WO2014070868A1 - Cancer treatment - Google Patents

Cancer treatment Download PDF

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Publication number
WO2014070868A1
WO2014070868A1 PCT/US2013/067469 US2013067469W WO2014070868A1 WO 2014070868 A1 WO2014070868 A1 WO 2014070868A1 US 2013067469 W US2013067469 W US 2013067469W WO 2014070868 A1 WO2014070868 A1 WO 2014070868A1
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WIPO (PCT)
Prior art keywords
certain embodiments
antisense compound
dose
phase
weeks
Prior art date
Application number
PCT/US2013/067469
Other languages
French (fr)
Inventor
Stanley T. Crooke
Mason YAMASHITA
Original Assignee
Isis Pharmaceuticals Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to NZ706540A priority Critical patent/NZ706540A/en
Priority to MEP-2019-68A priority patent/ME03363B/en
Application filed by Isis Pharmaceuticals Inc filed Critical Isis Pharmaceuticals Inc
Priority to RS20190296A priority patent/RS58576B1/en
Priority to DK13850047.5T priority patent/DK2920308T3/en
Priority to EP13850047.5A priority patent/EP2920308B1/en
Priority to RU2015113231A priority patent/RU2689548C2/en
Priority to BR112015009559A priority patent/BR112015009559A2/en
Priority to CN201380056691.0A priority patent/CN104755621A/en
Priority to MX2015005587A priority patent/MX365158B/en
Priority to CA2889630A priority patent/CA2889630C/en
Priority to US14/439,363 priority patent/US9540641B2/en
Priority to EP18206571.4A priority patent/EP3483273A1/en
Priority to PL13850047T priority patent/PL2920308T3/en
Priority to JP2015540744A priority patent/JP6542669B2/en
Priority to ES13850047T priority patent/ES2718082T3/en
Priority to SI201331353T priority patent/SI2920308T1/en
Priority to LTEP13850047.5T priority patent/LT2920308T/en
Publication of WO2014070868A1 publication Critical patent/WO2014070868A1/en
Priority to IL238249A priority patent/IL238249B/en
Priority to PH12015500935A priority patent/PH12015500935B1/en
Priority to HK16100033.1A priority patent/HK1211982A1/en
Priority to US15/356,947 priority patent/US9873876B2/en
Priority to US15/822,692 priority patent/US10619157B2/en
Priority to PH12018501827A priority patent/PH12018501827A1/en
Priority to HRP20190303TT priority patent/HRP20190303T1/en
Priority to CY20191100301T priority patent/CY1121873T1/en
Priority to IL267242A priority patent/IL267242B/en
Priority to US16/804,215 priority patent/US20200318112A1/en

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    • C12N15/113—Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing
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    • A61K31/7115—Nucleic acids or oligonucleotides having modified bases, i.e. other than adenine, guanine, cytosine, uracil or thymine
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    • A61K31/7125—Nucleic acids or oligonucleotides having modified internucleoside linkage, i.e. other than 3'-5' phosphodiesters
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    • C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • C07K14/46—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates
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Definitions

  • methods, compounds, and compositions for treating B-cell lymphoma by inhibiting expression of STAT3 mR A or protein in an animal are provided herein. Such methods, compounds, and compositions are useful to treat, prevent, or ameliorate B-cell lymphoma or hepatocellular carcinoma.
  • the STAT (signal transducers and activators of transcription) family of proteins are DNA-binding proteins that play a dual role in signal transduction and activation of transcription.
  • STAT1 DNA-binding proteins that play a dual role in signal transduction and activation of transcription.
  • STAT2 DNA-binding proteins that play a dual role in signal transduction and activation of transcription.
  • STAT3a DNA-binding proteins that play a dual role in signal transduction and activation of transcription.
  • STAT1 DNA-binding proteins that play a dual role in signal transduction and activation of transcription.
  • STAT1 The STAT1 , STAT2, STAT3, STAT4, STAT5, and STAT6
  • STAT la The activities of the STATs are modulated by various cytokines and mitogenic stimuli. Binding of a cytokine to its receptor results in the activation of Janus protein tyrosine kinases (JAKs) associated with these receptors.
  • JKs Janus protein tyrosine
  • STAT3 also acute phase response factor (APRF)
  • APRF acute phase response factor
  • STAT3 has been found to be responsive to interleukin-6 (IL-6) as well as epidermal growth factor (EGF) (Darnell, Jr., J.E., et al, Science, 1994, 264, 1415-1421).
  • IL-6 interleukin-6
  • EGF epidermal growth factor
  • STAT3 has been found to have an important role in signal transduction by interferons (Yang, C.-H., et al, Proc. Natl. Acad. Sci. USA, 1998, 95, 5568-5572).
  • ERK2 induces serine phosphorylation and also associates with STAT3 (Jain, N., et al, Oncogene, 1998, 17, 3157-3167).
  • STAT3 is expressed in most cell types (Zhong, Z., et al, Proc. Natl. Acad. Sci. USA, 1994, 91, 4806-4810). It induces the expression of genes involved in response to tissue injury and inflammation. STAT3 has also been shown to prevent apoptosis through the expression of bcl-2 (Fukada, T., et al, Immunity, 1996, 5, 449-460). Recently, STAT3 was detected in the mitochondria of transformed cells, and was shown to facilitate glycolytic and oxidative phosphorylation activities similar to that of cancer cells (Gough, D.J., et al, Science, 2009, 324, 1713-1716). The inhibition of STAT3 in the mitochondria impaired malignant transformation by activated Ras. The data confirms a Ras-mediated transformation function for STAT3 in the mitochondria in addition to its nuclear roles.
  • B-cell lymphoma is a B-lymphocyte blood cell cancer that is clinically classified as either Hodgkin's lymphoma or non-Hodgkin's lymphoma.
  • Hodgkin's lymphoma There are several types of non- Hodgkin's lymphoma, of which diffuse large B-cell lymphoma (DLBCL) is the most common type, accounting for approximately 30 percent of all lymphomas. In the United States, DLBCL affects about 7 out of 100,000 people each year.
  • DLBCL diffuse large B-cell lymphoma
  • antisense compounds targeting STAT3 are useful for treating B-cell lymphoma, such as DLBCL, at unexpectedly low doses for an antisense compound as a cancer therapeutic.
  • antisense compounds targeting STAT3 provided herein are administered to a subject having B-cell lymphoma at a fixed total weekly dose in the range of about 15-750 mg.
  • antisense compounds targeting STAT3 provided herein are administered to a subject having B-cell lymphoma in the range of about 0.2 to 3.5 milligrams of the antisense compound per kilogram of the subject's body weight per week (0.2-3.5 mg/kg/wk).
  • Such dose ranges are unexpectedly low for treating cancer.
  • a Phase 1 study of LY2275796, an antisense oligonucleotide targeted to cap-binding protein eukaryotic initiation factor 4E (eIF-4E) concluded that the maximum tolerable dose (MTD) and biologically effective dose (BED) of LY2275796 is 1 ,000 mg under a loading and maintenance dose regimen, but even at a 1,000 mg dose, no tumor response was observed. (Hong D.S. et al., Clin Cancer Res. 2011 17(20):6582-91).
  • 2'-deoxynucleoside means a nucleoside comprising 2'-H furanosyl sugar moiety, as found naturally occurring in deoxyribonucleosides (DNA).
  • a 2'-deoxynucleoside may comprise a modified nucleobase or may comprise an RNA nucleobase (e.g., uracil).
  • 2'-0-methoxyethyl refers to an O- methoxy-ethyl modification of the 2' position of a furosyl ring.
  • a 2'-0-methoxyethyl modified sugar is a modified sugar.
  • 2'-MOE nucleoside (also 2'-0-methoxyethyl nucleoside) means a nucleoside comprising a 2'-MOE modified sugar moiety.
  • 2 '-substituted nucleoside means a nucleoside comprising a substituent at the 2'- position other than H or OH. Unless otherwise indicated, a 2 '-substituted nucleoside is not a bicyclic nucleoside.
  • 5-methylcytosine means a cytosine modified with a methyl group attached to the 5' position.
  • a 5-methylcytosine is a modified nucleobase.
  • “About” as applied to dosing amounts means within ⁇ 12% of a value. For example, if it is stated, “the dose is an amount in the range of about 15-750 mg,” it is implied that the dose is an amount in the range of 13-840 mg. In another example, if it is stated that the dose is an amount of "about 50 mg,” it is implied that the dose can be from 44 mg to 56 mg.
  • “About” as applied to activity levels means within ⁇ 10% of a value. For example, if it is stated, “the compounds affected at least about 70% inhibition of STAT3", it is implied that the STAT3 levels are inhibited within a range of 63% and 77%.
  • Active pharmaceutical agent means the substance or substances in a pharmaceutical composition that provide a therapeutic benefit when administered to an individual.
  • an antisense oligonucleotide targeted to STAT3 is an active pharmaceutical agent.
  • Active target region or “target region” means a region to which one or more active antisense compounds is targeted.
  • Active antisense compounds means antisense compounds that reduce target nucleic acid levels or protein levels.
  • administering means providing a pharmaceutical agent to an individual, and includes, but is not limited to administering by a medical professional and self- administering.
  • “Amelioration” refers to a lessening of at least one indicator, sign, or symptom of an associated disease, disorder, or condition.
  • the severity of indicators may be determined by subjective or objective measures, which are known to those skilled in the art.
  • Animal refers to a human or non-human animal, including, but not limited to, mice, rats, rabbits, dogs, cats, pigs, and non-human primates, including, but not limited to, monkeys and chimpanzees.
  • Antisense activity means any detectable or measurable activity attributable to the hybridization of an antisense compound to its target nucleic acid. In certain embodiments, antisense activity is a decrease in the amount or expression of a target nucleic acid or protein encoded by such target nucleic acid.
  • Antisense compound means an oligomeric compound that is is capable of undergoing hybridization to a target nucleic acid through hydrogen bonding.
  • antisense compounds include single-stranded and double-stranded compounds, such as, antisense oligonucleotides, siR As, and shR As.
  • Antisense inhibition means reduction of target nucleic acid levels or target protein levels in the presence of an antisense compound complementary to a target nucleic acid as compared to target nucleic acid levels or target protein levels in the absence of the antisense compound.
  • Antisense oligonucleotide means a single-stranded oligonucleotide having a nucleobase sequence that permits hybridization to a corresponding region or segment of a target nucleic acid.
  • Bicyclic sugar means a furosyl ring modified by the bridging of two atoms.
  • a bicyclic sugar is a modified sugar.
  • Bicyclic nucleoside also BNA
  • BNA BNA
  • the bridge connects the 4 '-carbon and the 2'-carbon of the sugar ring.
  • Cap structure or “terminal cap moiety” means chemical modifications, which have been incorporated at either terminus of an antisense compound.
  • cEt or “constrained ethyl” means a bicyclic nucleoside having a sugar moiety comprising a bridge connecting the 4 '-carbon and the 2 '-carbon, wherein the bridge has the formula: 4'-CH(CH 3 )-0-2'.
  • Constrained ethyl nucleoside (also cEt nucleoside) means a nucleoside comprising a bicyclic sugar moiety comprising a 4'-CH(CH 3 )-0-2' bridge.
  • “Chemically distinct region” refers to a region of an antisense compound that is in some way chemically different than another region of the same antisense compound. For example, a region having 2 '-0-methoxyethyl nucleotides is chemically distinct from a region having nucleotides without 2'-0-methoxyethyl modifications.
  • Chimeric antisense compound means an antisense compound that has at least two chemically distinct regions.
  • Co-administration means administration of two or more pharmaceutical agents to an individual.
  • the two or more pharmaceutical agents may be in a single pharmaceutical composition, or may be in separate pharmaceutical compositions.
  • Each of the two or more pharmaceutical agents may be administered through the same or different routes of administration.
  • Co-administration encompasses parallel or sequential administration.
  • “Complementarity” means the capacity for pairing between nucleobases of a first nucleic acid and a second nucleic acid. "Contiguous nucleobases” means nucleobases immediately adjacent to each other.
  • “Diluent” means an ingredient in a composition that lacks pharmacological activity, but is pharmaceutically necessary or desirable.
  • the diluent in an injected composition may be a liquid, e.g. saline solution.
  • Dose means a specified quantity of a pharmaceutical agent provided in a single administration, or in a specified time period.
  • a dose may be administered in one, two, or more boluses, tablets, or injections.
  • the desired dose requires a volume not easily accommodated by a single injection, therefore, two or more injections may be used to achieve the desired dose.
  • the pharmaceutical agent is administered by infusion over an extended period of time or continuously. Doses may be stated as the amount of pharmaceutical agent per hour, day, week, or month.
  • single dose means administration of one dose, and only one dose, to a subject.
  • Dosage unit means a form in which a pharmaceutical agent is provided.
  • a dosage unit is a vial containing lyophilized ISIS 481464.
  • a dosage unit is a vial containing reconstituted ISIS 481464.
  • Dosing regimen is a combination of doses designed to achieve one or more desired effects. In certain embodiments, a dose regimen is designed to provide a therapeutic effect quickly.
  • Duration means the period of time during which an activity or event continues.
  • the duration of a loading phase is the period of time during which loading doses are administered.
  • the duration of the maintenance phase is the period of time during which maintenance doses are administered.
  • Effective amount means the amount of active pharmaceutical agent sufficient to effectuate a desired physiological outcome in an individual in need of the agent.
  • the effective amount may vary among individuals depending on the health and physical condition of the individual to be treated, the taxonomic group of the individuals to be treated, the formulation of the composition, assessment of the individual's medical condition, and other relevant factors.
  • First phase means a dosing phase during which administration is initiated and steady state concentrations of pharmaceutical agents can be, but is not necessarily, achieved in a target tissue.
  • Second phase means a dosing phase after the "first phase.” In certain embodiments, the dose or total weekly dose of the first phase and the second phase are different.
  • “Fully complementary” or “100% complementary” means each nucleobase of a first nucleic acid has a complementary nucleobase in a second nucleic acid.
  • a first nucleic acid is an antisense compound and a target nucleic acid is a second nucleic acid.
  • “Gapmer” means a chimeric antisense compound in which an internal region having a plurality of nucleosides that support RNase H cleavage is positioned between external regions having one or more nucleosides, wherein the nucleosides comprising the internal region are chemically distinct from the nucleoside or nucleosides comprising the external regions.
  • the internal region may be referred to as the "gap” and the external regions may be referred to as the "wings.”
  • Gap-widened means a chimeric antisense compound having a gap segment of 12 or more contiguous 2'-deoxyribonucleosides positioned between and immediately adjacent to 5' and 3' wing segments having from one to six nucleosides.
  • HCC hepatocellular carcinoma. It is the most common form of liver cancer and also referred to as malignant hepatoma.
  • Hybridization means the annealing of complementary nucleic acid molecules.
  • complementary nucleic acid molecules include an antisense compound and a target nucleic acid.
  • Hyperproliferative disease means a disease characterized by rapid or excessive growth and reproduction of cells. Examples of hyperproliferative diseases include cancer, e.g., carcinomas, sarcomas, lymphomas, and leukemias as well as associated malignancies and metastases.
  • Identifying an animal at risk for hyperproliferative disease means identifying an animal having been diagnosed with a hyperproliferative disease or identifying an animal predisposed to develop a hyperproliferative disease.
  • Individuals predisposed to develop a hyperproliferative disease include those having one or more risk factors for hyperproliferative disease including older age; history of other hyperproliferative diseases; history of tobacco use; history of exposure to sunlight and/or ionizing radiation; prior contact with certain chemicals, especially continuous contact; past or current infection with certain viruses and bacteria; prior or current use of certain hormone therapies; genetic predisposition; alcohol use; and certain lifestyle choices including poor diet, lack of physical activity, and/or being overweight.
  • identification may be accomplished by any method including evaluating an individual's medical history and standard clinical tests or assessments.
  • “Immediately adjacent” means there are no intervening elements between the immediately adjacent elements.
  • “Inhibiting STAT3” means reducing expression of STAT3 mRNA and/or protein levels in the presence of a STAT3 antisense compound, including a STAT3 antisense oligonucleotide, as compared to expression of STAT3 mRNA and/or protein levels in the absence of a STAT3 antisense compound, such as an antisense oligonucleotide.
  • “Individual” means a human or non-human animal selected for treatment or therapy.
  • Internucleoside linkage refers to the chemical bond between nucleosides.
  • ISIS 481464" means a STAT3 antisense oligonucleotide having the nucleobase sequence "CTATTTGGATGTCAGC", incorporated herein as SEQ ID NO: 12, where each internucleoside linkage is a phosphorothioate internucleoside linkage, each cytosine is a 5- methylcytosine, and each of nucleosides 1-3 and 14-16 comprise a cEt moeity.
  • ISIS 481464 is complementary to nucleobases 3016-3031 of the sequence of GENBANK Accession No. NM_139276.2, incorporated herein as SEQ ID NO: l.
  • Linked nucleosides means adjacent nucleosides which are bonded together.
  • Loading phase means a dosing phase during which administration is initiated and steady state concentrations of pharmaceutical agents are achieved in a target tissue.
  • a loading phase is a dosing phase during which steady state concentrations of antisense oligonucleotide are achieved in liver.
  • Maintenance phase means a dosing phase after target tissue steady state concentrations of pharmaceutical agents have been achieved.
  • a maintenance phase is a dosing phase after which steady state concentrations of antisense oligonucleotide are achieved in liver.
  • mismatch or “non-complementary nucleobase” refers to the case when a nucleobase of a first nucleic acid is not capable of pairing with the corresponding nucleobase of a second or target nucleic acid.
  • Modified internucleoside linkage refers to a substitution or any change from a naturally occurring internucleoside bond (i.e. a phosphodiester internucleoside bond).
  • Modified nucleobase refers to any nucleobase other than adenine, cytosine, guanine, thymidine, or uracil.
  • An "unmodified nucleobase” means the purine bases adenine (A) and guanine (G), and the pyrimidine bases thymine (T), cytosine (C), and uracil (U).
  • Modified nucleotide means a nucleotide having, independently, a modified sugar moiety, modified internucleoside linkage, or modified nucleobase.
  • a “modified nucleoside” means a nucleoside having, independently, a modified sugar moiety or modified nucleobase.
  • Modified oligonucleotide means an oligonucleotide comprising a modified internucleoside linkage, a modified sugar, and/or a modified nucleobase.
  • Modified sugar refers to a substitution or change from a natural sugar.
  • Microtif means the pattern of chemically distinct regions in an antisense compound.
  • Naturally occurring internucleoside linkage means a 3' to 5' phosphodiester linkage.
  • Natural sugar moiety means a sugar found in DNA (2'-H) or RNA (2'-OH).
  • Nucleic acid refers to molecules composed of monomeric nucleotides.
  • a nucleic acid includes ribonucleic acids (RNA), deoxyribonucleic acids (DNA), single-stranded nucleic acids, double-stranded nucleic acids, small interfering ribonucleic acids (siRNA), and microRNAs (miRNA).
  • RNA ribonucleic acids
  • DNA deoxyribonucleic acids
  • siRNA small interfering ribonucleic acids
  • miRNA microRNAs
  • Nucleobase means a heterocyclic moiety capable of pairing with a base of another nucleic acid.
  • Nucleobase sequence means the order of contiguous nucleobases independent of any sugar, linkage, or nucleobase modification.
  • Nucleoside means a nucleobase linked to a sugar.
  • Nucleoside mimetic includes those structures used to replace the sugar or the sugar and the base and not necessarily the linkage at one or more positions of an oligomeric compound such as for example nucleoside mimetics having morpholino, cyclohexenyl, cyclohexyl, tetrahydropyranyl, bicyclo or tricyclo sugar mimetics, e.g., non furanose sugar units.
  • Sugar surrogate overlaps with the slightly broader term nucleoside mimetic but is intended to indicate replacement of the sugar unit (furanose ring) only.
  • the tetrahydropyranyl rings provided herein are illustrative of an example of a sugar surrogate wherein the furanose sugar group has been replaced with a tetrahydropyranyl ring system.
  • Nucleotide means a nucleoside having a phosphate group covalently linked to the sugar portion of the nucleoside.
  • Off-target effect refers to an unwanted or deleterious biological effect associated with modulation of RNA or protein expression of a gene other than the intended target nucleic acid.
  • Oligomer means a polymer of linked monomeric subunits which is capable of hybridizing to at least a region of a nucleic acid molecule.
  • Oligomer means a polymer of linked nucleosides each of which can be modified or unmodified, independent one from another.
  • Parenteral administration means administration through injection (e.g., bolus injection) or infusion.
  • Parenteral administration includes subcutaneous administration, intravenous administration, intramuscular administration, intraarterial administration, intraperitoneal administration, or intracranial administration, e.g. , intrathecal or intracerebroventricular administration.
  • Peptide means a molecule formed by linking at least two amino acids by amide bonds. Peptide refers to polypeptides and proteins.
  • “Pharmaceutical composition” means a mixture of substances suitable for administering to an individual.
  • a pharmaceutical composition may comprise one or more active pharmaceutical agents and a sterile aqueous solution.
  • a pharmaceutical composition shows activity in free uptake assay in certain cell lines.
  • “Pharmaceutically acceptable derivative” encompasses pharmaceutically acceptable salts, conjugates, prodrugs or isomers of the compounds described herein.
  • “Pharmaceutically acceptable salts” means physiologically and pharmaceutically acceptable salts of antisense compounds, i.e., salts that retain the desired biological activity of the parent oligonucleotide and do not impart undesired toxico logical effects thereto.
  • Phosphorothioate linkage means a linkage between nucleosides where the phosphodiester bond is modified by replacing one of the non-bridging oxygen atoms with a sulfur atom.
  • Portion means a defined number of contiguous (i.e., linked) nucleobases of a nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of a target nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of an antisense compound.
  • Prevent refers to delaying or forestalling the onset or development of a disease, disorder, or condition for a period of time from minutes to indefinitely. Prevent also means reducing risk of developing a disease, disorder, or condition.
  • Prodrug means a therapeutic agent that is prepared in an inactive form that is converted to an active form within the body or cells thereof by the action of endogenous enzymes or other chemicals or conditions.
  • Side effects means physiological responses attributable to a treatment other than the desired effects.
  • side effects include injection site reactions, liver function test abnormalities, renal function abnormalities, liver toxicity, renal toxicity, central nervous system abnormalities, myopathies, and malaise.
  • increased aminotransferase levels in serum may indicate liver toxicity or liver function abnormality.
  • increased bilirubin may indicate liver toxicity or liver function abnormality.
  • a STAT3 nucleic acid includes a DNA sequence encoding STAT3, an RNA sequence transcribed from DNA encoding STAT3 (including genomic DNA comprising introns and exons), and an mRNA sequence encoding STAT3.
  • STAT3 mRNA means an mRNA encoding a STAT3 protein.
  • Single-stranded oligonucleotide means an oligonucleotide which is not hybridized to a complementary strand.
  • Specifically hybridizable refers to an antisense compound having a sufficient degree of complementarity between an antisense oligonucleotide and a target nucleic acid to induce a desired effect, while exhibiting minimal or no effects on non-target nucleic acids under conditions in which specific binding is desired, i.e., under physiological conditions in the case of in vivo assays and therapeutic treatments.
  • Subject means a human selected for treatment or therapy.
  • Targeting or “targeted” means the process of design and selection of an antisense compound that will specifically hybridize to a target nucleic acid and induce a desired effect.
  • Target nucleic acid refers to a nucleic acid capable of being targeted by antisense compounds.
  • Target segment means the sequence of nucleotides of a target nucleic acid to which an antisense compound is targeted.
  • 5' target site refers to the 5 '-most nucleotide of a target segment.
  • 3' target site refers to the 3 '-most nucleotide of a target segment.
  • “Therapeutically effective amount” means an amount of a pharmaceutical agent that provides a therapeutic benefit to an individual.
  • Treat refers to administering a pharmaceutical composition to effect an alteration or improvement of a disease, disorder, or condition.
  • Unmodified nucleotide means a nucleotide composed of naturally occuring nucleobases, sugar moieties, and internucleoside linkages.
  • an unmodified nucleotide is an RNA nucleotide (i.e. ⁇ -D-ribonucleosides) or a DNA nucleotide (i.e. ⁇ -D-deoxyribonucleoside).
  • a method of treating cancer in a subject which comprises administering to the subject an inhibitor of the JAK-STAT pathway.
  • the cancer is B-cell lymphoma or hepatocellular carcinoma (HCC).
  • a method of treating B-cell lymphoma in a subject which comprises administering to the subject an inhibitor of the JAK-STAT pathway.
  • a method of treating cancer such as B-cell lymphoma or HCC, in a subject which comprises administering to the subject a weekly dose of an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the dose comprises about 0.2 to 3.5 milligrams of the antisense compound per kilogram of the subject' s body weight per week (0.2-3.5 mg/kg/wk).
  • the dose is about 0.2 mg, about 0.3 mg, about 0.4 mg, about 0.5 mg, about 0.6 mg, about 0.7 mg, about 0.8 mg, about 0.9 mg, about 1.0 mg, about 1.1 mg, about 1.2 mg, about 1.3 mg, about 1.4 mg, about 1.5 mg, about 1.6 mg, about 1.7 mg, about 1.8 mg, about 1.9 mg, about 2.0 mg, about 2.1 mg, about 2.2 mg, about 2.3 mg, about 2.4 mg, about 2.5 mg, about 2.6 mg, about 2.7 mg, about 2.8 mg, about 2.9 mg, about 3.0 mg, about 3.1 mg, about 3.2 mg, about 3.3 mg, about 3.4 mg, or about 3.5 mg of the antisense compound per kilogram of the subject's body weight.
  • the dose comprises about 1.5 to 3.5 milligrams of the antisense compound per kilogram of the subject's body weight ( 1 .5-3.5 mg/kg/wk. In certain embodiments, the dose is 2.0 milligrams of the antisense compound per kilogram of the subject's body weight per week (2.0 mg/kg/wk). In certain embodiments, the dose is effective to treat cancer and acceptably tolerable.
  • the dose can be administered for at least 1-52 weeks, at least 1-10 weeks, at least 1-7 weeks, at least 1-5 weeks, at least 5 weeks, at least 6 weeks, or at least 7 weeks. In certain embodiments, the dose can be administered to the subject 1, 2, 3, 4, 5, 6, or 7 times per week.
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a single dose of a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the single dose comprises an amount of the compound in the range of about 15-250 mg. In certain embodiments, the single dose comprises an amount of the compound in the range of about 100-250 mg.
  • the single dose is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg.
  • the dose is effective to treat cancer and acceptably tolerable.
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a total weekly dose of a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the total weekly dose comprises an amount of the compound in the range of about 15-750 mg weekly. In certain embodiments, the total weekly dose comprises an amount of the compound in the range of about 100-750 mg weekly.
  • the total weekly dose is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg.
  • the dose is effective to treat cancer and acceptably tolerable.
  • the total weekly dose can be administered in 2, 3, 4, 5, 6, or 7 equal doses within a week, such that the total weekly dose does not exceed about 750 mg. In certain embodiments, the total weekly dose is administered in 3 equal doses within a week. It will be understood that the aforementioned total weekly dose ranges can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight.
  • the total weekly dose can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 750 mg/70 kg (10.7 mg/kg/wk).
  • the total weekly dose can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (4.6 mg/kg/wk
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase comprising a total weekly dose in the range of about 15-750 mg for the first 1-10 weeks, and a maintenance phase comprising a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase.
  • a loading phase comprising a total weekly dose in the range of about 15-750 mg for the first 1-10 weeks
  • a maintenance phase comprising a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase.
  • the loading phase is 1 week, 2 weeks, 3 weeks, 4 weeks, or 5 weeks. In certain embodiments, the loading phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week. In certain embodiments, the loading phase comprises administering the compound in 3 equal doses within a week.
  • the total weekly dose of the antisense compound in the loading phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg.
  • the aforementioned total weekly dose ranges in the loading phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose in the loading phase by an average adult body weight of 70 kg, in certain embodiments the total weekly dose can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 750 mg/70 kg (10.7 mg/kg/wk).
  • the total weekly dose in the loading phase can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (0.2 mg/
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066- 1069
  • the maintenance phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week.
  • the total weekly dose of the antisense compound in the maintenance phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg.
  • the total weekly dose in the maintenance phase is administered as a single dose per week.
  • the aforementioned total weekly dose ranges in the maintenance phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose by an average adult body weight of 70 kg, in certain embodiments the total weekly dose in the maintenance phase can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 250 mg/70 kg (3.6 mg/kg/wk).
  • the total weekly dose can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), or about 250 mg/70 kg (3.6 mg/kg/wk).
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase about 6, 7, 8, 9, or 10 weeks, and a maintenance phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase.
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase comprising a dose in the range of about 3 to 4 mg/kg/wk for about 6, 7, 8, 9, or 10 weeks, and a maintenance phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase.
  • body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000.
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase comprising a dose of about 3 mg/kg/wk for about 8 weeks, and a maintenance phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase.
  • cancer such as B-cell lymphoma or HCC
  • administering the antisense compound comprises: a loading phase comprising a dose of about 3 mg/kg/wk for about 8 weeks, and a maintenance phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase.
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase comprising a total weekly dose in the range of about 15-750 mg for the first 1-10 weeks, and a second phase comprising a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase.
  • the first phase is 1 week, 2 weeks, 3 weeks, 4 weeks, or 5 weeks. In certain embodiments, the first phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week. In certain embodiments, the first phase comprises administering the compound in 3 equal doses within a week.
  • the total weekly dose of the antisense compound in the first phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg.
  • the aforementioned total weekly dose ranges in the first phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose in the first phase by an average adult body weight of 70 kg, in certain embodiments the total weekly dose can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 750 mg/70 kg (10.7 mg/kg/wk).
  • the total weekly dose in the first phase can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (0.2 mg/
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • the second phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week.
  • the total weekly dose of the antisense compound in the second phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 1 10 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg.
  • the total weekly dose in the second phase is administered as a single dose per week.
  • the aforementioned total weekly dose ranges in the second phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose by an average adult body weight of 70 kg, in certain embodiments the total weekly dose in the second phase can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 250 mg/70 kg (3.6 mg/kg/wk).
  • the total weekly dose can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), or about 250 mg/70 kg (3.6 mg/kg/wk).
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase for about 6, 7, 8, 9, or 10 weeks, and a second phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase.
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase comprising a dose in the range of about 3 to 4 mg/kg/wk for about 6, 7, 8, 9, or 10 weeks, and a second phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase.
  • a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase comprising a dose of about 3 mg/kg/wk for about 8 weeks, and a second phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase.
  • the B-cell lymphoma is a non-Hodgkin's B-cell lymphoma.
  • non-Hodgkin's B-cell lymphoma of certain aspects include, but are not limited to, diffuse large B cell lymphoma (DLBCL), follicular lymphoma, mucosa- associated lymphatic tissue lymphoma (MALT), small cell lymphocytic lymphoma, chronic lymphocytic leukemia, mantle cell lymphoma (MCL), Burkitt lymphoma, mediastinal large B cell lymphoma, Waldenstrom macroglobulinemia, nodal marginal zone B cell lymphoma (NMZL), splenic marginal zone lymphoma (SMZL), intravascular large B-cell lymphoma, primary effusion lymphoma, and lymphomatoid granulomatosis.
  • the non-Hodgkin's B-cell lymphoma is diffuse large B cell lympho
  • the B-cell lymphoma is Hodgkin's B-cell lymphoma.
  • administering the dose of the antisense compound reduces tumor size or tumor volume in the subject. In certain embodiments, administering the dose of the antisense compound prolongs survival of the subject. In certain embodiments, administering the dose of the antisense compound treats cancer, such as B-cell lymphoma, in the subject. In any of the above embodiments, the method is effective to treat cancer and acceptably tolerable in a subject.
  • the subject is identified as having cancer, such as B-cell lymphoma, prior to administering the antisense compound to the subject.
  • the subject identified as having cancer, such as B-cell lymphoma received or is currently receiving anti-cancer treatment, such as a first-line treatment regimen.
  • the first-line treatment regimen is a combination of cyclophosphamide, hydroxydanuorubicin, Oncovin (vincristine), prednisone or prednisolone (CHOP).
  • the first-line treatment regimen is a combination of rituximab and CHOP (R-CHOP).
  • the subject is refractory to a first-line treatment regimen such as CHOP and/or R-CHOP.
  • the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 3008 to 3033 of SEQ ID NO: 1, wherein the nucleobase sequence is complementary to SEQ ID NO: 1.
  • the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 3016 to 3031 of SEQ ID NO: 1, wherein the nucleobase sequence is complementary to SEQ ID NO: 1.
  • the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 6476 to 6491 of SEQ ID NO: 2, wherein the nucleobase sequence is complementary to SEQ ID NO: 2.
  • the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 250-286; 250-285; 264-285; 264-282; 728-745; 729- 745; 729-744; 787-803; 867-883; 955-978; 1146-1170; 1896-1920; 1899-1920; 1899- 1919; 1899-1918; 1899-1916; 1901-1916; 1946-1963; 1947-1963; 2155-2205; 2155-2187; 2156-2179; 2204-2221; 2681-2696; 2699-2716; 3001-3033; 3008-3033, 3010-3033, 3010- 3032, 3015-3033, 3015-3032, 3015-3031, 3016-3033, 3016-3032, 3016-3033; 3452-3499
  • the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 2668-2688; 2703-2720; 5000-5021; 5001-5017; 5697- 5722; 5699-5716; 6475 - 6490; 6475 - 6491 ; 6476 - 6491; 7682-7705; 8078-8097; 8079- 8095; 9862-9811 ; 9870-9897; 9875-9893; 9875-9891; 9877-9893; 11699-11719; 12342- 12366; 12345-12364;12346-12364; 12347-12364; 12353-12380; 12357-12376; 12358- 12376; 12358-12373; 12360-12376;
  • the nucleobase sequence of the modified oligonucleotide comprises the sequence of SEQ ID NO: 12 or consists of the sequence of SEQ ID NO: 12. In certain embodiments, the modified oligonucleotide is 100% complementary to SEQ ID NO: 1 or 2. In certain embodiments, the nucleobase sequence of the modified oligonucleotide comprises the sequence of any of the STAT3 antisense oligonucleotides described in WO 2012/135736, which is incorporated by reference in its entirety herein. In certain embodiments, the modified oligonucleotide is a single-stranded modified oligonucleotide.
  • the modified oligonucleotide comprises at least one modified internucleoside linkage.
  • each internucleoside linkage is a phosphorothioate internucleoside linkage.
  • at least one nucleoside comprises a modified sugar, such as a bicyclic sugar including, but not limited to, a 4'- CH 2 -0-2 ' bridge or a 4 '-CH(CH 3 )-0-2' bridge.
  • the modified sugar comprises a 2'-0(CH 2 ) 2 -OCH 3 group.
  • at least one nucleoside comprises a modified nucleobase, such as a 5- methylcytosine.
  • the modified oligonucleotide comprises: a 5 '-wing consisting of 1 to 5 linked nucleosides; a 3 '-wing consisting of 1 to 5 linked nucleosides; and a gap between the 5 '-wing and the 3 '-wing consisting of 8 to 12 linked 2 '- deoxynucleosides; wherein at least one of the 5 '-wing and the 3 '-wing comprises at least one bicyclic nucleoside or one 2 '-substituted nucleoside.
  • the 2 '-substituted nucleoside comprises a 2'-0(CH 2 ) 2 -OCH 3 group or a 2 '-0-CH 3 group.
  • the bicyclic nucleoside comprises a 4'- CH 2 -0-2' bridge or a 4'-CH(CH 3 )- 0-2' bridge.
  • pharmaceutical compositions described herein are administered in the form of a dosage unit (e.g., injection, infusion, etc.).
  • such pharmaceutical compositions comprise an antisense oligonucleotide in an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg.
  • antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week.
  • the dosage unit can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464.
  • compositions described herein comprise a dose of antisense oligonucleotide in an amount in the range of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg.
  • antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week.
  • the dose of antisense oligonucleotide can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/kg/
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • compositions described herein may additionally contain other adjunct components conventionally found in pharmaceutical compositions, at their art-established usage levels.
  • the compositions may contain additional, compatible, pharmaceutically-active materials such as, for example, antipruritics, astringents, local anesthetics or anti-inflammatory agents.
  • additional, compatible, pharmaceutically-active materials such as, for example, antipruritics, astringents, local anesthetics or anti-inflammatory agents.
  • additional, compatible, pharmaceutically-active materials such as, for example, antipruritics, astringents, local anesthetics or anti-inflammatory agents.
  • the formulations can be sterilized and, if desired, mixed with auxiliary agents, e.g., preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings, and/or aromatic substances and the like which do not deleteriously interact with the oligonucleotide(s) of the formulation.
  • auxiliary agents e.g., preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings, and/or aromatic substances and the like which do not deleteriously interact with the oligonucleotide(s) of the formulation.
  • Antisense oligonucleotides may be covalently linked to one or more moieties or conjugates which enhance the activity, cellular distribution or cellular uptake of the antisense oligonucleotides.
  • Typical conjugate groups include cholesterol moieties and lipid moieties.
  • Additional conjugate groups include carbohydrates, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes.
  • Antisense oligonucleotides can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of antisense compounds to enhance properties such as, for example, nuclease stability. Included in stabilizing groups are cap structures. These terminal modifications protect the antisense oligonucleotide having terminal nucleic acid from exonuclease degradation, and can help in delivery and/or localization within a cell.
  • the cap can be present at the 5'-terminus (5'-cap), or at the 3'- terminus (3'-cap), or can be present on both termini.
  • Cap structures are well known in the art and include, for example, inverted deoxy abasic caps. Further 3' and 5 '-stabilizing groups that can be used to cap one or both ends of an antisense compound to impart nuclease stability include those disclosed in WO 03/004602 published on January 16, 2003.
  • a method of treating a subject suffering from cancer comprising administering to the subject an antisense compound complementary to human STAT3.
  • the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736.
  • the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma.
  • an antisense compound complementary to human STAT3 for use in treating cancer.
  • the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736.
  • the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma.
  • an antisense compound complementary to human STAT3 for use in a method of treating cancer in a subject in need thereof, wherein the method comprises administering to the subject the antisense compound in a loading phase and then a maintenance phase, wherein the loading phase involves administering a total weekly dose of the compound in the range of about 15-750 mg for the first 1-10 weeks, and the maintenance phase involves administering a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase.
  • the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736.
  • the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma.
  • Certain aspects are directed to use of an antisense compound complementary to human STAT3 for the manufacture of a medicament for treating cancer.
  • the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736.
  • the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma.
  • the B-cell lymphoma is a non- Hodgkin's B-cell lymphoma.
  • non-Hodgkin's B-cell lymphoma include, but are not limited to, diffuse large B cell lymphoma (DLBCL), follicular lymphoma, mucosa-associated lymphatic tissue lymphoma (MALT), small cell lymphocytic lymphoma, chronic lymphocytic leukemia, mantle cell lymphoma (MCL), Burkitt lymphoma, mediastinal large B cell lymphoma, Waldenstrom macroglobulinemia, nodal marginal zone B cell lymphoma (NMZL), splenic marginal zone lymphoma (SMZL), intravascular large B-cell lymphoma, primary effusion lymphoma, and lymphomatoid granulomatosis.
  • the non-Hodgkin's B-cell lymphoma is diffuse large B cell
  • compositions are administered according to a dosing regimen.
  • the dosing regimen comprises a loading phase and a maintenance phase.
  • the dosing regimen is effective to treat cancer and acceptably tolerable in a subject.
  • the pharmaceutical composition comprises an antisense oligonucleotide .
  • the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12.
  • the antisense oligonucleotide is ISIS 481464.
  • the loading phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 , 12, 13, 14, 15, 16, 17, 18, 19, or more than 20 doses.
  • the loading phase lasts from 1 day to 6 months. In certain embodiments a loading phase lasts 1 day, 2 days, 3, days, 4, days, 5 days, 6 days, or 7 days as measured from administration of the first dose of the loading phase to administration of the first dose of the maintenance phase. In certain embodiments a loading phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, or 26 weeks as measured from administration of the first dose of the loading phase to administration of the first dose of the maintenance phase. In certain embodiments, the loading phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, or 6 months as measured from administration of the first dose of the loading phase to administration of the first dose of the maintenance phase.
  • the dose administered during the loading phase is lower than the dose administered during the maintenance phase. In certain embodiments, the dose administered during the loading phase is lower than the dose administered during the maintenance phase to avoid undesired side effects. In certain embodiments, the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
  • the dose administered during the loading phase is higher than the dose administered during the maintenance phase. In certain embodiments, the dose administered during the loading phase is higher than the dose administered during the maintenance phase to quickly achieve steady state reduction of STAT3 mR A expression, STAT3 protein expression, and/or STAT3 activity. In certain embodiments, the dose administered during the loading phase is higher than the dose administered during the maintenance phase to avoid undesired side effects in the maintenance phase. In certain embodiments, the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
  • the doses administered during the loading phase are all the same amount as one another. In certain embodiments, the doses administered during the loading phase are not all the same amount. In certain embodiments, the doses given during the loading phase increase over time. In certain embodiments, the doses given during the loading phase decrease over time. In certain embodiments, a loading dose is administered by parenteral administration. In certain embodiments, the parenteral administration is subcutaneous administration. In certain embodiments, the parenteral administration is intravenous infusion.
  • the doses administered during the loading phase are about 0.2 mg, about 0.3 mg, about 0.4 mg, about 0.5 mg, about 0.6 mg, about 0.7 mg, about 0.8 mg, about 0.9 mg, about 1.0 mg, about 1.1 mg, about 1.2 mg, about 1.3 mg, about 1.4 mg, about 1.5 mg, about 1.6 mg, about 1.7 mg, about 1.8 mg, about 1.9 mg, about 2.0 mg, about 2.1 mg, about 2.2 mg, about 2.3 mg, about 2.4 mg, about 2.5 mg, about 2.6 mg, about 2.7 mg, about 2.8 mg, about 2.9 mg, about 3.0 mg, about 3.1 mg, about 3.2 mg, about 3.3 mg, about 3.4 mg, or about 3.5 mg of the antisense compound per kilogram of the subject's body weight.
  • the dose is 2.0 milligrams of the antisense compound per kilogram of the subject's body weight per week (2.0 mg/kg/wk).
  • the doses administered during the loading phase are about
  • antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week.
  • the doses can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3
  • Devine formula Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069
  • dose, dose frequency, and duration of the loading phase may be selected to achieve a desired effect.
  • those variables are adjusted to result in a desired concentration of pharmaceutical agent in a subject.
  • dose and dose frequency are adjusted to provide plasma concentration of a pharmaceutical agent at an amount sufficient to achieve a desired effect.
  • the plasma concentration is maintained above the minimal effective concentration (MEC).
  • pharmaceutical compositions described herein are administered with a dosage regimen designed to maintain a concentration above the MEC for 10-90% of the time, between 30-90% of the time, or between 50-90% of the time.
  • the pharmaceutical composition comprises an antisense oligonucleotide.
  • the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12.
  • the antisense oligonucleotide is ISIS 481464.
  • doses, dose frequency, and duration of the loading phase may be selected to achieve a desired plasma trough concentration of a pharmaceutical composition.
  • the pharmaceutical composition comprises an antisense oligonucleotide.
  • the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO : 12.
  • the antisense oligonucleotide is ISIS 481464.
  • the desired plasma trough concentration is from 5-100 ng/mL.
  • the desired plasma trough concentration is from 5-50 ng/mL.
  • the desired plasma trough concentration is from 10-40 ng/mL.
  • the desired plasma trough concentration is from 15-35 ng/mL.
  • the desired plasma trough concentration is from 20-30 ng/mL.
  • dose, dose frequency, and duration of the loading phase may be selected to achieve a desired effect within 1 to 26 weeks.
  • the dose is the same and the dose frequency is varied to achieve the desired effect within 1 to 26 weeks.
  • the dose increases over time and the dose frequency remains constant.
  • one or more doses of the loading phase are greater than one or more doses of the maintenance phase.
  • each of the loading doses is greater than each of the maintenance doses.
  • a loading phase with a high dose and/or high dose frequency may be desirable.
  • doses, dose frequency, and duration of the loading phase may be selected to achieve an acceptable safety profile.
  • such variables may be selected to mitigate toxicity of the pharmaceutical composition.
  • such variables are selected to mitigate liver toxicity.
  • such variables are selected to mitigate renal toxicity.
  • such variables are selected to mitigate thrombocytopenia or neutropenia.
  • doses increase over time.
  • one or more doses of the loading phase are lower than one or more doses of the maintenance phase.
  • a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal.
  • a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal, and bilirubin is elevated two or more times the upper limit of normal.
  • an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal.
  • an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal, and bilirubin elevations that do not exceed two times the upper limit of normal.
  • the dose and/or dose frequency is adjusted to mitigate the ALT elevation.
  • the maintenance phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more than 20 doses. In certain embodiments, the maintenance phase lasts from one day to the lifetime of the subject. In certain embodiments, the maintenance phase lasts 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, or 7 days as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase.
  • the maintenance phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, 26 weeks, 27 weeks, 28 weeks, 29 weeks, 30 weeks, 31 weeks, 32 weeks, 33 weeks, 34 weeks, 35 weeks, 36 weeks, 37 weeks, 38 weeks, 39 weeks, 40 weeks, 41 weeks, 42 weeks, 43 weeks, 44 weeks, 45 weeks, 46 weeks, 47 weeks, 48 weeks, 49 weeks, 50 weeks, 5 1 weeks, or 52 weeks as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase.
  • the maintenance phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, or 12 months as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase.
  • the maintenance phase lasts 1 year, 2 years, 3 years, 4 years, 5 years, 6 years, 7 years, 8 years, 9 years, 10 years, 1 1 years, 12 years, 13 years, 14 years, 15 years, 16 years, 17 years, 18 years, 19 years, 20 years, 21 years, 22 years, 23 years, 24 years, 25 years, 26 years, 27 years, 28 years, 29 years, 30 years, 31 years, 32 years, 33 years, 34 years 35 years, 36 years, 37 years, 38 years, 39 years, 40 years, 41 years, 42 years, 43 years, 44 years, 45 years, 46 years, 47 years, 48 years, 49 years, or 50 years as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase. In certain embodiments, the maintenance phase lasts as long as the dose continues to be needed, effective, and tolerated.
  • the doses administered during the maintenance phase are all the same as one another. In certain embodiments, the doses administered during the maintenance phase are not all the same. In certain embodiments, the doses increase over time. In certain embodiments, the doses decrease over time.
  • a maintenance dose is administered by parenteral administration.
  • the parenteral administration is subcutaneous administration.
  • the parenteral administration is intravenous infusion.
  • the doses during the maintenance phase are about 0.2 mg, about 0.3 mg, about 0.4 mg, about 0.5 mg, about 0.6 mg, about 0.7 mg, about 0.8 mg, about 0.9 mg, about 1.0 mg, about 1.1 mg, about 1.2 mg, about 1.3 mg, about 1.4 mg, about 1.5 mg, about 1.6 mg, about 1.7 mg, about 1.8 mg, about 1.9 mg, about 2.0 mg, about 2.1 mg, about 2.2 mg, about 2.3 mg, about 2.4 mg, about 2.5 mg, about 2.6 mg, about 2.7 mg, about 2.8 mg, about 2.9 mg, about 3.0 mg, about 3.1 mg, about 3.2 mg, about 3.3 mg, about 3.4 mg, or about 3.5 mg of the antisense compound per kilogram of the subject's body weight.
  • the dose is 2.0 milligrams of the antisense compound per kilogram of the subject's body weight per week (2.0 mg/kg/wk).
  • the doses during the maintenance phase are about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg.
  • antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week.
  • the doses can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), or about 250 mg/70 kg (3.6 mg/kg/wk).
  • doses, dose frequency, and duration of the maintenance phase may be selected to achieve a desired effect.
  • those variables are adjusted to result in a desired concentration of pharmaceutical agent in a subject.
  • dose and dose frequency are adjusted to provide plasma concentration of a pharmaceutical agent described herein at an amount sufficient to achieve a desired effect.
  • the plasma concentration is maintained above the minimal effective concentration (MEC).
  • pharmaceutical compositions described herein are administered with a dosage regimen designed to maintain a concentration above the MEC for 10-90% of the time, between 30-90% of the time, or between 50-90% of the time.
  • doses, dose frequency, and duration of the maintenance phase may be selected to achieve a desired plasma trough concentration of a pharmaceutical composition.
  • the pharmaceutical composition is an antisense oligonucleotide.
  • the desired plasma trough concentration is from 5-100 ng/mL. In certain embodiments, the desired plasma trough concentration is from 5-50 ng/mL. In certain embodiments, the desired plasma trough concentration is from 10-40 ng/mL. In certain embodiments, the desired plasma trough concentration is from 15-35 ng/mL. In certain embodiments, the desired plasma trough concentration is from 20-30 ng/mL.
  • doses, dose frequency, and duration of the maintenance phase may be selected to achieve a desired safety profile.
  • such variables may be selected to mitigate toxicity of the pharmaceutical composition.
  • such variables are selected to mitigate liver toxicity.
  • such variables are selected to mitigate renal toxicity.
  • such variables are selected to mitigate thrombocytopenia or neutropenia.
  • doses, dose frequency, and duration of the maintenance phase may be adjusted from time to time to achieve a desired effect.
  • subjects are monitored for effects (therapeutic and/or toxic effects) and doses, dose frequency, and/or duration of the maintenance phase may be adjusted based on the results of such monitoring.
  • compositions are administered according to a dosing regimen comprising a first phase and a second phase.
  • the pharmaceutical composition comprises an antisense oligonucleotide.
  • the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12.
  • the antisense oligonucleotide is ISIS 481464.
  • the first phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or more than 20 doses.
  • the first phase lasts from 1 day to 6 months. In certain embodiments a first phase lasts 1 day, 2 days, 3, days, 4, days, 5 days, 6 days, or 7 days as measured from administration of the first dose of the first phase to administration of the first dose of the second phase. In certain embodiments a first phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, or 26 weeks as measured from administration of the first dose of the first phase to administration of the first dose of the second phase. In certain embodiments, the first phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, or 6 months as measured from administration of the first dose of the first phase to administration of the first dose of the second phase.
  • the dose administered during the first phase is lower than the dose administered during the second phase. In certain embodiments, the dose administered during the first phase is lower than the dose administered during the second phase to avoid undesired side effects.
  • the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
  • the dose administered during the first phase is higher than the dose administered during the second phase. In certain embodiments, the dose administered during the first phase is higher than the dose administered during the second phase to quickly achieve steady state reduction of STAT3 mRNA expression, STAT3 protein expression, and/or STAT3 activity. In certain embodiments, the dose administered during the first phase is higher than the dose administered during the second phase to avoid undesired side effects in the second phase. In certain embodiments, the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
  • the doses administered during the first phase are all the same amount as one another. In certain embodiments, the doses administered during the first phase are not all the same amount. In certain embodiments, the doses given during the first phase increase over time. In certain embodiments, the doses given during the first phase decrease over time.
  • a first dose is administered by parenteral administration.
  • the parenteral administration is subcutaneous administration.
  • the parenteral administration is intravenous infusion. The range of dosages capable of being administered during the "first phase" and/or
  • second phase are the same as can be used for the "loading phase” and “maintenance phase” referred to above.
  • dose, dose frequency, and duration of the first phase and/or second phase may be selected to achieve a desired effect.
  • those variables are adjusted to result in a desired concentration of pharmaceutical agent in a subject.
  • dose and dose frequency are adjusted to provide plasma concentration of a pharmaceutical agent at an amount sufficient to achieve a desired effect.
  • the plasma concentration is maintained above the minimal effective concentration (MEC).
  • pharmaceutical compositions described herein are administered with a dosage regimen designed to maintain a concentration above the MEC for 10-90% of the time, between 30-90% of the time, or between 50-90% of the time.
  • the pharmaceutical composition comprises an antisense oligonucleotide.
  • the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12.
  • the antisense oligonucleotide is ISIS 481464.
  • doses, dose frequency, and duration of the first phase and/or second phase may be selected to achieve a desired plasma trough concentration of a pharmaceutical composition.
  • the pharmaceutical composition comprises an antisense oligonucleotide.
  • the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12.
  • the antisense oligonucleotide is ISIS 481464.
  • the desired plasma trough concentration is from 5-100 ng/mL. In certain embodiments, the desired plasma trough concentration is from 5-50 ng/mL. In certain embodiments, the desired plasma trough concentration is from 10-40 ng/mL. In certain embodiments, the desired plasma trough concentration is from 15-35 ng/mL. In certain embodiments, the desired plasma trough concentration is from 20-30 ng/mL.
  • dose, dose frequency, and duration of the first phase and/or second phase may be selected to achieve a desired effect within 1 to 26 weeks.
  • the dose is the same and the dose frequency is varied to achieve the desired effect within 1 to 26 weeks.
  • the dose increases over time and the dose frequency remains constant.
  • one or more doses of the first phase are greater than one or more doses of the second phase.
  • each of the first doses is greater than each of the second doses.
  • a first phase with a high dose and/or high dose frequency may be desirable.
  • doses, dose frequency, and duration of the first phase and/or second phase may be selected to achieve an acceptable safety profile.
  • such variables may be selected to mitigate toxicity of the pharmaceutical composition.
  • such variables are selected to mitigate liver toxicity.
  • such variables are selected to mitigate renal toxicity.
  • such variables are selected to mitigate thrombocytopenia or neutropenia.
  • doses increase over time.
  • one or more doses of the first phase are lower than one or more doses of the second phase.
  • a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal.
  • a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal, and bilirubin is elevated two or more times the upper limit of normal.
  • an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal.
  • an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal, and bilirubin elevations that do not exceed two times the upper limit of normal.
  • the dose and/or dose frequency is adjusted to mitigate the ALT elevation.
  • the second phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more than 20 doses. In certain embodiments, the second phase lasts from one day to the lifetime of the subject.
  • the second phase lasts 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, or 7 days as measured from administration of the last dose of the first phase to administration of the last dose of the second phase.
  • the second phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, 26 weeks, 27 weeks, 28 weeks, 29 weeks, 30 weeks, 31 weeks, 32 weeks, 33 weeks, 34 weeks, 35 weeks, 36 weeks, 37 weeks, 38 weeks, 39 weeks, 40 weeks, 41 weeks, 42 weeks, 43 weeks, 44 weeks, 45 weeks, 46 weeks, 47 weeks, 48 weeks, 49 weeks, 50 weeks, 51 weeks, or 52 weeks as measured from administration of the last dose of the first phase to administration of the last dose of the second phase.
  • the second phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, or 12 months as measured from administration of the last dose of the first phase to administration of the last dose of the second phase.
  • the second phase lasts 1 year, 2 years, 3 years, 4 years, 5 years, 6 years, 7 years, 8 years, 9 years, 10 years, 1 1 years, 12 years, 13 years, 14 years, 15 years, 16 years, 17 years, 18 years, 19 years, 20 years, 21 years, 22 years, 23 years, 24 years, 25 years, 26 years, 27 years, 28 years, 29 years, 30 years, 31 years, 32 years, 33 years, 34 years 35 years, 36 years, 37 years, 38 years, 39 years, 40 years, 41 years, 42 years, 43 years, 44 years, 45 years, 46 years, 47 years, 48 years, 49 years, or 50 years as measured from administration of the last dose of the first phase to administration of the last dose of the second phase.
  • the second phase lasts as long as the dose continues to be needed, effective, and tolerated. In certain embodiments where the second phase includes more than one dose, the doses administered during the second phase are all the same as one another. In certain embodiments, the doses administered during the second phase are not all the same. In certain embodiments, the doses increase over time. In certain embodiments, the doses decrease over time. In certain embodiments, a second dose is administered by parenteral administration.
  • the parenteral administration is subcutaneous administration. In certain embodiments, the parenteral administration is intravenous infusion.
  • Oligomeric compounds include, but are not limited to, oligonucleotides, oligonucleosides, oligonucleotide analogs, oligonucleotide mimetics, antisense compounds, antisense oligonucleotides, and siRNAs.
  • An oligomeric compound may be "antisense" to a target nucleic acid, meaning that is is capable of undergoing hybridization to a target nucleic acid through hydrogen bonding.
  • an antisense compound has a nucleobase sequence that, when written in the 5' to 3' direction, comprises the reverse complement of the target segment of a target nucleic acid to which it is targeted.
  • an antisense oligonucleotide has a nucleobase sequence that, when written in the 5' to 3' direction, comprises the reverse complement of the target segment of a target nucleic acid to which it is targeted.
  • an antisense compound targeted to a STAT3 nucleic acid is 12 to 30 subunits in length. In certain embodiments, an antisense compound targeted to a STAT3 nucleic acid is 14 to 30 subunits in length. In certain embodiments, an antisense compound targeted to a STAT3 nucleic acid is 12 to 22 subunits in length. In other words, such antisense compounds are from 12 to 30 linked subunits, 14 to 30 linked subunits, or 12 to 22 linked subunits, respectively.
  • the antisense compound is 8 to 80, 12 to 50, 13 to 30, 13 to 50, 14 to 30, 14 to 50, 15 to 30, 15 to 50, 16 to 30, 16 to 50, 17 to 30, 17 to 50, 18 to 22, 18 to 24, 18 to 30, 18 to 50, 19 to 22, 19 to 30, 19 to 50, or 20 to 30 linked subunits.
  • the antisense compounds are 8, 9, 10, 11 , 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, or 80 linked subunits in length, or a range defined by any two of the above values.
  • the antisense compound is an antisense oligonucleotide, and the linked subunits are nucleotides.
  • antisense oligonucleotides targeted to a STAT3 nucleic acid may be shortened or truncated.
  • a single subunit may be deleted from the 5' end (5' truncation), or alternatively from the 3' end (3' truncation).
  • a shortened or truncated antisense compound targeted to a STAT3 nucleic acid may have two subunits deleted from the 5' end, or alternatively may have two subunits deleted from the 3' end, of the antisense compound.
  • the deleted nucleosides may be dispersed throughout the antisense compound, for example, in an antisense compound having one nucleoside deleted from the 5' end and one nucleoside deleted from the 3' end.
  • the additional subunit may be located at the 5' or 3' end of the antisense compound.
  • the added subunits may be adjacent to each other, for example, in an antisense compound having two subunits added to the 5' end (5 ' addition), or alternatively to the 3' end (3' addition), of the antisense compound.
  • the added subunits may be dispersed throughout the antisense compound, for example, in an antisense compound having one subunit added to the 5' end and one subunit added to the 3 ' end.
  • an antisense compound such as an antisense oligonucleotide
  • an antisense oligonucleotide it is possible to increase or decrease the length of an antisense compound, such as an antisense oligonucleotide, and/or introduce mismatch bases without eliminating activity.
  • an antisense compound such as an antisense oligonucleotide
  • a series of antisense oligonucleotides 13-25 nucleobases in length were tested for their ability to induce cleavage of a target RNA in an oocyte injection model.
  • Antisense oligonucleotides 25 nucleobases in length with 8 or 1 1 mismatch bases near the ends of the antisense oligonucleotides were able to direct specific cleavage of the target mRNA, albeit to a lesser extent than the antisense oligonucleotides that contained no mismatches. Similarly, target specific cleavage was achieved using 13 nucleobase antisense oligonucleotides, including those with 1 or 3 mismatches.
  • Gautschi et al. demonstrated the ability of an oligonucleotide having 100% complementarity to the bcl-2 mRNA and having 3 mismatches to the bcl-xL mRNA to reduce the expression of both bcl-2 and bcl-xL in vitro and in vivo. Furthermore, this oligonucleotide demonstrated potent anti-tumor activity in vivo.
  • antisense compounds targeted to a STAT3 nucleic acid have chemically modified subunits arranged in patterns, or motifs, to confer to the antisense compounds properties such as enhanced inhibitory activity, increased binding affinity for a target nucleic acid, or resistance to degradation by in vivo nucleases.
  • Chimeric antisense compounds typically contain at least one region modified so as to confer increased resistance to nuclease degradation, increased cellular uptake, increased binding affinity for the target nucleic acid, and/or increased inhibitory activity.
  • a second region of a chimeric antisense compound may optionally serve as a substrate for the cellular endonuclease RNase H, which cleaves the RNA strand of an RNA:DNA duplex.
  • Antisense compounds having a gapmer motif are considered chimeric antisense compounds.
  • a gapmer an internal region having a plurality of nucleotides that supports RNaseH cleavage is positioned between external regions having a plurality of nucleotides that are chemically distinct from the nucleosides of the internal region.
  • the gap segment In the case of an antisense oligonucleotide having a gapmer motif, the gap segment generally serves as the substrate for endonuclease cleavage, while the wing segments comprise modified nucleosides.
  • the regions of a gapmer are differentiated by the types of sugar moieties comprising each distinct region.
  • sugar moieties that are used to differentiate the regions of a gapmer may in some embodiments include ⁇ -D- ribonucleosides, ⁇ -D-deoxyribonucleosides, 2'-modified nucleosides (such 2 '-modified nucleosides may include 2'-MOE and 2 '-0-CH 3 , among others), and bicyclic sugar modified nucleosides (such bicyclic sugar modified nucleosides may include those having a constrained ethyl).
  • wings may include several modified sugar moieties, including, for example 2'-MOE and constrained ethyl.
  • wings may include several modified and unmodified sugar moieties.
  • wings may include various combinations of 2 '-MOE nucleosides, constrained ethyl nucleosides, and 2'-deoxynucleosides.
  • Each distinct region may comprise uniform sugar moieties, variants, or alternating sugar moieties.
  • the wing-gap-wing motif is frequently described as "X-Y-Z", where "X” represents the length of the 5 '-wing, “Y” represents the length of the gap, and “Z” represents the length of the 3 '-wing.
  • "X” and “Z” may comprise uniform, variant, or alternating sugar moieties.
  • "X" and “Y” may include one or more 2'-deoxynucleosides.
  • “Y” may comprise 2'-deoxynucleosides.
  • a gapmer described as "X-Y-Z" has a configuration such that the gap is positioned immediately adjacent to each of the 5 '-wing and the 3 ' wing. Thus, no intervening nucleotides exist between the 5 '-wing and gap, or the gap and the 3 '-wing.
  • Any of the antisense compounds described herein can have a gapmer motif.
  • "X” and “Z” are the same, in other embodiments they are different.
  • ⁇ " is between 8 and 15 nucleosides.
  • X, Y, or Z can be any of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 1 1, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30 or more nucleosides.
  • gapmers provided herein include, for example, 1 1-mers having a motif of 1-9-1.
  • gapmers provided herein include, for example, 12-mers having a motif of 1-9-2, 2-9-1, or 1-10-1.
  • gapmers provided herein include, for example, 13-mers having a motif of 1-9-3, 2-9-2, 3-9-1, 1-10-2, or 2-10-1.
  • gapmers provided herein include, for example, 14-mers having a motif of 1-9-4, 2-9-3, 3-9-2, 4-9-1, 1-10-3, 2-10-2, or 3-10-1.
  • gapmers provided herein include, for example, 15-mers having a motif of 1-9-5, 2-9-4, 3-9-3, 4-9-2, 5-9-1, 1-10-4, 2-10-3, 3-10-2, or 4-10-1. In certain embodiments, gapmers provided herein include, for example, 16-mers having a motif of 2-9-5, 3-9-4, 4-9-3, 5-9-2, 1-10-5, 2-10-4, 3-10-3, 4-10-2, or 5-10-1.
  • gapmers provided herein include, for example, 17-mers having a motif of 3-9-5, 4-9-4, 5-9-3, 2-10-5, 3-10-4, 4-10-3, or 5-10-2.
  • gapmers provided herein include, for example, 18-mers having a motif of 4-9-5, 5-9-4, 3-10-5, 4-10-4, or 5-10-3.
  • gapmers provided herein include, for example, 19-mers having a motif of 5-9-5, 4-10-5, or 5-10-4.
  • gapmers provided herein include, for example, 20-mers having a motif of 5-10-5.
  • the antisense compound has a "wingmer" motif, having a wing-gap or gap-wing configuration, i.e. an X-Y or Y-Z configuration as described above for the gapmer configuration.
  • wingmer configurations provided herein include, but are not limited to, for example 5-10, 8-4, 4-12, 12-4, 3-14, 16-2, 18-1, 10-3, 2-10, 1-10, 8- 2, 2-13, 5-13, 5-8, or 6-8.
  • antisense compound targeted to a STAT3 nucleic acid has a 2-10-2 gapmer motif.
  • the antisense compound targeted to a STAT3 nucleic acid has a 3-10-3 gapmer motif. In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a 5-10-5 gapmer motif.
  • the antisense compound targeted to a STAT3 nucleic acid has a 1-10-5 gapmer motif.
  • the antisense compound targeted to a STAT3 nucleic acid has a 3 - 10-4 gapmer motif.
  • the antisense compound targeted to a STAT3 nucleic acid has a 2-10-4 gapmer motif.
  • the antisense compound targeted to a STAT3 nucleic acid has a 4-9-3 gapmer motif. In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a gap-widened motif.
  • the antisense compounds targeted to a STAT3 nucleic acid has any of the following sugar motifs: k-d(10)-k e-d(10)-k k-d(10)-e k-k-d(10)-k-k k-k-d(10)-e-e e-e-d(10)-k-k k-k-k-k-d(10)-k-k-k e-e-e-d(10)-k-k-k-k-k-k-k-d(10)-e-e-e k-k-k-d(10)-k-k-k-k e-k-k-d(10)-k-k-e e-e-k-d(10)-k-k-e e-d-k-d(10)-k-k-e e-d-k-d(10)-k-k-e e-d-k-d(10)-k-e-k-e e-d-k-d(10)-k-e-e
  • the antisense oligonucleotide has a sugar motif described by Formula A as follows: (J) m -(B) n -(J) p -(B) r -(A) t -(D) g -(A) v -(B) w -(J) x -(B) y -(J) z wherein: each A is independently a 2 '-substituted nucleoside; each B is independently a bicyclic nucleoside; each J is independently either a 2'-substituted nucleoside or a 2'-deoxynucleoside; each D is a 2'-deoxynucleoside; m is 0-4; n is 0-2; p is 0-2; r is 0-2; t is 0-2; v is 0-2; w is 0-4; x is 0-2; y is 0-2; z
  • Nucleotide sequences that encode STAT3 include, without limitation, the following: GENBANK Accession No. NM_ 139276.2 (incorporated herein as SEQ ID NO: 1) and the complement of GENBANK Accession No. NT 010755.14 truncated from nucleotides 4185000 to 4264000 (incorporated herein as SEQ ID NO: 2).
  • antisense compounds defined by a SEQ ID NO may comprise, independently, one or more modifications to a sugar moiety, an internucleoside linkage, or a nucleobase.
  • Antisense compounds described by Isis Number (Isis No) indicate a combination of nucleobase sequence and motif.
  • a target region is a structurally defined region of the target nucleic acid.
  • a target region may encompass a 3 ' UTR, a 5 ' UTR, an exon, an intron, an exon/intron junction, a coding region, a translation initiation region, translation termination region, or other defined nucleic acid region.
  • the structurally defined regions for STAT3 can be obtained by accession number from sequence databases such as NCBI and such information is incorporated herein by reference.
  • a target region may encompass the sequence from a 5 ' target site of one target segment within the target region to a 3' target site of another target segment within the same target region.
  • Targeting includes determination of at least one target segment to which an antisense compound hybridizes, such that a desired effect occurs.
  • the desired effect is a reduction in mRNA target nucleic acid levels.
  • the desired effect is reduction of levels of protein encoded by the target nucleic acid or a phenotypic change associated with the target nucleic acid.
  • a target region may contain one or more target segments. Multiple target segments within a target region may be overlapping. Alternatively, they may be non-overlapping. In certain embodiments, target segments within a target region are separated by no more than about 300 nucleotides. In certain emodiments, target segments within a target region are separated by a number of nucleotides that is, is about, is no more than, is no more than about, 250, 200, 150, 100, 90, 80, 70, 60, 50, 40, 30, 20, or 10 nucleotides on the target nucleic acid, or is a range defined by any two of the preceeding values.
  • target segments within a target region are separated by no more than, or no more than about, 5 nucleotides on the target nucleic acid. In certain embodiments, target segments are contiguous. Contemplated are target regions defined by a range having a starting nucleic acid that is any of the 5 ' target sites or 3 ' target sites listed herein.
  • Suitable target segments may be found within a 5 ' UTR, a coding region, a 3' UTR, an intron, an exon, or an exon/intron junction.
  • Target segments containing a start codon or a stop codon are also suitable target segments.
  • a suitable target segment may specifcally exclude a certain structurally defined region such as the start codon or stop codon.
  • the determination of suitable target segments may include a comparison of the sequence of a target nucleic acid to other sequences throughout the genome.
  • the BLAST algorithm may be used to identify regions of similarity amongst different nucleic acids. This comparison can prevent the selection of antisense compound sequences that may hybridize in a non-specific manner to sequences other than a selected target nucleic acid (i.e., non-target or off-target sequences).
  • reductions in STAT3 mRNA levels are indicative of inhibition of STAT3 expression.
  • Reductions in levels of a STAT3 protein are also indicative of inhibition of target mRNA expression.
  • phenotypic changes are indicative of inhibition of STAT3 expression.
  • reduced cellular growth, reduced tumor growth, and reduced tumor volume can be indicative of inhibition of STAT3 expression.
  • amelioration of symptoms associated with cancer can be indicative of inhibition of STAT3 expression.
  • reduction of cachexia is indicative of inhibition of STAT3 expression.
  • reduction of cancer markers can be indicative of inhibition of STAT3 expression.
  • hybridization occurs between an antisense compound disclosed herein and a STAT3 nucleic acid.
  • the most common mechanism of hybridization involves hydrogen bonding (e.g., Watson-Crick, Hoogsteen or reversed Hoogsteen hydrogen bonding) between complementary nucleobases of the nucleic acid molecules.
  • Hybridization can occur under varying conditions. Stringent conditions are sequence-dependent and are determined by the nature and composition of the nucleic acid molecules to be hybridized.
  • the antisense compounds provided herein are specifically hybridizable with a STAT3 nucleic acid.
  • An antisense compound and a target nucleic acid are complementary to each other when a sufficient number of nucleobases of the antisense compound can hydrogen bond with the corresponding nucleobases of the target nucleic acid, such that a desired effect will occur (e.g., antisense inhibition of a target nucleic acid, such as a STAT3 nucleic acid).
  • Non-complementary nucleobases between an antisense compound and a STAT3 nucleic acid may be tolerated provided that the antisense compound remains able to specifically hybridize to a target nucleic acid.
  • an antisense compound may hybridize over one or more segments of a STAT3 nucleic acid such that intervening or adjacent segments are not involved in the hybridization event (e.g., a loop structure, mismatch or hairpin structure).
  • the antisense compounds provided herein, or a specified portion thereof are, or are at least, 70%, 80%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or 100% complementary to a STAT3 nucleic acid, a target region, target segment, or specified portion thereof. Percent complementarity of an antisense compound with a target nucleic acid can be determined using routine methods.
  • an antisense compound in which 18 of 20 nucleobases of the antisense compound are complementary to a target region, and would therefore specifically hybridize would represent 90 percent complementarity.
  • the remaining noncomplementary nucleobases may be clustered or interspersed with complementary nucleobases and need not be contiguous to each other or to complementary nucleobases.
  • an antisense compound which is 1 8 nucleobases in length having four noncomplementary nucleobases which are flanked by two regions of complete complementarity with the target nucleic acid would have 77.8% overall complementarity with the target nucleic acid and would thus fall within the scope of the present invention.
  • Percent complementarity of an antisense compound with a region of a target nucleic acid can be determined routinely using BLAST programs (basic local alignment search tools) and PowerBLAST programs known in the art (Altschul et al., J. Mol. Biol., 1990, 215, 403 410; Zhang and Madden, Genome Res., 1997, 7, 649 656). Percent homology, sequence identity or complementarity, can be determined by, for example, the Gap program (Wisconsin Sequence Analysis Package, Version 8 for Unix, Genetics Computer Group, University Research Park, Madison Wis.), using default settings, which uses the algorithm of Smith and Waterman (Adv. Appl. Math., 1981, 2, 482 489).
  • the antisense compounds provided herein, or specified portions thereof are fully complementary (i.e. 100% complementary) to a target nucleic acid, or specified portion thereof.
  • an antisense compound may be fully complementary to a STAT3 nucleic acid, or a target region, or a target segment or target sequence thereof.
  • "fully complementary" means each nucleobase of an antisense compound is capable of precise base pairing with the corresponding nucleobases of a target nucleic acid.
  • a 20 nucleobase antisense compound is fully complementary to a target sequence that is 400 nucleobases long, so long as there is a corresponding 20 nucleobase portion of the target nucleic acid that is fully complementary to the antisense compound.
  • Fully complementary can also be used in reference to a specified portion of the first and /or the second nucleic acid.
  • a 20 nucleobase portion of a 30 nucleobase antisense compound can be "fully complementary" to a target sequence that is 400 nucleobases long.
  • the 20 nucleobase portion of the 30 nucleobase oligonucleotide is fully complementary to the target sequence if the target sequence has a corresponding 20 nucleobase portion wherein each nucleobase is complementary to the 20 nucleobase portion of the antisense compound.
  • the entire 30 nucleobase antisense compound may or may not be fully complementary to the target sequence, depending on whether the remaining 10 nucleobases of the antisense compound are also complementary to the target sequence.
  • the location of a non-complementary nucleobase may be at the 5' end or 3' end of the antisense compound. Alternatively, the non-complementary nucleobase or nucleobases may be at an internal position of the antisense compound.
  • non-complementary nucleobases When two or more non-complementary nucleobases are present, they may be contiguous (i.e. linked) or non- contiguous. In one embodiment, a non-complementary nucleobase is located in the wing segment of a gapmer antisense oligonucleotide.
  • antisense compounds that are, or are up to 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 nucleobases in length comprise no more than 4, no more than 3, no more than 2, or no more than 1 non-complementary nucleobase(s) relative to a target nucleic acid, such as a STAT3 nucleic acid, or specified portion thereof.
  • antisense compounds that are, or are up to 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 , 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleobases in length comprise no more than 6, no more than 5, no more than 4, no more than 3, no more than 2, or no more than 1 non-complementary nucleobase(s) relative to a target nucleic acid, such as a STAT3 nucleic acid, or specified portion thereof.
  • the antisense compounds provided herein also include those which are complementary to a portion of a target nucleic acid.
  • portion refers to a defined number of contiguous (i.e. linked) nucleobases within a region or segment of a target nucleic acid.
  • a “portion” can also refer to a defined number of contiguous nucleobases of an antisense compound.
  • the antisense compounds are complementary to at least an 8 nucleobase portion of a target segment.
  • the antisense compounds are complementary to at least a 9 nucleobase portion of a target segment.
  • the antisense compounds are complementary to at least a 10 nucleobase portion of a target segment.
  • the antisense compounds are complementary to at least an 1 1 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 12 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 13 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 14 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 15 nucleobase portion of a target segment. Also contemplated are antisense compounds that are complementary to at least a 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more nucleobase portion of a target segment, or a range defined by any two of these values.
  • the antisense compounds provided herein may also have a defined percent identity to a particular nucleotide sequence, SEQ ID NO, or compound represented by a specific Isis number, or portion thereof.
  • an antisense compound is identical to the sequence disclosed herein if it has the same nucleobase pairing ability.
  • a RNA which contains uracil in place of thymidine in a disclosed DNA sequence would be considered identical to the DNA sequence since both uracil and thymidine pair with adenine.
  • Shortened and lengthened versions of the antisense compounds described herein as well as compounds having non-identical bases relative to the antisense compounds provided herein also are contemplated.
  • the non-identical bases may be adjacent to each other or dispersed throughout the antisense compound. Percent identity of an antisense compound is calculated according to the number of bases that have identical base pairing relative to the sequence to which it is being compared.
  • the antisense compounds, or portions thereof are at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or 100% identical to one or more of the antisense compounds or SEQ ID NOs, or a portion thereof, disclosed herein.
  • a portion of the antisense compound is compared to an equal length portion of the target nucleic acid.
  • an 8, 9, 10, 1 1, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, or 25 nucleobase portion is compared to an equal length portion of the target nucleic acid.
  • a portion of the antisense oligonucleotide is compared to an equal length portion of the target nucleic acid.
  • an 8, 9, 10, 1 1, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 , 22, 23, 24, or 25 nucleobase portion is compared to an equal length portion of the target nucleic acid.
  • a nucleoside is a base-sugar combination.
  • the nucleobase (also known as base) portion of the nucleoside is normally a heterocyclic base moiety.
  • Nucleotides are nucleosides that further include a phosphate group covalently linked to the sugar portion of the nucleoside. For those nucleosides that include a pentofuranosyl sugar, the phosphate group can be linked to the 2', 3' or 5' hydroxyl moiety of the sugar. Oligonucleotides are formed through the covalent linkage of adjacent nucleosides to one another, to form a linear polymeric oligonucleotide.
  • the phosphate groups are commonly referred to as forming the internucleoside linkages of the oligonucleotide.
  • Modifications to antisense compounds encompass substitutions or changes to internucleoside linkages, sugar moieties, or nucleobases. Modified antisense compounds are often preferred over native forms because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for nucleic acid target, increased stability in the presence of nucleases, or increased inhibitory activity. Chemically modified nucleosides may also be employed to increase the binding affinity of a shortened or truncated antisense oligonucleotide for its target nucleic acid. Consequently, comparable results can often be obtained with shorter antisense compounds that have such chemically modified nucleosides.
  • Modified Internucleoside Linkages The naturally occuring internucleoside linkage of RNA and DNA is a 3' to 5' phosphodiester linkage. Antisense compounds having one or more modified, i.e. non- naturally occurring, internucleoside linkages are often selected over antisense compounds having naturally occurring internucleoside linkages because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for target nucleic acids, and increased stability in the presence of nucleases.
  • Oligonucleotides having modified internucleoside linkages include internucleoside linkages that retain a phosphorus atom as well as internucleoside linkages that do not have a phosphorus atom.
  • Representative phosphorus containing internucleoside linkages include, but are not limited to , phosphodiesters, phosphotriesters, methylphosphonates, phosphoramidate, and phosphorothioates. Methods of preparation of phosphorous-containing and non-phosphorous-containing linkages are well known.
  • antisense compounds targeted to a STAT3 nucleic acid comprise one or more modified internucleoside linkages.
  • the modified internucleoside linkages are phosphorothioate linkages.
  • each internucleoside linkage of an antisense compound is a phosphorothioate internucleoside linkage.
  • Antisense compounds provided herein can optionally contain one or more nucleosides wherein the sugar group has been modified. Such sugar modified nucleosides may impart enhanced nuclease stability, increased binding affinity, or some other beneficial biological property to the antisense compounds. In certain embodiments, nucleosides comprise a chemically modified ribofuranose ring moiety.
  • BNA bicyclic nucleic acids
  • Examples of chemically modified sugars include, 2'-F-5 '-methyl substituted nucleoside (see, PCT International Application WO 2008/101 157, published on 8/21/08 for other disclosed 5', 2'-bis substituted nucleosides), replacement of the ribosyl ring oxygen atom with S with further substitution at the 2'-position (see, published U.S. Patent Application US2005/0130923, published on June 16, 2005), or, alternatively, 5 '-substitution of a BNA (see, PCT International Application WO 2007/134181, published on 11/22/07, wherein LNA is substituted with, for example, a 5'-methyl or a 5'-vinyl group).
  • nucleosides having modified sugar moieties include, without limitation, nucleosides comprising 5'-vinyl, 5'-methyl (R or S), 4'-S, 2'-F, 2'-OCH 3 , and 2'- 0(CH 2 )20CH 3 substituent groups.
  • bicyclic nucleosides refer to modified nucleosides comprising a bicyclic sugar moiety.
  • examples of bicyclic nucleosides include, without limitation, nucleosides comprising a bridge between the 4' and the 2' ribosyl ring atoms.
  • antisense compounds provided herein include one or more bicyclic nucleosides wherein the bridge comprises a 4' to 2' bicyclic nucleoside.
  • 4' to 2' bicyclic nucleosides include, but are not limited to, one of the formulae: 4'-(CH 2 )- 0-2' (LNA); 4'-(CH 2 )-S-2'; 4 , -(CH 2 ) 2 -0-2' (ENA); 4'-CH(CH 3 )-0-2' and 4'-C- H(CH 2 OCH 3 )-0-2 * , and analogs thereof (see, U.S.
  • Patent 7,427,672, issued on September 23, 2008); 4 , -CH 2 -C(H)(CH 3 )-2' (see, Chattopadhyaya, et al, J. Org. Chem.,2009, 74, 1 18- 134); and 4'-CH 2 -C( CH 2 )-2', and analogs thereof (see, published PCT International Application WO 2008/154401 , published on December 8, 2008). Also see, for example: Singh et al, Chem. Commun., 1998, 4, 455-456; Koshkin et al, Tetrahedron, 1998, 54, 3607-3630; Wahlestedt et al, Proc. Natl. Acad. Sci. U. S.
  • bicyclic nucleosides can be prepared having one or more stereochemical sugar configurations including for example a-L-ribofuranose and ⁇ -D-ribofuranose (see PCT international application PCT/DK98/00393, published on March 25, 1999 as WO 99/14226).
  • the bridge is 4'-CH 2 -2', 4'-(CH2)2-2', 4 , -(CH 2 )3-2', 4'-CH 2 -0-2', 4'-(CH2)2-0-2', 4'-CH 2 -0-N(R)- 2', and 4'-CH 2 -N(R)-0-2'-, wherein each R is, independently, H, a protecting group, or Ci- C12 alkyl.
  • bicyclic nucleosides are further defined by isomeric configuration.
  • a nucleoside comprising a 4'-2' methylene-oxy bridge may be in the a-L configuration or in the ⁇ -D configuration.
  • a-L-methyleneoxy (4'- CH2-0-2') BNA's have been incorporated into antisense oligonucleotides that showed antisense activity (Frieden et ah, Nucleic Acids Research, 2003, 21, 6365-6372).
  • bicyclic nucleosides include, but are not limited to, (A) a-
  • Bx is the base moiety and R is, independently, H, a protecting group or C 1 -C 12 alkyl.
  • bicyclic nucleoside having Formula I having Formula I:
  • Bx is a heterocyclic base moiety
  • R c is Ci-Ci 2 alkyl or an amino protecting group
  • T a and T b are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium.
  • bicyclic nucleoside having Formula II having Formula II:
  • Bx is a heterocyclic base moiety
  • T a and T b are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium;
  • Z a is Ci-C 6 alkyl, C 2 -C 6 alkenyl, C 2 -C 6 alkynyl, substituted Ci-C 6 alkyl, substituted C 2 -C 6 alkenyl, substituted C 2 -C 6 alkynyl, acyl, substituted acyl, substituted amide, thiol, or substituted thio.
  • bicyclic nucleoside having Formula III having Formula III:
  • T a and T b are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium;
  • bicyclic nucleoside having Formula IV having Formula IV:
  • Bx is a heterocyclic base moiety
  • T a and T b are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium;
  • Rd is Ci-C 6 alkyl, substituted Ci-C 6 alkyl, C 2 -C 6 alkenyl, substituted C 2 -C 6 alkenyl, C 2 -C 6 alkynyl, or substituted C 2 -C 6 alkynyl; each q a , q b , q c and qa is, independently, H, halogen, Ci-C 6 alkyl, substituted Ci-C 6 alkyl, C 2 -C 6 alkenyl, substituted C 2 -C 6 alkenyl, C 2 -C 6 alkynyl, or substituted C 2 -C 6 alkynyl, Ci-C 6 alkoxyl, substituted Ci-C 6 alkoxyl, acyl, substituted acyl, Ci-C 6 aminoalkyl, or substituted Ci-C 6 aminoalkyl;
  • bicyclic nucleoside having Formula V having Formula V:
  • Bx is a heterocyclic base moiety
  • T a and T b are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium
  • bicyclic nucleoside having Formula VI having Formula VI:
  • Bx is a heterocyclic base moiety
  • 4'-2' bicyclic nucleoside or “4' to 2' bicyclic nucleoside” refers to a bicyclic nucleoside comprising a furanose ring comprising a bridge connecting the 2' carbon atom and the 4' carbon atom.
  • nucleosides refer to nucleosides comprising modified sugar moieties that are not bicyclic sugar moieties.
  • sugar moiety, or sugar moiety analogue, of a nucleoside may be modified or substituted at any position.
  • 2'-modified sugar means a furanosyl sugar modified at the 2' position.
  • modifications include substituents selected from: a halide, including, but not limited to substituted and unsubstituted alkoxy, substituted and unsubstituted thioalkyl, substituted and unsubstituted amino alkyl, substituted and unsubstituted alkyl, substituted and unsubstituted allyl, and substituted and unsubstituted alkynyl.
  • 2'- substituent groups can also be selected from: Ci-Ci 2 alkyl; substituted alkyl; alkenyl; alkynyl; alkaryl; aralkyl; O-alkaryl or O-aralkyl; SH; SCH 3 ; OCN; CI; Br; CN; CF 3 ; OCF 3 ; SOCH 3 ; S0 2 CH 3 ; ON0 2 ; N0 2 ; N 3 ; NH 2 ; heterocycloalkyl; heterocycloalkaryl; amino alky lamino; poly alky lamino; substituted silyl; an RNA cleaving group; a reporter group; an intercalator; a group for improving pharmacokinetic properties; and a group for improving the pharmacodynamic properties of an antisense compound, and other substituents having similar properties.
  • modifed nucleosides comprise a 2'-MOE side chain (see, e.g., Baker et al., J. Biol. Chem., 1997, 272, 1 1944- 12000).
  • 2'-MOE substitution have been described as having improved binding affinity compared to unmodified nucleosides and to other modified nucleosides, such as 2'- O-methyl, O-propyl, and O-aminopropyl.
  • Oligonucleotides having the 2'-MOE substituent also have been shown to be antisense inhibitors of gene expression with promising features for in vivo use (see, e.g., Martin, P., Helv. Chim.
  • a "modified tetrahydropyran nucleoside” or “modified THP nucleoside” means a nucleoside having a six-membered tetrahydropyran "sugar” substituted in for the pentofuranosyl residue in normal nucleosides (a sugar surrogate).
  • Modified THP nucleosides include, but are not limited to, what is referred to in the art as hexitol nucleic acid (HNA), anitol nucleic acid (ANA), manitol nucleic acid (MNA) (see Leumann, CJ. Bioorg. & Med. Chem. (2002) 10:841-854), fiuoro HNA (F-HNA), or those compounds having Formula X: Formula X:
  • Bx is a heterocyclic base moiety
  • the modified THP nucleosides of Formula X are provided wherein q m , q n , q p , q r , q s , q t , and q u are each H.
  • at least one of q m , q gut, q p , q r , q s , q t , and q u is other than H.
  • at least one of qm, qn, qp, qr, q s , q t and q u is methyl.
  • THP nucleosides of Formula X are provided wherein one of Ri and R2 is F.
  • Ri is fluoro and R2 is H
  • Ri is methoxy and R2 is H
  • Ri is methoxyethoxy and R2 is H.
  • 2'-modified or “2 '-substituted” refers to a nucleoside comprising a sugar comprising a substituent at the 2' position other than H or OH.
  • 2'-F refers to a sugar comprising a fluoro group at the 2' position.
  • oligonucleotide refers to a compound comprising a plurality of linked nucleosides. In certain embodiments, one or more of the plurality of nucleosides is modified. In certain embodiments, an oligonucleotide comprises one or more ribonucleosides (R A) and/or deoxyribonucleosides (DNA).
  • nucleobase moieties are maintained for hybridization with an appropriate nucleic acid target.
  • antisense compounds comprise one or more nucleotides having modified sugar moieties.
  • the modified sugar moiety is 2'- MOE.
  • the 2 '-MOE modified nucleotides are arranged in a gapmer motif.
  • the modified sugar moiety is a cEt.
  • the cEt modified nucleotides are arranged throughout the wings of a gapmer motif.
  • Antisense oligonucleotides may be admixed with pharmaceutically acceptable active or inert substances for the preparation of pharmaceutical compositions or formulations.
  • Compositions and methods for the formulation of pharmaceutical compositions are dependent upon a number of criteria, including, but not limited to, route of administration, extent of disease, or dose to be administered.
  • An antisense compound targeted to a STAT3 nucleic acid can be utilized in pharmaceutical compositions by combining the antisense compound with a suitable pharmaceutically acceptable diluent or carrier.
  • a pharmaceutically acceptable diluent includes phosphate-buffered saline (PB S).
  • PB S is a diluent suitable for use in compositions to be delivered parenterally.
  • employed in the methods described herein is a pharmaceutical composition comprising an antisense compound targeted to a STAT3 nucleic acid and a pharmaceutically acceptable diluent.
  • the pharmaceutically acceptable diluent is PBS .
  • the antisense compound is an antisense oligonucleotide.
  • compositions comprising antisense compounds encompass any pharmaceutically acceptable salts, esters, or salts of such esters, or any other oligonucleotide which, upon administration to an animal, including a human, is capable of providing (directly or indirectly) the biologically active metabolite or residue thereof. Accordingly, for example, the disclosure is also drawn to pharmaceutically acceptable salts of antisense compounds, prodrugs, pharmaceutically acceptable salts of such prodrugs, and other bioequivalents. Suitable pharmaceutically acceptable salts include, but are not limited to, sodium and potassium salts.
  • a prodrug can include the incorporation of additional nucleosides at one or both ends of an antisense compound which are cleaved by endogenous nucleases within the body, to form the active antisense compound.
  • Antisense compounds may be covalently linked to one or more moieties or conjugates which enhance the activity, cellular distribution or cellular uptake of the resulting antisense oligonucleotides.
  • Typical conjugate groups include cholesterol moieties and lipid moieties.
  • Additional conjugate groups include carbohydrates, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes.
  • Antisense compounds can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of antisense compounds to enhance properties such as, for example, nuclease stability. Included in stabilizing groups are cap structures. These terminal modifications protect the antisense compound having terminal nucleic acid from exonuclease degradation, and can help in delivery and/or localization within a cell. The cap can be present at the 5'-terminus (5'-cap), or at the 3'-terminus (3 - cap), or can be present on both termini. Cap structures are well known in the art and include, for example, inverted deoxy abasic caps. Further 3' and 5 '-stabilizing groups that can be used to cap one or both ends of an antisense compound to impart nuclease stability include those disclosed in WO 03/004602 published on January 16, 2003. Certain Antisense Compounds
  • antisense compounds useful for treating B-cell lymphoma at the doses and dosing regimens described above include any of the antisense oligonucleotides described in WO 2012/135736, which is incorporated by reference in its entirety herein.
  • antisense compounds described in WO 2012/135736 suitable for treating B-cell lymphoma include, but are not limited to, those described in Tables 1 & 2 below:
  • one or more pharmaceutical compositions provided herein are co-administered with one or more other pharmaceutical agents.
  • such one or more other pharmaceutical agents are designed to treat the same disease, disorder, or condition as the one or more pharmaceutical compositions provided herein.
  • such one or more other pharmaceutical agents are designed to treat a different disease, disorder, or condition as the one or more pharmaceutical compositions provided herein.
  • such one or more other pharmaceutical agents are designed to treat an undesired side effect of one or more pharmaceutical compositions provided herein.
  • one or more pharmaceutical compositions provided herein are co-administered with another pharmaceutical agent to treat an undesired effect of that other pharmaceutical agent.
  • one or more pharmaceutical compositions provided herein are co- administered with another pharmaceutical agent to produce a combinational effect. In certain embodiments, one or more pharmaceutical compositions provided herein are coadministered with another pharmaceutical agent to produce a synergistic effect.
  • one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are administered at the same time. In certain embodiments, one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are administered at different times. In certain embodiments, one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are prepared together in a single formulation. In certain embodiments, one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are prepared separately.
  • one or more other pharmaceutical agents include all-trans retinoic acid, azacitidine, azathioprine, bleomycin, carboplatin, capecitabine, cisplatin, chlorambucil, cyclophosphamide, cytarabine, daunorubicin, docetaxel, doxifluridine, doxorubicin, epirubicin, epothilone, etoposide, fluorouracil, gemcitabine, hydroxyurea, idarubicin, imatinib, mechlorethamine, mercaptopurine, methotrexate, mitoxantrone, oxaliplatin, paclitaxel, pemetrexed, teniposide, tioguanine, valrubicin, vinblastine, vincristine, vindesine, or vinorelbine.
  • one or more other pharmaceutical agents include a combination of cyclophosphamide, hydroxydanuorubicin, Oncovin (vincristine), prednisone or prednisolone (CHOP).
  • one or more other pharmaceutical agents include a combination of rituximab and CHOP (R-CHOP).
  • one or more other pharmaceutical agents include another antisense oligonucleotide.
  • another antisense oligonucleotide is a second STAT3 antisense oligonucleotide.
  • one or more other pharmaceutical agents include molecular targeted therapies.
  • the molecular targeted therapy is an EGFR inhibitor, a mTOR inhibitor, a HER2 inhibitor, or a VEGF/VEGFR inhibitor.
  • EGFR inhibitors include gefitinib, erlotinib, lapatinib, cetuximab, panitumumbo.
  • mTOR inhibitors include everolimus and temsirolimus.
  • HER2 inhibitors include trastuzumab and lapatinib.
  • VEGF/VEGFR inhibitors include pazopanib, bevacizumab, sunitinib, and sorafenib.
  • one more pharmaceutical compositions provided herein are administered with radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered at the same time as radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered before radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered after radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered at various time points throughout a radiation therapy regimen.
  • radiation therapy is useful for inhibiting tumor growth. In certain embodiments, radiation therapy is useful for increasing overall survival. In certain embodiments, radiation therapy used in conjunction with administration of one or more pharmaceuticals provided herein is advantageous over using either therapy alone because both radiation therapy and administration with one or more pharmaceuticals can be limited to achieve effective antiproliferative response with limited toxicity.
  • a physician designs a therapy regimen including both radiation therapy and administration of one more pharmaceutical compositions provided herein. In certain embodiments, a physician designs a therapy regimen including radiation therapy, administration of one or more pharmaceutical compositions provided herein, and administration of one or more other chemotherapeutic agents.
  • Example 1 Phase 1, open-label, study for treating a patient having advanced B cell lymphoma with a STAT3 antisense oligonucleotide
  • the criteria for patient inclusion with respect to their tumor status was that the tumors should be relapsed or refractory to at least one prior anti-cancer systemic therapy, and/or for which no standard therapy exists; that their disease should be measurable or evaluable, according to RECIST version 1.1 for solid tumors, or according to the International Workshop Response Criteria for Non-Hodgkin's Lymphoma for NHL tumors (Cheson, B.D. et al., J. Clin. Oncol. 1999, 17: 1244; Cheson, B.D. et al., J. Clin. Oncol. 2007, 25(5):579-86), or according to appropriate criteria for other advanced cancers.
  • RECIST Response Evaluation Criteria in Solid Tumors
  • RECIST Response Evaluation Criteria in Solid Tumors
  • Patient #1001 One patient fitting the criteria above is a 63 year old female with DLBCL designated herein as Patient #1001.
  • Patient #1001 Prior to commencing therapy, Patient #1001 showed multiple areas of hypermetabolic adenopathy, both above and below the diaphragm, including the supraclavicular, left paratracheal, right internal mammary, pericardial, left intra-mammary, pre-hepatic, retroperitoneal, and mesenteric regions.
  • the patient also noted 5-6 days of right-sided abdominal fullness and associated pain.
  • Patient therapy was commenced with a treatment period comprising administration during a first phase of 3 loading doses of ISIS 481464: a 3-hr intravenous infusion of 2 mg/kg ideal body weight of ISIS 481464 administered on days 1, 3, and 5 of cycle 0.
  • Treatment was then continued in a second phase by once-weekly administrations (Cycle 1 and beyond) of 2 mg/kg ideal body weight of ISIS 481464 until disease progression, unacceptable toxicity, or patient discontinuation for any other reason occurred.
  • Disease assessments were performed at the end of even cycles.
  • Tumor lesions were evaluated on each even-numbered cycle, starting with Cycle 2, day 15, by positron emission tomography (PET) scan.
  • PET positron emission tomography
  • a complete tumor response is achieved when all target lesions have disappeared.
  • Partial response is achieved when the sum of the diameters of all tumor lesions is reduced at least 30% compared to the sum of the tumor lesion diameters at pre-dose. The sum of the lesion diameters, if any, was calculated, per RECIST guidelines (Eisenhauer, E.A. et al, Eur. J. Cancer 45: 228-247, 2009).
  • ISIS 481464 After 28 days of treatment with ISIS 481464, the patient reported reduced fatigue and night sweats, and was tolerating the treatment well.
  • Patient #1001 After 133 days of treatment with ISIS 481464, Patient #1001 had a third PET scan and the partial response was found to be maintained at a 55% reduction in tumor size. After 162 days of treatment with ISIS 481464, further treatment was paused for a month during which Patient #1001 had a fourth PET scan, and the partial response was maintained at a 55% reduction in tumor size. Patient #1001 is scheduled for further scans.
  • Example 2 Phase 1, open-label, study for treating a patient having
  • AZD9150 will be administered to patients with advanced/metastatic hepatocellular carcinoma at a starting dose of 1 mg/kg intravenously 3x during week 1 followed by lx weekly and dose intensity will be escalated or de-escalated in subsequent cohorts through modification of unit dose administered and/or interval of administraion to determine a maximum tolerated dose and recommended phase II dose in patients with advanced/metastatic hepatocellular carcinoma (HCC).

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Abstract

In certain embodiments, methods, compounds, and compositions for treating B-cell lymphoma or hepatocellular carcinoma by inhibiting expression of ST AT3 mRNA or protein in an animal are provided herein. Such methods, compounds, and compositions are useful to treat, prevent, or ameliorate B-celllymphoma or hepatocellular carcinoma. The STAT (signal transducers and activators of transcription) family of proteins are DNA-binding proteins that play a dual role in signal transduction and activation of transcription.

Description

CANCER TREATMENT
Sequence Listing
The present application is being filed along with a Sequence Listing in electronic format. The Sequence Listing is provided as a file entitled BIOL0216USL2SEQ.txt created March 12, 2013, which is 124 kb in size. The information in the electronic format of the sequence listing is incorporated herein by reference in its entirety.
Field
In certain embodiments, methods, compounds, and compositions for treating B-cell lymphoma by inhibiting expression of STAT3 mR A or protein in an animal are provided herein. Such methods, compounds, and compositions are useful to treat, prevent, or ameliorate B-cell lymphoma or hepatocellular carcinoma.
Background
The STAT (signal transducers and activators of transcription) family of proteins are DNA-binding proteins that play a dual role in signal transduction and activation of transcription. Presently, there are six distinct members of the STAT family (STAT1 , STAT2, STAT3, STAT4, STAT5, and STAT6) and several isoforms (STAT la, STATip, STAT3a and STAT3P). The activities of the STATs are modulated by various cytokines and mitogenic stimuli. Binding of a cytokine to its receptor results in the activation of Janus protein tyrosine kinases (JAKs) associated with these receptors. This phosphorylates STAT, resulting in translocation to the nucleus and transcriptional activation of STAT responsive genes. Phosphorylation on a specific tyrosine residue on the STATs results in their activation, resulting in the formation of homodimers and/or heterodimers of STAT which bind to specific gene promoter sequences. Events mediated by cytokines through STAT activation include cell proliferation and differentiation and prevention of apoptosis. The specificity of STAT activation is due to specific cytokines, i.e., each STAT is responsive to a small number of specific cytokines. Other non-cytokine signaling molecules, such as growth factors, have also been found to activate STATs. Binding of these factors to a cell surface receptor associated with protein tyrosine kinase also results in phosphorylation of STAT. STAT3 (also acute phase response factor (APRF)), in particular, has been found to be responsive to interleukin-6 (IL-6) as well as epidermal growth factor (EGF) (Darnell, Jr., J.E., et al, Science, 1994, 264, 1415-1421). In addition, STAT3 has been found to have an important role in signal transduction by interferons (Yang, C.-H., et al, Proc. Natl. Acad. Sci. USA, 1998, 95, 5568-5572). Evidence exists suggesting that STAT3 may be regulated by the MAPK pathway. ERK2 induces serine phosphorylation and also associates with STAT3 (Jain, N., et al, Oncogene, 1998, 17, 3157-3167).
STAT3 is expressed in most cell types (Zhong, Z., et al, Proc. Natl. Acad. Sci. USA, 1994, 91, 4806-4810). It induces the expression of genes involved in response to tissue injury and inflammation. STAT3 has also been shown to prevent apoptosis through the expression of bcl-2 (Fukada, T., et al, Immunity, 1996, 5, 449-460). Recently, STAT3 was detected in the mitochondria of transformed cells, and was shown to facilitate glycolytic and oxidative phosphorylation activities similar to that of cancer cells (Gough, D.J., et al, Science, 2009, 324, 1713-1716). The inhibition of STAT3 in the mitochondria impaired malignant transformation by activated Ras. The data confirms a Ras-mediated transformation function for STAT3 in the mitochondria in addition to its nuclear roles.
Aberrant expression of or constitutive expression of STAT3 is associated with a number of disease processes.
Summary
B-cell lymphoma is a B-lymphocyte blood cell cancer that is clinically classified as either Hodgkin's lymphoma or non-Hodgkin's lymphoma. There are several types of non- Hodgkin's lymphoma, of which diffuse large B-cell lymphoma (DLBCL) is the most common type, accounting for approximately 30 percent of all lymphomas. In the United States, DLBCL affects about 7 out of 100,000 people each year.
Several embodiments provided herein relate to the discovery that inhibiting the JAK-STAT signaling pathway can be useful for treating B-cell lymphoma. In certain embodiments, antisense compounds targeting STAT3 are useful for treating B-cell lymphoma, such as DLBCL, at unexpectedly low doses for an antisense compound as a cancer therapeutic. In several embodiments, antisense compounds targeting STAT3 provided herein are administered to a subject having B-cell lymphoma at a fixed total weekly dose in the range of about 15-750 mg. In certain embodiments, antisense compounds targeting STAT3 provided herein are administered to a subject having B-cell lymphoma in the range of about 0.2 to 3.5 milligrams of the antisense compound per kilogram of the subject's body weight per week (0.2-3.5 mg/kg/wk). Such dose ranges are unexpectedly low for treating cancer. By comparison, a Phase 1 study of LY2275796, an antisense oligonucleotide targeted to cap-binding protein eukaryotic initiation factor 4E (eIF-4E), concluded that the maximum tolerable dose (MTD) and biologically effective dose (BED) of LY2275796 is 1 ,000 mg under a loading and maintenance dose regimen, but even at a 1,000 mg dose, no tumor response was observed. (Hong D.S. et al., Clin Cancer Res. 2011 17(20):6582-91).
Detailed Description
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed. Herein, the use of the singular includes the plural unless specifically stated otherwise. As used herein, the use of the term "or" means "and/or", unless stated otherwise. Furthermore, the use of the term "including" as well as other forms, such as "includes" and "included", is not limiting. Also, terms such as "element" or "component" encompass both elements and components comprising one unit and elements and components that comprise more than one subunit, unless specifically stated otherwise.
The section headings used herein are for organizational purposes only and are not to be construed as limiting the subject matter described. All documents, or portions of documents, cited in this application, including, but not limited to, patents, patent applications, articles, books, and treatises, are hereby expressly incorporated by reference for the portions of the document discussed herein, as well as in their entirety.
Definitions
Unless specific definitions are provided, the nomenclature utilized in connection with, and the procedures and techniques of, analytical chemistry, synthetic organic chemistry, and medicinal and pharmaceutical chemistry described herein are those well known and commonly used in the art. Standard techniques may be used for chemical synthesis, and chemical analysis. Where permitted, all patents, applications, published applications and other publications, GENBANK Accession Numbers and associated sequence information obtainable through databases such as National Center for Biotechnology Information (NCBI) and other data referred to throughout in the disclosure herein are incorporated by reference for the portions of the document discussed herein, as well as in their entirety. Unless otherwise indicated, the following terms have the following meanings:
"2'-deoxynucleoside" means a nucleoside comprising 2'-H furanosyl sugar moiety, as found naturally occurring in deoxyribonucleosides (DNA). In certain embodiments, a 2'-deoxynucleoside may comprise a modified nucleobase or may comprise an RNA nucleobase (e.g., uracil).
"2'-0-methoxyethyl" (also 2'-MOE and 2 '-0(CH2)2-OCH3) refers to an O- methoxy-ethyl modification of the 2' position of a furosyl ring. A 2'-0-methoxyethyl modified sugar is a modified sugar.
"2'-MOE nucleoside" (also 2'-0-methoxyethyl nucleoside) means a nucleoside comprising a 2'-MOE modified sugar moiety.
"2 '-substituted nucleoside" means a nucleoside comprising a substituent at the 2'- position other than H or OH. Unless otherwise indicated, a 2 '-substituted nucleoside is not a bicyclic nucleoside.
"5'-methylcytosine" means a cytosine modified with a methyl group attached to the 5' position. A 5-methylcytosine is a modified nucleobase.
"About" as applied to dosing amounts means within ±12% of a value. For example, if it is stated, "the dose is an amount in the range of about 15-750 mg," it is implied that the dose is an amount in the range of 13-840 mg. In another example, if it is stated that the dose is an amount of "about 50 mg," it is implied that the dose can be from 44 mg to 56 mg. "About" as applied to activity levels means within ±10% of a value. For example, if it is stated, "the compounds affected at least about 70% inhibition of STAT3", it is implied that the STAT3 levels are inhibited within a range of 63% and 77%.
"Active pharmaceutical agent" means the substance or substances in a pharmaceutical composition that provide a therapeutic benefit when administered to an individual. For example, in certain embodiments an antisense oligonucleotide targeted to STAT3 is an active pharmaceutical agent.
"Active target region" or "target region" means a region to which one or more active antisense compounds is targeted. "Active antisense compounds" means antisense compounds that reduce target nucleic acid levels or protein levels. "Administered concomitantly" refers to the co-administration of two agents in any manner in which the pharmacological effects of both are manifest in the patient at the same time. Concomitant administration does not require that both agents be administered in a single pharmaceutical composition, in the same dosage form, or by the same route of administration. The effects of both agents need not manifest themselves at the same time. The effects need only be overlapping for a period of time and need not be coextensive. "Administering" means providing a pharmaceutical agent to an individual, and includes, but is not limited to administering by a medical professional and self- administering.
"Amelioration" refers to a lessening of at least one indicator, sign, or symptom of an associated disease, disorder, or condition. The severity of indicators may be determined by subjective or objective measures, which are known to those skilled in the art.
"Animal" refers to a human or non-human animal, including, but not limited to, mice, rats, rabbits, dogs, cats, pigs, and non-human primates, including, but not limited to, monkeys and chimpanzees.
"Antisense activity" means any detectable or measurable activity attributable to the hybridization of an antisense compound to its target nucleic acid. In certain embodiments, antisense activity is a decrease in the amount or expression of a target nucleic acid or protein encoded by such target nucleic acid.
"Antisense compound" means an oligomeric compound that is is capable of undergoing hybridization to a target nucleic acid through hydrogen bonding. Examples of antisense compounds include single-stranded and double-stranded compounds, such as, antisense oligonucleotides, siR As, and shR As.
"Antisense inhibition" means reduction of target nucleic acid levels or target protein levels in the presence of an antisense compound complementary to a target nucleic acid as compared to target nucleic acid levels or target protein levels in the absence of the antisense compound.
"Antisense oligonucleotide" means a single-stranded oligonucleotide having a nucleobase sequence that permits hybridization to a corresponding region or segment of a target nucleic acid.
"Bicyclic sugar" means a furosyl ring modified by the bridging of two atoms. A bicyclic sugar is a modified sugar. "Bicyclic nucleoside" (also BNA) means a nucleoside having a sugar moiety comprising a bridge connecting two carbon atoms of the sugar ring, thereby forming a bicyclic ring system. In certain embodiments, the bridge connects the 4 '-carbon and the 2'-carbon of the sugar ring. "Cap structure" or "terminal cap moiety" means chemical modifications, which have been incorporated at either terminus of an antisense compound.
"cEt" or "constrained ethyl" means a bicyclic nucleoside having a sugar moiety comprising a bridge connecting the 4 '-carbon and the 2 '-carbon, wherein the bridge has the formula: 4'-CH(CH3)-0-2'. "Constrained ethyl nucleoside" (also cEt nucleoside) means a nucleoside comprising a bicyclic sugar moiety comprising a 4'-CH(CH3)-0-2' bridge.
"Chemically distinct region" refers to a region of an antisense compound that is in some way chemically different than another region of the same antisense compound. For example, a region having 2 '-0-methoxyethyl nucleotides is chemically distinct from a region having nucleotides without 2'-0-methoxyethyl modifications.
"Chimeric antisense compound" means an antisense compound that has at least two chemically distinct regions.
"Co-administration" means administration of two or more pharmaceutical agents to an individual. The two or more pharmaceutical agents may be in a single pharmaceutical composition, or may be in separate pharmaceutical compositions. Each of the two or more pharmaceutical agents may be administered through the same or different routes of administration. Co-administration encompasses parallel or sequential administration.
"Complementarity" means the capacity for pairing between nucleobases of a first nucleic acid and a second nucleic acid. "Contiguous nucleobases" means nucleobases immediately adjacent to each other.
"Diluent" means an ingredient in a composition that lacks pharmacological activity, but is pharmaceutically necessary or desirable. For example, the diluent in an injected composition may be a liquid, e.g. saline solution.
"Dose" means a specified quantity of a pharmaceutical agent provided in a single administration, or in a specified time period. In certain embodiments, a dose may be administered in one, two, or more boluses, tablets, or injections. For example, in certain embodiments where subcutaneous administration is desired, the desired dose requires a volume not easily accommodated by a single injection, therefore, two or more injections may be used to achieve the desired dose. In certain embodiments, the pharmaceutical agent is administered by infusion over an extended period of time or continuously. Doses may be stated as the amount of pharmaceutical agent per hour, day, week, or month. In certain embodiments, single dose means administration of one dose, and only one dose, to a subject.
"Dosage unit" means a form in which a pharmaceutical agent is provided. In certain embodiments, a dosage unit is a vial containing lyophilized ISIS 481464. In certain embodiments, a dosage unit is a vial containing reconstituted ISIS 481464.
"Dosing regimen" is a combination of doses designed to achieve one or more desired effects. In certain embodiments, a dose regimen is designed to provide a therapeutic effect quickly.
"Duration" means the period of time during which an activity or event continues. For example, the duration of a loading phase is the period of time during which loading doses are administered. For example, the duration of the maintenance phase is the period of time during which maintenance doses are administered.
"Effective amount" means the amount of active pharmaceutical agent sufficient to effectuate a desired physiological outcome in an individual in need of the agent. The effective amount may vary among individuals depending on the health and physical condition of the individual to be treated, the taxonomic group of the individuals to be treated, the formulation of the composition, assessment of the individual's medical condition, and other relevant factors.
"First phase" means a dosing phase during which administration is initiated and steady state concentrations of pharmaceutical agents can be, but is not necessarily, achieved in a target tissue. "Second phase" means a dosing phase after the "first phase." In certain embodiments, the dose or total weekly dose of the first phase and the second phase are different.
"Fully complementary" or "100% complementary" means each nucleobase of a first nucleic acid has a complementary nucleobase in a second nucleic acid. In certain embodiments, a first nucleic acid is an antisense compound and a target nucleic acid is a second nucleic acid. "Gapmer" means a chimeric antisense compound in which an internal region having a plurality of nucleosides that support RNase H cleavage is positioned between external regions having one or more nucleosides, wherein the nucleosides comprising the internal region are chemically distinct from the nucleoside or nucleosides comprising the external regions. The internal region may be referred to as the "gap" and the external regions may be referred to as the "wings."
"Gap-widened" means a chimeric antisense compound having a gap segment of 12 or more contiguous 2'-deoxyribonucleosides positioned between and immediately adjacent to 5' and 3' wing segments having from one to six nucleosides. "HCC" means hepatocellular carcinoma. It is the most common form of liver cancer and also referred to as malignant hepatoma.
"Hybridization" means the annealing of complementary nucleic acid molecules. In certain embodiments, complementary nucleic acid molecules include an antisense compound and a target nucleic acid. "Hyperproliferative disease" means a disease characterized by rapid or excessive growth and reproduction of cells. Examples of hyperproliferative diseases include cancer, e.g., carcinomas, sarcomas, lymphomas, and leukemias as well as associated malignancies and metastases.
"Identifying an animal at risk for hyperproliferative disease" means identifying an animal having been diagnosed with a hyperproliferative disease or identifying an animal predisposed to develop a hyperproliferative disease. Individuals predisposed to develop a hyperproliferative disease include those having one or more risk factors for hyperproliferative disease including older age; history of other hyperproliferative diseases; history of tobacco use; history of exposure to sunlight and/or ionizing radiation; prior contact with certain chemicals, especially continuous contact; past or current infection with certain viruses and bacteria; prior or current use of certain hormone therapies; genetic predisposition; alcohol use; and certain lifestyle choices including poor diet, lack of physical activity, and/or being overweight. Such identification may be accomplished by any method including evaluating an individual's medical history and standard clinical tests or assessments.
"Immediately adjacent" means there are no intervening elements between the immediately adjacent elements. "Inhibiting STAT3" means reducing expression of STAT3 mRNA and/or protein levels in the presence of a STAT3 antisense compound, including a STAT3 antisense oligonucleotide, as compared to expression of STAT3 mRNA and/or protein levels in the absence of a STAT3 antisense compound, such as an antisense oligonucleotide. "Individual" means a human or non-human animal selected for treatment or therapy.
"Internucleoside linkage" refers to the chemical bond between nucleosides.
"ISIS 481464" means a STAT3 antisense oligonucleotide having the nucleobase sequence "CTATTTGGATGTCAGC", incorporated herein as SEQ ID NO: 12, where each internucleoside linkage is a phosphorothioate internucleoside linkage, each cytosine is a 5- methylcytosine, and each of nucleosides 1-3 and 14-16 comprise a cEt moeity. ISIS 481464 is complementary to nucleobases 3016-3031 of the sequence of GENBANK Accession No. NM_139276.2, incorporated herein as SEQ ID NO: l.
"Linked nucleosides" means adjacent nucleosides which are bonded together. "Loading phase" means a dosing phase during which administration is initiated and steady state concentrations of pharmaceutical agents are achieved in a target tissue. For example, a loading phase is a dosing phase during which steady state concentrations of antisense oligonucleotide are achieved in liver.
"Maintenance phase" means a dosing phase after target tissue steady state concentrations of pharmaceutical agents have been achieved. For example, a maintenance phase is a dosing phase after which steady state concentrations of antisense oligonucleotide are achieved in liver.
"Mismatch" or "non-complementary nucleobase" refers to the case when a nucleobase of a first nucleic acid is not capable of pairing with the corresponding nucleobase of a second or target nucleic acid.
"Modified internucleoside linkage" refers to a substitution or any change from a naturally occurring internucleoside bond (i.e. a phosphodiester internucleoside bond).
"Modified nucleobase" refers to any nucleobase other than adenine, cytosine, guanine, thymidine, or uracil. An "unmodified nucleobase" means the purine bases adenine (A) and guanine (G), and the pyrimidine bases thymine (T), cytosine (C), and uracil (U). "Modified nucleotide" means a nucleotide having, independently, a modified sugar moiety, modified internucleoside linkage, or modified nucleobase. A "modified nucleoside" means a nucleoside having, independently, a modified sugar moiety or modified nucleobase.
"Modified oligonucleotide" means an oligonucleotide comprising a modified internucleoside linkage, a modified sugar, and/or a modified nucleobase.
"Modified sugar" refers to a substitution or change from a natural sugar.
"Motif means the pattern of chemically distinct regions in an antisense compound.
"Naturally occurring internucleoside linkage" means a 3' to 5' phosphodiester linkage.
"Natural sugar moiety" means a sugar found in DNA (2'-H) or RNA (2'-OH).
"Nucleic acid" refers to molecules composed of monomeric nucleotides. A nucleic acid includes ribonucleic acids (RNA), deoxyribonucleic acids (DNA), single-stranded nucleic acids, double-stranded nucleic acids, small interfering ribonucleic acids (siRNA), and microRNAs (miRNA).
"Nucleobase" means a heterocyclic moiety capable of pairing with a base of another nucleic acid.
"Nucleobase sequence" means the order of contiguous nucleobases independent of any sugar, linkage, or nucleobase modification.
"Nucleoside" means a nucleobase linked to a sugar.
"Nucleoside mimetic" includes those structures used to replace the sugar or the sugar and the base and not necessarily the linkage at one or more positions of an oligomeric compound such as for example nucleoside mimetics having morpholino, cyclohexenyl, cyclohexyl, tetrahydropyranyl, bicyclo or tricyclo sugar mimetics, e.g., non furanose sugar units. Nucleotide mimetic includes those structures used to replace the nucleoside and the linkage at one or more positions of an oligomeric compound such as for example peptide nucleic acids or morpholinos (morpholinos linked by -N(H)-C(=0)-0- or other non-phosphodiester linkage). Sugar surrogate overlaps with the slightly broader term nucleoside mimetic but is intended to indicate replacement of the sugar unit (furanose ring) only. The tetrahydropyranyl rings provided herein are illustrative of an example of a sugar surrogate wherein the furanose sugar group has been replaced with a tetrahydropyranyl ring system.
"Nucleotide" means a nucleoside having a phosphate group covalently linked to the sugar portion of the nucleoside. "Off-target effect" refers to an unwanted or deleterious biological effect associated with modulation of RNA or protein expression of a gene other than the intended target nucleic acid.
"Oligomeric compound" or "oligomer" means a polymer of linked monomeric subunits which is capable of hybridizing to at least a region of a nucleic acid molecule. "Oligonucleotide" means a polymer of linked nucleosides each of which can be modified or unmodified, independent one from another.
"Parenteral administration" means administration through injection (e.g., bolus injection) or infusion. Parenteral administration includes subcutaneous administration, intravenous administration, intramuscular administration, intraarterial administration, intraperitoneal administration, or intracranial administration, e.g. , intrathecal or intracerebroventricular administration.
"Peptide" means a molecule formed by linking at least two amino acids by amide bonds. Peptide refers to polypeptides and proteins.
"Pharmaceutical composition" means a mixture of substances suitable for administering to an individual. For example, a pharmaceutical composition may comprise one or more active pharmaceutical agents and a sterile aqueous solution. In certain embodiments, a pharmaceutical composition shows activity in free uptake assay in certain cell lines.
"Pharmaceutically acceptable derivative" encompasses pharmaceutically acceptable salts, conjugates, prodrugs or isomers of the compounds described herein.
"Pharmaceutically acceptable salts" means physiologically and pharmaceutically acceptable salts of antisense compounds, i.e., salts that retain the desired biological activity of the parent oligonucleotide and do not impart undesired toxico logical effects thereto.
"Phosphorothioate linkage" means a linkage between nucleosides where the phosphodiester bond is modified by replacing one of the non-bridging oxygen atoms with a sulfur atom. A phosphorothioate linkage (P=S) is a modified internucleoside linkage. "Portion" means a defined number of contiguous (i.e., linked) nucleobases of a nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of a target nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of an antisense compound. "Prevent" refers to delaying or forestalling the onset or development of a disease, disorder, or condition for a period of time from minutes to indefinitely. Prevent also means reducing risk of developing a disease, disorder, or condition.
"Prodrug" means a therapeutic agent that is prepared in an inactive form that is converted to an active form within the body or cells thereof by the action of endogenous enzymes or other chemicals or conditions.
"Side effects" means physiological responses attributable to a treatment other than the desired effects. In certain embodiments, side effects include injection site reactions, liver function test abnormalities, renal function abnormalities, liver toxicity, renal toxicity, central nervous system abnormalities, myopathies, and malaise. For example, increased aminotransferase levels in serum may indicate liver toxicity or liver function abnormality. For example, increased bilirubin may indicate liver toxicity or liver function abnormality.
"Signal Transducer and Activator of Transcription 3 nucleic acid" or "STAT3 nucleic acid" means any nucleic acid encoding STAT3. For example, in certain embodiments, a STAT3 nucleic acid includes a DNA sequence encoding STAT3, an RNA sequence transcribed from DNA encoding STAT3 (including genomic DNA comprising introns and exons), and an mRNA sequence encoding STAT3. "STAT3 mRNA" means an mRNA encoding a STAT3 protein.
"Single-stranded oligonucleotide" means an oligonucleotide which is not hybridized to a complementary strand. "Specifically hybridizable" refers to an antisense compound having a sufficient degree of complementarity between an antisense oligonucleotide and a target nucleic acid to induce a desired effect, while exhibiting minimal or no effects on non-target nucleic acids under conditions in which specific binding is desired, i.e., under physiological conditions in the case of in vivo assays and therapeutic treatments. "Subject" means a human selected for treatment or therapy. "Targeting" or "targeted" means the process of design and selection of an antisense compound that will specifically hybridize to a target nucleic acid and induce a desired effect.
"Target nucleic acid," "target RNA," "target mRNA," and "target RNA transcript" all refer to a nucleic acid capable of being targeted by antisense compounds.
"Target segment" means the sequence of nucleotides of a target nucleic acid to which an antisense compound is targeted. "5' target site" refers to the 5 '-most nucleotide of a target segment. "3' target site" refers to the 3 '-most nucleotide of a target segment.
"Therapeutically effective amount" means an amount of a pharmaceutical agent that provides a therapeutic benefit to an individual.
"Treat" refers to administering a pharmaceutical composition to effect an alteration or improvement of a disease, disorder, or condition.
"Unmodified nucleotide" means a nucleotide composed of naturally occuring nucleobases, sugar moieties, and internucleoside linkages. In certain embodiments, an unmodified nucleotide is an RNA nucleotide (i.e. β-D-ribonucleosides) or a DNA nucleotide (i.e. β-D-deoxyribonucleoside).
Certain Embodiments
In certain aspects, there is provided a method of treating cancer in a subject which comprises administering to the subject an inhibitor of the JAK-STAT pathway. In certain embodiments the cancer is B-cell lymphoma or hepatocellular carcinoma (HCC).
In certain aspects, there is provided a method of treating B-cell lymphoma in a subject which comprises administering to the subject an inhibitor of the JAK-STAT pathway.
In certain aspects, there is provided a method of treating cancer, such as B-cell lymphoma or HCC, in a subject which comprises administering to the subject a weekly dose of an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the dose comprises about 0.2 to 3.5 milligrams of the antisense compound per kilogram of the subject' s body weight per week (0.2-3.5 mg/kg/wk). In certain embodiments, the dose is about 0.2 mg, about 0.3 mg, about 0.4 mg, about 0.5 mg, about 0.6 mg, about 0.7 mg, about 0.8 mg, about 0.9 mg, about 1.0 mg, about 1.1 mg, about 1.2 mg, about 1.3 mg, about 1.4 mg, about 1.5 mg, about 1.6 mg, about 1.7 mg, about 1.8 mg, about 1.9 mg, about 2.0 mg, about 2.1 mg, about 2.2 mg, about 2.3 mg, about 2.4 mg, about 2.5 mg, about 2.6 mg, about 2.7 mg, about 2.8 mg, about 2.9 mg, about 3.0 mg, about 3.1 mg, about 3.2 mg, about 3.3 mg, about 3.4 mg, or about 3.5 mg of the antisense compound per kilogram of the subject's body weight. In certain embodiments, the dose comprises about 1.5 to 3.5 milligrams of the antisense compound per kilogram of the subject's body weight ( 1 .5-3.5 mg/kg/wk. In certain embodiments, the dose is 2.0 milligrams of the antisense compound per kilogram of the subject's body weight per week (2.0 mg/kg/wk). In certain embodiments, the dose is effective to treat cancer and acceptably tolerable. The dose can be administered for at least 1-52 weeks, at least 1-10 weeks, at least 1-7 weeks, at least 1-5 weeks, at least 5 weeks, at least 6 weeks, or at least 7 weeks. In certain embodiments, the dose can be administered to the subject 1, 2, 3, 4, 5, 6, or 7 times per week. In certain embodiments, the dose is administered to the subject 1-6 times per week. In several embodiments, the dose can be administered 6 times during the first week and 1 time each subsequent week. In certain embodiments, the subject's body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a single dose of a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the single dose comprises an amount of the compound in the range of about 15-250 mg. In certain embodiments, the single dose comprises an amount of the compound in the range of about 100-250 mg. In certain embodiments, the single dose is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg. In certain embodiments, the dose is effective to treat cancer and acceptably tolerable. In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a total weekly dose of a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the total weekly dose comprises an amount of the compound in the range of about 15-750 mg weekly. In certain embodiments, the total weekly dose comprises an amount of the compound in the range of about 100-750 mg weekly. In certain embodiments, the total weekly dose is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg. In certain embodiments, the dose is effective to treat cancer and acceptably tolerable. The total weekly dose can be administered in 2, 3, 4, 5, 6, or 7 equal doses within a week, such that the total weekly dose does not exceed about 750 mg. In certain embodiments, the total weekly dose is administered in 3 equal doses within a week. It will be understood that the aforementioned total weekly dose ranges can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose by an average adult body weight of 70 kg, in certain embodiments the total weekly dose can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, the total weekly dose can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (4.6 mg/kg/wk), about 350 mg/70 kg (5.0 mg/kg/wk), about 375 mg/70 kg (5.4 mg/kg/wk), about 400 mg/70 kg (5.7 mg/kg/wk), about 425 mg/70 kg (6.1 mg/kg/wk), about 450 mg/70 kg (6.4 mg/kg/wk), about 475 mg/70 kg (6.8 mg/kg/wk), about 500 mg/70 kg (7.1 mg/kg/wk), about 525 mg/70 kg (7.5 mg/kg/wk), about 550 mg/70 kg (7.9 mg/kg/wk), about 575 mg/70 kg (8.2 mg/kg/wk), about 600 mg/70 kg (8.6 mg/kg/wk), about 625 mg/70 kg (8.9 mg/kg/wk), about 650 mg/70 kg (9.3 mg/kg/wk), about 675 mg/70 kg (9.6 mg/kg/wk), about 700 mg/70 kg (10.0 mg/kg/wk), about 725 mg/70 kg (10.4 mg/kg/wk), or about 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain aspects, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase comprising a total weekly dose in the range of about 15-750 mg for the first 1-10 weeks, and a maintenance phase comprising a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase.
In certain embodiments, the loading phase is 1 week, 2 weeks, 3 weeks, 4 weeks, or 5 weeks. In certain embodiments, the loading phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week. In certain embodiments, the loading phase comprises administering the compound in 3 equal doses within a week. In several embodiments, the total weekly dose of the antisense compound in the loading phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg. It will be understood that the aforementioned total weekly dose ranges in the loading phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose in the loading phase by an average adult body weight of 70 kg, in certain embodiments the total weekly dose can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, the total weekly dose in the loading phase can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (4.6 mg/kg/wk), about 350 mg/70 kg (5.0 mg/kg/wk), about 375 mg/70 kg (5.4 mg/kg/wk), about 400 mg/70 kg (5.7 mg/kg/wk), about 425 mg/70 kg (6.1 mg/kg/wk), about 450 mg/70 kg (6.4 mg/kg/wk), about 475 mg/70 kg (6.8 mg/kg/wk), about 500 mg/70 kg (7.1 mg/kg/wk), about 525 mg/70 kg (7.5 mg/kg/wk), about 550 mg/70 kg (7.9 mg/kg/wk), about 575 mg/70 kg (8.2 mg/kg/wk), about 600 mg/70 kg (8.6 mg/kg/wk), about 625 mg/70 kg (8.9 mg/kg/wk), about 650 mg/70 kg (9.3 mg/kg/wk), about 675 mg/70 kg (9.6 mg/kg/wk), about 700 mg/70 kg (10.0 mg/kg/wk), about 725 mg/70 kg (10.4 mg/kg/wk), or about 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066- 1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, the maintenance phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week. In several embodiments, the total weekly dose of the antisense compound in the maintenance phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg. In certain embodiments, the total weekly dose in the maintenance phase is administered as a single dose per week. It will be understood that the aforementioned total weekly dose ranges in the maintenance phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose by an average adult body weight of 70 kg, in certain embodiments the total weekly dose in the maintenance phase can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 250 mg/70 kg (3.6 mg/kg/wk). In certain embodiments, the total weekly dose can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), or about 250 mg/70 kg (3.6 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase about 6, 7, 8, 9, or 10 weeks, and a maintenance phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase. In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase comprising a dose in the range of about 3 to 4 mg/kg/wk for about 6, 7, 8, 9, or 10 weeks, and a maintenance phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase. In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet. In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a loading phase comprising a dose of about 3 mg/kg/wk for about 8 weeks, and a maintenance phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase. In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase comprising a total weekly dose in the range of about 15-750 mg for the first 1-10 weeks, and a second phase comprising a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase.
In certain embodiments, the first phase is 1 week, 2 weeks, 3 weeks, 4 weeks, or 5 weeks. In certain embodiments, the first phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week. In certain embodiments, the first phase comprises administering the compound in 3 equal doses within a week. In several embodiments, the total weekly dose of the antisense compound in the first phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg. It will be understood that the aforementioned total weekly dose ranges in the first phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose in the first phase by an average adult body weight of 70 kg, in certain embodiments the total weekly dose can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, the total weekly dose in the first phase can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (4.6 mg/kg/wk), about 350 mg/70 kg (5.0 mg/kg/wk), about 375 mg/70 kg (5.4 mg/kg/wk), about 400 mg/70 kg (5.7 mg/kg/wk), about 425 mg/70 kg (6.1 mg/kg/wk), about 450 mg/70 kg (6.4 mg/kg/wk), about 475 mg/70 kg (6.8 mg/kg/wk), about 500 mg/70 kg (7.1 mg/kg/wk), about 525 mg/70 kg (7.5 mg/kg/wk), about 550 mg/70 kg (7.9 mg/kg/wk), about 575 mg/70 kg (8.2 mg/kg/wk), about 600 mg/70 kg (8.6 mg/kg/wk), about 625 mg/70 kg (8.9 mg/kg/wk), about 650 mg/70 kg (9.3 mg/kg/wk), about 675 mg/70 kg (9.6 mg/kg/wk), about 700 mg/70 kg (10.0 mg/kg/wk), about 725 mg/70 kg (10.4 mg/kg/wk), or about 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, the second phase comprises administering the compound in 2, 3, 4, 5, 6, or 7 equal doses within a week. In several embodiments, the total weekly dose of the antisense compound in the second phase is an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 1 10 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg. In certain embodiments, the total weekly dose in the second phase is administered as a single dose per week. It will be understood that the aforementioned total weekly dose ranges in the second phase can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the total weekly dose by the subject's body weight, such as the subject's ideal body weight. For example, dividing the aforementioned total weekly dose by an average adult body weight of 70 kg, in certain embodiments the total weekly dose in the second phase can be represented as an amount of about 15 mg/70 kg (0.2 mg/kg/wk) to 250 mg/70 kg (3.6 mg/kg/wk). In certain embodiments, the total weekly dose can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), or about 250 mg/70 kg (3.6 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase for about 6, 7, 8, 9, or 10 weeks, and a second phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase. In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066- 1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase comprising a dose in the range of about 3 to 4 mg/kg/wk for about 6, 7, 8, 9, or 10 weeks, and a second phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase. In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066- 1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, a method comprises administering to a subject having cancer, such as B-cell lymphoma or HCC, a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises: a first phase comprising a dose of about 3 mg/kg/wk for about 8 weeks, and a second phase comprising a dose of about 2 mg/kg/wk for at least 1 week after the loading phase. In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066- 1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In any of the above embodiments, the B-cell lymphoma is a non-Hodgkin's B-cell lymphoma. Examples of non-Hodgkin's B-cell lymphoma of certain aspects include, but are not limited to, diffuse large B cell lymphoma (DLBCL), follicular lymphoma, mucosa- associated lymphatic tissue lymphoma (MALT), small cell lymphocytic lymphoma, chronic lymphocytic leukemia, mantle cell lymphoma (MCL), Burkitt lymphoma, mediastinal large B cell lymphoma, Waldenstrom macroglobulinemia, nodal marginal zone B cell lymphoma (NMZL), splenic marginal zone lymphoma (SMZL), intravascular large B-cell lymphoma, primary effusion lymphoma, and lymphomatoid granulomatosis. In certain embodiments, the non-Hodgkin's B-cell lymphoma is diffuse large B cell lymphoma (DLBCL).
In any of the above embodiments, the B-cell lymphoma is Hodgkin's B-cell lymphoma. In any of the foregoing embodiments, administering the dose of the antisense compound reduces tumor size or tumor volume in the subject. In certain embodiments, administering the dose of the antisense compound prolongs survival of the subject. In certain embodiments, administering the dose of the antisense compound treats cancer, such as B-cell lymphoma, in the subject. In any of the above embodiments, the method is effective to treat cancer and acceptably tolerable in a subject.
In certain of the foregoing embodiments, the subject is identified as having cancer, such as B-cell lymphoma, prior to administering the antisense compound to the subject. In certain embodiments, the subject identified as having cancer, such as B-cell lymphoma, received or is currently receiving anti-cancer treatment, such as a first-line treatment regimen. For example, in certain embodiments the first-line treatment regimen is a combination of cyclophosphamide, hydroxydanuorubicin, Oncovin (vincristine), prednisone or prednisolone (CHOP). In certain embodiments, the first-line treatment regimen is a combination of rituximab and CHOP (R-CHOP). In certain embodiments, the subject is refractory to a first-line treatment regimen such as CHOP and/or R-CHOP.
In any of the foregoing embodiments, the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 3008 to 3033 of SEQ ID NO: 1, wherein the nucleobase sequence is complementary to SEQ ID NO: 1.
In any of the foregoing embodiment, the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 3016 to 3031 of SEQ ID NO: 1, wherein the nucleobase sequence is complementary to SEQ ID NO: 1.
In any of the foregoing embodiments, the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 6476 to 6491 of SEQ ID NO: 2, wherein the nucleobase sequence is complementary to SEQ ID NO: 2.
In any of the foregoing embodiments, the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 250-286; 250-285; 264-285; 264-282; 728-745; 729- 745; 729-744; 787-803; 867-883; 955-978; 1146-1170; 1896-1920; 1899-1920; 1899- 1919; 1899-1918; 1899-1916; 1901-1916; 1946-1963; 1947-1963; 2155-2205; 2155-2187; 2156-2179; 2204-2221; 2681-2696; 2699-2716; 3001-3033; 3008-3033, 3010-3033, 3010- 3032, 3015-3033, 3015-3032, 3015-3031, 3016-3033, 3016-3032, 3016-3033; 3452-3499; 3460-3476; 3583-3608; 3591-3616; 3595-3615; 3595-3614; 3595-3612; 3675-3706; 3713- 3790; 3715-3735; 3833-3878; 3889-3932; 3977-4012; 4067-4100; 4225-4256; 4234-4252; 4235-4252; 4235-4251; 4236-4252; 4306-4341; 4431-4456; 4439-4454; 4471-4510; 4488- 4505; 4530-4558; 4539-4572; 4541-4558; 4636-4801; 4782-4796; 4800-4823; 4811-4847; 4813-4859; 4813-4815; 4813-4831; 4827-4859; 4827-4844; or 4842-4859 of SEQ ID NO: 1, wherein the nucleobase sequence of the modified oligonucleotide is complementary to SEQ ID NO: 1.
In any of the foregoing embodiments, the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 2668-2688; 2703-2720; 5000-5021; 5001-5017; 5697- 5722; 5699-5716; 6475 - 6490; 6475 - 6491 ; 6476 - 6491; 7682-7705; 8078-8097; 8079- 8095; 9862-9811 ; 9870-9897; 9875-9893; 9875-9891; 9877-9893; 11699-11719; 12342- 12366; 12345-12364;12346-12364; 12347-12364; 12353-12380; 12357-12376; 12358- 12376; 12358-12373; 12360-12376; 14128-14148; 16863-16883; 46091-46111; 50692- 50709; 50693-50709; 50693-50708; 61325-61349; 66133-66157; 66136-66157; 66136 - 66155; 66136-66153; 66138-66153; 66184-66200; 67067-67083; 4171-74220; 74199- 74220; 74202-74220; 74171-74219; 74199-74219; 74202-74219; 74171-74218; 74199- 74218; 74202-74218; 74723-74768; 74764-74803; 74782-74802; 74782-74801; 74782- 74800; 74782-74799; 74783-74802; 74783-74801; 74783-74800; 74783-74799; 74862- 74893; 74900-74977; 74902-74922; 74902-74920; 75070-75119; 75164-75199; 75254- 75287; 75412-75443; 75421-75439; 75422-75439; 75422-75438; 75423-75439; 75423- 75438; 75493-75528; 75616-75643; 75626-75641; 75658-75699; 75676-75692; 75717- 75745; 75726-75759; 75726-75745; 75727-75745; 75728-75745; 75831-75988; 75852- 75969; 75969-75984; 75987-76056; 76000-76046; 76000-76032; 76000-76018; 76014- 76046; 76014-76032; 76029-76046; or 76031-76046 of SEQ ID NO: 2, wherein the nucleobase sequence of the modified oligonucleotide is complementary to SEQ ID NO: 2.
In certain embodiments, the nucleobase sequence of the modified oligonucleotide comprises the sequence of SEQ ID NO: 12 or consists of the sequence of SEQ ID NO: 12. In certain embodiments, the modified oligonucleotide is 100% complementary to SEQ ID NO: 1 or 2. In certain embodiments, the nucleobase sequence of the modified oligonucleotide comprises the sequence of any of the STAT3 antisense oligonucleotides described in WO 2012/135736, which is incorporated by reference in its entirety herein. In certain embodiments, the modified oligonucleotide is a single-stranded modified oligonucleotide. In certain embodiments, the modified oligonucleotide comprises at least one modified internucleoside linkage. In several embodiments, each internucleoside linkage is a phosphorothioate internucleoside linkage. In certain embodiments, at least one nucleoside comprises a modified sugar, such as a bicyclic sugar including, but not limited to, a 4'- CH2-0-2 ' bridge or a 4 '-CH(CH3)-0-2' bridge. In certain embodiments, the modified sugar comprises a 2'-0(CH2)2-OCH3 group. In certain embodiments, at least one nucleoside comprises a modified nucleobase, such as a 5- methylcytosine. In certain embodiments, the modified oligonucleotide comprises: a 5 '-wing consisting of 1 to 5 linked nucleosides; a 3 '-wing consisting of 1 to 5 linked nucleosides; and a gap between the 5 '-wing and the 3 '-wing consisting of 8 to 12 linked 2 '- deoxynucleosides; wherein at least one of the 5 '-wing and the 3 '-wing comprises at least one bicyclic nucleoside or one 2 '-substituted nucleoside. In certain embodiments, the 2 '-substituted nucleoside comprises a 2'-0(CH2)2-OCH3 group or a 2 '-0-CH3 group. In certain embodiments, the bicyclic nucleoside comprises a 4'- CH2-0-2' bridge or a 4'-CH(CH3)- 0-2' bridge. In certain embodiments, pharmaceutical compositions described herein are administered in the form of a dosage unit (e.g., injection, infusion, etc.). In certain embodiments, such pharmaceutical compositions comprise an antisense oligonucleotide in an amount of any of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg. It will be understood that the aforementioned amounts of antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week. For example, dividing the aforementioned amounts by an average adult body weight of 70 kg, in certain embodiments the dosage unit can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (4.6 mg/kg/wk), about 350 mg/70 kg (5.0 mg/kg/wk), about 375 mg/70 kg (5.4 mg/kg/wk), about 400 mg/70 kg (5.7 mg/kg/wk), about 425 mg/70 kg (6.1 mg/kg/wk), about 450 mg/70 kg (6.4 mg/kg/wk), about 475 mg/70 kg (6.8 mg/kg/wk), about 500 mg/70 kg (7.1 mg/kg/wk), about 525 mg/70 kg (7.5 mg/kg/wk), about 550 mg/70 kg (7.9 mg/kg/wk), about 575 mg/70 kg (8.2 mg/kg/wk), about 600 mg/70 kg (8.6 mg/kg/wk), about 625 mg/70 kg (8.9 mg/kg/wk), about 650 mg/70 kg (9.3 mg/kg/wk), about 675 mg/70 kg (9.6 mg/kg/wk), about 700 mg/70 kg (10.0 mg/kg/wk), about 725 mg/70 kg (10.4 mg/kg/wk), or about 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464.
In certain embodiments, pharmaceutical compositions described herein comprise a dose of antisense oligonucleotide in an amount in the range of about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg. It will be understood that the aforementioned amounts of antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week. For example, dividing the aforementioned amounts by an average adult body weight of 70 kg, in certain embodiments the dose of antisense oligonucleotide can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (4.6 mg/kg/wk), about 350 mg/70 kg (5.0 mg/kg/wk), about 375 mg/70 kg (5.4 mg/kg/wk), about 400 mg/70 kg (5.7 mg/kg/wk), about 425 mg/70 kg (6.1 mg/kg/wk), about 450 mg/70 kg (6.4 mg/kg/wk), about 475 mg/70 kg (6.8 mg/kg/wk), about 500 mg/70 kg (7.1 mg/kg/wk), about 525 mg/70 kg (7.5 mg/kg/wk), about 550 mg/70 kg (7.9 mg/kg/wk), about 575 mg/70 kg (8.2 mg/kg/wk), about 600 mg/70 kg (8.6 mg/kg/wk), about 625 mg/70 kg (8.9 mg/kg/wk), about 650 mg/70 kg (9.3 mg/kg/wk), about 675 mg/70 kg (9.6 mg/kg/wk), about 700 mg/70 kg (10.0 mg/kg/wk), about 725 mg/70 kg (10.4 mg/kg/wk), or about 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
The compositions described herein may additionally contain other adjunct components conventionally found in pharmaceutical compositions, at their art-established usage levels. Thus, for example, the compositions may contain additional, compatible, pharmaceutically-active materials such as, for example, antipruritics, astringents, local anesthetics or anti-inflammatory agents. However, such materials, when added, should not unduly interfere with the biological activities of the components of the compositions described herein. The formulations can be sterilized and, if desired, mixed with auxiliary agents, e.g., preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings, and/or aromatic substances and the like which do not deleteriously interact with the oligonucleotide(s) of the formulation.
Antisense oligonucleotides may be covalently linked to one or more moieties or conjugates which enhance the activity, cellular distribution or cellular uptake of the antisense oligonucleotides. Typical conjugate groups include cholesterol moieties and lipid moieties. Additional conjugate groups include carbohydrates, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes. Antisense oligonucleotides can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of antisense compounds to enhance properties such as, for example, nuclease stability. Included in stabilizing groups are cap structures. These terminal modifications protect the antisense oligonucleotide having terminal nucleic acid from exonuclease degradation, and can help in delivery and/or localization within a cell. The cap can be present at the 5'-terminus (5'-cap), or at the 3'- terminus (3'-cap), or can be present on both termini. Cap structures are well known in the art and include, for example, inverted deoxy abasic caps. Further 3' and 5 '-stabilizing groups that can be used to cap one or both ends of an antisense compound to impart nuclease stability include those disclosed in WO 03/004602 published on January 16, 2003.
Certain treatments
In certain aspects there is provided a method of treating a subject suffering from cancer comprising administering to the subject an antisense compound complementary to human STAT3. In certain embodiments the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736.
In certain embodiments the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma. In certain aspects there is provided an antisense compound complementary to human STAT3 for use in treating cancer. In certain embodiments the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736. In certain embodiments the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma.
In certain aspects there is provided an antisense compound complementary to human STAT3 for use in a method of treating cancer in a subject in need thereof, wherein the method comprises administering to the subject the antisense compound in a loading phase and then a maintenance phase, wherein the loading phase involves administering a total weekly dose of the compound in the range of about 15-750 mg for the first 1-10 weeks, and the maintenance phase involves administering a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase. In certain embodiments the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736. In certain embodiments the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma. Certain aspects are directed to use of an antisense compound complementary to human STAT3 for the manufacture of a medicament for treating cancer. In certain embodiments the antisense compound complementary to human STAT3 is as described herein or as disclosed in WO2012/135736. In certain embodiments the cancer is selected from B-cell lymphoma or hepatocellularcarcinoma.
In particular embodiments of any of these aspects, the B-cell lymphoma is a non- Hodgkin's B-cell lymphoma. Examples of non-Hodgkin's B-cell lymphoma of certain aspects include, but are not limited to, diffuse large B cell lymphoma (DLBCL), follicular lymphoma, mucosa-associated lymphatic tissue lymphoma (MALT), small cell lymphocytic lymphoma, chronic lymphocytic leukemia, mantle cell lymphoma (MCL), Burkitt lymphoma, mediastinal large B cell lymphoma, Waldenstrom macroglobulinemia, nodal marginal zone B cell lymphoma (NMZL), splenic marginal zone lymphoma (SMZL), intravascular large B-cell lymphoma, primary effusion lymphoma, and lymphomatoid granulomatosis. In certain embodiments, the non-Hodgkin's B-cell lymphoma is diffuse large B cell lymphoma (DLBCL).
Certain Dosing Regimens
In certain embodiments, pharmaceutical compositions are administered according to a dosing regimen. In certain such embodiments, the dosing regimen comprises a loading phase and a maintenance phase. In certain such embodiments, the dosing regimen is effective to treat cancer and acceptably tolerable in a subject. In certain embodiments, the pharmaceutical composition comprises an antisense oligonucleotide . In certain embodiments, the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464.
In certain embodiments, the loading phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 , 12, 13, 14, 15, 16, 17, 18, 19, or more than 20 doses.
In certain embodiments, the loading phase lasts from 1 day to 6 months. In certain embodiments a loading phase lasts 1 day, 2 days, 3, days, 4, days, 5 days, 6 days, or 7 days as measured from administration of the first dose of the loading phase to administration of the first dose of the maintenance phase. In certain embodiments a loading phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, or 26 weeks as measured from administration of the first dose of the loading phase to administration of the first dose of the maintenance phase. In certain embodiments, the loading phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, or 6 months as measured from administration of the first dose of the loading phase to administration of the first dose of the maintenance phase.
In certain embodiments, the dose administered during the loading phase is lower than the dose administered during the maintenance phase. In certain embodiments, the dose administered during the loading phase is lower than the dose administered during the maintenance phase to avoid undesired side effects. In certain embodiments, the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
In certain embodiments, the dose administered during the loading phase is higher than the dose administered during the maintenance phase. In certain embodiments, the dose administered during the loading phase is higher than the dose administered during the maintenance phase to quickly achieve steady state reduction of STAT3 mR A expression, STAT3 protein expression, and/or STAT3 activity. In certain embodiments, the dose administered during the loading phase is higher than the dose administered during the maintenance phase to avoid undesired side effects in the maintenance phase. In certain embodiments, the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
In certain embodiments where the loading phase includes more than one dose, the doses administered during the loading phase are all the same amount as one another. In certain embodiments, the doses administered during the loading phase are not all the same amount. In certain embodiments, the doses given during the loading phase increase over time. In certain embodiments, the doses given during the loading phase decrease over time. In certain embodiments, a loading dose is administered by parenteral administration. In certain embodiments, the parenteral administration is subcutaneous administration. In certain embodiments, the parenteral administration is intravenous infusion.
In certain embodiments, the doses administered during the loading phase are about 0.2 mg, about 0.3 mg, about 0.4 mg, about 0.5 mg, about 0.6 mg, about 0.7 mg, about 0.8 mg, about 0.9 mg, about 1.0 mg, about 1.1 mg, about 1.2 mg, about 1.3 mg, about 1.4 mg, about 1.5 mg, about 1.6 mg, about 1.7 mg, about 1.8 mg, about 1.9 mg, about 2.0 mg, about 2.1 mg, about 2.2 mg, about 2.3 mg, about 2.4 mg, about 2.5 mg, about 2.6 mg, about 2.7 mg, about 2.8 mg, about 2.9 mg, about 3.0 mg, about 3.1 mg, about 3.2 mg, about 3.3 mg, about 3.4 mg, or about 3.5 mg of the antisense compound per kilogram of the subject's body weight. In certain embodiments, the dose is 2.0 milligrams of the antisense compound per kilogram of the subject's body weight per week (2.0 mg/kg/wk). In certain embodiments, the subject's body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066- 1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet. In certain embodiments, the doses administered during the loading phase are about
15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, or about 750 mg. It will be understood that the aforementioned doses of antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week. For example, dividing the aforementioned amounts by an average adult body weight of 70 kg, in certain embodiments the doses can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), about 250 mg/70 kg (3.6 mg/kg/wk), about 275 mg/70 kg (3.9 mg/kg/wk), about 300 mg/70 kg (4.3 mg/kg/wk), about 325 mg/70 kg (4.6 mg/kg/wk), about 350 mg/70 kg (5.0 mg/kg/wk), about 375 mg/70 kg (5.4 mg/kg/wk), about 400 mg/70 kg (5.7 mg/kg/wk), about 425 mg/70 kg (6.1 mg/kg/wk), about 450 mg/70 kg (6.4 mg/kg/wk), about 475 mg/70 kg (6.8 mg/kg/wk), about 500 mg/70 kg (7.1 mg/kg/wk), about 525 mg/70 kg (7.5 mg/kg/wk), about 550 mg/70 kg (7.9 mg/kg/wk), about 575 mg/70 kg (8.2 mg/kg/wk), about 600 mg/70 kg (8.6 mg/kg/wk), about 625 mg/70 kg (8.9 mg/kg/wk), about 650 mg/70 kg (9.3 mg/kg/wk), about 675 mg/70 kg (9.6 mg/kg/wk), about 700 mg/70 kg (10.0 mg/kg/wk), about 725 mg/70 kg (10.4 mg/kg/wk), or about 750 mg/70 kg (10.7 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet.
In certain embodiments, dose, dose frequency, and duration of the loading phase may be selected to achieve a desired effect. In certain embodiments, those variables are adjusted to result in a desired concentration of pharmaceutical agent in a subject. For example, in certain embodiments, dose and dose frequency are adjusted to provide plasma concentration of a pharmaceutical agent at an amount sufficient to achieve a desired effect. In certain embodiments, the plasma concentration is maintained above the minimal effective concentration (MEC). In certain embodiments, pharmaceutical compositions described herein are administered with a dosage regimen designed to maintain a concentration above the MEC for 10-90% of the time, between 30-90% of the time, or between 50-90% of the time. In certain embodiments, the pharmaceutical composition comprises an antisense oligonucleotide. In certain embodiments, the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464.
In certain embodiments, doses, dose frequency, and duration of the loading phase may be selected to achieve a desired plasma trough concentration of a pharmaceutical composition. In certain embodiments, the pharmaceutical composition comprises an antisense oligonucleotide. In certain embodiments, the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO : 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464. In certain embodiments, the desired plasma trough concentration is from 5-100 ng/mL. In certain embodiments, the desired plasma trough concentration is from 5-50 ng/mL. In certain embodiments, the desired plasma trough concentration is from 10-40 ng/mL. In certain embodiments, the desired plasma trough concentration is from 15-35 ng/mL. In certain embodiments, the desired plasma trough concentration is from 20-30 ng/mL.
In certain embodiments, dose, dose frequency, and duration of the loading phase may be selected to achieve a desired effect within 1 to 26 weeks. In certain embodiments, the dose is the same and the dose frequency is varied to achieve the desired effect within 1 to 26 weeks. In certain embodiments, the dose increases over time and the dose frequency remains constant. In certain embodiments, one or more doses of the loading phase are greater than one or more doses of the maintenance phase. In certain embodiments, each of the loading doses is greater than each of the maintenance doses. In certain embodiments, it is desirable to achieve a desired effect as quickly as possible. In certain embodiments, a loading phase with a high dose and/or high dose frequency may be desirable.
In certain embodiments, doses, dose frequency, and duration of the loading phase may be selected to achieve an acceptable safety profile. For example, in certain embodiments, such variables may be selected to mitigate toxicity of the pharmaceutical composition. In certain embodiments, such variables are selected to mitigate liver toxicity. In certain embodiments, such variables are selected to mitigate renal toxicity. In certain embodiments, such variables are selected to mitigate thrombocytopenia or neutropenia.
In certain embodiments, doses increase over time. In certain embodiments, one or more doses of the loading phase are lower than one or more doses of the maintenance phase. In certain embodiments, a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal. In certain embodiments, a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal, and bilirubin is elevated two or more times the upper limit of normal. In certain embodiments, an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal. In certain embodiments, an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal, and bilirubin elevations that do not exceed two times the upper limit of normal. In certain embodiments, when administration of a pharmaceutical composition of the invention results in ALT elevations that are above three times the upper limit of normal, the dose and/or dose frequency is adjusted to mitigate the ALT elevation.
In certain embodiments, the maintenance phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more than 20 doses. In certain embodiments, the maintenance phase lasts from one day to the lifetime of the subject. In certain embodiments, the maintenance phase lasts 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, or 7 days as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase. In certain embodiments, the maintenance phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, 26 weeks, 27 weeks, 28 weeks, 29 weeks, 30 weeks, 31 weeks, 32 weeks, 33 weeks, 34 weeks, 35 weeks, 36 weeks, 37 weeks, 38 weeks, 39 weeks, 40 weeks, 41 weeks, 42 weeks, 43 weeks, 44 weeks, 45 weeks, 46 weeks, 47 weeks, 48 weeks, 49 weeks, 50 weeks, 5 1 weeks, or 52 weeks as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase. In certain embodiments, the maintenance phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, or 12 months as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase. In certain embodiments, the maintenance phase lasts 1 year, 2 years, 3 years, 4 years, 5 years, 6 years, 7 years, 8 years, 9 years, 10 years, 1 1 years, 12 years, 13 years, 14 years, 15 years, 16 years, 17 years, 18 years, 19 years, 20 years, 21 years, 22 years, 23 years, 24 years, 25 years, 26 years, 27 years, 28 years, 29 years, 30 years, 31 years, 32 years, 33 years, 34 years 35 years, 36 years, 37 years, 38 years, 39 years, 40 years, 41 years, 42 years, 43 years, 44 years, 45 years, 46 years, 47 years, 48 years, 49 years, or 50 years as measured from administration of the last dose of the loading phase to administration of the last dose of the maintenance phase. In certain embodiments, the maintenance phase lasts as long as the dose continues to be needed, effective, and tolerated.
In certain embodiments where the maintenance phase includes more than one dose, the doses administered during the maintenance phase are all the same as one another. In certain embodiments, the doses administered during the maintenance phase are not all the same. In certain embodiments, the doses increase over time. In certain embodiments, the doses decrease over time.
In certain embodiments, a maintenance dose is administered by parenteral administration. In certain embodiments, the parenteral administration is subcutaneous administration. In certain embodiments, the parenteral administration is intravenous infusion.
In certain embodiments, the doses during the maintenance phase are about 0.2 mg, about 0.3 mg, about 0.4 mg, about 0.5 mg, about 0.6 mg, about 0.7 mg, about 0.8 mg, about 0.9 mg, about 1.0 mg, about 1.1 mg, about 1.2 mg, about 1.3 mg, about 1.4 mg, about 1.5 mg, about 1.6 mg, about 1.7 mg, about 1.8 mg, about 1.9 mg, about 2.0 mg, about 2.1 mg, about 2.2 mg, about 2.3 mg, about 2.4 mg, about 2.5 mg, about 2.6 mg, about 2.7 mg, about 2.8 mg, about 2.9 mg, about 3.0 mg, about 3.1 mg, about 3.2 mg, about 3.3 mg, about 3.4 mg, or about 3.5 mg of the antisense compound per kilogram of the subject's body weight. In certain embodiments, the dose is 2.0 milligrams of the antisense compound per kilogram of the subject's body weight per week (2.0 mg/kg/wk). In certain embodiments, the subject's body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066- 1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet. In certain embodiments, the doses during the maintenance phase are about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg, about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 210 mg, about 220 mg, about 230 mg, about 240 mg, or about 250 mg. It will be understood that the aforementioned doses of antisense oligonucleotide can be readily represented as milligrams of the antisense compound per kilogram of the subject's body weight per week (mg/kg/wk) by simply dividing the amount by the subject's body weight per week. For example, dividing the aforementioned amounts by an average adult body weight of 70 kg, in certain embodiments the doses can be represented as any of about 15 mg/70 kg (0.2 mg/kg/wk), about 20 mg/70 kg (0.3 mg/kg/wk), about 30 mg/70 kg (0.4 mg/kg/wk), about 40 mg/70 kg (0.6 mg/kg/wk), about 50 mg/70 kg (0.7 mg/kg/wk), about 75 mg/70 kg (1.1 mg/kg/wk), about 100 mg/70 kg (1.4 mg/kg/wk), about 125 mg/70 kg (1.8 mg/kg/wk), about 150 mg/70 kg (2.1 mg/kg/wk), about 175 mg/70 kg (2.5 mg/kg/wk), about 200 mg/70 kg (2.9 mg/kg/wk), about 225 mg/70 kg (3.2 mg/kg/wk), or about 250 mg/70 kg (3.6 mg/kg/wk). In certain embodiments, body weight is calculated as the ideal body weight using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet. In certain embodiments, doses, dose frequency, and duration of the maintenance phase may be selected to achieve a desired effect. In certain embodiments, those variables are adjusted to result in a desired concentration of pharmaceutical agent in a subject. For example, in certain embodiments, dose and dose frequency are adjusted to provide plasma concentration of a pharmaceutical agent described herein at an amount sufficient to achieve a desired effect. In certain embodiments, the plasma concentration is maintained above the minimal effective concentration (MEC). In certain embodiments, pharmaceutical compositions described herein are administered with a dosage regimen designed to maintain a concentration above the MEC for 10-90% of the time, between 30-90% of the time, or between 50-90% of the time.
In certain embodiments, doses, dose frequency, and duration of the maintenance phase may be selected to achieve a desired plasma trough concentration of a pharmaceutical composition. In certain embodiments, the pharmaceutical composition is an antisense oligonucleotide. In certain embodiments, the desired plasma trough concentration is from 5-100 ng/mL. In certain embodiments, the desired plasma trough concentration is from 5-50 ng/mL. In certain embodiments, the desired plasma trough concentration is from 10-40 ng/mL. In certain embodiments, the desired plasma trough concentration is from 15-35 ng/mL. In certain embodiments, the desired plasma trough concentration is from 20-30 ng/mL. In certain embodiments, doses, dose frequency, and duration of the maintenance phase may be selected to achieve a desired safety profile. For example, in certain embodiments, such variables may be selected to mitigate toxicity of the pharmaceutical composition. In certain embodiments, such variables are selected to mitigate liver toxicity. In certain embodiments, such variables are selected to mitigate renal toxicity. In certain embodiments, such variables are selected to mitigate thrombocytopenia or neutropenia.
In certain embodiments, doses, dose frequency, and duration of the maintenance phase may be adjusted from time to time to achieve a desired effect. In certain embodiments, subjects are monitored for effects (therapeutic and/or toxic effects) and doses, dose frequency, and/or duration of the maintenance phase may be adjusted based on the results of such monitoring.
In certain embodiments, pharmaceutical compositions are administered according to a dosing regimen comprising a first phase and a second phase. In certain embodiments, the pharmaceutical composition comprises an antisense oligonucleotide. In certain embodiments, the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464.
In certain embodiments, the first phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or more than 20 doses.
In certain embodiments, the first phase lasts from 1 day to 6 months. In certain embodiments a first phase lasts 1 day, 2 days, 3, days, 4, days, 5 days, 6 days, or 7 days as measured from administration of the first dose of the first phase to administration of the first dose of the second phase. In certain embodiments a first phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, or 26 weeks as measured from administration of the first dose of the first phase to administration of the first dose of the second phase. In certain embodiments, the first phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, or 6 months as measured from administration of the first dose of the first phase to administration of the first dose of the second phase.
In certain embodiments, the dose administered during the first phase is lower than the dose administered during the second phase. In certain embodiments, the dose administered during the first phase is lower than the dose administered during the second phase to avoid undesired side effects. In certain embodiments, the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
In certain embodiments, the dose administered during the first phase is higher than the dose administered during the second phase. In certain embodiments, the dose administered during the first phase is higher than the dose administered during the second phase to quickly achieve steady state reduction of STAT3 mRNA expression, STAT3 protein expression, and/or STAT3 activity. In certain embodiments, the dose administered during the first phase is higher than the dose administered during the second phase to avoid undesired side effects in the second phase. In certain embodiments, the undesired side effect is increased liver markers. In certain embodiments, the undesired side effect is increased ALT. In certain embodiments, the undesired side effect is increased AST. In certain embodiments, the undesired side effect is thrombocytopenia or neutropenia.
In certain embodiments where the first phase includes more than one dose, the doses administered during the first phase are all the same amount as one another. In certain embodiments, the doses administered during the first phase are not all the same amount. In certain embodiments, the doses given during the first phase increase over time. In certain embodiments, the doses given during the first phase decrease over time.
In certain embodiments, a first dose is administered by parenteral administration. In certain embodiments, the parenteral administration is subcutaneous administration. In certain embodiments, the parenteral administration is intravenous infusion. The range of dosages capable of being administered during the "first phase" and/or
"second phase" are the same as can be used for the "loading phase" and "maintenance phase" referred to above. In certain embodiments, dose, dose frequency, and duration of the first phase and/or second phase may be selected to achieve a desired effect. In certain embodiments, those variables are adjusted to result in a desired concentration of pharmaceutical agent in a subject. For example, in certain embodiments, dose and dose frequency are adjusted to provide plasma concentration of a pharmaceutical agent at an amount sufficient to achieve a desired effect. In certain embodiments, the plasma concentration is maintained above the minimal effective concentration (MEC). In certain embodiments, pharmaceutical compositions described herein are administered with a dosage regimen designed to maintain a concentration above the MEC for 10-90% of the time, between 30-90% of the time, or between 50-90% of the time. In certain embodiments, the pharmaceutical composition comprises an antisense oligonucleotide. In certain embodiments, the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464. In certain embodiments, doses, dose frequency, and duration of the first phase and/or second phase may be selected to achieve a desired plasma trough concentration of a pharmaceutical composition. In certain embodiments, the pharmaceutical composition comprises an antisense oligonucleotide. In certain embodiments, the antisense oligonucleotide has the nucleobase sequence of SEQ ID NO: 12. In certain embodiments, the antisense oligonucleotide is ISIS 481464. In certain embodiments, the desired plasma trough concentration is from 5-100 ng/mL. In certain embodiments, the desired plasma trough concentration is from 5-50 ng/mL. In certain embodiments, the desired plasma trough concentration is from 10-40 ng/mL. In certain embodiments, the desired plasma trough concentration is from 15-35 ng/mL. In certain embodiments, the desired plasma trough concentration is from 20-30 ng/mL.
In certain embodiments, dose, dose frequency, and duration of the first phase and/or second phase may be selected to achieve a desired effect within 1 to 26 weeks. In certain embodiments, the dose is the same and the dose frequency is varied to achieve the desired effect within 1 to 26 weeks. In certain embodiments, the dose increases over time and the dose frequency remains constant. In certain embodiments, one or more doses of the first phase are greater than one or more doses of the second phase. In certain embodiments, each of the first doses is greater than each of the second doses. In certain embodiments, it is desirable to achieve a desired effect as quickly as possible. In certain embodiments, a first phase with a high dose and/or high dose frequency may be desirable.
In certain embodiments, doses, dose frequency, and duration of the first phase and/or second phase may be selected to achieve an acceptable safety profile. For example, in certain embodiments, such variables may be selected to mitigate toxicity of the pharmaceutical composition. In certain embodiments, such variables are selected to mitigate liver toxicity. In certain embodiments, such variables are selected to mitigate renal toxicity. In certain embodiments, such variables are selected to mitigate thrombocytopenia or neutropenia.
In certain embodiments, doses increase over time. In certain embodiments, one or more doses of the first phase are lower than one or more doses of the second phase. In certain embodiments, a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal. In certain embodiments, a safety profile is not acceptable when ALT is 5-10 times the upper limit of normal, and bilirubin is elevated two or more times the upper limit of normal. In certain embodiments, an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal. In certain embodiments, an acceptable safety profile comprises ALT elevations that are above three times the upper limit of normal, but do not exceed five times the upper limit of normal, and bilirubin elevations that do not exceed two times the upper limit of normal. In certain embodiments, when administration of a pharmaceutical composition of the invention results in ALT elevations that are above three times the upper limit of normal, the dose and/or dose frequency is adjusted to mitigate the ALT elevation. In certain embodiments, the second phase includes 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more than 20 doses. In certain embodiments, the second phase lasts from one day to the lifetime of the subject. In certain embodiments, the second phase lasts 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, or 7 days as measured from administration of the last dose of the first phase to administration of the last dose of the second phase. In certain embodiments, the second phase lasts 1 week, 2 weeks, 3, weeks, 4, weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, 26 weeks, 27 weeks, 28 weeks, 29 weeks, 30 weeks, 31 weeks, 32 weeks, 33 weeks, 34 weeks, 35 weeks, 36 weeks, 37 weeks, 38 weeks, 39 weeks, 40 weeks, 41 weeks, 42 weeks, 43 weeks, 44 weeks, 45 weeks, 46 weeks, 47 weeks, 48 weeks, 49 weeks, 50 weeks, 51 weeks, or 52 weeks as measured from administration of the last dose of the first phase to administration of the last dose of the second phase. In certain embodiments, the second phase lasts 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, or 12 months as measured from administration of the last dose of the first phase to administration of the last dose of the second phase. In certain embodiments, the second phase lasts 1 year, 2 years, 3 years, 4 years, 5 years, 6 years, 7 years, 8 years, 9 years, 10 years, 1 1 years, 12 years, 13 years, 14 years, 15 years, 16 years, 17 years, 18 years, 19 years, 20 years, 21 years, 22 years, 23 years, 24 years, 25 years, 26 years, 27 years, 28 years, 29 years, 30 years, 31 years, 32 years, 33 years, 34 years 35 years, 36 years, 37 years, 38 years, 39 years, 40 years, 41 years, 42 years, 43 years, 44 years, 45 years, 46 years, 47 years, 48 years, 49 years, or 50 years as measured from administration of the last dose of the first phase to administration of the last dose of the second phase. In certain embodiments, the second phase lasts as long as the dose continues to be needed, effective, and tolerated. In certain embodiments where the second phase includes more than one dose, the doses administered during the second phase are all the same as one another. In certain embodiments, the doses administered during the second phase are not all the same. In certain embodiments, the doses increase over time. In certain embodiments, the doses decrease over time. In certain embodiments, a second dose is administered by parenteral administration.
In certain embodiments, the parenteral administration is subcutaneous administration. In certain embodiments, the parenteral administration is intravenous infusion.
Antisense compounds Oligomeric compounds include, but are not limited to, oligonucleotides, oligonucleosides, oligonucleotide analogs, oligonucleotide mimetics, antisense compounds, antisense oligonucleotides, and siRNAs. An oligomeric compound may be "antisense" to a target nucleic acid, meaning that is is capable of undergoing hybridization to a target nucleic acid through hydrogen bonding.
In certain embodiments, an antisense compound has a nucleobase sequence that, when written in the 5' to 3' direction, comprises the reverse complement of the target segment of a target nucleic acid to which it is targeted. In certain such embodiments, an antisense oligonucleotide has a nucleobase sequence that, when written in the 5' to 3' direction, comprises the reverse complement of the target segment of a target nucleic acid to which it is targeted.
In certain embodiments, an antisense compound targeted to a STAT3 nucleic acid is 12 to 30 subunits in length. In certain embodiments, an antisense compound targeted to a STAT3 nucleic acid is 14 to 30 subunits in length. In certain embodiments, an antisense compound targeted to a STAT3 nucleic acid is 12 to 22 subunits in length. In other words, such antisense compounds are from 12 to 30 linked subunits, 14 to 30 linked subunits, or 12 to 22 linked subunits, respectively. In other embodiments, the antisense compound is 8 to 80, 12 to 50, 13 to 30, 13 to 50, 14 to 30, 14 to 50, 15 to 30, 15 to 50, 16 to 30, 16 to 50, 17 to 30, 17 to 50, 18 to 22, 18 to 24, 18 to 30, 18 to 50, 19 to 22, 19 to 30, 19 to 50, or 20 to 30 linked subunits. In certain such embodiments, the antisense compounds are 8, 9, 10, 11 , 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, or 80 linked subunits in length, or a range defined by any two of the above values. In some embodiments, the antisense compound is an antisense oligonucleotide, and the linked subunits are nucleotides.
In certain embodiments, antisense oligonucleotides targeted to a STAT3 nucleic acid may be shortened or truncated. For example, a single subunit may be deleted from the 5' end (5' truncation), or alternatively from the 3' end (3' truncation). A shortened or truncated antisense compound targeted to a STAT3 nucleic acid may have two subunits deleted from the 5' end, or alternatively may have two subunits deleted from the 3' end, of the antisense compound. Alternatively, the deleted nucleosides may be dispersed throughout the antisense compound, for example, in an antisense compound having one nucleoside deleted from the 5' end and one nucleoside deleted from the 3' end.
When a single additional subunit is present in a lengthened antisense compound, the additional subunit may be located at the 5' or 3' end of the antisense compound. When two or more additional subunits are present, the added subunits may be adjacent to each other, for example, in an antisense compound having two subunits added to the 5' end (5 ' addition), or alternatively to the 3' end (3' addition), of the antisense compound. Alternatively, the added subunits may be dispersed throughout the antisense compound, for example, in an antisense compound having one subunit added to the 5' end and one subunit added to the 3 ' end.
It is possible to increase or decrease the length of an antisense compound, such as an antisense oligonucleotide, and/or introduce mismatch bases without eliminating activity. For example, in Woolf et al. (Proc. Natl. Acad. Sci. USA 89:7305-7309, 1992), a series of antisense oligonucleotides 13-25 nucleobases in length were tested for their ability to induce cleavage of a target RNA in an oocyte injection model. Antisense oligonucleotides 25 nucleobases in length with 8 or 1 1 mismatch bases near the ends of the antisense oligonucleotides were able to direct specific cleavage of the target mRNA, albeit to a lesser extent than the antisense oligonucleotides that contained no mismatches. Similarly, target specific cleavage was achieved using 13 nucleobase antisense oligonucleotides, including those with 1 or 3 mismatches.
Gautschi et al. (J. Natl. Cancer Inst. 93:463-471, March 2001) demonstrated the ability of an oligonucleotide having 100% complementarity to the bcl-2 mRNA and having 3 mismatches to the bcl-xL mRNA to reduce the expression of both bcl-2 and bcl-xL in vitro and in vivo. Furthermore, this oligonucleotide demonstrated potent anti-tumor activity in vivo.
Maher and Dolnick (Nuc. Acid. Res. 16:3341-3358,1988) tested a series of tandem 14 nucleobase antisense oligonucleotides, and a 28 and 42 nucleobase antisense oligonucleotides comprised of the sequence of two or three of the tandem antisense oligonucleotides, respectively, for their ability to arrest translation of human DHFR in a rabbit reticulocyte assay. Each of the three 14 nucleobase antisense oligonucleotides alone was able to inhibit translation, albeit at a more modest level than the 28 or 42 nucleobase antisense oligonucleotides. Antisense Compound Motifs
In certain embodiments, antisense compounds targeted to a STAT3 nucleic acid have chemically modified subunits arranged in patterns, or motifs, to confer to the antisense compounds properties such as enhanced inhibitory activity, increased binding affinity for a target nucleic acid, or resistance to degradation by in vivo nucleases.
Chimeric antisense compounds typically contain at least one region modified so as to confer increased resistance to nuclease degradation, increased cellular uptake, increased binding affinity for the target nucleic acid, and/or increased inhibitory activity. A second region of a chimeric antisense compound may optionally serve as a substrate for the cellular endonuclease RNase H, which cleaves the RNA strand of an RNA:DNA duplex.
Antisense compounds having a gapmer motif are considered chimeric antisense compounds. In a gapmer an internal region having a plurality of nucleotides that supports RNaseH cleavage is positioned between external regions having a plurality of nucleotides that are chemically distinct from the nucleosides of the internal region. In the case of an antisense oligonucleotide having a gapmer motif, the gap segment generally serves as the substrate for endonuclease cleavage, while the wing segments comprise modified nucleosides. In certain embodiments, the regions of a gapmer are differentiated by the types of sugar moieties comprising each distinct region. The types of sugar moieties that are used to differentiate the regions of a gapmer may in some embodiments include β-D- ribonucleosides, β-D-deoxyribonucleosides, 2'-modified nucleosides (such 2 '-modified nucleosides may include 2'-MOE and 2 '-0-CH3, among others), and bicyclic sugar modified nucleosides (such bicyclic sugar modified nucleosides may include those having a constrained ethyl). In certain embodiments, wings may include several modified sugar moieties, including, for example 2'-MOE and constrained ethyl. In certain embodiments, wings may include several modified and unmodified sugar moieties. In certain embodiments, wings may include various combinations of 2 '-MOE nucleosides, constrained ethyl nucleosides, and 2'-deoxynucleosides.
Each distinct region may comprise uniform sugar moieties, variants, or alternating sugar moieties. The wing-gap-wing motif is frequently described as "X-Y-Z", where "X" represents the length of the 5 '-wing, "Y" represents the length of the gap, and "Z" represents the length of the 3 '-wing. "X" and "Z" may comprise uniform, variant, or alternating sugar moieties. In certain embodiments, "X" and "Y" may include one or more 2'-deoxynucleosides. "Y" may comprise 2'-deoxynucleosides. As used herein, a gapmer described as "X-Y-Z" has a configuration such that the gap is positioned immediately adjacent to each of the 5 '-wing and the 3 ' wing. Thus, no intervening nucleotides exist between the 5 '-wing and gap, or the gap and the 3 '-wing. Any of the antisense compounds described herein can have a gapmer motif. In certain embodiments, "X" and "Z" are the same, in other embodiments they are different. In certain embodiments, Ύ" is between 8 and 15 nucleosides. X, Y, or Z can be any of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 1 1, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30 or more nucleosides. In certain embodiments, gapmers provided herein include, for example, 1 1-mers having a motif of 1-9-1.
In certain embodiments, gapmers provided herein include, for example, 12-mers having a motif of 1-9-2, 2-9-1, or 1-10-1.
In certain embodiments, gapmers provided herein include, for example, 13-mers having a motif of 1-9-3, 2-9-2, 3-9-1, 1-10-2, or 2-10-1.
In certain embodiments, gapmers provided herein include, for example, 14-mers having a motif of 1-9-4, 2-9-3, 3-9-2, 4-9-1, 1-10-3, 2-10-2, or 3-10-1.
In certain embodiments, gapmers provided herein include, for example, 15-mers having a motif of 1-9-5, 2-9-4, 3-9-3, 4-9-2, 5-9-1, 1-10-4, 2-10-3, 3-10-2, or 4-10-1. In certain embodiments, gapmers provided herein include, for example, 16-mers having a motif of 2-9-5, 3-9-4, 4-9-3, 5-9-2, 1-10-5, 2-10-4, 3-10-3, 4-10-2, or 5-10-1.
In certain embodiments, gapmers provided herein include, for example, 17-mers having a motif of 3-9-5, 4-9-4, 5-9-3, 2-10-5, 3-10-4, 4-10-3, or 5-10-2.
In certain embodiments, gapmers provided herein include, for example, 18-mers having a motif of 4-9-5, 5-9-4, 3-10-5, 4-10-4, or 5-10-3.
In certain embodiments, gapmers provided herein include, for example, 19-mers having a motif of 5-9-5, 4-10-5, or 5-10-4.
In certain embodiments, gapmers provided herein include, for example, 20-mers having a motif of 5-10-5. In certain embodiments, the antisense compound has a "wingmer" motif, having a wing-gap or gap-wing configuration, i.e. an X-Y or Y-Z configuration as described above for the gapmer configuration. Thus, wingmer configurations provided herein include, but are not limited to, for example 5-10, 8-4, 4-12, 12-4, 3-14, 16-2, 18-1, 10-3, 2-10, 1-10, 8- 2, 2-13, 5-13, 5-8, or 6-8.
In certain embodiments, antisense compound targeted to a STAT3 nucleic acid has a 2-10-2 gapmer motif.
In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a 3-10-3 gapmer motif. In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a 5-10-5 gapmer motif.
In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a 1-10-5 gapmer motif.
In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a 3 - 10-4 gapmer motif.
In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a 2-10-4 gapmer motif.
In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a 4-9-3 gapmer motif. In certain embodiments, the antisense compound targeted to a STAT3 nucleic acid has a gap-widened motif.
In certain embodiments, the antisense compounds targeted to a STAT3 nucleic acid has any of the following sugar motifs: k-d(10)-k e-d(10)-k k-d(10)-e k-k-d(10)-k-k k-k-d(10)-e-e e-e-d(10)-k-k k-k-k-d(10)-k-k-k e-e-e-d(10)-k-k-k k-k-k-d(10)-e-e-e k-k-k-d(10)-k-k-k e-k-k-d(10)-k-k-e e-e-k-d(10)-k-k-e e-d-k-d(10)-k-k-e e-k-d(10)-k-e-k-e k-d(10)-k-e-k-e-e e-e-k-d(10)-k-e-k-e e-d-d-k-d(9)-k-k-e e-e-e-e-d(9)-k-k-e wherein, k is a constrained ethyl nucleoside, e is a 2'-MOE substituted nucleoside, and d is a 2'-deoxynucleoside.
In certain embodiments, the antisense oligonucleotide has a sugar motif described by Formula A as follows: (J)m-(B)n-(J)p-(B)r-(A)t-(D)g-(A)v-(B)w-(J)x-(B)y-(J)z wherein: each A is independently a 2 '-substituted nucleoside; each B is independently a bicyclic nucleoside; each J is independently either a 2'-substituted nucleoside or a 2'-deoxynucleoside; each D is a 2'-deoxynucleoside; m is 0-4; n is 0-2; p is 0-2; r is 0-2; t is 0-2; v is 0-2; w is 0-4; x is 0-2; y is 0-2; z is 0-4; g is 6-14; provided that: at least one of m, n, and r is other than 0; at least one of w and y is other than 0; the sum of m, n, p, r, and t is from 2 to 5; and the sum of v, w, x, y, and z is from 2 to 5.
Target Nucleic Acids, Target Regions and Nucleotide Sequences
Nucleotide sequences that encode STAT3 include, without limitation, the following: GENBANK Accession No. NM_ 139276.2 (incorporated herein as SEQ ID NO: 1) and the complement of GENBANK Accession No. NT 010755.14 truncated from nucleotides 4185000 to 4264000 (incorporated herein as SEQ ID NO: 2).
It is understood that the sequence set forth in each SEQ ID NO contained herein is independent of any modification to a sugar moiety, an internucleoside linkage, or a nucleobase. As such, antisense compounds defined by a SEQ ID NO may comprise, independently, one or more modifications to a sugar moiety, an internucleoside linkage, or a nucleobase. Antisense compounds described by Isis Number (Isis No) indicate a combination of nucleobase sequence and motif.
In certain embodiments, a target region is a structurally defined region of the target nucleic acid. For example, a target region may encompass a 3 ' UTR, a 5 ' UTR, an exon, an intron, an exon/intron junction, a coding region, a translation initiation region, translation termination region, or other defined nucleic acid region. The structurally defined regions for STAT3 can be obtained by accession number from sequence databases such as NCBI and such information is incorporated herein by reference. In certain embodiments, a target region may encompass the sequence from a 5 ' target site of one target segment within the target region to a 3' target site of another target segment within the same target region.
Targeting includes determination of at least one target segment to which an antisense compound hybridizes, such that a desired effect occurs. In certain embodiments, the desired effect is a reduction in mRNA target nucleic acid levels. In certain embodiments, the desired effect is reduction of levels of protein encoded by the target nucleic acid or a phenotypic change associated with the target nucleic acid.
A target region may contain one or more target segments. Multiple target segments within a target region may be overlapping. Alternatively, they may be non-overlapping. In certain embodiments, target segments within a target region are separated by no more than about 300 nucleotides. In certain emodiments, target segments within a target region are separated by a number of nucleotides that is, is about, is no more than, is no more than about, 250, 200, 150, 100, 90, 80, 70, 60, 50, 40, 30, 20, or 10 nucleotides on the target nucleic acid, or is a range defined by any two of the preceeding values. In certain embodiments, target segments within a target region are separated by no more than, or no more than about, 5 nucleotides on the target nucleic acid. In certain embodiments, target segments are contiguous. Contemplated are target regions defined by a range having a starting nucleic acid that is any of the 5 ' target sites or 3 ' target sites listed herein.
Suitable target segments may be found within a 5 ' UTR, a coding region, a 3' UTR, an intron, an exon, or an exon/intron junction. Target segments containing a start codon or a stop codon are also suitable target segments. A suitable target segment may specifcally exclude a certain structurally defined region such as the start codon or stop codon.
The determination of suitable target segments may include a comparison of the sequence of a target nucleic acid to other sequences throughout the genome. For example, the BLAST algorithm may be used to identify regions of similarity amongst different nucleic acids. This comparison can prevent the selection of antisense compound sequences that may hybridize in a non-specific manner to sequences other than a selected target nucleic acid (i.e., non-target or off-target sequences).
There may be variation in activity (e.g., as defined by percent reduction of target nucleic acid levels) of the antisense compounds within an active target region. In certain embodiments, reductions in STAT3 mRNA levels are indicative of inhibition of STAT3 expression. Reductions in levels of a STAT3 protein are also indicative of inhibition of target mRNA expression. Further, phenotypic changes are indicative of inhibition of STAT3 expression. In certain embodiments, reduced cellular growth, reduced tumor growth, and reduced tumor volume can be indicative of inhibition of STAT3 expression. In certain embodiments, amelioration of symptoms associated with cancer can be indicative of inhibition of STAT3 expression. In certain embodiments, reduction of cachexia is indicative of inhibition of STAT3 expression. In certain embodiments, reduction of cancer markers can be indicative of inhibition of STAT3 expression.
Hybridization
In some embodiments, hybridization occurs between an antisense compound disclosed herein and a STAT3 nucleic acid. The most common mechanism of hybridization involves hydrogen bonding (e.g., Watson-Crick, Hoogsteen or reversed Hoogsteen hydrogen bonding) between complementary nucleobases of the nucleic acid molecules.
Hybridization can occur under varying conditions. Stringent conditions are sequence-dependent and are determined by the nature and composition of the nucleic acid molecules to be hybridized.
Methods of determining whether a sequence is specifically hybridizable to a target nucleic acid are well known in the art. In certain embodiments, the antisense compounds provided herein are specifically hybridizable with a STAT3 nucleic acid.
Complementarity
An antisense compound and a target nucleic acid are complementary to each other when a sufficient number of nucleobases of the antisense compound can hydrogen bond with the corresponding nucleobases of the target nucleic acid, such that a desired effect will occur (e.g., antisense inhibition of a target nucleic acid, such as a STAT3 nucleic acid).
Non-complementary nucleobases between an antisense compound and a STAT3 nucleic acid may be tolerated provided that the antisense compound remains able to specifically hybridize to a target nucleic acid. Moreover, an antisense compound may hybridize over one or more segments of a STAT3 nucleic acid such that intervening or adjacent segments are not involved in the hybridization event (e.g., a loop structure, mismatch or hairpin structure).
In certain embodiments, the antisense compounds provided herein, or a specified portion thereof, are, or are at least, 70%, 80%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or 100% complementary to a STAT3 nucleic acid, a target region, target segment, or specified portion thereof. Percent complementarity of an antisense compound with a target nucleic acid can be determined using routine methods.
For example, an antisense compound in which 18 of 20 nucleobases of the antisense compound are complementary to a target region, and would therefore specifically hybridize, would represent 90 percent complementarity. In this example, the remaining noncomplementary nucleobases may be clustered or interspersed with complementary nucleobases and need not be contiguous to each other or to complementary nucleobases. As such, an antisense compound which is 1 8 nucleobases in length having four noncomplementary nucleobases which are flanked by two regions of complete complementarity with the target nucleic acid would have 77.8% overall complementarity with the target nucleic acid and would thus fall within the scope of the present invention. Percent complementarity of an antisense compound with a region of a target nucleic acid can be determined routinely using BLAST programs (basic local alignment search tools) and PowerBLAST programs known in the art (Altschul et al., J. Mol. Biol., 1990, 215, 403 410; Zhang and Madden, Genome Res., 1997, 7, 649 656). Percent homology, sequence identity or complementarity, can be determined by, for example, the Gap program (Wisconsin Sequence Analysis Package, Version 8 for Unix, Genetics Computer Group, University Research Park, Madison Wis.), using default settings, which uses the algorithm of Smith and Waterman (Adv. Appl. Math., 1981, 2, 482 489).
In certain embodiments, the antisense compounds provided herein, or specified portions thereof, are fully complementary (i.e. 100% complementary) to a target nucleic acid, or specified portion thereof. For example, an antisense compound may be fully complementary to a STAT3 nucleic acid, or a target region, or a target segment or target sequence thereof. As used herein, "fully complementary" means each nucleobase of an antisense compound is capable of precise base pairing with the corresponding nucleobases of a target nucleic acid. For example, a 20 nucleobase antisense compound is fully complementary to a target sequence that is 400 nucleobases long, so long as there is a corresponding 20 nucleobase portion of the target nucleic acid that is fully complementary to the antisense compound. Fully complementary can also be used in reference to a specified portion of the first and /or the second nucleic acid. For example, a 20 nucleobase portion of a 30 nucleobase antisense compound can be "fully complementary" to a target sequence that is 400 nucleobases long. The 20 nucleobase portion of the 30 nucleobase oligonucleotide is fully complementary to the target sequence if the target sequence has a corresponding 20 nucleobase portion wherein each nucleobase is complementary to the 20 nucleobase portion of the antisense compound. At the same time, the entire 30 nucleobase antisense compound may or may not be fully complementary to the target sequence, depending on whether the remaining 10 nucleobases of the antisense compound are also complementary to the target sequence. The location of a non-complementary nucleobase may be at the 5' end or 3' end of the antisense compound. Alternatively, the non-complementary nucleobase or nucleobases may be at an internal position of the antisense compound. When two or more non-complementary nucleobases are present, they may be contiguous (i.e. linked) or non- contiguous. In one embodiment, a non-complementary nucleobase is located in the wing segment of a gapmer antisense oligonucleotide.
In certain embodiments, antisense compounds that are, or are up to 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 nucleobases in length comprise no more than 4, no more than 3, no more than 2, or no more than 1 non-complementary nucleobase(s) relative to a target nucleic acid, such as a STAT3 nucleic acid, or specified portion thereof.
In certain embodiments, antisense compounds that are, or are up to 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 , 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleobases in length comprise no more than 6, no more than 5, no more than 4, no more than 3, no more than 2, or no more than 1 non-complementary nucleobase(s) relative to a target nucleic acid, such as a STAT3 nucleic acid, or specified portion thereof.
The antisense compounds provided herein also include those which are complementary to a portion of a target nucleic acid. As used herein, "portion" refers to a defined number of contiguous (i.e. linked) nucleobases within a region or segment of a target nucleic acid. A "portion" can also refer to a defined number of contiguous nucleobases of an antisense compound. In certain embodiments, the antisense compounds, are complementary to at least an 8 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 9 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 10 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least an 1 1 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 12 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 13 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 14 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 15 nucleobase portion of a target segment. Also contemplated are antisense compounds that are complementary to at least a 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more nucleobase portion of a target segment, or a range defined by any two of these values.
Identity
The antisense compounds provided herein may also have a defined percent identity to a particular nucleotide sequence, SEQ ID NO, or compound represented by a specific Isis number, or portion thereof. As used herein, an antisense compound is identical to the sequence disclosed herein if it has the same nucleobase pairing ability. For example, a RNA which contains uracil in place of thymidine in a disclosed DNA sequence would be considered identical to the DNA sequence since both uracil and thymidine pair with adenine. Shortened and lengthened versions of the antisense compounds described herein as well as compounds having non-identical bases relative to the antisense compounds provided herein also are contemplated. The non-identical bases may be adjacent to each other or dispersed throughout the antisense compound. Percent identity of an antisense compound is calculated according to the number of bases that have identical base pairing relative to the sequence to which it is being compared.
In certain embodiments, the antisense compounds, or portions thereof, are at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or 100% identical to one or more of the antisense compounds or SEQ ID NOs, or a portion thereof, disclosed herein.
In certain embodiments, a portion of the antisense compound is compared to an equal length portion of the target nucleic acid. In certain embodiments, an 8, 9, 10, 1 1, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, or 25 nucleobase portion is compared to an equal length portion of the target nucleic acid.
In certain embodiments, a portion of the antisense oligonucleotide is compared to an equal length portion of the target nucleic acid. In certain embodiments, an 8, 9, 10, 1 1, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 , 22, 23, 24, or 25 nucleobase portion is compared to an equal length portion of the target nucleic acid.
Modifications
A nucleoside is a base-sugar combination. The nucleobase (also known as base) portion of the nucleoside is normally a heterocyclic base moiety. Nucleotides are nucleosides that further include a phosphate group covalently linked to the sugar portion of the nucleoside. For those nucleosides that include a pentofuranosyl sugar, the phosphate group can be linked to the 2', 3' or 5' hydroxyl moiety of the sugar. Oligonucleotides are formed through the covalent linkage of adjacent nucleosides to one another, to form a linear polymeric oligonucleotide. Within the oligonucleotide structure, the phosphate groups are commonly referred to as forming the internucleoside linkages of the oligonucleotide. Modifications to antisense compounds encompass substitutions or changes to internucleoside linkages, sugar moieties, or nucleobases. Modified antisense compounds are often preferred over native forms because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for nucleic acid target, increased stability in the presence of nucleases, or increased inhibitory activity. Chemically modified nucleosides may also be employed to increase the binding affinity of a shortened or truncated antisense oligonucleotide for its target nucleic acid. Consequently, comparable results can often be obtained with shorter antisense compounds that have such chemically modified nucleosides.
Modified Internucleoside Linkages The naturally occuring internucleoside linkage of RNA and DNA is a 3' to 5' phosphodiester linkage. Antisense compounds having one or more modified, i.e. non- naturally occurring, internucleoside linkages are often selected over antisense compounds having naturally occurring internucleoside linkages because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for target nucleic acids, and increased stability in the presence of nucleases.
Oligonucleotides having modified internucleoside linkages include internucleoside linkages that retain a phosphorus atom as well as internucleoside linkages that do not have a phosphorus atom. Representative phosphorus containing internucleoside linkages include, but are not limited to , phosphodiesters, phosphotriesters, methylphosphonates, phosphoramidate, and phosphorothioates. Methods of preparation of phosphorous-containing and non-phosphorous-containing linkages are well known.
In certain embodiments, antisense compounds targeted to a STAT3 nucleic acid comprise one or more modified internucleoside linkages. In certain embodiments, the modified internucleoside linkages are phosphorothioate linkages. In certain embodiments, each internucleoside linkage of an antisense compound is a phosphorothioate internucleoside linkage.
Modified Sugar Moieties Antisense compounds provided herein can optionally contain one or more nucleosides wherein the sugar group has been modified. Such sugar modified nucleosides may impart enhanced nuclease stability, increased binding affinity, or some other beneficial biological property to the antisense compounds. In certain embodiments, nucleosides comprise a chemically modified ribofuranose ring moiety. Examples of chemically modified ribofuranose rings include, without limitation, addition of substitutent groups (including 5' and 2' substituent groups); bridging of non-geminal ring atoms to form bicyclic nucleic acids (BNA); replacement of the ribosyl ring oxygen atom with S, N(R), or C(R1)(R)2 (R = H, C1-C12 alkyl or a protecting group); and combinations thereof. Examples of chemically modified sugars include, 2'-F-5 '-methyl substituted nucleoside (see, PCT International Application WO 2008/101 157, published on 8/21/08 for other disclosed 5', 2'-bis substituted nucleosides), replacement of the ribosyl ring oxygen atom with S with further substitution at the 2'-position (see, published U.S. Patent Application US2005/0130923, published on June 16, 2005), or, alternatively, 5 '-substitution of a BNA (see, PCT International Application WO 2007/134181, published on 11/22/07, wherein LNA is substituted with, for example, a 5'-methyl or a 5'-vinyl group).
Examples of nucleosides having modified sugar moieties include, without limitation, nucleosides comprising 5'-vinyl, 5'-methyl (R or S), 4'-S, 2'-F, 2'-OCH3, and 2'- 0(CH2)20CH3 substituent groups. The substituent at the 2' position can also be selected from allyl, amino, azido, thio, O-allyl, O-Ci-Cio alkyl, OCF3, 0(CH2)2SCH3, 0(CH2)2-0- N(Rm)(Rn), and 0-CH2-C(=0)-N(Rm)(Rn), where each Rm and Rn is, independently, H or substituted or unsubstituted C1-C10 alkyl.
As used herein, "bicyclic nucleosides" refer to modified nucleosides comprising a bicyclic sugar moiety. Examples of bicyclic nucleosides include, without limitation, nucleosides comprising a bridge between the 4' and the 2' ribosyl ring atoms. In certain embodiments, antisense compounds provided herein include one or more bicyclic nucleosides wherein the bridge comprises a 4' to 2' bicyclic nucleoside. Examples of such 4' to 2' bicyclic nucleosides, include, but are not limited to, one of the formulae: 4'-(CH2)- 0-2' (LNA); 4'-(CH2)-S-2'; 4,-(CH2)2-0-2' (ENA); 4'-CH(CH3)-0-2' and 4'-C- H(CH2OCH3)-0-2*, and analogs thereof (see, U.S. Patent 7,399,845, issued on July 15, 2008); 4*-C(CH3)(CH3)-0-2*, and analogs thereof (see, published PCT International Application WO2009/006478, published January 8, 2009); 4,-CH2-N(OCH3)-2\ and analogs thereof (see, published PCT International Application WO2008/150729, published December 1 1 , 2008); 4*-CH2-0-N(CH3)-2* (see, published U.S . Patent Application US2004/0171570, published September 2, 2004); 4'-CH2-N(R)-0-2', wherein R is H, Ci- Ci2 alkyl, or a protecting group (see, U.S. Patent 7,427,672, issued on September 23, 2008); 4,-CH2-C(H)(CH3)-2' (see, Chattopadhyaya, et al, J. Org. Chem.,2009, 74, 1 18- 134); and 4'-CH2-C(=CH2)-2', and analogs thereof (see, published PCT International Application WO 2008/154401 , published on December 8, 2008). Also see, for example: Singh et al, Chem. Commun., 1998, 4, 455-456; Koshkin et al, Tetrahedron, 1998, 54, 3607-3630; Wahlestedt et al, Proc. Natl. Acad. Sci. U. S. A., 2000, 97, 5633-5638; Kumar et al, Bioorg. Med. Chem. Lett., 1998, 8, 2219-2222; Singh et al, J. Org. Chem., 1998, 63, 10035-10039; Srivastava et al, J. Am. Chem. Soc, 129(26) 8362-8379 (Jul. 4, 2007); Elayadi et al., Curr. Opinion Invens. Drugs, 2001, 2, 558-561; Braasch et al., Chem. Biol., 2001, 8, 1-7; Orum et al., Curr. Opinion Mol. Ther., 2001, 3, 239-243; U.S. Patent Nos U.S. 6,670,461, 7,053,207, 6,268,490, 6,770,748, 6,794,499, 7,034, 133, 6,525, 191 , 7,399,845; published PCT International applications WO 2004/106356, WO 94/14226, WO 2005/021570, and WO 2007/134181 ; U.S. Patent Publication Nos. US2004/0171570, US2007/0287831, and US2008/0039618; and U.S. Patent Serial Nos. 12/129, 154, 60/989,574, 61/026,995 , 61 /026,998 , 61/056,564, 61/086,23 1 , 61 /097,787, and 61/099,844; and PCT International Application Nos. PCT/US2008/064591, PCT/US2008/066154, and PCT/US2008/068922. Each of the foregoing bicyclic nucleosides can be prepared having one or more stereochemical sugar configurations including for example a-L-ribofuranose and β-D-ribofuranose (see PCT international application PCT/DK98/00393, published on March 25, 1999 as WO 99/14226).
In certain embodiments, bicyclic sugar moieties of BNA nucleosides include, but are not limited to, compounds having at least one bridge between the 4' and the 2' position of the pentofuranosyl sugar moiety wherein such bridges independently comprises 1 or from 2 to 4 linked groups independently selected from -[C(Ra)(Rb)]n-, -C(Ra)=C(Rb)-, -C(Ra)=N-, -C(=NRa)-, -C(=0)-, -C(=S)-, -0-, -Si(Ra)2-, -S(=0)x-, and -N(Ra)-; wherein: x is 0, 1, or 2; n is 1, 2, 3, or 4; each Ra and Rb is, independently, H, a protecting group, hydroxyl, C1-C12 alkyl, substituted C1-C12 alkyl, C2-Ci2 alkenyl, substituted C2-Ci2 alkenyl, C2-Ci2 alkynyl, substituted C2-C12 alkynyl, C5-C20 aryl, substituted C5-C20 aryl, heterocycle radical, substituted heterocycle radical, heteroaryl, substituted heteroaryl, C5-C7 alicyclic radical, substituted C5-C7 alicyclic radical, halogen, OJi , NJ1J2, SJi , N3, COOJi , acyl (C(=0)-H), substituted acyl, CN, sulfonyl (S(=0)2-Ji), or sulfoxyl (S(=0)-Ji); and each Ji and is, independently, H, C1-C12 alkyl, substituted C1-C12 alkyl, C2-C12 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, C5-C20 aryl, substituted C5-C20 aryl, acyl (C(=0)-H), substituted acyl, a heterocycle radical, a substituted heterocycle radical, C1-C12 aminoalkyl, substituted C1-C12 aminoalkyl, or a protecting group. In certain embodiments, the bridge of a bicyclic sugar moiety is, -[C(Ra)(Rb)]n-,
-[C(Ra)(Rb)]„-0-, -C(RaRb)-N(R)-0- or, -C(RaRb)-0-N(R)-. In certain embodiments, the bridge is 4'-CH2-2', 4'-(CH2)2-2', 4,-(CH2)3-2', 4'-CH2-0-2', 4'-(CH2)2-0-2', 4'-CH2-0-N(R)- 2', and 4'-CH2-N(R)-0-2'-, wherein each R is, independently, H, a protecting group, or Ci- C12 alkyl. In certain embodiments, bicyclic nucleosides are further defined by isomeric configuration. For example, a nucleoside comprising a 4'-2' methylene-oxy bridge, may be in the a-L configuration or in the β-D configuration. Previously, a-L-methyleneoxy (4'- CH2-0-2') BNA's have been incorporated into antisense oligonucleotides that showed antisense activity (Frieden et ah, Nucleic Acids Research, 2003, 21, 6365-6372). In certain embodiments, bicyclic nucleosides include, but are not limited to, (A) a-
L-Methyleneoxy (4'-CH2-0-2') BNA , (B) β-D-Methyleneoxy (4'-CH2-0-2') BNA , (C) Ethyleneoxy (4'-(CH2)2-0-2 ') BNA , (D) Aminooxy (4 '-CH2-0-N(R)-2 ') BNA, (E) Oxyamino (4'-CH2-N(R)-0-2 ') BNA, (F) Methyl(methyleneoxy) (4 '-CH(CH3)-0-2') BNA, (G) methylene-thio (4'-CH2-S-2') BNA, (H) methylene-amino (4'-CH2-N(R)-2') BNA, (I) methyl carbocyclic (4'-CH2-CH(CH3)-2') BNA, and (J) propylene carbocyclic (4'-(CH2)3-2') BNA as depicted below.
Figure imgf000058_0001
Figure imgf000058_0002
wherein Bx is the base moiety and R is, independently, H, a protecting group or C1-C12 alkyl.
In certain embodiments, bicyclic nucleoside having Formula I:
Figure imgf000058_0003
wherein:
Bx is a heterocyclic base moiety;
-Qa-Qb-Qc- is -CH2-N(Rc)-CH2-, -C(=0)-N(Rc)-CH2-, -CH2-0-N(Rc)-, -CH2-N(Rc)- 0-, or -N(Rc)-0-CH2;
Rc is Ci-Ci2 alkyl or an amino protecting group; and Ta and Tb are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium.
In certain embodiments, bicyclic nucleoside having Formula II:
Figure imgf000059_0001
wherein:
Bx is a heterocyclic base moiety;
Ta and Tb are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium;
Za is Ci-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, substituted Ci-C6 alkyl, substituted C2-C6 alkenyl, substituted C2-C6 alkynyl, acyl, substituted acyl, substituted amide, thiol, or substituted thio.
In one embodiment, each of the substituted groups is, independently, mono or poly substituted with substituent groups independently selected from halogen, oxo, hydroxyl, OJc, NJJd, SJc, N3, OC(=X)Jc, and NJeC(=X)NJcJd, wherein each Jc, Jd, and Je is, independently, H, Ci-C6 alkyl, or substituted Ci-C6 alkyl and X is O or NJC.
In certain embodiments, bicyclic nucleoside having Formula III:
Figure imgf000059_0002
wherein:
Bx is a heterocyclic base moiety; Ta and Tb are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium;
Zb is Ci-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, substituted Ci-C6 alkyl, substituted C2-C6 alkenyl, substituted C2-C6 alkynyl, or substituted acyl (C(=0)-).
In certain embodiments, bicyclic nucleoside having Formula IV:
Figure imgf000060_0001
wherein:
Bx is a heterocyclic base moiety;
Ta and Tb are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium;
Rd is Ci-C6 alkyl, substituted Ci-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, C2-C6 alkynyl, or substituted C2-C6 alkynyl; each qa, qb, qc and qa is, independently, H, halogen, Ci-C6 alkyl, substituted Ci-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, C2-C6 alkynyl, or substituted C2-C6 alkynyl, Ci-C6 alkoxyl, substituted Ci-C6 alkoxyl, acyl, substituted acyl, Ci-C6 aminoalkyl, or substituted Ci-C6 aminoalkyl;
In certain embodiments, bicyclic nucleoside having Formula V:
Figure imgf000060_0002
wherein:
Bx is a heterocyclic base moiety; Ta and Tb are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium; qa, b, e and qf are each, independently, hydrogen, halogen, C1-C12 alkyl, substituted C1-C12 alkyl, C2-C12 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, C1-C12 alkoxy, substituted C1-C12 alkoxy, OJj, SJj, SOJj, S02Jj, NJjJk, N3, CN, C(=0)OJj, C(=0)NJjJk, C(=0)Jj, 0-C(=0)NJjJk, N(H)C(=NH)NJjJk, N(H)C(=0)NJj Jk or N(H)C(=S)NJjJk; or qe and qf together are =C(qg)(qh); qg and qh are each, independently, H, halogen, C1-C12 alkyl, or substituted C1-C12 alkyl.
The synthesis and preparation of the methyleneoxy (4'- ¾-0-2') BNA monomers adenine, cytosine, guanine, 5-methyl-cytosine, thymine, and uracil, along with their ohgomerization, and nucleic acid recognition properties have been described (see, e.g., Koshkin et al, Tetrahedron, 1998, 54, 3607-3630). BNAs and preparation thereof are also described in WO 98/39352 and WO 99/14226.
Analogs of methyleneoxy (4 '-CH2-0-2 ') BNA, methyleneoxy (4 '-CH2-0-2') BNA, and 2'-thio-BNAs, have also been prepared (see, e.g., Kumar et al, Bioorg. Med. Chem. Lett. , 1998, 8, 2219-2222). Preparation of locked nucleoside analogs comprising oligodeoxyribonucleotide duplexes as substrates for nucleic acid polymerases has also been described (see, e.g., Wengel et al, WO 99/14226). Furthermore, synthesis of 2'- amino-BNA, a novel comformationally restricted high-affinity oligonucleotide analog, has been described in the art (see, e.g., Singh et al, J. Org. Chem. , 1998, 63, 10035-10039). In addition, 2'-amino- and 2'-methylamino-BNA's have been prepared and the thermal stability of their duplexes with complementary RNA and DNA strands has been previously reported.
In certain embodiments, bicyclic nucleoside having Formula VI:
Figure imgf000061_0001
wherein:
Bx is a heterocyclic base moiety;
Ta and Tb are each, independently, H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety, or a covalent attachment to a support medium; each φ, c , qk and qi is, independently, H, halogen, C1-C12 alkyl, substituted C1-C12 alkyl, C2-C12 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, d-C12 alkoxyl, substituted d-C12 alkoxyl, OJj, SJj, SOJj, S02Jj, NJjJk, N3, CN, C(=0)OJj, C(=0)NJjJk, C(=0)Jj, 0-C(=0)NJjJk, N(H)C(=NH)NJjJk, N(H)C(=0)NJjJk, or N(H)C(=S)NJjJk; and φ and qj or qi and qk together are =C(qg)(qh), wherein qg and qh are each, independently, H, halogen, d-C12 alkyl, or substituted C1-C12 alkyl.
One carbocyclic bicyclic nucleoside having a 4'-(CH2)3-2' bridge and the alkenyl analog, bridge 4'-CH=CH-CH2-2', have been described (see, e.g., Freier et al., Nucleic Acids Research, 1997, 25(22), 4429-4443 and Albaek et al., J. Org. Chem., 2006, 71, 7731-7740). The synthesis and preparation of carbocyclic bicyclic nucleosides along with their oligomerization and biochemical studies have also been described (see, e.g., Srivastava et al., J. Am. Chem. Soc. 2007, 129(26), 8362-8379).
As used herein, "4'-2' bicyclic nucleoside" or "4' to 2' bicyclic nucleoside" refers to a bicyclic nucleoside comprising a furanose ring comprising a bridge connecting the 2' carbon atom and the 4' carbon atom.
As used herein, "monocylic nucleosides" refer to nucleosides comprising modified sugar moieties that are not bicyclic sugar moieties. In certain embodiments, the sugar moiety, or sugar moiety analogue, of a nucleoside may be modified or substituted at any position.
As used herein, "2'-modified sugar" means a furanosyl sugar modified at the 2' position. In certain embodiments, such modifications include substituents selected from: a halide, including, but not limited to substituted and unsubstituted alkoxy, substituted and unsubstituted thioalkyl, substituted and unsubstituted amino alkyl, substituted and unsubstituted alkyl, substituted and unsubstituted allyl, and substituted and unsubstituted alkynyl. In certain embodiments, 2' modifications are selected from substituents including, but not limited to: 0[(CH2)„0]mCH3, 0(CH2)„NH2, 0(CH2)nCH3, 0(CH2)nONH2, OCH2C(=0)N(H)CH3, and 0(CH2)nON[(CH2)nCH3]2, where n and m are from 1 to about 10. Other 2'- substituent groups can also be selected from: Ci-Ci2 alkyl; substituted alkyl; alkenyl; alkynyl; alkaryl; aralkyl; O-alkaryl or O-aralkyl; SH; SCH3; OCN; CI; Br; CN; CF3; OCF3; SOCH3; S02CH3; ON02; N02; N3; NH2; heterocycloalkyl; heterocycloalkaryl; amino alky lamino; poly alky lamino; substituted silyl; an RNA cleaving group; a reporter group; an intercalator; a group for improving pharmacokinetic properties; and a group for improving the pharmacodynamic properties of an antisense compound, and other substituents having similar properties. In certain embodiments, modifed nucleosides comprise a 2'-MOE side chain (see, e.g., Baker et al., J. Biol. Chem., 1997, 272, 1 1944- 12000). Such 2'-MOE substitution have been described as having improved binding affinity compared to unmodified nucleosides and to other modified nucleosides, such as 2'- O-methyl, O-propyl, and O-aminopropyl. Oligonucleotides having the 2'-MOE substituent also have been shown to be antisense inhibitors of gene expression with promising features for in vivo use (see, e.g., Martin, P., Helv. Chim. Acta, 1995, 78, 486-504; Altmann et al., Chimia, 1996, 50, 168-176; Altmann et al, Biochem. Soc. Trans., 1996, 24, 630-637; and Altmann et al, Nucleosides Nucleotides, 1997, 16, 917-926).
As used herein, a "modified tetrahydropyran nucleoside" or "modified THP nucleoside" means a nucleoside having a six-membered tetrahydropyran "sugar" substituted in for the pentofuranosyl residue in normal nucleosides (a sugar surrogate). Modified THP nucleosides include, but are not limited to, what is referred to in the art as hexitol nucleic acid (HNA), anitol nucleic acid (ANA), manitol nucleic acid (MNA) (see Leumann, CJ. Bioorg. & Med. Chem. (2002) 10:841-854), fiuoro HNA (F-HNA), or those compounds having Formula X: Formula X:
Figure imgf000063_0001
X wherein independently for each of said at least one tetrahydropyran nucleoside analog of Formula X: Bx is a heterocyclic base moiety;
T3 and T4 are each, independently, an internucleoside linking group linking the tetrahydropyran nucleoside analog to the antisense compound or one of T3 and T4 is an internucleoside linking group linking the tetrahydropyran nucleoside analog to the antisense compound and the other of T3 and T4 is H, a hydroxyl protecting group, a linked conjugate group, or a 5 ' or 3 '-terminal group; qi, q2, q3, q4, q5, q6 and q7 are each, independently, H, Ci-C6 alkyl, substituted Ci- C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, C2-C6 alkynyl, or substituted C2-C6 alkynyl; and one of Ri and R2 is hydrogen and the other is selected from halogen, substituted or unsubstituted alkoxy, NJjJ2, SJi, N3, OC(=X)Ji, OC(=X)NJiJ2,
Figure imgf000064_0001
and CN, wherein X is O, S, or NJi, and each Ji, J2, and J3 is, independently, H or Ci-C6 alkyl.
In certain embodiments, the modified THP nucleosides of Formula X are provided wherein qm, qn, qp, qr, qs, qt, and qu are each H. In certain embodiments, at least one of qm, q„, qp, qr, qs, qt, and qu is other than H. In certain embodiments, at least one of qm, qn, qp, qr, qs, qt and qu is methyl. In certain embodiments, THP nucleosides of Formula X are provided wherein one of Ri and R2 is F. In certain embodiments, Ri is fluoro and R2 is H, Ri is methoxy and R2 is H, and Ri is methoxyethoxy and R2 is H.
As used herein, "2'-modified" or "2 '-substituted" refers to a nucleoside comprising a sugar comprising a substituent at the 2' position other than H or OH. 2 '-modified nucleosides, include, but are not limited to, bicyclic nucleosides wherein the bridge connecting two carbon atoms of the sugar ring connects the 2' carbon and another carbon of the sugar ring and nucleosides with non-bridging 2'substituents, such as allyl, amino, azido, thio, O-allyl, O-Ci-Cio alkyl, -OCF3, 0-(CH2)2-0-CH3, 2'-0(CH2)2SCH3, 0-(CH2)2- 0-N(Rm)(Rn), or 0-CH2-C(=0)-N(Rm)(R„), where each Rm and R„ is, independently, H or substituted or unsubstituted C1-C10 alkyl. 2 '-modifed nucleosides may further comprise other modifications, for example, at other positions of the sugar and/or at the nucleobase.
As used herein, "2'-F" refers to a sugar comprising a fluoro group at the 2' position.
As used herein, "2 '-OMe" or "2 '-OCH3" or "2 '-O-methyl" each refers to a nucleoside comprising a sugar comprising an -OCH3 group at the 2' position of the sugar ring. As used herein, "oligonucleotide" refers to a compound comprising a plurality of linked nucleosides. In certain embodiments, one or more of the plurality of nucleosides is modified. In certain embodiments, an oligonucleotide comprises one or more ribonucleosides (R A) and/or deoxyribonucleosides (DNA). Many other bicyclo and tricyclo sugar surrogate ring systems are also known in the art that can be used to modify nucleosides for incorporation into antisense compounds (see, e.g., review article: Leumann, J. C, Bioorganic & Medicinal Chemistry, 2002, 10, 841- 854).
Such ring systems can undergo various additional substitutions to enhance activity. Methods for the preparations of modified sugars are well known to those skilled in the art.
In nucleotides having modified sugar moieties, the nucleobase moieties (natural, modified, or a combination thereof) are maintained for hybridization with an appropriate nucleic acid target. In certain embodiments, antisense compounds comprise one or more nucleotides having modified sugar moieties. In certain embodiments, the modified sugar moiety is 2'- MOE. In certain embodiments, the 2 '-MOE modified nucleotides are arranged in a gapmer motif. In certain embodiments, the modified sugar moiety is a cEt. In certain embodiments, the cEt modified nucleotides are arranged throughout the wings of a gapmer motif.
Compositions and Methods for Formulating Pharmaceutical Compositions
Antisense oligonucleotides may be admixed with pharmaceutically acceptable active or inert substances for the preparation of pharmaceutical compositions or formulations. Compositions and methods for the formulation of pharmaceutical compositions are dependent upon a number of criteria, including, but not limited to, route of administration, extent of disease, or dose to be administered.
An antisense compound targeted to a STAT3 nucleic acid can be utilized in pharmaceutical compositions by combining the antisense compound with a suitable pharmaceutically acceptable diluent or carrier. A pharmaceutically acceptable diluent includes phosphate-buffered saline (PB S). PB S is a diluent suitable for use in compositions to be delivered parenterally. Accordingly, in one embodiment, employed in the methods described herein is a pharmaceutical composition comprising an antisense compound targeted to a STAT3 nucleic acid and a pharmaceutically acceptable diluent. In certain embodiments, the pharmaceutically acceptable diluent is PBS . In certain embodiments, the antisense compound is an antisense oligonucleotide. Pharmaceutical compositions comprising antisense compounds encompass any pharmaceutically acceptable salts, esters, or salts of such esters, or any other oligonucleotide which, upon administration to an animal, including a human, is capable of providing (directly or indirectly) the biologically active metabolite or residue thereof. Accordingly, for example, the disclosure is also drawn to pharmaceutically acceptable salts of antisense compounds, prodrugs, pharmaceutically acceptable salts of such prodrugs, and other bioequivalents. Suitable pharmaceutically acceptable salts include, but are not limited to, sodium and potassium salts.
A prodrug can include the incorporation of additional nucleosides at one or both ends of an antisense compound which are cleaved by endogenous nucleases within the body, to form the active antisense compound.
Conjugated Antisense compounds
Antisense compounds may be covalently linked to one or more moieties or conjugates which enhance the activity, cellular distribution or cellular uptake of the resulting antisense oligonucleotides. Typical conjugate groups include cholesterol moieties and lipid moieties. Additional conjugate groups include carbohydrates, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes.
Antisense compounds can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of antisense compounds to enhance properties such as, for example, nuclease stability. Included in stabilizing groups are cap structures. These terminal modifications protect the antisense compound having terminal nucleic acid from exonuclease degradation, and can help in delivery and/or localization within a cell. The cap can be present at the 5'-terminus (5'-cap), or at the 3'-terminus (3 - cap), or can be present on both termini. Cap structures are well known in the art and include, for example, inverted deoxy abasic caps. Further 3' and 5 '-stabilizing groups that can be used to cap one or both ends of an antisense compound to impart nuclease stability include those disclosed in WO 03/004602 published on January 16, 2003. Certain Antisense Compounds
In certain embodiments, antisense compounds useful for treating B-cell lymphoma at the doses and dosing regimens described above include any of the antisense oligonucleotides described in WO 2012/135736, which is incorporated by reference in its entirety herein. Examples of antisense compounds described in WO 2012/135736 suitable for treating B-cell lymphoma include, but are not limited to, those described in Tables 1 & 2 below:
Table 1 cEt and MOE chimeric antisense oligonucleotides targeted to STAT3 (SEQ ID NO: 1)
Figure imgf000067_0001
481690 3033 3046 AGATAGTCCTATCT 2-10-2 cEt 15
481466 3047 3062 AAGAAACCTAGGGCTT 3-10-3 cEt 16
481691 3048 3061 AGAAACCTAGGGCT 2-10-2 cEt 17
481467 3097 3112 GCTGATACAGTGTTTT 3-10-3 cEt 18
481692 3098 3111 CTGATACAGTGTTT 2-10-2 cEt 19
481468 3112 3127 ATACAGAAAGGCTATG 3-10-3 cEt 20
481693 3113 3126 TACAGAAAGGCTAT 2-10-2 cEt 21
481469 3127 3142 GCTTAAGTTTCTTAAA 3-10-3 cEt 22
481694 3128 3141 CTTAAGTTTCTTAA 2-10-2 cEt 23
481470 3461 3476 AGCACCAAGGAGGCTG 3-10-3 cEt 24
481695 3462 3475 GCACCAAGGAGGCT 2-10-2 cEt 25
481471 3476 3491 AAGCTGAATGCTTAAA 3-10-3 cEt 26
481696 3477 3490 AGCTGAATGCTTAA 2-10-2 cEt 27
481472 3491 3506 TTACCAGCCTGAAGGA 3-10-3 cEt 28
481697 3492 3505 TACCAGCCTGAAGG 2-10-2 cEt 29
481473 3506 3521 CAGGGATTATATAAAT 3-10-3 cEt 30
481698 3507 3520 AGGGATTATATAAA 2-10-2 cEt 31
481474 3521 3536 ACCTGAAGCCCGTTTC 3-10-3 cEt 32
481699 3522 3535 CCTGAAGCCCGTTT 2-10-2 cEt 33
481475 3536 3551 TGTCTTAAGGGTTTGA 3-10-3 cEt 34
481700 3537 3550 GTCTTAAGGGTTTG 2-10-2 cEt 35 481476 3551 3566 GGTTGCAGCTTCAGAT 3-10-3 cEt 36
481701 3552 3565 GTTGCAGCTTCAGA 2-10-2 cEt 37
481477 3567 3582 TCAACACCAAAGGCCA 3-10-3 cEt 38
481702 3568 3581 CAACACCAAAGGCC 2-10-2 cEt 39
481478 3585 3600 TCCTTAAACCTTCCTA 3-10-3 cEt 40
481703 3586 3599 CCTTAAACCTTCCT 2-10-2 cEt 41
481479 3600 3615 AAAATGCTTAGATTCT 3-10-3 cEt 42
481704 3601 3614 AAATGCTTAGATTC 2-10-2 cEt 43
481480 3628 3643 AAATAAGTCTATTTAT 3-10-3 cEt 44
481705 3629 3642 AATAAGTCTATTTA 2-10-2 cEt 45
481481 3648 3663 GGCCAATACATTACAA 3-10-3 cEt 46
481706 3649 3662 GCCAATACATTACA 2-10-2 cEt 47
481482 3670 3685 TGCCCAGCCTTACTCA 3-10-3 cEt 48
481707 3671 3684 GCCCAGCCTTACTC 2-10-2 cEt 49
481483 3685 3700 GTTGTAAGCACCCTCT 3-10-3 cEt 50
481708 3686 3699 TTGTAAGCACCCTC 2-10-2 cEt 51
481484 3700 3715 AGAAAGGGAGTCAAGG 3-10-3 cEt 52
481709 3701 3714 GAAAGGGAGTCAAG 2-10-2 cEt 53
481485 3717 3732 GCAGATCAAGTCCAGG 3-10-3 cEt 54
481710 3718 3731 CAGATCAAGTCCAG 2-10-2 cEt 55
481486 3730 3745 AGCCTCTGAAACAGCA 3-10-3 cEt 56 481711 3731 3744 GCCTCTGAAACAGC 2-10-2 cEt 57
481487 3746 3761 CCCACAGAAACAACCT 3-10-3 cEt 58
481712 3747 3760 CCACAGAAACAACC 2-10-2 cEt 59
481488 3761 3776 AGCCCTGATAAGGCAC 3-10-3 cEt 60
481713 3762 3775 GCCCTGATAAGGCA 2-10-2 cEt 61
481489 3776 3791 AATCAGAAGTATCCCA 3-10-3 cEt 62
481714 3777 3790 ATCAGAAGTATCCC 2-10-2 cEt 63
481490 3833 3848 GCCTCTAGCAGGATCA 3-10-3 cEt 64
481715 3834 3847 CCTCTAGCAGGATC 2-10-2 cEt 65
481491 3848 3863 CACGCAAGGAGACATG 3-10-3 cEt 66
481716 3849 3862 AC GC AAGG AG AC AT 2-10-2 cEt 67
481492 3863 3878 TGAGGGACCTTTAGAC 3-10-3 cEt 68
481717 3864 3877 GAGGGACCTTTAGA 2-10-2 cEt 69
481493 3886 3901 CAGGATTCCTAAAACA 3-10-3 cEt 70
481718 3887 3900 AGGATTCCTAAAAC 2-10-2 cEt 71
481494 3901 3916 ATGAGGTCCTGAGACC 3-10-3 cEt 72
481719 3902 3915 TGAGGTCCTGAGAC 2-10-2 cEt 73
481495 3940 3955 CATCATGTCCAACCTG 3-10-3 cEt 74
481720 3941 3954 ATCATGTCCAACCT 2-10-2 cEt 75
481496 3955 3970 GGGCCCCATAGTGTGC 3-10-3 cEt 76
481721 3956 3969 GGCCCCATAGTGTG 2-10-2 cEt 77 481497 3977 3992 AGCTCAACCAGACACG 3-10-3 cEt 78
481722 3978 3991 GCTCAACCAGACAC 2-10-2 cEt 79
481498 3992 4007 GAACCATATTCCCTGA 3-10-3 cEt 80
481723 3993 4006 AACCATATTCCCTG 2-10-2 cEt 81
481499 4007 4022 CAAGAAACTGGCTAAG 3-10-3 cEt 82
481724 4008 4021 AAGAAACTGGCTAA 2-10-2 cEt 83
481500 4022 4037 GCCACTGGATATCACC 3-10-3 cEt 84
481501 4048 4063 AACTGAATGAAGACGC 3-10-3 cEt 85
481523 4489 4504 GCTTATTATGTACTGA 3-10-3 cEt 86
481748 4490 4503 CTTATTATGTACTG 2-10-2 cEt 87
481524 4530 4545 GCCCAAGTCTCACCTT 3-10-3 cEt 88
481749 4531 4544 CCCAAGTCTCACCT 2-10-2 cEt 89
481525 4541 4556 CCCAATGGTAAGCCCA 3-10-3 cEt 90
481750 4542 4555 CCAATGGTAAGCCC 2-10-2 cEt 91
481526 4543 4558 AACCCAATGGTAAGCC 3-10-3 cEt 92
481751 4544 4557 ACCCAATGGTAAGC 2-10-2 cEt 93
481527 4560 4575 TAGGTCCCTATGATTT 3-10-3 cEt 94
481752 4561 4574 AGGTCCCTATGATT 2-10-2 cEt 95
481528 4579 4594 AAGCCCTGAACCCTCG 3-10-3 cEt 96
481753 4580 4593 AGCCCTGAACCCTC 2-10-2 cEt 97
481529 4615 4630 CCTAAGGCCATGAACT 3-10-3 cEt 98 481754 4616 4629 CTAAGGCCATGAAC 2-10-2 cEt 99
481530 4630 4645 ACCAGATACATGCTAC 3-10-3 cEt 100
481755 4631 4644 CCAGATACATGCTA 2-10-2 cEt 101
481531 4646 4661 TACAATCAGAGTTAAG 3-10-3 cEt 102
481756 4647 4660 ACAATCAGAGTTAA 2-10-2 cEt 103
481532 4664 4679 TCCTCTCAGAACTTTT 3-10-3 cEt 104
481757 4665 4678 CCTCTCAGAACTTT 2-10-2 cEt 105
481533 4666 4681 GCTCCTCTCAGAACTT 3-10-3 cEt 106
481758 4667 4680 CTCCTCTCAGAACT 2-10-2 cEt 107
481534 4693 4708 TTCTTTAATGGGCCAC 3-10-3 cEt 108
481759 4694 4707 TCTTTAATGGGCCA 2-10-2 cEt 109
481535 4767 4782 ACGGGATTCCCTCGGC 3-10-3 cEt 110
481760 4768 4781 CGGGATTCCCTCGG 2-10-2 cEt 111
481536 4782 4797 GTAGGTAAGCAACCCA 3-10-3 cEt 112
481761 4783 4796 TAGGTAAGCAACCC 2-10-2 cEt 113
481537 4830 4845 GAATTTGAATGCAGTG 3-10-3 cEt 114
481762 4831 4844 AATTTGAATGCAGT 2-10-2 cEt 115
481538 4844 4859 TGAAGTACACATTGGA 3-10-3 cEt 116
481763 4845 4858 GAAGTACACATTGG 2-10-2 cEt 117
481539 4860 4875 ATAAATTTTTACACTA 3-10-3 cEt 118
481764 4861 4874 TAAATTTTTACACT 2-10-2 cEt 119 481765 4869 4882 CAATAATATAAATT 2-10-2 cEt 120
481541 4934 4949 CTGGAAGTTAAAGTAG 3-10-3 cEt 121
481766 4935 4948 TGGAAGTTAAAGTA 2-10-2 cEt 122
Table 2
Chimeric antisense oligonucleotides targeted to STAT3 (SEQ ID NO: 2)
Figure imgf000073_0001
Certain Combination Therapies
In certain embodiments, one or more pharmaceutical compositions provided herein are co-administered with one or more other pharmaceutical agents. In certain embodiments, such one or more other pharmaceutical agents are designed to treat the same disease, disorder, or condition as the one or more pharmaceutical compositions provided herein. In certain embodiments, such one or more other pharmaceutical agents are designed to treat a different disease, disorder, or condition as the one or more pharmaceutical compositions provided herein. In certain embodiments, such one or more other pharmaceutical agents are designed to treat an undesired side effect of one or more pharmaceutical compositions provided herein. In certain embodiments, one or more pharmaceutical compositions provided herein are co-administered with another pharmaceutical agent to treat an undesired effect of that other pharmaceutical agent. In certain embodiments, one or more pharmaceutical compositions provided herein are co- administered with another pharmaceutical agent to produce a combinational effect. In certain embodiments, one or more pharmaceutical compositions provided herein are coadministered with another pharmaceutical agent to produce a synergistic effect.
In certain embodiments, one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are administered at the same time. In certain embodiments, one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are administered at different times. In certain embodiments, one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are prepared together in a single formulation. In certain embodiments, one or more pharmaceutical compositions provided herein and one or more other pharmaceutical agents are prepared separately. In certain embodiments, one or more other pharmaceutical agents include all-trans retinoic acid, azacitidine, azathioprine, bleomycin, carboplatin, capecitabine, cisplatin, chlorambucil, cyclophosphamide, cytarabine, daunorubicin, docetaxel, doxifluridine, doxorubicin, epirubicin, epothilone, etoposide, fluorouracil, gemcitabine, hydroxyurea, idarubicin, imatinib, mechlorethamine, mercaptopurine, methotrexate, mitoxantrone, oxaliplatin, paclitaxel, pemetrexed, teniposide, tioguanine, valrubicin, vinblastine, vincristine, vindesine, or vinorelbine. In certain embodiments, one or more other pharmaceutical agents include a combination of cyclophosphamide, hydroxydanuorubicin, Oncovin (vincristine), prednisone or prednisolone (CHOP). In certain embodiments, one or more other pharmaceutical agents include a combination of rituximab and CHOP (R-CHOP). In certain embodiments, one or more other pharmaceutical agents include another antisense oligonucleotide. In certain embodiments, another antisense oligonucleotide is a second STAT3 antisense oligonucleotide. In certain embodiments, one or more other pharmaceutical agents include molecular targeted therapies. In certain embodiments, the molecular targeted therapy is an EGFR inhibitor, a mTOR inhibitor, a HER2 inhibitor, or a VEGF/VEGFR inhibitor. In certain embodiments, EGFR inhibitors include gefitinib, erlotinib, lapatinib, cetuximab, panitumumbo. In certain embodiments, mTOR inhibitors include everolimus and temsirolimus. In certain embodiments, HER2 inhibitors include trastuzumab and lapatinib. In certain embodiments, VEGF/VEGFR inhibitors include pazopanib, bevacizumab, sunitinib, and sorafenib.
In certain embodiments, one more pharmaceutical compositions provided herein are administered with radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered at the same time as radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered before radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered after radiation therapy. In certain embodiments, one or more pharmaceutical compositions are administered at various time points throughout a radiation therapy regimen.
In certain embodiments, radiation therapy is useful for inhibiting tumor growth. In certain embodiments, radiation therapy is useful for increasing overall survival. In certain embodiments, radiation therapy used in conjunction with administration of one or more pharmaceuticals provided herein is advantageous over using either therapy alone because both radiation therapy and administration with one or more pharmaceuticals can be limited to achieve effective antiproliferative response with limited toxicity.
In certain embodiments, a physician designs a therapy regimen including both radiation therapy and administration of one more pharmaceutical compositions provided herein. In certain embodiments, a physician designs a therapy regimen including radiation therapy, administration of one or more pharmaceutical compositions provided herein, and administration of one or more other chemotherapeutic agents.
EXAMPLES
Non-limiting disclosure and incorporation by reference While certain compounds, compositions and methods described herein have been described with specificity in accordance with certain embodiments, the following examples serve only to illustrate certain embodiments described herein and are not intended to limit the same. Each of the references recited in the present application is incorporated herein by reference in its entirety.
Example 1: Phase 1, open-label, study for treating a patient having advanced B cell lymphoma with a STAT3 antisense oligonucleotide
The effect of intravenous infusion of the STAT3 antisense oligonucleotide, ISIS 481464, in patients with advanced B cell lymphomas was studied. Patients with diffuse large B-cell lymphomas (DLBCL) were recruited for this study.
The criteria for patient inclusion with respect to their tumor status was that the tumors should be relapsed or refractory to at least one prior anti-cancer systemic therapy, and/or for which no standard therapy exists; that their disease should be measurable or evaluable, according to RECIST version 1.1 for solid tumors, or according to the International Workshop Response Criteria for Non-Hodgkin's Lymphoma for NHL tumors (Cheson, B.D. et al., J. Clin. Oncol. 1999, 17: 1244; Cheson, B.D. et al., J. Clin. Oncol. 2007, 25(5):579-86), or according to appropriate criteria for other advanced cancers. RECIST (Response Evaluation Criteria in Solid Tumors) is an internationally accepted set of guidelines used in clinical trials for solid tumor disease.
One patient fitting the criteria above is a 63 year old female with DLBCL designated herein as Patient #1001. Prior to commencing therapy, Patient #1001 showed multiple areas of hypermetabolic adenopathy, both above and below the diaphragm, including the supraclavicular, left paratracheal, right internal mammary, pericardial, left intra-mammary, pre-hepatic, retroperitoneal, and mesenteric regions. In addition, the patient suffered from fatigue, nausea, night sweats, shortness of breath on exertion, and peripheral neuropathy. The patient also noted 5-6 days of right-sided abdominal fullness and associated pain. Patient therapy was commenced with a treatment period comprising administration during a first phase of 3 loading doses of ISIS 481464: a 3-hr intravenous infusion of 2 mg/kg ideal body weight of ISIS 481464 administered on days 1, 3, and 5 of cycle 0. The ideal body weight was determined using the Devine formula (Pai, M.P. and Paloucek, F.P. Ann. Pharmacol. 2000. 34: 1066-1069): for men (in kg) = 50 + 2.3 kg/inch over 5 feet; for women (in kg) = 45.5 + 2.3 kg/inch over 5 feet. Treatment was then continued in a second phase by once-weekly administrations (Cycle 1 and beyond) of 2 mg/kg ideal body weight of ISIS 481464 until disease progression, unacceptable toxicity, or patient discontinuation for any other reason occurred. Disease assessments were performed at the end of even cycles.
Tumor lesions were evaluated on each even-numbered cycle, starting with Cycle 2, day 15, by positron emission tomography (PET) scan. According to RECIST guidelines, a complete tumor response is achieved when all target lesions have disappeared. Partial response is achieved when the sum of the diameters of all tumor lesions is reduced at least 30% compared to the sum of the tumor lesion diameters at pre-dose. The sum of the lesion diameters, if any, was calculated, per RECIST guidelines (Eisenhauer, E.A. et al, Eur. J. Cancer 45: 228-247, 2009). After 28 days of treatment with ISIS 481464, the patient reported reduced fatigue and night sweats, and was tolerating the treatment well.
After 49 days of treatment with ISIS 481464, a PET scan was performed and revealed a 55% reduction in tumor size. Tumors were reduced in all compartments, but most notably, in the supraclavicular, paratracheal, pericardial, and mesenteric regions. After 91 days of treatment with ISIS 481464, Patient # 1001 had a second PET scan and the partial response observed in the first scan was found to be maintained at a 55% reduction in tumor size.
After 133 days of treatment with ISIS 481464, Patient #1001 had a third PET scan and the partial response was found to be maintained at a 55% reduction in tumor size. After 162 days of treatment with ISIS 481464, further treatment was paused for a month during which Patient #1001 had a fourth PET scan, and the partial response was maintained at a 55% reduction in tumor size. Patient #1001 is scheduled for further scans.
Example 2: Phase 1, open-label, study for treating a patient having
advanced/metastatic hepatocellular carcinoma with a STAT3 antisense
oligonucleotide
The effect of intravenous infusion of the STAT3 antisense oligonucleotide, ISIS 481464, in patients with advanced/metastatic hepatocellular carcinoma is being studied in an on-going clinical trial. In the study described in this protocol, AZD9150 will be administered to patients with advanced/metastatic hepatocellular carcinoma at a starting dose of 1 mg/kg intravenously 3x during week 1 followed by lx weekly and dose intensity will be escalated or de-escalated in subsequent cohorts through modification of unit dose administered and/or interval of administraion to determine a maximum tolerated dose and recommended phase II dose in patients with advanced/metastatic hepatocellular carcinoma (HCC).
Following the dose escalation phase of the study additional patients will be enrolled to a dose expansion phase to explore further the safety, tolerability, pharmacokinetics and biological activity at selected dose(s)/schedules. Patients included in the study are relapsed, refractory, intolerant or unlikely to benefit from first-line systemic therapy (sorafenib).
To date, the 1 mg/kg and 1.5 mg/kg cohorts have completed. From the 1 mg/kg cohort 4 patients remain on study with stable disease in excess of 3 months. Stable disease has also been seen in 1.5 mg/kg cohort. These patients and future patients will be monitored further for clinical activity as the trial progresses.

Claims

CLAIMS:
1. A method of treating cancer in a subject comprising administering to the subject a weekly dose of an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the dose comprises about 1.5 to 3.5 milligrams of the antisense compound per kilogram of the subject's body weight per week (1.5-3.5 mg/kg/wk).
2. A method of treating cancer in a subject comprising administering to the subject a weekly dose of an antisense compound complementary to a nucleic acid encoding human STAT3, wherein the dose comprises about 15 milligrams to 250 milligrams of the antisense compound per week.
3. A method comprising administering to a subject having cancer a pharmaceutical composition comprising an antisense compound complementary to a nucleic acid encoding human STAT3, wherein administering the antisense compound comprises:
a loading phase comprising a total weekly dose in the range of about 100-750 mg for the first 1-10 weeks, and
a maintenance phase comprising a total weekly dose in the range of 100-250 mg for at least 1 week after the loading phase.
4. The method of claim 1, wherein the dose is 3.0 milligrams of the antisense compound per kilogram of the subject's body weight per week (3.0 mg/kg/wk).
5. The method of claim 1 - 4 wherein the dose is administered for at least 1-52 weeks.
6. The method of any one of claims 1 - 4, wherein the dose is administered to the subject 1-6 times per week.
7. The method of any one of claims 1 - 4, wherein the dose is administered 1-6 times during the first week and 1 time each subsequent week.
8. The method of claim 3, wherein the loading phase is 1 week.
9. The method of claim 3, wherein the total weekly dose of the antisense compound in the loading phase is an amount of any of about 100 mg, 125 mg, 150 mg, 175 mg, 200 mg, 225 mg, 250 mg, 275 mg, 300 mg, 325 mg, 350 mg, 375 mg, 400 mg, 425 mg, 450 mg, 475 mg, 500 mg, 525 mg, 550 mg, 575 mg, 600 mg, 625 mg, 650 mg, 675 mg, 700 mg, 725 mg, or 750 mg.
10. The method of any one of claims 3 or 17, wherein the total weekly dose of the antisense compound in the maintenance phase is an amount of any of about 100 mg, 110 mg, 120 mg, 130 mg, 140 mg, 150 mg, 160 mg, 170 mg, 180 mg, 190 mg, 200 mg, 210 mg, 220 mg, 230 mg, 240 mg, or 250 mg.
11. The method of any one of claims 1-10, wherein the cancer is B-cell lymphoma or hepatocellular carcinoma (HCC).
12. The method of claim 11, wherein the B-cell lymphoma is a non-Hodgkin's B-cell lymphoma.
13. The method of claim 12, wherein the non-Hodgkin's B-cell lymphoma is selected from the group consisting of: diffuse large B cell lymphoma (DLBCL), follicular lymphoma, mucosa-associated lymphatic tissue lymphoma (MALT), small cell lymphocytic lymphoma, chronic lymphocytic leukemia, mantle cell lymphoma (MCL), Burkitt lymphoma, mediastinal large B cell lymphoma, Waldenstrom macroglobulinemia, nodal marginal zone B cell lymphoma (NMZL), splenic marginal zone lymphoma (SMZL), intravascular large B-cell lymphoma, primary effusion lymphoma, and lymphomatoid granulomatosis.
14. The method of claim 12, wherein the non-Hodgkin's B-cell lymphoma is diffuse large B cell lymphoma (DLBCL).
15. The method of any one of claims 1-14, wherein the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 3016 to 3031 of SEQ ID NO: 1, wherein the nucleobase sequence is complementary to SEQ ID NO: 1.
16. The method of claim 15, wherein the nucleobase sequence of the modified oligonucleotide comprises the sequence of SEQ ID NO: 12.
17. The method of claims 15 or 16, wherein the modified oligonucleotide is a single- stranded modified oligonucleotide.
18. The method of any one of claims 15-17, wherein the modified oligonucleotide comprises at least one modified internucleoside linkage.
19. The method of claim 18, wherein each internucleoside linkage is a phosphorothioate internucleoside linkage.
20. The method of any one of claims 15-19, wherein at least one nucleoside comprises a modified sugar.
21. The method of claim 20, wherein at least one modified sugar is a bicyclic sugar.
22. The method of claim 21 , wherein the bicyclic sugar comprises a 4'- CH2-0-2' bridge, a 4'-CH(CH3)-0-2' bridge or a 2'-0(CH2)2-OCH3 group.
23. The method of any one of claims 15-22, wherein at least one nucleoside comprises a modified nucleobase.
24 The method of claim 23, wherein the modified nucleobase is a 5'-methylcytosine.
25. The method of any one of claims 15-24, wherein the modified oligonucleotide is single-stranded consisting of 16 linked nucleosides having a nucleobase sequence consisting of SEQ ID NO: 12, comprising:
a gap segment consisting of ten linked deoxynucleosides;
a 5' wing segment consisting of 3 linked nucleosides; and
a 3' wing segment consisting of 3 linked nucleosides;
wherein the gap segment is positioned between the 5' wing segment and the 3' wing segment; wherein each nucleoside of each wing segment comprises a constrained ethyl nucleoside; wherein each internucleoside linkage of the modified oligonucleotide is a phosphorothioate linkage; and wherein each cytosine of the modified oligonucleotide is a 5 '-methylcytosine.
26. A method of treating B-cell lymphoma in a subject comprising administering to the subject an antisense compound complementary to human STAT3, thereby treating B-cell lymphoma in the subject.
27. A method of treating hepatocellular carcinoma in a subject comprising administering to the subject an antisense compound complementary to human STAT3, thereby treating the hepatocellular carcinoma in the subject.
28. An antisense compound complementary to human STAT3 for use in a method of treating cancer in a subject in need thereof, wherein the method comprises administering to the subject the antisense compound in a first phase and then a second phase, wherein the first phase involves administering a total weekly dose of the compound in the range of about 15-750 mg for the first 1-10 weeks, and the second phase involves administering a total weekly dose in the range of 15-250 mg for at least 1 week after the loading phase.
29. The antisense compound of claim 28, wherein the antisense compound comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides having a nucleobase sequence comprising a portion of at least 12 contiguous nucleobases complementary to an equal length portion of nucleobases 3016 to 3031 of SEQ ID NO: 1, wherein the nucleobase sequence is complementary to SEQ ID NO: 1.
30. The antisense compound of claim 29, wherein the nucleobase sequence of the modified oligonucleotide comprises the sequence of SEQ ID NO: 12.
31. The antisense compound of claim 29, wherein the antisense compound is a single- stranded modified oligonucleotide consisting of 16 linked nucleosides having a nucleobase sequence consisting of SEQ ID NO: 12, comprising:
a gap segment consisting of ten linked deoxynucleosides;
a 5' wing segment consisting of 3 linked nucleosides; and
a 3' wing segment consisting of 3 linked nucleosides; wherein the gap segment is positioned between the 5' wing segment and the 3' wing segment; wherein each nucleoside of each wing segment comprises a constrained ethyl nucleoside; wherein each internucleoside linkage of the modified oligonucleotide is a phosphorothioate linkage; and wherein each cytosine of the modified oligonucleotide is a 5 '-methylcytosine.
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