Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07F—ACYCLIC, CARBOCYCLIC OR HETEROCYCLIC COMPOUNDS CONTAINING ELEMENTS OTHER THAN CARBON, HYDROGEN, HALOGEN, OXYGEN, NITROGEN, SULFUR, SELENIUM OR TELLURIUM
  • C07F9/00—Compounds containing elements of Groups 5 or 15 of the Periodic Table
  • C07F9/66—Arsenic compounds
  • C07F9/70—Organo-arsenic compounds
  • C07F9/72—Aliphatic compounds
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/28—Compounds containing heavy metals
  • A61K31/285—Arsenic compounds
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K33/00—Medicinal preparations containing inorganic active ingredients
  • A61K33/24—Heavy metals; Compounds thereof
  • A61K33/36—Arsenic; Compounds thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
  • A61P35/02—Antineoplastic agents specific for leukemia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07B—GENERAL METHODS OF ORGANIC CHEMISTRY; APPARATUS THEREFOR
  • C07B2200/00—Indexing scheme relating to specific properties of organic compounds
  • C07B2200/13—Crystalline forms, e.g. polymorphs

Definitions

• the present invention relates generally to the field of anti-cancer therapy. More particularly, it provides novel crystalline forms of organic arsenic compounds and methods for their use in treating cancers such as leukemia and solid tumors.
• Arsenic trioxide an inorganic compound, has been approved for the treatment of patients with relapsed or refractory acute promyelocytic leukemia (APL) and is being evaluated as therapy for other leukemia types.
• APL acute promyelocytic leukemia
• Preliminary data from China and the recent experience in the U.S. suggest a role for arsenic trioxide in the other hematologic cancers as well. Consequently, the effectiveness of arsenic trioxide as an anti-leukemic agent is currently being investigated in many types of leukemia.
• OA organic arsenical
• the properties of the solid state are critical factors that determine the choice of an appropriate salt form of a drug molecule.
• a given salt form may exist as different solid phases which may arise during crystallization or pharmaceutical processing.
• Such solid forms include polymorphs, for example.
• Polymorphism is the ability of a substance to exist as two or more crystalline phases that have different crystal lattices. Polymorphs have different physico- chemical properties such as crystal packing, bulk thermodynamic, spectroscopic, kinetic, surface and mechanical properties; see pages 1-33 of D.J.W. Grant, "Theory and origin of
• polymorphism in: Polymorphism in Pharmaceutical Solids, ed. H.G. Brittain, Marcel Dekker, New York, 1999, incorporated herein by reference in its entirety.
• Different solid phases may confer different properties and characteristics to the drug molecule such as processability, stability, melting point, solubility, and shelf life which in turn may affect in vivo pharmacology, such as therapeutic efficacy, toxicity and bioavailability. Given these property differences, new crystal forms of devicesaparsin would be of potential use in preparing pharmaceutical formulations.
• the present invention provides novel crystalline forms of organic arsenical compounds having anti-cancer properties.
• the present invention provides a crystalline form of a compound having a structure of formula (I) (darinaparsin)
• the crystalline form has a melting point greater than or equal to 185 °C.
• the crystalline form has a melting point in the range of about 185-200 °C.
• the crystalline form has a melting point in the range of about 187-200 °C, e.g., 187-197 °C.
• the crystalline form has a melting point in the range of about 190-200 °C.
• the invention provides a crystalline form of a compound having a structure of formula (I) (darinaparsin) wherein the crystal form has an X-ray- powder diffraction pattern comprising characteristic peaks, expressed in terms of 2 ⁇ , at one or more of the following angles: about 16.6°, about 17.4°, about 21.4° and about 25.2°.
• the X-ray powder diffraction pattern of the crystalline form of a compound having a structure of formula (I) (darinaparsin) also has characteristic peaks, expressed in terms of 2 ⁇ , at one or more of the following angles: about 14.4°, about 19.3°, about 22.0°, about 23.3° and about 25.0°.
• the X-ray powder diffraction pattern of the crystalline form of a compound having a structure of formula (I) (darinaparsin) has characteristic peaks substantially as shown in Figure 2.
• the crystalline form of a compound having a structure of formula (I) (darinaparsin) also has a differential scanning calorimetry trace substantially as shown in Figure 1.
• the invention provides a crystalline form of a compound having a structure of formula (I) (darinaparsin) wherein the crystal form has (a) a melting point greater than or equal to 185 °C and (b) an X-ray powder diffraction pattern comprising characteristic peaks, expressed in terms of 2 ⁇ , at one or more of the following angles: about 16.6°, about 17.4°, about 21.4°, and about 25.2°.
• the invention provides a crystalline form of a compound having a structure of formula (I) (darinaparsin) wherein the crystal form has (a) a melting point in the range of about 185-200 °C and (b) an X-ray powder diffraction pattern comprising characteristic peaks, expressed in terms of 2 ⁇ , at one or more of the following angles: about 16.6°, about 17.4°, about 21.4°, and about 25.2°.
• formula (I) (darinaparsin) wherein the crystal form has (a) a melting point in the range of about 185-200 °C and (b) an X-ray powder diffraction pattern comprising characteristic peaks, expressed in terms of 2 ⁇ , at one or more of the following angles: about 16.6°, about 17.4°, about 21.4°, and about 25.2°.
• the invention provides a crystalline form of a compound having a structure of formula (I) (darinaparsin) wherein the crystal form has (a) a melting point in the range of about 190-200 °C and (b) an X-ray powder diffraction pattern comprising characteristic peaks, expressed in terms of 2 ⁇ , at one or more of the following angles: about 16.6°, about 17.4°, about 21.4°, and about 25.2°.
• formula (I) (darinaparsin) wherein the crystal form has (a) a melting point in the range of about 190-200 °C and (b) an X-ray powder diffraction pattern comprising characteristic peaks, expressed in terms of 2 ⁇ , at one or more of the following angles: about 16.6°, about 17.4°, about 21.4°, and about 25.2°.
• the invention provides a method for the preparation of a pharmaceutical composition, such as an aqueous solution having a pH in the range of 4 to 7, which comprises dissolving a crystalline preparation of a compound having a structure of formula (I) as described herein in water (e.g., water for injection); and optionally adjusting the pH.
• a pharmaceutical composition such as an aqueous solution having a pH in the range of 4 to 7, which comprises dissolving a crystalline preparation of a compound having a structure of formula (I) as described herein in water (e.g., water for injection); and optionally adjusting the pH.
• the invention provides a method for the preparation of a lyophilisate, which comprises preparing an aqueous solution of a compound having a structure of formula (I) and lyophilizing the aqueous solution.
• Figure 1 depicts a differential scanning calorimetry (DSC) thermogram for the crystalline preparation of a compound of formula (I) according to the protocol of Example 1, which was recorded using a TA Instrument 2920 differential scanning calorimeter; 25-250 °C at 10 °C/min.
• DSC differential scanning calorimetry
• Figure 2 depicts a powder X-ray diffraction (PXRD) pattern for the crystalline preparation of a compound of formula (I) according to the protocol of Example 1, which was recorded using a Shimadzu XRD-6000 X-ray powder diffractometer in the 2 ⁇ geometry;
• PXRD powder X-ray diffraction
• a crystalline form of diaparsin or a pharmaceutically acceptable salt thereof has a melting point greater than or equal to 185 °C, e.g., in the range of 185-200 °C or even in the range of 187-197 °C.
• a crystalline form of diaparsin or a pharmaceutically acceptable salt thereof has a melting point in the range of 190-200°C, e.g., in the range of 190-198 °C or even in the range of 191-196 °C.
• the invention further provides pharmaceutical compositions including using a crystalline form of a compound having a structure of formula (I) or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable diluent or carrier.
• the pharmaceutical composition is an aqueous solution that has a pH greater than about 4 or even greater than about 5, in some embodiments in the range from about 4 to about 8; in other embodiments from about 5 to about 8, in some embodiments in the range from about 4 to about 7, or in some embodiments about 5 to about 7.
• a method for the preparation of a pharmaceutical composition wherein the composition is an aqueous solution having a pH in a range described above that comprises a compound having a structure of formula (I) or a
• Such a method comprises dissolving the crystalline form in water for injection and optionally adjusting the pH.
• the pH may be adjusted with pharmaceutically acceptable base or acid, such as sodium hydroxide or hydrochloric acid.
• the invention relates to pharmaceutical compositions comprising a crystalline form of a compound having a structure of formula (I) or a
• the pharmaceutical composition is a lyophilisate.
• the invention provides a composition of the compound of formula (I) or a pharmaceutically acceptable salt thereof in which at least 50% by weight of the compound of formula (I) in the pharmaceutical composition is present as the crystalline form as described herein, in some embodiments at least 70% , in other embodiments at least 80%, in other embodiments at least 90%, in other embodiments at least 95%, in other embodiments at least 97%, in other embodiments at least 99%, in other embodiments at least 99.5% or in other embodiments at least 99.9%.
• the lyophilisate comprising a crystalline form of a compound having a structure of formula (I) or a pharmaceutically acceptable salt thereof is prepared by a method comprising preparing an aqueous solution of the crystalline form of a compound having a structure of formula (I) or a pharmaceutically acceptable salt thereof and lyophilizing the aqueous solution.
• the lyophilization is performed in less than about 72 hours, less than about 60 hours, less than about 48 hours, or even less than about 36 hours.
• the lyophilization is performed by decreasing the
• lyophilization is performed by decreasing the temperature in the range from about -30°C to about -50 °C.
• the temperature is decreased at a rate of about 1.0, about 0.7, about 0.5, about 0.3, or about 0.1 °C/min.
• the temperature is decreased at a rate of about 1.0 to about 0.1°C/min.
• the composition is then held at a certain temperature as described herein for about 100, about 200, about 250, about 300, about 350, or about 400 minutes.
• the composition is held at a certain temperature as described herein for about 100 to about 400 minutes.
• the composition is then subjected to a vacuum such that the pressure is about 200, about 100, about 75, about 50, or about 25 Torr. In some embodiments, the composition is subjected to a vacuum such that the pressure is about 25 to about 200 Torr.
• the temperature is increased to about - 10, about -5, about 0, about 5 or about 10 °C. In some embodiments, the temperature is increased from about -10 °C to about 10 °C. In certain such embodiments, the temperature is increased at a rate of about 0.5, about 0.3, about 0.1, or about 0.05 °C/min.
• the temperature is increased at a rate of about 0.05 to about 0.5°C/min.
• the composition is held at a certain temperature and pressure as described herein for about 500, about 700, about 800, about 1000, about 1200, or about 1400 minutes. In some embodiments, the composition is held at a certain temperatures and pressure for about 500 to about 1400 minutes.
• the composition is then subjected to a vacuum such that the pressure is either raised or lowered in relation to the abovementioned vacuum pressure and the pressure is about 200, about 100, about 75, about 50, or about 25 Torr. In some embodiments, the composition is subjected to a vacuum such that the pressure is raised or lowered and the pressure is about 25 to about 200 Torr. In certain such embodiments the temperature is increased to about 15, about 20, about 25, about 30 or about 35 °C. In some embodiments, the temperature is increased from about 15 °C to about 35 °C. In certain such embodiments, the temperature is increased at a rate of about 0.5, about 0.3, about 0.1, or about 0.05 °C/min. In some
• the temperature is increased at a rate of about 0.05 to about 0.5 °C/min.
• the composition is held at a given temperature and pressure for about 600, about 700, about 720, about 740, about 760, about 780, about 800, or about 900 minutes. In some embodiments, the composition is held at a certain temperatures and pressure for about 600 to about 900 minutes.
• Another aspect of the invention provides a method for treating cancer, comprising administering a therapeutically effective amount of a crystalline form of a compound having a structure of formula (I) or a pharmaceutically acceptable salt thereof.
• the invention also relates to the use of a crystalline form of a compound having a structure of formula (I) or a pharmaceutically acceptable salt thereof in the manufacture of a medicament for the treatment of cancer.
• the cancer is selected from a solid tumor, such as brain, lung, liver, spleen, kidney, lymph node, small intestine, pancreas, blood cells, bone, colon, stomach, breast, endometrial, prostate, testicle, ovary, central nervous system, skin, head and neck, esophagus, or bone marrow, or a hematological cancer, such as leukemia, acute promyelocytic leukemia, lymphoma, multiple myeloma, myelodysplasia, myeloproliferative disease, or refractory leukemia.
• the cancer is a leukemia selected from acute and chronic leukemia.
• the cancer is a lymphoma selected from non-Hodgkin's and Hodgkin's lymphoma.
• the non-Hodgkin's lymphoma is selected from peripheral T-cell lymphoma (PTCL), diffuse large B-cell lymphoma, and marginal zone lymphoma.
• the Hodgkin's lymphoma is Hodgkin's nodular sclerosis.
• the invention comprises a method of treating a patient with cancer comprising administering to the patient a composition comprising a crystalline form of a compound having a structure of formula (I) or a pharmaceutically acceptable salt thereof or a pharmaceutical composition as described above.
• the therapeutically effective amount of a compound may be 0.1 - 1000 mg/kg, 1 - 500 mg/kg, or 10 - 100 mg/kg.
• the method comprises administering the composition weekly, twice weekly, or even daily. It is 15 further contemplated that, in some embodiments, the treatment methods involve multiple administrations daily.
• the method comprises administering the composition parenterally.
• the method comprises administering the compound daily such as by injection or infusion. Alternative routes and methods of administration described in the specification may also be used and the mode of administration will mainly depend on the type and location of the cancer.
• Alternative routes and methods of administration described in the specification may also be used and the mode of administration will mainly depend on the type and location of the cancer.
• the method further comprises administering one or more additional agents to the patient.
• additional agents include all-trans-retinoic acid, 9-cis retinoic acid, Am-80, or ascorbic acid.
• adjunct cancer therapies such as chemotherapy, radiotherapy, gene therapy, hormone therapy, and other cancer therapies known in the art are also contemplated in conjunction with the methods of the present invention.
• Various methods of administration are contemplated, including regional, systemic, direct administration and by perfusion. Such methods include administration by injection, oral routes, intravenous, intraarterial, intratumoral, administration to tumoral vasculature, intraperitoneal, intratracheal, intramuscular, endoscopical, intralesional, percutaneous, subcutaneous, topical, nasal, buccal, mucosal, anogenital, rectal and the like.
• phrases "pharmaceutically acceptable” is employed herein to refer to those salts, excipients, carriers, ligands, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
• preventing is art-recognized, and when used in relation to a condition, such as a local recurrence (e.g., pain), a disease such as cancer, a syndrome complex such as heart failure or any other medical condition, is well understood in the art, and includes administration of a composition which reduces the frequency of, or delays the onset of, symptoms of a medical condition in a subject relative to a subject which does not receive 15 the composition.
• a condition such as a local recurrence (e.g., pain)
• a disease such as cancer
• a syndrome complex such as heart failure or any other medical condition
• prevention of cancer includes, for example, reducing the number of detectable cancerous growths in a population of patients receiving a prophylactic treatment relative to an untreated control population, and/or delaying the appearance of detectable cancerous growths in a treated population versus an untreated control population, e.g., by a statistically and/or clinically significant amount.
• Prevention of an infection includes, for example, reducing the number of diagnoses of the infection in a treated population versus an untreated control population, and/or delaying the onset of symptoms of the infection in a treated population versus an untreated control population.
• Prevention of pain includes, for example, reducing the magnitude of, or alternatively delaying, pain sensations experienced by subjects in a treated population versus an untreated control population.
• prophylactic or therapeutic treatment is art-recognized and includes administration to the host of one or more of the subject compositions. If it is administered prior to clinical manifestation of the unwanted condition (e.g., disease or other unwanted state of the host animal) then the treatment is prophylactic, (i.e., it protects the host against developing the unwanted condition), whereas if it is administered after manifestation of the unwanted condition, the treatment is therapeutic, (i.e., it is intended to diminish, ameliorate, or stabilize the existing unwanted condition or side effects thereof).
• the unwanted condition e.g., disease or other unwanted state of the host animal
• substantially free refers to less than 5% by weight, preferably less than 2% by weight, more preferably less than 1% by weight.
• a "therapeutically effective amount" of a compound or composition refers to an amount of the compound(s) or composition which, when administered as part of a desired dosage regimen (e.g., to a mammal, in some embodiments, a human) prevents the disease, for example in an individual that may be predisposed to it alleviates a symptom, ameliorates a condition, and/or slows the onset of disease conditions according to clinically acceptable standards for the disorder or condition to be treated or the cosmetic purpose, e.g., at a reasonable benefit/risk ratio applicable to any medical treatment.
• a desired dosage regimen e.g., to a mammal, in some embodiments, a human
• treating includes reversing, reducing, or arresting the symptoms, clinical signs, and underlying pathology of a condition in manner 15 to improve or stabilize a subject's condition.
• the organic arsenicals of the current invention may be used to treat a variety of cancers, including all solid tumors and all hematological cancers, including leukemia, lymphoma, multiple myeloma, myelodysplasia, or myeloproliferative disorders.
• the OA is also useful for treatment of hematological cancers that have become refractory to other forms of treatment.
• Leukemia is a malignant neoplasm of blood-forming tissues, characterized by abnormal proliferation of leukocytes and is one of the four major types of cancer. Leukemias are classified according to the type of leucocyte most prominently involved. Acute leukemias are predominantly undifferentiated cell populations and chronic leukemias have more mature cell forms (WO9924029).
• the acute leukemias are divided into lymphoblastic (ALL) and non-lymphoblastic (ANLL) types and may be further subdivided by morphologic and cytochemical appearance according to the French- American-British classification or according to their type and degree of differentiation. Specific B- and T-cell, as well as myeloid cell surface markers/antigens are used in the classification too. ALL is predominantly a childhood disease while ANLL, also known as acute myeloid leukemia, is a more common acute leukemia among adults.
• CLL lymphocytic
• CML myeloid
• CLL is characterized by the increased number of mature lymphocytes in blood, bone marrow, and lymphoid organs. Most CLL patients have clonal expansion of lymphocytes with B cell characteristics.
• CLL is a disease of older persons.
• CML the granulocytic cells predominate at all stages of differentiation in blood and bone marrow, but may also affect liver, spleen, and other organs.
• Other malignant hematological diseases that may be treated with the OA of the current invention, include, but are not limited to: myelodysplasia, myeloproliferative diseases, lymphomas, and multiple myeloma.
• Lymphoma is a malignant neoplasm of the hematopoietic and lymphoid tissues that develops from the abnormal growth and proliferation of lymphocytes. Lymphomas are divided into two main classes, Hodgkin's lymphoma and non-Hodgkin's lymphoma.
• HL Hodgkin's lymphoma
• NHL non-Hodgkin's lymphoma
• PTCL peripheral T-cell lymphoma
• B-cell lymphoma diffuse large B-cell lymphoma
• marginal zone lymphoma PTCL
• compositions are prepared by any suitable method, typically by uniformly mixing the active compound(s) with liquids or finely divided solid carriers, or both, in the desired proportions, and optionally forming the resulting mixture into a desired shape.
• pharmaceutically acceptable carrier includes any and all solvents, dispersion media, coatings, surfactants, antioxidants, preservatives (e.g. , antibacterial agents, antifungal agents), isotonic agents, absorption delaying agents, salts, preservatives, drugs, drug stabilizers, gels, binders, excipients, disintegration agents, lubricants, sweetening agents, flavoring agents, dyes, such like materials and combinations thereof, as would be known to one of ordinary skill in the art (see, for example, Remington' s Pharmaceutical Sciences, 18th Ed. Mack Printing Company, 1990, pp. 1289- 1329, incorporated herein by reference). Except insofar as any conventional carrier is incompatible with the active ingredient, its use in the therapeutic or pharmaceutical compositions is contemplated.
• the organic arsenical may be combined with different types of carriers depending on whether it is to be administered in solid, liquid or aerosol form, and whether it need to be sterile for such routes of administration as injection.
• the present invention can be administered intravenously, intradermally, intraarterially, intraperitoneally, intralesionally, intracranially, intraarticularly, intrapro statically, intrapleurally, intratracheally, intranasally, intravitreally, intravaginally, intrarectally, topically, intratumorally, intramuscularly, intraperitoneally, subcutaneously, subconjunctivally, intravesicularly, mucosally, intrapericardially,
• the actual dosage amount of a composition of the present invention administered to a patient can be determined by physical and physiological factors such as body weight, severity of condition, the type of disease being treated, previous or concurrent therapeutic interventions, idiopathy of the patient and on the route of administration.
• the practitioner responsible for administration will, in any event, determine the concentration of active ingredient(s) in a composition and appropriate dose(s) for the individual subject.
• compositions may comprise, for example, at least about 0.1% by weight of the organic arsenical compound.
• the OA compound comprises between about 2% to about 75% of the weight of the composition, or between about 25% to about 60%, for example, and any range derivable therein.
• a dose also comprises from about 0.1 mg/kg/body weight, 0.5 mg/kg/ body weight, 1 mg/kg/body weight, about 5mg/kg/body weight, about 10 mg/kg/body weight, about 20 mg/kg/body weight, about 30 mg/kg/body weight, about 40 mg/kg/body weight, about 50 mg/kg/body weight, about 75 mg/kg/body weight, about 100 mg/kg/body weight, about 200 mg/kg/body weight, about 350 mg/kg/body weight, about 500 mg/kg/body weight, about 750 mg/kg/body weight, to about 1000 mg/kg/body weight or more per administration, and any range derivable therein.
• a derivable range from the numbers listed herein, a range of about 10 mg/kg/body weight to about 100 mg/kg/body weight, etc., is administered, based on the numbers described above.
• the desired dose is administered in a single dose or as divided doses administered 10 at appropriate intervals.
• the composition comprises one or more antioxidants to retard oxidation of one or more component.
• the prevention of the action of microorganisms is brought about by preservatives such as various antibacterial and antifungal agents, including, but not limited to parabens (e.g. , methylparabens, propylparabens), chlorobutanol, phenol, sorbic acid, thimerosal or combinations thereof.
• parabens e.g. , methylparabens, propylparabens
• chlorobutanol phenol
• sorbic acid thimerosal or combinations thereof.
• the organic arsenical may be formulated into a composition in a free base, neutral or salt form.
• Pharmaceutically acceptable salts include the salts formed with the free carboxyl groups derived from inorganic bases such as for example, sodium, potassium, ammonium, calcium or ferric hydroxides; or such organic bases as isopropylamine, trimethylamine, histidine or procaine.
• a carrier can be a solvent or dispersion medium comprising, but not limited to, water, ethanol, polyol (e.g. , glycerol, propylene glycol, liquid polyethylene glycol, etc.), lipids (e.g. , triglycerides, vegetable oils, liposomes) and combinations thereof.
• the proper fluidity is maintained, for example, by the use of a coating, such as lecithin; by the maintenance of the required particle size, by dispersion in carriers such as, for example liquid polyol or lipids; by the use of surfactants such as, for example hydroxypropylcellulose; or combinations thereof such methods.
• the compositions include isotonic agents, such as, for example, sugars, sodium chloride or combinations thereof.
• Sterile injectable solutions are prepared by incorporating the active compounds in the required amount of the appropriate solvent with various of the other exemplary ingredients enumerated above, as required, followed by filtered sterilization.
• dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and/or the other ingredients.
• the preferred methods of preparation are vacuum-drying or 10 freeze-drying techniques which yield a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered liquid medium thereof.
• the liquid medium should be suitably buffered if necessary and the liquid diluent first rendered isotonic prior to injection with sufficient saline or glucose.
• the preparation of highly concentrated compositions for direct injection is also contemplated, where the use of DMSO as solvent is envisioned to result in extremely rapid penetration, delivering high concentrations of the active agents to a small area.
• compositions should be stable under the conditions of manufacture and storage, and preserved against the contaminating action of microorganisms, such as bacteria and fungi.
• preferred compositions have a pH greater than about, preferably from about 5 to about 8, more preferably from about 5 to about 7. It will be appreciated that endotoxin contamination should be kept minimally at a safe level, for example, less that 0.5 ng/mg protein.
• prolonged absorption of an injectable composition can be brought about by the use in the compositions of agents delaying absorption, such as, for example, aluminum monostearate, gelatin or combinations thereof.
• diaparsin can be used in combination with another agent or therapy method, preferably another cancer treatment.
• Darinaparsin may precede or follow the other agent treatment by intervals ranging from minutes to weeks.
• the other agent and expression construct are applied separately to the cell, one would generally ensure that a significant period of time did not elapse between the time of each delivery, such that the agent and expression construct would still be able to exert an
• one or more agents may be administered within about 1 minute, about 5 minutes, about 10 minutes, about 20 minutes about 30 minutes, about 45 minutes, about 60 minutes, about 2 hours, about 3 hours, about 4 hours, about 5 hours, about 6 hours, about 7 hours about 8 hours, about 9 hours, about 10 hours, about 11 hours, about 12 hours, about 13 hours, about 14 hours, about 15 hours, about 16 hours, about 17 hours, about 18 hours, about 19 hours, about 20 hours, about 21 hours, about 22 hours, about 23 hours, about 24 hours, about 25 hours, about 26 hours, about 27 hours, about 28 hours, about 29 hours, about 30 hours, about 31 hours, about 32 hours, about 33 hours, about 34 hours, about 35 hours, about 36 hours, about 37 hours, about 38 hours, about 39 hours, about 40 hours, about 41 hours, about 42 hours, about 43 hours, about 44 hours, about 45 hours, about 46 hours, about 47 hours, to about 48 hours or more prior to and/or after administering the organic arsenical.
• an agent is administered within about 1 day, about 2 days, about 3 days, about 4 days, about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, about 10 days, about 11 days, about 12 days, about 13 days, about 14 days, about 15 days, about 16 days, about 17 days, about 18 days, about 19 days, about 20, to about 21 days prior to and/or after administering the organic arsenical.
• the organic arsenical is "A” and the secondary agent, which can be one or more other therapeutic agents, is "B”:
• Cancer therapies also include a variety of combination therapies with both chemical and radiation based treatments.
• Combination chemotherapies include, for example, cisplatin (CDDP), carboplatin, procarbazine, mechlorethamine, cyclophosphamide, camptothecin, ifosfamide, melphalan, chlorambucil, busulfan, 15 nitrosurea, dactinomycin, daunorubicin, doxorubicin, bleomycin, plicomycin, mitomycin, etoposide (VP16), tamoxifen, raloxifene, estrogen receptor binding agents, taxol, gemcitabine, navelbine, farnesyl-protein transferase inhibitors, transplatinum, 5- fluorouracil, vincristine, vinblastine and methotrexate, or any analog or derivative variant of the foregoing.
• CDDP cisplatin
• carboplatin carboplatin
• diaparsin is administered in combination with one or more other therapeutic agents selected from bortezomib, melphalan, dexamethasone, irinotecan, oxaliplatin, 5-fluorouracil, doxorubicin, and sorafenib.
• the other therapeutic agent is selected from bortezomib, dexamethasone, irinotecan, oxaliplatin, and sorafenib, preferably bortezomib.
• the other therapeutic agent is selected from bortezomib, dexamethasone, irinotecan, oxaliplatin, 5-fluorouracil, sorafenib, all-trans retinoic acid, 9-cis retinoic acid, Am-80 and ascorbic acid.
• the other therapeutic agent is selected from cisplatin (CDDP), carboplatin, procarbazine,
• transplatinum 5- fluorouracil, vincristine, vinblastine, and methotrexate, or any analog or derivative variant thereof.
• the combination is synergistic.
• the combination is additive.
• diaparsin is administered in combination with one or more other therapeutic agents such that the combination is synergistic.
• the other therapeutic agent is bortezomib and/or oxaliplatin.
• diaparsin is administered in combination with one or 10 more other therapeutic agents such that the combination is additive.
• the other therapeutic agent is dexamethasone, irinotecan, and/or sorafenib.
• ⁇ -rays 15 what are commonly known as ⁇ -rays, X-rays, and/or the directed delivery of radioisotopes to tumor cells.
• DNA damaging factors are also contemplated such as microwaves and UV-irradiation. It is most likely that all of these factors effect a broad range of damage on DNA, on the precursors of DNA, on the replication and repair of DNA, and on the assembly and maintenance of chromosomes.
• Dosage ranges for X-rays range from daily doses of 50 to 200 roentgens for prolonged periods of time (3 to 4 wk), to single doses of 2000 to 6000 roentgens.
• Dosage ranges for radioisotopes vary widely, and depend on the half-life of the isotope, the strength and type of radiation emitted, and the uptake by the neoplastic cells. The terms
• contacted and “exposed,” when applied to a cell are used herein to describe the process by which a therapeutic construct and a chemotherapeutic or radiotherapeutic agent are delivered to a target cell or are placed in direct juxtaposition with the target cell.
• both agents are delivered to a cell in a combined amount effective to kill the cell or prevent it from dividing.
• Immunotherapeutics generally, rely on the use of immune effector cells and molecules to target and destroy cancer cells.
• the immune effector may be, for example, an antibody specific for some marker on the surface of a tumor cell.
• the antibody alone may serve as an effector of therapy or it may recruit other cells to actually effect cell killing.
• the antibody also may be conjugated to a drug or toxin (chemotherapeutic, radionucleotide, ricin A chain, cholera toxin, pertussis toxin, etc.) and serve merely as a targeting agent.
• the effector may be a lymphocyte carrying a surface molecule that interacts, either directly or indirectly, with a tumor cell target.
• Various effector cells include cytotoxic T cells and NK cells.
• Immunotherapy could be used as part of a combined therapy, in conjunction with gene therapy.
• the general approach for combined therapy is discussed below.
• the tumor cell must bear some marker that is amenable to targeting, i.e., is not present on the majority of other cells.
• Common tumor markers include carcinoembryonic antigen, prostate specific antigen, urinary tumor associated antigen, fetal antigen, tyrosinase (p97), gp68, TAG-72, HMFG, Sialyl Lewis Antigen, MucA, MucB, PLAP, estrogen receptor, laminin receptor, erb B and pi 55.
• the secondary treatment is a secondary gene therapy in which a therapeutic polynucleotide is administered before, after, or at the same time a first therapeutic agent. Delivery of the therapeutic agent in conjunction with a vector encoding a gene product will have a combined anti-hyperproliferative effect on target tissues.
• Curative surgery is a cancer treatment that may be used in conjunction with other therapies, such as the treatment of the present invention, chemotherapy, radiotherapy, hormonal therapy, gene therapy,
• Curative surgery includes resection in which all or part of cancerous tissue is physically removed, excised, and/or destroyed.
• Tumor resection refers to physical removal of at least part of a tumor.
• treatment by surgery includes laser surgery, cryosurgery, electro surgery, and microscopically controlled surgery (Mohs' surgery). It is further contemplated that the present invention may be used in conjunction with removal of superficial cancers, precancers, or incidental amounts of normal tissue.
• the slurry was stirred at ambient temperature for 2 hours before filtration, washing successively with ethyl alcohol (200 proof, 27 L) and acetone (27 L) and dried in suction for 60 minutes.
• the resulting solid was transferred to drying trays and dried in a vacuum oven at ambient temperature for 66 hours to provide structuresaparsin as a solid with the differential scanning calorimetry (DSC) thermogram of Figure 1, with an extrapolated onset temperature at about 191.36° C and a peak temperature at about 195.65° C.
• DSC differential scanning calorimetry

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