WO2012015914A2 - Aryl hydrocarbon receptor (ahr) modifiers as novel cancer therapeutics - Google Patents
Aryl hydrocarbon receptor (ahr) modifiers as novel cancer therapeutics Download PDFInfo
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- WO2012015914A2 WO2012015914A2 PCT/US2011/045526 US2011045526W WO2012015914A2 WO 2012015914 A2 WO2012015914 A2 WO 2012015914A2 US 2011045526 W US2011045526 W US 2011045526W WO 2012015914 A2 WO2012015914 A2 WO 2012015914A2
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- ahr
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- 0 CCC[C@@]1C(C)C(C(C)C)C2[C@]1*2 Chemical compound CCC[C@@]1C(C)C(C(C)C)C2[C@]1*2 0.000 description 3
- DVMUABJHWJACBH-QHCPKHFHSA-N Cc(cc1)ccc1S(N/C(/O)=[O]/[O]=C(\C1)/c2cc(OC)ccc2O[C@@H]1c(cc1Br)ccc1OC)(=O)=O Chemical compound Cc(cc1)ccc1S(N/C(/O)=[O]/[O]=C(\C1)/c2cc(OC)ccc2O[C@@H]1c(cc1Br)ccc1OC)(=O)=O DVMUABJHWJACBH-QHCPKHFHSA-N 0.000 description 1
Classifications
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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
- A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
- A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
- A61K31/352—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline
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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
- A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
- A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
- A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
- A61K31/352—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline
- A61K31/353—3,4-Dihydrobenzopyrans, e.g. chroman, catechin
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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
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
- A61P35/02—Antineoplastic agents specific for leukemia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07D—HETEROCYCLIC COMPOUNDS
- C07D311/00—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only hetero atom, condensed with other rings
- C07D311/02—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only hetero atom, condensed with other rings ortho- or peri-condensed with carbocyclic rings or ring systems
- C07D311/04—Benzo[b]pyrans, not hydrogenated in the carbocyclic ring
- C07D311/22—Benzo[b]pyrans, not hydrogenated in the carbocyclic ring with oxygen or sulfur atoms directly attached in position 4
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07D—HETEROCYCLIC COMPOUNDS
- C07D407/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having oxygen atoms as the only ring hetero atoms, not provided for by group C07D405/00
- C07D407/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having oxygen atoms as the only ring hetero atoms, not provided for by group C07D405/00 containing two hetero rings
- C07D407/04—Heterocyclic compounds containing two or more hetero rings, at least one ring having oxygen atoms as the only ring hetero atoms, not provided for by group C07D405/00 containing two hetero rings directly linked by a ring-member-to-ring-member bond
Definitions
- the invention generally relates to compositions and methods for modulating AhR activity.
- Cancer remains one of the most deadly threats to human health. In the U.S., cancer affects nearly 1.3 million new patients each year, and is the second leading cause of death after heart disease, accounting for approximately 1 in 4 deaths. It is also predicted that cancer may surpass cardiovascular diseases as the number one cause of death within the next decade. Solid tumors are responsible for most of those deaths. Although there have been significant advances in the medical treatment of certain cancers, the overall 5-year survival rate for all cancers has improved only by about 10% in the past 20 years. Cancers, or malignant tumors, metastasize and grow rapidly in an uncontrolled manner, making timely detection and treatment extremely difficult.
- compositions and methods thereof for inhibiting cancer cell proliferation and tumor cell invasion and metastasis are novel agents that modulate AhR activity for use in therapeutic compositions and methods thereof for inhibiting cancer cell proliferation and tumor cell invasion and metastasis.
- compositions and methods are based on the inventors' novel discovery that pharmaceutical compositions comprising small molecule compounds of Formula (I) and (II) described herein modulate AhR activity, such as constitutive AhR activity.
- the inventors have discovered that such small molecules can bind to the AhR and block or inhibit those functions and signaling pathways regulated by the AhR that influence cancer cell growth and proliferation, and tumor cell invasiveness.
- compositions comprising small molecule compounds of Formula (I) and (II) described herein can act as either AhR inhibitors or non- constitutive AhR agonists, and further provide novel methods and assays to distinguish the types of AhR modulators. Accordingly, provided herein are novel therapeutic pharmaceutical compositions and methods thereof comprising AhR inhibitors or non-constitutive AhR agonists of Formula (I) and (II) for the inhibition of cancer cell growth and parameters that characterize tumor metastasis, such as tumor cell invasiveness.
- compositions comprising an aryl hydrocarbon receptor (AhR) modulator of Formula (I):
- Y is C or N
- X is ORi, NHRi, SR CH 2 (n)Ri, halo, or H;
- n 0-6;
- Z is O, S, or NH
- R 1; and R 2 are independently H, alkyl, alkenyl, alkynyl, amino, aminosulfonyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R4, R 5 and R 6 are independently absent, H, halo, alkyl, alkenyl, alkynyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- the AhR modulator of Formula (I) is an AhR inhibitor or a non-constitutive AhR agonist.
- the AhR inhibitor is CB7993113 having a chemical structure:
- the non-constitutive AhR agonist is CB7950998 having a chemical structure:
- the pharmaceutical composition comprises an AhR modulator of
- X' is H, alkyl, aminosulfonyl, alkoxy, amino, acyl, aryl, or heteroaryl, each of which may be optionally substituted;
- n 0-6;
- R 2 is H, alkyl, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R5 and R 6 are independently H, alkyl, acyl, halo, aryl, or heteroaryl, each of which may be optionally substituted;
- X' is alkyl, alkoxy, amino, or aminosulfonyl
- n 0 or 1 ;
- R 2 is aryl, substituted aryl, heteroaryl, or substituted aryl
- R 3 , R 4 , R 5 and R 6 are independently H, alkoxy, alkyl, or halo.
- the AhR modulator of Formula (la) is an AhR inhibitor or a non-constitutive AhR agonist.
- compositions comprising a compound of
- Y is C or N
- X is ORj, NHRj, SRi, CH 2 (n)R ! , halo, or H;
- n 0-6;
- Z is O, S, or NH
- R 1; and R 2 are independently H, alkyl, alkenyl, alkynyl, amino, aminosulfonyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R5 and R 6 are independently absent, H, halo, alkyl, alkenyl, alkynyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted; and
- the C at position 2 is in the R configuration and the C at position 3 is in the S configuration. In some embodiments of these aspects, the C at position 2 is in the S configuration and the C at position 3 is in the R configuration. In some embodiments of these aspects, the C at position 2 is in the R configuration and the C at position 3 is in the R configuration. In some embodiments of these aspects, the C at position 2 is in the S configuration and the C at position 3 is in the S configuration. In some embodiments of these aspects, the C at position 2 is in the S
- the compound is CMLD-2166 having a chemical structure:
- X' is H, alkyl, aminosulfonyl, alkoxy, acyl, aryl, or heteroaryl, each of which may be optionally substituted;
- n 0-6;
- R 2 is H, alkyl, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R5 and R 6 are independently H, alkyl, acyl, halo, aryl, or heteroaryl, each of which may be optionally substituted;
- X' is alkyl, alkoxy, aminosulfonyl
- n 0 or 1 ;
- R 2 is aryl, substituted aryl, heteroaryl, or substituted aryl
- R 3 , R 4 , R5 and R 6 are independently H, alkoxy, alkyl, or halo.
- compositions comprising an aryl hydrocarbon receptor (AhR) modulator of Formula (II):
- Y is C or N
- X is ORi, NHRi, SR CH 2 (n)Ri, halo, or H;
- n 0-6;
- Z is O, S, or NH
- Ri, and R 2 are independently H, alkyl, alkenyl, alkynyl, amino, aminosulfonyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R 5 and R 6 are independently absent, H, halo, alkyl, alkenyl, alkynyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- the stereoisomers thereof comprise the C at position 2 in an R configuration and the C at position 3 in an S configuration. In some embodiments of the aspect, the stereoisomers thereof comprise the C at position 2 in an S configuration and the C at position 3 in an R configuration. In some embodiments of the aspect, the stereoisomers thereof comprise the C at position 2 in an R configuration and the C at position 3 in an R configuration. In some embodiments of the aspect, the stereoisomers thereof comprise the C at position 2 in an S configuration and the C at position 3 in an S configuration.
- the AhR modulator of Formula (II) is an AhR inhibitor or a non-constitutive AhR agonist.
- the AhR modulator of Formula (II) is CMLD-
- compositions comprising an aryl hydrocarbon receptor (AhR) modulator of Formula (Ila):
- X' is H, alkyl, aminosulfonyl, alkoxy, acyl, aryl, or heteroaryl, each of which may be optionally substituted;
- n 0-6;
- R 2 is H, alkyl, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R5 and R 6 are independently H, alkyl, acyl, halo, aryl, or heteroaryl, each of which may be optionally substituted;
- X' is alkyl, alkoxy, aminosulfonyl
- n 0 or 1 ;
- R 2 is aryl, substituted aryl, heteroaryl, or substituted aryl
- R 3 , R 4 , R 5 and R 6 are independently H, alkoxy, alkyl, or halo.
- the AhR modulator of Formula (Ila) is an AhR inhibitor or a non-constitutive AhR agonist.
- methods of modulating constitutive AhR activity in a subject in need thereof comprise administering to a subject having constitutive AhR activity a therapeutically effective amount of any of the pharmaceutical compositions comprising an AhR modulator, such as an AhR inhibitor (e.g. , CB7993113 or CMLD- 2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila) described herein.
- the methods further comprise the step of selecting the subject having constitutive AhR activity.
- Described herein are methods of treating a cancer or a cancerous condition by modulating AhR activity.
- Such methods comprise administering to a subject having a cancer or cancerous condition a therapeutically effective amount of any of the pharmaceutical compositions comprising an AhR modulator, such as an AhR inhibitor (e.g. , CB7993113 or CMLD- 2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila) described herein.
- an AhR modulator such as an AhR inhibitor (e.g. , CB7993113 or CMLD- 2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila) described herein.
- Described herein are methods of inhibiting tumor cell invasiveness in a subject having a cancer, a cancerous condition, or a tumor.
- Such methods comprise administering to a subject having a cancer or a tumor a therapeutically effective amount of any of the pharmaceutical compositions comprising an AhR modulator, such as an AhR inhibitor (e.g. , CB7993113 or CMLD- 2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila) described herein.
- an AhR modulator such as an AhR inhibitor (e.g. , CB7993113 or CMLD- 2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila) described herein.
- the methods further comprise the step of selecting the subject having a cancer, a cancerous condition, or a tumor.
- the cancer is a breast cancer, squamous cell cancer, lung cancer, a cancer of the peritoneum, a hepatocellular cancer, a gastric cancer, a pancreatic cancer, a glioblastoma, a cervical cancer, an ovarian cancer, a liver cancer, a bladder cancer, a hepatoma, a colon cancer, a colorectal cancer, an endometrial or uterine carcinoma, a salivary gland carcinoma, a kidney or renal cancer, a prostate cancer, a vulval cancer, a thyroid cancer, a head and neck cancer, a B-cell lymphoma, a chronic lymphocytic leukemia (CLL); an acute lymphoblastic leukemia (ALL), a Hairy cell leukemia, or a chronic myeloblastic leukemia.
- the cancer is a breast cancer.
- Some embodiments of these methods can further comprise administration or treatment with one or more additional anti-cancer therapies.
- the additional anti-cancer therapy comprises surgery, radiation therapy, biotherapy, immunotherapy, chemotherapy, or any combination thereof.
- Some embodiments of these methods can further comprise administration or treatment with one or more anti-cancer therapeutic agents.
- the anti-cancer therapeutic agent is a chemotherapeutic agent, a growth inhibitor agent, an anti-angiogenesis agent, a cytotoxic agent, an anti-hormonal agent, a prodrug, or a cytokine.
- compositions comprising an AhR modulator, such as an AhR inhibitor (e.g. , CB7993113 or CMLD-2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila), for use in modulating constitutive AhR activity in a subject in need thereof.
- an AhR modulator such as an AhR inhibitor (e.g. , CB7993113 or CMLD-2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila), for use in modulating constitutive AhR activity in a subject in need thereof.
- compositions comprising an AhR modulator, such as an AhR inhibitor (e.g. , CB7993113 or CMLD-2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila), are provided for use in treating a cancer or a cancerous condition by modulating AhR activity.
- an AhR modulator such as an AhR inhibitor (e.g. , CB7993113 or CMLD-2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila)
- compositions comprising an AhR modulator, such as an AhR inhibitor (e.g. , CB7993113 or CMLD-2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila), are provided for use in inhibiting tumor cell invasiveness in a subject having a cancer, a cancerous condition, or a tumor.
- an AhR modulator such as an AhR inhibitor (e.g. , CB7993113 or CMLD-2166), or a non-constitutive AhR agonist (e.g. , CB7950998) of Formulas (I), (la), (II), or (Ila)
- the use further comprises the step of selecting the subject having a cancer, a cancerous condition, or a tumor.
- the cancer is a breast cancer, squamous cell cancer, lung cancer, a cancer of the peritoneum, a hepatocellular cancer, a gastric cancer, a pancreatic cancer, a glioblastoma, a cervical cancer, an ovarian cancer, a liver cancer, a bladder cancer, a hepatoma, a colon cancer, a colorectal cancer, an endometrial or uterine carcinoma, a salivary gland carcinoma, a kidney or renal cancer, a prostate cancer, a vulval cancer, a thyroid cancer, a head and neck cancer, a B-cell lymphoma, a chronic lymphocytic leukemia (CLL); an acute lymphoblastic leukemia (ALL), a Hairy cell leukemia, or a chronic mye
- CLL chronic lymphocytic leukemia
- the use further comprises one or more additional anti-cancer therapies.
- the additional anti-cancer therapy comprises surgery, radiation therapy, biotherapy, immunotherapy, or chemotherapy.
- the use further comprises one or more anti-cancer therapeutic agents.
- the anticancer therapeutic agent is a chemotherapeutic agent, a growth inhibitor agent, an anti-angiogenesis agent, a cytotoxic agent, an anti-hormonal agent, a prodrug, or a cytokine.
- AhR modulator such as an AhR inhibitor or a non-constitutive AhR agonist, of Formula (I), (la), (II), or (Ila).
- a screening method of identifying an AhR modulator comprising: a. contacting a cell comprising a sequence encoding an AhR receptor operably linked to a sequence encoding a reporter molecule with a strong AhR activator, such that expression of the reporter molecule by the cell indicates that the AhR receptor is activated by the strong AhR activator
- the screening method further comprises contacting the partial AhR agonist with a tumor activity assay system comprising: (i) a tumor cell and (ii) a mixture comprising one or more extracellular matrix components, wherein inhibition of tumor activity by the partial AhR agonist indicates that the partial AhR agonist is a non-constitutive AhR agonist, and wherein an increase in tumor activity by the partial AhR agonist indicates that the partial AhR agonist is a constitutive AhR agonist.
- a tumor activity assay system comprising: (i) a tumor cell and (ii) a mixture comprising one or more extracellular matrix components, wherein inhibition of tumor activity by the partial AhR agonist indicates that the partial AhR agonist is a non-constitutive AhR agonist, and wherein an increase in tumor activity by the partial AhR agonist indicates that the partial AhR agonist is a constitutive AhR agonist.
- the reporter is a fluorescent protein, such as GFP (green fluorescent protein) or RFP (red fluorescent protein).
- the strong AhR activator is TCDD or BNF.
- the tumor activity being measured in the tumor activity assay system is tumor cell proliferation or tumor cell invasiveness.
- the tumor cell is a human mammary tumor cell.
- the mixture comprising one or more extracellular matrix components is Matrigel.
- the one or more extracellular matrix components comprises laminin and collagen.
- aryl hydrocarbon receptor (AhR) modulator refers to an agent that causes or facilitates a qualitative or quantitative change, alteration, or modification in one or more processes, mechanisms, effects, responses, functions, activities or pathways mediated by the AhR receptor.
- Such changes mediated by an AhR modulator can refer to a decrease or an increase in the activity or function of the AhR, such as a decrease in, inhibition of, or diversion of, constitutive activity of the AhR.
- AhR inhibitor refers to an agent or compound, that inhibits one or more AhR signaling and downstream effector pathways, including constitutive AhR signaling, as those terms are used herein.
- AhR inhibitor refers to an agent that inhibits expression of the AhR polypeptide or polynucleotide encoding the AhR, or one that binds to, partially or totally blocks stimulation, decreases, prevents, delays activation, inactivates, desensitizes, or down regulates the activity of the AhR polypeptide or polynucleotide encoding the AhR.
- Such AhR inhibitors can e.g., inhibit AhR expression, e.g., AhR translation, post-translational processing of the AhR, stability, degradation, or nuclear or cytoplasmic localization of the AhR polypeptide, or transcription, post transcriptional processing, stability or degradation of a polynucleotide encoding the AhR, or bind to, partially or totally block stimulation, DNA binding, or transcription factor activity of the AhR.
- An AhR inhibitor can act directly or indirectly.
- an AhR antagonist refers to an AhR inhibitor that does not provoke a biological response itself upon specifically binding to the AhR polypeptide or polynucleotide encoding the AhR, but blocks or dampens agonist-mediated or ligand-mediated responses, i.e. , an AhR antagonist can bind but does not activate the AhR polypeptide or polynucleotide encoding the AhR, and the binding disrupts the interaction, displaces an AhR agonist, and/or inhibits the function of an AhR agonist.
- an AhR antagonist does not function as an inducer of AhR activity when bound to the AhR, i.e., they function as pure AhR inhibitors.
- non-constitutive agonist of AhR refers to an agent or compound that binds to the AhR and hyperactivates or diverts constitutive AhR signaling and downstream effector pathways, as those terms are used herein.
- non-constitutive AhR agonists of can increase expression of the AhR polypeptide or polynucleotide encoding the AhR, or bind to the AhR, and partially or totally divert constitutive AhR signaling and downstream activity, such as cancer cell growth and tumor invasive properties.
- a non-constitutive AhR agonist of can divert constitutive AhR signaling by about at least 10% or more, at least 20% or more, at least 30% or more, at least 40% or more, at least 50% or more, at least 60% or more, at least 70% or more, at least 80% or more, at least 90% or more, at least 95% or more, or at least 100% or completely in comparison to a reference or control level in the absence of the non-constitutive AhR agonist.
- AhR agonists, AhR non-constitutive agonists, AhR inhibitors, and AhR antagonists described herein can be naturally occurring and synthetic ligands, antagonists, agonists, small chemical molecules, antibodies or antigen-binding fragments thereof, inhibitory RNA molecules (i.e. , siRNA or antisense RNA) and the like.
- Assays to identify AhR agonists, AhR non- constitutive agonists, AhR inhibitors, and AhR antagonists include, e.g. , applying putative AhR modulator compounds to cells, in the presence or absence of a polypeptide or polynucleotide and then determining the functional effects on a polypeptide or polynucleotide.
- subject and “individual” are used interchangeably herein, and refer to an animal, for example a human, recipient of the small molecule AhR modulators of Formula (I) or Formula (II) described herein.
- the term “subject” refers to that specific animal.
- the terms 'non- human animals' and 'non-human mammals' are used interchangeably herein, and include mammals such as rats, mice, rabbits, sheep, cats, dogs, cows, pigs, and non-human primates.
- subject also encompasses any vertebrate including but not limited to mammals, reptiles, amphibians and fish.
- cancer and “cancerous” refer to or describe the physiological condition in mammals that is typically characterized by unregulated cell growth or proliferation, which interferes with the normal functioning of the bodily organs and systems. Cancers which migrate from their original location and seed vital organs can eventually lead to the death of the subject through the functional deterioration of the affected organs. Hematopoietic cancers, such as leukemia, are able to out-compete the normal hematopoietic compartments in a subject, thereby leading to hematopoietic failure (in the form of anemia, thrombocytopenia and neutropenia) ultimately causing death. Included in this definition are benign and malignant cancers, as well as dormant tumors or micrometastatses.
- anti-cancer therapy refers to a therapy or therapeutic agent useful in treating cancer.
- anti-cancer therapeutic agents include, but are limited to, e.g. , surgery, chemotherapeutic agents, growth inhibitory agents, cytotoxic agents, agents used in radiation therapy, anti-angiogenesis agents, apoptotic agents, anti-tubulin agents, and other agents to treat cancer, such as anti-HER-2 antibodies (e.g. , HerceptinTM), anti-CD20 antibodies, an epidermal growth factor receptor (EGFR) antagonist (e.g. , a tyrosine kinase inhibitor), HER1/EGFR inhibitor (e.g.
- erlotinib TarcevaTM
- platelet derived growth factor inhibitors e.g. , GleevecTM (Imatinib Mesylate)
- a COX-2 inhibitor e.g. , celecoxib
- interferons cytokines
- antagonists e.g. , neutralizing antibodies
- screening refers to the use of cells and tissues in the laboratory, and methods thereof, to identify agents with a specific function, e.g. , a modulating activity.
- agents e.g., compounds or drugs
- compositions, methods, and respective component(s) thereof are used in reference to compositions, methods, and respective component(s) thereof, that are essential to the invention, yet open to the inclusion of unspecified elements, whether essential or not.
- the term "consisting essentially of” refers to those elements required for a given embodiment. The term permits the presence of additional elements that do not materially affect the basic and novel or functional characteristic(s) of that embodiment of the invention.
- compositions, methods, and respective components thereof as described herein, which are exclusive of any element not recited in that description of the embodiment.
- Figure 1 shows that AhR inhibition with AhRR upregulates p21 and decreases MCF-
- FIG. 1 demonstrates that AhR inhibition with AhRR inhibits tumor invasion in matrigel.
- FIG. 3 demonstrates that AhR downregulation with AhR siRNA inhibits invasion in Boyden Chambers.
- the number of cells above and below the MatrigeHcontaining membrane was determined after 48 hrs and the percentage of cells in the lower chamber calculated. *p ⁇ 0.04;
- FIGS 4A-4B show that high-throughput screening (HTS) for AhR agonists and antagonists.
- Figure 4A shows H1G1 cells expressing an AhR-driven GFP reporter construct and treated with candidate AhR modifiers alone (dark line) or together with BNF, a known AhR agonist (light line).
- a dark circle identifies an AhR inhibitor while the light circle indicates an agonist.
- Figure 4B shows data from the non-toxic compound identified in "A,” which was titered in the presence of BNF to calculate the IC 50 . Over 4,000 compounds were screened in this semi-automated assay.
- Figures 5 A-5B demonstrate that CH223191 and CMLD 2166 inhibit constitutive
- FIG. 5A shows data from malignant BPl and immortalized MCF-IOF cells that were transiently transfected with AhR-responsive pGudLuc and treated with vehicle
- FIG. 5B shows data from BPl and MCF-IOF cells that were grown for 18 hrs in the presence of DMSO, CH2231 91, or 2166 and 3H-thymidine incorporation determined. *p ⁇ 0.05.
- FIG. 6 demonstrates that CB7993113 blocks translocation of the AhR to the nucleus after stimulation of cells with DMBA, an AhR agonist.
- Hepa-1 cells were treated with vehicle or 1-10 ⁇ CH223191.
- One hour later cells were treated with 0.1 ⁇ DMBA (where indicated) and incubated for 30 minutes.
- Cells were harvested and proteins from the cytoplasm and nuclei were extracted. Extracted proteins were subjected to AhR- or, as loading control, ⁇ -actin-specific western immunoblots. Data are representative of 3 independent experiments.
- Figures 7A -7B demonstrate that CH223191, CMLD-2166 and CMLD-2186 inhibit tumor invasion.
- Hs578T cells were cultured in Boyden Chambers ( Figure 7A) or in Matrigel ( Figure 7B) in the presence of DMSO, 10 "5 M CMLD-2166, CMLD-.2186 (a 2166 enantiomer) or CH223191 and assayed for invasion 2 (Boyden Chambers) or 7 (Matrigel) days later.
- Figures 8A-8B demonstrate that CB7993113 is capable of blocking acutely toxic effects of a potent AhR ligand and prototypic PAH, DMBA, in vivo, and that three subpopulations of bone marrow cells affected by DMBA are all rescued by treatment with CB7993113.
- Figure 8A shows data from C57BL/6 mice (6/group) that were injected i.p. on day -1 and day 0 with vehicle (oil) or 50 mg/kg CB7993113. Mice then were injected with 50 mg/kg DMBA. Mice were sacrificed 48 hours later. Bone marrow hematopoietic cells were expunged from the bone and viable cells counted.
- Figure 8B confirms the data shown in Figure 8 A and further demonstrates that the three subpopulations of bone marrow cells affected by DMBA are all rescued by treatment with CB7993113.
- C57BL/6 mice (6/group) were treated as in Figure 8A.
- the percentage and number of viable bone marrow pro B cells, pre B cells, and neutrophils were determined 48 hours later by flow cytometry.
- Data are presented as the average number of viable cells of each subtype + SE. (*p ⁇ 0.05, **P ⁇ 0.01, student's t-test).
- Figure 9 depicts computational strategies for shape-and electrostatic similarity searching.
- Figure 10 demonstrates that compounds CMLD-2166 and CB7993113 bind human
- AhR AhR.
- the compounds CMLD-2166 and CB7993113 were mixed with in vitro translated human AhR and radiolabeled TCDD (dioxin), a high affinity AhR ligand. Complexes then were separated on a sucrose gradient and fractions assayed for radioactivity. A decrease in the signal (displacement of radiolabeled TCDD) can be seen in fractions 13-16 indicating binding of the test compound to the AhR and displacement of TCDD. These results demonstrate that these compounds are competitive AhR inhibitors.
- FIG. 11 demonstrates that AhR inhibitors do not significantly block PPARy- mediated transcription. Data were pooled from 4 experiments. Unlike their ability to block AhR- driven reporter activity, the AhR inhibitors had no effect on the PPARy-driven reporter activity.
- FIG. 12 demonstrates that AhR siRNA transfection blocks tumor invasion in matrigel.
- BPl or Hs578T human mammary tumor cells were transiently transfected with control siRNA or AhR siRNA to knock down AhR expression and cells were cultured in Matrigel for 6 days. Shown are colonies of tumor cells that grow from single cells during those 6 days.
- FIG. 13 demonstrates that doxycycline -inducible AhR shRNA blocks tumor invasion in matrigel.
- Hs578T cells were stably transduced with doxycyline -inducible control (scrambled/non-silencing) shRNA (left) or AhR-specific shRNA (right). Cells were treated with doxycyline to activate both control and AhR shRNA vectors and cells were cultured in Matrigel for 5 days.
- FIG. 14 demonstrates that AhR Inhibitor CB993113 blocks BPl tumor invasion in matrigel.
- BPl cells were cultured in the presence of vehicle (left) or 5 uM CB7993113 in Matrigel for 5 days.
- CB7993113 is not toxic at the highest doses tested, 10 uM.
- Figure 15 is a schematic depicting how AhR inhibitors and non-competitive agonists can inhibit tumor invasion.
- FIGS. 16A-16B demonstrate that AhR agonists reduce human mammary tumor cell
- BPl BPl invasion in matrigel.
- BPl cells were cultured in Matrigel in the presence of vehicle, 5 uM DIM (16A), vehicle or 5 uM CB7950998 (16B) for 5 days.
- novel compositions and methods comprising agents that modulate AhR activity.
- the inventors have discovered novel small molecule compounds of Formula (I) and (II), as described herein, that modulate constitutive AhR activity and can be used to treat and inhibit proliferative disorders such as cancer, based on the ability to inhibit cancer cell growth and other parameters that characterize tumor metastasis, such as tumor cell invasiveness.
- the Aryl Hydrocarbon Receptor (“AhR”) is a ligand-dependent member of the family of basic -helix-loop-helix transcription factors that has been found to be activated by numerous structurally diverse synthetic and naturally occurring compounds, such as poly cyclic aromatic hydrocarbons, indoles, and flavonoids.
- AhR is present in a latent conformation in the cytoplasmic compartment of the cell associated with two molecules of the molecular chaperone heat shock protein 90 (“hsp90”) (Perdew, J. Biol. Chem. 263: 13802-13805 (1988) and Wilhelmsson et al., EMBO J.
- Ligand binding initiates a cascade of events that includes translocation to the nucleus, release of hsp90, and heterodimerization with ARNT (Schmidt et al., Annu. Rev. Cell. Dev. Biol. 12:55-89 (1996) and Rowlands et al., Crit. Rev. Toxicol. 27: 109-134 (1997)).
- the ligand bound AhR-ARNT complex is capable of recognizing consensus sequences termed dioxin-response elements ("DRE"s) located in the promoter region of CYP1 Al and other responsive genes, thereby activating transcription (Schmidt et al., Annu. Rev. Cell. Dev. Biol.
- AhR-associated proteins include, but are not limited to, hsp90 p23, XAP2, p60, hsp70, and p48.
- the AhR protein contains several domains critical for function and is classified as a member of the basic helix-loop-helix/Per-Arnt-Sim (bHLH/PAS) family of transcription factors.
- the bHLH motif is located in the N-terminal of the protein.
- Members of the bHLH superfamily have two functionally distinctive and highly conserved domains. The first is the basic -region (b) which is involved in the binding of the transcription factor to DNA. The second is the helix-loop-helix (HLH) region which facilitates protein-protein interactions.
- PAS-A and PAS-B are stretches of 200-350 amino acids that exhibit a high sequence homology to the protein domains that were originally found in the Drosophila genes period (Per) and single minded (Sim) and in AhR's dimerization partner, the aryl hydrocarbon receptor nuclear translocator (ARNT).
- the PAS domains support specific secondary interactions with other PAS domain containing proteins, as is the case with AhR and ARNT, so that heterozygous and homozygous protein complexes can form.
- the ligand binding site of AhR is contained within the PAS-B domain and contains several conserved residues critical for ligand binding.
- a Q-rich domain is located in the C-terminal region of the protein and is involved in co-activator recruitment and transactivation.
- aryl hydrocarbon receptor or "AhR” as used herein refers to the 848 amino acid polypeptide having the amino acid sequence of:
- AhR refers to human AhR.
- AhR is also used to refer to truncated forms or fragments of the AhR polypeptide, comprising, for example, specific AhR domains. Reference to any such forms of the AhR can be identified in the application, e.g. , by "AhR (122-224)."
- cytosolic AhR binds to a ligand, such as a suitable small molecule, which facilitates AhR translocation to the nucleus and eventually results in de novo transcription of target genes.
- the promoters of AhR target genes have the responsive element 5' - TNGCGTG-3' , termed "DRE” or "XRE” for "dioxin responsive elements” or "xenobiotic responsive elements.”
- DRE responsive element 5' - TNGCGTG-3'
- XRE xenobiotic responsive elements
- the genes for xenobiotic-metabolizing enzymes e.g. , cytochrome P450
- AhR battery genes Hundreds of other genes also have DREs.
- AhR can bind to retinoblastoma protein, estrogen receptor (ER), the transcription factor E2F1 and to the NFKB pathway subunits RelA and RelB.
- ER estrogen receptor
- E2F1 the transcription factor
- RelA and RelB the NFKB pathway subunits
- AhR can act as a ubiquitin ligase, targeting the ER for proteasomal degradation. In these signaling pathways, AhR and the other proteins sometimes mutually repress each other's function. Indeed, bioinformatics analysis points to the existence of complex signal cross-talk between AhR and further transcription factors or transcription co-activators (C. Esser et al., Trends in Immunology 2009, Vol. 30: 9, pp. 447-454).
- AhR ligands that is, they have binding dissociation constants (K d ) and effective concentrations at the level expected for a physiologically relevant AhR ligand.
- Physical fluid shear stress which causes oxidation of low-density lipoproteins
- the second messengers cAMP and Ca 2+ serum and growth medium components all activate AhR responses (C. Esser et al., Trends in Immunology 2009, Vol. 30: 9, pp. 447-454).
- AhR has not yet been crystallized, so information on ligand-dependent structural changes is currently lacking.
- Ligand-protected protease digestion studies indicated that only one binding pocket for ligands exists (S. Kronenberg et al., Nucleic Acids Res.
- AhR ligands only need to meet minimal requirements for size and planar shape to fit into the AhR binding pocket. Consequently, a broad range of low-molecular-weight chemicals can activate AhR, albeit at different affinities ranging between 10 ⁇ 12 and 10 ⁇ 3 M. Many ligands have two carbon ring systems, such as tryptophan derivatives, flavonoids and biphenyls. The AhR system is genetically polymorphic and different alleles influence responsiveness to AhR ligands (C. Esser et al., Trends in Immunology 2009, Vol. 30: 9, pp. 447-454). AhR ligands can generally be classified into two categories, synthetic or naturally occurring.
- the first ligands to be discovered were synthetic and members of the halogenated aromatic hydrocarbons (dibenzo-dioxins, dibenzofurans and biphenyls) and polycyclic aromatic hydrocarbons (3-methylcholanthrene, benzo(a)pyrene, benzanthracenes and benzoflavones).
- Naturally occurring compounds that have been identified as ligands of AhR include derivatives of tryptophan such as indigo and indirubin, tetrapyroles such as bilirubinthe arachidonic acid metabolites lipoxin A4 and prostaglandin G, modified low-density lipoprotein and several dietary carotinoids.
- Exemplary AhR ligands include, but are not limited to, endogenous ligands such as
- ITE eicosanoid with anti-inflammatory properties
- ITE eicosanoid with anti-inflammatory properties
- ITE eicosanoid with anti-inflammatory properties
- ITE eicosanoid with anti-inflammatory properties
- ITE eicosanoid with anti-inflammatory properties
- ITE eicosanoid with anti-inflammatory properties
- ITE 2-(l' H-indole-3' -carbonyl)-thiazole-4- carboxylic acid methyl ester
- Environmental pollutants formed during combustion of organic material
- TCDD 2,3,7, 8-tetrachlorodibenzo-p-dioxin
- Benz[a]pyrene dietary ligands, such as quercetin (present in apples and onions), indol-3-carbinol (present in many Brassicaceae, e.g. cabbage)
- resveratrol present in red wine
- curcumin a spice
- drugs synthetic
- drugs such as M50367 ⁇ 3- [2-(2-phenylethyl) benzoimidazole-4-yl]-3-hydroxypropanoic acid, and VAF347 ⁇ [4-(3-chloro- phenyl)-pyrimidin-2-yl] ⁇ .
- AhR antagonists Two of the most potent and well-characterized AhR antagonists include the synthetic flavonoid, 3'-methoxy-4'nitroflavone (“3M4NF”), and the indole derivative 3,3'-diindolylmethane ("DIM"). These compounds have been shown to function through direct competition for binding to the AhR ligand binding site (Henry et al., Mol. Pharmacol. 55:716-725 (1999); Hestermann et al., Mol. Cell. Biol 23:7920-7925 (2003)). The fate of the AhR upon binding of these structurally distinct antagonists is very different.
- Binding of 3M4NF to the AhR inhibits TCDD-mediated nuclear localization, ARNT dimerization, and DNA binding (Henry et al., Mol. Pharmacol. 55:716-725 (1999)). 3M4NF is believed to inhibit a conformational change within the AhR complex necessary for exposure of the nuclear localization sequence, resulting in retention of the AhR in the cytoplasmic compartment of the cell. Conversely, binding of DIM to the AhR allows nuclear localization, ARNT dimerization, and subsequent DNA binding. However, unlike the TCDD-bound AhR- ARNT dimer, this DIM-bound complex is incapable of recruiting the necessary co-factors responsible for initiating transcription (Hestermann et al., Mol. Cell.
- Halogenated and nitro- substituted flavones can exhibit structure -dependent aryl hydrocarbon receptor (AhR) agonist and antagonist activities comparable to that observed for 2,3,7, 8-tetrachlorodibenzo-p-dioxin (TCDD) (F. Lu et al., Biochemical Pharmacology. 51. 1077 (1996)).
- novel flavone and hydroflavone AhR modulator compounds described herein such as the small molecules of Formula (I) and Formula (II), e.g. , CB7993113, CB9950998, and CMLD-2166, modulate constitutive AhR activity, by functioning as AhR inhibitors or non-constitutive AhR agonists.
- AhR modulator compounds can inhibit cancer cell growth, as well as tumor invasion, and are absorbed in vivo and can be used at pharmacologically effective doses to target peripheral organs, such as bone marrow.
- novel small molecule modulators of the AhR and constitutive AhR signaling for use in therapeutic compositions for, and methods of, treating and inhibiting cancer growth and tumor cell invasion, and other hyperproliferative disorders.
- the AhR mediates a variety of functional responses, including, but not limited to de novo transcription of target genes or AhR battery genes having the DRE or XRE responsive element 5' -TNGCGTG-3' .
- Alternative pathways of AhR signaling have also been described, such as binding to retinoblastoma protein, estrogen receptor (ER), the transcription factor E2F1 and to the NFKB pathway subunits RelA and RelB.
- the AhR can also act as a ubiquitin ligase. Accordingly, signaling via the AhR comprises multiple pathways, including constitutive and non-constitutive AhR signaling pathways or signaling activity, as those terms are defined herein.
- Constitutive AhR signaling refers to one or more signaling pathways mediated or regulated by the AhR that are activated or driven by one or more endogenous AhR ligands, or one or more environmental ligands, such as toxins or pollutants, that cause constitutive or long-term translocation of the AhR to the nucleus, and activation or modulation of one or more AhR battery genes involved in unregulated cell growth and proliferation, tumor cell invasiveness, or a combination thereof.
- a "constitutive AhR agonist” is an AhR agonist that selectively binds to the AhR and can induce AhR activity or signaling or activate AhR function by itself, as measured or assayed using any method known to one of skill in the art, such as an in vitro AhR reporter assay, and can cause unregulated cell growth, tumor cell invasiveness, or a combination thereof.
- a constitutive AhR agonist up-regulates expression of CYP1A1, CYP1B1, or a combination thereof.
- Activation by an AhR agonist is achieved when the activity value of the AhR is at least 10% greater, at least 25% greater, at least 50% greater, at least 75% greater, at least 100% greater, at least 2-fold greater, at least 5-fold greater, at least 10-fold greater, at least 25-fold greater, at least 50-fold greater, at least 100-fold greater, at least 1000-fold greater, or more, relative to a control in the absence of the AhR agonist.
- non-constitutive AhR signaling refers to one or more signaling pathways mediated or induced by the AhR that does not cause constitutive or long-term translocation of the AhR to the nucleus, nor activation or modulation of one or more AhR battery genes involved in unregulated cell growth, tumor cell invasiveness, or a combination thereof.
- non-constitutive AhR signaling does not cause upregulation of expression of CYP1A1, CYP1B1, or a combination thereof.
- an "AhR modulator,” as the term is used herein refers to an agent, such as a small molecule of Formula (I), e.g., small molecules of formula (la), or Formula (II), e.g. , small molecules of formula (Ila), that modulates or causes or facilitates a qualitative or quantitative change, alteration, or modification in one or more processes, mechanisms, effects, responses, functions, activities or pathways mediated by the AhR receptor.
- Such changes mediated by an AhR modulator can refer to a decrease or an increase in the expression, activity or function of the AhR, such as a decrease in, inhibition of, or diversion of, constitutive activity of the AhR.
- expression refers to the cellular processes involved in producing RNA and proteins and as appropriate, secreting proteins, including where applicable, but not limited to, for example, transcription, translation, folding, modification and processing.
- Expression products include RNA transcribed from a gene and polypeptides obtained by translation of mRNA transcribed from a gene.
- modulate in reference to an Ahr modulator is used consistently with its use in the art, e.g., meaning to cause or facilitate a qualitative or quantitative change, alteration, or modification in one or more biological processes, mechanisms, effects, responses, functions, activities, pathways, or other phenomena of interest. Accordingly, as used herein, modulate refers to a qualitative or quantitative change, alteration, or modification in one or more processes, mechanisms, effects, responses, functions, activities or pathways mediated by the AhR receptor.
- agent as used herein in reference to an AhR modulator means any compound or substance such as, but not limited to, a small molecule, nucleic acid, polypeptide, peptide, drug, ion, etc.
- An “agent” can be any chemical, entity, or moiety, including, without limitation, synthetic and naturally-occurring proteinaceous and non-proteinaceous entities.
- an agent is a nucleic acid, a nucleic acid analogue, a protein, an antibody, a peptide, an aptamer, an oligomer of nucleic acids, an amino acid, or a carbohydrate, and includes, without limitation, proteins, oligonucleotides, ribozymes, DNAzymes, glycoproteins, siRNAs, lipoproteins, aptamers, and modifications and combinations thereof etc.
- agents are small molecules having a chemical moiety.
- chemical moieties include unsubstituted or substituted alkyl, aromatic, or heterocyclyl moieties.
- Compounds can be known to have a desired activity and/or property, e.g., modulate AhR activity, or can be selected from a library of diverse compounds, using, for example, the screening methods described herein.
- small molecule refers to a chemical agent which can include, but is not limited to, a peptide, a peptidomimetic, an amino acid, an amino acid analog, a polynucleotide, a polynucleotide analog, an aptamer, a nucleotide, a nucleotide analog, an organic or inorganic compound (e.g.
- organic or inorganic compounds having a molecular weight less than about 10,000 grams per mole organic or inorganic compounds having a molecular weight less than about 5,000 grams per mole, organic or inorganic compounds having a molecular weight less than about 1 ,000 grams per mole, organic or inorganic compounds having a molecular weight less than about 500 grams per mole, and salts, esters, and other pharmaceutically acceptable forms of such compounds.
- an AhR modulator selectively binds to the AhR.
- “selectively binds” or “specifically binds” refers to the ability of an AhR agonist or AhR inhibitor, such as an AhR antagonist, described herein to bind to a target, such as the AhR polypeptide, with a K D 10 "5 M (10000 nM) or less, e.g. , 10 "6 M or less, 10 "7 M or less, 10 "8 M or less, 10 “9 M or less, 10 "10 M or less, 10 "11 M or less, or 10 "12 M or less.
- an agonist or inhibitor described herein binds to the AhR polypeptide with a K D of 10 "5 M or lower, but not to other molecules, or a related homologue, then the agent is said to specifically bind the AhR polypeptide.
- Specific binding can be influenced by, for example, the affinity and avidity of the agonist or inhibitor and the concentration of the agonist or inhibitor used.
- the person of ordinary skill in the art can determine appropriate conditions under which the agonists or inhibitors described herein selectively bind using any suitable methods, such as titration of an AhR agonist or AhR inhibitor in a suitable cell binding assay, such as those described herein.
- the term "ligand interaction site” on the AhR means a site, epitope, antigenic determinant, part, domain or stretch of amino acid residues on the AhR that is a site for binding to a ligand, receptor or other binding partner, a catalytic site, a cleavage site, a site for allosteric interaction, a site involved in multimerisation (such as homomerization or
- a " ligand interaction site” can be any site, epitope, antigenic determinant, part, domain or stretch of amino acid residues on the AhR polypeptide to which an inhibitor or agonist described herein can bind, such that AhR activity and/or expression is (and/or any pathway, interaction, signalling, biological mechanism or biological effect in which the AhR is involved) is modulated.
- AhR modulators are AhR inhibitors having the chemical structures of Formula (I), Formula (la), Formula (II), or Formula (Ila) described herein.
- the terms "inhibitor of AhR” or “AhR inhibitor” refers to an agent or compound, such as the small molecules of Formula (I) or Formula (II) described herein, e.g.,
- AhR inhibitor refers to an agent that inhibits expression of the AhR polypeptide or
- AhR inhibitors can e.g. , inhibit AhR expression, e.g. , AhR translation, post-translational processing of the AhR, stability, degradation, or nuclear or cytoplasmic localization of the AhR polypeptide, or transcription, post transcriptional processing, stability or degradation of a polynucleotide encoding the AhR, or bind to, partially or totally block stimulation, DNA binding, or transcription factor activity of the AhR.
- An AhR inhibitor can act directly or indirectly. In some embodiments, an AhR inhibitor selectively binds to the AhR.
- AhR inhibition is achieved when the activity value of an AhR polypeptide, or a polynucleotide encoding the AhR is about at least 10% less, at least 20% less, at least 30% less, at least 40% less, at least 50% less, at least 60% less, at least 70% less, at least 80% less, at least 90% less, at least 95% less, at least 98% less, at least 99% less, up to including 100% or less, i.e., absent, or undetectable, in comparison to a reference or control level in the absence of the inhibitor.
- the AhR inhibitors inhibit constitutive AhR activity.
- the AhR inhibitor is an "AhR antagonist.”
- AhR antagonist refers to an AhR inhibitor that does not provoke a biological response itself upon specifically binding to the AhR polypeptide or polynucleotide encoding the AhR, but blocks or dampens agonist-mediated or ligand-mediated responses, i.e. , an AhR antagonist can bind but does not activate the AhR polypeptide or polynucleotide encoding the AhR, and the binding disrupts the interaction, displaces an AhR agonist, and/or inhibits the function of an AhR agonist.
- the AhR inhibitor is an AhR antagonist that prevents or inhibits binding of 2,3,7,8- tetrachlorodibenzo-p-dioxin (TCDD) to the AhR.
- TCDD 2,3,7,8- tetrachlorodibenzo-p-dioxin
- an AhR antagonist is identified as a small molecule compound that blocks activation of the AhR by a strong AhR activator, such as BNF or TCDD, but does not induce AhR activity or signaling by itself, as measured or assayed using any method known to one of skill in the art, such as in vitro AhR reporter assays.
- a strong AhR activator such as BNF or TCDD
- an AhR antagonist does not function as an inducer of AhR activity when bound to the AhR, i.e. , they function as pure AhR inhibitors.
- an AhR antagonist selectively binds to the AhR.
- the AhR inhibitors described herein such as the small molecules of Formula (I) or Formula (II), e.g. , CB7993113 and CMLD-2166 respectively, block constitutive AhR effector functions that mediate growth and progression of established tumors.
- the small molecule AhR inhibitors of Formula (I) or Formula (II), e.g., CB7993113 and CMLD-2166, described herein act as chemopreventatives by blocking AhR-mediated CYP1A1 induction and mutagen production on exposure to environmental ligands.
- the small molecule AhR inhibitors of Formula 1 [00102] In some embodiments of these aspects, the small molecule AhR inhibitors of Formula
- the small molecule AhR inhibitors of Formula (I) or Formula (II), e.g., CB7993113 and CMLD-2166, described herein inhibit the early contributions of constitutively active AhR in driving malignant transformation.
- the small molecule AhR inhibitors of Formula (I) or Formula (II), e.g., CB7993113 and CMLD-2166, described herein inhibit constitutive AhR signaling-mediated cancer or tumor cell growth.
- the small molecule AhR inhibitors of Formula (I) or Formula (II), e.g., CB7993113 and CMLD-2166, described herein inhibit constitutive AhR signaling-mediated tumor invasion in driving malignant transformation.
- the AhR modulators described herein are non-constitutive AhR agonists having the chemical structures of Formula (I) or Formula (II), such as CB7950998.
- non-constitutive agonist of AhR refers to a small molecule of Formula (I) or Formula (II) described herein, e.g., CB7950998, that binds to the AhR and hyperactivates or diverts constitutive AhR signaling and downstream effector pathways, as those terms are used herein.
- Such small molecule non-constitutive AhR agonists of Formula (I) or Formula (II) described herein, e.g., CB7950998, that binds to the AhR and hyperactivates or diverts constitutive AhR signaling and downstream effector pathways, as those terms are used herein.
- Such small molecule non-constitutive AhR agonists of Formula (I) or Formula (II) described herein, e.g., CB7950998, that binds to the AhR and hyperactivates or diverts constitutive AhR signaling and downstream effector pathways, as those terms are used herein.
- (II) e.g. , CB7950998, can increase expression of the AhR polypeptide or polynucleotide encoding the AhR, or bind to the AhR, and partially or totally divert constitutive AhR signaling and downstream activity, such as cancer cell growth and tumor invasive properties.
- a non- constitutive AhR agonist selectively binds to the AhR.
- the non-constitutive AhR agonist blocks or dampens constitutive endogenous ligand-mediated responses, i.e., a non-constitutive AhR agonist can bind and signal via the AhR, but does not activate the constitutive activity of the AhR polypeptide or polynucleotide encoding the AhR, and the binding disrupts the interaction and/or inhibits the function of an endogenous AhR ligand activating the constitutive AhR pathway.
- a non- constitutive AhR agonist of Formula (I) or Formula (II) e.g.
- CB7950998 can divert constitutive AhR signaling by about at least 10% or more, at least 20% or more, at least 30% or more, at least 40% or more, at least 50% or more, at least 60% or more, at least 70% or more, at least 80% or more, at least 90% or more, at least 95% or more, or at least 100% or completely in comparison to a reference or control level in the absence of the non-constitutive AhR agonist.
- Formula (I) or Formula (II), e.g. , CB7950998, described herein bind the AhR and mediate non- constitutive AhR signaling, and inhibit or block constitutive AhR effector functions that mediate growth and progression of established tumors.
- the non-constitutive AhR agonists of Formula (I) or Formula (II), , e.g., CB7950998, described herein act as
- the non- constitutive AhR agonists of Formula (I) or Formula (II), e.g., CB7950998, described herein inhibit the early contributions of constitutively active AhR in driving malignant transformation.
- the non-constitutive AhR agonists of Formula (I) or Formula (II), e.g. , CB7950998, described herein inhibit or prevent cancer or tumor cell growth mediated by, in part or totally, constitutive AhR signaling.
- the non-constitutive AhR agonists of Formula (I) or Formula (II), e.g., CB7950998, described herein inhibit or prevent tumor invasiveness mediated by, in part or totally, constitutive AhR signaling.
- a non-constitutive AhR agonist is identified as a small molecule compound that: binds the AhR, and can displace binding by an AhR activator, such as BNF or TCDD; can activate the AhR, as measured or assayed using any method known to one of skill in the art; and does not cause, and preferably inhibits, cancer cell growth or proliferation or tumor invasiveness, as measured using any assay known to one of skill in the art.
- Activation of the AhR by a non-constitutive agonist can be measured using, for example, any of the in vitro AhR reporter assays described herein.
- Assays to determine whether an AhR agonist functions as a non-constitutive AhR agonist that inhibits cancer cell growth and proliferation can be based on any method known to one of skill in the art, such as the Matrigel assays described in the identification of CB7950998 at Figures 14A-14B.
- Y is C or N
- X is ORi, NHRj, SR CH 2 (n)R ! , halo, or H;
- n 0-6;
- Z is O, S, or NH;
- R 1; and R 2 are independently H, alkyl, alkenyl, alkynyl, amino, aminosulfonyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R 5 and R 6 are independently absent, H, halo, alkyl, alkenyl, alkynyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- Y is C or N
- X is ORj, NHRj, SRi, CH 2 (n)R ! , halo, or H;
- n 0-6;
- Z is O, S, or NH
- R 1; and R 2 are independently H, alkyl, alkenyl, alkynyl, amino, aminosulfonyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R5 and R 6 are independently absent, H, halo, alkyl, alkenyl, alkynyl, alkoxy, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- stereoisomers of Formula (II) can be prepared.
- stereoisomers focused on the two chiral centers represent (2R, 3S), (2S, 3R), (2R, 3R), and (2S, 3S) stereoisomers of the compound.
- a chiral center is oriented in an R configuration or an S configuration will, of course, depend on the substituents accorded to the different variables.
- the following generic stereoisomers are examples of the various (2R, 3S), (2S, 3R), (2R, 3R), and (2S, 3S) configurations of Formula (II):
- Formula (I) can be represented as Formula (la):
- X' is H, alkyl, aminosulfonyl, alkoxy, amino, acyl, aryl, or heteroaryl, each of which may be optionally substituted;
- n 0-6;
- R 2 is H, alkyl, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R 5 and R 6 are independently H, alkyl, acyl, halo, aryl, or heteroaryl, each of which may be optionally substituted;
- X' is alkyl, alkoxy, amino, aminosulfonyl
- n is 0 or 1 ;
- R 2 is aryl, substituted aryl, heteroaryl, or substituted aryl; and
- R 3 , R4, R 5 and R 6 are independently H, alkoxy, alkyl, or halo.
- Representative compounds of Formula I include the following compounds: CB7993113:
- X' is H, alkyl, aminosulfonyl, alkoxy, acyl, aryl, or heteroaryl, each of which may be optionally substituted;
- n 0-6;
- R 2 is H, alkyl, acyl, aryl, heteroaryl, arylalkyl, cycloalkyl, heteroarylalkyl, heterocyclyl, or haloalkyl, each of which may be optionally substituted;
- R 3 , R 4 , R 5 and R 6 are independently H, alkyl, acyl, halo, aryl, or heteroaryl, each of which may be optionally substituted;
- X' is alkyl, alkoxy, aminosulfonyl (optionally substituted with aryl, or aralkyl groups such as toluene); n is 0 or 1 ; R 2 is aryl, substituted aryl, heteroaryl, or substituted aryl; and R 3 , R 4 , R 5 and R 6 are independently H, alkoxy, alkyl, or halo.
- Representative compounds of Formula II include the following compounds:
- chemical moieties as defined and referred to throughout can be univalent chemical moieties (e.g. , alkyl, aryl, etc.) or multivalent moieties under the appropriate structural circumstances clear to those skilled in the art.
- an "alkyl" moiety can refer to a monovalent radical (e.g. CH 3 -CH 2 -), or in other embodiments, a bivalent linking moiety can be "alkyl,” in which case those skilled in the art will understand the alkyl to be a divalent radical (e.g.
- cycloalkyl refer to the corresponding divalent moiety.
- halo refers to any radical of fluorine, chlorine, bromine or iodine.
- acyl refers to an alkylcarbonyl, cycloalkylcarbonyl, arylcarbonyl, heterocyclylcarbonyl, or heteroarylcarbonyl substituent, any of which may be further substituted by substituents.
- exemplary acyl groups include, but are not limited to, (Ci-C 6 )alkanoyl (e.g. , formyl, acetyl, propionyl, butyryl, valeryl, caproyl, t- butylacetyl, etc.), (C 3 -C 6 )cycloalkylcarbonyl (e.g.
- heterocyclic carbonyl e.g. , pyrrolidinylcarbonyl, pyrrolid-2-one-5 -carbonyl, piperidinylcarbonyl, piperazinylcarbonyl, tetrahydrofuranylcarbonyl, etc.
- aroyl e.g. , benzoyl
- heteroaroyl e.g.
- alkyl, cycloalkyl, heterocycle, aryl and heteroaryl portion of the acyl group may be any one of the groups described in the respective definitions.
- alkyl refers to saturated non-aromatic hydrocarbon chains that may be a straight chain or branched chain, containing the indicated number of carbon atoms (these include without limitation methyl, ethyl, propyl, butyl, pentyl, hexanyl, which may be optionally inserted with N, O, S, SS, S0 2 ,C(0), C(0)0, OC(O), C(0)N or NC(O).
- C C 6 indicates that the group may have from 1 to 6 (inclusive) carbon atoms in it.
- alkenyl refers to an alkyl that comprises at least one double bond.
- alkenyl groups include, but are not limited to, for example, ethenyl, propenyl, butenyl, 1- methyl-2-buten-l-yl and the like.
- alkynyl refers to an alkyl that comprises at least one triple bond.
- alkoxy refers to an -O-alkyl radical.
- aminoalkyl refers to an alkyl substituted with an amino
- aryl refers to monocyclic, bicyclic, or tricyclic aromatic ring system wherein 0, 1 , 2, 3, or 4 atoms of each ring may be substituted by a substituent.
- exemplary aryl groups include, but are not limited to, phenyl, naphthyl, anthracenyl, azulenyl, fluorenyl, indanyl, indenyl, naphthyl, phenyl, tetrahydronaphthyl, and the like.
- arylalkyl refers to alkyl substituted with an aryl or aryl substituted with an alkyl.
- cycloalkyl refers to saturated and partially unsaturated cyclic hydrocarbon groups having 3 to 12 carbons, for example, 3 to 8 carbons, and, for example, 3 to 6 carbons, wherein the cycloalkyl group additionally may be optionally substituted.
- exemplary cycloalkyl groups include, but are not limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclopentenyl, cyclohexyl, cyclohexenyl, cycloheptyl, cyclooctyl, and the like.
- heteroaryl refers to an aromatic 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system having 1 -3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic, said heteroatoms selected from O, N, or S (e.g. , carbon atoms and 1-3, 1-6, or 1 -9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1 , 2, 3, or 4 atoms of each ring may be substituted by a substituent.
- heteroaryl groups include, but are not limited to, pyridyl, furyl or furanyl, imidazolyl, benzimidazolyl, pyrimidinyl, thiophenyl or thienyl, pyridazinyl, pyrazinyl, quinolinyl, indolyl, thiazolyl, naphthyridinyl, and the like.
- heteroarylalkyl refers to an alkyl substituted with a heteroaryl.
- heterocyclyl refers to a non-aromatic 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system having 1 -3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic, said heteroatoms selected from O, N, or S (e.g., carbon atoms and 1-3, 1-6, or 1-9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1, 2 or 3 atoms of each ring may be substituted by a substituent.
- Examplary heterocyclyl groups include, but are not limited to piperazinyl, pyrrolidinyl, dioxanyl, morpholinyl, tetrahydrofuranyl, and the like.
- haloalkyl refers to an alkyl group having one, two, three or more halogen atoms attached thereto.
- exemplary haloalkyl groups include, but are not limited to chloromethyl, bromoethyl, trifluoromethyl, and the like.
- substituents may be "separate" substituents, for instance, a halo group and an alkoxy groups bonded to different carbon atoms in a benzene ring, or the substituents may be "stacked" on one another, for instance, an acyl group (such as formyl) that is substituted with an aminosulfonyl group that is substituted with an arylalkyl (such as toluene).
- substituted groups refers to a group that replaces a hydrogen at any atom of the substituted group or moiety, as well as a group “substituted” on an alkyl, alkenyl, alkynyl, cycloalkyl, aryl, heterocyclyl, heteroaryl, acyl, amino group at any atom of that group.
- Suitable substituents include, without limitation, halo, hydroxy, oxo, nitro, haloalkyl, alkyl, alkenyl, alkynyl, alkaryl, aryl, aralkyl, alkoxy, aryloxy, amino, aminosulfonyl, acylamino, alkylcarbanoyl, arylcarbanoyl, aminoalkyl, alkoxycarbonyl, carboxy, hydroxyalkyl, alkylthio, CF 3 , N-morphilino, phenylthio, alkanesulfonyl, arenesulfonyl, alkanesulfonamido, arenesulfonamido, aralkylsulfonamido, alkylcarbonyl, acyloxy, cyano or ureido.
- two substituents, together with the carbons to which they are attached to can form a ring.
- protecting groups are used during preparation of the compounds of the invention.
- the term "protected” means that the indicated moiety has a protecting group appended thereon.
- compounds contain one or more protecting groups.
- a wide variety of protecting groups can be employed in the methods of the invention. In general, protecting groups render chemical functionalities inert to specific reaction conditions, and can be appended to and removed from such functionalities in a molecule without substantially damaging the remainder of the molecule.
- hydroxyl protecting groups for example, are disclosed by Beaucage et al. (Tetrahedron 1992, 48, 2223-2311). Further hydroxyl protecting groups, as well as other representative protecting groups, are disclosed in Greene and Wuts, Protective Groups in Organic Synthesis, Chapter 2, 2d ed., John Wiley & Sons, New York, 1991, and Oligonucleotides And
- hydroxyl protecting groups include, but are not limited to, t-butyl, t-butoxymethyl, methoxymethyl,
- tetrahydropyranyl 1-ethoxy ethyl, l-(2-chloroethoxy)ethyl, 2-trimethylsilylethyl, p-chlorophenyl, 2,4- dinitrophenyl, benzyl, 2,6-dichlorobenzyl, diphenylmethyl, ⁇ , ⁇ '-dinitrobenzhydryl, p-nitrobenzyl, triphenylmethyl, trimethylsilyl, triethylsilyl, t-butyldimethylsilyl, t-butyldiphenylsilyl, triphenylsilyl, benzoylformate, acetate, chloroacetate, trichloroacetate, trifluoroacetate, pivaloate, benzoate, p- phenylbenzoate, 9-fluorenylmethyl carbonate, mesylate and tosylate.
- Nitrogen- or amino-protecting groups stable to acid treatment are selectively removed with base treatment, and are used to make reactive amino groups selectively available for substitution.
- exemplary amino-protecting groups include, but are not limited to, carbamate protecting groups, such as 2-trimethylsilylethoxycarbonyl (Teoc), 1 -methyl- l-(4-biphenylyl)ethoxycarbonyl (Bpoc), t- butoxycarbonyl (BOC), allyloxycarbonyl (Alloc), 9-fluorenylmethyloxycarbonyl (Fmoc), and benzyloxycarbonyl (Cbz); amide protecting groups, such as formyl, acetyl, trihaloacetyl, benzoyl, and nitrophenylacetyl; sulfonamide protecting groups, such as 2-nitrobenzenesulfonyl; and imine and cyclic imide protecting groups, such as phthalimido and dithiasuccinoyl
- Formula (II) for use in methods of treating a subject having or at risk for developing a proliferative disorder, such as a cancer.
- the small molecule AhR modulators of Formula (I) or Formula (II) described herein, such as AhR inhibitors e.g. , CB7993113 and CMLD-2166, and non-constitutive AhR agonists, e.g. , CB7950998, can be administered to a subject in need thereof by any appropriate route which results in an effective treatment in the subject.
- AhR activity in a subject Such methods comprise administering to a subject having constitutive AhR activity a therapeutically effective amount of a small molecule AhR modulators of Formula (I) or Formula (II) described herein.
- the AhR modulator is an AhR inhibitor of Formula (I), e.g., CB7993113.
- the AhR modulator is an AhR inhibitor of Formula (II), e.g., CMLD-2166.
- the AhR modulator is a non-constitutive AhR agonist of Formula (I), e.g., CB7950998, or Formula (II).
- subject and “individual” are used interchangeably herein, and refer to an animal, for example a human, recipient of the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g., AhR inhibitors, such as CB7993113 and CMLD-2166, and non- constitutive AhR agonists, such as CB7950998.
- AhR inhibitors such as CB7993113 and CMLD-2166
- non- constitutive AhR agonists such as CB7950998.
- subject refers to that specific animal.
- 'non-human animals' and 'non-human mammals' are used interchangeably herein, and include mammals such as rats, mice, rabbits, sheep, cats, dogs, cows, pigs, and non-human primates.
- subject also encompasses any vertebrate including but not limited to mammals, reptiles, amphibians and fish.
- a small molecule AhR modulators of Formula (I) or Formula (II) described herein comprising administering to a subject having a cancer or cancerous condition, or at risk for cancer or a cancerous condition, a therapeutically effective amount of a small molecule AhR modulators of Formula (I) or Formula (II) described herein.
- the AhR modulator is an AhR inhibitor of Formula (I), e.g. , CB7993113.
- the AhR modulator is an AhR inhibitor of Formula (II), e.g., CMLD-2166.
- the AhR modulator is a non-constitutive AhR agonist of Formula (I), e.g. , CB7950998, or Formula (II).
- cancer refers to or describe the physiological condition in mammals that is typically characterized by unregulated cell growth or proliferation, which interferes with the normal functioning of the bodily organs and systems. Accordingly, the terms “cancer” or “tumor” as used herein refers to an uncontrolled growth of cells which interferes with the normal functioning of the bodily organs and systems, including cancer stem cells and tumor vascular niches.
- a subject that has a cancer or a tumor is a subject having objectively measurable cancer cells present in the subject's body. Cancers which migrate from their original location and seed vital organs can eventually lead to the death of the subject through the functional deterioration of the affected organs.
- Hematopoietic cancers such as leukemia, are able to out-compete the normal hematopoietic compartments in a subject, thereby leading to hematopoietic failure (in the form of anemia, thrombocytopenia and neutropenia) ultimately causing death. Included in this definition are benign and malignant cancers, as well as dormant tumors or micrometastatses.
- a "metastasis” refers to the spread of cancer from its primary site to other places in the body. Cancer cells can break away from a primary tumor, penetrate into lymphatic and blood vessels, circulate through the bloodstream, and grow in a distant focus (metastasize) in normal tissues elsewhere in the body. Metastasis can be local or distant. Metastasis is a sequential process, contingent on tumor cells breaking off from the primary tumor, traveling through the bloodstream, and stopping at a distant site. At the new site, the cells establish a blood supply and can grow to form a life -threatening mass. Both stimulatory and inhibitory molecular pathways within the tumor cell regulate this behavior, and interactions between the tumor cell and host cells in the distant site are also significant.
- Metastases are most often detected through the sole or combined use of magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, blood and platelet counts, liver function studies, chest X-rays and bone scans in addition to the monitoring of specific symptoms.
- MRI magnetic resonance imaging
- CT computed tomography
- liver function studies liver function studies
- chest X-rays and bone scans in addition to the monitoring of specific symptoms.
- cancers that can be treated using the compositions and methods described in the various aspects herein include, but are not limited to, carcinoma, lymphoma, blastoma, sarcoma, and leukemia. More particular examples of such cancers include, but are not limited to, breast cancer; basal cell carcinoma, biliary tract cancer; bladder cancer; bone cancer; brain and CNS cancer; cancer of the peritoneum; cervical cancer; choriocarcinoma; colon and rectum cancer; connective tissue cancer; cancer of the digestive system; endometrial cancer; esophageal cancer; eye cancer; cancer of the head and neck; gastric cancer (including gastrointestinal cancer); glioblastoma; hepatic carcinoma; hepatoma; intra-epithelial neoplasm; kidney or renal cancer; larynx cancer; leukemia; liver cancer; lung cancer (e.g., small-cell lung cancer, non-small cell lung cancer, adenocarcinoma of the lung, and
- retinoblastoma rhabdomyosarcoma
- rectal cancer cancer of the respiratory system; salivary gland carcinoma; sarcoma; skin cancer; squamous cell cancer; stomach cancer; testicular cancer; thyroid cancer; uterine or endometrial cancer; cancer of the urinary system; vulval cancer; as well as other carcinomas and sarcomas; as well as B-cell lymphoma (including low grade/follicular non-Hodgkin's lymphoma (NHL); small lymphocytic (SL) NHL; intermediate grade/follicular NHL; intermediate grade diffuse NHL; high grade immunoblastic NHL; high grade lymphoblastic NHL; high grade small non-cleaved cell NHL; bulky disease NHL; mantle cell lymphoma; AIDS-related lymphoma; and Waldenstrom's Macroglobulinemia); chronic lymphocytic leukemia (CLL); acute lymphoblastic leukemia (ALL); Hairy cell leukemia; chronic myelob
- a cancer can be a solid tumor.
- a solid tumor refers to an abnormal mass of tissue that usually does not contain cysts or liquid areas. Solid tumors can be benign or malignant. Different types of solid tumors are named for the type of cells that form them. Non-limiting examples of solid tumors are sarcomas, carcinomas, and lymphomas. Leukemias and other cancers of the blood generally do not form solid tumors and are not hence encompassed by the term 'solid tumor' as used herein.
- a subject refers to a human subject having a cancer or at increased risk for a cancerous condition.
- a subject that has a cancer or a tumor is a subject having objectively measurable cancer cells present in the subject's body.
- a subject that has increased risk for a cancerous condition includes subjects with a known genetic risk factor for cancer, or for whom there is a familial history of cancer.
- the cancer is a breast cancer.
- the cancer is a solid tumor.
- the methods of treating cancer or a cancerous condition further comprise the step of selecting, diagnosing, or identifying a subject having cancer or a cancerous condition.
- a subject is identified as having cancer by objective determination of the presence of cancer cells or a tumor in the subject's body by one of skill in the art.
- objective determinations can be performed through the sole or combined use of tissue biopsies, blood and platelet cell counts, urine analyses, magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, liver function studies, chest X-rays and bone scans in addition to the monitoring of specific symptoms associated with a cancer.
- MRI magnetic resonance imaging
- CT computed tomography
- a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g. , AhR inhibitors, such as CB7993113 and CMLD-2166, and non-constitutive AhR agonists, such as CB7950996, can be formulated, dosed, and administered in a fashion consistent with good medical practice for use in the treatment of the cancers and cancerous conditions described herein, such as breast cancer.
- Factors for consideration in this context include the particular disorder or type of disorder, e.g., cancer, being treated, the particular subject being treated, the clinical condition of the individual subject, the cause of the disorder, the site of delivery of the agent, the method of administration, the scheduling of administration, and other factors known to medical practitioners.
- the "therapeutically effective amount" of a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g. , AhR inhibitors, such as CB7993113 and CMLD-2166, and non-constitutive AhR agonists, such as CB7950996, to be administered is governed by such considerations, and, as used herein, refers to the minimum amount necessary to prevent, ameliorate, or treat, or stabilize, a disorder or condition, such as one mediated by constitutive AhR activity.
- the therapeutically effective amount of a small molecule AhR modulator of Formula (I) or Formula (II) described herein is the minimum amount necessary to, for example, increase the time until progression (duration of progression free survival), to inhibit or prevent tumor invasion, or to treat or prevent the occurrence or recurrence of a tumor, a dormant tumor, or a micrometastases.
- a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g.
- an AhR inhibitor such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, is optionally formulated with one or more agents currently used to prevent or treat cancer or a risk of developing a cancer.
- the effective amount of such other agents depends on the amount of AhR inhibitor or non-constitutive AhR agonist present in the formulation, the type of disorder or treatment, and other factors discussed herein, and as understood by one of skill in the art. These are generally used in the same dosages and with administration routes as used herein before or about from 1 to 99% of the heretofore employed dosages.
- An effective amount as used herein also includes an amount sufficient to delay the development of a symptom of the cancer, alter the course of a cancer (for example but not limited to, slow the progression of a symptom of the cancer, such as growth of a tumor), or reverse a symptom of the cancer or tumor. Thus, it is not possible to specify the exact "effective amount”. However, for any given case, an appropriate "effective amount” can be determined by one of ordinary skill in the art using only routine experimentation. [00152] Effective amounts, toxicity, and therapeutic efficacy of the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g. , an AhR inhibitor, such as
- CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996 can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD 50 (the dose lethal to 50% of the population) and the ED 50 (the dose therapeutically effective in 50% of the population).
- the dosage can vary depending upon the dosage form employed and the route of administration utilized.
- the dose ratio between toxic and therapeutic effects is the therapeutic index and can be expressed as the ratio LD 50 /ED 50 .
- Compositions and methods that exhibit large therapeutic indices are preferred.
- a therapeutically effective dose can be estimated initially from cell culture assays.
- a dose can be formulated in animal models to achieve a circulating plasma concentration range that includes the IC 50 (i.e. , the concentration of the AhR inhibitor or non-constitutive AhR agonist), which achieves a half-maximal inhibition of symptoms) as determined in cell culture, or in an appropriate animal model.
- IC 50 i.e. , the concentration of the AhR inhibitor or non-constitutive AhR agonist
- levels in plasma can be measured, for example, by high performance liquid chromatography.
- the effects of any particular dosage can be monitored by a suitable bioassay. The dosage can be determined by a physician and adjusted, as necessary, to suit observed effects of the treatment.
- a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, is an initial candidate dosage range for administration to the subject, whether, for example, by one or more separate administrations, or by continuous infusion.
- a typical daily dosage might range from about 1 g/kg to about 100 mg/kg or more, depending on the factors mentioned above.
- the treatment is sustained until the cancer is treated, as measured by the methods described above or known in the art.
- other dosage regimens may be useful.
- such dosing regimen is used in combination with a chemotherapy regimen as the first line therapy for treating locally recurrent or metastatic breast cancer.
- the duration of the therapeutic methods described herein can continue for as long as medically indicated or until a desired therapeutic effect (e.g., those described herein) is achieved.
- administration of an AhR modulator i.e. , "AhR inhibitor therapy” or “non- constitutive AhR agonist therapy” is continued for at least 1 month, at least 2 months, at least 4 months, at least 6 months, at least 8 months, at least 10 months, at least 1 year, at least 2 years, at least 3 years, at least 4 years, at least 5 years, at least 10 years, at least 20 years, or for at least a period of years up to the lifetime of the subject.
- the small molecule AhR modulators of Formula (I) or Formula (II) described herein can be administered to a subject, e.g., a human subject, in accordance with known methods, such as intravenous administration as a bolus or by continuous infusion over a period of time, by intramuscular, intraperitoneal, intracerobrospinal, subcutaneous, intra-articular, intrasynovial, intrathecal, oral, topical, or inhalation routes.
- Local administration can be used if, for example, extensive side effects or toxicity is associated with the AhR inhibitor or the non-constitutive AhR agonist.
- An ex vivo strategy can also be used for therapeutic applications.
- Formula (I) or Formula (II) described herein include, but are not limited to, injection, infusion, inhalation ⁇ e.g. , intranasal or intratracheal), ingestion, rectal, and topical (including buccal and sublingual) administration.
- AhR inhibitor such as CB7993113 and CMLD- 2166
- non-constitutive AhR agonist such as CB7950996
- parenterally refers to modes of administration other than enteral and topical administration, usually by injection.
- injection includes, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intraventricular, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, sub capsular, subarachnoid, intraspinal, intracerebro spinal, and intrasternal injection and infusion.
- systemic administration refers to the administration of a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, other than directly into a target site, tissue, or organ, such as the lung, such that it enters the subject's circulatory system and, thus, is subject to metabolism and other like processes.
- a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, other than directly into a target site, tissue, or organ, such as the lung, such that it enters the subject's circulatory system and, thus, is subject to metabolism and other like processes.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non- constitutive AhR agonist such as CB7950996
- the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g. , an AhR inhibitor, such as CB7993113 and CMLD- 2166, or a non-constitutive AhR agonist, such as CB7950996, can be administered by intralesional administration.
- the AhR inhibitor or non-constitutive AhR agonists described herein can be administered by pulse infusion, particularly with declining doses of the inhibitors or non-constitutive agonists.
- the dosing is given by injections, most preferably intravenous or subcutaneous injections, depending in part on whether the administration is brief or chronic.
- the small molecule AhR modulators of Formula (I) or Formula (I) are particularly preferred.
- an AhR inhibitor such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996, is administered locally, e.g., by direct injections, when the disorder or location of the tumor permits, and the injections can be repeated periodically.
- the AhR inhibitors or non-constitutive AhR agonists described herein can also be delivered systemically to the subject or directly to the tumor cells, e.g. , to a tumor or a tumor bed, following surgical excision of the tumor, in order to prevent or reduce local recurrence or metastasis, for example of a dormant tumor or micrometastases.
- Therapeutic formulations of AhR inhibitors can be prepared, in some aspects, by mixing a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as
- Such therapeutic formulations of the AhR inhibitors or non-constitutive AhR agonists described herein include formulation into pharmaceutical compositions or pharmaceutical formulations for parenteral administration, e.g. , intravenous; mucosal, e.g. , intranasal; enteral, e.g. , oral; topical, e.g., transdermal; ocular, or other mode of administration.
- the phrase "pharmaceutically acceptable” refers to those compounds, 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, media, encapsulating material, manufacturing aid (e.g.
- AhR modulators of Formula (I) or Formula (II) described herein e. g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996, from one organ, or portion of the body, to another organ, or portion of the body.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non- constitutive AhR agonist such as CB7950996, from one organ, or portion of the body, to another organ, or portion of the body.
- acceptable carriers, excipients, or stabilizers that are nontoxic to recipients at the dosages and concentrations employed, include pH buffered solutions such as phosphate, citrate, and other organic acids; antioxidants, including ascorbic acid and methionine; lubricating agents, such as magnesium stearate, sodium lauryl sulfate and talc; excipients, such as cocoa butter and suppository waxes; oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil and soybean oil; preservatives (such as octadecyldimethylbenzyl ammonium chloride; hexamethonium chloride; benzalkonium chloride, benzethonium chloride; phenol, butyl or benzyl alcohol; alkyl parabens such as methyl or propyl paraben; catechol; resorcinol; cyclohexan
- buffering agents such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogen-free water; isotonic saline; Ringer's solution; polyesters, polycarbonates and/or poly anhydrides; C2-C12 alcohols, such as ethanol; powdered tragacanth; malt; and/or non-ionic surfactants such as TWEENTM, PLURONICSTM or polyethylene glycol (PEG); and/or other non-toxic compatible substances employed in pharmaceutical formulations.
- Wetting agents, coloring agents, release agents, coating agents, sweetening agents, flavoring agents, perfuming agents, preservative and antioxidants can also be present in the formulation.
- the therapeutic formulation comprising an AhR inhibitor comprises a pharmaceutically acceptable salt, typically, e.g. , sodium chloride, and preferably at about physiological concentrations.
- a pharmaceutically acceptable salt typically, e.g. , sodium chloride, and preferably at about physiological concentrations.
- the formulations described herein can contain a
- the preservative concentration ranges from 0.1 to 2.0%, typically v/v.
- Suitable preservatives include those known in the
- the formulations of the invention can include a
- a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, can be specially formulated for administration of the compound to a subject in solid, liquid or gel form, including those adapted for the following: (1) oral administration, for example, drenches (aqueous or nonaqueous solutions or suspensions), lozenges, dragees, capsules, pills, tablets (e.g.
- parenteral administration for example, by subcutaneous, intramuscular, intravenous or epidural injection as, for example, a sterile solution or suspension, or sustained-release formulation
- parenteral application for example, as a cream, ointment, or a controlled-release patch or spray applied to the skin
- topical application for example, as a cream, ointment, or a controlled-release patch or spray applied to the skin
- intravaginally or intrarectally for example, as a pessary, cream or foam
- sublingually (6) ocularly; (7) transdermally; (8) transmucosally; or (9) nasally.
- a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, can be implanted into a patient or injected using a drug delivery system.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non-constitutive AhR agonist such as CB7950996
- Examples of dosage forms include, but are not limited to: tablets; caplets; capsules, such as hard gelatin capsules and soft elastic gelatin capsules; cachets; troches; lozenges; dispersions;
- suppositories ointments; cataplasms (poultices); pastes; powders; dressings; creams; plasters;
- solutions solutions; patches; aerosols (e.g. , nasal sprays or inhalers); gels; liquids such as suspensions (e.g. , aqueous or non-aqueous liquid suspensions, oil-in- water emulsions, or water-in-oil liquid emulsions), solutions, and elixirs; and sterile solids (e.g. , crystalline or amorphous solids) that can be reconstituted to provide liquid dosage forms.
- suspensions e.g. , aqueous or non-aqueous liquid suspensions, oil-in- water emulsions, or water-in-oil liquid emulsions
- solutions and elixirs
- sterile solids e.g. , crystalline or amorphous solids
- CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996 can be administered to a subject with a cancer or at increased risk for cancer by various routes, including, but not limited to, subcutaneous, intravenous (including bolus injection), intramuscular, and intraarterial. Since administration of parenteral dosage forms typically bypasses the patient's natural defenses against contaminants, parenteral dosage forms are preferably sterile or capable of being sterilized prior to administration to a patient. Examples of parenteral dosage forms include, but are not limited to, solutions ready for injection, dry products ready to be dissolved or suspended in a
- Suitable vehicles that can be used to provide parenteral dosage forms described herein are well known to those skilled in the art. Examples include, without limitation: sterile water; water for injection USP; saline solution; glucose solution; aqueous vehicles such as but not limited to, sodium chloride injection, Ringer's injection, dextrose Injection, dextrose and sodium chloride injection, and lactated Ringer's injection; water-miscible vehicles such as, but not limited to, ethyl alcohol, polyethylene glycol, and propylene glycol; and non-aqueous vehicles such as, but not limited to, corn oil, cottonseed oil, peanut oil, sesame oil, ethyl oleate, isopropyl myristate, and benzyl benzoate.
- an AhR inhibitor such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996
- a non- constitutive AhR agonist such as CB7950996
- discrete dosage forms such as, but not limited to, tablets (including without limitation scored or coated tablets), pills, caplets, capsules, chewable tablets, powder packets, cachets, troches, wafers, aerosol sprays, or liquids, such as but not limited to, syrups, elixirs, solutions or suspensions in an aqueous liquid, a non-aqueous liquid, an oil-in-water emulsion, or a water-in-oil emulsion.
- compositions contain a predetermined amount of the pharmaceutically acceptable salt of the disclosed compounds, and may be prepared by methods of pharmacy well known to those skilled in the art. See generally, Remington's Pharmaceutical Sciences, 18th ed., Mack Publishing, Easton, Pa. (1990).
- tablets and capsules represent the most advantageous solid oral dosage unit forms, in which case solid pharmaceutical excipients are used. If desired, tablets can be coated by standard aqueous or nonaqueous techniques. These dosage forms can be prepared by any of the methods of pharmacy. In general, pharmaceutical compositions and dosage forms are prepared by uniformly and intimately admixing the active ingredient(s) with liquid carriers, finely divided solid carriers, or both, and then shaping the product into the desired presentation if necessary.
- Typical oral dosage forms of the compositions are prepared by combining the pharmaceutically acceptable salt of a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, in an intimate admixture with at least one excipient according to conventional pharmaceutical compounding techniques.
- Excipients can take a wide variety of forms depending on the form of the composition desired for administration.
- excipients suitable for use in oral liquid or aerosol dosage forms include, but are not limited to, water, glycols, oils, alcohols, flavoring agents, preservatives, and coloring agents.
- excipients suitable for use in solid oral dosage forms include, but are not limited to, starches, sugars, microcrystalline cellulose, kaolin, diluents, granulating agents, lubricants, binders, and disintegrating agents.
- Binders suitable for use in the pharmaceutical formulations described herein include, but are not limited to, corn starch, potato starch, or other starches, gelatin, natural and synthetic gums such as acacia, sodium alginate, alginic acid, other alginates, powdered tragacanth, guar gum, cellulose and its derivatives (e.g. , ethyl cellulose, cellulose acetate, carboxymethyl cellulose calcium, sodium carboxymethyl cellulose), polyvinyl pyrrolidone, methyl cellulose, pre-gelatinized starch, hydroxypropyl methyl cellulose, (e.g. , Nos. 2208, 2906, 2910), microcrystalline cellulose, and mixtures thereof.
- natural and synthetic gums such as acacia, sodium alginate, alginic acid, other alginates, powdered tragacanth, guar gum, cellulose and its derivatives (e.g. , ethyl cellulose, cellulose acetate
- fillers suitable for use in the pharmaceutical formulations described herein include, but are not limited to, talc, calcium carbonate (e.g. , granules or powder),
- microcrystalline cellulose powdered cellulose, dextrates, kaolin, mannitol, silicic acid, sorbitol, starch, pre-gelatinized starch, and mixtures thereof.
- the binder or filler in pharmaceutical compositions described herein is typically present in from about 50 to about 99 weight percent of the
- Disintegrants are used in the oral pharmaceutical formulations described herein to provide tablets that disintegrate when exposed to an aqueous environment.
- a sufficient amount of disintegrant that is neither too little nor too much to detrimentally alter the release of the active ingredient(s) should be used to form solid oral dosage forms of the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g. , an AhR inhibitor, such as CB7993113 and CMLD- 2166, or a non-constitutive AhR agonist, such as CB7950996.
- the amount of disintegrant used varies based upon the type of formulation, and is readily discernible to those of ordinary skill in the art.
- Disintegrants that can be used to form oral pharmaceutical formulations include, but are not limited to, agar, alginic acid, calcium carbonate, microcrystalline cellulose, croscarmellose sodium, crospovidone, polacrilin potassium, sodium starch glycolate, potato or tapioca starch, other starches, pre -gelatinized starch, clays, other algins, other celluloses, gums, and mixtures thereof.
- Lubricants that can be used to form oral pharmaceutical formulations of the AhR inhibitors described herein, include, but are not limited to, calcium stearate, magnesium stearate, mineral oil, light mineral oil, glycerin, sorbitol, mannitol, polyethylene glycol, other glycols, stearic acid, sodium lauryl sulfate, talc, hydrogenated vegetable oil (e.g. , peanut oil, cottonseed oil, sunflower oil, sesame oil, olive oil, corn oil, and soybean oil), zinc stearate, ethyl oleate, ethyl laureate, agar, and mixtures thereof.
- Additional lubricants include, for example, a syloid silica gel (AEROSIL ® 200, manufactured by W. R. Grace Co. of Baltimore, Md.), a coagulated aerosol of synthetic silica
- lubricants are typically used in an amount of less than about 1 weight percent of the pharmaceutical compositions or dosage forms into which they are incorporated.
- lactose-free pharmaceutical formulations and dosage forms are provided , wherein such compositions preferably contain little, if any, lactose or other mono- or di- saccharides.
- lactose-free means that the amount of lactose present, if any, is insufficient to substantially increase the degradation rate of an active ingredient.
- Lactose-free compositions of the disclosure can comprise excipients which are well known in the art and are listed in the USP (XXI )/NF (XVI), which is incorporated herein by reference.
- Formula (II) described herein e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996, further encompass, in some embodiments, anhydrous pharmaceutical compositions and dosage forms comprising the AhR inhibitors or non-constitutive AhR agonists described herein as active ingredients, since water can facilitate the degradation of some compounds.
- water e.g. , 5%
- water e.g. 5%
- Anhydrous pharmaceutical compositions and dosage forms described herein can be prepared using anhydrous or low moisture containing ingredients and low moisture or low humidity conditions.
- Pharmaceutical compositions and dosage forms that comprise lactose and at least one active ingredient that comprises a primary or secondary amine are preferably anhydrous if substantial contact with moisture and/or humidity during manufacturing, packaging, and/or storage is expected.
- Anhydrous compositions are preferably packaged using materials known to prevent exposure to water such that they can be included in suitable formulary kits. Examples of suitable packaging include, but are not limited to, hermetically sealed foils, plastics, unit dose containers (e.g. , vials) with or without desiccants, blister packs, and strip packs.
- Formula (II), e.g. , CB7993113 and CMLD-2166 can be administered directly to the airways in the form of an aerosol or by nebulization.
- an AhR inhibitor described herein such as a small molecule of Formula (I) or Formula (II), e.g. , CB7993113 and CMLD-2166, may be packaged in a pressurized aerosol container together with suitable propellants, for example, hydrocarbon propellants like propane, butane, or isobutane with conventional adjuvants.
- the AhR inhibitor can be administered in a non- pressurized form such as in a nebulizer or atomizer.
- nebulization is well known in the art to include reducing liquid to a fine spray.
- small liquid droplets of uniform size are produced from a larger body of liquid in a controlled manner.
- Nebulization can be achieved by any suitable means, including by using many nebulizers known and marketed today.
- any suitable gas can be used to apply pressure during the nebulization, with preferred gases being those which are chemically inert to the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non-constitutive AhR agonist such as CB7950996,
- gases include, but are not limited to, nitrogen, argon or helium.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non- constitutive AhR agonist such as CB7950996
- an AhR inhibitor or non-constitutive AhR agonist can be administered by use of an inhaler.
- exemplary inhalers include metered dose inhalers and dry powdered inhalers.
- Suitable powder compositions include, by way of illustration, powdered preparations of a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as
- the powder compositions can be administered via an aerosol dispenser or encased in a breakable capsule which may be inserted by the subject into a device that punctures the capsule and blows the powder out in a steady stream suitable for inhalation.
- the compositions can include propellants, surfactants, and co-solvents and may be filled into conventional aerosol containers that are closed by a suitable metering valve.
- Aerosols for the delivery to the respiratory tract are known in the art. See for example, Adjei, A. and Garren, J. Pharm. Res., 1 : 565-569 (1990); Zanen, P. and Lamm, J.-W. J. Int. J. Pharm., 114: 111-115 (1995); Gonda, I. "Aerosols for delivery of therapeutic an diagnostic agents to the respiratory tract," in Critical Reviews in Therapeutic Drug Carrier Systems, 6:273-313 (1990); Anderson et al., Am. Rev. Respir.
- Formula (II) described herein e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996, are also provided in some embodiments, and include, but are not limited to, creams, lotions, ointments, gels, shampoos, sprays, aerosols, solutions, emulsions, and other forms known to one of skill in the art. See, e.g. , Remington's Pharmaceutical Sciences, 18th ed., Mack Publishing, Easton, Pa. (1990); and Introduction to Pharmaceutical Dosage Forms, 4th ed., Lea & Febiger, Philadelphia, Pa. (1985).
- viscous to semi-solid or solid forms comprising a carrier or one or more excipients compatible with topical application and having a dynamic viscosity preferably greater than water are typically employed.
- suitable formulations include, without limitation, solutions, suspensions, emulsions, creams, ointments, powders, liniments, salves, and the like, which are, if desired, sterilized or mixed with auxiliary agents (e.g. , preservatives, stabilizers, wetting agents, buffers, or salts) for influencing various properties, such as, for example, osmotic pressure.
- suitable topical dosage forms include sprayable aerosol preparations wherein the active ingredient, preferably in combination with a solid or liquid inert carrier, is packaged in a mixture with a pressurized volatile (e.g. , a gaseous propellant, such as freon), or in a squeeze bottle.
- a pressurized volatile e.g. , a gaseous propellant, such as freon
- Moisturizers or humectants can also be added to pharmaceutical compositions and dosage forms if desired. Examples of such additional ingredients are well known in the art. See, e.g. , Remington's Pharmaceutical Sciences, 18.sup.th Ed., Mack Publishing, Easton, Pa. (1990). and Introduction to Pharmaceutical Dosage Forms, 4th Ed., Lea & Febiger, Philadelphia, Pa. (1985).
- Dosage forms suitable for treating mucosal tissues within the oral cavity can be formulated as mouthwashes, as oral gels, or as buccal patches.
- Additional transdermal dosage forms include "reservoir type” or “matrix type” patches, which can be applied to the skin and worn for a specific period of time to permit the penetration of a desired amount of active ingredient.
- transdermal dosage forms and methods of administration that can be used to administer a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, include, but are not limited to, those disclosed in U.S. Pat. Nos.: 4,624,665;
- Suitable excipients e.g. , carriers and diluents
- other materials that can be used to provide transdermal and mucosal dosage forms of the inhibitors described herein are well known to those skilled in the pharmaceutical arts, and depend on the particular tissue or organ to which a given pharmaceutical composition or dosage form will be applied.
- additional components may be used prior to, in conjunction with, or subsequent to treatment with a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996.
- penetration enhancers can be used to assist in delivering the active ingredients to or across the tissue.
- the pharmaceutical formulations comprising the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, can further comprise more than one active compound as necessary for the particular indication being treated, preferably those with complementary activities that do not adversely affect each other.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non-constitutive AhR agonist such as CB7950996
- it can be desirable to further provide antibodies which bind to EGFR, VEGF, VEGFR, or ErbB2 e.g.
- HerceptinTM in the formulation comprising the AhR inhibitor or non-constitutive AhR agonist of Formula (I) or Formula (II).
- the formulation comprising the AhR inhibitor or non-constitutive AhR agonist of Formula (I) or Formula (II) can comprise a cytotoxic agent, cytokine, growth inhibitory agent and/or VEGFR antagonist. Such molecules are suitably present in combination in amounts that are effective for the purpose intended.
- the active ingredients of the formulations comprising AhR inhibitors and non-constitutive AhR agonists described herein can also be entrapped in microcapsules prepared, for example, by coacervation techniques or by interfacial polymerization, for example, hydroxymethylcellulose or gelatin-microcapsules and poly-(methylmethacylate) microcapsules, respectively, in colloidal drug delivery systems (for example, liposomes, albumin microspheres, microemulsions, nano-particles and nanocapsules) or in macroemulsions.
- colloidal drug delivery systems for example, liposomes, albumin microspheres, microemulsions, nano-particles and nanocapsules
- the small molecule AhR modulators of the invention are small molecule AhR modulators of the invention.
- Formula (I) or Formula (II) described herein can be administered to a subject by controlled- or delayed-release means.
- an AhR inhibitor such as CB7993113 and CMLD- 2166
- a non-constitutive AhR agonist such as CB7950996
- the use of an optimally designed controlled-release preparation in medical treatment is characterized by a minimum of drug substance being employed to cure or control the condition in a minimum amount of time.
- controlled-release formulations include: 1) extended activity of the drug; 2) reduced dosage frequency; 3) increased patient compliance; 4) usage of less total drug; 5) reduction in local or systemic side effects; 6) minimization of drug accumulation; 7) reduction in blood level fluctuations; 8) improvement in efficacy of treatment; 9) reduction of potentiation or loss of drug activity; and 10) improvement in speed of control of diseases or conditions.
- Controlled-release formulations can be used to control an AhR inhibitor's onset of action, duration of action, plasma levels within the therapeutic window, and peak blood levels.
- controlled- or extended-release dosage forms or formulations can be used to ensure that the maximum effectiveness of the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as
- CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, is achieved while minimizing potential adverse effects and safety concerns, which can occur both from underdosing a drug (i.e., going below the minimum therapeutic levels) as well as exceeding the toxicity level for the drug.
- a variety of known controlled- or extended-release dosage forms, formulations, and devices can be adapted for use with the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996.
- AhR modulators of Formula (I) or Formula (II) described herein e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996.
- AhR inhibitor such as CB7993113 and CMLD-2166
- a non- constitutive AhR agonist such as CB7950996.
- Examples include, but are not limited to, those described in U.S. Pat. Nos.: 3,845,770; 3,916,899; 3,536,809; 3,598,123; 4,008,719; 5674,5
- hydroxypropylmethyl cellulose other polymer matrices, gels, permeable membranes, osmotic systems (such as OROS ® (Alza Corporation, Mountain View, Calif. USA)), multilayer coatings, microparticles, liposomes, or microspheres or a combination thereof to provide the desired release profile in varying proportions.
- ion exchange materials can be used to prepare immobilized, adsorbed salt forms of the disclosed compounds and thus effect controlled delivery of the drug. Examples of specific anion exchangers include, but are not limited to, Duolite ® A568 and Duolite ® AP143 (Rohm&Haas, Spring House, Pa. USA).
- the small molecule AhR modulators of Formula 1 [00187] In some embodiments of the aspects, the small molecule AhR modulators of Formula
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non-constitutive AhR agonist such as CB7950996
- Pulse therapy is not a form of discontinuous administration of the same amount of a composition over time, but comprises administration of the same dose of the composition at a reduced frequency or administration of reduced doses.
- Sustained release or pulse administrations are particularly preferred in chronic conditions, such as cancer, as each pulse dose can be reduced and the total amount of a compound of an AhR inhibitor administered over the course of treatment to the patient is minimized.
- the interval between pulses when necessary, can be determined by one of ordinary skill in the art. Often, the interval between pulses can be calculated by administering another dose of the composition when the composition or the active component of the composition is no longer detectable in the subject prior to delivery of the next pulse. Intervals can also be calculated from the in vivo half -life of the composition. Intervals may be calculated as greater than the in vivo half-life, or 2, 3, 4, 5 and even 10 times greater the composition half -life.
- Various methods and apparatus for pulsing compositions by infusion or other forms of delivery to the patient are disclosed in U.S. Pat. Nos. 4,747,825; 4,723,958; 4,948,592; 4,965,251 and 5,403,590.
- sustained-release preparations comprising the small molecule
- AhR modulators of Formula (I) or Formula (II) described herein e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, can be prepared.
- Suitable examples of sustained-release preparations include semipermeable matrices of solid hydrophobic polymers containing the inhibitor, in which matrices are in the form of shaped articles, e.g., films, or microcapsule.
- sustained-release matrices include polyesters, hydrogels (for example, poly(2-hydroxyethyl-methacrylate), or poly(vinylalcohol)), polylactides (U.S. Pat. No.
- DEPOT.TM injectable microspheres composed of lactic acid-glycolic acid copolymer and leuprolide acetate), and poly-D-(-)-3-hydroxybutyric acid.
- Formula (II) described herein e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996, to be used for in vivo administration are preferably sterile. This is readily accomplished by filtration through, for example, sterile filtration membranes, and other methods known to one of skill in the art.
- One key advantage of the methods, uses and compositions comprising the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, is the ability of producing marked anti-cancer effects in a human subject without causing significant toxicities or adverse effects.
- the efficacy of the treatments described herein can be measured by various parameters commonly used in evaluating cancer treatments, including but not limited to, tumor regression, tumor weight or size shrinkage, reduction in rate of tumor growth, the presence or the size of a dormant tumor, the presence or size of metastases or micrometastases, degree of tumor or cancer invasiveness, size or number of the blood vessels, time to progression, duration of survival, progression free survival, overall response rate, duration of response, and quality of life.
- tumor shrinkage of greater than 50% in a 2-dimensional analysis is the standard cut-off for declaring a response.
- the compositions comprising the small molecule AhR modulators of Formula (I) or Formula (II) described herein can be used to cause inhibition of metastatic spread without shrinkage of the primary tumor, or can simply exert a tumoristatic effect.
- the therapeutically effective amount of the compositions comprising the small molecule AhR modulators of Formula (I) or Formula (II) described herein can reduce the number of cancer cells; reduce the tumor size; inhibit ⁇ i.e., slow to some extent and preferably stop) cancer cell infiltration into peripheral organs; inhibit ⁇ i.e., slow to some extent and preferably stop) tumor metastasis; inhibit, to some extent, tumor growth; and/or relieve to some extent one or more of the symptoms associated with the disorder.
- compositions comprising the small molecule AhR modulators of Formula (I) or Formula (II) described herein can prevent growth and/or kill existing cancer cells, it can be cytostatic and/or cytotoxic.
- efficacy in vivo can, for example, be measured by assessing the duration of survival, duration of progression free survival (PFS), the response rates (RR), duration of response, and/or quality of life.
- time to disease progression is defined as the time from administration of the drug until disease progression or death.
- the method of treatments described herein using small molecule AhR modulators of Formula (I) or Formula (II) described herein e.g.
- an AhR inhibitor such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, and, in some further embodiments, one or more chemotherapeutic agents, significantly increases progression free survival by at least about 1 month, at least about 2 months, at least about 3 months, at least about 4 months, at least about 5 months, at least about 6 months, at least about 7 months, at least about 8 months, at least about 9 months, at least about 10 months, at least about 11 months, when compared to no treatment or a treatment with chemotherapy alone.
- the methods of treatment described herein significantly increase response rate in a group of human subjects susceptible to or diagnosed with a cancer who are treated with various therapeutics.
- Response rate is defined as the percentage of treated subjects who responded to the treatment.
- the combination treatments described herein comprising using a small molecule AhR modulator of Formula (I) or Formula (II), e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, and, in some further embodiments, one or more chemotherapeutic agents, significantly increases response rate in the treated subject group compared to an untreated group or a group treated with chemotherapy alone.
- a small molecule AhR modulator of Formula (I) or Formula (II) e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, and, in some further embodiments, one or more chemotherapeutic agents, significantly increases response rate in the treated subject group compared to an untreated group or a group treated with chemotherapy alone.
- the administration of a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g. , an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, is used for increasing duration of response in a human subject or a group of human subjects susceptible to or diagnosed with a cancer.
- “duration of response” is defined as the time from the initial response to disease progression.
- the AhR inhibitors and non-constitutive AhR agonists described herein can be used for increasing the duration of survival of a human subject susceptible to or diagnosed with a cancer.
- the terms “treat,” “treatment,” “treating,” or “amelioration” refer to therapeutic treatments, wherein the object is to reverse, alleviate, ameliorate, inhibit, slow down or stop the progression or severity of a condition associated with, a disease or disorder.
- the term “treating” includes reducing or alleviating at least one adverse effect or symptom of a condition, disease or disorder associated with a chronic immune condition, such as, but not limited to, a chronic infection or a cancer.
- Treatment is generally “effective” if one or more symptoms or clinical markers are reduced. Alternatively, treatment is “effective” if the progression of a disease is reduced or halted.
- treatment includes not just the improvement of symptoms or markers, but also a cessation of at least slowing of progress or worsening of symptoms that would be expected in absence of treatment.
- Beneficial or desired clinical results include, but are not limited to, alleviation of one or more symptom(s), diminishment of extent of disease, stabilized (i.e., not worsening) state 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 also includes providing relief from the symptoms or side -effects of the disease (including palliative treatment).
- the methods described herein comprise administering an effective amount of the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non- constitutive AhR agonist, such as CB7950996, described herein to a subject in order to alleviate a symptom of a cancer, or other such disorder.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non- constitutive AhR agonist such as CB7950996, described herein
- such reduction or degree of prevention is at least 5%, 10%, 20%, 40%, 50%, 60%, 80%, 90%, 95%, or 100% as measured by any standard technique.
- the cancer is completely cleared as detected by any standard method known in the art, in which case the cancer is considered to have been treated.
- a patient who is being treated for a cancer is one who a medical practitioner has diagnosed as having such a condition. Diagnosis can be by any suitable means.
- Diagnosis and monitoring can involve, for example, detecting the level of cancer cells in a biological sample (for example, a tissue or lymph node biopsy, blood test, or urine test), detecting the level of a surrogate marker of the cancer in a biological sample, detecting symptoms associated with the specific cancer, or detecting immune cells involved in the immune response typical of such a cancer infections.
- a biological sample for example, a tissue or lymph node biopsy, blood test, or urine test
- detecting the level of a surrogate marker of the cancer in a biological sample detecting symptoms associated with the specific cancer, or detecting immune cells involved in the immune response typical of such a cancer infections.
- compositions and methods comprising the novel the small molecule AhR modulators of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, further comprise administration or treatment with one or more additional cancer therapies.
- additional cancer therapies include, without limitation, surgery, radiation therapy (radiotherapy), biotherapy, immunotherapy, chemotherapy, or a combination of these therapies.
- cytotoxic agents, anti-angiogenic and anti-proliferative agents can be used in combination with the AhR inhibitor(s).
- the appropriate dosage of a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, will depend on the type of disease to be treated, as defined above, the severity and course of the disease, whether the AhR inhibitor or non-constitutive AhR agonist is administered for preventive or therapeutic purposes, previous therapy, the subject's clinical history and response to the AhR inhibitor or non-constitutive AhR agonist, and the discretion of the attending physician.
- the AhR inhibitor or non-constitutive AhR agonist is suitably administered to the subject at one time or over a series of treatments.
- a small molecule AhR modulator of Formula (I) or Formula (II) described herein e.g., an AhR inhibitor, such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, and one or more anti-cancer therapeutic agents as described herein are administered in a therapeutically effective or synergistic amount.
- a therapeutically effective amount is such that co-administration of a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g.
- an AhR inhibitor such as CB7993113 and CMLD- 2166, or a non-constitutive AhR agonist, such as CB7950996, and one or more other therapeutic agents, or administration of a therapeutic composition or formulation comprising an AhR inhibitor or non-constitutive AhR agonist as described herein, results in reduction or inhibition of the cancer as described herein.
- a “therapeutically synergistic amount” is that amount of a small molecule AhR modulator of Formula (I) or Formula (II) described herein, e.g.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non-constitutive AhR agonist such as CB7950996
- one or more other therapeutic agents necessary to synergistically or significantly reduce or eliminate conditions or symptoms associated with a particular cancer.
- an AhR inhibitor such as CB7993113 and CMLD-2166
- a non- constitutive AhR agonist such as CB7950996
- one or more other therapeutic agents can be administered simultaneously or sequentially in an amount and for a time sufficient to reduce or eliminate the occurrence or recurrence of a tumor, a dormant tumor, or a micrometastases.
- the small molecule AhR modulators of Formula (I) or Formula (II) described herein e.g.
- an AhR inhibitor such as CB7993113 and CMLD-2166, or a non-constitutive AhR agonist, such as CB7950996, and one or more other therapeutic agents can be administered as maintenance therapy to prevent or reduce the likelihood of recurrence of the tumor.
- chemotherapeutic agents or other anti-cancer agents will be generally around those already employed in clinical therapies, e.g. , where the chemotherapeutics are administered alone or in combination with other chemotherapeutics. Variation in dosage will likely occur depending on the condition being treated. The physician administering treatment will be able to determine the appropriate dose for the individual subject.
- the subject can be subjected to radiation therapy.
- anti-cancer therapy refers to a therapy useful in treating cancer.
- anti-cancer therapeutic agents include, but are limited to, e.g. , surgery, radiation therapy, chemotherapeutic agents, growth inhibitory agents, cytotoxic agents, agents used in radiation therapy, anti-angiogenesis agents, apoptotic agents, anti-tubulin agents, and other agents to treat cancer, such as anti-HER-2 antibodies (e.g. , HerceptinTM), anti-CD20 antibodies, an epidermal growth factor receptor (EGFR) antagonist (e.g. , a tyrosine kinase inhibitor), HER1/EGFR inhibitor (e.g.
- erlotinib TarcevaTM
- platelet derived growth factor inhibitors e.g. , GleevecTM (Imatinib Mesylate)
- a COX -2 inhibitor e.g. , celecoxib
- interferons cytokines
- antagonists e.g. , neutralizing antibodies
- cytotoxic agent refers to a substance that inhibits or prevents the function of cells and/or causes destruction of cells.
- the term is intended to include radioactive isotopes (e.g. At 211 , 1 131 , 1 125 , Y 90 , Re 186 , Re 188 , Sm 153 , Bi 212 , P 32 and radioactive isotopes of Lu), chemotherapeutic agents, and toxins such as small molecule toxins or enzymatically active toxins of bacterial, fungal, plant or animal origin, including fragments and/or variants thereof.
- radioactive isotopes e.g. At 211 , 1 131 , 1 125 , Y 90 , Re 186 , Re 188 , Sm 153 , Bi 212 , P 32 and radioactive isotopes of Lu
- chemotherapeutic agents e.g. At 211 , 1 131 , 1 125 , Y 90 , Re 186
- chemotherapeutic agent is a chemical compound useful in the treatment of cancer.
- chemotherapeutic agents include, but are not limited to, alkylating agents such as thiotepa and CYTOXANTM cyclosphosphamide; alkyl sulfonates such as busulfan, improsulfan and piposulfan; aziridines such as benzodopa, carboquone, meturedopa, and uredopa; ethylenimines and methylamelamines including altretamine, triethylenemelamine,
- trietylenephosphoramide, triethiylenethiophosphoramide and trimethylolomelamine acetogenins (especially bullatacin and bullatacinone); a camptothecin (including the synthetic analogue topotecan); bryostatin; callystatin; CC-1065 (including its adozelesin, carzelesin and bizelesin synthetic analogues); cryptophycins (particularly cryptophycin 1 and cryptophycin 8); dolastatin; duocarmycin (including the synthetic analogues, KW-2189 and CB 1-TM1); eleutherobin;
- pancratistatin a sarcodictyin; spongistatin; nitrogen mustards such as chlorambucil, chlornaphazine, cholophosphamide, estramustine, ifosfamide, mechlorethamine, mechlorethamine oxide
- neocarzinostatin chromophore and related chromoprotein enediyne antiobiotic chromophores aclacinomysins, actinomycin, authramycin, azaserine, bleomycins, cactinomycin, carabicin, caminomycin, carzinophilin, chromomycinis, dactinomycin, daunorubicin, detorubicin, 6-diazo-5- oxo-L-norleucine, ADRIAMYCINTM, doxorubicin (including morpholino-doxorubicin,
- dromostanolone propionate epitiostanol, mepitiostane, testolactone
- anti-adrenals such as aminoglutethimide, mitotane, trilostane
- folic acid replenisher such as frolinic acid; aceglatone; aldophosphamide glycoside; aminolevulinic acid; eniluracil; amsacrine; bestrabucil; bisantrene;
- edatraxate defofamine; demecolcine; diaziquone; elformithine; elliptinium acetate; an epothilone; etoglucid; gallium nitrate; hydroxyurea; lentinan; lonidainine; maytansinoids such as maytansine and ansamitocins; mitoguazone; mitoxantrone; mopidanmol; nitraerine; pentostatin; phenamet;
- pirarubicin pirarubicin; losoxantrone; podophyllinic acid; 2-ethylhydrazide; procarbazine; PSKTM, polysaccharide complex (JHS Natural Products, Eugene, Oreg.); razoxane; rhizoxin; sizofuran; spirogermanium; tenuazonic acid; triaziquone; 2,2',2"-trichlorotriethylamine; trichothecenes (especially T-2 toxin, verracurin A, roridin A and anguidine); urethan; vindesine; dacarbazine; mannomustine; mitobronitol; mitolactol; pipobroman; gacytosine; arabinoside ("Ara-C"); cyclophosphamide; thiotepa; taxoids, e.g.
- TAXOLTM paclitaxel
- paclitaxel Bristol-Myers Squibb Oncology, Princeton, N.J.
- ABRAXANETM Cremophor- free, albumin-engineered nanoparticle formulation of paclitaxel (American Pharmaceutical Partners, Schaumberg, 111.)
- TAXOTERETM doxetaxel (Rhone-Poulenc Rorer, Antony, France);
- chloranbucil GEMZARTM gemcitabine; 6-thioguanine; mercaptopurine; methotrexate; platinum analogs such as cisplatin, oxaliplatin and carboplatin; vinblastine; platinum; etoposide (VP-16);
- ifosfamide mitoxantrone; vincristine; NAVELBINE.RTM. vinorelbine; novantrone; teniposide;
- edatrexate edatrexate
- daunomycin aminopterin
- xeloda xeloda
- ibandronate irinotecan (Camptosar, CPT-11)
- irinotecan including the treatment regimen of irinotecan with 5-FU and leucovorin); topoisomerase inhibitor RFS 2000; difluoromethylornithine (DMFO); retinoids such as retinoic acid; capecitabine;
- combretastatin combretastatin
- leucovorin LV
- oxaliplatin including the oxaliplatin treatment regimen (FOLFOX); lapatinib (TykerbTM); inhibitors of PKC-alpha, Raf, H-Ras, EGFR (e.g. , erlotinib (TarcevaTM.)) and VEGF-A that reduce cell proliferation and pharmaceutically acceptable salts, acids or derivatives of any of the above.
- anti-hormonal agents that act to regulate or inhibit hormone action on tumors
- SERMs selective estrogen receptor modulators
- tamoxifen including NOLVADEXTM tamoxifen
- raloxifene including NOLVADEXTM tamoxifen
- droloxifene including NOLVADEXTM tamoxifen
- 4- hydroxytamoxifen including, for example, tamoxifen (including NOLVADEXTM tamoxifen), raloxifene, droloxifene, 4- hydroxytamoxifen, trioxifene, keoxifene, LY117018, onapristone, and FARESTON toremifene;
- aromatase inhibitors that inhibit the enzyme aromatase, which regulates estrogen production in the adrenal glands, such as, for example, 4(5)-imidazoles, aminoglutethimide, MEGASETM megestrol acetate, AROMASINTM exemestane, formestanie, fadrozole, RIVISORTM vorozole, FEMARATM letrozole, and ARIMIDEXTM anastrozole; and anti-androgens such as flutamide, nilutamide, bicalutamide, leuprolide, and goserelin; as well as troxacitabine (a 1 ,3-dioxolane nucleoside cytosine analog); antisense oligonucleotides, particularly those which inhibit expression of genes in signaling pathways implicated in aberrant cell proliferation, such as, for example, PKC-alpha, Ralf and H-Ras; ribozymes such as a VEGF expression inhibitor (e
- ANGIOZYMETM ribozyme and a HER2 expression inhibitor
- vaccines such as gene therapy vaccines, for example, ALLOVECTINTM vaccine, LEUVECTINTM vaccine, and VAXIDTM vaccine
- PROLEUKINTM rIL-2 PROLEUKINTM rIL-2
- LURTOTECANTM topoisomerase 1 inhibitor ABARELIXTM rmRH
- pharmaceutically acceptable salts, acids or derivatives of any of the above are examples of any of the above.
- cytokine is a generic term for proteins released by one cell population which act on another cell as intercellular mediators.
- cytokines are lymphokines, monokines, and traditional polypeptide hormones. Included among the cytokines are growth hormone such as human growth hormone, N-methionyl human growth hormone, and bovine growth hormone; parathyroid hormone; thyroxine; insulin; proinsulin; relaxin; prorelaxin; glycoprotein hormones such as follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), and luteinizing hormone (LH); epidermal growth factor; hepatic growth factor; fibroblast growth factor; prolactin; placental lactogen; tumor necrosis factor-alpha and -beta; mullerian-inhibiting substance; mouse gonadotropin- associated peptide; inhibin; activin; vascular endothelial growth factor; integrin; thrombopoietin (TPO); nerve growth factors
- growth hormone such as human
- a “growth inhibitory agent” when used herein refers to a compound or composition which inhibits growth of a cell in vitro and/or in vivo.
- the growth inhibitory agent may be one which significantly reduces the percentage of cells in S phase.
- growth inhibitory agents include agents that block cell cycle progression (at a place other than S phase), such as agents that induce Gl arrest and M-phase arrest.
- Classical M-phase blockers include the vincas (vincristine and vinblastine), TAXOLTM, and topo II inhibitors such as doxorubicin, epirubicin, daunorubicin, etoposide, and bleomycin.
- DNA alkylating agents such as tamoxifen, prednisone, dacarbazine, mechlorethamine, cisplatin, methotrexate, 5-fluorouracil, and ara-C. Further information can be found in The Molecular Basis of Cancer, Mendelsohn and Israel, eds., Chapter 1, entitled “Cell cycle regulation, oncogenes, and antineoplastic drugs” by Murakami et al. (WB Saunders: Philadelphia, 1995), especially p. 13.
- prodrug refers to a precursor or derivative form of a pharmaceutically active substance that is less cytotoxic to tumor cells compared to the parent drug and is capable of being enzymatically activated or converted into the more active parent form. See, e.g. , Wilman, "Prodrugs in Cancer Chemotherapy” Biochemical Society Transactions, 14, pp. 375-382, 615th Meeting Harbor (1986) and Stella et al., "Prodrugs: A Chemical Approach to Targeted Drug Delivery,” Directed Drug Delivery, Borchardt et al., (ed.), pp. 247-267 ' , Humana Press (1985).
- the prodrugs of this invention include, but are not limited to, phosphate -containing prodrugs,
- cytotoxic drugs that can be derivatized into a prodrug form for use in this invention include, but are not limited to, those chemotherapeutic agents described above.
- radiation therapy is meant the use of directed gamma rays or beta rays to induce sufficient damage to a cell so as to limit its ability to function normally or to destroy the cell altogether. It will be appreciated that there will be many ways known in the art to determine the dosage and duration of treatment. Typical treatments are given as a one time administration and typical dosages range from 10 to 200 units (Grays) per day.
- AhR aryl hydrocarbon receptor
- AhR inhibitors and non-constitutive AhR agonists and for use as therapeutics for reducing tumor growth, invasion and metastasis.
- novel targeted therapeutics for treatment of breast cancer at any stage are particularly useful in patients that have failed conventional non-targeted chemotherapeutics or Her2/neu-, ER-, or PR-dependent therapeutics.
- High throughput screening of over 4000 compounds identified several AhR modifiers, including both AhR inhibitors and non-constitutive AhR agonists, at least three of which inhibit tumor invasion.
- Hit-to-lead chemistry can be employed using the novel biologic assays of tumor
- AhR inhibitors and non-constitutive AhR agonists can be identified in commercial chemical libraries.
- Such AhR inhibitors and non-constitutive AhR agonists can be evaluated by HTS and, in an iterative process, chemically altered to produce ligands with improved AhR-ibinding affinity, potency, stability, and solubility.
- Novel synthetic AhR inhibitors and non-constitutive AhR agonists can be evaluated using the secondary breast tumor growth and invasion assays described herein prior to in vitro toxicity, specificity, stability, and absorption testing.
- the synthetic AhR inhibitors and non-constitutive AhR agonists described herein can be used in be the synthesis of lead compounds that significantly block tumor progression in vitro and are exhibit a high level of efficacy and specificity in preclinical animal testing.
- the synthetic AhR inhibitors and non-constitutive AhR agonists are useful in the treatment of advanced breast cancers, as a preventative for high risk patients, and are applicable for treatment of a variety of solid tumors.
- Ubiquitous AhR ligands initiate mammary tumorigenesis by activating aryl hydrocarbon receptor/transcription factor.
- the cytosolic AhR can be "activated” by pollutants such as dioxins, non-ortho substituted polychlorinated biphenyls, and poly cyclic aromatic hydrocarbons, resulting in AhR translocation to the nucleus and gene regulation.
- pollutants such as dioxins, non-ortho substituted polychlorinated biphenyls, and poly cyclic aromatic hydrocarbons, resulting in AhR translocation to the nucleus and gene regulation.
- the inventors investigate the activation and function of this receptor/transcription factor in malignant cells, and were the first to demonstrate a remarkable 50-fold increase in AhR mRNA in rat mammary tumors relative to normal tissue (2), in contrast to other studies that describe acute toxicological outcomes of AhR activation in normal cells.
- the inventors have identified AhR over-expression in mouse mammary tumors, human and mouse tumor lines, and primary human mammary tumors (3- 15).
- the inventors demonstrated in all of these systems that the AhR is constitutively active in the absence of environmental stimuli, indicating that the AhR contributes to mammary cancer initiation, growth, and invasion.
- Other data correlates constitutive AhR transcriptional activity with tumor growth rates and invasiveness, and with up-regulated oncogenes associated with tumor growth and invasion (9, 12, 16), and by the direct demonstration that AhR knock down by molecular techniques inhibits immortalized cell growth (through p21 up-regulation) and tumor invasion in vitro (8, 12, 14, 17) ( Figures 1-3). Given what is known of AhR biology and the large therapeutic window afforded by AhR
- AhR inhibitors and non-constitutive AhR agonists can be protective for individuals at high risk because of genetic predispositions or environmental exposures.
- CMLD compounds 4000 CMLD compounds, FDA drugs, and NCI-generated extracts were screened, and 8 non-toxic AhR inhibitors (2 from the CMLD) and 19 AhR agonists (14 from the CMLD) were identified (as shown in, e.g. , Figures 4A-4B).
- IC 50 values for inhibitors and EC 50 values for agonists were determined (Table 1).
- One of these discovered inhibitors CMLD-2166
- CMLD- 2186 its enantiomer
- CH223191 a previously described lipid soluble AhR inhibitor
- Hepa-1 cells were treated with 1-10 uM
- agonist structures help define moieties important for AhR binding, while a comparison of agonists and antagonists facilitates identification of residues responsible for receptor inhibition.
- Pharmacophore modeling also can be performed as a complementary computational approach. Using the Accelrys Discovery Studio computational package, structures and construct pharmacophores can be imported using our AhR ligand training set. Three-dimensional maps of each structure with associated moiety functionality (e.g. , hydrogen bond acceptors/donors, lipophilic regions) can be generated. Candidate compounds can then be re-selected from commercial chemical sets.
- Antagonists can be characterized as competitive versus non-competitive by their ability to displace radiolabeled TCDD as we described (24).
- lead compounds can be titered into cultures of BP1 and Hs578T human mammary tumor cells, and inhibition of nuclear AhR translocation assayed as described (24).
- Compound CMLD-21 66 shown to inhibit tumor invasion ( Figures 7A-7B), can be used as a positive control.
- Compounds inhibiting constitutive AhR nuclear translocation then can be evaluated in secondary assays for inhibition of tumor growth ( 3 H-thymidine incorporation) and invasion (morphology in Matrigel and migration in Boyden Chambers), as described herein (see Figures 5A-5B and 7A-7B).
- ADMET Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) analyses of lead compounds can be outsourced to companies, such as for example, Apredica, Inc.
- parameters that can be evaluated include, but are not limited to: 1) compound permeability using Caco-2 monolayers to predict human oral bioavailability; 2) metabolic breakdown in the presence of liver microsomes or mouse/human plasma; and 3) stability in the presence of gastric and intestinal fluids.
- experimental measurement of compound solubility can be employed to complement the computed values utilized during the compound design and optimization cycles.
- the studies described herein are useful for advancing product development from the biologic discovery to the lead optimization phase.
- in vivo pharmacokinetic and efficacy studies can be performed using, for example, a human mammary tumor xenograft model to quantify tumor growth and metastasis in live mice in real time in 3 dimensions (25, 26).
- the compounds described herein can be targeted towards patients with aggressive "triple negative" breast cancers, for example, those patients that have failed conventional chemotherapy or Her2/neu-, ER-, or PR-dependent therapeutics, since constitutive AhR activity increases with, and likely contributes to increasing levels of tumor aggressiveness (8).
- the small molecule compounds of Formula (I) and Formula (II) described herein are useful as targeted therapeutics directed specifically at a protein (the AhR) expressed at extremely high levels in cancers, and because AhR modifiers are not expected to be associated with significant mechanism-based toxicities, in some embodiments, the small molecule compounds of Formula (I) and Formula (II) can be used, for example, as an adjuvant ⁇ e.g. , postsurgical) therapeutic for patients desiring a non-toxic alternative for improved quality of life, or for patients requiring targeted therapeutics because of accumulated organ toxicity.
- an adjuvant ⁇ e.g. , postsurgical
- AhR therapy using the small molecule compounds of Formula (I) and Formula (II) described herein can be used as a long-term preventative for women at high risk of breast cancer.
- the compounds described herein are used as prophylactic therapeutics in women at high or increased genetic or environmental risk for breast cancer due to inheritance of mutated BRCA1, BRCA2, CHEK2, ATM, BRIP1, or PALB2 genes, family histories of reproductive organ cancers, or chronic exposures to environmental carcinogens (36).
- the small molecule compounds of Formula (I) and Formula (II) described herein can be used as long-term preventatives for the 42,000 high risk women diagnosed each year with pre-cancerous lesions (ductal carcinoma in situ/DCIS), most of whom will develop invasive adenocarcinomas (37).
- the studies described herein further indicate that the AhR is hyper-expressed and constitutively active in virtually all cancer types, including other epithelial tumors such as prostate, lung, and pancreatic ductal cell carcinomas. Accordingly, in some embodiments, the compounds described herein can be used in the treatment of cancer.
- Figure 1 shows that AhR inhibition with AhRR upregulates p21 and decreases MCF-
- MCF-IOF cells were stably transduced with lenti virus vectors encoding GFP or GFP and AhR repressor (AhRR) to suppress AhR activity.
- AhRR-GFPlow and AhRR-iGFPhigh cells were selected by flow cytometry. Cells were plated at equal numbers and cell numbers determined 1-6 days later. Insert: p21 protein levels in control or AhRR-transduced cells.
- FIG. 2 demonstrates that AhR inhibition with AhRR inhibits tumor invasion in matrigel.
- Malignant BPl and Hs578T cells were transiently transfected with control (pSport) or AhR Repressor plasmids, to suppress AhR activity and plated in Matrigel. Photos were taken 5-7 days later.
- FIG. 3 demonstrates that AhR downregulation with AhR siRNA inhibits invasion in
- Matrigel-icontaining membrane was determined 48 hrs later and the percentage of cells in the lower chamber calculated. *p ⁇ 0.04; **p ⁇ 0.03.
- FIGS 4A-4B show high-throughput screening (HTS) for AhR agonists and antagonists.
- Figure 4A shows H1G1 cells expressing an AhR-driven GFP reporter construct were plated into 384 well plates and treated with candidate AhR modifiers alone (dark line) or together with BNF, a known AhR agonist (light line). 24 hours later GFP fluorescence was measured and cells stained for viability. A dark circle identifies an AhR inhibitor while the light circle indicates an agonist.
- Figure 4B shows data from the non-toxic compound identified in "A,” which was titered in the presence of BNF to calculate the IC 50 . Over 4,000 compounds were screened in this semi- automated assay.
- Figures 5 A-5B demonstrate that CH223191 and CMLD 2166 inhibit constitutive
- FIG. 5 A shows data from malignant BPl and immortalized MCF-IOF cells that were transiently transfected with AhR-responsive pGudLuc and treated with vehicle
- FIG. 5B shows data from BPl and MCF-IOF cells that were grown for 18 hrs in the presence of DMSO, CH2231 91, or 2166 and 3H-thymidine incorporation determined. *p ⁇ 0.05.
- FIG. 6 demonstrates that CB7993113 blocks translocation of the AhR to the nucleus after stimulation of cells with DMBA, an AhR agonist.
- Hepa-1 cells were treated with vehicle or 1-10 ⁇ CH223191.
- One hour later cells were treated with 0.1 ⁇ DMBA (where indicated) and incubated for 30 minutes.
- Cells were harvested and proteins from the cytoplasm and nuclei were extracted. Extracted proteins were subjected to AhR- or, as loading control, ⁇ -ac tin-specific western immunoblots. Data are representative of 3 independent experiments.
- Figures 7A -7B demonstrate that CH223191, CMLD-2166 and CMLD-2186 inhibit tumor invasion.
- Hs578T cells were cultured in Boyden Chambers ( Figure 7A) or in Matrigel ( Figure 7B) in the presence of DMSO, 10 "5 M CMLD-2166, CMLD-.2186 (a 2166 enantiomer) or CH223191 and assayed for invasion 2 (Boyden Chambers) or 7 (Matrigel) days later.
- Figures 8A-8B demonstrate that CB7993113 is capable of blocking acutely toxic effects of a potent AhR ligand and prototypic PAH, DMBA, in vivo, and that three subpopulations of bone marrow cells affected by DMBA are all rescued by treatment with CB7993113.
- Figure 8A shows data from C57BL/6 mice (6/group) that were injected i.p. on day -1 and day 0 with vehicle (oil) or 50 mg/kg CB7993113. Mice then were injected with 50 mg/kg DMBA. Mice were sacrificed 48 hours later. Bone marrow hematopoietic cells were expunged from the bone and viable cells counted.
- Figure 8B confirms the data shown in Figure 8 A and further demonstrates that the three subpopulations of bone marrow cells affected by DMBA are all rescued by treatment with CB7993113.
- C57BL/6 mice (6/group) were treated as in Figure 8A.
- the percentage and number of viable bone marrow pro B cells, pre B cells, and neutrophils were determined 48 hours later by flow cytometry.
- Data are presented as the average number of viable cells of each subtype + SE. (*p ⁇ 0.05, **P ⁇ 0.01, student's t-test).
- Figure 9 depicts computational strategies for shape-and electrostatic similarity searching.
- the SMILES strings can be expanded into a 3D conformer database using the OpenEye program OMEGA (v.2.2.1), allowing an energy window of 8 kcal/mol above ground state and a msd cutoff of 0.8 A per the method described in (1).
- the maximum rotatable bonds for these experiments is by 16.
- a fragment library can be pre-generated using the program makefragmentlib.
- the 3D conformer database then can be searched using ROCS (v.2.3.1), queried against the top 20 lowest energy conformations of the most potent HTS hits, determined using OMEGA.
- the shape comparison program ROCS can be run using a built-in color force field and hits can be ranked on the basis of the sum of their shape Tanimoto and the color score (known as the "combo score").
- the highest scoring overlaps from ROCS can be subjected to electrostatic overlap comparison using EON.
- the electrostatic Tanimoto combo score can be used for ranking. This is the sum of the shape Tanimoto and the Poisson-Boltzman electrostatic Tanimoto.
- the top 200 compounds from each commercial set can be procured and screened in the high throughput AhR functional assays.
- FIG. 10 demonstrates that compounds CMLD-2166 and and CB7993113 bind human AhR.
- the compounds CMLD-2166 and CB7993113 were mixed with in vitro translated human AhR and radiolabeled TCDD (dioxin), a high affinity AhR ligand. Complexes then were separated on a sucrose gradient and fractions assayed for radioactivity. A decrease in the signal (displacement of radiolabeled TCDD) can be seen in fractions 13-16 indicating binding of the test compound to the AhR and displacement of TCDD. These results demonstrate that these compounds are competitive AhR inhibitors.
- TCDD radiolabeled TCDD
- FIG. 11 demonstrates that AhR inhibitors do not block PPARy-mediated transcription.
- Cos7 cells were transfected with the peroxisome proliferator activator receptor- ⁇ (PPARy), its dimerization partner, RXR, a PPARy-driven lucif erase reporter construct, and a control CMV-driven GFP reporter for 24 hours. Cells then were treated with a vehicle, 10 ⁇ AhR inhibitor CH223191, 50 ⁇ AhR inhibitor CMLD-2166, or 10 ⁇ AhR inhibitor CB7993113. (These represent high AhR inhibitor doses).
- PPARy peroxisome proliferator activator receptor- ⁇
- Rosiglitazone (1 ⁇ ) a strong PPARy agonist, was added 1 hour later and cells assayed 18-24 hrs thereafter for PPARy-driven reporter activity (lucif erase intensity), normalized to the GFP signal. Data were pooled from 4 experiments. Unlike their ability to block AhR-driven reporter activity, the AhR inhibitors had no effect on the PPARy-driven reporter activity.
- Figure 12 demonstrates that AhR siRNA transfection blocks tumor invasion in matrigel.
- BPl or Hs578T human mammary tumor cells were transiently transfected with control siRNA or AhR siRNA to knock down AhR expression and cells were cultured in Matrigel for 6 days. Shown are colonies of tumor cells that grow from single cells during those 6 days.
- Figure 13 demonstrates that doxy cycline -inducible AhR shRNA blocks tumor invasion in matrigel. Hs578T cells were stably transduced with doxycyline -inducible control
- FIG. 14 demonstrates that AhR Inhibitor CB993113 blocks BPl tumor invasion in matrigel.
- BPl cells were cultured in the presence of vehicle (left) or 5 uM CB7993113 in Matrigel for 5 days.
- CB7993113 is not toxic at the highest doses tested, 10 uM.
- Figure 15 is a schematic depicting how AhR inhibitors and agonists can inhibit tumor invasion.
- Figures 16A-16B demonstrate that AhR agonists reduce human mammary tumor cell
- BPl BPl invasion in matrigel.
- BPl cells were cultured in Matrigel in the presence of vehicle, 5 uM DIM (16A), vehicle or 5 uM CB7950998 (16B) for 5 days.
- AhR AhR receptor/transcription factor
- Green tea extracts decrease carcinogen-induced mammary tumor burden in rats and rate of breast cancer cell proliferation in culture. J Cell Biochem 82:387-398.
- CCK2 cholecystokinin-2
- DCIS Ductal carcinoma in situ
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US13/812,375 US10314810B2 (en) | 2010-07-27 | 2011-07-27 | Aryl hydrocarbon receptor (AhR) modifiers as novel cancer therapeutics |
CN201180046119.7A CN103179968B (en) | 2010-07-27 | 2011-07-27 | It is used as aromatic hydrocarbon receptor (AhR) conditioning agent of cancer therapy |
EA201390031A EA035288B1 (en) | 2010-07-27 | 2011-07-27 | ARYL HYDROCARBON RECEPTOR (AhR) MODIFIERS AS NOVEL CANCER THERAPEUTICS |
BR112013002079-2A BR112013002079B1 (en) | 2010-07-27 | 2011-07-27 | ARIL HYDROCARBIDE (AHR) RECEIVER MODIFIERS AS NEW CANCER THERAPEUTICS |
AU2011282776A AU2011282776B2 (en) | 2010-07-27 | 2011-07-27 | Aryl hydrocarbon receptor (AhR) modifiers as novel cancer therapeutics |
JP2013521935A JP6047092B2 (en) | 2010-07-27 | 2011-07-27 | Aryl hydrocarbon receptor (AhR) modifier as a novel cancer therapy |
EP11813107.7A EP2598138B1 (en) | 2010-07-27 | 2011-07-27 | Aryl hydrocarbon receptor (ahr) modifiers as novel cancer therapeutics |
CA2807199A CA2807199C (en) | 2010-07-27 | 2011-07-27 | Flavonoid-derived aryl hydrocarbon receptor modulators useful in the treatment of cancer |
US15/059,911 US10258600B2 (en) | 2010-07-27 | 2016-03-03 | Aryl hydrocarbon receptor (AhR) modifiers as novel cancer therapeutics |
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WO2014028749A2 (en) | 2012-08-15 | 2014-02-20 | Boston Medical Center Corporation | Production of red blood cells and platelets from stem cells |
US20160175278A1 (en) * | 2010-07-27 | 2016-06-23 | Trustees Of Boston University | ARYL HYDROCARBON RECEPTOR (AhR) MODIFIERS AS NOVEL CANCER THERAPEUTICS |
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CN103179968B (en) | 2017-10-03 |
WO2012015914A3 (en) | 2012-05-31 |
AU2011282776B2 (en) | 2014-06-12 |
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JP2017014252A (en) | 2017-01-19 |
AU2011282776A1 (en) | 2013-02-14 |
JP6621501B2 (en) | 2019-12-18 |
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US10314810B2 (en) | 2019-06-11 |
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EP2598138A4 (en) | 2014-04-23 |
US10258600B2 (en) | 2019-04-16 |
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CA2807199C (en) | 2020-07-07 |
CN103179968A (en) | 2013-06-26 |
EA201390031A1 (en) | 2013-05-30 |
CN107648216A (en) | 2018-02-02 |
CN107648216B (en) | 2021-03-30 |
EP2598138B1 (en) | 2020-05-06 |
BR112013002079A2 (en) | 2016-11-08 |
BR112013002079B1 (en) | 2021-09-14 |
CA2807199A1 (en) | 2012-02-02 |
EA035288B1 (en) | 2020-05-25 |
JP2018131454A (en) | 2018-08-23 |
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