等等。
在本发明的一种实施方案中, 所述半抗原选自三硝基苯酚 (TNP), 二硝基苯 酚 (DNP), N-碘乙酰基一 N,一 (5—磺酸基 1一萘基) 亚乙基二酰胺 (AED), 二 硝基氟苯 (DNFB), Ovabulin (OVA), 白蛋白 ( albumin )。
在本发明的一种实施方案中, 所述组合物进一步包含一种抗肿瘤剂。
在本发明的一种实施方案中, 组合物中的抗肿瘤齐是一种抗血管生成剂。 在本发明的一种实施方案中, 抗血管生成剂选自一种基底膜降解抑制剂, 一 种细胞迁移抑制剂, 一种内皮细胞增生抑制剂, 一种三维结构和效能的建立的抑 制剂。
在本发明的一种实施方案中, 抗血管生成剂选自一种血管抑制基因, 一种血 管抑制趋化因子基因, AGM-1470 (T P-470), 血管抑制类固醇, 血管抑素, 抗 νβ3抗体, 抗碱性成纤维细胞生长因子抗体, 抗 IL-1抗体, 抗 TNF-ot抗体, 抗 VEGF抗体, 金诺芬, 咪唑硫嘌呤, BB-94, BB-2516, 碱性 FGF-可溶性受体, 羧 基氨基三唑类(CAI), 软骨衍生抑制剂 (CDI), 几丁质, 氯喹, 顺铂, CM101 , 可的松 /肝素, 可的松 / hyaluroflan, cortexolone/肝素, CT-2584, 环磷酰胺, 环孢 菌素 A, 地塞米松, 二氯酚酸 /透明质酸糖胺多糖, 嗜酸性主要碱性蛋白, 纤连蛋 白肽, 明胶酶抑制剂, 神经胶质瘤血管生成抑制因子 (GD-AIF), GM1474, 氯化 金, 硫羟苹果酸金, 肝素酶, 透明质酸糖胺多糖(高分子量和低分子量种类), 氫 化可的松, β环状右旋糖苷, 布洛芬, 吲哚美辛, α-干扰素, γ-干扰素诱导蛋白质 10, γ-干扰素, IL-1, IL-2, IL-4, IL-12, 层粘连蛋白, 左旋咪唑, 三羟氨基喹啉, LM609, 基质金属蛋白酶抑制剂, marimastat (BB-2516), 甲羟孕酮, 6-甲基巯基 嘌呤核糖核苷, metastat ( Col-3), 氨甲喋呤, 二甲胺四环素, 一氧化氮, 奥曲肽 (生长激素释放抑制激素类似物), 杉醇, D-青霉酸衍胺, 多硫戊聚糖, 胎盘 proliferin相关蛋白, 胎盘核糖核酸酶抑制剂, 纤溶酶原激活因子抑制剂 (PAI), 血小板因子 -4 (PF4), 氢化泼尼松, 催乳素 (16Kda片断), proliferin相关蛋白, 前列腺素合酶抑制剂, 鱼精蛋白, 类维生素 A, 罗喹美克(LS-2616, 三羟氨基喹 啉), 生长激素释放抑制激素, 基质溶素抑制剂, 物质 p (Substance P), 苏拉明, SU101 , tecogalan sodium (DS-4152), 四氢皮质醇 -sthrombospondins (TSPs), 金
属蛋白质酶组织抑制剂 (TIMP1 , 2, 3 ), 血管内皮生长因子抑制剂, 维生素 A, vitaxin和玻璃体液。
在本发明的一种实施方案中, 抗肿瘤剂选自一种垸化剂, 一种抗代谢剂, 一 种天然产物, 一种铂配位复合物, 一种蒽二酮, 取代脲, 甲肼衍生物, 皮质激素 抑制物, 某些激素和拮抗剂, 抗癌症多糖和某些草药提取物如中药提取物。
在本发明的一种实施方案中, 抗肿瘤剂是一种癌基因抑制物或一种肿瘤抑制 基因或蛋白。
在本发明的一种实施方案中, 癌基因抑制物是一种抗癌基因抗体或一种抗癌 基因反义寡聚核苷酸。
在本发明的一种实施方案中, 癌基因选自 abl, erbA , erbB, ets, fes(fps), fgr, fins, fos, hst, intl , int2, jun, hit, B-lym, mas, met, mil(rqf), mos, myb, myc, N-m c, neu(ErbB2) , ral(mil) , Ha-ras, Ki-ras, N-ras, rel, ros, sis, src, ski, trk 在本发明的一种实施方案中, 肿瘤抑制基因选自 pl6, p21, p27, p53, RB, WT—1, DCC, NF—l和 APC。
在本发明的一种实施方案中, 组合物中进一步包含含有癌基因或肿瘤抑制基 因序列的病毒载体。
在本发明的一种实施方案中, 病毒载体选自腺病毒载体, 猿病毒载体和条件 复制人免疫缺陷病毒载体, 反转录病毒载体, SV40载体, 单纯孢疹病毒扩增子载 体和痘病毒载体。
在本发明的一种实施方案中, 组合物中进一步包含促进半抗原和肿瘤赘生物 的肿瘤抗原的接合的促进剂。
在本发明的一种实施方案中, 所述促进剂是螯合剂或化学交联剂。
在本发明的一种实施方案中, 螯合剂是甘氨酰酪氨酰基- (N-e-二乙三胺五乙 酸) -赖氨酸 (GYK-DTPA) 或亚德利亚霉素己二酸-二酰肼 (ADR-ADH)。
在本发明的一种实施方案中, 化学连接剂是碳二亚胺。
在本发明的一种实施方案中, 组合物中进一步包含免疫受体增效剂。
在本发明的一种实施方案中, 免疫受体增效剂选自卡介苗 (BCG), 小棒状杆 菌, 流产布鲁氏菌, 葡聚糖, 左旋咪唑, 泰洛伦, 一种酶和非烈性病毒。
在本发明的一种实施方案中, 组合物中所述的氧化还原剂是 SnCl2, 所述靶向 载体剂是指所有具有器官或肿瘤靶向的化合物。
在本发明的一种实施方案中, 组合物中的氧化还原剂是 SnCl2, 抗癌药物是指 所有具有抗癌作用的化合物。
在本发明的一种实施方案中, 组合物中的氧化还原剂大约从 0.01% (w/w) 到 大约 35% (w/w), 使用的靶向载体剂从大约 1 % (w/w) 到大约 98 % (w/w), 使 用的抗癌药物从大约 lmg/ml到大约 80mg/ml, 使用的半抗原为从大约 lmg/ml到
大约 80mg/ml。
在本发明的一种实施方案中, 提供了一种包含组合物的试剂盒。 所述组合物 包括: a)氧化剂或还原剂; b) 靶向载体剂; c)抗癌药物; 和 d) 半抗原。
在本发明的一种实施方案中,提供了一种生产的制品,其中包括: i)包装材料; ii)上述组合物; iii)且一个表明所述制品是用于治疗肿瘤的标签。
在本发明中, 也提供了有效量的组合治疗剂在制备用于治疗哺乳动物肿瘤的 药物中的用途。
在一种实施方案中, 所述组合治疗剂包括: a) 氧化剂或还原剂; b) 靶向载体 剂; c) 抗癌药物; 和 d) 半抗原。
在本发明的一种用途中, 所述哺乳动物是人。
在本发明的一种用途中, 靶向载体剂选自: 二巯丁二钠 (III)(Sodium Dimercaptosuccinate (DMSA-III)); 二巯丁二钠 (V)(Sodium Dimercaptosuccinate (DMSA-V)),- 注射用亚锡焦磷酸钠 (Sodium Pyrophosphate and Stannous Chloride for Injection (PYP)); 注射用亚甲基二膦酸盐(Methylene diphosphonate Injection (MDP)); 聚合白蛋白; 硫乙甘肽; 亚锡喷替酸 (Pentetie Acid and Stannous Chloride (DTP A)); 亚锡葡庚糖酸钠 (Sodium Glucoheptonate and Stannous Chloride); 亚锡双 半胱氨酸乙酯 (L,L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); 依沙美肟 (Exametazime)(HMPAO); 亚锡依替菲宁 (Etifenin and Stannous Chloride); 亚锡植酸 钠 (Sodium Phytate and Stahnous Chloride) ; 甲 氧 基异 丁 基 异 腈盐 [Cu(MIBI)4BF ](MIBI); 甲基 -L-酪氨酸 (a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile); 硝基咪唑类化合物 (2-nitroimidazole); 单克隆抗体和肿瘤单克隆抗体; 及中药提取物如鸭胆子素 (Bruceantin)、 汉防已甲素 (Tetrandrine)、 唐松草碱 (thalicarpine)、 美登素 (maytansine)等等。
在本发明的一种用途中, 抗癌药物选自: 一切可以用于治疗癌症的药物, 顺 铂, 卡铂, 亚叶酸钙, 长春新碱, 甲氨蝶呤, 氟尿嘧啶, 阿糖胞苷, 环磷酰胺, 表阿霉素, 速溶阿霉素, 丝裂霉素, 足叶乙甙, 平阳霉素, 等等。
在本发明的一种用途中,半抗原选自:三硝基苯酚(TNP),二硝基苯酚 (DNP), N-碘乙酰基一 N'— (5—磺酸基 1一萘基) 亚乙基二酰胺 (AED ), 二硝基氟苯 (DNFB), Ovabulin (OVA) 和白蛋白 ( Albumin )。
在本发明的一种用途中, 氧化剂选自: 氯化亚锡 SnCl2; 硫酸亚锡 SnS03 ; — 氧化锡 SnO;二氧化锡 Sn02 ;锡酸钠 Na2Sn03 ;亚锡酸钠 Na2Sn02 ;氯化亚锡 SnCl2 ; 四氯化锡 SnCl4; 硫代锡酸盐 SnS3 ; 硫化亚锡 SnS。
在本发明的一种用途中, 组合物还包括螯合剂, 是甘氨酰酪氨酰基一 (N-e— 二乙三胺五乙酸)一赖氨酸(GYK— DTPA)或亚德利亚霉素己二酸一二酰肼(ADR ~ADH) o
在本发明的一种用途中, 组合物还包括化学交联剂, 是碳化二亚胺。
在本发明的一种用途中, 所述用途进一步包括使用免疫应答增效剂。
在本发明的一种用途中, 所述免疫应答增效剂选自卡介苗(BCG), 小棒状杆 菌, 流产布氏菌提取物, 葡聚糖, 左旋咪唑, 泰洛伦, 酶, 非致病性病毒, 多糖 和草药提取物。
在本发明的一种用途中, 所述酶选自霍乱弧菌神经氨酸酶(VCN), 木瓜蛋白 酶, β-半乳糖苷酶和伴刀豆球蛋白 A。
在本发明的一种用途中, 所述氧化还原剂、 靶向载体、 抗癌药物和半抗原可 以配制成单一的药物组合物, 或分别以每一种药物的组合物形式组成配方。
在本发明的一种用途中, 所述靶向载体剂可以是两种或多种, 所述两种或多 种靶向载体剂和一种抗癌药物可以配制成单一的药物组合物, 或分别以每一种药 物的组合物形式组成配方。
在本发明的一种用途中, 所述抗癌药物可以是两种或多种, 所述两种或多种 抗癌药物和一种靶向载体剂可以配制成单一的药物组合物, 或分别以每一种药物 的组合物形式组成配方。
在本发明的一种用途中, 所述氧化剂或还原剂、 靶向载体剂和抗癌药物可以 配制在一起成为单一的药物组合物。
在本发明的一种用途中, 所述氧化剂或还原剂、 靶向载体剂和半抗原可以配 制在一起成为单一的药物组合物。
在本发明的一种用途中, 所述两种或多种抗癌药物中的一种抗癌药物可以是 一种半抗原。
在本发明的一种用途中, 所述半抗原是硝基咪唑, 三硝基苯酚(TOP), 二硝 基苯酚(DNP), N-碘乙酰基一 N'—(5—磺酸基 1一萘基)亚乙基二酰胺(AED), 二硝基氟苯(DNFB), Ovabulin (OVA)或 白蛋白 (albumin)。
在本发明的一种用途中, 所述组合物进一步包括一种抗肿瘤剂。
在本发明的一种用途中, 所述抗肿瘤剂是一种抗血管生成剂。
在本发明的一种用途中, 所述抗肿瘤剂是选自一种烷化剂, 一种抗代谢剂, 一种天然产物, 一种铂配位复合物, 一种蒽二酮, 取代脲, 甲肼衍生物, 皮质激 素抑制物, 激素和拮抗剂。
在本发明的一种用途中, 所述抗肿瘤剂是一种癌基因抑制物或一种肿瘤抑制 基因或蛋白。
在本发明的一种用途中, 所述癌基因抑制物是一种抗癌基因抗体或一种抗癌 基因反义寡聚核苷酸。
在本发明的一种用途中, 所述癌基因选自 abl, erbA , erbB。 Ets, fesffps), f , fms, fos, hst, intl , int2, jun, hit, B-lym, mas, met, mxl(raf), mos, myb, myc, N-myc, neu(ErbB2), ral(mil), Ha-ras, Ki-ras ' N-ras, reh ros, sis, src, ski, trk 禾口 > 。
在本发明的一种用途中, 所述肿瘤抑制基因选自 pl6, P21 , p27, p53, RB, WT- 1 , DCC, NF— 1禾口 APC。
在本发明的一种用途中, 所述组合物进一步包含含有癌基因或肿瘤抑制基因 序列的病毒载体。
在本发明的一种用途中, 所述病毒载体选自腺病毒载体, 猿病毒载体和条件 复制人免疫缺陷病毒载体, 逆转录病毒载体, SV40载体, 单纯孢疹病毒扩增子载 体和痘病毒载体。
在本发明的一种用途中, 用于治疗的肿瘤选自肾上腺, 肛门, 听觉神经, 胆 管, 膀胱, 骨, 骨转移癌, 脑, 乳房, 中枢神经系统, 子宫颈, 结肠, 耳, 子宫 粘膜, 食管, 目艮, 眼睑, 输卵管, 肠胃束, 头和颈, 心脏, 肾, 喉, 肝脏, 肺, 上颚, 下颌髁, 上颌骨, 嘴, 鼻咽, 鼻, 口腔, 卵巢, 胰腺, 腮腺, 阴茎, 耳廓, 垂体, 前列腺, 直肠, 视网膜, 唾液腺, 皮肤, 小肠, 脊髓, 胃, 睾丸, 甲状腺, 扁桃体, 尿道, 子宫, 阴道, 前庭蜗神经, 和外阴肿瘤, 各种癌的淋巴和淋巴结 转移病 '灶和恶性淋巴瘤。
在本发明的一种用途中, 所述用于治疗的肿瘤是实体肿瘤, 但不限于实体肿 瘤。
在本发明的一种用途中, 所述实体肿瘤的大小大于 108个细胞。
在本发明的一种用途中, 所述实体肿瘤的大小从大约 5X109到大约 1011个细 胞。
在本发明的一种用途中, 所述组合物是通过静脉注射或直接注射施于肿瘤的。 在本发明的一种用途中, 所述组合物是通过与外科手术程序结合的方式施于 肿瘤的。
本发明还通过了治疗哺乳动物肿瘤的方法, 包括向所述哺乳动物施用有效量 的治疗组合物, 所述治疗组合物包含: a) 氧化剂或还原剂; b) 靶向载体剂; c)抗 癌药物; 和 d) 半抗原。 也就是, 所述治疗组合物包含: a)氧化剂; b)靶向载体 剂; c) 抗癌药物; 和 d) 半抗原, 或者所述治疗组合物包含: a) 还原剂; b)靶 向载体剂; c)抗癌药物; 和 d) 半抗原。
在本发明的一种方法中, 所述氧化剂或还原剂、 靶向载体剂、 抗癌药物和半 抗原被配制在单一的组合物中。
在本发明的一种方法中, 所述氧化剂或还原剂、 靶向载体剂、 抗癌药物和半 抗原各自配成独立的组合物, 并且, 它们在施用之前被合并在一起后再使用。
在本发明的一种方法中, 所述氧化剂或还原剂、 靶向载体剂和抗癌药物被配 成—个单一的组合物, 而所述氧化剂或还原剂、 靶向载体剂和半抗原被配成另一 个单一的组合物, 并且, 这两个组合物在施用之前被合并在一起后再使用。
在本发明的一种方法中, 被治疗的哺乳动物是人。
在本发明的一种方法中, 被治疗的肿瘤选自肾上腺, 肛门, 听觉神经, 胆管,
膀胱, 骨, 骨转移癌, 脑, 乳房, 中枢神经系统, 子宫颈, 结肠, 耳, 子宫粘膜, 食管, 目艮, 眼睑, 输卵管, 肠胃束, 头和颈, 心脏, 肾, 喉, 肝脏, 肺, 上颚, 下颌髑, 上颌骨, 嘴, 鼻咽, 鼻, 口腔, 卵巢, 胰腺, 腮腺, 阴茎, 耳廓, 垂体, 前列腺, 直肠, 视网膜, 唾液腺, 皮肤, 小肠, 脊髓, 胃, 睾丸, 甲状腺, 扁桃 体, 尿道, 子宫, 阴道, 前庭蜗神经和外阴及各种癌的淋巴和淋巴结转移病灶和 恶性淋巴瘤。
附图简述
图 1 显示的是流式细胞测量结果, 其表明, 相对于对照组 (仅仅阿霉素), Bruceantin-Adm-DNP螯合物对小鼠肿瘤具有明显更好的治疗效果 (40%对 28%)。 参见后文的实施例 3。
其中图 1中的上图是对照组情况, 图 1中的下图是治疗组情况。
发明详述
本发明是将化疗和免疫治疗结合起来, 在提供原发肿瘤或全身多发肿瘤的载 体靶向治疗的同时, 激发体内免疫能力根除身体内多个位点的全身性微小胂瘤。 这可以通过使靶向于^"瘤的载体与化疗剂有机的结合起来形成偶联物, 以及使靶 向于肿瘤的载体与免疫佐剂有机的结合起来形成偶联物, 并将载体-化学药物和载 体-免疫佐剂进行给药来实施; 或者, 可以使载体、 化疗药物与免疫佐剂有机的结 合起来形成偶联物。 经静脉将化疗药物和免疫佐剂送达肿瘤部位 (它们可以同时 到达肿瘤部位), 化疗药物杀死肿瘤, 免疫佐剂起到修饰肿瘤分解物或肿瘤降解蛋 白质的作用, 由此得到的产物能由主要组织相容性复合物 (Major Histocompatibity Complex, MHC ) 提呈, 可为免疫细胞所识别并产生免疫应答, 因而具有肿瘤特 异免疫性抗原的免疫学作用。 本发明起到了增强肿瘤免疫原性的作用, 最终起到 了免疫治疗作用, 从而增强抗癌作用, 同时减少化疗的剂量和副作用, 弥补化疗 的不足, 可减少肿瘤的复发几率, 或预防肿瘤的转移, 甚至有可能治疗肿瘤微小 转移灶。
在本发明的偶联物或螯合物的形成中, 主要利用了氧化还原剂, 例如氯化亚 锡 (SnCl2)。例如,利用氧化还原剂,一种亲肿瘤化合物如亚甲基二膦酸盐 (Methylene diphosphonate Injection, MDP) 与一种抗癌药物如阿糖胞苷和一种免疫佐剂 DNP 形成偶联物。 利用 MDP的亲骨性, 可有效地将这一 MDP-阿糖胞苷 -DNP偶联物 载到骨肿瘤组织, 从而让抗癌药物阿糖胞苷发挥抗癌作用, DNP发挥免疫佐剂的 修饰抗原作用。
在本发明的偶联物或螯合物的形成中, 常温下, 例如室温下, 可以进行氧化 剂或者还原剂促进的反应, 形成有用的偶联物或螯合物, 例如载体和药物的偶联 物或者螯合物, 载体和半抗原的偶联物或者螯合物。
对于本发明所用物质形成结构复杂的物质复合体的方式, 以及所述物质复合 体的具体形式没有特定的限制。 所述各种物质的组合, 导致作用的协同和更高选
择性, 因此本发明的范围在于这些物质的联合作用。
本发明提供了用于肿瘤治疗的组合物, 其可以通过静脉给药, 其中包括肿瘤 组织靶向试剂、 对肿瘤组织具有杀伤作用的试剂和能提高针对所所杀伤组织团块 的发炎性反应的试剂。在这些组合物中,优选的是那些包括四种成分的组合物(称 为四合一或 FIO), SP , 包括一种或多种氧化剂和 /或还原剂、 肿瘤组织革巴向剂与抗 癌制剂, 以及半抗原。 这些组合物用于治疗肿瘤, 如, 实体肿瘤。 因此, 本发明 也提供了应用这些组合物进行治疗的方法。
本发明的组合物, 在治疗多种赘生性肿瘤、 肿瘤和癌症, 特别是用传统的癌 症治疗方法如手术、 辐射治疗、 化疗和免疫治疗不能有效治疗的实体肿瘤中有很 大的适用性。
本发明提供了治疗恶性肿瘤、 肿瘤和癌症的方法和组合物。 这些方法包括使 用含有一种或多种氧化剂或还原剂、 肿瘤组织靶向剂与抗癌制剂和半抗原的组合 物, 其能减轻、 减少、 改善或阻止赘生性肿瘤、 肿瘤和癌症; 或者调整或保持在 临床症状或诊断标示的减轻状态, 临床症状或诊断标示是与赘生性肿瘤、 肿瘤和 癌症相关, 特别是用传统的癌症治疗方法如手术、 辐射治疗、 化疗和免疫治疗不 能有效治疗的实体肿瘤相关。 该组合物可以单独使用或与别的治疗赘生性肿瘤、 肿瘤和癌症的方法相结合施用。
能治疗的赘生性肿瘤、肿瘤和癌症包括, 但不局限于, 肾上腺, 肛门, 听觉神经, 胆管, 膀胱, 骨, 脑, 乳房, bruccal, 中枢神经系统, 子宫颈, 结肠, 耳, 子宫 内膜, 食管, 目艮, 眼睑, 输卵管, 胃肠道, 头和颈, 心脏, 肾, 喉, 肝脏, 肺, 下颌骨, 下颌髁, 上颌骨, 嘴, 鼻咽, 鼻, 口腔, 卵巢, 胰腺, 腮腺, 阴茎, 耳 廓, 垂体, 前列腺, 直肠, 视网膜, 唾液腺, 皮肤, 小肠, 脊髓, 胃, 睾丸, 甲 状腺, 扁桃体, 尿道, 子宫, 阴道, 前庭蜗神经, 外阴赘生性肿瘤, 各种癌的淋 巴和淋巴结转移病灶和恶性淋巴瘤。 优选的是, 治疗的赘生性肿瘤、 肿瘤和癌症 是实体肿瘤。 对于实体肿瘤, 包括大于 108个细胞的实体肿瘤, 如从大约 5X109 到 10"个细胞的实体肿瘤, 该组合物特别有效。 然而, 应该知道, 本发明组合物 对其它的实体肿瘤也可以是有效的。
提供的所述组合物可以提高大多数癌症患者的癌症治疗的治疗效果, 包括可 见肿瘤团块和不适合作为手术治疗的候选者的早期癌症患者和已失去手术机会的 肿瘤体积较大或转移的晚期癌症患者。
本发明提供的组合物, 可以是单一药物组合物的形式, 其中包括一种或多种 氧化剂和 /或还原剂、 肿瘤组织靶向剂与抗癌剂、 以及半抗原。 在该单一药物组合 物的形式中, 所包含的组分例如氧化剂和 /或还原剂、 肿瘤组织靶向剂、 抗癌剂以 及半抗原已经被混合在一起。 或者, 本发明提供的组合物所包含的组分例如氧化 剂和 /或还原剂、 肿瘤组织靶向剂、 抗癌制剂以及半抗原已经被有选择地混合在一 起, 例如, 一部分的氧化剂和 /或还原剂与肿瘤组织靶向剂和半抗原已经混合在一
起, 而一部分的氧化剂和 /或还原剂与肿瘤组织靶向剂和抗癌剂已经混合在一起。 或者, 可选的是, 本发明提供的组合物所包含的组分例如氧化剂和 /或还原剂、 肿 瘤组织靶向剂、 抗癌制剂以及半抗原是分离的形式, 例如, 它们分别盛于不同的 容器中, 它们可在被给药前即刻被混合在一起后再使用, 或者, 它们可以以彼此 较短的时间间隔被分别施用。 例如, 当接连地或间断地给药时, 每一给药的间隔 一般小于一天, 优选地, 小于一小时, 但可以长一些。 给药的精确顺序和时间选 择可以按经验决定。
组合物的剂量可以由经验决定, 但一般是正常用于治疗赘生性肿瘤、 肿瘤和 癌症的剂量, 数量足以进一步强化别的赘生性肿瘤的治疗。 该组合物可以包装为 试剂盒。
组合物中还可包括额外的免疫试剂, 包括, 但不局限于, 卡介苗 (BCG)、 干扰 素、 或用低剂量的环磷酰胺 (cyclophosphamide ) 预处理后的集落剌激因子 GM— CSF。
组合物 FIO被施用以便形成载体靶向治疗, 治疗通过抗癌药物直接杀死许多 肿瘤细胞, 导致肿瘤的皱缩。 这使肿瘤荷载值降低而可以用免疫治疗和肿瘤疫苗 治疗发挥作用。 同时也形成了肿瘤发炎区吸引淋巴细胞和别的发炎反应介体到达 靶向肿瘤位点。 被吸引的淋巴细胞包括肿瘤抗原递呈细胞 (APC)、 巨噬细胞、 树 突细胞 (DC )和活化 B细胞。 这些淋巴细胞暴露于由肿瘤细胞裂解而产生的肿瘤 抗原而引发肿瘤特异性免疫反应。
当 FIO实施后伴随肿瘤发炎和肿瘤细胞裂解时, 在形成的位点中, 裂解的肿 瘤细胞被半抗原修饰, 产生修饰的具有更复杂的免疫原的 MHC—相关肽, 然后被 释放, 作为自身肿瘤疫苗发挥作用。 这样的肿瘤疫苗加强了患者自己的肿瘤免疫 原性, 剌激 T淋巴细胞攻击那些未被杀死的肿瘤内和周边的活的肿瘤细胞, 和全 身转移肿瘤和微小潜在肿瘤。 这种自身肿瘤疫苗在阻止肿瘤转移和肿瘤复发中发 挥重要作用。
另外, 附加的治疗性病毒和核酸, 如 DNA、 cDNA, 也能包括在该组合物中。 在施用时, 这些可以被包裹在螯合物中, 能融合到或转染入一些保留的肿瘤细胞 中, 原位产生遗传修饰了的肿瘤疫苗和杂交疫苗。 从肿瘤裂解得到的肿瘤 DNA和 RNA可以转染入树突细胞, 其直接接受肿瘤抗原信号。 化学和遗传修饰的肿瘤内 肿瘤疫苗联合产生有效的抗原特异性和抗原非特异性的或共刺激信号抗肿瘤免疫 反应。
该组合物也可包括别的试剂, 如抗血管生成试剂、 放射致敏剂和别的癌症治 疗剂。 例如, 也可通过 FIO形成偶联物, 缓慢释放抗血管生成试剂以抑制新肿瘤 生长所需的微血管的形成。
在该组合物和方法中使用的抗肿瘤 (抗癌症) 试剂包括, 但不局限于, 抗血 管生成剂, 烷化剂, 抗代谢物, 天然产物, 铂配位复合物, 蒽二酮, 取代尿素,
甲基肼衍生物, 肾上腺皮质遏抑剂, 激素和拮抗剂, 癌基因抑制剂如抗癌基因抗 体或抗癌基因反义寡聚核苷酸, 抗癌多聚糖, 或药草提取物如中草药提取物。
抗血管生成试剂包括, 但不局限于, 基底膜降解抑制剂, 细胞迁移抑制剂, 内皮细胞增殖抑制剂, 三维组织和构建效能抑制剂, 血管抑制基因, 血管抑制化 学因子基因, AGM-1470 (TNP-470), 血管抑制类固醇, 血管抑素, 抗 avfi3的抗 体,抗碱性成纤维细胞生长因子抗体, IL-1的抗体, TNF-α的抗体, VEGF的抗体, 金诺芬 (auranofin), 咪唑硫嘌吟, BB-94, BB-2156, 碱式可溶 FGF受体, 羧基 胺基三唑类(CAI), 软骨衍生抑制剂 (CDI), 几丁质, 氯喹, 顺铂, CM101 , 可的 松 /肝素, 可的松 /hyaluroflan, 11-脱氧皮甾醇 /肝素, CT-2584, 环磷酰胺, 环孢菌 素入, 地塞米松, 二氯酚酸 /透明质酸糖胺多糖, 嗜酸性的主要碱性蛋白, 纤连蛋 白肽, 明胶酶抑制剂, 神经胶质瘤衍生的血管生成抑制因子(GD-AIF), GM1474, 氯化金,硫羟苹果酸金, 肝素酶, 透明质酸糖胺多糖(高分子量和低分子量种类), 氢化可的松 /β环状右旋糖苷, 布洛芬, 吲哚美辛, α-干扰素, γ-干扰素诱导蛋白质 10, γ-干扰素, IL-1, IL-2, IL-4, IL-12, 层粘连蛋白, 左旋咪唑, 三羧氨基喹啉, LM609, 基质金属蛋白酶抑制剂, 马马司他(marimastat (BB-2516)), 甲羟孕酮, 6—甲基巯基嘌呤核糖核苷, metastat (Col-3), 氨甲喋呤, 二甲胺四环素, 一氧化 氮, 奥曲肽(生长激素释放抑制激素类似物), 紫杉醇, D-青霉酸衍胺, 多硫戊聚 糖, 胎盘 proliferin相关蛋白, 胎盘核糖核酸酶抑制剂, 纤溶酶原激活因子抑制剂 (PAD, 血小板因子 -4 (PF4), 氢化泼尼松, 催乳素(16Kda片断), proliferin相 关蛋白, 前列腺素合酶抑制剂, 鱼精蛋白, 类维生素 A, 罗喹美克 (LS-2616, 三 羟氨基喹啉),生长激素释放抑制激素,基质溶素抑制剂,物质 p, 苏拉明, SU101, tecogalan sodium (DS-4152), 四氢皮质醇 -sthxombospondins (TSPs), 金属蛋白质 酶组织抑制剂 (TIMP1 , 2, 3 ), 血管内皮生长因子抑制剂, 维生素 A, vitaxin和 玻璃体液。
在一个实施方案中, 本发明组合物包括单一的组合物, 其含有一种或多种氧 化剂和 /或还原剂、 肿瘤组织靶向剂与抗癌制剂和半抗原, 由此组成的配方可以用 于注射形式的药物传输, 或者包括三种组合物, 一个含有氧化 ^1或还原剂, 另一 个含有组织靶向制剂和抗癌药物, 还有一种含有半抗原, 每一种都与药学上可接 受的载剂或赋形剂混合组成可以注射的形式, 或者包括四种组合物, 一个含有氧 化剂或还原剂, 另一个含有组织靶向制剂, 另一个含有抗癌药物, 还有一种含有 半抗原, 每一种都与药学上可接受的载剂或赋形剂混合组成可以注射的形式。 同 时也提供了特定的医疗程序、 药学组合物和试剂盒。
在一个特定的实施方案中, 提供一种组合物, 其含有: a) —种氧化剂或还原 剂; b)—种组织靶向剂; 和 c)一种抗肿瘤 (抗癌)剂, 如 Arc-C, 和 d)—种半抗 原 DNP或 TNP。
同时也提供一种治疗哺乳动物优选为人的肿瘤尤其是实体肿瘤的一种方法,
包括肿瘤靶向施用有效量的半抗原和药物治疗剂, 其引起肿瘤赘生物的炎症坏死, 由此产生针对肿瘤的自身免疫应答, 治疗肿瘤赘生物。 针对肿瘤的自身免疫应答 可以是体液的和 /或细胞免疫应答。
在本发明中应用的半抗原包括, 但不限于, 三硝基苯酚 (TNP), 二硝基苯酚 (DNP) , N-碘乙酰基 -Ν'- ( 5-磺酸基 -1-萘基) 亚乙基二酰胺(AED), 二硝基氟苯 (DNFB ) 和 Ovabulin ( OVA)。
本方法和组合物所用的氧化剂包括, 但不限于, 氯化亚锡(SnCl2) ; 硫酸亚锡 ( SnS04) ; 亚硫酸亚锡 (SnS03 ) ; —氧化锡 (SnO ) ; 二氧化锡 (Sn02 ) ; 锡酸钠 (Na2Sn03 ) ; 亚锡酸钠(Na2Sn02) ; 氯化亚锡 ( SnCl2 ) ; 四氯化锡 ( SnCl4) ; 硫代 锡酸盐 (SnS3 ) ; 硫化亚锡 (SnS)。
本方法和组合物中使用的还原剂包括, 但不限于, 苏木精, 一种含氧量低的 还原剂如一种硝基咪唑, 和非硝基化合物 SR 4233。
用于本组合物和治疗的组织靶向剂包括, 但不限于, 二巯丁二钠 (niXSodium Dimercapto succinate (DMSA-III)); 二疏丁二钠 (V)(Sodium Dimercaptosuccinate (DMSA-V)); 注射用亚锡焦磷酸钠 (Sodium Pyrophosphate and Stannous Chloride for Injection (PYP)); 注射用亚甲基二膦酸盐 (Methylene diphosphonate Injection (MDP)); 聚合白蛋白; 硫乙甘肽; 亚锡喷替酸 (Pentetic Acid and Stannous Chloride (DTP A)); 亚锡葡庚糖酸钠 (Sodium Glucoheptonate and Stannous Chloride); 亚锡双 半胱氨酸乙酯 (L,L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); 依沙美肟 (Exametazime)(HMPAO); 亚锡依替菲宁 (Etifenin and Stannous Chloride); 亚锡植酸 钠 (Sodium Phytate and Stahnous Chloride) ; 甲 氧基异 丁 基异腈 盐 [Cu(MIBI)4BF4](MIBI); 甲基 -L-酪氨酸 (a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile); 硝基咪唑类化合物 (2-nitroimidazole); 单克隆抗体和肿瘤单克隆抗体; 及中药提取物如鸭胆子素 (Braceantin)、 汉防已甲素 (Tetrandrine)、 唐松草碱 (thalicarpine)、 美登素 (maytansine)等等。
优选地, 该组合物也包括一种促进剂, 该方法进一步包括施用一种促进剂, 该促进剂促进了半抗原和肿瘤赘生物的肿瘤抗原的接合。 促进剂包括, 但不限于, 螯合剂如甘氨酰酪氨酰基- (N-e-二乙三胺五乙酸) -赖氨酸 (GYK-DTPA) 或亚德 利亚霉素己二酸-二酰肼 (ADR-ADH) , 或一个化学交联试剂如碳化二亚胺。
同时优选地, 该组合物也包括一个免疫应答增效剂, 还进一步包括在肿瘤上 施用免疫应答增效剂的方法。 该免疫应答增效剂包括, 但不限于, 多糖, 草药提 取物如中草药提取物, 卡介苗 (BCG), 小棒状杆菌, 一种酶如霍乱弧菌神经氨酸 酶 (VCN), 木瓜蛋白酶, β-半乳糖苷酶和伴刀豆球蛋白 A, 以及非致病性病毒如 非致病性的新城疫病毒。 也可以施用编码癌基因的核酸或编码的基因产物, 或者 包括于组合物中来提高免疫应答。其中的癌基因的实例包括,但不限于, ab erbA, erbB, ets, fes(fps) , fgr, fins, fas, hst, intl, int2, jun, hit, B-lym, mas, met,
mtl(raf), mos, myb, myc, N-myc, neu(ErbB2) , ral(mil), Ha-ras, Ki-ras, N-ras, rel, ros, sis, src, ski, rA:和 y s。
这些组合物和方法也可以同时施用, 连续施用或者与化学治疗结合起来施用, 如, 进一步在组织靶向剂组合物中包括两种或多种抗肿瘤剂或者施用在此提供的 组合物, 然后优选地在同一天、 同一周或其它周期下, 施用联合化学治疗。
目前的预期方法也可以与基因治疗结合, 如, 进一步在组合物中包括肿瘤抑 制基因如 pl6, p21 , P27, p53, RB, WT-1 , DCC, NF-1和 APC。 优选地, 肿瘤 抑制基因在一个病毒载体中如腺病毒载体, 猿病毒载体和条件复制人免疫缺陷病 毒载体中。
在优选的实施方案中, 在治疗中应用特定的组合物, 其中氯化亚锡作为氧化 剂, MDP作为骨组织靶向剂, ARC-C作为抗癌剂和 TOP作为半抗原, 实施于治 疗骨癌和恶性肿瘤骨转移。
在组合物中, 每种组分均可以以各种不同的量存在。 在优选的实施方案中, 使用的氧化剂或还原剂大约从 0.01% (w/w) 到大约 35 % (w/w), 使用的靶向化 合物从大约 1 % (w/w) 到大约 98% (w/w), 使用的化疗药物 (如抗癌剂) 从大 约 lmg/ml到大约 80mg/ml, 且使用的半抗原从大约 lmg/ml到大约 80mg/ml。
偶联作用可以以本领域已知的方式形成, 例如通过在例如常温下混合。 偶联 作用也可以通过某些物理方法来进行, 包括低温, 激光疑聚 (ILC), 射频诱导和 辐射。
在优选的实施方案中, 半抗原和抗癌药物与组织靶向剂的偶联物通过注射施 用于肿瘤赘生物。
在优选的实施方案中, 半抗原和抗癌药物与组织靶向剂通过与外科手术过程 组合施用于肿瘤赘生物。
进一步提供了在哺乳动物中优选人类中, 治疗肿瘤尤其是实体瘤的方法, 包 括原位施用有效量的抗肿瘤 (抗癌)剂, 如 Ara-C, 半抗原, 氧化还原剂, 组织靶 向剂 (肿瘤靶向剂), 其能靶向到达肿瘤的组织, 由此治疗肿瘤。
在另一个特定的实施方案中, 提供了在哺乳动物中优选人类中治疗肿瘤, 尤 其是实体肿瘤的方法, 该方法包括原位施用有效量的抗肿瘤(抗癌)剂,如 Am-C, 半抗原, 氧化还原剂, 二巯丁二钠 (V)(Sodium Dimercaptosuccinate (DMSA-V))作为 肿瘤组织靶向剂, 其能到达软组织肿瘤, 由此治疗软组织肿瘤。
在另一个特定的实施方案中, 提供了治疗肿瘤尤其是实体肿瘤的方法, 该方 法包括原位施用有效量的抗肿瘤 (抗癌) 剂, 如 Am-C, 免疫佐剂 DNP, 氧化还 原剂, 亚锡喷替酸 (Pentetic Acid and Stannous Chloride (DTPA)) 作为肿瘤组织靶 向剂和, 其能到达肾肿瘤, 由此治疗肾组织肿瘤。
在另一个特定的实施方案中, 提供了治疗肿瘤尤其是实体肿瘤的方法, 该方 法包括原位施用有效量的抗肿瘤(抗癌)剂, 如 Ara-C, 氧化还原剂, 恩欧乙替药
盒 (NOET) 作为肿瘤组织靶向剂和 DNP免疫佐剂, 其能到达肿瘤组织, 由此治 疗肿瘤。
在另一个特定的实施方案中, 提供了治疗肿瘤尤其是实体肿瘤的方法, 该方 法包括原位施用有效量的抗肿瘤(抗癌)剂,如 Ara-C,氧化还原剂,植酸钠(PHY) 作为肝组织靶向剂 (或淋巴靶向剂)和 DNP免疫佐剂, 其能到达肿瘤组织, 由此 治疗肝部肿瘤 (或淋巴系统的恶性肿瘤)。
在另一个特定的实施方案中, 提供了治疗肿瘤尤其是实体肿瘤的方法, 该方 法包括璩位施用有效量的抗肿瘤 (抗癌)剂, 如 Ara-C, 氧化还原剂, 依替菲宁药 盒 (EHIDA) 作为肝胆系统靶向剂和 DNP免疫佐剂, 其能到达肝胆组织, 由此治 疗肝胆系统的恶性肿瘤。
在另一个特定的实施方案中, 提供了治疗肿瘤尤其是实体肿瘤的方法, 该方 法包括原位施用有效量的抗肿瘤(抗癌)剂, 如 Ara-C, 氧化还原剂, 亚锡双半胱 乙酯 (ECD ) 作为脑靶向剂和 DNP免疫佐剂, 其能到达脑组织, 由此治疗脑系统 的恶性肿瘤。
在其它特定的实施方案中, 提供了一种在哺乳动物中优选是人中治疗肿瘤尤 其是实体肿瘤的方法, 该方法包括原位注射有效量的半抗原, 组织靶向剂, 抗癌 剂以及氧化剂和 /或还原剂, 由此产生对肿瘤的自身免疫反应, 且治疗肿瘤。
本发明的一些特点和优点在于, 1 : 本发明主要是用于静脉给药治疗肿瘤的方 法; 2: 本发明可以是载体、 药物和佐剂形成一体, 可以是偶联物或其他形式的螯 合; 3 : 在本发明所述的偶联物中, 载体发挥其作用, 运载药物到达靶向地点 (肿 瘤或肿瘤所在的器官),药物和佐剂分别发挥作用达到治疗的目的,药物杀死肿瘤, 佐剂修饰被药物杀死的肿瘤的碎片, 起到肿瘤疫苗的作用; 4: 在本发明中, 氧化 还原剂在形成偶联物时发挥作用, 不参与肿瘤的治疗的作用; 5 : 本发明是一个全 身系统的治疗方法, 可以直接治疗一个以上的不同部位肿瘤, 任何部位的肿瘤和 任何大小的肿瘤都可以被治疗, 包括亚临床肿瘤灶和亚临床转移病灶; 6: 在本发 明中, 被治疗的肿瘤的炎症反应和免疫应答, 可能产生抗肿瘤的抗体和具有细胞 毒性、 对肿瘤发挥杀伤作用的淋巴细胞。
当然本发明不是受限制于上述理论机理, 也不受限制于任何其他的理论机理, 本发明提供的是有效的治疗肿瘤的方法和材料, 本发明也延伸到与所描述的各个 方法和材料等价的方法和材料上, 这些是本发明的一部分。
本发明的特定组合物和方法描述于以下的部分和随后的小部分中。
具体实施方式
本发明提供了组合物和方法, 其用于全身肿瘤综合化疗诱发的免疫治疗, 涉 及肿瘤赘生物、 肿瘤和癌症组织, 优选的是与肿瘤内、 基因疗法、 放射疗法相组 合。 在此公开的是在肿瘤赘生物、 肿瘤或癌组织细胞受到化疗杀伤死亡的同时, 和肿瘤原位传送半抗原的同时, 诱导了全身的免疫治疗, 这是治疗这些肿瘤赘生
物、 肿瘤或癌症的特色有效方法。
尽管不希望受到在此描述的任何理论或机制的局限, 目前了解的是以下载体 化疗是对肿瘤治疗有效的方法, 同时可以诱导一定的免疫治疗作用, 通过载体同 时将半抗原与化疗药物到达肿瘤部位, 可以; 大增强化疗诱导的免疫治疗, 这对 于治疗肿瘤赘生物、 肿瘤和癌症有更积极的作用。 首先, 通过化学载体的方法介 导的治疗, 杀死至少一些, 大多数情况下, 靶肿瘤中多于 50%的瘤细胞。 总的来 说, 肿瘤负荷减少, 其降低了肿瘤的重量, 有利于后续的免疫治疗。 此外, 化疗 也可以导 m细胞表面、 胞外基质的结构变化和细胞裂解, 释放肿瘤细胞的成分, 即局部发炎。 这一发炎效应, 与加入的半抗原一起, 进一步产生更多的复合的免 疫原, 其中半抗原与通过凝聚作用导致的肿瘤细胞裂解产生的肿瘤特异抗原结合。 发炎区域吸引不同的淋巴细 '胞, 如肿瘤抗原递呈细胞 (APC ), 巨噬细胞, 树突细 胞 (DC) 和活化的 B细胞, 淋巴细胞聚集于发炎区域且与肿瘤抗原作用, 如, 复 合的肿瘤抗原, DNA, RNA和其它从细胞裂解释放的组分。 这些相互作用诱导了 肿瘤特异的免疫应答, 其中包括体液的、 细胞的和补体介导的应答。 这一局部的 肿瘤特异免疫应答通过在邻近存在的没有通过开始的凝聚作用杀死的活肿瘤赘生 细胞得到更进一步增强。 通过这种方式, 后续的肿瘤特异免疫应答增强了化疗作 用的效果 (原位接种疫苗) 并且延伸至转移的肿瘤赘生物部位, 阻止肿瘤细胞的 复发和转移。
该组合物和方法也可以通过载体到达包括肿瘤组织区域在内的组织区域, 对 肿瘤胞外基质 (EM) 的作用效果来达到治疗效果。 在体内, 肿瘤细胞被胞外基质 包围, 如胶原, 纤维结合素, 蛋白聚糖(蛋白 /碳水化合物), 透明质酸和其它高分 子量的物质。 已经显示, 肿瘤细胞与正常细胞的胞外基质是不同的。
肿瘤特异性免疫反应可以通过原位施用或通过包含载体化合物、 促进半抗原 与肿瘤抗原结合的促进剂、 免疫反应增效剂、 抗肿瘤剂、 癌基因产物或任何这些 物质的组合物而增强。
预期的治疗可以单独使用或与别的癌症治疗相结合, 例如, 但不局限于, 手 术, 辐射治疗, 化疗和传统的免疫治疗。 例如, 这种治疗可以通过在靶向载体剂 组合物中加入多种抗肿瘤剂, 如抗血管生成剂, 与化疗一起使用。 这种组合治疗 是有利的, 因为靶向载体增加抗肿瘤剂保留在肿瘤团块中的时间, 使肿瘤团块暴 露于抗肿瘤剂下更长的时间。 在这一点上, 载体是作为控制药物释放的工具。
总之, 靶向载体化疗减少靶肿瘤内的至少一些或大于 50%的肿瘤细胞。 抗胂 瘤剂杀死的或仍活着的细胞, 可以进一步与半抗原结合, 产生免疫治疗作用。 等 同于原位 "接种肿瘤疫苗", 进一步减少活的肿瘤细胞, 导致比任何单一的一种治 疗效果更好。
在一实施例中, 通过在靶向载体组合物中加入辐射致敏剂, 治疗可以与辐射 治疗一起使用。 在这方面, 靶向载体作为控制药物释放的工具, 释放辐射致敏剂
到仍活着的肿瘤细胞, 增加辐射治疗的效果。
在另一实施例中, 治疗可以在手术前使用。 在这方面, 靶向载体组合物在预 治疗肿瘤前发挥重要作用, 使手术易于排除肿瘤团块, 减少肿瘤转移率。
在另一实施例中, 通过在靶向载体组合物中加入编码所要的野生型癌基因、 肿瘤抑制基因、 免疫细胞因子基因或凋亡基因的核酸, 该治疗可以与基因治疗结 合使用。 这种组合治疗是有利的, 因为靶向载体有利于把这些野生型癌基因或肿 瘤抑制基因导入活的肿瘤细胞。
在所有的治疗中, 免疫佐剂, 如 BCG, 可以与靶向载体剂组合物相结合增加 对肿瘤细胞的免疫反应。 免疫佐剂可以重复地再注射, 如每隔 2到 4周注射。 低 剂量 Cyclosphamide, 如 200到 300mg/m2也可以预先施用, 例如提前 3天, 每一 原位免疫接种可以加强对抗原的细胞介导免疫的发展。
A .定义
除非另外定义, 在此使用的所有技术和科学术语都有与本发明所属技术领域 的技术人员一般理解的同样意义。 所有在此参考的专利、 申请、 公开的申请和别 的出版物和来自 GenBank和其他数据库的序列被完整地引入本文作为参考。 如果 此节中阐明的定义与引入本文作为参考的申请、 公开的申请和别的出版物和来自 GenBank和其他数据库的序列中阐明的定义相反或不一致, 此节中阐明的定义比 在本文引入作为参考的定义优先。
正如在此使用, "偶联物"意味着通过各种作用结合在一起的物质。其包括各种 组合物、 化合物、 螯合物、 连接物, 例如但不限于, 靶向化合物与辅助药物的偶 联物。 含靶向化合物的偶联物是靶向载体与其它物质结合在一起形成的物质, 在 靶向于靶标的同时, 将与其结合的物质也带到靶标中。
正如在此使用, "一个 "意味着"至少一个"或"一个或多个"。
正如在此使用, 氧化一还原反应指电子从供体传到受体分子的反应。
正如在此使用, 氧化试剂 (或氧化剂) 指在氧化一还原反应中接受电子的试 剂。
正如在此使用, 还原试剂 (或还原剂) 指在氧化一还原反应中提供电子的试 剂。
正如在此使用, 靶向载体指能靶向运输化合物的化合物, 也就是, 能部分或 全部到达特定组织的化合物或生物物质。
正如在此使用, 半抗原指除非与载体或分子相结合, 才能诱导抗体形成的抗 体特异性物质。 一旦半抗原与载体 /分子结合, 用该偶合物产生的抗体可以识别半 抗原和 /或载体 /部分。 半抗原一载体 /分子的偶合物也可以产生特异的细胞免疫反 应。
正如在此使用, 抗肿瘤治疗指设计的任何减少或改良其症状的治疗肿瘤赘生 物、 肿瘤或癌症的治疗方案。 预防肿瘤赘生物、 肿瘤或癌症复发或减少其严重性
的治疗方法也在考虑之列。
正如在此使用, 肿瘤赘生物指异常的新的生长, 所以与肿瘤同义, 可以是良 性瘤或恶性瘤。 不同于增生, 肿瘤赘生物的增殖甚至在没有起始的刺激的情况下 还在持续。
正如在此使用, 癌症指由任何形式的恶性肿瘤引起的一类疾病的总称。
正如在此使用, 恶性的, 当用于肿瘤时, 指具有癌扩散转移能力, 同时失去 生长控制和位置控制的初级瘤。
正如在此使用, 抗肿瘤剂(可以与抗赘生物肿瘤剂, 抗瘤或抗癌剂互换使用) 指任何用于抗肿瘤治疗的试剂。 这些试剂包括, 当单独使用或与别的化合物组合 使用的任何试剂, 它们可以减轻、 减少、 改善、 阻止或调整或保持与赘生性肿瘤、 肿瘤或癌症相关联的临床症状或诊断标记的缓解状态, 它们可以用于此处所提供 的方法、 组合和组合物中。 抗赘生物肿瘤剂包括, 但不限于, 抗血管生成剂, 垸 化剂, 抗代谢物, 一些天然产物, 铂配位复合物, 蒽二酮, 取代脲, 甲肼衍生物, 肾上腺皮质激素抑制物, 某些激素和拮抗剂, 抗癌症多糖和某些草药提取物如中 草药提取物。
正如在此使用, 抗肿瘤剂 (或抗肿瘤或抗癌剂) 或抗赘生物肿瘤治疗并不包 括包含氧化剂或还原剂, 蛋白变性剂; 和半抗原的组合物, 或采用它们的治疗, 但包括本技术领域的技术人员所知的为了改善肿瘤赘生物、 肿瘤或癌症的一些形 式的症状的所有药剂和治疗形式。
正如在此使用, "血管生成"指从母微血管中产生新的血管。血管生成是由血管 生成刺激物和抑制物系统严密调控的。 病理的血管生成是由血管生成刺激物和抑 制物间的净平衡的移动导致, 如, 过量产生正常的或畸形的血管生成介体, 或由 于在此过程中相对缺乏抑制物。
正如在此使用, "不需要的和 /或不受控制的血管生成"指病理的血管生成, 其 中血管生成的刺激物影响超出了血管生成抑制物的影响。
正如在此使用,"抗血管生成治疗或药剂 "指包括当单独使用或与别的化合物组 合使用的任何治疗方案和化合物, 它们可以减轻、 减少、 改善、 阻止或调节或保 持与不理想和 /或不受控制的血管生成相联系的临床症状或诊断标记的缓解状态。 正如在这里所用, "内皮酶抑制剂"不认为是"抗血管生成处理或抗血管生成剂"。
正如在此使用, "肿瘤抑制基因"(或抗癌基因, 癌症易感基因)指编码正常地 负调控细胞周期的产物的基因, 它们在细胞进行快速分裂前必须变异否则是无活 性。 肿瘤抑制基因的实例包括, 但不局限于, pl6, p21, p53, RB (成视网膜细胞 瘤), WT-1 (胚性癌肉瘤), DCC (在结肠癌中发生缺失), NF-1 (神经纤维肉瘤) 和 APC (结肠息肉样腺瘤)。
正如在此使用, "癌基因"指动物细胞 (原癌基因) 的正常基因的变异和 /或过 度表达形式, 其占优势时能使细胞脱离正常的生长抑制, 从而单独, 或与其它变
化相结合, 可把细胞转变为肿瘤细胞。 肿瘤抑制基因的实例包括, 但不局限于, abl, erbB, ets, fes (fps), fgr, fins, fos, hst, intl, int2, jun, hit, B-lym, mas, met, mil (raf), mos, myb , myc, N-myc, neu (ErbB2 ) ,ral (mil), Ha-ras, Ki-ras, N-ras, rel, ros, sis, src, ski, t' 禾口 w。
正如在此使用, "反义寡核苷酸"指与 mR A或双链 DNA的有意链互补的核 苷酸碱基的合成序列。 有意和反义寡聚核苷酸混合物在合适条件下可以导致两种 分子的配对或杂交。 当这些寡聚核苷酸与 mRNA配对(杂交), 发生阻碍蛋白合成 (翻译)。 当这些寡聚核苷酸与双链 DNA配对, 发生阻碍 RNA合成 (转录)。 所 致翻译和 /或转录的抑 导致有意链编码的蛋白的合成受阻。
正如在此使用, 抗体包括抗体片段, 如 Fab片段, 其由轻链和重链的可变区 组成。
正如在此使用,人源化抗体指通过修饰以便包括"人"氨基酸序列的抗体, 以至 施用于人而不会引起免疫应答。 制备这些抗体的方法是已知的。 例如, 表达单克 隆抗体的杂交瘤已经被重组 DNA技术改变从而来表达其中的不变区的氨基酸组成 是以人抗体为基础的抗体。 已经设计了计算机程序来确定这些区域。
正如在此使用, "促进剂,它们促进半抗原与肿瘤抗原的结合 "指一种交联半抗 原与肿瘤抗原的试剂, 或任何促进交联反应的试剂。 半抗原与肿瘤抗原的交联可 以是共价键或非共价键, 可以通过疏水、 极性、 离子静电或其它相互作用介导。
正如在此使用, "免疫应答"指一个生物体在应答一个抗原时,其免疫系统的反 应性的变化; 在脊椎动物中, 这可以包括抗体的产生, 诱导细胞介导的免疫, 补 体激活或免疫耐受性的发展。
正如在此使用,"免疫应答增效剂 "指一种可以增强抗原引起一种免疫应答效应 的物质。
正如在此使用, 细胞因子是一种因子, 如淋巴因子或单核因子, 它由细胞产 生,影响相同或别的细胞。 "细胞因子"是在免疫反应中在细胞之间传递信号的分子 组中的一种。 细胞因子是蛋白质或肽; 一些是糖蛋白。
正如在此使用, "白细胞介素 (IL ) "指主要由 T细胞产生的一大组细胞因子, 虽然一些由单核吞噬细胞产生, 或由组织细胞产生。 它们有多种功能, 但大多数 直接参与指导别的细胞分裂和分化。 每一种白细胞介素作用于特定的, 有限的表 达此种细胞因子的正确受体的细胞。
正如在此使用, 白细胞介素 -1 ( IL- 1 ) 指某种肿瘤抗原递呈细胞 (APC ) 产生 的白细胞介素, 与 IL-6—起, 作为 T细胞激活的共刺激信号。 IL一 1基因组包括 IL-la, IL-Ι β和 IL-1受体拮抗物(IL-lRa) (Dinarello, Eur, Cytokine Netw. , 5 ( 6 ) : 517-522 ( 1994) )。每一种成员首先合成为前体蛋白; IL-1前体(ProIL-la, ProIL-Ι β ) 的分子量是大约 31000道尔顿。 ProIL-la和成熟的 17000道尔顿的 IL-la都有生物 活性, 然而 ProIL-Ιβ需要切割成 17000道尔顿的肽而有最佳的生物活性。 IL-lRa
前体有一前导序列,切割后成为成熟形式,象大多数蛋白一样分泌。 IL-la和 IL-Ιβ 是强效的激动剂, IL-Ra是特定的受体拮抗剂。 而且, IL-Ra显然是纯粹的受体拮 抗剂而在体外或体内没有激动剂活性。 虽然 IL-lRa是分泌蛋白, 但这种分子具有 另一保留在细胞内的形式。 它被叫做"胞内"(ic) IL-lRa。 ML-lRa由改变的 IL 一 IRa基因的 mRNA拼接插入物替代编码信号肽的外显子而产生。 IL一 IRa形式 在功能性上是不可区别的。
因而, 例如, 提及的 "IL—1"包括所有的由 IL—1基因家族包括 IL—la, IL— 1β, IL- lRa, 和 icIL-IRa编码的蛋白质, 或别的来源或合成制备的同等分子。预 计包含保守氨基酸被取代, 但取代不改变其活性的 IL-1。 本技术领域的技术人员 知道合适的保守取代氨基酸, 并且这些取代一般不改变得到的分子的生物活性。 本技术领域的技术人员认识到, 一般地, 在多肽的非必需区单个氨基酸取代并不 一定改变生物活性(参见,如, Watson et al Molecular Biology of the Gene, 4th edition, 1987, the Bej acmin/ Cummings Pub co, p224 )
优选的这些取代与表 1列出的一致, 如下所示:
表 1
正如在此使用, 在此出现的多种氨基酸序列中的氨基酸根据它们众所周知的 三个字母或一个字母的缩写来表示。在多种 DNA片段中出现的核苷酸用本技术领 域中常规使用的标准单字母表示来表达。
正如在此使用, 术语"治疗剂", "治疗法", "辐射防护剂", "化疗药剂"指传统 的药物和药物治疗, 包括疫苗,其为本技术领域的技术人员所知。 "辐射治疗"剂在 本技术领域也是已知的。
正如在此使用, "疫苗"指用于积极的免疫学预防的任何组合物。疫苗可以在治 疗上用作治疗疾病, 或者主动地或在感染后阻止疾病的发展或减轻疾病的严重性。 疫苗的实例包括, 但不局限于, 已被杀死的烈性菌株细菌或减毒 (变种或变异) 菌株的活细菌, 或微生物, 真菌, 植物, 原生动物, 后生动物衍生物或产物的制
备物。 "疫苗 "也包含基于蛋白质 /肽和核苷酸的疫苗。
正如在此使用, "细胞毒性细胞"指杀死病毒性感染靶细胞的细胞,靶细胞表达
MHC1型分子的抗原肽。
, 正如在此使用, "血清 "指除去了纤维蛋白凝块和血细胞后得到的血液液体部 分, 区别于循环血中的血浆。
正如在此使用, 治疗特定疾病的化合物的有效量是足以改善或以某种方式减 少与疾病相关的症状的量。 此量可以作为单一剂量施用或根据情况决定, 借此可 以有效治疗。 药物剂量可以治愈疾病, 但一般的, 治疗是为了缓解疾病症状。 重 复的施用可以得到理想的症状缓解效果。
正如在此使用, 这种偶合物的药物可接受盐, 酯或别的衍生物包括任何盐, 酯或衍生物, 这些物质可以由本技术领域的技术人员使用已知的此种衍生方法容 易地制备它们, 这一过程产生施用到动物或人, 不会产生实质毒性作用的化合物, 这些化合物或者有药物活性或者是前体药物。
正如在此使用, 治疗意味着任何方式, 其中一种情况、 紊乱或疾病的症状发 生好转或有利的改变。 治疗也包括在此讨论的组合物的药物上的用途。
正如在此使用, 通过施用特定药物组合物发生特定紊乱的症状的改善指任何 减轻, 或者是永久的或者是暂时的, 持续的或短暂的, 都可以归为或与该组合物 的施用有关。
正如在此使用, 充分纯粹是指足够均一, 通过常规的分析方法确定没有容易 检出的杂质的状态, 这些分析方法包括薄层色谱 (TLC), 凝胶电泳和高效液相色 谱(HPLC), 本技术领域的技术人员使用这些方法达到这种纯度, 或者足够纯粹, 以致进一步的纯化不能可检测地改变物质的物理或化学性质, 例如酶或生物活性。 化合物通过纯化得到充分化学纯的化合物的方法对于本技术领域的技术人员来说 是熟知的。 但是, 一种充分化学纯的化合物可以是立体异构体或异构体的混合物。 在这些例子中, 进一步的纯化可能会增加化合物的特异活性。
正如在此使用, 前体药物是一种化合物, 一旦进入体内, 其可以代谢为或转 化为具有生物活性, 药学活性或治疗活性形式的化合物。 为了制作一种前体药物, 药学活性的化合物经过修饰以使活性化合物可以通过代谢过程再生。 前体药物可 以设计成改变了代谢稳定性或药物的运输特性, 屏蔽了药物的副作用或毒性, 改 进了药物的味道或改变了药物的其它特点或性质。 依靠在体内的药物动力学过程 和药物代谢的知识, 本技术领域的技术人员, 一旦知道了药物活性形式的化合物, 就可以设计该化合物的前体药物(参见,如 Nogrady ( 1985) Medicinal Chemistry A Biochemical Approach, Oxford University Press (牛津大学出版社 ), New York, 388 一 392页)。
正如在此使用, 生物活性指对于体内施用一种化合物、 组合物或其它混合物, 该化合物在体内的活性或它们引起的生理性反应。 这样, 生物学活性包括治疗效
应和这些化合物、 组合物和混合物的药理学活性。 生物学活性可以通过设计用于 检测或利用这些活性的体外系统来观察。 这样, 在此所述的用途中, 荧光素酶的 生物活性是其氧合酶活性, 即, 通过氧化一种底物而发光。
正如在此使用, 受体指对于一种特定的配体具有亲和性的分子。 受体可以是 天然产生的或合成的分子。 受体在本技术领域也可以指抗配体。 在此所用, 受体 和抗配体可以互换使用。 受体可以以其未变化的状态或与其它种类分子形成聚集 体使用。 受体可以直接或经由一个特殊的结合物或连接物间接地附着, 共价或非 共价, 或物理接触结合到结合成员上。 受体的例子包括, 但不限于; 抗体, 细胞 膜受体表面受体和内在化的受体,单克隆抗体和与特定的抗原决定族作用 [如病毒, 细胞, 或其它物质]的抗血清, 药物, 多聚核苷酸, 核酸, 肽, 辅因子, 凝集素, 糖, 多糖, 细胞, 细胞膜, 和细胞器。
受体和使用这些受体的应用的例子包括, 但不限于:
a) 酶:对于微生物的生存而必须的特定转运蛋白或酶,其可以作为抗生素 [配 体]选择的靶子;
b) 抗体: 研究确定与有关抗原的表位结合的抗体分子的配体结合位点; 通过 模仿抗原表位序列的确定可以导致以一个或多个这些序列为基础的免疫原的疫苗 的发展, 或导致对于如自身免疫疾病的治疗有用的相关诊断剂或治疗中有用化合 物的发展。
c) 核酸: 确定配体, 如蛋白或 RNA, 结合位点;
d) 催化性多肽; 聚合物, 优选为多肽, 其可以加速包括转化一种或多种反应 物为一种或多种产物的化学反应; 这些多肽一般包括与至少一种反应物或反应中 间物特异结合的位点和一个靠近结合位点的活性功能基, 其中的功能基是可以化 学修饰所结合的反应物 [参见, 如, 美国专利 5,215,899];
e) 激素受体: 以高亲和力结合于受体的配体的确定对于发展激素替代疗法有 用; 如, 确定结合于这样的受体的配体可以导致控制血压的药物的发展; 且
f) 阿片制剂受体: 确定与在脑中的阿片制剂受体结合的配体对于发展低成瘾 替换吗啡和相关药物有用。
正如在此使用, 抗体包括抗体片段, 如 Fab片段, 其由轻链和重链的可变区 组成。
正如在此使用, 通过重组生产是指通过使用重组 DNA技术, 是指使用已熟知 的分子生物学方法来表达克隆的 DNA编码的蛋白。
正如在此使用, 一种产品的实质相同是指足够相似, 以便相关的性质足以保 持不变化, 以至于这种实质相同的产物可以代替该产品。
正如在此所用, 等效的, 当提到核酸的两个序列时, 意味着讨论的两个序列 编码相同序列的氨基酸或等效的蛋白质。 当在提到两种蛋白或肽时, 使用"等效" 意味着两种蛋白或肽实质上有相同的氨基酸序列, 只有保守的氨基酸取代(参见,
如, 以上表 1 ), 并不实质上改变蛋白或肽的活性或功能。 当"等效"指性质时, 性 质并不需要达到同样的程度 (如, 两种肽可以表现出同样类型的酶活性, 但具有 不同的速度), 但活性实质上优选为相同的。 当指出两个核苷酸序列"互补"时, 意 味着核苷酸的两个序列能杂交, 优选的少于 25%, 更优选的少于 15 % , 甚至更优 选的少于 5 %, 最优选的是相对的核苷酸之间没有错配。优选地, 两个分子在高度 严格的条件下杂交。
正如在此使用: 确定错配百分率的杂交严紧度如下:
1 )高度严紧: 0.1XSSPE, 0.1 SDS, 65V
2) 中度严紧: 0.2XSSPE, 0.1 %SDS, 50 °C
3)低度严紧: 1.0XSSPE, 0.1 %SDS, 50°C
应当能理解到, 当使用可替换的缓冲液、 盐和温度时, 可以达到等效的严格 条件。
术语"实质上 "相同或同源或相似在本上下文中发生变化,正如相关技术领域的 技术人员所理解的那样, 一般意味着至少 70 %, 优选的至少 80%, 更优选的至少 90% , 最优选的至少 95 %的同一性。
正如在此使用, 组合物指任何混合物。 它可以是溶液, 悬浮液, 液体, 粉末, 糊剂, 含水的, 不含水的, 或它们的任何组合物。
正如在此使用, 组合指两个或多个项目的联合。 组合包括两种或多种组分包 含在一个单一的混合物中的组合物; 它也包括相关的两种独立的组合物。
正如在此使用, 液体指任何可以流动的组合物。 所以液体包含以半固体、 糊 剂、 溶液、 含水的混合物、 凝胶、 洗剂、 乳膏和别的这样的组合物形式的组合物。
正如在此使用, 保护基团、 氨基酸和其它化合物的缩写, 除非特别指明, 均 与其普遍用法、 公认缩写方式或国际理论与应用化学联合会-国际生物化学联合会 (IUPAC— IUB)所制定的生物化学命名相一致(参见, 1972) Biochem, 11: 1726)。
为公开的清楚起见, 但并不受其限制, 对本发明的详细描述分为以下几个小 部分。
B. 组合物
在一个特定的实施方案中, 其中所提供的是一种用于肿瘤治疗的组合物, 该 组合物包括: A) —种氧化剂和 /或一种还原剂; B ) —种靶向载体剂; C)一种抗 癌药物; 和 D) —种半抗原。
该氧化或还原剂、 靶向载体剂、 抗癌药物和半抗原可以配制为一种单一的药 剂组合物, 或每一种可分别配制为药剂组合物。
任何一种具生物耐受性的氧化剂可用于该组合物中。 在一个优选的实施方案 中,所使用的氧化剂为氯化亚锡(SnCl2);硫酸亚锡(SnS04);亚硫酸亚锡(SnS03); 一氧化锡 (SnO); 二氧化锡(Sn02); 锡酸钠 (Na2Sn03); 亚锡酸钠 (Na2Sn02); 氯化亚锡 (SnCl2); 四氯化锡 (SnCl4); 硫代锡酸盐 (SnS3 ); 硫化亚锡 (SnS)。
任何一种具生物耐受性的还原剂可用于该组合物中。 在一个优选的实施方案 中, 所使用的还原剂为苏木精、 一种如硝基咪唑的低氧还原剂或无氮化合物替拉 扎明 (SR-4233 ) (Zhang和 Stevens, Melanoma Res., 8(6V.510-5(1998
任何一种靶向载体化合物可用于该组合物中。 在一个优选的实施方案中, 所 使用的靶向载体为, 但不限于, 二巯丁二钠 (III)(Sodium Dimercaptosuccinate (DMSA-III)); 二巯丁二钠 (V)(Sodium Dimercaptosuccinate (DMSA- V)); 注射用亚 锡焦磷酸钠 (Sodium Pyrophosphate and Stannous Chloride for Injection (PYP)); 注射 用亚甲基二膦酸盐 (Methylene diphosphonate Inj ection (MDP));聚合白蛋白;硫乙甘 肽; 亚锡喷替酸 (Pentetic Acid and Stannous Chloride (DTPA)),- 亚锡葡庚糖酸钠 (Sodium Glucoheptonate and Stannous Chloride); 亚锡双半胱氨酸乙酯 (L,L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); 依沙美月亏 (Exametazime)(HMPAO); 亚锡依替菲宁 (Etifenin and Stannous Chloride); 亚锡植酸钠 (Sodium Phytate and Stahnous Chloride); 甲氧基异丁基异腈盐 [Cu(MIBI)4BF4](MIBI); 甲基 -L-酪氨酸 (a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile); 硝基咪唑类化合物 (2-nitroimidazole) ; 单克隆抗体和肿瘤单克隆抗体; 及中药提取物如鸭胆子素 (Bmceantin)、汉防已甲素 (Tetrandrine)、唐松草碱 (thalicarpine)、美登素 (maytansine) 任何一种具生物耐受性的半抗原可用于该组合物中。 在一个优选的实施方案 中, 所使用的半抗原为三硝基苯(TOP) (Dieli等人, Int. Immunol, 9(1): 1-8(1997)), 二硝基苯 (DNP) (Stjarnkvist等人, J. Pharm. Sci., 80(5}:436-40(1991)), N-碘乙酰 -N,-(5-磺基 -1-萘基)亚乙基二酰胺 (AED ) (Mizuochi 等人, J. Immunol, 134(2):673-6(1985)), 二硝基氟苯(DNFB)(Claman, J. Immunol., 1160}:704-9(1976)), Ovabulin ( OVA ) (Katz 等人, J. Immunol., 102(5}: 1319-28(1971)), 或白蛋白 ( albumin
在另一个特定的实施方案中, 该组合物进一步包括一种抗肿瘤试剂, 用于联 合肿瘤内治疗和化疗。
任何抗肿瘤试剂可用于这种组合物中。 在一个优选的实施方案中, 所使用的 抗肿瘤试剂是一种抗血管生成剂。 更加优选的, 这种抗血管生成剂是一种基底膜 降解抑制剂、 一种细胞迁移抑制剂、 一种内皮细胞增殖的抑制剂、 一种组织和构 建三维结构效能的抑制剂。 该类抗血管生成剂的实例进一步表现在下面的表 2 中
( Auerbach禾卩 Auerbach, Pharmacol. Ther., 63(3):265-311(1994) ) )。
表 2抗血管生成剂
子类型 实例
基底膜降 蛋白酶抑制剂 血浆酶原激活剂 (如: ΡΑΙ-1,ΡΑΙ-2)金属蛋 解抑制剂 白酶组织抑制剂 (如 ,ΤΙΜΡ-1 和 ΤΙΜΡ-2)苯 基丙氨酰-丙烯基-精氨酸 氯甲基酮 -凝血 软骨衍生抑制剂 软骨衍生抑制剂 (CDI)
上皮细胞衍生抑制剂
佛波醇酯 1-10-二氮杂菲
类固醇 甲孕酮,地塞米松,甲羟孕酮, 去炎松缩酮, 脯氨酸类似物和反式类维生素 Α,抑生长 素类似物
抗生素 二甲氨四环素, 偏端霉素 Α的磺酸盐衍生 物
细胞迁移 红豆杉醇,诺考达唑,秋水仙 红豆杉醇,诺考达唑,秋水仙碱,长春碱 抑制剂 碱,长春碱
干扰素 白细胞 (α/β)干扰素
霍乱毒素
β型转化生长因子家族
α-甲基二氟鸟氨酸和其它
鸟氨酸脱羧酶抑制剂 成纤维细胞生长因子抑制
齐 11, 鱼精蛋白 (Protanine),
血小板因子 4 (PF4), 苏拉
明
皮质类固醇和肝素 硫酸氨基己醣聚糖
白介素 -8
富含半胱氨酸的酸性分泌 SPAPC (分泌性蛋白质,酸性, 富含半胱氨 蛋白 (SPAPC) 酸)
血小板活化因子抑制剂 具窍蝮蛇属的蛇毒 (venon) 靶目标为肥大细胞和巨噬
细胞: 硫醇和含金化合物
靶目标为淋巴细胞: 类固 环孢霉素类吗啡物,如: β-内啡呔或硫酸吗 醇,抗淋巴细胞血清, 辐射 啡, AGM-1470
靶目标为胞外基质 :多肽,
抗体, 硫酸几丁质衍生物
肝素
前列腺素抑制剂 合成前列腺素,像吲哚美辛和阿斯匹林,酮 类,米托蒽醌或双蒽生 (bisantrene) ,α顺乌 头酸及其衍生物,氨氯吡脒 类型 子类型 实例
胎盘核糖核酸酶抑制剂 核糖核酸酶,甘氨酸 -精氨酸-甘氨酸-天冬酰 胺酸-丝氨酸 (GRGDS),肌动蛋白和一种抗 肌动蛋白抗体抑制剂 ,
抗生素 Herbamycin,博来霉素, eponemycin,erbstatin, 根赤壳菌素禾口 staurosporine
其它细胞迁移抑制剂 尼卡地平、 鞘氨醇 -1-磷酸盐,三羧氮基喹啉
(N-甲基苯基 -1,2-二氢 -4-羟氢氧基 -1-甲基 -2-氧喹啉 -3-氨甲酰:),血小板内皮细胞粘附 分子 -1(PECAM-1)
内皮细胞 成纤维原细胞生长抑制剂 FGF封闭坑体,戊聚糖多聚硫酸盐,肝素酶, 增殖抑制 鱼精蛋白,生长抑素类似物,如奥曲肽 剂 血栓抑制剂 TSP1,TSP2和 TSP3
佛波醇酯
类维生素 A Etretin, 苯壬四烯酯或异维甲酸, 阿齐特 林,染料木素
TGF 家族 TGFp,TGF l 和 TGFP2
肿瘤坏死因子,干扰素,白介 TNF,IL-l,IFN-^IFN-a和巨噬细胞衍生物、 素和其它细胞因子 内皮细胞抑制剂
类固醇和肝素 四氢化 S,氢化可的松 ,β-环糊精十四烷硫酸, 雌激素代谢物 如 2-甲基乙氧基雌二醇,类 固醇与 DS4152 (—种细菌来源的多糖混合 物)联合用药
苏拉明 苏拉明,阿扑利辛磺化脲
cc2-巨球蛋白
生长因子抗体 bFGF抗体, VEGF抗体,肝细胞生长因子
(扩散因子)抗体,抗扩散因子抗体 抗血管生长的多肽 泌乳刺激素的 6KD片段,粘连蛋白来源的 肝素结合多肽片段, TSP的选择性多肽,前 房尿钠排泄的多肽, PF4,—种非肝素结合型 PF4类似物, rPF4-241
视网膜衍生抑制剂 视网膜的粗提取液与成人血清联合 抗生素 雷帕霉素, eponemycin, 含亚精胺结构的化 合 15-脱氧精胍菌素, TAN-1120,—种 baumycin组蒽环类抗生素, d-青霉酸衍胺,烟 曲霉素和它的更有效的合成的类似物 AGM-1470(TNP-470),FR-111142, 从菌 株 Scolecobasiwn arenarium的 F-2015中分离 而来, WF-16775A1 禾卩 A2从 chaetasbolisia 丹毒中分离而来, SP-PG (或它的活性成 分, DS-4152),—种硫酸多肽聚糖混合物, 由 Arthobacter生产,四环素,二甲胺四环素 粘多糖 透明质酸盐
SPARC
其它药剂 氯喹,镍锰合金盐,磺胺嘧啶,几种阿片样物 质,金化合物,二甲基亚砜
组织和构 TGFp族 TGFpl,TGF 2,TGFp3
建三维结 千扰素 干扰素 -λ,干扰素 -α
构效应的 脂肪酸
抑制剂 唑酮 MD27032(4-丙基 -5(4-Ρ比啶基 -2(3Η)-唑酮) 基底膜生物合成抑制剂 环腺苷一磷酸盐, 顺式-羟基-脯氨酸, 一种 胶原产品抑制剂
细胞粘附分子抑制剂 含 YSIGR肽, Arg-Gly-Asp(RGD)-含肽 Gly- Arg-Gly-Asp-Ser(GRGDS), vitronectin,纤连 蛋白,抗体,整连蛋白 α1β3, α1β3 抑制剂抗 体, Ε-选择素抗体, sialyl Lewis-X配基的抗 体
其它内皮细胞三维构成的 尼卡地平、 磷酸激酶 C 抑制剂,如 抑制剂 calphostin C和 星形孢菌素,一种嵌全毒素, 其是 aFGF 被融合到假单孢菌属外毒素的 突变体中, IL-lp,IL-6,TGF-P 和 血小板衍 生生长因子 -BB,irsogladine,fenietinide,一 种脯氨酸类似物, L-adetine-2-羧基酸, 环孢 霉素, 泌乳刺激素的 16kDa片段
生理和物 细胞-细胞相互作用 外膜细胞,内皮细胞-外膜细胞相互作用,心 理千涉作 脏微血管内皮细胞和心室肌细胞的共培养 用 血液流动
光力学治疗 光力学治疗的激光凝固法 过高温疗法 高热疗法的效果可通过杀死内皮细胞、 抑 制复制,抑制细胞迁移或者三种机制联合来 产生
缺氧 在另一个优选的实施方案中, 所使用的抗血管生成剂是 AGM-1470 (TNP-470), 血管抑制类固醇、 血管抑素、抗 νβ3的抗体、 抗碱性成纤维细胞生 长因子抗体、 抗白介素 -1抗体、 抗肿瘤坏死因子 α抗体、 抗血管内皮细胞生长因 子抗体、 金诺芬、 咪唑硫嘌呤、 ΒΒ-94、 ΒΒ-2516、 碱性成纤维细胞生长因子的可 溶性受体、 羧基酰胺三唑类 (CAI)、 软骨衍生抑制剂 (CDI)、 几丁质、 氯奎、 顺铂、 CM10K 可的松 /肝素、 可的松 /透明质酸、 11-脱氧皮甾醇 /肝素、 CT-2584、 环磷酰 胺、 环孢菌素 A、 地塞米松、 二氯酚酸 /透明质酸、 嗜酸性的主要碱性蛋白、 纤连 蛋白肽、 白明胶酶抑制剂、 神经胶质瘤衍生的血管生成抑制因子 (GD-AIF)、 GM1474、 氯化金、 硫羟苹果酸金、 肝素酶、 透明质酸糖胺多糖(高和低分子量的 种类), 氢化可的松 /β环右旋糖苷、 布洛芬、 吲哚美辛、 α干扰素、 γ干扰素诱导 的蛋白质 10、 γ干扰素、 白介素 1、 白介素 2、 白介素 4、 白介素 12、层粘连蛋白、 左旋咪唑、三羧氨基喹啉、 LM609,基质金属蛋白酶抑制剂、马马司他(ΒΒ2516〉、 甲羟孕酮、 6-甲基硫基嘌呤、 metastat(C0l-3)、 甲氨蝶呤、 美满霉素、 氧化氮、 奥 曲肽 (生长激素抑制剂类似物)、 紫杉醇、 D-青霉酸衍胺、 多聚硫酸戊糖、 胎盘 proliferin相关蛋白、 胎盘核糖核酸酶抑制剂、 纤溶酶原激活因子抑制物 (PAI)、 血小板因子 4 (PF4)、氢化泼尼松、催乳素(16Kda片段)、 proliferin相关蛋白、 前 列腺素合成酶抑制剂、 鱼鱼精蛋白、 类维生素 A、 罗喹美克 (LS— 2616, 三羧氨 基喹啉)、生长抑素、基质溶素抑制剂、 P物质、苏拉明、 SU101、 tecogalan sodium, 四氢皮质醇 -sthrombospondins (TSPs)、 组织基质金属蛋白酶抑制剂(TIMP1 , 2, 3)、血管内皮细胞生长因子抑制剂、维生素 A、 Vitaxin, 玻璃体液、沙利度胺、 3 一氨基沙利度胺、 3—羟基沙利度胺及沙利度胺、 3—氨基沙利度胺、 3—羟基沙利 度胺的代谢物或水解物 (O'Reilly, Investigational New Drugs, 15:5-13(1997); J Nat'l Cancer Instit,88:786-788(1996);美国专利 5593990、 5629327和 5712291)。 同样优 选的, 使用的抗血管生成剂是一种血管抑制基因, 如血管阻素、 内皮他丁、 kringle-5、 PEX、 TIMP TIMP2> TIMP3、 TIMP4、 endo::angio或 endo::PEX、 或 是一种血管抑制趋化因子基因, 如 IP-10、 Mig或 SDF-lo
在另一个更加优选的实施方案中, 所使用的抗肿瘤试剂是一种垸化剂、 一种 抗代 i射物、 一种天然产品、 一种铂配位复合物、 一种恩二酮、 一种替代的尿素、 一种甲基肼衍生物、 一种肾上腺皮质激素抑制剂、 一种激素和一种拮抗剂。 该类 抗肿瘤试剂的实例见下面的表 3。
用于肿瘤疾病的化疗剂
试剂类型 化学名称 疾病
二氯甲基二乙胺 霍奇金病,非霍奇金淋巴瘤病 环磷酰胺 急慢性淋巴白血病, 霍奇金病, 非霍奇金淋巴瘤病,多发性骨髓 瘤,成神经细胞瘤,乳房、卵巢、 氮芥 肺、 胚性癌肉瘤、 宫颈、 睾丸、 软组织等器官的肉瘤
美法仑 多发性骨髓瘤,乳房、卵巢肉瘤 苯丁酸氮芥 慢性淋巴白血病,初级巨球蛋白 血症, 霍奇金病,非霍奇金病 氮丙啶和甲 六甲基磷酰胺 卵巢
基黑色素 噻替派 膀胱、 乳房、 卵巢
垸化剂 垸 基 白消安 慢性粒细胞白血病
(Alkly)
磺酸盐
双氯乙基亚硝脲(BCNU) 霍奇金病, 非霍奇金淋巴瘤病, 初期脑瘤,多发性骨髓瘤,恶性 黑色素瘤
亚硝基脲 液氧氮芥(CCNU) 霍奇金病, 非霍奇金淋巴瘤病 初期脑瘤, 小细胞肺瘤 硒氮芥 (甲基 -CCNU) 初期脑瘤, 胃、 结肠癌 链脲霉素 恶性胰腺胰岛素瘤,恶性类癌瘤 三氮烯 Dacarbazine(DTIC, 二甲基 恶性黑素瘤, 霍奇金病,淋巴肉 色胺 -中吡咯-羧基胺) 芽肿病, 软组织瘤
叶酸类似物 甲氨蝶吟 (氨甲蝶吟) 急性淋巴白血病, 绒 (毛)膜癌, 抗代谢
霉菌病, 乳房、头、颈、肺、骨 物
等恶性肿瘤
氟尿嘧啶 (5-氟尿嘧啶, 乳房、 结肠、 胃、 胰腺、 卵巢、 5-FU)氟脱氧尿苷(5-氟脱 头颈、膀胱癌变前的局部表皮损 嘧啶类似物
氧尿 FUdR) 伤
阿糖胞甙 急性粒细胞和急性淋巴白血病 嘌呤类似物 巯 (基)嘌呤 (6-巯基嘌呤, 6— 急性淋巴、急性粒细胞和慢性粒 及相关的抑 MP) 细胞白血病
制剂 硫鸟嘌吟(6-硫鸟嘌呤; TG) 急性粒细胞、急性淋巴和慢性粒 细胞白血病
戊聚糖 (2-去氧皮质酮) 毛状细胞白血病, 霉菌病,慢性 淋巴白血病
长春碱 (VLB) 霍奇金病, 非霍奇金淋巴瘤病, 乳房、 睾丸
长春花生物 长春新碱 急性淋巴白血病, 成神经细胞 碱 瘤, 胚性癌肉瘤, 横紋肌肉瘤, 霍奇金病, 非霍奇金淋巴瘤病, 小细胞肺瘤
表鬼臼脂素 依托泊甙, 替尼伯甙 睾丸、 小细胞肺瘤和其它肺癌, 乳房、霍奇金病, 非霍奇金淋巴 瘤病, 急性粒细胞减少白血病, 皮肤多发性出血性肉瘤 绒 (毛)膜癌, 胚性癌肉瘤, 横纹 肌肉瘤,睾丸、皮肤多发性出血 性肉瘤
道诺霉素 急性粒细胞减少和急性淋巴性 白血病
天然产
软组织、骨纤维和其它肉瘤,霍
FT口
奇金病,非霍奇金淋巴瘤病,急 抗生素 性白血病, 乳房、生殖器、 甲状 腺、 肺、 胃、 成神经细胞瘤 睾丸、 头和颈、 皮肤、食道、肺 和泌尿生殖系统,霍奇金病,非 霍奇金淋巴瘤病,
光辉霉素 (光神霉素) 睾丸、 恶性血钙过多
丝裂霉素 (丝裂霉素 C) 胃、 宫颈、 结肠、 乳房、 胰腺、 膀胱、 头和颈
酶 天 (门)冬酰胺酶 急性淋巴性白血病
生物反应调 干扰素 -α 毛细胞白血病, 皮肤多发性出 节物 血性肉瘤,黑色素瘤,良性肿瘤, 肾脏,卵巢,膀胱,非霍奇金淋巴 瘤,霉菌 (真菌) 病,多发性骨髓 瘤,慢性粒细胞白血病
顺铂 (cis-DDP) 睾丸,卵巢,膀胱,头和颈,肺,甲状 铂配位复合
卡铂 腺,宫颈,子宫内膜,成神经细胞 物
瘤,骨源性肉瘤
蒽二酮 米托蒽醌 急性粒细胞减少白血病,乳房 脲替代物 羟基脲 慢性粒细胞减少白血病,红血球 各种药
增多症,血小板增多症,恶性黑色 剂 甲基肼衍生 甲基苄肼 (N-甲基肼 ,ΜΙΗ) 霍奇金病
物
肾上腺皮质 邻氯苯对氯苯二氯乙烷 肾上腺皮质
抑制物 (ο,ρ'-DDD)
肾上腺皮质 强的松 (有其它几种等效药 急性和慢性淋巴白血病,非霍奇 类固醇 制剂, 见 59节) 金淋巴病,霍奇金病,乳房瘤病 孕酮 羟孕酮,葵酸盐,甲孕酮, 醋 子宫内膜,乳房瘤
酸甲羟孕酮
雌激素 二乙基已烯雌酚 乙炔基雌 乳房, 前列腺
二醇 (其它等效药制剂, 见
57节)
激素和 抗雌激素 它莫西芬 乳房
对抗物 男性激素 丙醋睾丸酮,氟羚甲基睾丸 乳房
素 (其它可用药制剂见 58
节)
抗雄激素物 氟硝丁酰胺 前列腺
质
促性腺激素 促性腺激素类似物 前列腺
-分泌荷尔
蒙类似物 在另一个优选的实施方案中, 使用的抗肿瘤药剂是胞嘧啶类似物如胞苷阿糖 腺苷 (Ara-C)、 道诺霉素、 阿霉素、 氨甲蝶吟 (MTX)、 氟化嘧啶如 5—氟尿嘧啶 (5— FU)、 羟基脲、 6—巯基嘌呤、 植物生物碱如长春新碱(VCR)、 VP— 16和长 春碱 (VLB); 垸化剂如环磷酰胺肿瘤细胞裂解剂、 美司钠、 美法仑、 1,3-双氯乙 基亚硝基脲 (BCNU)、 顺铂、 氮芥 (HN2)、 三胺 (HN3 ), 非典型垸化剂如甲基 苄肼、 博来霉素、 丝裂霉素 C、 放线菌素 D (DACT), 或一种酶如 L一天冬酰胺 酶。
在另一个优选的实施方案中, 使用的抗肿瘤药剂是一种癌基因抑制剂。 更优
选的, 该癌基因抑制剂是抗癌基因抗体或抗癌基因反义寡核苷酸。例如, 下面表 4 中所列的寡核苷酸抗体和反义寡核苷酸可用于该组合物。
表 4.癌基因和瘤病毒
简称 病毒 种类 癌源 注释
abl Abelson白血病 小鼠 慢性骨髓性 TyrPK(src)
白血病
erbA 骨髓成红血细胞增多 鸡 同源于人类肾上腺
症 皮质激素受体 erbB 骨髓成红血细胞增多 鸡 TryPK EGK/TGFc受 症 体
ets E26分支杆菌肿瘤 鸡 核
fes(¾)s)a 斯奈德-泰勒肉瘤 猫 TyrPK(src)
加德纳 -Arnsein肉瘤
fgr 加德纳 -Rasheed肉瘤 猫 TyrPK(src)
fins McDonough肉瘤 猫 TyrPK(src)受体
S(fes)a Fujinami肉瘤 鸡 TyrP (src)
fos FJB骨肉瘤 小鼠 核, TR
hst NVT 人 胃肿瘤 FGF同源体
Intl NVT 小鼠 MMTV引起 核, TR
恶性肿瘤
Int2 NVT 小鼠 MMTV引起 FGF同源体
恶性肿瘤
jun ASV17肉瘤 鸡 核, TR
hit Hardy-Zuckerman 4肉 猫 TyrPK GFR L
B-lym NVT 鸡 粘液囊淋巴 mas NVT 人 表皮癌 对血管紧缩素 II强
反应
met NVT 小鼠 骨肉瘤 TyrPK GFR L mil(raf) Mill Hill2急性淋巴管 鸡 Ser/ TyrPK(src)
炎
mos 莫洛尼氏肉瘤 小鼠 Ser/ TyrPK(src) myb 成髄细胞组织增生 鸡 白血病 核, TR
myc MC29髓细胞组织增 鸡 淋巴瘤 核, TR
生
N-myc NVT 人 成神经细胞 核 neu(Erb NVT 大鼠 成神经细胞 TyrPK GFR L
B2) 瘤
Ral(mil) 3611肉瘤 小鼠 Ser/ TyrPK(src) b
Ha-ras 哈维鼠科肉瘤 大鼠 膀胱, 乳腺和 结合三磷酸鸟苷
皮肤癌
Kr-ras 柯尔斯顿-鼠科肉瘤 大鼠 肺, 结肠癌 结合三磷酸鸟苷 n-ras NVT 人 成神经细胞 结合三磷酸鸟苷 白血病
rel 网状内皮组织增殖 火鸡
ros UR2 鸡 TyrPK GFR L
sis 猿肉瘤 猴 PDGF的一条链 src 鲁斯氏肉瘤 鸡 TyrPK
ski SKV770 鸡 核
trk NVT 人 结肠癌 TyrPK GFR L
yes Y73, Esh肉瘤 鸡 TyrPK(src) 在另一个实施方案中, 使用的抗肿瘤药剂是一种细胞基质抑制剂。 更加优选 的, 细胞基质抑制剂是一种抗细胞基质抗体或抗细胞基质反义寡核苷酸。 例如, 可使用抗以下细胞基质或细胞基质基因的抗体和反义寡核苷酸: 小窝蛋白 -1、核心 蛋白多糖、 钙粘蛋白、 连环蛋白、 整连蛋白。 '
在一个特定的实施方案中, 该组合物进一步包括一种用于联合肿瘤内治疗和 基因治疗的肿瘤抑制基因。在一个优选的实施方案中,使用的肿瘤抑制基因是 pl6, p21, p27, p53, RB, WT-1, DCC, NF-1和 APC。在另一个特定的实施方案中, 该组合 物进一步包括一种自杀基因如 HSVltk(l型单纯疱疹病毒胸腺嘧啶激酶)、 tdk&tmk (胸腺嘧啶激酶&胸苷酸激酶)、 coda&upp (胞嘧啶脱氨酶&尿嘧啶磷酸核糖转移 酶);一种溶细胞基因如粒酶 A、粒酶 B、穿孔素;或一种凋亡基因如 Bak, Bax, Bcl-XL, Bcl-XS, Bik, Sarp-2, TRAIL。 在另一个更加优选的实施方案中, 该组合物进一步包 括一种细胞因子基因, 如白介素 1β、 白介素 2、 白介素 4、 白介素 6、 白介素 8、 白介素 10、 白介素 12、 白介素 15、 GM— CSF、 干扰素 α、 干扰素 β、 干扰素 γ、 肿瘤坏死因子 a、 B7.1或 Β7.2以增强免疫应答。
作为基因转运系统原件的基因可使用裸 DNA、复合 DNA、 cDNA、质粒 DNA、
RNA或它们的其它组合物。 在另一个实施方案中, 肿瘤抑制基因包含于一个病毒 载体中。 任何适用于基因治疗的病毒载体均可应用于该组合物中。 例如, 可应用 一种腺病毒载体(美国专利 5869305)、 一种猿病毒载体(美国专利 5962274)、 - 种条件复制型人免疫缺陷病毒载体(美国专利 5888767)、 逆转录病毒, SV40, 单 纯疱疹病毒复制子载体和痘苗病毒载体。 另外, 可以用非病毒载体系统如脂质体 转运基因, 其中的脂质可保护 DNA或其它生物材料在凝集过程中免于氧化。
在另一个特定的实施方案中, 该组合物进一步包括一种辐射致敏剂用于联合 肿瘤内治疗和放疗。在一个优选的实施方案中,所使用的辐射致敏剂是 SR2508 (依 他硝唑)(Chang等人, Int J Radiat Oncol Biol Phys,40(l):65-70(1998 )^ Buthionine sulfoximine (BSO) (Vahrmeijer 等 人 , Cancer Chemother Pharmacol, 44{2}: 1 11-6(1999))
在另一个特定的实施方案中, 该组合物进一步包括一种促进剂, 可促进半抗 原与肿瘤抗原之间的偶联以提高自身肿瘤特异性免疫应答。 优选的, 所使用的促 进剂是一种螯合剂或是一种化学交联剂。 更优选的, 使用的螯合剂是甘氨酰酪氨 酰基- (N-e-二乙三胺五乙酸) -赖氨酸(GYK-DTPA)或亚德利亚霉素己二酸 -二酰 肼(ADR-ADH)。 同样更优选的, 使用的化学交联剂是碳化二亚胺。
在另一个特定的实施方案中, 该组合物进一步包括一种免疫应答增效剂以增 强自身肿瘤特异性免疫应答。优选的,所使用的增效剂是卡介苗(BCG) (Ratliff, Eur Urol, 2:17-21(1992)), 小棒状杆菌 (Lillehoj 等人, Avian Dis, 37(3):371-40Π 993))、流 产布氏杆菌提取物、 葡聚糖、 左旋咪唑、 泰洛伦、 一种酶、 一种非毒性病毒、 多 糖, 或草药提取物如中草药提取物。 更优选的, 所使用的酶是霍乱孤菌神经酰氨 酶(VCN) (Seiler和 Sedlacek, Recent Results Cancer Res,J^:53-60(1980)); 木瓜蛋 白酶 (Helting禾 B Nau, Acta Pathol. Microbiol. Immunol. Scand, 92f !):59-63(1984); 和 Hess'Eur J Immunol 6(3): 188-93(1976)), β-半乳糖苷酶或伴刀豆球蛋白 A。同样 更优选的, 所使用的非毒性病毒是一种非毒性新城疫病毒 (Meulemans等人, Vet Rec, 14 01):300-3(1998);和 Adams, Poult Sci, 49(1):229-33(1970))。 进一步更优选 的, 所使用的多聚糖是来源于液体培养的蘑菇属 blazei mill菌丝体的抗肿瘤多聚 糖(起先为葡苷露聚糖, 主链为 β-1,2-连接 -D-甘露吡喃残基, 侧链为 β-D-葡萄糖 吡喃残基 -3-0-β- D-葡萄糖吡喃残基) (Mizuno 等人, Biochem Mol Biol Int,47{4}:707-14(1999)) ;从绒状火菇得到的抗肿瘤多聚糖制备物(多聚糖的主链主 要含 β- ( 1->3 ) -D-连接葡萄糖, 其分子量大约为 200KD ) (Leung 等人, Immunopharmacology, 35{3):255-63(1997)); 西佐糖 (SPG) (Tanji等人, Yakugaku Zasshi, 110(11}: 869-75(1990)); schizophyllan(Sakagami等人, Biochem Biophys Res Commun, 155(2}:650-5(1998)); 甘露聚糖(Gavrilenko 等人, Vopr Onkol, 29£4}:67-70(1983)); 蘑菇多糖 (Haba等人, Int J Cancer, 18(1 :93-104(1976 ); Su-多 糖(Su-Ps)(Kumazawa 等人, Gan To Kagaku Ryoho, 14£12}:3329-35(1987));
mannozym (Zastrow, Padiatr Grenzgeb, 24(3):229-36Π985^ ο
在另一个特定的实施方案中, 该组合物也可含一种凝集溶解剂以增强自身肿 瘤特异性免疫应答。
在另一个特定的实施方案中, 该组合物也可含一种细胞因子以增强自身肿瘤 特异性免疫应答。 优选的, 给予的细胞因子是用于储存配方的脂质侔包埋的白介 素 2 (Krup等人, J Immimother, 22(6: 525 -38 (; 1999^ ) , 或储存配方为粒细胞-巨噬细 胞集落剌激因子 (GMt-CSF ) (Leong等人, J Immunot er, 22(2) : 166-74(1999)) o 在另一个特定的实施方案中, 该组合物可进一步含一种癌基因以增强自身肿 瘤特异性免疫应答。 优选的, 可使用以上表 4中所列的癌基因。
在另一个实施方案中, 该组合物可以包括一种减毒的、 可复制的病毒载体以 增强自身肿瘤特异性免疫应答。 优选的, 使用的减毒的、 可复制的病毒载体是 1 型单纯疱疹病毒 (HSV-1 ) 的突变体 G207, 它可在人肿瘤细胞中复制并引起细胞 死亡, 从而抑制肿瘤的生长, 但对正常组织没有致病性 (Toda等人, Hum. Gene. Ther., 10(3):385-93(19991 ) ο
在另一个实施方案中, 该组合物可以包括一种报告子来监测治疗进程。 该报 告子可以是化学制品或酶。 优选的, 这种报告酶是 β-半乳糖苷酶或它的基因。 也 可用其它在本技术领域中已知的报告子。
在一个典范的实施方案中, 该组合物含过氧化氢作为氧化剂, ΤΝΡ为半抗原。 也可以含碳化二亚胺作为促进剂。
在组合物中被施用的氧化剂或还原剂的浓度大约 0.01%(w/w)到 35%(w/w),靶 向载体化合物的浓度约为大约 l%Cw/w;>到 98%(w/w),抗癌药物的浓度约为 lmg/ml 到 80mg/ml, 半抗原的浓度约为 lmg/ml到 80mg/ml。
本发明也提供用于肿瘤内治疗的试剂盒, 该试剂盒含这种组合物, 其中包括 的成分为一种或多种 A )氧化剂和 /或还原剂; B )靶向载体剂; C )抗癌剂; 和 D ) 半抗原。 试剂盒也包含用于将所述组合物给药的注射器以及给药说明书。
本发明也提供用于肿瘤内治疗的生产商品。 该生产商品包括: A )包装材料; B ) 一种或多种氧化剂或还原剂, 靶向载体剂, 抗癌剂和半抗原; 以及 C )一种标 签, 指明该商品用于治疗肿瘤。
C . 治疗方法
本发明提供的是用于治疗哺乳动物体内肿瘤的方法, 该方法通过向哺.乳动物 施用有效剂量的组合物来实施, 所述组合物包括半抗原、 化学药物例如抗癌剂、 靶向载体,所述半抗原和 /或化学药物已经通过或者可以通过氧化剂和 /或还原剂的 作用与靶向载体形成偶联物或螯合物, 或者, 所述半抗原、 化学药物、 靶向载体 三者已经通过或者可以通过氧化剂和 /或还原剂的作用形成偶联物或螯合物。 本发 明通过对肿瘤产生自身免疫应答从而治疗该肿瘤。 在一个特定的实施方案中, 所 治疗的哺乳动物是人。
在一个特定的实施方案中, 所使用的半抗原为三硝基苯 (TNP )、 二硝基苯 (DNP )、 N-碘乙酰 -N,- ( 5-磺基 1-萘基) 亚乙基二酰胺 (AED )、 二硝基氟苯 (DNFB) 和 ovabulin(OVA)。
在另外一个特定的实施方案中, 该治疗方法可进一步包括原位给予一种促进 剂, 通过促进半抗原和肿瘤抗原之间的偶联来增强肿瘤特异性自身免疫应答。 优 选的, 所使用的促进剂是一种螯合剂或是一种化学交联剂。 更优选的, 使用的螯 合剂是甘氨酰酪氨酰基- (N-e-二乙三胺五乙酸) -赖氨酸(GYK-DTPA) 或亚德利 亚霉素己二酸-二酰肼 (ADR-ADH)。 同样更优选的, 使用的化学交联剂是碳化二 亚胺。
在另外一个特定的实施方案中, 该治疗方法可进一步包括原位给予一种免疫 应答增效剂, 以增强肿瘤特异性自身免疫应答。 优选的, 所使用的免疫应答增效 剂是卡介苗 (BCG) (Ratliff, Eur Urol, 2:17-21(1992)), 小棒状杆菌 (Lillehoj 等人, Avian Dis, 37(3):371-40(1993)).流产布氏杆菌提取物、葡聚糖、左旋咪唑、泰洛伦、 一种酶、 一种非毒性病毒、 多糖、 或草药提取物如中草药提取物。
对于本发明组合物, 氧化或还原剂、 靶向化合剂、 抗癌剂和半抗原可以配制 为一种药剂组合物, 或每一种可分别配制为药剂组合物。
在一个优选的实施方案中, 所使用的氧化剂为但不限于, 氯化亚锡 (SnCl2); 硫酸亚锡 (SnS04); 亚硫酸亚锡 (SnS03); —氧化锡 (SnO); 二氧化锡 (Sn02); 锡酸钠(Na2Sn03) ; 亚锡酸钠(Na2Sn02); 氯化亚锡(SnCl2); 四氯化锡(SnCl4); 硫代锡酸盐 (SnS3 ); 硫化亚锡 (SnS:)。
在另一个特定的实施方案中, 所使用靶向化合载体为但不限于, 二巯丁二钠 (III)(Sodium Dimercaptosuccinate (DMSA-III)) ; 二 巯 丁 二 钠 (V)(Sodium Dimercaptosuccinate (DMSA-V)); 注射用亚锡焦磷酸钠(Sodium Pyrophosphate and Stannous Chloride for Injection (PYP)); 注射用亚甲基二膦酸盐(Methylene diphosphonate Injection (MDP)); 聚合白蛋白; 硫乙甘肽; 亚锡喷替酸 (Pentetic Acid and Stannous Chloride (DTP A)); 亚锡葡庚糖酸钠(Sodium Glucoheptonate and Stannous Chloride); 亚锡双半胱氨酸乙酯 (L,L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); 依沙美肟 (Exametazime)(HMPAO); 亚锡依替菲宁 (Etifenin and Stannous Chloride); 亚锡植酸钠 (Sodium Phytate and Stahnous Chloride); 甲氧基异 丁基异腈盐 [Cu(MIBI)4BF4](MIBI) ; 甲基 -L-酪氨酸(a-methyltyosine) ; MIBI (2-methoxy isobutyl isonitrile); 硝基咪唑类化合物 (2-nitroimidazole); 单克隆抗体和 肿瘤单克隆抗体; 及中药提取物如鸭胆子素 (Bruceantin)、汉防已甲素 (Tetrandrine)、 唐松草碱 (thalicarpine)、 美登素 (maytansine)等等。
本发明提供的肿瘤治疗可单独或与其它癌症治疗法联合应用。 在一个特定的 实施方案中, 该肿瘤疗法与化疗联合应用, 即进一步给予一种抗肿瘤剂。
可应用任何抗肿瘤剂。 在一个优选的实施方案中, 所使用的抗肿瘤试剂是一
02671 种抗血管生成剂。 更加优选的, 这种抗血管生成剂是一种基底膜降解抑制剂、 一 种细胞迁移的抑制剂、 内皮细胞增殖的抑制剂、 组织和构建三维结构的抑制剂。 更加优选的, 所使用的抗血管生成剂是 AGM-1470 (TNP-470 ), 血管抑制类固醇、 新血管抑素、抗 &νβ3的抗体、抗碱性成纤维细胞生长因子抗体、抗白介素 -1抗体、 抗肿瘤坏死因子(X抗体、 抗血管内皮细胞生长因子抗体、 金诺芬、 咪唑硫嘌吟、 BB-94、 BB-2516,碱性成纤维细胞生长因子的可溶性受体、羧基胺三唑类(CAI)、 软骨抑制剂、几丁质、氯奎、顺式铂氨、 CM101、可的 feV肝素、可的松 /透明质酸、 11-脱氧皮甾醇 /肝素、 CT-2584、 环磷酰胺、 环孢菌素八、 地塞米松、 二氯酚酸 /透 明质酸糖胺多糖、 嗜酸性的主要碱性蛋白、 纤维连接肽、 白明胶酶抑制剂、 神经 胶质瘤来源的抗生血抑制因子 (GD-AIF)、 GM1474, 金卡方氯化物、 硫羟苹果酸 金、 肝素酶、 透明质酸糖胺多糖(高和低分子量的种类), 氢化可的松 /β环右旋糖 苷、 布洛芬、 吲哚美辛、 α干扰素、 γ干扰素诱导的蛋白质 10、 γ干扰素、 白介素 1、白介素 2、白介素 4、白介素 12、层粘连蛋白、左旋咪唑、三羧氨基喹啉、 LM609、 基质蛋白酶抑制剂、 马马司他 (BB2516 )、 甲羟孕酮、 6-甲基硫基嘌呤、 metastat(Col-3),甲氨蝶吟、美满霉素、氧化氮、奥曲肽(生长激素抑制剂类似物)、 紫杉醇、 D—青霉酸 胺、 多聚硫酸戊糖、 胎盘 proliferin相关蛋白、 胎盘核糖核 酸酶抑制剂、纤溶酶原激活因子抑制物(PAI)、血小板因子 4 (PF4)、氢化泼尼松、 催乳素(16Kda片段)、 proliferin相关蛋白、前列腺素合成酶抑制剂、鱼鱼精蛋白、 类维生素八、 罗喹美克 (LS— 2616)、 生长抑素、 基质降解酶抑制剂、 P物质、 苏 拉明、 SU101、 tecogalan sodium ( -4152)、 四氢皮质醇 -sthrombospondins (TSPs)、 组织基质金属蛋白酶抑制剂 (TIMP1 , 2, 3)、 血管内皮细胞生长因子抑制剂、 维 生素 A、 Vitaxin,玻璃体液、沙利度胺、 3—氨基沙利度胺、 3—羟基沙利度胺及沙 利度胺、 3—氨基沙利度胺、 3—羟基沙利度胺的代谢物或水解物。也可以应用在 B 节中描述的其它抗血管生长剂。 同样优选的, 所使用的抗血管生长剂是一种血管 抑制基因,如血管抑素、 内皮他丁、 kringle— 5、 PEX、 TIMP TIMP2. TIMP3、 TIMP4、 endo::angio、或 endo::PEX、或是一种血管抑制趋化因子基因, 如 IP— 10、 Mig或 SDF—la。
在另一个优选的实施方案中, 所使用的抗肿瘤试剂是一种垸化剂、 一种抗代 谢物、 一种天然产品、 铂配位复合物、 一种蒽二酮、 一种取代的尿素、 一种甲基 肼衍生物、 一种肾上腺皮质抑制素、 一种激素、 一种拮抗剂、 一种抗癌多糖、 或 草药提取物如中草药提取物。 也可能使用 B节中所描述的另外的抗肿瘤剂。
在另一个优选的实施方案中, 使用的抗肿瘤药剂是一种癌基因抑制剂如抗癌 基因抗体或抗癌基因反义寡核苷酸。 例如, 可使用抗以下癌基因的抗癌基因抗体 或抗癌基因反义寡核苷酸: abl、 erbA、 erbB、 ets、 fes(fps)、 fgr、 fms、 fos、 s intl、 int2、 Jun、 hit、 B-lym、 mas、 met、 mil(raf)、 mos、 myb、 myc、 N-myc、 neu(ErbB2)、 ral(mil)、 Ha-ras、 Ki-ras、 i'el、 ros、 sis、 src、 ski、 trk禾口 yes。
N2007/002671 在另一个特定的实施方案中, 通过进一步给肿瘤原位注射一种肿瘤抑制基因 序列, 将肿瘤内治疗和基因治疗联合应用。 优选的, 使用的肿瘤抑制基因序列是 pl6, p21, p27, p53, RB, WT-1 , DCC, NF-1和 APC。在另一个特定的实施方案中, 该 方法进一步包括原位给予一种自杀基因如 HSVltk (单纯疱疹病毒 1胸腺嘧啶激酶:)、 tdk&tmk (胸腺嘧啶激酶 &胸苷酸激酶)、 coda&upp (胞嘧啶脱氨酶 &尿嘧啶磷酸核 糖转移酶) ;一种溶细胞基因如粒酶 A、粒酶 B、穿孔素;或一种凋亡基因如 Bak, Bax, Bcl-XL, Bcl-XB, Bik, Sarp-2, TRAIL。 在另一个更加特定的实施方案中, 该方法进 一步包括原位给予一种细胞因子基因, 如白介素 1 β、 白介素 2、 白介素 4、 白介素 6、 白介素 8、 白介素 10、 白介素 12、 白介素 15、 GM— CSF、干扰素 α、干扰素 β、 干扰素 γ、 肿瘤坏死因子 α、 B7.1或 Β7.2以增强免疫应答。
作为该组合物成分的基因转运系统中的基因可使用的形式为裸 DNA、 复合 DNA、 cDNA、 质粒 DNA。 在另一个优选的实施方案中, 肿瘤抑制基因序列由一 个病毒载体携带。 任何适用于基因治疗的病毒载体均可应用于该组合物中。 例如, 可应用一种腺病毒载体(美国专利 5869305)、一种猿病毒载体 (美国专利 5962274)、 一种条件复制型人免疫缺陷病毒载体和痘病毒载体 (美国专利 5888767), 逆转录 病毒, SV40, 表达相关基因的单纯疱疹病毒扩增子载体和痘病毒载体。 另外, 可 以用非病毒载体系统如脂质体转运基因,其中的脂质可保护 DNA或其它生物材料 在凝集过程中免于氧化。
在另一个特定的实施方案中, 该方法进一步包括原位给予一种辐射致敏剂用 于肿瘤 治疗和放疗的联合应用。 在一个优选的实施方案中, 所使用的辐射致敏剂 是 raf 的反义脱氧寡核苷酸 (Gokhale 等人, Antisense Nucleic Acid Drug Dev, 9(2): 191 -201 (1999); ) SR2508 (依他硝唑) (Chang 等人, Lit J Radiat Oncol Biol Phvs,40il :65-70(1998 )或 Buthionine sulfoximine(BSO)(Vahrmeijer 等人, Cancer Chemother Pharmacol, 44(2): 111-6(1999))。
在另一个特定的实施方案中, 该方法进一步包括原位给予一种含细胞因子的 储存体以增强自身肿瘤特异性免疫应答。 优选的, 所使用的含细胞因子的储存体 是一种配方为脂质体包埋的 IL-2 (Krup等人, J Immunother, 22(6^:525-38(1999) ) , 或配方为粒细胞-巨噬细胞集落刺激因子(Leong 等人, J Immunother, 22(2): 166-74(1999 。
在另一个特定的实施方案中, 该方法进一步包括原位给予一种癌基因序列以 增强自身肿瘤特异性免疫应答。 优选的, 可使用上面表 4中所显示的癌基因序列。
在另一个特定的实施方案中, 该方法进一歩包括原位给予一种减毒的、 可复 制的病毒载体以增强自身肿瘤特异性免疫应答。 优选的, 使用的减毒的、 可复制 的病毒载体是 1型单纯疱疹病毒 (HSV-1 ) 的突变体 G207, 它可在人肿瘤细胞中 复制并引起细胞死亡, 从而抑制肿瘤的生长, 但对正常组织没有致病性 (Toda等 人, Hum Gene Ther, 10Π :385-93(Ί999 ) ο
在另一个实施方案中, 该方法进一步包括原位给予一种报告子来监测治疗进 程。 该报告子可以是化学制品或酶。 优选的, 这种报告酶是 β-半乳糖苷酶或它的 基因。 也可用其它在本技术领域中已知的报告子。
在一个特定的实施方案中, 在治疗中使用 Τ Ρ和 DNP同时作为半抗原。 在另一个特定的实施方案中, 在治疗中使用的氧化剂或还原剂的浓度大约为 0.01%(w/w)到 35%(w/w),靶向载体剂的浓度约为大约 l%(w/w)到 99%(w/w),半抗 原的浓度约为 lmg/ml到 80mg/ml。
在一个特定的实施方案中, 由半抗原和抗癌剂或治疗的联合作用所产生的自 身免疫应答是一种体液和 /或细胞免疫应答。
任何肿瘤赘生物、 肿瘤或癌都可由这里提供的方法治疗。 例如, 可治疗以下 部位的肿瘤: 肾上腺、 肛门、 耳神经、 胆道、 膀胱、 骨、 脑、 胸、 bruCcal、 中枢 神经系统、 子宫颈、 结肠、 耳、 子宫内膜、 食管、 眼、 眼睑、 输卵管、 胃肠道、 头和颈、 心脏、 肾脏、 喉、 肝脏、 肺、 下颚、 下颚骨齿突、 上颌骨、 口、 鼻咽、 鼻、 口腔、 卵巢、 胰腺、 腮腺、 阴茎、 耳廓、 垂体、 前列腺、 直肠、 视网膜、 唾液腺、 皮肤、 小肠、 脊髓、 胃、 睾丸、 甲状腺、 扁桃体、 尿道、 子宫、 阴道、 前庭耳蜗神经、 或外阴, 各种癌的淋巴和淋巴结转移病灶和恶性淋巴瘤。
可用这种方法治疗的其它肿瘤和癌的例子包括: 乳腺癌、 肺癌、 结肠直肠癌、 胰腺肿瘤、 胆囊肝管肿瘤、 肝肿瘤、 胃肿瘤、 食管癌、 恶性黑色素瘤、 尿道和男 性生殖器癌、 皮肤癌、 头颈和甲状腺癌、 中枢神经系统和垂体癌、 眼和眼附属器 肿瘤、 骨恶性肿瘤、 软组织肉瘤、 霍奇金疾病和非霍奇金疾病、 多发性骨髓瘤、 小儿实体瘤、 妇产科癌。 其它的例子还包括:
A. 间质来源的肿瘤:
( 1 ) 结締组织及其衍生物: 肉瘤、 纤维肉瘤、 粘液肉瘤、 脂肪肉瘤、 软骨肉 瘤、 成骨肉瘤。
(2) 内皮及相关组织血管: 血管肉瘤、 淋巴血管肉瘤、 滑膜瘤、 间皮瘤、 侵 袭性脑膜瘤。
B. 上皮来源的肿瘤:
( 1 ) 鳞状分层的: 癌、 鳞状细胞或表皮样癌
(2) 皮肤或附件基细胞: 基细胞癌
(3) 皮肤附属器腺体: 汗腺癌、 皮脂腺癌
(4) 上皮内层: 腺癌、 乳头癌、 乳头状腺癌、 囊腺癌、 髓癌、 未分化腺癌
( 5 ) 呼吸道: 支气管腺癌
(6) 神经外胚层: 黑色素瘤
( 7) 肾上皮: 肾细胞癌、 肾上腺样瘤
( 8) 肝细胞: 肝细胞瘤 (肝细胞癌)
(9) 胆道: 胆管癌、 滴虫血管肉瘤 (chlangiocarcinoma)
( 10) 泌尿道上皮: 乳头癌、 移行性细胞癌、 鳞状细胞癌
( 11 ) 胎盘上皮: 绒毛膜癌
( 12) 睾丸上皮 (胚细胞 精原细胞癌、 胚癌
进一步, 也可以治疗来源于一种类型以上瘤细胞或一个以上胚层的肿瘤。 在一个优选的实施方案中, 所治疗的肿瘤是一种实体瘤。 更优选的, 这种实 体瘤的大小大于 108个细胞。 最优选的, 实体瘤的大小为 5xl09到 1011个细胞。
下面的实施例被提供是为了更加充分地解释本发明的优选实施方式。 这些实 施例不应被解释为对本发明范围的限制。
D. 实施例
实施例 1 :
将亚甲基二膦酸盐 (MDP) lOOmg和抗癌药物阿糖胞苷 (ARA-C) 50mg, 半 抗原二硝基苯酚(DNP) 0.5mg溶解在含有氯化亚锡 SnCl2 0.05mg的溶液中, 放置 5分钟, 在薄层层析板上点样, 用丙酮进行层析分析。 结果显示, 螯合物只显示一 个色带, 未有其他杂色带。 螯合物形成后, 层析是在原点, 标记率 100%。
形成螯合物的机理有待进一步研究, 但是用氧化还原法标记同位素已经应用 多年。 而同时标记一个药物或多个药物和半抗原, 是我们首创。 实施例 2:
C57小鼠皮下接种骨癌细胞 (Osteosarcoma Cells) 约 10X103, —周后肿瘤长 为直径 1CM大小,将亚甲基二膦酸盐 (MDP) lOOmg和抗癌药物阿糖胞苷(ARA-C) 50mg, 半抗原二硝基苯酚 (DNP) 0.5mg溶解在含有氯化亚锡 SnCl2 0.05mg的盐 水 10ml中, 放置 5分钟后, 形成了 MDP-ARCR-DNP螯合物。 治疗组: 静脉注射 螯合物 0.2ML, 每周二次, 共三周, 对照组: 静脉注射仅 0.2ML ARCR, 每周二 次, 共三周。 结果: 治疗组肿瘤明显小于对照组 (P小于 0.05 )。 手术取下肿瘤标 本, 进行病理切片, 进行 CD4和 CD8 免疫染色。 MDP-ARCR-DNP螯合物治疗的 肿瘤呈阳性, 对照组呈阴性。 实验说明, 这种靶向物 (MDP) 通过螯合的形式能 够将药物和半抗原运输到肿瘤的部位, 同时释放药物杀死肿瘤及释放半抗原对被 杀死肿瘤细胞或细胞碎片进行免疫修饰, 起到肿瘤疫苗的作用。 实施例 3:
C57小鼠皮下接种淋巴瘤细胞 (lymphoma cells) 10X103, 一周后肿瘤长为直 径 1CM大小, 将鸭胆子素 (Bruceantin)5ml和抗癌药物阿霉素(Adm) 10mg, 半抗 原二硝基苯酚 (DNP) 0.5mg溶解在含有氯化亚锡 SnCl2 0.05mg的盐水 10ml中, 放置 5 分钟后, 形成了 Bruceantin-Adm-DNP螯合物。 治疗组: 静脉注射螯合物 0.2ML, 每周二次, 共三周, 对照组: 静脉注射仅 0.2ML阿霉素每周二次, 共三 周。 结果: 治疗组肿瘤明显小于对照组 (P小于 0.05)。 手术取下肿瘤标本, 进行
病理切片, 进行 CD4和 CD8 免疫染色。 Bmceantin-Adm-DNP螯合物治疗的肿瘤 呈阳性, 对照组呈阴性。 同时发现淋巴结重量治疗组重于对照组, 取脾脏称重量 并用 CD4和 CD8抗体测定流式细胞。流式细胞指数治疗组为: 40%,对照组: 28%。 该结果显示于图 1 中。 实验说明这种靶向物 (鸭胆子素) 通过螯合的形式能够将 药物和半抗原运输到肿瘤及淋巴结的部位, 同时释放药物杀死肿瘤及释放半抗原 对被杀死肿瘤细胞或细胞碎片进行免疫修饰, 起到肿瘤疫苗的作用。 实施例 4: 骨癌治疗与化疗, 局部治疗联合应用
患者黄 XX, 男, 68岁, 北京, 诊断: 骶髂部骨肉瘤, 双肺弥漫性转移, 全 身多发骨转移。
两年前入我院, 左下肢腰骶部疼痛明显, 大小便无力, 食欲差, 被动右侧卧 位, 双下肢活动受限。 2005年 4月 24日的胸骶部 CT示双肺弥漫大小不等类圆形 结节灶, 大者约 2.0cm, 右侧胸水, 骶骨左侧髂部骨质破坏, 软组织填充。
入院后给予止疼, 营养对症支持, 患者共行骶髂部缓释库治疗 9次 (同以前 的发明治疗) , 其中左髂外侧肿块注射 3次(与骶部肿块一起注射) , 后 CT显示 肿块明显缩小。 最后两次注射药物患者均有骶部及左下肢外侧放 ¾1生疼痛。
共行三氧活化化疗 4次, 分别为 (1 ) CTX0.8dl.8 DDP20mgdl-5 EPI50mgdl VCRlmgdl; (2) CTX0.8dl.8 DDP20mgdl-5 VCRlmgdl ; (3) (4) CTX0.8dl.8 DDP20mgdl-5 EPI40mgdl VCRlmgdl , 无明显消化道反应及骨髓抑制, 无脱发, 肝肾功无变化。
共行亚甲基二膦酸盐 100加 Ara-c50mg,含氯化亚锡 0.05mg,在 10ml 的盐水 中,形成螯合物,静脉给药,治疗 16+8次,行亚锡焦磷酸钠加表阿霉素 (EPI) 40mg), 含氯化亚锡 0.05mg, 在 10ml 的盐水中形成螯合物, 静脉给药, 治疗 6次 (因患 者 7月份出现多次心律失常, 为减轻亚锡焦磷酸钠中 EPI对心脏损伤, 用亚甲基 二膦酸盐加代替) , 治疗间隔应用泉升支持, 无不良反应, ECT 显示骶骨肿瘤及 骨转移瘤较前减轻, 胸部及骶髂部 CT较前明显好转, 病人一般情况良好, 食欲. 睡眠良好, 大小便正常, 可不借外物行走, 无明显疼痛。 于 2006年 1月 16日, 好转出院。
一年前第二次入院, CT示胸部及骶髂部 CT较上次出院无明显变化, 入院后 给予亚甲基二膦酸盐加治疗(亚甲基二膦酸盐加 Am-c50mg, 含氯化亚锡 0.05mg, 在 10ml 的盐水中, 形成螯合物, 静脉给药, 共 4次, 亚锡焦磷酸钠 DDP20mg, 含氯化亚锡, 在 0.05mg 10ml 的盐水中, 形成螯合物, 静脉给药) 。 病人能行走, 开车, 肿瘤明显缩小。 实施例 5. 胃癌和肝癌治疗, 局部治疗联合应用。
康某 男 57岁, 北京某集团干部
患者因 "腹胀返酸 2月余, 胃穿孔修补发现胃癌 20余天", 不能行走, 抬入我 院, 2006年 1月 18日首次入我院。
入院诊断: 胃窦 CaW期 Τ4ΝχΜ1, 腹腔淋巴结转移, 胸腔积水, 胃穿孔手术 后伤口未愈合。 入院后抗癌中药口服, 营养支持, 腹部手术切口处 (5— Fu、 双氧 水) 换药, 于 3月初伤口愈合。
胃窦小弯侧肿块缓释库治疗 5次, 胰头区肿块缓释库治疗 2次, 行腹腔灌注 6 次,其中 5—Fu+DDP 20mg+白介素 Π 100万 u2次, 鸭胆子素加阿霉素腹腔灌注 4 次。
2月 11 日 B超显示肝内占位, 门静脉栓子, 考虑转移瘤, 因入我院前外院所 査 AFP1676.3ng/ml, 不排除原发性肝癌, 行肝内肿块缓释库治疗 1次 (同以前的 发明方法), 并行植酸钠螯合药物治疗 6次, {所螯合药物主要为: Ara— c 50mg*l 次, DDP 20mg* l次, 5— Fu*2次, Ara—c 25mg*2次}。 依替菲宁药盒 (EHIDA) 配合药物治疗 6次, {所配药物主要为: DDP 20mg*2次, 5— Fu0.5*2次, Ara—c 25!¾*2次}, 植酸钠和依替菲宁药盒 (EHIDA)配合药物治疗患者出现腹痛、腹胀、 食欲下降、 伴盗汗乏力, 对症处理后缓解。
患者于 2月后出院, 出院时进食增加, 肝功恢复正常, 一般情况好转, B超 CT显示胃窦小弯处胰头区肿块较入院时明显缩小。
2 月 11 日 B 超胰头区见肿块 6.5*6.3*4.6cm 实性低回声团块, 胃体后方 3.7*3.5cm, 肝内见肿块 4.0*2.5cm、 1.6* 1.5cm, 门静脉栓子 2.0*1.5cm。
4月 20日 B超胰头区见肿块 4.4*3.4*3.1cm, 肝内见散在实性低回声团块, 大 小约 1.4*1. lcm、 1.0*0.8cm, 门静脉栓子 l.l*0.7cm。 )
4月 26日外院 CT见肝右叶多个异常强化体。
2006年 05月 07日第二次入院, 患者情况一般, 进食差, 食后腹胀, 有时伴 恶心呕吐。
胃小弯侧肿块缓释库 2次, 肝缓释库 6次 (包括门静脉栓子), 胃窦处肿块胃镜 下缓释库治疗一次。
植酸钠螯合 5— Fu0.5 三次, DDP20mg —次, 三氧化二砷 5mg Ara— c 25mg+MTX5mg 四次。 依替菲宁药盒 (EHIDA)螯合 5— Fu0.5两次, DDP20mg— 次, EPI30mg两次, Ara-C 50mg两次, 三氧化二砷 5mg , Ara—c 25mg+MTX5mg 四次。
鸭胆子素螯合阿霉素腹腔灌注, 7月 2日干扰素 400万 u+ADM20mg灌注,发 热两天最高 38°C, 伴腹痛恶心呕吐。 对症治疗可缓解。
胃窦处肿块变化不大, 肝内肿块始终存在, 病情稳定。 肝功能除 r-GT高于 正常 (最高 88.57U/1) 外均正常, AFP 降到 240ng/ml。 病人能自由活动和饮食, 感觉良好。
实施例 6: 治疗卵巢癌
一名 56岁的女性卵巢癌患者 8年前进行了外科手术。 患者在治疗前下腹部有 一个很大的团块。声像学显示体积为 5x4.1x3厘米。病人做了化疗结果导致肿瘤生 长。 患者接受亚锡二巯丁二钠 (DMS ) 螯合抗癌药物 (阿糖胞苷及 5-FU) 静脉治 疗和替曲膦药盒 (Tetrofosmiii) 螯合抗癌药物 (阿糖胞苷及 5-FU) 静脉治疗。 两 周后, 肿瘤体积减小为 3.4x3.5x2厘米。 病人感觉良好, 血细胞计数正常。 实施例 7: 恶性淋巴瘤治疗
患者, 男, 57岁, 健康查体时 B超示: 上腹部胰腺周围多发肿大淋巴结。 胃 镜检査发现粘膜溃疡及多发结节, 活检病理示: 弥漫性非何杰金淋巴瘤, 小细胞 型。 5年前行腋下淋巴结活检, 病理为 NHL小细胞型, CD20 阳性。 同时开始行 双腋下区放疗 DT49Gy, 双颈部放疗 DT45Gy。 放疗后胸部 CT示: 左腋下淋巴结 大小同前相仿。 此后定期复査, 3年前 CT示: 右膈肌下肿物 11.0*11.3CM。 于 11 月份入住中国医学科学院, 行穿刺活检, 病理示: 右膈肌下肿物非何杰金淋巴瘤, 小核裂细胞, 形态及免疫组化支持帽带区淋巴瘤 CD20 ( + )。 给予化疗 DDP (40mgdl-3 ) Vp-16 0.1dl-3IF0 (以环磷酰胺) 2.0d2-4, 化疗中出现 III度骨髓抑制。 化疗 2 周期后复査 CT示: 右后胸膜及膈角后不规则软组织肿物较前缩小, 最大 截面 8.5*3.2CM, 下腔静脉后低密度影与前相仿, 考虑受侵, 腹腔, 腹膜后, 骶前 多发结节, 右腹股沟多个淋巴结, 右侧胸腔中等量积液。 行右胸腔穿刺抽液, 细 胞学报: 大量淋巴细胞及间皮细胞。 其听说我院, 为求进一步治疗入我院。
1年前 B超: 肝脏形态大小正常, 于肝左叶探及大小约 4.5*1.8CM实性低回 声结节, 形态不规则, 边界清晰, 内回声均匀, 肝右叶探及大小约.1.1* 1.0CM囊 性回声, 余肝实质回声均匀, 血管走行清晰规则, 门静脉不宽; 腹腔内血管旁探 及多个实性低回声结节, 大者大小约 1.5*0.8CM, 右下腹(脐右侧)探及部分小肠 壁弥漫性增厚,最厚约 1.2CM; 右膈后下角探及范围约 6.5*4.4*1.9CM实性低回声 区, 边界清晰, 回声均勾。
鸭胆子素 (Braceantin), 汉防已甲素(Tetrandrine), 唐松草碱(thalicarpine), 美登素 (maytansine) 螯合抗癌药物(各种抗癌药物及半抗原)静脉治疗,效果显著。
B超: 右下腹小肠壁增厚部分较前范围明显缩小, 肠壁厚约 1.1CM
在 3个月内应用鸭胆子素及汉防已甲素螯合抗癌药物(阿糖胞苷, 5-FU, 阿霉 素) 静脉化疗一周期。 山东医学影像研究所彩色多普勒超声复査报告: 肝脏大小 形态正常, 于右后叶探及一约 1.7*1.3cm 的囊性暗区, 内透生好, 于左叶探及 1.6*1.3cm的低回声结节, 边界清, 内回声均质, 门静脉及肝内外胆管无扩张, 胆、 胰、脾、双肾未见异常; 腹膜后扫査: 于胰体上方探及一 0.5*0.7cm的低回声结节, 形态规则; 右侧胸腔内探及不规则液性暗区范围约 5.4*3.8cm, 右肋膈角处胸膜增 厚, 最厚处约 1.1cm 于右膈后下角探及范围约 2.8*L2*2.6cm的实性低回声, 边界
清, 回声均。
继续应用鸭胆子素螯合抗癌药物(阿糖胞苷, 5-FU, 阿霉素, 三氧化二砷)静 脉化疗, 山东医学影像研究所 CT复查报告: 腹膜后淋巴瘤复査: 右侧下腔静脉与 膈角间病灶消失, 右侧后腹壁病灶亦基本消失, 同侧膈肌仍增厚, 右肺上叶尖段 及左肺上叶后段见斑片状, 索条状高密度影, 右侧胸膜局部增厚并部分粘连, 诸 支气管通畅, 管腔未见狭窄, 肺门, 纵隔内未见异常增大淋巴结。 右侧盆腔内壁 髂内肌内侧软组织肿块较前缩小。
患者在住院期间共应用应用鸭胆子素,螯合药物治疗 16次(三氧化二砷 5 mg) 及 6次 (阿糖胞苷 50mg), 12 次 (环磷酰胺 0.1 ), 2次 (VP 16) 50mg。 实施例 8: 治疗胰腺癌
1名患者, 女性, 68岁, 患胰腺癌并侵入到主动脉。 KPS分数是 70, 声像学 显示肿瘤大小为 4.6x5.3厘米, 呈不规则球形。 临床诊断为 II期胰腺癌, T3N1M0。 她接受恩欧乙替药盒(NOET)螯合阿糖胞苷的静脉治疗, 螯合物含乙半抗原和抗 癌药 AraC。 4周后,肿瘤萎缩为 3.7x4.5厘米。病人情况非常好,血细胞计数正常。 实施例 9: 治疗肾癌
患者, 男性, 68岁, X射线显示肾癌, 病理诊断为肾细胞癌, 约有一个 1.5x2 厘米的肿瘤。病人接受了亚锡喷替酸和二巯丁二钠药盒(DMSA)螯合抗癌药物(阿 糖胞苷及 5- FU) 静脉治疗, 交替的进行化疗, 半抗原和抗癌药 AraC也在的螯合 物之中。 两周后, 病人感觉好转,。 三周后, 肿瘤消失。 病人情况非常好, 血细胞 计数正常。 实施例 10: 治疗脑癌
患者, 男性, 58岁, 脑瘤, 星形细胞瘤 V级, CT示右额叶 3 X 4 CM肿瘤, 一般情况可, 曾行化疗 5 次, 效果不佳, 来我院治疗。 病人接受亚锡双半胱乙酯 (ECD)和亚锡依沙美肟(Exametazime Injection)螯合抗癌药物(阿糖胞苷及 5-FU) 的化疗, 亚锡双半胱乙酯 (ECD) 螯合阿霉素静脉治疗 2次, 亚锡依沙螯合 CTX 和 MTX静脉治疗 4 次。 效果很好, 肿瘤明显缩小, CT显示 I X 1.5 CM大小。 本发明并不限于本申请描述的特定实施方式, 所述的特定实施方式仅是本发 明各方面的一些例示。 对本发明进行各种修改和变化是可能的, 它们并不脱离本 发明的精神和范围, 这对于本领域技术人员是明显的。 根据本文前面的描述, 除 了本文提及的方法和组合, 本发明范围内的功能上等价的方法和组合对本技术领 域的技术人员是明显的。 这样的修改和变化在所附权利要求的范围内。 本发明仅 受所附权利要求以及其等价物的范围的限制。 应该理解, 本发明不限于特定的方 法、 试剂、 组合物或生物系统, 它们可以变化。 还应该理解, 本文使用的术语仅
是出于描述具体的实施方案的目的, 并不是限制性的。 本发明的其它实施方式在 权利要求中提出。
Claims
1.一种组合物, 包括- a)氧化剂或还原剂;
b)靶向载体剂;
c)抗癌药物; 和
c) 半抗原。
2.如权利要求 1 的组合物, 其中所述氧化剂或还原剂、 靶向载体剂、 抗癌药 物和半抗原配成单一的药物组合物或每个配成独立的药物组合物。
3.如权利要求 1 的组合物, 其中所述氧化剂选自氯化亚锡 (SnCl2); 硫酸亚 锡 (SnS04) ; 亚硫酸亚锡 (SnS03); —氧化锡 (SnO) ; 二氧化锡 (Sn02); 锡酸 钠 (Na2Sn03 ); 亚锡酸钠 (Na2Sn02); 氯化亚锡 (SnCl2); 四氯化锡 (SnCl4); 硫 代锡酸盐 ( SnS3); 硫化亚锡 (SnS) o
4.如权利要求 1 的组合物, 其中所述还原剂选自一种含氧量低的还原剂和非 硝基化合物替拉扎明 (SR— 4233 )。
5.如权利要求 4的组合物, 其中所述含氧量低的还原剂是硝基咪唑。
6.如权利要求 1 的组合物, 其中所述靶向载体剂选自: 可以运载药物到靶向 组织的载体, 二巯丁二钠 (m)(Sodiimi Dimercaptosuccinate (DMSA-ΙΠ)); 二巯丁二 钠(V)(Sodium Dimercaptosuccinate (DMSA-V)); 注射用亚锡焦磷酸钠(Sodium Pyrophosphate and Stannous Chloride for Injection (PYP)); 注射用亚甲基二膦酸盐 (Methylene diphosphonate Injection (MDP)); 聚合白蛋白; 硫乙甘肽; 亚锡喷替酸 (Pentetic Acid and Stannous Chloride (DTP A)); 亚锡葡庚糖酸钠(Sodium Glucoheptonate and Stannous Chloride); 亚锡双半胱氨酸乙酯 (L,L-Etiiyl Cysteinate Dimer and Stannous Chloride (ECD)); 依沙美肟 (Exametazime)(HMPAO); 亚锡依替 菲宁 (Etifenin and Stannous Chloride); 亚锡植酸钠(Sodium Phytate and Stahnous Chloride); 甲氧基异丁基异腈盐 [Cu(MIBI)4BF4](MIBI); 甲基 -L-酪氨酸 (a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile); 硝基咪唑类化合物 (2-nitroimidazole) ; 单克隆抗体和肿瘤单克隆抗体; 及中药提取物如鸭胆子素 (Bruceantin)、汉防已甲素 (Tetrandrine)、唐松草碱 (thalicarpine)、美登素 (maytansine) 等等。
7.如权利要求 1所述的组合物, 其中所述抗癌药物选自: 可以用于治疗癌症 的药物, 顺铂, 卡铂, 亚叶酸钙, 长春新碱, 甲氨蝶呤, 氟尿嘧啶, 阿糖胞苷, 环磷酰胺, 表阿霉素, 速溶阿霉素, 丝裂霉素, 足叶乙甙, 平阳霉素, 等等。
8.如权利要求 1所述的组合物, 其中所述半抗原选自三硝基苯酚(T P), 二 硝基苯酚(DNP), N-碘乙酰基 -N,-(5-磺酸基 -1-萘基)亚乙基二酰胺(AED), 二硝 基氟苯 (DNFB), Ovabulin (OVA)和白蛋白 ( albumin )。
9.如权利要求 1所述的组合物, 进一步包含抗肿瘤剂。
10.如权利要求 9所述的组合物, 其中所述抗肿瘤剂是抗血管生成剂。
11.如权利要求 10所述的组合物, 其中所述抗血管生成剂选自基底膜降解抑 制剂, 细胞迁移抑制剂, 内皮细胞增生抑制剂, 三维结构和效能的建立的抑制剂。
12.如权利要求 10所述的组合物, 其中所述抗血管生成剂选自一种血管抑制 基因, 一种血管抑制趋化因子基因, AGM-1470 (TNP-470), 血管抑制类固醇, 血 管抑素, 抗 &νβ3抗体, 抗碱性成纤维细胞生长因子抗体, 抗 IL-1抗体, 抗 TNF-a 抗体, 抗 VEGF抗体, 金诺芬, 咪唑硫嘌呤, BB-94, BB-2516, 碱性 FGF-可溶性 受体, 羧基氨基三唑类(CAI), 软骨衍生抑制剂 (CDI), 几丁质, 氯喹, 顺铂, CM101 , 可的松 /肝素, 可的松 / hyaluroflan, cortexolone/肝素, CT-2584, 环磷酰 胺, 环孢菌素 A, 地塞米松, 二氯酚酸 /透明质酸糖胺多糖, 嗜酸性主要碱性蛋白, 纤连蛋白肽, 明胶酶抑制剂,神经胶质瘤血管生成抑制因子(GD-AIF), GM1474, 氯化金,硫羟苹果酸金, 肝素酶,透明质酸糖胺多糖(高分子量和低分子量种类), 氢化可的松, β环状右旋糖苷, 布洛芬, 吲哚美辛, (X-干扰素, γ-干扰素诱导蛋白 质 10, γ-干扰素, IL-1, IL-2, IL-4, IL-12, 层 Ϋ占连蛋白, 左旋咪唑, 三羟氨基喹 啉, LM609, 基质金属蛋白酶抑制剂, marimastat (BB-2516), 甲羟孕酮, 6-甲基 巯基嘌吟核糖核苷, metastat ( Col-3 ), 氨甲喋呤, 二甲胺四环素, 一氧化氮, 奥 曲肽(生长激素释放抑制激素类似物), 杉醇, D-青霉酸衍胺, 多硫戊聚糖, 胎盘 proliferin相关蛋白, 胎盘核糖核酸酶抑制剂, 纤溶酶原激活因子抑制剂 (PAI), 血小板因子 -4 (PF4), 氢化泼尼松, 催乳素 ( 16Kda片断), proliferin相关蛋白, 前列腺素合酶抑制剂, 鱼精蛋白, 类维生素 A, 罗喹美克 (LS-2616, 三羟氨基喹 啉), 生长激素释放抑制激素, 基质溶素抑制剂, 物质 p (Substance P), 苏拉明, SU101 , tecogalan sodium (DS-4152), 四氢皮质醇 -sthrombospondins (TSPs), 金 属蛋白质酶组织抑制剂 (TIMP1 , 2, 3), 血管内皮生长因子抑制剂, 维生素 A, vitaxin和玻璃体液。
13.如权利要求 9所述的组合物, 其中所述抗肿瘤剂选自一种垸化剂, 一种抗 代谢剂, 一种天然产物, 一种铂配位复合物, 蒽二酮, 取代脲, 甲肼衍生物, 皮 质激素抑制物, 某些激素和拮抗剂, 抗癌症多糖和某些草药提取物如中药提取物。
14.如权利要求 9所述的组合物,其中所述抗肿瘤剂是一种癌基因抑制物或一 种肿瘤抑制基因或蛋白。
15.如权利要求 14所述的组合物, 其中所述癌基因抑制物是一种抗癌基因抗 体或一种抗癌基因反义寡聚核苷酸。
16.如权利要求 14所述的组合物,其中所述癌基因选自 abl, erbA, erbB, ets, fes(fps) , fgr, fins, fos, hst, intl , int2, j n, hit, B-lym, mas, met, mil(raf) , mos, myb, myc, N-myc, neu(Erb 2), ral(mil) , Ha-ras, Ki-ras, N-ras, rel, ros, sis, src, ski, trA;禾口; ^。
17.如权利要求 14所述的组合物,其中所述肿瘤抑制基因选自 pl6, p21, p27, p53 , RB, WT- 1 , DCC, NF— 1和 APC。
18.如权利要求 1所述的组合物,进一步包括含有癌基因或肿瘤抑制基因序列 的病毒载体。
19.如权利要求 18所述的组合物, 其中所述病毒载体选自腺病毒载体, 猿病 毒载体和条件复制人免疫缺陷病毒载体, 反转录病毒载体, SV40载体, 单纯孢疹 病毒扩增子载体和痘病毒载体。
20.如权利要求 1所述的组合物,进一步包括促进半抗原和肿瘤赘生物的肿瘤 抗原的接合的促进剂。
21.如权利要求 20所述的组合物, 其中所述促进剂是螯合剂或化学交联剂。
22.如权利要求 21 所述的组合物, 其中所述螯合剂是甘氨酰酪氨酰基 -(N-e- 二乙三胺五乙酸) -赖氨酸 (GYK-DTPA ) 或亚德利亚霉素己二酸-二酰肼
(ADR-ADH) o 23.如权利要求 21所述的组合物, 其中所述化学交联剂是碳二亚胺。
24.如权利要求 1所述的组合物, 进一步包括免疫受体增效剂。
25.如权利要求 24 所述的组合物, 其中所述免疫受体增效剂选自卡介苗 (BCG), 小棒状杆菌, 流产布鲁氏菌, 葡聚糖, 左旋咪唑, 泰洛伦, 一种酶和非 烈性病毒。
26.如权利要求 1所述的组合物, 其中所述氧化剂是 SnCl2, 所述靶向载体剂 是任一具有器官或肿瘤靶向的化合物。
27.如权利要求 1所述的组合物, 其中所述氧化剂是 SnCl2, 所述抗癌药物是 任一具有抗癌作用的化合物。
28 .如权利要求 1所述的组合物, 其中所述氧化剂或还原剂为大约从 0.01% (w/w)到大约 35 % (w/w),靶向载体剂为从大约 \ % (w/w)到大约 98 % (w/w), 抗癌药物为从大约 lmg/ml 到大约 80mg/ml, 半抗原为从大约 lmg/ml 到大约
29.—种包含权利要求 1所述组合物的试剂盒。
30.—种生产的制品, 包括:
a) 包装材料;
b) 权利要求 1所述的组合物; 且
c) 一个表明所述制品是用于治疗肿瘤的标签。
31.有效量的组合治疗剂在制备用于治疗哺乳动物肿瘤的药物中的用途, 其 中, 所述组合治疗剂包括:
a)氧化剂或还原剂;
b)靶向载体剂;
c)抗癌药物; 和
d) 半抗原。
32.如权利要求 31所述的用途, 其中所述哺乳动物是人。
33.如权利要求 31 所述的用途, 其中所述靶向载体剂选自: 二巯丁二钠 (III)(Sodium Dimercaptosuccinate (DMSA-III)) ; 二 巯 丁 二 钠 (V)(Sodium Dimercaptosuccinate (DMSA-V)); 注射用亚锡焦磷酸钠 (Sodium Pyrophosphate and Stannous Chloride for Injection (PYP)); 注射用亚甲基二膦酸盐(Methylene diphosphonate Injection (MDP)); 聚合白蛋白; 硫乙甘肽; 亚锡喷替酸 (Pentetic Acid
and Stannous Chloride (DTP A)); 亚锡葡庚糖酸钠(Sodium Glucoheptonate and Stannous Chloride); 亚锡双半胱氨酸乙酯 (L,L-Ethyl Cysteinate Dimer and Stannous Chloride (ECD)); 依沙美肟 (Exametazime)(HMPAO) ; 亚锡依替菲宁 (Etifenin and Stannous Chloride); 亚锡植酸钠 (Sodium Phytate and Stahnous Chloride); 甲氧基异 丁基异腈盐 [Cu(MIBI)4BF4](MIBI); 甲基 -L-酪氨酸(a-methyltyosine); MIBI (2-methoxy isobutyl isonitrile); 硝基咪唑类化合物 (2-nitroimidazole); 单克隆抗体和 肿瘤单克隆抗体; 及中药提取物如鸭胆子素 (Bruceantin)、汉防已甲素 (Tetrandrine)、 唐松草碱 (thalicarpine;)、 美登素 (maytansine)等等。
34.如权利要求 31所述的用途, 其中所述抗癌药物选自: 可以用于治疗癌症 的药物, 顺铂, 卡铂, 亚叶酸钙, 长春新碱, 甲氨蝶呤, 氟尿嘧啶, 阿糖胞苷, 环磷酰胺, 表阿霉素, 速溶阿霉素, 丝裂霉素, 足叶乙甙, 平阳霉素, 等等。
35.如权利要求 31所述的用途, 其中所述半抗原选自: 三硝基苯酚 (TNP), 二硝基苯酚 (DNP), N-碘乙酰基 -N,-(5-磺酸基 -1-萘基)亚乙基二酰胺 (AED), 二 硝基氟苯 (DNFB), Ovabulin (OVA) 和白蛋白 ( albumin )。
36 .如权利要求 31所述的用途, 其中所述氧化剂选自: 氯化亚锡 (SnCl2); 硫酸亚锡 (SnS04 ); 亚硫酸亚锡 (SnS03 ); —氧化锡 (SnO); 二氧化锡 (Sn02); 锡酸钠(Na2Sn03 ); 亚锡酸钠(Na2Sn02); 氯化亚锡(SnCl2); 四氯化锡(SnCl4); 硫代锡酸盐 (SnS3); 硫化亚锡 ( SnS) c
38.如权利要求 31所述的用途, 其中进一步包括化学交联剂, 为碳化二亚胺。
39.如权利要求 31所述的用途, 其中进一步包括使用免疫应答增效剂。
40.如权利要求 39所述的用途,其中所述免疫应答增效剂选自卡介苗(BCG), 小棒状杆菌, 流产布氏菌提取物, 葡聚糖, 左旋咪唑, 泰洛伦, 酶, 非致病性病 毒, 多糖和草药提取物。
41.如权利要求 40所述的用途,其中所述酶选自霍乱弧菌神经氨酸酶(VCN), 木瓜蛋白酶, β-半乳糖苷酶和伴刀豆球蛋白 A。
42.如权利要求 31 所述的用途, 其中所述氧化剂或还原剂、 靶向载体剂、 抗 癌药物和半抗原可以配制成单一的药物组合物, 或分别以每一种药物的组合物形 式组成配方。
43.如权利要求 31 所述的用途, 其中所述氧化剂或还原剂、 靶向载体剂和抗 癌药物可以配制在一起成为单一的药物组合物。
44.如权利要求 31 所述的用途, 其中所述氧化剂或还原剂、 靶向载体剂和半 抗原可以配制在一起成为单一的药物组合物。
45.如权利要求 44所述的用途, 其中所述两种或多种抗癌药物中的一种抗癌 药物可以是一种半抗原。
46.如权利要求 31 所述的用途, 其中所述半抗原是硝基咪唑, 三硝基苯酚 ( TOP ) , 二硝基苯酚 (DNP ), N-碘乙酰基 -N,-(5-磺酸基 -1-萘基)亚乙基二酰胺
(AED ) , 二硝基氟苯 (DNFB ), Ovabulin ( OVA) 或 白蛋白 ( albumin )。
47.如权利要求 31 所述的用途, 其中所述组合治疗剂进一步包括一种抗肿瘤 剂。
48.如权利要求 47所述的用途, 其中所述抗肿瘤剂是一种抗血管生成剂。
49.如权利要求 47所述的用途, 其中所述抗肿瘤剂选自一种烷化剂, 一种抗 代谢剂, 一种天然产物, 一种铂配位复合物, 蒽二酮, 取代脲, 甲肼衍生物, 皮 质激素抑制物, 激素和拮抗剂。
50.如权利要求 47所述的用途, 其中所述抗肿瘤剂是一种癌基因抑制物或一 种肿瘤抑制基因或蛋白。
51.如权利要求 50所述的用途, 其中所述癌基因抑制物是一种抗癌基因抗体 或一种抗癌基因反义寡聚核苷酸。
52.如权利要求 50所述的用途, 其中所述癌基因选自 , erbA , erbB。 Ets, fes(fps) , fgr, fins, fos , hst, intl , int2 , jun, hit, B-lym , mas, met, mil(raf), mos, myb, myc, N-myc, neu(ErbB2), ral(mil) , Ha-ras, Ki-ras, N-ras, reh ros, sis, src, ski, t 禾口;
53.如权利要求 50所述的用途, 其中所述肿瘤抑制基因选自 pl6, p21 , p27, p53 , RB, WT-1 , DCC, NF-1和 APC。
54.如权利要求 31所述的用途, 其中所述组合治疗剂进一步包括含有癌基因 或肿瘤抑制基因序列的病毒载体。
55.如权利要求 54所述的用途, 其中所述病毒载体选自腺病毒载体, 猿病毒 载体和条件复制人免疫缺陷病毒载体, 逆转录病毒载体, SV40载体, 单纯孢疹病 毒扩增子载体和痘病毒载体。
56.如权利要求 31所述的用途, 其中所述用于治疗的肿瘤选自肾上腺, 肛门, 听觉神经, 胆管, 膀胱, 骨, 骨转移癌, 脑, 乳房, 中枢神经系统, 子宫颈, 结 肠, 耳, 子宫粘膜, 食管, 眼, 眼睑, 输卵管, 肠胃束, 头和颈, 心脏, 肾, 喉, 肝脏, 肺, 上颚, 下颌髁, 上颌骨, 嘴, 鼻咽, 鼻, 口腔, 卵巢, 胰腺, 腮腺, 阴茎, 耳廓, 垂体, 前列腺, 直肠, 视网膜, 唾液腺, 皮肤, 小肠, 脊髓, 胃, 睾丸, 甲状腺, 扁桃体, 尿道, 子宫, 阴道, 前庭蜗神经和外阴及各种癌的淋巴 和淋巴结转移病灶和恶性淋巴瘤。
57.如权利要求 31所述的用途, 其中所述用于治疗的肿瘤是实体肿瘤。
58.如权利要求 31所述的用途, 其中所述用于治疗的肿瘤不是实体肿瘤。
59.如权利要求 57所述的用途, 其中所述实体肿瘤的大小大于 108个细胞。
60.如权利要求 57所述的用途, 其中所述实体肿瘤的大小为从大约 5X109到 大约 1011个细胞。
61.如权利要求 31所述的用途, 其中所述药物是通过静脉注射或直接注射施 于肿瘤的。
62.如权利要求 31所述的用途, 其中所述药物是通过与外科手术程序结合的 方式施于肿瘤的。
63. 治疗哺乳动物肿瘤的方法, 包括向所述哺乳动物施用有效量的治疗组合 物, 所述治疗组合物包含:
a)氧化剂或还原剂;
b)靶向载体剂;
C)抗癌药物; 和
c)半抗原。
64.如权利要求 63所述的方法, 其中所述氧化剂或还原剂、 靶向载体剂、抗 癌药物和半抗原被配制在单一的组合物中。
65.如权利要求 63所述的方法, 其中所述氧化剂或还原剂、 靶向载体剂、 抗 癌药物和半抗原各自配成独立的组合物, 并且, 它们在施用之前被合并在一起。 65.如权利要求 63所述的方法, 其中所述氧化剂或还原剂、 靶向载体剂和抗 癌药物被配成一个单一的组合物, 而所述氧化剂或还原剂、 靶向载体剂和半抗原 被配成另一个单一的组合物, 并且, 这两个组合物在施用之前被合并在一起。
66. 如权利要求 63所述的方法, 其中所述哺乳动物是人。
67.如权利要求 66所述的方法,其中所述肿瘤选自肾上腺,肛门,听觉神经, 胆管, 膀胱, 骨, 骨转移癌, 脑, 乳房, 中枢神经系统, 子宫颈, 结肠, 耳, 子 宫粘膜, 食管, 眼, 眼睑, 输卵管, 肠胃束, 头和颈, 心脏, 肾, 喉, 肝脏, 肺, 上颚, 下颌髁, 上颌骨, 嘴, 鼻咽, 鼻, 口腔, 卵巢, 胰腺, 腮腺, 阴茎, 耳廓, 垂体, 前列腺, 直肠, 视网膜, 唾液腺, 皮肤, 小肠, 脊髓, 胃, 睾丸, 甲状腺, 扁桃体, 尿道, 子宫, 阴道, 前庭蜗神经和外阴及各种癌的淋巴和淋巴结转移病 灶和恶性淋巴瘤。
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CN101549153A (zh) * | 2008-04-02 | 2009-10-07 | 于保法 | 用于自体治疗肿瘤的组合物和方法 |
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CN114525283A (zh) * | 2021-11-29 | 2022-05-24 | 江苏师范大学 | 红豆杉转录因子TcMYB29在调控红豆杉愈伤中紫杉醇生物合成中的应用 |
CN114525283B (zh) * | 2021-11-29 | 2023-08-29 | 江苏师范大学 | 红豆杉转录因子TcMYB29在调控红豆杉愈伤中紫杉醇生物合成中的应用 |
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US20140037695A1 (en) | 2014-02-06 |
US20100104660A1 (en) | 2010-04-29 |
CN101138634A (zh) | 2008-03-12 |
US8501243B2 (en) | 2013-08-06 |
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