WO2018153971A1 - Combinaison d'inhibiteurs de kinase atr - Google Patents

Combinaison d'inhibiteurs de kinase atr Download PDF

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WO2018153971A1
WO2018153971A1 PCT/EP2018/054364 EP2018054364W WO2018153971A1 WO 2018153971 A1 WO2018153971 A1 WO 2018153971A1 EP 2018054364 W EP2018054364 W EP 2018054364W WO 2018153971 A1 WO2018153971 A1 WO 2018153971A1
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Prior art keywords
pyrazol
naphthyridine
methylmorpholin
morpholin
naphthyridin
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PCT/EP2018/054364
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English (en)
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Antje Margret Wengner
Gerhard Siemeister
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Bayer Pharma Aktiengesellschaft
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Publication of WO2018153971A1 publication Critical patent/WO2018153971A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
    • A61K31/5375—1,4-Oxazines, e.g. morpholine
    • A61K31/5377—1,4-Oxazines, e.g. morpholine not condensed and containing further heterocyclic rings, e.g. timolol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00—Medicinal preparations containing inorganic active ingredients
    • A61K33/24—Heavy metals; Compounds thereof
    • A61K33/243—Platinum; Compounds thereof
    • 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
    • A61K31/282—Platinum 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
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/4738—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems
    • A61K31/4745—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems condensed with ring systems having nitrogen as a ring hetero atom, e.g. phenantrolines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/555—Heterocyclic compounds containing heavy metals, e.g. hemin, hematin, melarsoprol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/14—Peptides containing saccharide radicals; Derivatives thereof, e.g. bleomycin, phleomycin, muramylpeptides or vancomycin
    • 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
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • 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
    • A61K33/244—Lanthanides; Compounds thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N2005/1092—Details
    • A61N2005/1098—Enhancing the effect of the particle by an injected agent or implanted device

Definitions

  • the present invention covers combinations of at least two components, component A and component B, comprising component A being an ATR kinase inhibitor, particularly Compound A, and component B either being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF- A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof; or component B being ionizing radiation.
  • Another aspect of the present invention covers the use of such combinations as described herein for the preparation of a medicament for the treatment or
  • Cancer is the second most prevalent cause of death in the United States, causing 450,000 deaths per year. While substantial progress has been made in identifying some of the likely environmental and hereditary causes of cancer, there is a need for additional therapeutic modalities that target cancer and related diseases. In particular there is a need for therapeutic methods for treating diseases associated with dysregulated growth / proliferation.
  • Cancer is a complex disease arising after a selection process for cells with acquired functional capabilities like enhanced survival / resistance towards apoptosis and a limitless proliferative potential. Thus, it is preferred to develop drugs for cancer therapy addressing distinct features of established tumors.
  • DDR DNA damage response
  • Proteins that directly recognize aberrant DNA structures such as the MRE11-Rad50-Nbsl complex recognizing DNA double strand breaks by binding to double-stranded DNA ends, or RPA (replication protein A) binding to single stranded DNA, recruit and activate the most upstream kinases of the DDR pathway, ATM (ataxia-telangiectasia mutated), ATR (ATM-and Rad3-related, UniProtKB/Swiss-Prot Q13535), and DNA-PKcs (DNA-dependent protein kinase).
  • ATM is primarily activated by DNA double strand breaks
  • DNA-PKcs is mainly involved in non-homologous end joining process of DNA repair
  • ATR responds to a broad spectrum of DNA damage, including double- strand breaks and lesions derived from interference with DNA replication.
  • Major components of downstream signaling of ATM include Chk2 and p53, whereas ATR signaling involves Chkl and cdc25.
  • Knockout of the ATR gene in mice is embryonically lethal and ATR knockout cells develop chromosome breaks and undergo apoptosis [E.J. Brown, D. Baltimore: ATR disruption leads to chromosomal fragmentation and early embryonic lethality. Genes Dev. 14, 397-402, 2000].
  • ATM is not essential for cell survival although ATM knockout cells are hypersensitive to ionizing radiation and agents which cause DNA double-strand breaks.
  • ATR which forms a complex with ATRIP (ATR-interacting protein, UniProtKB/Swiss-Prot Q8WXE1) is mainly activated by long stretches of single-stranded DNA which are generated by the continuing DNA unwinding activity of helicases upon stalled replication.
  • This replication stress with stalled replication forks may be induced by ultraviolet light, certain chemotherapeutic drugs, hydroxyurea, or aberrant oncogenic signaling resulting in increased replication initiation or origin firing.
  • Activation of ATR results in inhibition of the cell cycle in S or G2 phase via the Chkl-cdc25 pathway and in suppression of late origin firing.
  • the cell gains time to resolve the replication stress and, eventually, to restart replication after the source of stress has been removed.
  • As the ATR pathway ensures cell survival after replication stress it potentially contributes to resistance to chemotherapy. Thus inhibition of ATR kinase activity could be useful for cancer treatment.
  • oncogene-driven tumor cells e.g. Ras mutation/upregulation, Myc upregulation, CyclinE overexpression
  • ATR suppression in Ras oncogene driven cells was reported to result in substantial tumor cell killing [O. Gilad, BY Nabet, et al.: Combining ATR suppression with oncogenic Ras synergistically increases genomic instability, causing synthetic lethality or tumorigenesis in a dosage-dependent manner. Cancer Res. 70, 9693-9702, 2010].
  • ATM and ATR are principally activated by different types of DNA damage their signaling includes some cross-talk thus that they can, at least partially, substitute for each others function.
  • This finding suggests some tumor-cell selectivity of pharmaceutical inhibition of ATR.
  • a healthy normal cell which has ATM and ATR pathways in parallel, arrests in Gl phase of the cell cycle upon induced DNA damage even in presence of an ATR inhibitor.
  • a tumor cell which most often deficient in ATM and/or p53 signaling relies on the ATR pathway and undergoes cell death in presence of an ATR inhibitor. This suggests that ATR inhibitors may be used for the treatment of tumors with deficient ATM signaling and/or p53 function.
  • Cimprich causes and consequences of replication stress. Nat. Cell Biol. 16, 2-9, 2014. S. Llona-Minguez, A. Hoglund et al.: Chemical strategies for development of ATR inhibitors. Exp. Rev. Mol. Med. 16, elO, 2014. Thus inhibitors of ATR kinase represent valuable compounds that should complement therapeutic options not only as single agents but also in combination with other anti- hyperproliferative, cytotoxic and/or cytostatic drugs, which are currently used as standard of care in the treatment of hyperproliferative diseases. There is an acute medical need for additional therapeutic options for the treatment of hyper-proliferative diseases.
  • ATR kinase inhibitor particularly 2-[(3R)-3-methylmorpholin-4-yl]-4-(l-methyl-lH-pyrazol-5- yl)-8-(lH-pyrazol-5-yl)-l,7-naphthyridine (in the following called "Compound A"), either in combination with
  • an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof;
  • certain combinations of the present invention have shown surprising therapeutic efficacy in cancer models, which are less sensitive to treatment with the aforementioned standard of care anti-hyperproliferative, cytotoxic and/or cytostatic agents or to treatment with radiation alone.
  • the present invention provides combinations of at least two components, component A and component B, comprising component A being an inhibitor of ATR kinase, particularly Compound A, or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and component B being either an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or
  • the present invention concerns combinations of at least two components A and B, comprising component A being an inhibitor of ATR kinase, particularly Compound A, and component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof.
  • 5-FU or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur
  • the present invention concerns combinations of at least two components A and B, comprising component A being an inhibitor of ATR kinase, particularly Compound A, and component B being ionizing radiation.
  • the combinations comprising at least two components A and B, as decribed and defined herein, are also referred to as "combinations of the present invention”.
  • the present invention covers a kit comprising:
  • component A one or more ATR kinase inhibitors as described herein, particularly
  • component B either 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride or a solvate or a hydrate thereof;
  • kit optionally either or both of said components A and B in any of the above-mentioned combinations are in the form of a pharmaceutical composition which is ready for use to be administered simultaneously, concurrently, separately or sequentially.
  • the components may be administered independently of one another by the oral, intravenous, topical, local installations, intraperitoneal or nasal route.
  • the present invention concerns the combinations as described herein for the treatment or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra.
  • the present invention covers the use of such combinations as described herein for the preparation of a medicament for the treatment or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra.
  • the present invention concerns methods for the treatment and/or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra, using an effective amount of the combinations as described herein.
  • inhibitor of ATR kinase or the term “ATR kinase inhibitor” as used herein means a compound that inhibits ATR kinase and that is component A as described infra ("COMPONENT A OF THE COMBINATION"). Preferably, it refers to Compound A as described infra.
  • halogen atom halo- or Hal-
  • fluorine chlorine, bromine or iodine atom.
  • Ci-C6-alkyl is to be understood as meaning a linear or branched, saturated, monovalent hydrocarbon group having 1, 2, 3, 4, 5, or 6 carbon atoms, e.g. a methyl, ethyl, propyl, butyl, pentyl, hexyl, iso-propyl, iso-butyl, sec-butyl, tert-butyl, iso-pentyl, 2-methylbutyl, 1-methylbutyl, 1-ethylpropyl, 1,2-dimethylpropyl, neo-pentyl, 1,1-dimethylpropyl, 4- methylpentyl, 3-methylpentyl, 2-methylpentyl, 1-methylpentyl, 2-ethylbutyl, 1-ethylbutyl, 3,3- dimethylbutyl, 2,2-dimethylbutyl, 1,1-dimethylbutyl, 2,3-dimethylbutyl, 1,3
  • said group has 1, 2, 3 or 4 carbon atoms ("Ci-C/t-alkyl”), e.g. a methyl, ethyl, propyl, butyl, iso-propyl, iso-butyl, sec-butyl, tert- butyl group, more particularly 1, 2 or 3 carbon atoms (“Ci-C 3 -alkyl”), e.g. a methyl, ethyl, n- propyl or iso-propyl group.
  • Si-C/t-alkyl 1, 2, 3 or 4 carbon atoms
  • Ci-C6-haloalkyl is to be understood as meaning a linear or branched, saturated, monovalent hydrocarbon group in which the term "Ci-C6-alkyl” is defined supra, and in which one or more hydrogen atoms is replaced by a halogen atom, in identically or differently, i.e. one halogen atom being independent from another. Particularly, said halogen atom is F.
  • Said C 1 -C6- haloalkyl group is, for example, -CF3, -CHF2, -CH2F, -CF2CF3 or -CH2CF3.
  • Ci-C t-hydroxyaikyl is to be understood as meaning a linear or branched, saturated, monovalent hydrocarbon group in which the term "Ci-C t-alkyl” is defined supra, and in which one or more hydrogen atoms is replaced by a hydroxy group, e.g. a hydroxymethyl, 1- hydroxyethyl, 2-hydroxyethyl, 1,2-dihydroxyethyl, 3-hydroxypropyl, 2-hydroxypropyl, 2,3- dihydroxypropyl, l,3-dihydroxypropan-2-yl, 3-hydroxy-2-methyl-propyl, 2-hydroxy-2-methyl- propyl, l-hydroxy-2-methyl-propyl group.
  • a hydroxymethyl 1- hydroxyethyl, 2-hydroxyethyl, 1,2-dihydroxyethyl, 3-hydroxypropyl, 2-hydroxypropyl, 2,3- dihydroxypropyl, l,3-dihydroxypropan-2-yl, 3-hydroxy-2-methyl-propyl
  • Ci-C6-alkoxy is to be understood as meaning a linear or branched, saturated, monovalent, hydrocarbon group of formula -O-alkyl, in which the term “alkyl” is defined supra, e.g. a methoxy, ethoxy, n-propoxy, iso-propoxy, n-butoxy, iso-butoxy, tert-butoxy, sec-butoxy, pentoxy, iso-pentoxy, or n-hexoxy group, or an isomer thereof.
  • said "Ci-C6-alkoxy” can contain 1, 2, 3, 4 or 5 carbon atoms, (a "Ci-Cs-alkoxy”), preferably 1, 2, 3 or 4 carbon atoms ("Ci-C 4 -alkoxy").
  • Ci-C6-haloalkoxy is to be understood as meaning a linear or branched, saturated, monovalent Ci-C6-alkoxy group, as defined supra, in which one or more of the hydrogen atoms is replaced, in identically or differently, by a halogen atom. Particularly, said halogen atom is F.
  • Said Ci-Ce-haloalkoxy group is, for example, -OCF 3 , -OCHF 2 , -OCH 2 F, -OCF 2 CF 3 , or
  • C2-C6-alkenyl is to be understood as meaning a linear or branched, monovalent hydrocarbon group, which contains one or more double bonds, and which has 2, 3, 4, 5 or 6 carbon atoms or 2, 3 or 4 carbon atoms ("C 2 -C4-alkenyl), particularly 2 or 3 carbon atoms (“C 2 - C3-alkenyl”), it being understood that in the case in which said alkenyl group contains more than one double bond, then said double bonds may be isolated from, or conjugated with, each other.
  • Said alkenyl group is, for example, a vinyl, allyl, (E)-2-methylvinyl, (Z)-2-methylvinyl, homoallyl, (E)-but-2-enyl, (Z)-but-2-enyl, (E)-but-l-enyl, (Z)-but-l-enyl, pent-4-enyl, (E)-pent- 3-enyl, (Z)-pent-3-enyl, (E)-pent-2-enyl, (Z)-pent-2-enyl, (E)-pent-l-enyl, (Z)-pent-l-enyl, hex- 5-enyl, (E)-hex-4-enyl, (Z)-hex-4-enyl, (E)-hex-3-enyl, (Z)-hex-3-enyl, (E)-hex-2-enyl, (Z)-hex- 2-enyl, (
  • C3-Cio-cycloalkyl is to be understood as meaning a saturated, monovalent, mono-, or bicyclic hydrocarbon ring which contains 3, 4, 5, 6, 7, 8, 9 or 10 carbon atoms ("C3-C10- cycloalkyl").
  • Said C3-Cio-cycloalkyl group is for example, a monocyclic hydrocarbon ring, e.g.
  • said ring contains 3, 4, 5 or 6 carbon atoms ("C3-C6-cycloalkyl”), preferably cyclopropyl.
  • said 3- to 10-membered heterocycloalkyl can contain 2, 3, 4, or 5 carbon atoms, and one or more of the above-mentioned heteroatom-containing groups (a "3- to 6-membered heterocycloalkyl"), more particularly said heterocycloalkyl can contain 4 or 5 carbon atoms, and one or more of the above-mentioned heteroatom-containing groups (a "5- to 6-membered heterocycloalkyl").
  • said heterocycloalkyl can be a 4-membered ring, such as an azetidinyl, oxetanyl, or a 5-membered ring, such as tetrahydrofuranyl, dioxolinyl, pyrrolidinyl, imidazolidinyl, pyrazolidinyl, pyrrolinyl, or a 6-membered ring, such as tetrahydropyranyl, piperidinyl, morpholinyl, dithianyl, thiomorpholinyl, piperazinyl, or trithianyl, or a 7-membered ring, such as a diazepanyl ring, for example.
  • said heterocycloalkyl can be benzo fused.
  • the 3- to 6-membered heterocycloalkyl is a tetrahydrofuranyl, tetrahydropyranyl or piperazinyl
  • Said heterocycloalkyl can be bicyclic, such as, without being limited thereto, a 5,5-membered ring, e.g. a hexahydrocyclopenta[c]pyrrol-2(lH)-yl ring, or a 5,6-membered bicyclic ring, e.g. a hexahydropyrrolo[l,2-a]pyrazin-2(lH)-yl ring.
  • said nitrogen atom-containing ring can be partially unsaturated, i.e. it can contain one or more double bonds, such as, without being limited thereto, a 2,5-dihydro-lH- pyrrolyl, 4H-[l,3,4]thiadiazinyl, 4,5-dihydrooxazolyl, or 4H-[l,4]thiazinyl ring, for example, or, it may be benzo-fused, such as, without being limited thereto, a dihydroisoquinolinyl ring, for example.
  • oxygen atom e.g. a pyrrolidineoxy, tetrahydrofuraneoxy or tetrahydropyranoxy.
  • heterocycloalkenyl may contain one or more double bonds, e.g. 4H-pyranyl, 2H-pyranyl, 3,6- dihydro-2H-pyran-4-yl, 3,6-dihydro-2H-thiopyran-4-yl, l,2,3,6-tetrahydropyridin-4-yl, 3H- diazirinyl, 2,5-dihydro-lH-pyrrolyl, [l,3]dioxolyl, 4H-[l,3,4]thiadiazinyl, 2,5-dihydrofuranyl, 2,3-dihydrofuranyl, 2,5-dihydrothiophenyl, 2,3-dihydrothiophenyl, 4,5-dihydrooxazolyl, 4H- [l,4]thiazinyl or 5,6-dihydroimidazo[l,2-a]pyrazin-7(8H)-yl group or it may be be be
  • heteroaryl is understood as meaning a monovalent, monocyclic- , bicyclic- or tricyclic aromatic ring system having 5, 6, 7, 8, 9, 10, 11, 12, 13 or 14 ring atoms (a "5- to 14- membered heteroaryl” group), 5 or 6 or 9 or 10 ring atoms (a "5- to 10-membered heteroaryl” group) or particularly 5 or 6 ring atoms ("5- to 6-membered heteroaryl” group), and which contains at least one heteroatom which may be identical or different, said heteroatom being such as oxygen, nitrogen or sulfur, and in addition in each case can be benzocondensed.
  • heteroaryl is selected from thienyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, triazolyl, thiadiazolyl, thia-4H-pyrazolyl etc., and benzo derivatives thereof, such as, for example, benzofuranyl, benzothienyl, benzoxazolyl, benzisoxazolyl, benzimidazolyl, benzotriazolyl, indazolyl, indolyl, isoindolyl, etc.; or pyridyl, pyridazinyl, pyrimidinyl, pyrazinyl, triazinyl, etc., and benzo derivatives thereof, such as, for example, quinolinyl, quinazolinyl, isoquinolinyl, etc.;
  • the heteroarylic or heteroarylenic radicals include all the possible isomeric forms thereof, e.g. the positional isomers thereof.
  • the term pyridinyl or pyridinylene includes pyridin-2-yl, pyridin-2-ylene, pyridin-3-yl, pyridin-3-ylene, pyridin-4-yl and pyridin-4-ylene; or the term thienyl or thienylene includes thien-2-yl, thien-2-ylene, thien-3-yl and thien-3-ylene.
  • Ci-Ce as used throughout this text, e.g. in the context of the definition of "C1-C6- alkyl", “Ci-C6-haloalkyl", “Ci-C6-alkoxy”, or “Ci-C6-haloalkoxy” is to be understood as meaning an alkyl group having a finite number of carbon atoms of 1 to 6, i.e. 1, 2, 3, 4, 5, or 6 carbon atoms. It is to be understood further that said term “Ci-Ce” is to be interpreted as any subrange comprised therein, e.g.
  • C1-C6 C2-C5 , C3-C4 , C1-C2 , C1-C3 , C1-C4 , C1-C5 ; particularly C1-C2 , C1-C3 , C1-C4 , C1-C5, Ci-Ce; more particularly C1-C4 ; in the case of "Ci-C6-haloalkyl" or "Ci-C6-haloalkoxy" even more particularly C1-C2.
  • C 2 -C6 as used throughout this text, e.g. in the context of the definitions of "C 2 -C6-alkenyl” and “C 2 -C6-alkynyl”, is to be understood as meaning an alkenyl group or an alkynyl group having a finite number of carbon atoms of 2 to 6, i.e. 2, 3, 4, 5, or 6 carbon atoms. It is to be understood further that said term “C 2 -C6” is to be interpreted as any subrange comprised therein, e.g. C2-C6, C3-C5, C3-C4, C2-C3, C2-C4, C2-C5; particularly C2-C3.
  • C3-C6 as used throughout this text, e.g. in the context of the definition of "C3-C6-cycloalkyl”, is to be understood as meaning a cycloalkyl group having a finite number of carbon atoms of 3 to 6, i.e. 3, 4, 5 or 6 carbon atoms. It is to be understood further that said term “C3-C6” is to be interpreted as any sub-range comprised therein, e.g. C3-C6, C4-C5, C3-C5, C3-C4, C 4 -C 6 , C 5 -C 6 ; particularly C 3 -C 6 .
  • C 2 -C4-alkenyl is to be understood as meaning a alkenyl group having a finite number of carbon atoms of 2 to 4, i.e. 2, 3 or 4 carbon atoms. It is to be understood further that said term “C2-C4" is to be interpreted as any sub-range comprised therein, e.g. C2-C4, C2-C3, C3-C4.
  • substituted means that one or more hydrogens on the designated atom is replaced with a selection from the indicated group, provided that the designated atom's normal valency under the existing circumstances is not exceeded, and that the substitution results in a stable compound. Combinations of substituents and/or variables are permissible only if such combinations result in stable compounds.
  • optionally substituted means optional substitution with the specified groups, radicals or moieties.
  • Ring system substituent means a substituent attached to an aromatic or nonaromatic ring system which, for example, replaces an available hydrogen on the ring system.
  • stable compound' or “stable structure” is meant a compound that is sufficiently robust to survive isolation to a useful degree of purity from a reaction mixture, and formulation into an efficacious therapeutic agent.
  • the term "one or more”, e.g. in the definition of the substituents of the compounds of the general formulae of the present invention, is understood as meaning “one, two, three, four or five, particularly one, two, three or four, more particularly one, two or three, even more particularly one or two”.
  • the invention also includes all suitable isotopic variations of the compound of component A, particularly of Compound A.
  • An isotopic variation of the compound of component A is defined as one in which at least one atom is replaced by an atom having the same atomic number but an atomic mass different from the atomic mass usually or predominantly found in nature.
  • isotopes that can be incorporated into the compound of component A include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorus, sulphur, fluorine, chlorine, bromine and iodine, such as 2 H (deuterium), 3 H (tritium), U C, 13 C, 14 C, 15 N, 17 0, 18 0, 32 P, 33 P, 33 S, 34 S, 35 S, 36 S, 18 F, 36 C1, 82 Br, 123 I, 124 I, 129 I and 131 I, respectively.
  • isotopic variations of the compound of component A are useful in drug and/or substrate tissue distribution studies. Tritiated and carbon- 14, i.e., 14 C, isotopes are particularly preferred for their ease of preparation and detectability. Further, substitution with isotopes such as deuterium may afford certain therapeutic advantages resulting from greater metabolic stability, for example, increased in vivo half-life or reduced dosage requirements and hence may be preferred in some circumstances.
  • isotopic variations of the compound of component A can generally be prepared by conventional procedures known by a person skilled in the art such as by the illustrative methods or by the preparations described in the examples hereafter using appropriate isotopic variations of suitable reagents.
  • the compounds of component A may contain one or more asymmetric centre, depending upon the location and nature of the various substituents desired.
  • Asymmetric carbon atoms may be present in the (R) or (S) configuration, resulting in racemic mixtures in the case of a single asymmetric centre, and diastereomeric mixtures in the case of multiple asymmetric centres.
  • asymmetry may also be present due to restricted rotation about a given bond, for example, the central bond adjoining two substituted aromatic rings of the specified compounds.
  • the compounds of component A may contain sulphur atoms which are asymmetric, such as an asymmetric sul hoxide or sulphoximine group, of structure:
  • Preferred compounds of component A are those which produce the more desirable biological activity, particularly preferred is Compound A.
  • Separated, pure or partially purified isomers and stereoisomers or racemic or diastereomeric mixtures of the compounds of component A are also included within the scope of the present invention.
  • the purification and the separation of such materials can be accomplished by standard techniques known in the art.
  • the optical isomers can be obtained by resolution of the racemic mixtures according to conventional processes, for example, by the formation of diastereoisomeric salts using an optically active acid or base or formation of covalent diastereomers.
  • Examples of appropriate acids are tartaric, diacetyltartaric, ditoluoyltartaric and camphorsulfonic acid.
  • optically active bases or acids are then liberated from the separated diastereomeric salts.
  • a different process for separation of optical isomers involves the use of chiral chromatography (e.g., chiral HPLC columns), with or without conventional derivatisation, optimally chosen to maximise the separation of the enantiomers. Suitable chiral HPLC columns are manufactured by Daicel, e.g., Chiracel OD and Chiracel OJ among many others, all routinely selectable. Enzymatic separations, with or without derivatisation, are also useful.
  • the optically active compounds of this invention can likewise be obtained by chiral syntheses utilizing optically active starting materials.
  • the present invention includes all possible stereoisomers of the compounds of component A as single stereoisomers, or as any mixture of said stereoisomers, e.g. R- or S- isomers, or E- or Z- isomers, in any ratio.
  • Isolation of a single stereoisomer, e.g. a single enantiomer or a single diastereomer, of a compound of component A may be achieved by any suitable state of the art method, such as chromatography, especially chiral chromatography, for example.
  • the compounds of component A may exist as tautomers.
  • any compound of component A which contains a pyrazole moiety as a heteroaryl group for example can exist as a 1H tautomer, or a 2H tautomer, or even a mixture in any amount of the two tautomers, or a triazole moiety for example can exist as a 1H tautomer, a 2H tautomer, or a 4H tautomer, or even a mixture in any amount of said 1H, 2H and 4H tautomers, namely :
  • the present combination includes all possible tautomers of the compounds of component A, particularly the 1 H-tautomer or the 2H-tautomer of the pyrazol-5-yl group in 8-position of the naphthyridine core of Compound A, as single tautomers, or as any mixture of said tautomers, in any ratio.
  • the compounds of component A can exist as N-oxides, which are defined in that at least one nitrogen of the compounds of the present invention is oxidised.
  • the present combination includes all such possible N-oxides of component A.
  • the present combination also relates to useful forms of the compounds as disclosed herein, such as metabolites, hydrates, solvates, prodrugs, salts, in particular pharmaceutically acceptable salts, and co-precipitates.
  • the compounds of the present combination can exist as a hydrate, or as a solvate, wherein the compounds of the present combination contain polar solvents, in particular water, methanol or ethanol for example as structural element of the crystal lattice of the compounds.
  • the amount of polar solvents, in particular water may exist in a stoichiometric or non- stoichiometric ratio. In the case of stoichiometric solvates, e.g.
  • a hydrate, hemi-, (semi-), mono-, sesqui-, di-, tri-, terra-, penta- etc. solvates or hydrates, respectively, are possible.
  • the present combination includes all such hydrates or solvates.
  • the compounds of the present combination can exist in free form, e.g. as a free base, or as a free acid, or as a zwitterion, or can exist in the form of a salt.
  • Said salt may be any salt, either an organic or inorganic addition salt, particularly any pharmaceutically acceptable organic or inorganic addition salt, customarily used in pharmacy.
  • the present invention includes all possible salts of the components of the present combination as single salts, or as any mixture of said salts, in any ratio.
  • the present invention includes all possible crystalline forms, or polymorphs, of the compounds of components of the present combination, either as single polymorphs, or as a mixture of more than one polymorphs, in any ratio.
  • radicals in the compounds of the present combination When radicals in the compounds of the present combination are substituted, the radicals may be mono- or polysubstituted, unless specified otherwise. In the context of the present invention, all radicals which occur more than once are defined independently of one another. Substitution by one, two or three identical or different substituents is preferred.
  • treatment includes inhibition, retardation, checking, alleviating, attenuating, restricting, reducing, suppressing, repelling or healing of a disease or the development, the course or the progression of such states and/or the symptoms of such states.
  • disease includes but is not limited a condition, a disorder, an injury or a health problem.
  • therapy is understood here to be synonymous with the term “treatment”.
  • prevention means the avoidance or reduction of the risk of contracting, experiencing, suffering from or having a disease or a development or advancement of such states and/or the symptoms of such states.
  • the treatment or prevention of a disease may be partial or complete.
  • COMPONENT A OF THE COMBINATION embodiment of the present invention component A is a compound of general formula (I)
  • each 4- to 10-membered heterocycloalkenyl is optionally substituted, one or more times, independently from each other, with Ci-C/t-alkyl;
  • R 3 , R 4 represent, independently from each other, hydrogen or methyl
  • R 7 , R 8 represent, independently from each other, hydrogen, Ci-C6-alkyl, C3-C6-cycloalkyl or phenyl, which phenyl is optionally substituted, one or more times, with halogen; or R 7 and R 8 together represent a 4-, 5-, 6- or 7-membered cyclic amine group, which is optionally substituted, one or more times, independently from each other, with a substituent selected from Ci-C6-alkyl, Ci-C6-haloalkyl, said 4-, 5-, 6- or 7-membered cyclic amine group optionally containing one further heteroatom selected from the group consisting of O, N and S;
  • R 9 represents Ci-C t-alkyl or phenyl, wherein each Ci-C/t-alkyl or phenyl is optionally
  • R 10 represents Ci-C t-alkyl
  • R 11 represents hydrogen, Ci-C 4 -alkyl, -(CO)OR 7 , -(CO)NR 7 R 8 or CN;
  • R 12 represents hydrogen or Ci-C t-alkyl
  • R 13 represents halogen, OH, -NR 7 R 8 , CN, N0 2 , G-Ce-alkyl, G-Ce-haloalkyl, G-Ce-alkoxy, Ci-Ce-haloalkoxy, C 2 -C 6 -alkenyl, C 3 -C 6 -cycloalkyl, -(CO)OR 7 or -(CO)NR 7 R 8 ;
  • component A is a compound of general formula (lb)
  • R 1 , R 2 , R 4 , R 7 , R 8 , R 9 , R 10 , R 11 , R 12 and R 13 are as defined for the compound of general formula (I) supra.
  • component A is a compound of general formula (lb)
  • R 2 represents hydrogen, fluoro, chloro, CN, methyl, G-C t-alkoxy, C2-C3-alkenyl,
  • each 4- to 6-membered heterocycloalkenyl is optionally substituted, one or more times, with methyl;
  • R 4 represents hydrogen or methyl
  • R 7 , R 8 represent, independently from each other, hydrogen or Ci-C/t-aikyl
  • R 9 represents Ci-C t-aikyl
  • R 10 represents Ci-C t-aikyl
  • R 11 represents hydrogen, methyl, -(CO)OR 7 ;
  • said component A is a compound of general formula (I) or (lb), supra, which is selected from:
  • component A is 2-[(3R)-3-methylmorpholin-4-yl]-4-(l-mefhyl- lH-pyrazol-5-yl)-8-(lH-pyrazol-5-yl)-l,7-naphthyridine ("Compound A”), or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof.
  • component A is Compound A of structure
  • pharmaceutically acceptable salt refers to a relatively non-toxic, inorganic or organic acid addition salt of a compound of the present invention.
  • pharmaceutically acceptable salts include those obtained by reacting the main compound, functioning as a base, with an inorganic or organic acid to form a salt, for example, salts of hydrochloric acid, sulfuric acid, phosphoric acid, methane sulfonic acid, camphor sulfonic acid, oxalic acid, maleic acid, succinic acid and citric acid.
  • Pharmaceutically acceptable salts also include those in which the main compound functions as an acid and is reacted with an appropriate base to form, e.g., sodium, potassium, calcium, magnesium, ammonium, and chorine salts.
  • an appropriate base e.g., sodium, potassium, calcium, magnesium, ammonium, and chorine salts.
  • acid addition salts of the claimed compounds may be prepared by reaction of the compounds with the appropriate inorganic or organic acid via any of a number of known methods.
  • alkali and alkaline earth metal salts of acidic compounds of the invention are prepared by reacting the compounds of the invention with the appropriate base via a variety of known methods.
  • Representative salts of a component A of this invention include the conventional non-toxic salts and the quaternary ammonium salts which are formed, for example, from inorganic or organic acids or bases by means well known in the art.
  • acid addition salts include acetate, adipate, alginate, ascorbate, aspartate, benzoate, benzenesulfonate, bisulfate, butyrate, citrate, camphorate, camphorsulfonate, cinnamate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, fumarate, glucoheptanoate, glycerophosphate, hemisulfate, heptanoate, hexanoate, chloride, bromide, iodide, 2-hydroxyethanesulfonate, itaconate, lactate, maleate, mandelate, methanesulfonate, 2-
  • Base salts include alkali metal salts such as potassium and sodium salts, alkaline earth metal salts such as calcium and magnesium salts, and ammonium salts with organic bases such as dicyclohexylamine and N-methyl-D-glucamine. Additionally, basic nitrogen containing groups may be quaternized with such agents as lower alkyl halides such as methyl, ethyl, propyl, or butyl chlorides, bromides and iodides; dialkyl sulfates like dimethyl, diethyl, dibutyl sulfate, or diamyl sulfates, long chain halides such as decyl, lauryl, myristyl and strearyl chlorides, bromides and iodides, aralkyl halides like benzyl and phenethyl bromides and others.
  • lower alkyl halides such as methyl, ethyl, propyl, or butyl chlorides,
  • Said component A, particularly Compound A may be in the form of a pharmaceutical formulation which is ready for use to be administered simultaneously, concurrently, separately or sequentially with component B and optionally component C as further described infra.
  • the components A, particularly Compound A, and B and optionally C may be administered independently of one another by the oral, intravenous, topical, local installations, intraperitoneal or nasal route.
  • COMPONENT B OF THE COMBINATION Component B is either
  • an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38;
  • bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof;
  • component B is an agent selected from 5-FU, cisplatin, carboplatin, oxaliplatin, irinotecan, SN-38 and bleomycin sulfate. According to another preferred embodiment of the aspects of the present invention, component B is ionizing radiation.
  • 5-FU may be administered as a prodrug, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, ftorafur, UFT (ftorafur plus uracil), and S-l (ftorafur plus 5-chloro-2,4- dihydroxypyridine plus potassium oxonate).
  • a prodrug such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, ftorafur, UFT (ftorafur plus uracil), and S-l (ftorafur plus 5-chloro-2,4- dihydroxypyridine plus potassium oxonate).
  • S-l is an oral anticancer medicament based on 5-Fluorouacil as active substance combining three components: Tegafur, a prodrug of 5-FU, Gimeracil (aka 5-chloro-2,4-dihydroxypyridine, CHDP (CAS 103766-25-2)) and Oteracil potassium (potassium oxonate).
  • S-l consists of a fixed dose combination of the three above-mentioned components which complement/support each other at the pharmacokintiec and pharmacodynamics level: Tegafur is a prodrug of 5-FU, the active substance, which is converted into 5-FU following administration.
  • the Gimeracil component of S-l inhibits the enzyme dihydropyrimidin-dehydrogenase (DPD), the rate-limiting enzyme in the catabolic pathway of 5-FU. Gimeracil prevents in such way the conversion of 5-FU into the toxic metabolite F-b-alanine.
  • F-b-alanine (FBAL) is a main metabolite of 5-FU.
  • F-b-alanine and fluorocitrate are thought to cause the cardiotoxic and neurotoxic effects of 5-FU by inhibiting the tricarboxylic acid cycle (Koenig and Patel, 1970; Okeda et al, 1990; Robben et al, 1993; Diasio, 1998; Kuwata et al, 2000; Kato et al, 2001). Consequently, the plasma FBAL concentration after oral administration of S-l is significantly lower than that after protracted intravenous infusion (PVI) of 5-FU thus leading to reduced side effects and simultaneously a higher concentration of 5-FU available to produce the desired cytotoxic effects.
  • PVI protracted intravenous infusion
  • Oteracil potassium prevents gastrointestinal side effects.
  • Oteracil potassium is an orotate phosphoribosyl transferase inhibitor that is distributed primarily to the gastrointestinal tract. This component of S-l decreases the incorporation of 5-fluorouridine triphosphate into RNA in the gastrointestinal mucosa and reduces the incidence of diarrhoea.
  • UFT is an oral agent combining two components : uracil, a competitive inhibitor of DPD, with tegafur, a prodrug of 5-FU, in a 4: 1 molar ratio.
  • the tegafur is taken up by the cancer cells and breaks down into 5-FU.
  • Excess uracil competes with 5-FU for DPD, thus inhibiting 5-FU catabolism and allowing higher amounts of 5-FU to stay inside the cells for its cytotoxic effects.
  • the uracil has also been stated to help protect the gastrointestinal tract from 5-FU toxicity and of its metabolites.
  • Oxaliplatin is a member of the platinum-based antineoplastic agents, which also includes cisplatin and carboplatin.
  • Irinotecan is an inhibitor of topoisomerase 1. It is a semisynthetic molecule similar to the natural alkaloid camptothecin.
  • irinotecan SN-38 is also an an inhibitor of topoisomerase 1 and an antineoplastic drug. It is the active metabolite of irinotecan.
  • Bleomycin is an anti-cancer chemotherapy drug, also classified as an "antitumor antibiotic".
  • the term includes pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride. Preferred is bleomycin sulfate.
  • Suitable dose(s), administration regime(s) and administration route(s) for platinum-based antineoplastic agents include those described in the NCCN Clinical Practice Guidelines in Oncology (NCCN guidelines), in particular in the NCCN Guidelines in Oncology, Version 1.2014 which is included herein by reference in its entirety.
  • cytotoxic refers to an agent which can be administered to kill or eliminate a cancer cell.
  • cytostatic refers to an agent which can be administered to restrain tumor proliferation rather than induce cytotoxic cytoreduction yielding an elimination of the cancer cell from the total viable cell population of the patient.
  • anti-hyperproliferative refers to an agent which can inhibit the survival or multiplication of the tumor cells with high proliferation rate.
  • chemotherapeutic agents described herein e.g. 5-FU, capecitabine, oxaliplatin are considered cytotoxic, cytostatic agent, or anti-hyper-proliferative agent depending on individual tumor types. These anti-hyperproliferative, cytotoxic and cytostatic agents have gained wide spread use as chemotherapeutics in the treatment of various cancer types and are well known.
  • Component B may be administered by the oral, intravenous, topical, local installations, intraperitoneal or nasal route.
  • Fluorouracil or 5-FU (tradenames Adrucil® (IV), Carac® (topical), Efudex® and Efudix® (topical)) is a drug that is a pyrimidine analog which is used in the treatment of cancer. It is a suicide inhibitor and works through irreversible inhibition of thymidylate synthase. It belongs to the family of drugs called the antimetabolites. 5-FU acts in several ways, but principally as a thymidylate synthase (TS) inhibitor. Interrupting the action of this enzyme blocks synthesis of the pyrimidine thymidine, which is a nucleoside required for DNA replication.
  • TS thymidylate synthase
  • Thymidylate synthase methylates deoxyuridine monophosphate (dUMP) to form thymidine monophosphate (dTMP).
  • dUMP deoxyuridine monophosphate
  • dTMP thymidine monophosphate
  • 5-FU causes a scarcity in dTMP, so rapidly dividing cancerous cells undergo cell death via thymineless death.
  • Capecitabine (INN) (tradename Xeloda®, Roche) is an orally- administered chemotherapeutic agent used in the treatment of numerous cancers.
  • Capecitabine is a prodrug, that is enzymatically converted to 5-fluorouracil (5-FU) in the body.
  • Oxaliplatin (tradename Eloxatin® by Sanofi) is a platinum-based antineoplastic agent used in cancer chemotherapy. Oxaliplatin fights carcinoma through non-targeted cytotoxic effects. Like other platinum compounds, its cytotoxicity is thought to result from inhibition of DNA synthesis in cells. In particular, oxaliplatin forms both inter- and intra-strand cross links in DNA, which prevent DNA replication and transcription, causing cell death.
  • Cisplatin (aka cisplatinum) (SP-4-2)-diamminedichloroplatinum(II), CAS No. 15663-27-1) was the first member of the drug class of platinum-based antineoplastic agents, which also includes carboplatin and oxaliplatin. Cisplatin crosslinks DNA in several different ways, interfering with cell division by mitosis. The damaged DNA elicits DNA repair mechanisms, which in turn activate apoptosis when repair proves impossible. Cisplatin is administered intravenously.
  • Carboplatin sold under the trade name Paraplatin® (cw-diammine(cyclobutane-l,l- dicarboxylate-0,0')platinum(II), CAS No. 41575-94-4) is a platinum-based antineoplastic agent used in cancer chemotherapy. Carboplatin interacts with DNA to interfere with DNA repair. Carboplatin is administered intravenously.
  • ionizing radiation includes photon radiation (e.g. x-rays and gamma rays) as well as particle radiation (such as electrons, protons, neutrons, carbon ions, alpha particles, and beta particles).
  • a high-energy photon beam is the most common form of ionizing radiation used for cancer treatment. It comes from a radioactive source such as cobalt, cesium, or a machine called a linear accelerator (linac, for short).
  • a radioactive source such as cobalt, cesium, or a machine called a linear accelerator (linac, for short).
  • Electron beams or particle beams, examples of particle radiation are also produced by a linear accelerator.
  • Proton beams are another form of particle beam radiation.
  • Neutron beams are particularly used for some cancers of the head, neck, and prostate and for certain inoperable tumors.
  • Carbon ion radiation as another example of ionizing radiation can be helpful in treating cancers, particularly in treating radioresistant cancers. It is also called heavy ion radiation.
  • Alpha and beta particles are mainly produced by special radioactive substances that may be injected, swallowed, or put into the body.
  • the present invention provides combinations of at least two components, preferably two components, component A and component B, comprising component A being an inhibitor of ATR kinase, particularly Compound A, or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and component B being either being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF- A2, tegafur, UFT, or S-1; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate
  • a combination of the present invention comprising Compound A and 5-FU, or a prodrug of 5-FU, particularly 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-1 is another aspect of the invention.
  • a combination of the present invention comprising Compound A and 5-FU, or a prodrug of 5- FU is a preferred aspect of the invention.
  • a combination of the present invention comprising Compound A and a platinum-based antineoplastic agent, particularly oxaliplatin, cisplatin or carboplatin is another aspect of the invention.
  • a preferred embodiment of the invention is a combination comprising Compound A and a platinum-based antineoplastic agent selected from oxaliplatin, cisplatin or carboplatin.
  • Another preferred embodiment of the invention is a combination comprising Compound A and a platinum-based antineoplastic agent selected from cisplatin or carboplatin.
  • Another preferred embodiment of the invention is a combination comprising Compound A and cisplatin.
  • Another preferred embodiment of the invention is a combination comprising Compound A and carboplatin.
  • a combination of the present invention comprising Compound A and a topoisomerase inhibitor, particularly irinotecan, topotecan, camptothecin or SN-38 is another aspect of the invention.
  • Another preferred embodiment of the invention is a combination comprising Compound A and a topoisomerase inhibitor seleted from irinotecan and SN-38. Further, a combination of the present invention comprising Compound A and bleomycin, particularly bleomycin sulfate or bleomycin hydrochloride, is another aspect of the invention.
  • Another preferred embodiment of the invention is a combination comprising Compound A and bleomycin sulfate.
  • Another preferred embodiment of the invention is a combination comprising Compound A and ionizing radiation.
  • kits comprising: component A: one or more, preferably one, ATR kinase inhibitor(s) as described supra, particularly Compound A, or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof;
  • component B an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof as described supra.
  • 5-FU or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l
  • a platinum-based antineoplastic agent such as oxaliplatin, cisplatin
  • either or both of said components A and B in any of the above-mentioned combinations are in the form of a pharmaceutical composition which is ready for use to be administered simultaneously, concurrently, separately or sequentially.
  • the components A and B may be administered independently of one another by the oral, intravenous, topical, local installations, intraperitoneal or nasal route.
  • Preferably components A and B are administered by the oral route.
  • kits comprising:
  • component A one or more, preferably one, ATR kinase inhibitor(s) as described supra, particularly Compound A, or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof;
  • component B an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof as described supra; and, optionally,
  • component C one or more, preferably one, further pharmaceutical agent(s),
  • component C being at least one pharmaceutical agent includes the effective compound itself as well as its pharmaceutically acceptable salts, solvates, hydrates or stereoisomers as well as any pharmaceutical composition comprising such effective compound or its pharmaceutically acceptable salts, solvates, hydrates or stereoisomers.
  • a list of such pharmaceutical agents of component C is being provided further below.
  • the combinations of component A and component B of this invention can be administered as the sole pharmaceutical agent or in combination with one or more further pharmaceutical agents C where the resulting combination of components A, B and C causes no unacceptable adverse effects.
  • the combinations of components A and B of this invention can be combined with component C, i.e. one or more further pharmaceutical agents, such as known anti-angiogenesis, anti-hyper-proliferative, antiinflammatory, analgesic, immunoregulatory, diuretic, antiarrhytmic, anti-hypercholsterolemia, anti-dyslipidemia, anti-diabetic or antiviral agents, and the like, as well as with admixtures and combinations thereof.
  • Optional pharmaceutical agents which can be added as component C to the combination of components A and B can be one or more pharmaceutical agents such as 1311-chTNT, abarelix, abiraterone, aclarubicin, ado-trastuzumab emtansine, afatinib, aflibercept, aldesleukin, alectinib, alemtuzumab, alendronic acid, alitretinoin, altretamine, amifostine, aminoglutethimide, hexyl aminolevulinate, amrubicin, amsacrine, anastrozole, ancestim, anethole dithiolethione, anetumab ravtansine, angiotensin II, antithrombin III, aprepitant, arcitumomab, arglabin, arsenic trioxide, asparaginase, axitinib, azacitidine, basilixima
  • the present invention covers a pharmaceutical composition comprising a combination of the present invention as described herein together with one or more pharmaceutically acceptable excipients.
  • the present invention covers a pharmaceutical composition
  • a pharmaceutical composition comprising a combination of at least two components, component A and component B, component A being an inhibitor of ATR kinase, particularly Compound A, or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and component B either being an anti- hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin ; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulf
  • the present invention covers a pharmaceutical composition
  • a pharmaceutical composition comprising a combination of at least two components, component A and component B, component A being an inhibitor of ATR kinase, particularly Compound A, or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and component B being an anti- hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin ; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate
  • components A and B, and optionally component C are present in a joint formulation.
  • compositions are non-toxic, preferably they are non-toxic and inert.
  • Pharmaceutically acceptable excipients include, inter alia,
  • fillers and excipients for example cellulose, microcrystalline cellulose, such as, for example, Avicel®, lactose, mannitol, starch, calcium phosphate such as, for example,
  • ointment bases for example petroleum jelly, paraffins, triglycerides, waxes, wool wax, wool wax alcohols, lanolin, hydrophilic ointment, polyethylene glycols
  • ointment bases for example petroleum jelly, paraffins, triglycerides, waxes, wool wax, wool wax alcohols, lanolin, hydrophilic ointment, polyethylene glycols
  • bases for suppositories for example polyethylene glycols, cacao butter, hard fat
  • solvents for example water, ethanol, Isopropanol, glycerol, propylene glycol, medium chain-length triglycerides fatty oils, liquid polyethylene glycols, paraffins
  • suppositories for example polyethylene glycols, cacao butter, hard fat
  • solvents for example water, ethanol, Isopropanol, glycerol, propylene glycol, medium chain-length triglycerides fatty oils, liquid polyethylene glycols, paraffins
  • surfactants for example sodium dodecyle sulphate, lecithin, phospholipids, fatty alcohols such as, for example, Lanette®, sorbitan fatty acid esters such as, for example, Span®, polyoxyethylene sorbitan fatty acid esters such as, for example, Tween®, polyoxyethylene fatty acid glycerides such as, for example, Cremophor®, polyoxethylene fatty acid esters, polyoxyethylene fatty alcohol ethers, glycerol fatty acid esters, poloxamers such as, for example, Pluronic®),
  • surfactants for example sodium dodecyle sulphate, lecithin, phospholipids, fatty alcohols such as, for example, Lanette®, sorbitan fatty acid esters such as, for example, Span®, polyoxyethylene sorbitan fatty acid esters such as, for example, Tween®, polyoxyethylene fatty acid glycerides such as, for example, Crem
  • buffers and also acids and bases for example phosphates, carbonates, citric acid, acetic acid, hydrochloric acid, sodium hydroxide solution, ammonium carbonate, trometamol, triethanolamine
  • isotonicity agents for example glucose, sodium chloride
  • adsorbents for example highly-disperse silicas
  • viscosity-increasing agents for example polyvinylpyrrolidon, methylcellulose, hydroxypropylmethylcellulose, hydroxypropylcellulose, carboxymethylcellulose-sodium, starch, carbomers, polyacrylic acids such as, for example, Carbopol®, alginates, gelatine),
  • binders for example polyvinylpyrrolidon, methylcellulose, hydroxypropylmethylcellulose, hydroxypropylcellulose, carboxymethylcellulose-sodium, starch, carbomers, polyacrylic acids such as, for example, Carbopol®, alginates, gelatine
  • disintegrants for example modified starch, carboxymethylcellulose-sodium, sodium starch glycolate such as, for example, Explotab®, cross- linked polyvinylpyrrolidon, croscarmellose-sodium such as, for example, AcDiSol®
  • modified starch carboxymethylcellulose-sodium, sodium starch glycolate such as, for example, Explotab®, cross- linked polyvinylpyrrolidon, croscarmellose-sodium such as, for example, AcDiSol®
  • disintegrants for example modified starch, carboxymethylcellulose-sodium, sodium starch glycolate such as, for example, Explotab®, cross- linked polyvinylpyrrolidon, croscarmellose-sodium such as, for example, AcDiSol®
  • lubricants for example magnesium stearate, stearic acid, talc, highly-disperse silicas such as, for example, Aerosil®
  • coating materials for example sugar, shellac
  • film formers for films or diffusion membranes which dissolve rapidly or in a modified manner for example polyvinylpyrrolidones such as, for example, Kollidon®, polyvinyl alcohol, hydroxypropylmethylcellulose, hydroxypropylcellulose, ethylcellulose, hydroxypropylmethylcellulose phthalate, cellulose acetate, cellulose acetate phthalate, polyacrylates, polymethacrylates such as, for example, Eudragit®),
  • capsule materials for example gelatine, hydroxypropylmethylcellulose
  • synthetic polymers for example polylactides, polyglycolides, polyacrylates, polymethacrylates such as, for example, Eudragit®, polyvinylpyrrolidones such as, for example, Kollidon®, polyvinyl alcohols, polyvinyl acetates, polyethylene oxides, polyethylene glycols and their copolymers and blockcopolymers
  • synthetic polymers for example polylactides, polyglycolides, polyacrylates, polymethacrylates such as, for example, Eudragit®, polyvinylpyrrolidones such as, for example, Kollidon®, polyvinyl alcohols, polyvinyl acetates, polyethylene oxides, polyethylene glycols and their copolymers and blockcopolymers
  • plasticizers for example polyethylene glycols, propylene glycol, glycerol, triacetine, triacetyl citrate, dibutyl phthalate
  • stabilisers for example antioxidants such as, for example, ascorbic acid, ascorbyl palmitate, sodium ascorbate, butylhydroxyanisole, butylhydroxytoluene, propyl gallate
  • preservatives for example parabens, sorbic acid, thiomersal, benzalkonium chloride, chlorhexidine acetate, sodium benzoate
  • colourants for example inorganic pigments such as, for example, iron oxides, titanium dioxide
  • flavourings • flavourings, sweeteners, flavour- and/or odour-masking agents.
  • the components A, B and C may be administered independently of one another by the oral, intravenous, topical, local installations, intraperitoneal or nasal route.
  • Components A, B and C are preferably administered orally.
  • compositions of this invention varies by the route of administration.
  • Components of this invention can be tableted with conventional tablet bases such as lactose, sucrose and cornstarch in combination with binders such as acacia, corn starch or gelatin, disintegrating agents intended to assist the break-up and dissolution of the tablet following administration such as potato starch, alginic acid, corn starch, and guar gum, gum tragacanth, acacia, lubricants intended to improve the flow of tablet granulation and to prevent the adhesion of tablet material to the surfaces of the tablet dies and punches, for example talc, stearic acid, or magnesium, calcium or zinc stearate, dyes, coloring agents, and flavoring agents such as peppermint, oil of wintergreen, or cherry flavoring, intended to enhance the aesthetic qualities of the tablets and make them more acceptable to the patient.
  • binders such as acacia, corn starch or gelatin
  • disintegrating agents intended to assist the break-up and dissolution of the tablet
  • Suitable excipients for use in oral liquid dosage forms include dicalcium phosphate and diluents such as water and alcohols, for example, ethanol, benzyl alcohol, and polyethylene alcohols, either with or without the addition of a pharmaceutically acceptable surfactant, suspending agent or emulsifying agent.
  • Various other materials may be present as coatings or to otherwise modify the physical form of the dosage unit. For instance tablets, pills or capsules may be coated with shellac, sugar or both.
  • Dispersible powders and granules are suitable for the preparation of an aqueous suspension. They provide the active ingredient in admixture with a dispersing or wetting agent, a suspending agent and one or more preservatives. Suitable dispersing or wetting agents and suspending agents are exemplified by those already mentioned above. Additional excipients, for example those sweetening, flavoring and coloring agents described above, may also be present.
  • Components of this invention can also be in the form of oil-in- water emulsions.
  • the oily phase may be a vegetable oil such as liquid paraffin or a mixture of vegetable oils.
  • Suitable emulsifying agents may be (1) naturally occurring gums such as gum acacia and gum tragacanth, (2) naturally occurring phosphatides such as soy bean and lecithin, (3) esters or partial esters derived form fatty acids and hexitol anhydrides, for example, sorbitan monooleate, (4) condensation products of said partial esters with ethylene oxide, for example, polyoxyethylene sorbitan monooleate.
  • the emulsions may also contain sweetening and flavoring agents.
  • Oily suspensions can be formulated by suspending the active ingredient in a vegetable oil such as, for example, arachis oil, olive oil, sesame oil or coconut oil, or in a mineral oil such as liquid paraffin.
  • the oily suspensions may contain a thickening agent such as, for example, beeswax, hard paraffin, or cetyl alcohol.
  • the suspensions may also contain one or more preservatives, for example, ethyl or n-propyl p-hydroxybenzoate; one or more coloring agents; one or more flavoring agents; and one or more sweetening agents such as sucrose or saccharin.
  • Syrups and elixirs can be formulated with sweetening agents such as, for example, glycerol, propylene glycol, sorbitol or sucrose. Such formulations may also contain a demulcent, and preservative, such as methyl and propyl parabens and flavoring and coloring agents.
  • sweetening agents such as, for example, glycerol, propylene glycol, sorbitol or sucrose.
  • Such formulations may also contain a demulcent, and preservative, such as methyl and propyl parabens and flavoring and coloring agents.
  • Components of this invention can also be administered parenterally, that is, subcutaneously, intravenously, intraocularly, intrasynovially, intramuscularly, or interperitoneally, as injectable dosages of the compound in preferably a pharmaceutically acceptable diluent with a pharmaceutical carrier which can be a sterile liquid or mixture of liquids such as water, saline, aqueous dextrose and related sugar solutions, an alcohol such as ethanol, isopropanol, or hexadecyl alcohol, glycols such as propylene glycol or polyethylene glycol, glycerol ketals such as 2,2-dimethyl-l,l-dioxolane-4-methanol, ethers such as poly(ethylene glycol) 400, an oil, a fatty acid, a fatty acid ester or, a fatty acid glyceride, or an acetylated fatty acid glyceride, with or without the addition of a pharmaceutically acceptable surfact
  • Suitable fatty acids include oleic acid, stearic acid, isostearic acid and myristic acid.
  • Suitable fatty acid esters are, for example, ethyl oleate and isopropyl myristate.
  • Suitable soaps include fatty acid alkali metal, ammonium, and triethanolamine salts and suitable detergents include cationic detergents, for example dimethyl dialkyl ammonium halides, alkyl pyridinium halides, and alkylamine acetates; anionic detergents, for example, alkyl, aryl, and olefin sulfonates, alkyl, olefin, ether, and monoglyceride sulfates, and sulfosuccinates; non-ionic detergents, for example, fatty amine oxides, fatty acid alkanolamides, and poly(oxyethylene-oxypropylene)s or ethylene oxide or propylene oxide copolymers; and amphoteric detergents, for example, alkyl-beta- aminopropionates, and 2-alkylimidazoline quarternary ammonium salts, as well as mixtures.
  • suitable detergents include cationic detergents, for example dimethyl dial
  • compositions of this invention will typically contain from about 0.5% to about 25% by weight of the active ingredient in solution. Preservatives and buffers may also be used advantageously. In order to minimize or eliminate irritation at the site of injection, such compositions may contain a non-ionic surfactant having a hydrophile-lipophile balance (HLB) preferably of from about 12 to about 17. The quantity of surfactant in such formulation preferably ranges from about 5% to about 15% by weight.
  • the surfactant can be a single component having the above HLB or can be a mixture of two or more components having the desired HLB.
  • surfactants used in parenteral formulations are the class of polyethylene sorbitan fatty acid esters, for example, sorbitan monooleate and the high molecular weight adducts of ethylene oxide with a hydrophobic base, formed by the condensation of propylene oxide with propylene glycol.
  • compositions of the present invention can be in the form of sterile injectable aqueous suspensions.
  • suspensions may be formulated according to known methods using suitable dispersing or wetting agents and suspending agents such as, for example, sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethyl-cellulose, sodium alginate, polyvinylpyrrolidone, gum tragacanth and gum acacia; dispersing or wetting agents which may be a naturally occurring phosphatide such as lecithin, a condensation product of an alkylene oxide with a fatty acid, for example, polyoxyethylene stearate, a condensation product of ethylene oxide with a long chain aliphatic alcohol, for example, heptadeca-ethyleneoxycetanol, a condensation product of ethylene oxide with a partial ester derived form a fatty acid and a hexitol such as polyoxyethylene sorbitol monooleate, or a condensation product of an ethylene oxide with a partial ester derived
  • the sterile injectable preparation can also be a sterile injectable solution or suspension in a non- toxic parenterally acceptable diluent or solvent.
  • Diluents and solvents that may be employed are, for example, water, Ringer's solution, isotonic sodium chloride solutions and isotonic glucose solutions.
  • sterile fixed oils are conventionally employed as solvents or suspending media.
  • any bland, fixed oil may be employed including synthetic mono- or diglycerides.
  • fatty acids such as oleic acid can be used in the preparation of injectables.
  • Components of the invention can also be administered in the form of suppositories for rectal administration of the drug.
  • These components can be prepared by mixing the drug with a suitable non-irritation excipient which is solid at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum to release the drug.
  • suitable non-irritation excipient which is solid at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum to release the drug.
  • Such materials are, for example, cocoa butter and polyethylene glycol.
  • transdermal delivery devices Such transdermal patches may be used to provide continuous or discontinuous infusion of the compounds of the present invention in controlled amounts.
  • transdermal patches for the delivery of pharmaceutical agents is well known in the art (see, e.g., US Patent No. 5,023,252, issued June 11, 1991, incorporated herein by reference).
  • patches may be constructed for continuous, pulsatile, or on demand delivery of pharmaceutical agents.
  • Controlled release formulations for parenteral administration include liposomal, polymeric microsphere and polymeric gel formulations that are known in the art.
  • the present invention concerns the use of the combination of the present invention as described supra for the treatment or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra and/or metastases thereof, preferably metastases in bone.
  • the present invention concerns the kit as described supra for the treatment or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra.
  • the present invention concerns the pharmaceutical composition as described supra for the treatment or prophylaxis of a disease, preferably a hyper- proliferative disease as described infra.
  • the present invention covers the use of such combinations as described supra for the preparation of a medicament for the treatment or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra.
  • the present invention covers the use of such kit as described supra for the preparation of a medicament for the treatment or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra.
  • the present invention covers the use of such pharmaceutical composition as described supra for the preparation of a medicament for the treatment or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra.
  • the present invention concerns methods for the treatment and/or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra using an effective amount of the combination of the present invention as described supra.
  • the present invention concerns methods for the treatment and/or prophylaxis of a disease, preferably a hyper-proliferative disease as described infra using an effective amount of the kit or pharmaceutical composition as described supra.
  • the present invention concerns a method of treating a disease in a patient, preferably a hyper-proliferative disease as described infra comprising a) administering component A being an inhibitor of ATR kinase or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and
  • component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l ; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride.
  • 5-FU or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l
  • a platinum-based antineoplastic agent such as oxaliplatin, cisplatin or carboplatin
  • the present invention concerns a method of treating a disease in a patient, preferably a hyper-proliferative disease as described infra comprising
  • component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l ; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride,
  • components A and B are administered simultaneously, concurrently, separately or sequentially.
  • the present invention concerns a method of treating a disease in a patient, preferably a hyper-proliferative disease as described infra comprising
  • Compound A being an inhibitor of ATR kinase or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and
  • component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l ; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride,
  • the present invention concerns a method of treating a disease in a patient, preferably a hyper-proliferative disease as described infra comprising
  • Compound A being an inhibitor of ATR kinase or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and
  • component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride, wherein component B is administered prior to component A.
  • 5-FU or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l
  • a platinum-based antineoplastic agent such as oxaliplatin,
  • the present invention concerns a method of treating a disease in a patient, preferably a hyper-proliferative disease as described infra comprising
  • Compound A being an inhibitor of ATR kinase or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and
  • component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride, wherein Compound A is administered prior to component B.
  • 5-FU or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l
  • a platinum-based antineoplastic agent such as oxaliplatin
  • the present invention concerns a method of treating a disease in a patient, preferably a hyper-proliferative disease as described infra comprising
  • component A being an inhibitor of ATR kinase, particularly Compound A, or a stereoisomer, a tautomer, an N-oxide, a hydrate, a solvate, or a pharmaceutically acceptable salt thereof, and
  • component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; pharmaceutically acceptable salts of bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof; and optionally
  • component C being a pharmaceutical agent as described supra.
  • Another aspect of the invention concerns the combination, the kit or the pharmaceutical composition according to the present invention for use in the treatment or prophylaxis of a hyper-proliferative disease.
  • the present invention concerns the combination, the kit or the pharmaceutical composition according to the present invention for use in the treatment or prophylaxis of a hyper-proliferative disease, wherein components A, particularly Compound A, and B are administered simultaneously, concurrently, separately or sequentially.
  • the present invention concerns the combination, the kit or the pharmaceutical composition according to the present invention for use in the treatment or prophylaxis of a hyper-proliferative disease,_wherein components A, particularly Compound A, and B are administered concurrently.
  • the present invention concerns the combination, the kit or the pharmaceutical composition according to the present invention for use in the treatment or prophylaxis of a hyper-proliferative disease,_wherein component B is administered prior to component A, particularly Compound A.
  • the present invention concerns the combination, the kit or the pharmaceutical composition according to the present invention for use in the treatment or prophylaxis of a hyper-proliferative disease, wherein component A, particularly Compound A, is administered prior to component B.
  • kits or pharmaceutical compositions of the present invention thus can be used for the treatment or prophylaxis of hyper-proliferative diseases, including diseases of uncontrolled cell growth, proliferation and/or survival, inappropriate cellular immune responses, or inappropriate cellular inflammatory responses, or diseases which are accompanied with uncontrolled cell growth, proliferation and/or survival, inappropriate cellular immune responses, or inappropriate cellular inflammatory responses, particularly in which the uncontrolled cell growth, proliferation and/or survival, inappropriate cellular immune responses, or inappropriate cellular inflammatory responses, such as, for example, haematological tumors and/or metastases thereof, solid tumors, and/or metastases thereof, e.g.
  • leukemias multiple myeloma thereof and myelodysplasia syndrome
  • malignant lymphomas breast tumors including and bone metastases thereof
  • tumors of the thorax including non-small cell and small cell lung tumors and bone metastases thereof
  • gastrointestinal tumors endocrine tumors, mammary and other gynaecological tumors and bone metastases thereof
  • urological tumors including renal, bladder and prostate tumors, skin tumors, and sarcomas, and/or metastases thereof.
  • inappropriate within the context of the present invention, in particular in the context of "inappropriate cellular immune responses, or inappropriate cellular inflammatory responses", as used herein, is to be understood as preferably meaning a response which is less than, or greater than normal, and which is associated with, responsible for, or results in, the pathology of said diseases.
  • kits or pharmaceutical compositions of the present invention might be utilized to inhibit, block, reduce, decrease, etc., cell proliferation and/or cell division, and/or produce apoptosis.
  • This invention includes a method comprising administering to a mammal in need thereof, including a human, an amount of a component A, particularly of Compound A, and an amount of component B of this invention, or a pharmaceutically acceptable salt, isomer, polymorph, metabolite, hydrate, solvate or ester thereof, which is effective to treat the hyper-proliferative disease.
  • Hyper-proliferative diseases include but are not limited, e.g., psoriasis, keloids, and other hyperplasias affecting the skin, benign prostate hyperplasia (BPH), as well as malignant neoplasia.
  • BPH benign prostate hyperplasia
  • malignant neoplasia treatable with the compounds according to the present invention include solid and hematological tumors. Solid tumors can be exemplified by tumors of the breast, bladder, bone, brain, central and peripheral nervous system, colon, anum, endocrine glands (e.g.
  • malignant neoplasias include inherited cancers exemplified by Retinoblastoma and Wilms tumor. In addition, malignant neoplasias include primary tumors in said organs and corresponding secondary tumors in distant organs ("tumor metastases").
  • Hematological tumors can be exemplified by aggressive and indolent forms of leukemia and lymphoma, namely non- Hodgkins disease, chronic and acute myeloid leukemia (CML / AML), acute lymphoblastic leukemia (ALL), Hodgkins disease, multiple myeloma and T-cell lymphoma. Also included are myelodysplastic syndrome, plasma cell neoplasia, paraneoplastic syndromes, and cancers of unknown primary site as well as AIDS related malignancies.
  • breast cancer examples include, but are not limited to invasive ductal carcinoma, invasive lobular carcinoma, ductal carcinoma in situ, and lobular carcinoma in situ, particularly with bone metastases.
  • cancers of the respiratory tract include, but are not limited to small-cell and non- small-cell lung carcinoma, as well as bronchial adenoma and pleuropulmonary blastoma.
  • brain cancers include, but are not limited to brain stem and hypophtalmic glioma, cerebellar and cerebral astrocytoma, medulloblastoma, ependymoma, as well as neuroectodermal and pineal tumor.
  • Tumors of the male reproductive organs include, but are not limited to prostate and testicular cancer.
  • Tumors of the female reproductive organs include, but are not limited to endometrial, cervical, ovarian, vaginal, and vulvar cancer, as well as sarcoma of the uterus.
  • Tumors of the digestive tract include, but are not limited to anal, colon, colorectal, esophageal, gallbladder, gastric, pancreatic, rectal, small-intestine, and salivary gland cancers.
  • Tumors of the urinary tract include, but are not limited to bladder, penile, kidney, renal pelvis, ureter, urethral and human papillary renal cancers.
  • Eye cancers include, but are not limited to intraocular melanoma and retinoblastoma.
  • liver cancers include, but are not limited to hepatocellular carcinoma (liver cell carcinomas with or without fibrolamellar variant), cholangiocarcinoma (intrahepatic bile duct carcinoma), and mixed hepatocellular cholangiocarcinoma.
  • Skin cancers include, but are not limited to squamous cell carcinoma, Kaposi's sarcoma, malignant melanoma, Merkel cell skin cancer, and non-melanoma skin cancer.
  • Head-and-neck cancers include, but are not limited to laryngeal, hypopharyngeal, nasopharyngeal, oropharyngeal cancer, lip and oral cavity cancer and squamous cell.
  • Lymphomas include, but are not limited to AIDS -related lymphoma, non-Hodgkin's lymphoma, cutaneous T-cell lymphoma, Burkitt lymphoma, Hodgkin's disease, and lymphoma of the central nervous system.
  • Sarcomas include, but are not limited to sarcoma of the soft tissue, osteosarcoma, malignant fibrous histiocytoma, lymphosarcoma, and rhabdomyosarcoma.
  • Leukemias include, but are not limited to acute myeloid leukemia, acute lymphoblastic leukemia, chronic lymphocytic leukemia, chronic myelogenous leukemia, and hairy cell leukemia.
  • Combinations of the present invention might also be used for treating diseases associated with excessive and/or abnormal angiogenesis.
  • Inappropriate and ectopic expression of angiogenesis can be deleterious to an organism.
  • a number of pathological conditions are associated with the growth of extraneous blood vessels. These include, e.g., diabetic retinopathy, ischemic retinal-vein occlusion, and retinopathy of prematurity [Aiello et al. New Engl. J. Med. 1994, 331, 1480 ; Peer et al. Lab. Invest. 1995, 72, 638], age-related macular degeneration [AMD ; see, Lopez et al. Invest. Opththalmol. Vis. Sci.
  • neovascular glaucoma neovascular glaucoma, psoriasis, retrolental fibroplasias, angiofibroma, inflammation, rheumatoid arthritis (RA), restenosis, in-stent restenosis, vascular graft restenosis, etc.
  • RA rheumatoid arthritis
  • restenosis in-stent restenosis
  • vascular graft restenosis etc.
  • the increased blood supply associated with cancerous and neoplastic tissue encourages growth, leading to rapid tumor enlargement and metastases.
  • the growth of new blood and lymph vessels in a tumor provides an escape route for renegade cells, encouraging metastases and the consequence spread of the cancer.
  • combinations of the present invention can be utilized to treat and/or prevent any of the aforementioned angiogenesis diseases, e.g., by inhibiting and/or reducing blood vessel formation; by inhibiting, blocking, reducing, decreasing, etc. endothelial cell proliferation or other types involved in angiogenesis, as well as causing cell death or apoptosis of such cell types.
  • the present invention covers the treatment of lung cancer, colorectal cancer, cervical cancer, bladder cancer, breast cancer, melanoma, B-cell lymphoma, prostate cancer, gliomas, ovarian cancer, glioblastoma, neuroblastoma, chronic lymphocytic leukemia (CLL), fibrosarcoma, gastric cancer, esophageal cancer, pancreatic cancer, chronic and acute myeloid leukemia (CML / AML), acute lymphoblastic leukemia (ALL), Hodgkins disease, multiple myeloma (MM) and T-cell lymphoma, ovarian cancer, endometrial cancer, vaginal cancer, and vulvar cancer, as well as sarcoma of the uterus.
  • CLL chronic lymphocytic leukemia
  • ALL acute lymphoblastic leukemia
  • NHL Hodgkins disease
  • MM multiple myeloma
  • T-cell lymphoma ovarian cancer
  • the present invention covers the treatment of lung cancer, particularly non-small cell lung carcinoma, colorectal cancer, cervical cancer, particularly human cervical adenocarcinoma, colon cancer, mantle cell lymphoma, prostate cancer, particularly prostate adenocarcinoma.
  • lung cancer particularly non-small cell lung carcinoma, colorectal cancer, cervical cancer, particularly human cervical adenocarcinoma, colon cancer, mantle cell lymphoma, prostate cancer, particularly prostate adenocarcinoma.
  • the invention covers a method of treatment or prophylaxis of a cancer, particularly lung cancer, colorectal cancer, cervical cancer, bladder cancer, breast cancer, melanoma, B-cell lymphoma, prostate cancer, gliomas, ovarian cancer, glioblastoma, neuroblastoma, chronic lymphocytic leukemia (CLL), fibrosarcoma, gastric cancer, esophageal cancer, pancreatic cancer, chronic and acute myeloid leukemia (CML / AML), acute lymphoblastic leukemia (ALL), Hodgkins disease, multiple myeloma (MM) and T-cell lymphoma, ovarian cancer, endometrial cancer, vaginal cancer, and vulvar cancer, as well as sarcoma of the uterus in a subject, comprising administering to said subject a therapeutically effective amount of a combination according to the present invention.
  • a cancer particularly lung cancer, colorectal cancer, cervical cancer, bladder cancer, breast
  • the invention covers a method of treatment or prophylaxis of a cancer, particularly lung cancer, particularly non-small cell lung carcinoma, colorectal cancer, cervical cancer, particularly human cervical adenocarcinoma, colon cancer, mantle cell lymphoma, prostate cancer, particularly prostate adenocarcinoma, in a subject, comprising administering to said subject a therapeutically effective amount of a combination according to the present invention.
  • a cancer particularly lung cancer, particularly non-small cell lung carcinoma, colorectal cancer, cervical cancer, particularly human cervical adenocarcinoma, colon cancer, mantle cell lymphoma, prostate cancer, particularly prostate adenocarcinoma
  • the effective dosage of the compounds of this invention can readily be determined for treatment of each desired indication.
  • the amount of the active ingredients to be administered in the treatment of one of these conditions can vary widely according to such considerations as the particular component and dosage unit employed, the mode of administration, the period of treatment, the age and sex of the patient treated, and the nature and extent of the condition treated.
  • the total amount of the active ingredients to be administered will generally range from about 0.001 mg/kg to about 200 mg/kg body weight per day, and preferably from about 0.01 mg/kg to about 50 mg/kg body weight per day.
  • Clinically useful dosing schedules of a compound will range from one to three times a day dosing to once every four weeks dosing.
  • "drug holidays" in which a patient is not dosed with a drug for a certain period of time may be beneficial to the overall balance between pharmacological effect and tolerability.
  • a unit dosage may contain from about 0.5 mg to about 1500 mg of active ingredient, and can be administered one or more times per day or less than once a day.
  • the average daily dosage for administration by injection will preferably be from 0.01 to 200 mg/kg of total body weight.
  • the average daily rectal dosage regimen will preferably be from 0.01 to 200 mg/kg of total body weight.
  • the average daily vaginal dosage regimen will preferably be from 0.01 to 200 mg/kg of total body weight.
  • the average daily topical dosage regimen will preferably be from 0.1 to 200 mg administered between one to four times daily.
  • the transdermal concentration will preferably be that required to maintain a daily dose of from 0.01 to 200 mg/kg.
  • the average daily inhalation dosage regimen will preferably be from 0.01 to 100 mg/kg of total body weight.
  • Component B being an anti-hyperproliferative, cytotoxic and/or cytostatic agent selected from: 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin ; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38;
  • 5-FU or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l
  • a platinum-based antineoplastic agent such as oxaliplatin, cisplatin or carboplatin
  • a topoisomerase inhibitor such as irinotecan, topotecan, camptothecin or
  • bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof, particularly 5-FU, oxaliplatin, cisplatin, carboplatin, bleomycin sulfate, SN-38 or irinotecan, and combinations thereof, can be administered to a patient at a dosage which can range from about 0.1 to about 300 mg/kg of total body weight.
  • the agents can also be administered in conventional amounts routinely used in cancer chemotherapy.
  • the specific initial and continuing dosage regimen for each patient will vary according to the nature and severity of the condition as determined by the attending diagnostician, the activity of the specific compounds employed, the age and general condition of the patient, time of administration, route of administration, rate of excretion of the drug, drug combinations, and the like.
  • the desired mode of treatment and number of doses of a compound of the present invention or a pharmaceutically acceptable salt or ester or composition thereof can be ascertained by those skilled in the art using conventional treatment tests.
  • the dose(s), administration regime(s) and administration route(s) may have to be adapted according to, inter alia, the indication, the indication stage, the patient age and/or the patient gender, among other factors. Such adaptations can be readily determined by standard techniques known to the skilled person.
  • Suitable dose(s), administration regime(s) and administration route(s) for 5-FU, oxaliplatin, carboplatin, cisplatin, irinotecan, SN-38, bleomycin sulfate and combinations thereof include those described in the NCCN Clinical Practice Guidelines in Oncology (NCCN guidelines), in particular in the NCCN Guidelines in Oncology, Version 1.2014, which is included herein by reference in its entirety.
  • the hyper-proliferative, cytotoxic or cytostatic agent selected from : 5-FU, or a prodrug of 5-FU, such as 5'-deoxy-5-fluorouridine, capecitabine, BOF-A2, tegafur, UFT, or S-l ; a platinum-based antineoplastic agent, such as oxaliplatin, cisplatin or carboplatin; a topoisomerase inhibitor, such as irinotecan, topotecan, camptothecin or SN-38; a pharmaceutically acceptable salt of bleomycin such as bleomycin sulfate or bleomycin hydrochloride; or combinations thereof (particularly 5-FU, oxaliplatin, cisplatin, carboplatin, irinotecan, SN-38 and combinations thereof), the administered dosage of the compound(s) may be modified depending on any superior or unexpected results which may
  • the hyper-proliferative, cytotoxic or cytostatic agent can be administered to a patient orally, topically, parenterally, rectally, by inhalation, and by injection.
  • Administration by injection includes intravenous, intramuscular, subcutaneous, and parenterally as well as by infusion techniques.
  • the agents can be administered by any of the conventional routes of administration for these compounds.
  • the preferred route of administration for the hyper- proliferative/cytotoxic/cytostatic agents using this invention is typically orally, which is the same route of administration used for the agent alone.
  • Any of the hyper-proliferative, cytotoxic or cytostatic agents can be administered in combination with a compound of general formula (I) or (lb) described supra, particularly with Compound A, by any of the mentioned routes of administration.
  • the compound of general formula (I) or (lb) described supra, particularly Compound A, and the hyper-proliferative/cytotoxic/cytostatic agent(s), by any of the routes of administration herein discussed can be administered simultaneously with the hyper-proliferative, cytotoxic or cytostatic agent.
  • This can be performed by administering a single formulation which contains both the compound of general formula (I) or (lb), particularly Compound A, and the hyper - proliferative/cytotoxic/cytostatic agent or administering the compound of general formula (I) or (lb), particularly compound A, and the hyperproliferative/cytotoxic/cytostatic agents in independent formulations at the same time to a patient.
  • the compound of general formula (I) or (lb) described supra, particularly Compound A can be administered in tandem with the hyper-proliferative/cytotoxic/cytostatic agent.
  • the compound of general formula (I) or (lb) described supra, particularly Compound A can be administered prior to the hyper-proliferative/cytotoxic/cytostatic agent.
  • the compound of general formula (I) or (lb) described supra, particularly Compound A can be administered once or more times per day up to 28 consecutive days, or once or more times per week up to 4 consecutive weeks followed by administration of the hyper-proliferative, cytotoxic or cytostatic agent.
  • the hyper-proliferative, cytotoxic or cytostatic agent can be administered first followed by adminstration of compound of general formula (I) or (lb) described supra, particularly Compound A.
  • the choice of sequence administration of the compound of general formula (I) or (lb) described supra, particularly Compound A, relative to the hyper-proliferative/cytotoxic/cytostatic agent may vary for different agents.
  • the hyper - proliferative/cytotoxic or cytostatic agent can be administered using any regimen which is conventionally used for these agents.
  • the compound of general formula (I) or (lb) described supra, particularly Compound A, and the hyper-proliferative/cytotoxic/cytostatic agent can be administered once or more times per day on the day of administration. Any of the routes and regimens of administration may be modified depending on any superior or unexpected results which may be obtained as routinely determined with this invention.
  • the dosage of ionizing radiation may depend on various factors, such as effectiveness and duration of action of the ionizing radiation, mode of administration, location of administration, sex, age, weight and individual condition of the subject to be treated.
  • the dosage of ionizing radiation must be carefully defined by the attending physician.
  • Component A is a compound having Component A:
  • Compound A is an example of component A.
  • Compound A is described in Example 111 of International Patent Application WO2016020320 (Al).
  • Compound A is 2-[(3R)-3-methylmorpholin-4-yl]-4-(l- methyl-lH-pyrazol-5-yl)-8-(lH-pyrazol-5-yl)-l,7-naphthyridine, of structure:
  • ATCC American Type Culture Collection
  • DSMZ Deutsche Sammlung von Mikroorganismen und Zellkulturen GmbH
  • fs frame shift
  • del deletion
  • * stop codon
  • amp gene amplification
  • MSI-H Microsatellite Instability High
  • Tumor cells (Table 1) were propagated in a humidified 37°C incubator in their respective growth medium supplemented 10% fetal calf serum.
  • cells were plated in 384-well plates at the 600 or 800 cells per well.
  • Compound A interacts with components B (Cisplatin, SN-38, Bleomycin) in a more than additive (synergistic) manner in cell lines of different indications such as melanoma, colon, prostate, cervical and lung cancer.
  • mice were implanted subcutaneously with tumor cells.
  • n 10 animals/group
  • the oral and intraperitoneal application volume was 10 ml/kg, intraveneous application volume was 5 ml/kg.
  • the time interval between two applications per day was 6-7h.
  • the treatment was ended as soon as the untreated control group had tumors of area ⁇ 225 mm 2 .
  • the tumor area was detected by means of an electronic caliper gauge [length (mm) x width (mm)] .
  • T/C ratio (Treatment/Control) calculated with tumor areas at study end by the formula [(tumor area of treatment group at day x) - (tumor area of treatment group at day before first treatment)] / [(tumor area of control group at day x) - (tumor area of control group at day before first treatment)].
  • Compounds having a T/C below 0.5 were defined as active (effective).
  • Statistical analysis was assessed using SigmaStat software. A one-way analysis of variance was performed and differences to the control were compared by a pair-wise comparison procedure (Dunn's method).
  • Combination of Compound A with component B 5-FU showed strong synergistic anti-tumor efficacy in the human LOVO colorectal cancer model at good tolerability.
  • Combination of Compound A with component B radiation showed strong synergistic anti-tumor efficacy in the human LOVO colorectal cancer model at good tolerability.
  • Table 5 Anti-tumor activity of Compound A and components B (Cisplatin, Irinotecan, 5-FU, radiation) in combination in different human cancer xenograft models in mice.
  • T/C ratio of the tumor area of treatment versus [(tumor area of treatment group at day x) - (tumor area of treatment group at day before first treatment)] / [(tumor area of control group at day x) - (tumor area of control group at day before first treatment)] .
  • the abbreviation QD means once per day, 2QD means twice per day, po means peroral, i.p. means intraperitoneal, i.v. means intraveneous.
  • mice The anti-tumor activity of combination treatment of Compound A and carboplatin was examined in the human colorectal cancer (CRC) patient-derived xenograft (PDX) model CR5038 in mice.
  • CRC human colorectal cancer
  • PDX patient-derived xenograft
  • NOD/Scid mice were implanted subcutaneously with tumor cells.
  • the oral and intraperitoneal application volume was 10 ml/kg.
  • the tumor size and the body weights were determined three times weekly.
  • T/C ratio (Treatment/Control) calculated with tumor volumes at treatment start and study end (day x) by the formula [(tumor volume of treatment group at day x) - (tumor volume of treatment group at day before first treatment)] / [(tumor volume of control group at day x) - (tumor volume of control group at day before first treatment)].
  • Compounds having a T/C below 0.5 are defined as active (effective).
  • Statistical analysis was assessed using SigmaStat software. A one-way analysis of variance was performed and differences to the control were compared by a pair-wise comparison procedure (Dunn's method).
  • T/C ratio of the tumor volume of treatment versus control [(tumor volume of
  • the abbreviation QD means once per day, p.o. means per oral, i.p. means intraperitoneal.

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Abstract

La présente invention couvre des combinaisons d'au moins deux constituants, le constituant A et le constituant B, comprenant le constituant A qui est un inhibiteur de kinase ATR, en particulier le composé A, et le constituant B qui est soit un agent anti-hyperprolifératif, cytotoxique et/ou cytostatique choisi parmi : le 5-FU, ou un promédicament de 5-FU, tel que la 5'-désoxy-5-fluoro-uridine, la capécitabine, le BOF-A2, le tégafur, l'UFT ou le S-1 ; un agent antinéoplasique à base de platine, tel que l'oxaliplatine, le cisplatine ou le carboplatine ; un inhibiteur de la topo-isomérase, tel que l'irinotécan, le topotécan, la camptothécine ou le SN-38 ; des sels pharmaceutiquement acceptables de la bléomycine tels que le sulfate de bléomycine ou le chlorhydrate de bléomycine ; ou des combinaisons correspondantes ; soit le constituant B est un rayonnement ionisant. Un autre aspect de la présente invention concerne l'utilisation des combinaisons telles que décrites dans la description pour la préparation d'un médicament destiné au traitement ou à la prophylaxie d'une maladie, en particulier le traitement d'une maladie hyperproliférative.
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US10729680B2 (en) 2016-01-14 2020-08-04 Bayer Pharma Aktiengesellschaft 5-substituted 2-(morpholin-4-yl)-1,7-naphthyridines
US10772893B2 (en) 2014-08-04 2020-09-15 Bayer Pharma Aktiengesellschaft 2-(morpholin-4-yl)-1,7-naphthyridines
WO2021048412A1 (fr) * 2019-09-11 2021-03-18 Seald As Polythérapies comprenant du panobinostat pour le traitement du cholangiocarcinome
WO2021048418A1 (fr) * 2019-09-11 2021-03-18 Seald As Polythérapies comprenant du bortézomib pour le traitement du cholangiocarcinome
WO2021048419A1 (fr) * 2019-09-11 2021-03-18 Seald As Polythérapies comprenant du tramétinib pour le traitement du cholangiocarcinome
WO2023118062A1 (fr) * 2021-12-21 2023-06-29 INSERM (Institut National de la Santé et de la Recherche Médicale) Combinaison de cisplatine et d'élimusertib pour le traitement de cancers du foie pédiatriques

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US10772893B2 (en) 2014-08-04 2020-09-15 Bayer Pharma Aktiengesellschaft 2-(morpholin-4-yl)-1,7-naphthyridines
US11529356B2 (en) 2014-08-04 2022-12-20 Bayer Pharma Aktiengesellschaft 2-(morpholin-4-yl)-1,7-naphthyridines
US10729680B2 (en) 2016-01-14 2020-08-04 Bayer Pharma Aktiengesellschaft 5-substituted 2-(morpholin-4-yl)-1,7-naphthyridines
WO2021048412A1 (fr) * 2019-09-11 2021-03-18 Seald As Polythérapies comprenant du panobinostat pour le traitement du cholangiocarcinome
WO2021048418A1 (fr) * 2019-09-11 2021-03-18 Seald As Polythérapies comprenant du bortézomib pour le traitement du cholangiocarcinome
WO2021048419A1 (fr) * 2019-09-11 2021-03-18 Seald As Polythérapies comprenant du tramétinib pour le traitement du cholangiocarcinome
CN114650816A (zh) * 2019-09-11 2022-06-21 海尔德股份有限公司 用于治疗胆管癌的包含帕比司他的联合疗法
WO2023118062A1 (fr) * 2021-12-21 2023-06-29 INSERM (Institut National de la Santé et de la Recherche Médicale) Combinaison de cisplatine et d'élimusertib pour le traitement de cancers du foie pédiatriques

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