Classifications

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  • A61K31/47—Quinolines; Isoquinolines
  • A61K31/4738—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems
  • A61K31/4745—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems condensed with ring systems having nitrogen as a ring hetero atom, e.g. phenantrolines
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  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
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  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
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  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
  • A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
  • A61K31/573—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
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  • A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
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Definitions

• Arsenic trioxide an inorganic compound, has been approved for the treatment of patients with relapsed or refractory acute promyelocytic leukemia (APL) and is being evaluated as therapy for other leukemia types.
• APL acute promyelocytic leukemia
• Preliminary data and recent experience in the U.S. suggest a role for arsenic trioxide in the other hematologic cancers as well. Consequently, the activity of arsenic trioxide as an anti-leukemic agent is currently being investigated in many types of leukemia.
• S-dimethylarsino-glutathione (SGLU-I) has a multifaceted mechanism of action mediated by disrupted mitochondrial function, increased reactive oxygen species (ROS) production, modified signal transduction, and anti-angiogenesis and has been shown to be active against multiple in vitro and animal cancer models.
• ROS reactive oxygen species
• One aspect of the invention provides a combination therapy wherein one or more other therapeutic agents are administered with an organic arsenical, preferably SGLU-I, shown below or a pharmaceutically acceptable salt thereof
• Such combination treatment may be achieved by way of the simultaneous, sequential, or separate dosing of the individual components of the treatment.
• the invention relates to methods for the treatment of cancer, comprising administering SGLU-I in combination with another therapeutic agent.
• the cancer is selected from brain, lung, liver, spleen, kidney, lymph node, small intestine, pancreas, blood cells, bone, colon, stomach, breast, endometrium, prostate, testicle, ovary, central nervous system, skin, head and neck, esophagus, and bone marrow cancer.
• Another aspect of the invention relates to a kit comprising SGLU-I and another therapeutic agent.
• Figure 1 shows dose response of SGLU-I single agent in HCTl 16 colon carcinoma, RPMI 8226 multiple myeloma and HepG2 hepatocellular carcinoma cell lines
• Figure 2 shows percent viability vs. vehicle control of RPMI 8226 cells incubated in the presence of melphalan (2.5 ⁇ M) and SGLU-I (0.31 and 0.63 ⁇ M) combination and single agents as described in the example 2.
• Figure 3 shows % viability vs. vehicle control of RPMI 8226 cells incubated in the presence of bortezomib (2.5 nM) and SGLU-I (0.625 and 1.125 ⁇ M) combination and single agents as described in the example 2.
• Figure 4 shows % viability vs. vehicle control of RPMI 8226 cells incubated in the presence of dexamethasone (3.75 and 7.5 nM) and SGLU-I (0.31 and 1.25 ⁇ M) combination and single agents as described in the example 2.
• Figure 5 shows % viability vs. vehicle control of HCTl 16 cells incubated in the presence of irinotecan ( 1 ⁇ iM) and SGLU-I (0.63 and 1.25 ⁇ M) combination and single agents as described in the example 2.
• Figure 6 shows % viability vs. vehicle control of HCTl 16 cells incubated in the presence of oxaliplatin (5 ⁇ M) and SGLU-I (0.31 and 0.63 ⁇ M) combination and single agents as described in the example 2.
• Figure 7 shows % viability vs. vehicle control of HCTl 16 cells incubated in the presence of 5-fluorouracil (3 ⁇ M) and SGLU-I (0.625 and 1.25 ⁇ M) combination and single agents as described in the example 2.
• Figure 8 shows % viability vs. vehicle control of HepG2 cells incubated in the presence of 5-fluorouracil (2 ⁇ M) and SGLU-I (1 and 2 ⁇ M) combination and single agents as described in the example 2.
• Figure 9 shows % viability vs. vehicle control of HepG2 cells incubated in the presence of doxorubicin (78 nM) and SGLU-I (1 and 2 ⁇ M) combination and single agents as described in the example 2.
• Figure 10 shows % viability vs. vehicle control of HepG2 cells incubated in the presence of sorafenib (312.5 nM) and SGLU-I (1 and 2 ⁇ M) combination and single agents as described in the example 2.
• One aspect of the invention provides a combination therapy wherein one or more other therapeutic agents are administered with an organic arsenical, preferably SGLU-I, shown below
• Such combination treatment may be achieved by way of the simultaneous, sequential, or separate dosing of the individual components of the treatment.
• Such a combination may be synergistic (effect elicited by combination exceeds expected sum of effects elicited by individual drugs) or additive (effect elicited by combination equals the sum of the effects by individual drugs).
• SGLU-I is administered in combination with another therapeutic agent selected from bortezomib, melphalan, dexamethasone, irinotecan, oxaliplatin, 5-fluorouracil, doxorubicin, and sorafenib.
• the other therapeutic agent is selected from bortezomib, dexamethasone, irinotecan, oxaliplatin, and sorafenib, preferably bortezomib.
• the combination is synergistic.
• the combination is additive.
• SGLU-I is administered in combination with another therapeutic agent such that the combination is synergistic.
• the other therapeutic agent is selected from bortezomib and oxaliplatin.
• SGLU-I is administered in combination with another therapeutic agent such that the combination is additive.
• the other therapeutic agent is selected from dexamethasone, irinotecan, and sorafenib.
• Another aspect of the invention relates to methods for the treatment of cancer, comprising administering SGLU-I in combination with another therapeutic agent.
• the invention relates to methods for the treatment of a cancer selected from brain, lung, liver, spleen, kidney, lymph node, small intestine, pancreas, blood cells, bone, colon, stomach, breast, endometrium, prostate, testicle, ovary, central nervous system, skin, head and neck, esophagus, and bone marrow cancer.
• the cancer is a hematological cancer.
• the cancer is selected from leukemia, lymphoma, multiple myeloma, myelodysplasia, myeloproliferative disease, and refractory leukemia. In certain such embodiments, the cancer is acute promyelocytic leukemia.
• the cancer is selected from multiple myeloma, colon, and hepatocellular carcinoma.
• treatment is an approach for obtaining beneficial or desired results, including clinical results.
• beneficial or desired clinical results can include, but are not limited to, alleviation or amelioration of one or more symptoms or conditions, diminishment of extent of disease, stabilized (i.e., not worsening) state of disease, preventing spread of disease, delay or slowing of disease progression, amelioration or palliation of the disease state, and remission (whether partial or total), whether detectable or undetectable.
• Treatment can also mean prolonging survival as compared to expected survival if not receiving treatment.
• kits comprising SGLU-I and another therapeutic agent.
• the other therapeutic agent is selected from bortezomib, melphalan, dexamethasone, irinotecan, oxaliplatin, 5- fluorouracil, doxorubicin, and sorafenib.
• Administration of the SGLU-I may precede or follow the other therapeutic agent by intervals ranging from minutes to days.
• the SGLU-I and the other therapeutic agent may be administered within about 1 minute, about 5 minutes, about 10 minutes, about 30 minutes, about 60 minutes, about 2 hours, about 4 hours, about 6 hours, 8 hours, about 10 hours, about 12 hours, about 18 hours, about 24 hours, about 36 hours, or even about 48 hours or more of one another.
• administration of the SGLU-I and the other therapeutic agent will be within about 1 minute, about 5 minutes, about 30 minutes, or even about 60 minutes of one another.
• the SGLU-I and the other therapeutic agent may be administered according to different dosing regimen (e.g., the SGLU-I, for example may be administered once a day while the other therapeutic agent may be administered only once every three weeks) such that in some instances administration of the SGLU-I and the other therapeutic agent will be within about 60 minutes of one another, while in other instances, administration of the SGLU-I and the other therapeutic agent will be within days or even weeks of one another.
• the SGLU-I and the other therapeutic agent may be administered according to different dosing regimen (e.g., the SGLU-I, for example may be administered once a day while the other therapeutic agent may be administered only once every three weeks) such that in some instances administration of the SGLU-I and the other therapeutic agent will be within about 60 minutes of one another, while in other instances, administration of the SGLU-I and the other therapeutic agent will be within days or even weeks of one another.
• SGLU-I is provided as a formulation further comprising a pharmaceutical carrier, wherein the formulation has a pH of 5 to 8, or even 5 to 7.
• Compounds described herein can be administered in various forms, depending on the disorder to be treated and the age, condition, and body weight of the patient, as is well known in the art.
• the compounds may be formulated as tablets, capsules, granules, powders, or syrups; or for parenteral administration, they may be formulated as injections (intravenous, intramuscular, or subcutaneous), or drop infusion preparations.
• the active ingredient may be mixed with any conventional additive or excipient, such as a binder, a disintegrating agent, a lubricant, a corrigent, a solubilizing agent, a suspension aid, an emulsifying agent, a coating agent, a cyclodextrin, and/or a buffer.
• a binder such as a binder, a disintegrating agent, a lubricant, a corrigent, a solubilizing agent, a suspension aid, an emulsifying agent, a coating agent, a cyclodextrin, and/or a buffer.
• the SGLU-I and the other therapeutic agent may be in the same form (e.g., both may be administered as tablets or both may be administered intravenously) while in certain alternative embodiments, the SGLU-I and the other therapeutic agent may be in different forms (e.g. one may be administered as a tablet while the other is administered intravenously).
• the precise time of administration and/or amount of the composition that will yield the most effective results in terms of efficacy of treatment in a given patient will depend upon the activity, pharmacokinetics, and bioavailability of a particular compound, physiological condition of the patient (including age, sex, disease type and stage, general physical condition, responsiveness to a given dosage, and type of medication), route of administration, etc.
• physiological condition of the patient including age, sex, disease type and stage, general physical condition, responsiveness to a given dosage, and type of medication
• route of administration etc.
• the above guidelines can be used as the basis for fine-tuning the treatment, e.g., determining the optimum time and/or amount of administration, which will require no more than routine experimentation consisting of monitoring the subject and adjusting the dosage and/or timing.
• phrases "pharmaceutically acceptable” is employed herein to refer to those ligands, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
• pharmaceutically acceptable carrier means a pharmaceutically acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, excipient, solvent or encapsulating material. Each carrier must be “acceptable” in the sense of being compatible with the other ingredients of the formulation and not injurious to the patient.
• materials which can serve as pharmaceutically acceptable carriers include: (1) sugars, such as lactose, glucose, and sucrose; (2) starches, such as corn starch, potato starch, and substituted or unsubstituted ⁇ -cyclodextrin; (3) cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose, and cellulose acetate; (4) powdered tragacanth; (5) malt; (6) gelatin; (7) talc; (8) excipients, such as cocoa butter and suppository waxes; (9) oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil, and soybean oil; (10) glycols, such as propylene glycol; (1 1) polyols, such as glycerin, sorbitol, mannitol, and polyethylene glycol; (12) esters, such as ethyl oleate and ethyl laurate;
• pharmaceutically acceptable salt refers to the relatively nontoxic, inorganic and organic acid addition salts of the inhibitor(s). These salts can be prepared in situ during the final isolation and purification of the inhibitor(s), or by separately reacting a purified inhibitor(s) in its free base form with a suitable organic or inorganic acid, and isolating the salt thus formed.
• Representative salts include the hydrobromide, hydrochloride, sulfate, bisulfate, phosphate, nitrate, acetate, valerate, oleate, palmitate, stearate, laurate, benzoate, lactate, phosphate, tosylate, citrate, maleate, fumarate, succinate, tartrate, naphthylate, mesylate, glucoheptonate, lactobionate, laurylsulphonate salts, and amino acid salts, and the like.
• sulfate bisulfate
• phosphate nitrate
• acetate valerate
• oleate palmitate
• stearate laurate
• benzoate lactate
• phosphate tosylate
• citrate maleate
• fumarate succinate
• tartrate naphthylate
• mesylate glucoheptonate
• lactobionate lactobionate
• laurylsulphonate salts
• the inhibitors useful in the methods of the present invention may contain one or more acidic functional groups and, thus, are capable of forming pharmaceutically acceptable salts with pharmaceutically acceptable bases.
• pharmaceutically acceptable salts refers to the relatively non- toxic inorganic and organic base addition salts of an inhibitor(s). These salts can likewise be prepared in situ during the final isolation and purification of the inhibitor(s), or by separately reacting the purified inhibitor(s) in its free acid form with a suitable base, such as the hydroxide, carbonate, or bicarbonate of a pharmaceutically acceptable metal cation, with ammonia, or with a pharmaceutically acceptable organic primary, secondary, or tertiary amine.
• Representative alkali or alkaline earth salts include the lithium, sodium, potassium, calcium, magnesium, and aluminum salts, and the like.
• Representative organic amines useful for the formation of base addition salts include ethylamine, diethylamine, ethylenediamine, ethanolamine, diethanolamine, piperazine, and the like (see, for example, Berge et al., supra).
• wetting agents such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, release agents, coating agents, sweetening, flavoring, and perfuming agents, preservatives and antioxidants can also be present in the compositions.
• antioxidants examples include: (1 ) water soluble antioxidants, such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite, and the like; (2) oil-soluble antioxidants, such as ascorbyl palmitate, butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), lecithin, propyl gallate, alpha-tocopherol, and the like; and (3) metal chelating agents, such as citric acid, ethylenediamine tetraacetic acid (EDTA), sorbitol, tartaric acid, phosphoric acid, and the like.
• water soluble antioxidants such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite, and the like
• oil-soluble antioxidants such as ascorbyl palmitate, butylated hydroxyanisole (BHA), butylated hydroxytoluene (
• Formulations suitable for oral administration may be in the form of capsules, cachets, pills, tablets, lozenges (using a flavored basis, usually sucrose and acacia or tragacanth), powders, granules, or as a solution or a suspension in an aqueous or non-aqueous liquid, or as an oil-in-water or water-in-oil liquid emulsion, or as an elixir or syrup, or as pastilles (using an inert matrix, such as gelatin and glycerin, or sucrose and acacia) and/or as mouthwashes, and the like, each containing a predetermined amount of an inhibitor(s) as an active ingredient.
• a composition may also be administered as a bolus, electuary, or paste.
• the active ingredient is mixed with one or more pharmaceutically acceptable carriers, such as sodium citrate or dicalcium phosphate, and/or any of the following: (1) fillers or extenders, such as starches, cyclodextrins, lactose, sucrose, glucose, mannitol, and/or silicic acid; (2) binders, such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinyl pyrrolidone, sucrose, and/or acacia; (3) humectants, such as glycerol; (4) disintegrating agents, such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate; (5) solution retarding agents, such as paraffin; (6) absorption accelerators, such as quaternary ammonium compounds; (7) wetting agents,
• pharmaceutically acceptable carriers such as sodium citrate or dicalcium phosphate, and/or any of the following: (1) fillers or extenders
• compositions may also comprise buffering agents.
• Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugars, as well as high molecular weight polyethylene glycols, and the like.
• a tablet may be made by compression or molding, optionally with one or more accessory ingredients.
• Compressed tablets may be prepared using binder (for example, gelatin or hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (for example, sodium starch glycolate or cross-linked sodium carboxymethyl cellulose), surface-active or dispersing agent.
• Molded tablets may be made by molding in a suitable machine a mixture of the powdered inhibitor(s) moistened with an inert liquid diluent.
• Tablets, and other solid dosage forms may optionally be scored or prepared with coatings and shells, such as enteric coatings and other coatings well known in the pharmaceutical-formulating art. They may also be formulated so as to provide slow or controlled release of the active ingredient therein using, for example, hydroxypropylmethyl cellulose in varying proportions to provide the desired release profile, other polymer matrices, liposomes, and/or microspheres. They may be sterilized by, for example, filtration through a bacteria-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved in sterile water, or some other sterile injectable medium immediately before use.
• compositions may also optionally contain opacifying agents and may be of a composition that they release the active ingredient(s) only, or preferentially, in a certain portion of the gastrointestinal tract, optionally, in a delayed manner.
• opacifying agents include polymeric substances and waxes.
• the active ingredient can also be in micro-encapsulated form, if appropriate, with one or more of the above-described excipients.
• Liquid dosage forms for oral administration include pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups, and elixirs.
• the liquid dosage forms may contain inert diluents commonly used in the art, such as, for example, water or other solvents, solubilizing agents, and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1 ,3- butylene glycol, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofuryl alcohol, polyethylene glycols, and fatty acid esters of sorbitan, and mixtures thereof.
• inert diluents commonly used in the art, such as, for example, water or other solvents, solubilizing agents, and
• the oral compositions can also include adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, coloring, perfuming, and preservative agents.
• adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, coloring, perfuming, and preservative agents.
• Suspensions in addition to the active inhibitor(s) may contain suspending agents as, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar and tragacanth, and mixtures thereof.
• suspending agents as, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar and tragacanth, and mixtures thereof.
• compositions of this invention suitable for parenteral administration comprise one or more inhibitors(s) in combination with one or more pharmaceutically acceptable sterile aqueous or nonaqueous solutions, dispersions, suspensions or emulsions, or sterile powders which may be reconstituted into sterile injectable solutions or dispersions just prior to use, which may contain antioxidants, buffers, bacteriostats, solutes which render the formulation isotonic with the blood of the intended recipient or suspending or thickening agents.
• aqueous and nonaqueous carriers examples include water, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol, and the like), and suitable mixtures thereof, vegetable oils, such as olive oil, and injectable organic esters, such as ethyl oleate.
• polyols such as glycerol, propylene glycol, polyethylene glycol, and the like
• vegetable oils such as olive oil
• injectable organic esters such as ethyl oleate.
• Proper fluidity can be maintained, for example, by the use of coating materials, such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants.
• These compositions may also contain adjuvants such as preservatives, wetting agents, emulsifying agents, and dispersing agents.
• microorganisms Prevention of the action of microorganisms may be ensured by the inclusion of various antibacterial and antifungal agents, for example, paraben, chlorobutanol, phenol sorbic acid, and the like. It may also be desirable to include tonicity-adjusting agents, such as sugars, sodium chloride, and the like into the compositions. In addition, prolonged absorption of the injectable pharmaceutical form may be brought about by the inclusion of agents which delay absorption such as aluminum monostearate and gelatin.
• agents which delay absorption such as aluminum monostearate and gelatin.
• delayed absorption of a parenterally administered drug form is accomplished by dissolving or suspending the drug in an oil vehicle.
• Injectable depot forms are made by forming microencapsule matrices of inhibitor(s) in biodegradable polymers such as polylactide-polyglycolide. Depending on the ratio of drug to polymer, and the nature of the particular polymer employed, the rate of drug release can be controlled. Examples of other biodegradable polymers include poly(orthoesters) and poly( anhydrides). Depot injectable formulations are also prepared by entrapping the drug in liposomes or microemulsions which are compatible with body tissue.
• parenteral administration and “administered parenterally” as used herein means modes of administration other than enteral and topical administration, usually by injection, and includes, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid, intraspinal and intrasternal injection, and infusion.
• systemic administration means the administration of a ligand, drug, or other material other than directly into the central nervous system, such that it enters the patient's system and thus, is subject to metabolism and other like processes, for example, subcutaneous administration.
• compositions of the present invention administered to a patient will follow general protocols for the administration of chemotherapeutics, taking into account the toxicity, if any. It is expected that the treatment cycles would be repeated as necessary. It also is contemplated that various standard therapies or adjunct cancer therapies, as well as surgical intervention, may be applied in combination with the described arsenical agent.
• the inhibitor(s), which may be used in a suitable hydrated form, and/or the pharmaceutical compositions of the present invention, are formulated into pharmaceutically acceptable dosage forms by conventional methods known to those of skill in the art.
• Actual dosage levels of the active ingredients in the pharmaceutical compositions of this invention may be varied so as to obtain an amount of the active ingredient which is effective to achieve the desired therapeutic response for a particular patient, composition, and mode of administration, without being toxic to the patient. Examples
• cytotoxic effects of SGLU-I , bortezomib, dexamethasone, doxorubicin, melphalan, 5- fluorouracil, irinotecan, sorafenib and oxaliplatin single agents were determined in the respective cell lines using the CellTiter-Glo (Promega) assay
• HCTl 16 cells were seeded at 5,000 cells/well in 96-well plates and incubated overnight in a 37 °C, 5% CO 2 cell culture incubator. 24 hr after seeding, all compounds were added to the appropriate wells. Cells were exposed to compounds for 72 hr CellTiter-Glo assays were carried out according to manufacturer instructions.
• Example 1 The results from Example 1 were used to select the concentration ranges of each compound for the combination studies with SGLU-I in order to investigate any synergistic or additive interaction.
• Two-dimensional serial dilution concentration matrix 96-well plates were set up with each well containing unique combination of concentrations of test agents (prototype matrix plate setup shown in Table 1). As seen in figures 2 to 10, additive and synergistic effects were observed.

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