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  • A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
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  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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• • A—HUMAN NECESSITIES
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  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
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  • A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
• • A—HUMAN NECESSITIES
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  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
  • A61K47/56—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule
  • A61K47/59—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyureas or polyurethanes
  • A61K47/60—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyureas or polyurethanes the organic macromolecular compound being a polyoxyalkylene oligomer, polymer or dendrimer, e.g. PEG, PPG, PEO or polyglycerol
• • A—HUMAN NECESSITIES
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  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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• • A—HUMAN NECESSITIES
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  • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
  • A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
  • A61K9/51—Nanocapsules; Nanoparticles
  • A61K9/5107—Excipients; Inactive ingredients
  • A61K9/513—Organic macromolecular compounds; Dendrimers
  • A61K9/5146—Organic macromolecular compounds; Dendrimers obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, polyamines, polyanhydrides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
  • A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
  • A61K9/51—Nanocapsules; Nanoparticles
  • A61K9/5107—Excipients; Inactive ingredients
  • A61K9/513—Organic macromolecular compounds; Dendrimers
  • A61K9/5146—Organic macromolecular compounds; Dendrimers obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, polyamines, polyanhydrides
  • A61K9/5153—Polyesters, e.g. poly(lactide-co-glycolide)

Definitions

• This invention relates to therapeutic methods and compositions in general, and more particularly to therapeutic methods and compositions for the treatment of neuroblastoma in a juvenile mammalian body.
• NB Neuroblastoma
• neuroblastoma extracranial solid cancer in childhood, and the most common cancer in infancy, with an incidence of about six hundred fifty cases per year in the U.S., and a hundred cases per year in the UK. Nearly half of neuroblastoma cases occur in children younger than two years. It is a neuroendocrine tumor, arising from any neural crest element of the sympathetic nervous system (SNS) . Neuroblastoma most frequently originates in one of the adrenal glands, but can also develop in nerve tissues in the neck, chest, abdomen, or pelvis. Note that while neuroblastoma arises from nerve tissues, it is not a tumor of the central nervous system ( CNS ) .
• CNS central nervous system
• Neuroblastoma is one of the few human
• Neuroblastoma is a disease exhibiting extreme heterogeneity, and is stratified into three risk categories: low-risk, intermediate-risk, and high- risk. Low-risk neuroblastoma is most common in infants and good outcomes are common with observation only or surgery, whereas high-risk neuroblastoma is difficult to treat successfully even with the most intensive multi-modal therapies available.
• therapy e.g., intensive chemotherapy, surgery, radiation therapy, stem cell transplant,
• differentiation agent isotrentinoin (also called 13- cis-retinoic acid) , and frequently immunotherapy with anti-GD2 immunotherapy with anti-GD2 monoclonal antibody therapy.
• High-risk neuroblastoma is generally treated with intensive chemotherapy, surgery, radiation therapy, bone marrow/hematopoietic stem cell transplantation, biological-based therapy with 13-cis-retinoic acid (isotretinoin or Accutane) and antibody therapy
• cytokines GM-CSF and IL-2. cytokines
• Chemotherapy agents used in combination have been found to be effective against neuroblastoma. Agents commonly used in induction and for stem cell
• transplant conditioning are platinum compounds
• topoisomerase I inhibitors topotecan and irinotecan in induction which have been found to be effective against recurrent disease.
• taurolidine is used to treat neuroblastoma in juvenile mammalian bodies.
• the taurolidine is given with a dosage range of from 5 mg/kg to 280 mg/kg, and preferably with a dosage range of between 5 mg/kg and 60 mg/kg.
• This dosage is administered from once daily through weekly for an effective period of time based on individual patient response.
• the taurolidine is delivered systemically, preferably either intravenously (more preferred) or intramuscularly .
• the taurolidine is delivered systemically in a "shielded form" so that hydrolysis of the taurolidine is delayed until the taurolidine reaches the site of the
• the taurolidine may be delivered as a single agent or in combination with one or more oncolytic agents and/or radiotherapy.
• a method for treating neuroblastoma in juvenile mammals comprising administering taurolidine to the juvenile mammal.
• the taurolidine is administered with a dosage range of from 5 mg/kg to 280 mg/kg, for an effective period of time, based on individual patient response.
• the taurolidine is administered with a dosage range of from 5 mg/kg and 60 mg/kg.
• the dosage is administered from once daily through weekly.
• the taurolidine is administered systemically .
• the taurolidine is administered intravenously.
• the taurolidine is administered intramuscularly.
• the taurolidine is included in a nanoparticle, and the nanoparticle is configured to delay hydrolysis of the taurolidine until the nanoparticle reaches the site of a tumor.
• the taurolidine is included in a nanoparticle, the nanoparticle comprises a taurolidine core and an exterior coating, and the exterior coating is configured to prevent exposure of the taurolidine prior to arrival of the nanoparticle at the site of the tumor.
• the taurolidine is included in a nanoparticle, the nanoparticle comprises a taurolidine core and an exterior coating, and the exterior coating comprises an absorbable polymer or lipid which breaks down as the nanoparticle travels from the site of insertion to the site of the tumor.
• the taurolidine is delivered using a polymer system which is configured to delay hydrolysis of the taurolidine.
• the taurolidine is delivered using a polymer system, with the taurolidine being “pegylated” using polyethylene glycols (PEGs) to delay premature of hydrolysis of taurolidine.
• PEGs polyethylene glycols
• the taurolidine is administered to humans. In one form of the invention, the taurolidine is administered to at least one from the group consisting of infants, children and adolescents.
• the taurolidine is administered as a single agent.
• the taurolidine is administered in combination with at least one
• the taurolidine is administered in combination with at least one
• the at least one oncolytic agent is selected from the group consisting of platinum compounds (cisplatin, carboplatin) , alkylating agents (cyclophosphamide, ifosfamide, melphalan,
• the taurolidine is administered in combination with radiotherapy.
• Fig. 1 is a graph showing that leukemia cell lines appear more sensitive to the effects of
• taurolidine compared to healthy lymphocytes in vitro ( not in vivo ) ;
• Fig. 2 is a graph showing that neuroblastoma cell lines are more sensitive to a decrease in viability due to taurolidine when compared to healthy
• Figs. 3-6 are graphs or photographs showing that taurolidine given to CB57 SCID mice with measurable tumors from a neuroblastoma cell line implanted subcutaneously in the CB57 SCID mice has efficacy in
• Figs. 7 and 8 are graphs showing that
• Taurolidine is a well known antimicrobial with a published mechanism of action and antimicrobial spectrum. Taurolidine is unstable in circulation and therefore has not been successfully developed for systemic infections. Taurolidine has demonstrated efficacy in local application for peritonitis and for prevention of infection when infused as a catheter- lock solution.
• Taurolidine has recently been investigated for oncolytic activity and found to have inhibitory effect on cell lines in culture, in combination with standard chemotherapy or alone. Despite claims that in vitro inhibitory concentrations are clinically achievable, the only published human pharmacokinetic study showed NO measurable concentration of taurolidine in healthy volunteers when 5 grams of taurolidine were given intravenously by 20 minute infusion. This is believed to be due to the rapid hydrolysis of taurolidine when administered systemically in a mammalian body.
• neuroblastoma cell lines are more sensitive to a decrease in viability due to taurolidine when compared to healthy
• taurolidine given to CB57 SCID mice with measurable tumors from a neuroblastoma cell line implanted subcutaneously in the CB57 SCID mice showed efficacy in IMR5 tumors and measurable efficacy in SK- N-AS tumors in vivo (not in vitro) . See Figs. 3-6.
• taurolidine may be used to treat neuroblastoma in a juvenile mammalian body .
• the taurolidine is given with a dosage range of from 5 mg/kg to 280 mg/kg, and preferably with a dosage range of between 5 mg/kg and 60 mg/kg.
• Effective dosage was computed by computing the human equivalent dosage from the effective mouse dose, using the following formula:
• This dosage is administered from once daily through weekly for an effective period of time based on individual patient response.
• the taurolidine is delivered systemically, preferably either intravenously (more preferred) or intramuscularly.
• intravenously more preferred
• intramuscularly preferably either intravenously (more preferred) or intramuscularly.
• the taurolidine is delivered systemically in a "shielded form" so that hydrolysis of the
• taurolidine is delayed until the taurolidine reaches the site of the neuroblastoma, whereupon hydrolysis of the taurolidine occurs.
• the taurolidine is delivered in the form of a nanoparticle, where the nanoparticle comprises a taurolidine core and an exterior coating which is configured to prevent premature exposure of the taurolidine prior to the arrival of the nanoparticle to the tumor site.
• the exterior coating breaks down as the nanoparticle travels from the site of insertion to the site of the tumor so as to release the taurolidine for hydrolysis at the site of the tumor.
• the coating comprises an absorbable polymer or lipid which breaks down as the nanoparticle travels from the site of insertion to the site of the tumor.
• the coating can be created from combinations of copolymers and multimers derived from polymers structured from 1-lactide, glycolide, e- caprolactone, p-dioxanone, and trimethylene carbonate.
• the coating may also be associated with glycols such as polyethylene glycols (PEGs), which can either be linear or multi-arm structures.
• PEGs polyethylene glycols
• the nanoparticle may comprise an excipient (e.g., a buffer for providing enhanced hydrolytic stability of the taurolidine within the nanoparticle) .
• an excipient e.g., a buffer for providing enhanced hydrolytic stability of the taurolidine within the nanoparticle
• the nanoparticle can further comprise a coating, wherein the coating is configured to target the nanoparticle to the site of a neuroblastoma so as to improve the efficacy of the taurolidine for treatment of the neuroblastoma.
• the coating comprises binding molecules which are configured to target delivery of the nanoparticle to specific tissue.
• the coating for the nanoparticle comprises a monoclonal antibody against N-type calcium channels (e.g., an anti-N-type calcium channel exofacial Fab fragment) for causing the nanoparticle to bind to neural tissue (e.g., to a neuroblastoma tumor) .
• the taurolidine may be delivered using a polymer system which is configured to delay hydrolysis of the taurolidine and/or optimize the release properties of the
• taurolidine may be “pegylated” using polyethylene glycols (PEGs) to delay premature of hydrolysis of taurolidine and/or optimize the release properties of the taurolidine.
• PEGs polyethylene glycols
• the taurolidine may be delivered as a single agent or in combination with one or more oncolytic agents and/or radiotherapy.
• oncolytic agents that can be combined with taurolidine for delivery to a juvenile mammal for treating
• neuroblastoma are platinum compounds (cisplatin, carboplatin) , alkylating agents (cyclophosphamide, ifosfamide, melphalan, topoisomerase II inhibitor), vinca alkaloids (vincristine), and topoisomerase I inhibitors (topotecan and irinotecan) .

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