Classifications

• • 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
  • 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
  • A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene or sparfloxacin
• • 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
  • A61K31/4965—Non-condensed pyrazines
• • 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
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
  • A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
  • A61K31/573—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
• • 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
  • A61K31/69—Boron compounds
• • 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
  • A61K38/05—Dipeptides
• • 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
  • A61K38/07—Tetrapeptides
• • 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
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00

Definitions

• the present application relates to the fields of chemistry, biochemistry and medicine. More particularly, disclosed herein are monotherapies and combination therapies, and methods of treating diseases and/or conditions with the therapies descried herein.
• Amyloidosis refers to a group of diseases caused by protein misfolding and aggregation into highly ordered amyloid fibrils that deposit in tissues.
• Some of the types of amyloidosis include amyloid light-chain (AL) amyloidosis, amyloid type A (AA) amyloidosis, dialysis-related amyloidosis (DRA), familial or hereditary amyloidosis, age-related (senile) systemic amyloidosis, and organ-specific amyloidosis. If left untreated, amyloidosis may result in progressive organ damage.
• Current amyloidosis treatments include chemotherapy, stem cell transplant therapy, steroid therapy, treatment of the underlying disorder, and combinations thereof. However, there still exists a need for effective amyloidosis treatments.
• Various embodiments provide a use of an effective amount of a compound of Formula (A), or a pharmaceutically acceptable salt thereof, in the preparation of a medicament for treating amyloidosis, as described in detail below and summarized in the claims.
• a method for treating amyloidosis that includes administering to a subject an effective amount of a compound of Formula (A), or a pharmaceutically acceptable salt thereof, as described in detail below and summarized in the claims.
• a method for treating amyloidosis that includes contacting a diseased cell with an effective amount of a compound of Formula (A), or a pharmaceutically acceptable salt thereof, as described in detail below and summarized in the claims.
• Figure 1 shows the results of a tumor growth study in response to Compound (A) in a OPM-2 mouse model.
• Figure 2 shows the results of a tumor growth study in response to Compound (A) in a KMS-12-BM mouse model.
• Figure 3 shows the results of a tumor growth study in response to monotherapies and a combination therapy with Compound (A) and dexamethasone in a KMS-12-BM mouse model.
• Figure 4 shows the results of a tumor growth study in response to monotherapies and a combination therapy with Compound (A) and bortezomib in a KMS-12-BM mouse model.
• the indicated “optionally substituted” or “substituted” group may be substituted with one or more group(s) individually and independently selected from alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, heteroaryl, heterocyclyl, aryl(alkyl), cycloalkyl(alkyl), heteroaryl(alkyl), heterocyclyl(alkyl), hydroxy, alkoxy, acyl, cyano, halogen, thiocarbonyl, O-carbamyl, N-carbamyl, O-thiocarbamyl, N-thiocarbamyl, C-amido, N-amido, S-sulfonamido, N-sulfonamido, C-carboxy, O-carboxy, nitro, sulfenyl, sulfinyl, sulfonyl,
• C a to G ' in which "a” and “b” are integers refer to the number of carbon atoms in a group.
• the indicated group can contain from “a” to "b", inclusive, carbon atoms.
• a “Ci to C4 alkyl” group refers to all alkyl groups having from 1 to 4 carbons, that is, CH3-, CH3CH2-, CH3CH2CH2-, (CH 3 )2CH-, CH3CH2CH2CH2-, CH 3 CH2CH(CH 3 )- and (CHs sC-. If no "a” and "b” are designated, the broadest range described in these definitions is to be assumed.
• R groups are described as being “taken together” the R groups and the atoms they are attached to can form a cycloalkyl, cycloalkenyl, aryl, heteroaryl or heterocycle.
• R a and R b of an NR a R b group are indicated to be “taken together,” it means that they are covalently bonded to one another to form a ring:
• alkyl refers to a fully saturated aliphatic hydrocarbon group.
• the alkyl moiety may be branched or straight chain.
• branched alkyl groups include, but are not limited to, iso-propyl, sec-butyl, t-butyl and the like.
• straight chain alkyl groups include, but are not limited to, methyl, ethyl, n-propyl, n-butyl, n-pentyl, n-hexyl, n-heptyl and the like.
• the alkyl group may have 1 to 30 carbon atoms (whenever it appears herein, a numerical range such as “1 to 30" refers to each integer in the given range; e.g., "1 to 30 carbon atoms” means that the alkyl group may consist of 1 carbon atom, 2 carbon atoms, 3 carbon atoms, etc., up to and including 30 carbon atoms, although the present definition also covers the occurrence of the term "alkyl” where no numerical range is designated).
• the alkyl group may also be a medium size alkyl having 1 to 12 carbon atoms.
• the alkyl group could also be a lower alkyl having 1 to 6 carbon atoms.
• An alkyl group may be substituted or unsubstituted.
• alkylene refers to a bivalent fully saturated straight chain aliphatic hydrocarbon group.
• alkylene groups include, but are not limited to, methylene, ethylene, propylene, butylene, pentylene, hexylene, heptylene and octylene.
• An alkylene group may be represented by followed by the number of carbon atoms, followed by a "*". For example, to represent ethylene.
• the alkylene group may have 1 to 30 carbon atoms (whenever it appears herein, a numerical range such as “1 to 30" refers to each integer in the given range; e.g., "1 to 30 carbon atoms” means that the alkyl group may consist of 1 carbon atom, 2 carbon atoms, 3 carbon atoms, etc., up to and including 30 carbon atoms, although the present definition also covers the occurrence of the term "alkylene” where no numerical range is designated).
• the alkylene group may also be a medium size alkyl having 1 to 12 carbon atoms.
• the alkylene group could also be a lower alkyl having 1 to 4 carbon atoms.
• An alkylene group may be substituted or unsubstituted.
• a lower alkylene group can be substituted by replacing one or more hydrogen of the lower alkylene group and/or by substituting both hydrogens on the same carbon with a C3-6 monocyclic cycloalkyl group (e.g., -C- ).
• alkenyl refers to a monovalent straight or branched chain radical of from two to twenty carbon atoms containing a carbon double bond(s) including, but not limited to, 1-propenyl, 2-propenyl, 2-methyl-l- propenyl, 1-butenyl, 2-butenyl and the like.
• An alkenyl group may be unsubstituted or substituted.
• alkynyl refers to a monovalent straight or branched chain radical of from two to twenty carbon atoms containing a carbon triple bond(s) including, but not limited to, 1-propynyl, 1-butynyl, 2-butynyl and the like.
• An alkynyl group may be unsubstituted or substituted.
• cycloalkyl refers to a completely saturated (no double or triple bonds) mono- or multi- cyclic (such as bicyclic) hydrocarbon ring system. When composed of two or more rings, the rings may be joined together in a fused, bridged or spiro fashion. As used herein, the term “fused” refers to two rings which have two atoms and one bond in common. As used herein, the term “bridged cycloalkyl” refers to compounds wherein the cycloalkyl contains a linkage of one or more atoms connecting non-adjacent atoms.
• Cycloalkyl groups can contain 3 to 30 atoms in the ring(s), 3 to 20 atoms in the ring(s), 3 to 10 atoms in the ring(s), 3 to 8 atoms in the ring(s) or 3 to 6 atoms in the ring(s).
• a cycloalkyl group may be unsubstituted or substituted.
• Examples of mono-cycloalkyl groups include, but are in no way limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl and cyclooctyl.
• Examples of fused cycloalkyl groups are decahydronaphthalenyl, dodecahydro-lH-phenalenyl and tetradecahydroanthracenyl;
• examples of bridged cycloalkyl groups are bicyclo[l .1.
• cycloalkenyl refers to a mono- or multi- cyclic (such as bicyclic) hydrocarbon ring system that contains one or more double bonds in at least one ring; although, if there is more than one, the double bonds cannot form a fully delocalized pi-electron system throughout all the rings (otherwise the group would be "aryl,” as defined herein).
• Cycloalkenyl groups can contain 3 to 10 atoms in the ring(s), 3 to 8 atoms in the ring(s) or 3 to 6 atoms in the ring(s). When composed of two or more rings, the rings may be connected together in a fused, bridged or spiro fashion. A cycloalkenyl group may be unsubstituted or substituted.
• aryl refers to a carbocyclic (all carbon) monocyclic or multicyclic (such as bicyclic) aromatic ring system (including fused ring systems where two carbocyclic rings share a chemical bond) that has a fully delocalized pi-electron system throughout all the rings.
• the number of carbon atoms in an aryl group can vary.
• the aryl group can be a C6-C14 aryl group, a C6-C10 aryl group or a C 6 aryl group.
• Examples of aryl groups include, but are not limited to, benzene, naphthalene and azulene.
• An aryl group may be substituted or unsubstituted.
• heteroaryl refers to a monocyclic or multicyclic (such as bicyclic) aromatic ring system (a ring system with fully delocalized pi- electron system) that contain(s) one or more heteroatoms (for example, 1, 2 or 3 heteroatoms), that is, an element other than carbon, including but not limited to, nitrogen, oxygen and sulfur.
• heteroatoms for example, 1, 2 or 3 heteroatoms
• the number of atoms in the ring(s) of a heteroaryl group can vary.
• the heteroaryl group can contain 4 to 14 atoms in the ring(s), 5 to 10 atoms in the ring(s) or 5 to 6 atoms in the ring(s), such as nine carbon atoms and one heteroatom; eight carbon atoms and two heteroatoms; seven carbon atoms and three heteroatoms; eight carbon atoms and one heteroatom; seven carbon atoms and two heteroatoms; six carbon atoms and three heteroatoms; five carbon atoms and four heteroatoms; five carbon atoms and one heteroatom; four carbon atoms and two heteroatoms; three carbon atoms and three heteroatoms; four carbon atoms and one heteroatom; three carbon atoms and two heteroatoms; or two carbon atoms and three heteroatoms.
• heteroaryl includes fused ring systems where two rings, such as at least one aryl ring and at least one heteroaryl ring or at least two heteroaryl rings, share at least one chemical bond.
• heteroaryl rings include, but are not limited to, furan, furazan, thiophene, benzothiophene, phthalazine, pyrrole, oxazole, benzoxazole, 1,2,3-oxadiazole, 1,2,4-oxadiazole, thiazole, 1,2,3-thiadiazole, 1,2,4- thiadiazole, benzothiazole, imidazole, benzimidazole, indole, indazole, pyrazole, benzopyrazole, isoxazole, benzoisoxazole, isothiazole, triazole, benzotriazole, thiadiazole, tetrazole, pyridine, pyridazine, pyrimidine
• heterocyclyl or “heteroalicyclyl” refers to three-, four-, five-, six-, seven-, eight-, nine-, ten-, up to 18-membered monocyclic, bicyclic and tricyclic ring system wherein carbon atoms together with from 1 to 5 heteroatoms constitute said ring system.
• a heterocycle may optionally contain one or more unsaturated bonds situated in such a way, however, that a fully delocalized pi-electron system does not occur throughout all the rings.
• the heteroatom(s) is an element other than carbon including, but not limited to, oxygen, sulfur and nitrogen.
• a heterocycle may further contain one or more carbonyl or thiocarbonyl functionalities, so as to make the definition include oxo-systems and thio-systems such as lactams, lactones, cyclic imides, cyclic thioimides and cyclic carbamates.
• oxo-systems and thio-systems such as lactams, lactones, cyclic imides, cyclic thioimides and cyclic carbamates.
• the rings When composed of two or more rings, the rings may be joined together in a fused, bridged or spiro fashion.
• the term "fused" refers to two rings which have two atoms and one bond in common.
• bridged heterocyclyl or “bridged heteroalicyclyl” refers to compounds wherein the heterocyclyl or heteroalicyclyl contains a linkage of one or more atoms connecting non-adjacent atoms.
• spiro refers to two rings which have one atom in common and the two rings are not linked by a bridge.
• Heterocyclyl and heteroalicyclyl groups can contain 3 to 30 atoms in the ring(s), 3 to 20 atoms in the ring(s), 3 to 10 atoms in the ring(s), 3 to 8 atoms in the ring(s) or 3 to 6 atoms in the ring(s).
• any nitrogens in a heteroalicyclic may be quaternized.
• Heterocyclyl or heteroalicyclic groups may be unsubstituted or substituted.
• heterocyclyl or “heteroalicyclyl” groups include but are not limited to, 1,3-dioxin, 1,3-dioxane, 1,4- dioxane, 1,2-dioxolane, 1,3-dioxolane, 1,4-dioxolane, 1,3-oxathiane, 1,4-oxathiin, 1,3-oxathiolane, 1,3-dithiole, 1,3-dithiolane, 1,4-oxathiane, tetrahydro-l,4-thiazine, 2H-l,2-oxazine, maleimide, succinimide, barbituric acid, thiobarbituric acid, dioxopiperazine, hydantoin, dihydrouracil, trioxane, hexahydro-l,3,5-triazine, imidazoline, imidazolidine, isoxazoline, isoxazoline, isox
• spiro heterocyclyl groups examples include 2-azaspiro[3.3]heptane, 2-oxaspiro[3.3]heptane, 2-oxa- 6-azaspiro[3.3] heptane, 2,6-diazaspiro[3.3]heptane, 2-oxaspiro[3.4]octane and 2- azaspiro[3.4]octane.
• aralkyl and “aryl(alkyl)” refer to an aryl group connected, as a substituent, via a lower alkylene group.
• the lower alkylene and aryl group of an aralkyl may be substituted or unsubstituted. Examples include but are not limited to benzyl, 2-phenylalkyl, 3-phenylalkyl and naphthylalkyl.
• heteroarylkyl and “heteroaryl(alkyl)” refer to a heteroaryl group connected, as a substituent, via a lower alkylene group.
• the lower alkylene and heteroaryl group of heteroaralkyl may be substituted or unsubstituted. Examples include but are not limited to 2-thienylalkyl, 3-thienylalkyl, furylalkyl, thienylalkyl, pyrrolylalkyl, pyridylalkyl, isoxazolylalkyl and imidazolylalkyl and their benzo-fused analogs.
• heteroalicyclyl(alkyl) and “heterocyclyl(alkyl)” refer to a heterocyclic or a heteroalicyclic group connected, as a substituent, via a lower alkylene group.
• the lower alkylene and heterocyclyl of a (heteroa I icycly l)a I ky I may be substituted or unsubstituted.
• Examples include but are not limited tetrahydro-2H- pyran-4-yl (methyl), piperidin-4-yl(ethyl), piperidin-4-yl(propyl), tetrahydro-2H- thiopyran-4-yl(methyl) and l,3-thiazinan-4-yl(methyl).
• hydroxy refers to a -OH group.
• alkoxy refers to the Formula -OR wherein R is an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl(alkyl) or heterocyclyl(alkyl) is defined herein.
• R is an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl(alkyl) or heterocyclyl(alkyl) is defined herein.
• a non-limiting list of alkoxys are methoxy, ethoxy, n-propoxy, 1- methylethoxy (isopropoxy), n-butoxy, iso-butoxy
• acyl refers to a hydrogen, alkyl, alkenyl, alkynyl, aryl, heteroaryl, heterocyclyl, aryl(alkyl), heteroaryl(alkyl) and heterocyclyl(alkyl) connected, as substituents, via a carbonyl group. Examples include formyl, acetyl, propanoyl, benzoyl and acryl. An acyl may be substituted or unsubstituted.
• a "cyano" group refers to a "-CN” group.
• halogen atom or "halogen” as used herein, means any one of the radio-stable atoms of column 7 of the Periodic Table of the Elements, such as, fluorine, chlorine, bromine and iodine.
• a thiocarbonyl may be substituted or unsubstituted.
• An O-carbamyl may be substituted or unsubstituted.
• R and RA can be independently hydrogen, an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl (alkyl) or heterocyclyl(alkyl).
• An N-carbamyl may be substituted or unsubstituted.
• An O-thiocarbamyl may be substituted or unsubstituted.
• An N-thiocarbamyl may be substituted or unsubstituted.
• a C-amido may be substituted or unsubstituted.
• R and RA can be independently hydrogen, an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl (alkyl) or heterocyclyl(alkyl).
• An N-amido may be substituted or unsubstituted.
• S-sulfonamido refers to a "-SC>2N(RARB)" group in which RA and RB can be independently hydrogen, an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl (alkyl) or heterocyclyl(alkyl).
• An S-sulfonamido may be substituted or unsubstituted.
• N-sulfonamido refers to a "RSC>2N(RA)-" group in which R and RA can be independently hydrogen, an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl (alkyl) or heterocyclyl(alkyl).
• R and RA can be independently hydrogen, an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl (alkyl) or heterocyclyl(alkyl).
• An N-sulfonamido may be substituted or unsubstituted.
• An O-carboxy may be substituted or unsubstituted.
• An ester and C- carboxy may be substituted or unsubstituted.
• a "nitro” group refers to an "-NO2" group.
• a “sulfenyl” group refers to an "-SR" group in which R can be hydrogen, an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl(alkyl) or heterocyclyl(alkyl).
• R can be hydrogen, an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl(alkyl) or heterocyclyl(alkyl).
• a sulfenyl may be substituted or unsubstituted.
• a sulfinyl may be substituted or unsubstituted.
• a “sulfonyl” group refers to an “SO2R” group in which R can be the same as defined with respect to sulfenyl.
• a sulfonyl may be substituted or unsubstituted.
• haloalkyl refers to an alkyl group in which one or more of the hydrogen atoms are replaced by a halogen (e.g., mono-haloalkyl, di- haloalkyl, tri-haloalkyl and polyhaloalkyl).
• a halogen e.g., mono-haloalkyl, di- haloalkyl, tri-haloalkyl and polyhaloalkyl.
• groups include but are not limited to, chloromethyl, fluoromethyl, difluoromethyl, trifluoromethyl, l-chloro-2-fluoromethyl, 2-fluoroisobutyl and pentafluoroethyl.
• a haloalkyl may be substituted or unsubstituted.
• haloalkoxy refers to an alkoxy group in which one or more of the hydrogen atoms are replaced by a halogen (e.g., mono-haloalkoxy, di- haloalkoxy and tri- haloalkoxy).
• a halogen e.g., mono-haloalkoxy, di- haloalkoxy and tri- haloalkoxy.
• groups include but are not limited to, chloromethoxy, fluoromethoxy, difluoromethoxy, trifluoromethoxy, l-chloro-2- fluoromethoxy and 2-fluoroisobutoxy.
• a haloalkoxy may be substituted or unsubstituted.
• amino and “unsubstituted amino” as used herein refer to a
• a "mono-substituted amine” group refers to a "-NHRA” group in which RA can be an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloalkyl(alkyl), aryl(alkyl), heteroaryl(alkyl) or heterocyclyl(alkyl), as defined herein.
• the RA may be substituted or unsubstituted.
• a mono-substituted amine group can include, for example, a mono-alkylamine group, a mono-Ci-C6 alkylamine group, a mono-arylamine group, a mono-C6-Cio arylamine group and the like.
• Examples of mono-substituted amine groups include, but are not limited to, -NH(methyl), -NH(phenyl) and the like.
• a "di-substituted amine” group refers to a "-NRARB” group in which RA and RB can be independently an alkyl, an alkenyl, an alkynyl, a cycloalkyl, a cycloalkenyl, aryl, heteroaryl, heterocyclyl, cycloa I kyl (a I kyl), aryl(alkyl), heteroaryl (alkyl) or heterocyclyl(alkyl), as defined herein.
• RA and RB can independently be substituted or unsubstituted.
• a di-substituted amine group can include, for example, a di-alkylamine group, a di-Ci-C 6 alkylamine group, a di- arylamine group, a di-C 6 -Cio arylamine group and the like.
• Examples of di-substituted amine groups include, but are not limited to, -N(methyl)2, -N(phenyl)(methyl), -N(ethyl)(methyl) and the like.
• mono-substituted amine(alkyl) refers to a mono-substituted amine as provided herein connected, as a substituent, via a lower alkylene group.
• a mono-substituted amine(alkyl) may be substituted or unsubstituted.
• a mono-substituted amine(alkyl) group can include, for example, a mono-alkylamine(alkyl) group, a mono-Ci-C6 alkylamine(Ci-C6 alkyl) group, a mono- arylamine(alkyl group), a mono-C6-Cio arylamine(Ci-C6 alkyl) group and the like.
• Examples of mono-substituted amine(alkyl) groups include, but are not limited to, -CH 2 NH(methyl), -ChteNHCphenyl), -CH 2 CH 2 NH(methyl), -CH 2 CH 2 NH(phenyl) and the like.
• di-substituted amine(alkyl) refers to a di-substituted amine as provided herein connected, as a substituent, via a lower alkylene group.
• a di-substituted amine(alkyl) may be substituted or unsubstituted.
• a di-substituted amine(alkyl) group can include, for example, a dialkylamine(alkyl) group, a di-Ci-C6 alkylamine(Ci-C6 alkyl) group, a di-arylamine(alkyl) group, a di-C6- Cio arylamine(Ci-C6 alkyl) group and the like.
• di-substituted amine(alkyl)groups include, but are not limited to, -CH 2 N(methyl) 2 , -CH 2 N(phenyl)(methyl), -NCH 2 (ethyl)(methyl), -CH 2 CH 2 N(methyl) 2 ,
• substituents there may be one or more substituents present.
• haloalkyl may include one or more of the same or different halogens.
• C 1 -C 3 alkoxyphenyl may include one or more of the same or different alkoxy groups containing one, two or three atoms.
• a radical indicates species with a single, unpaired electron such that the species containing the radical can be covalently bonded to another species.
• a radical is not necessarily a free radical. Rather, a radical indicates a specific portion of a larger molecule.
• the term "radical” can be used interchangeably with the term "group.”
• salts refers to a salt of a compound that does not cause significant irritation to an organism to which it is administered and does not abrogate the biological activity and properties of the compound.
• the salt is an acid addition salt of the compound.
• Pharmaceutical salts can be obtained by reacting a compound with inorganic acids such as hydrohalic acid (e.g., hydrochloric acid or hydrobromic acid), a sulfuric acid, a nitric acid and a phosphoric acid (such as 2,3-dihydroxypropyl dihydrogen phosphate).
• Pharmaceutical salts can also be obtained by reacting a compound with an organic acid such as aliphatic or aromatic carboxylic or sulfonic acids, for example formic, acetic, succinic, lactic, malic, tartaric, citric, ascorbic, nicotinic, methanesulfonic, ethanesulfonic, p-toluensulfonic, trifluoroacetic, benzoic, salicylic, 2-oxopentanedioic or naphthalenesulfonic acid.
• an organic acid such as aliphatic or aromatic carboxylic or sulfonic acids
• Pharmaceutical salts can also be obtained by reacting a compound with a base to form a salt such as an ammonium salt, an alkali metal salt, such as a sodium, a potassium or a lithium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of a carbonate, a salt of a bicarbonate, a salt of organic bases such as dicyclohexylamine, N-methyl-D- glucamine, tris(hydroxymethyl)methylamine, C 1 -C7 alkylamine, cyclohexylamine, triethanolamine, ethylenediamine and salts with amino acids such as arginine and lysine.
• a salt such as an ammonium salt, an alkali metal salt, such as a sodium, a potassium or a lithium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of a carbonate, a salt of a bicarbonate, a salt of organic bases such
• a salt is formed by protonation of a nitrogen-based group (for example, NH2)
• the nitrogen-based group can be associated with a positive charge (for example, NH2 can become NH3 + ) and the positive charge can be balanced by a negatively charged counterion (such as Cl ).
• each center may independently be of R-configuration or S-configuration or a mixture thereof.
• the compounds provided herein may be enantiomerically pure, enantiomerically enriched, racemic mixture, diastereomerically pure, diastereomerically enriched or a stereoisomeric mixture.
• each double bond may independently be E or Z a mixture thereof.
• all tautomeric forms are also intended to be included.
• each chemical element as represented in a compound structure may include any isotope of said element.
• a hydrogen atom may be explicitly disclosed or understood to be present in the compound.
• the hydrogen atom can be any isotope of hydrogen, including but not limited to hydrogen-1 (protium) and hydrogen-2 (deuterium).
• reference herein to a compound encompasses all potential isotopic forms unless the context clearly dictates otherwise.
• the methods and combinations described herein include crystalline forms (also known as polymorphs, which include the different crystal packing arrangements of the same elemental composition of a compound), amorphous phases, salts, solvates and hydrates.
• the compounds described herein exist in solvated forms with pharmaceutically acceptable solvents such as water, ethanol or the like.
• the compounds described herein exist in unsolvated form.
• Solvates contain either stoichiometric or non-stoichiometric amounts of a solvent, and may be formed during the process of crystallization with pharmaceutically acceptable solvents such as water, ethanol or the like. Hydrates are formed when the solvent is water or alcoholates are formed when the solvent is alcohol.
• the compounds provided herein can exist in unsolvated as well as solvated forms.
• the solvated forms are considered equivalent to the unsolvated forms for the purposes of the compounds and methods provided herein. [0059] Where a range of values is provided, it is understood that the upper and lower limit, and each intervening value between the upper and lower limit of the range is encompassed within the embodiments.
• the term “comprising” is to be interpreted synonymously with the phrases “having at least” or “including at least”.
• the term “comprising” means that the compound, composition or device includes at least the recited features or components, but may also include additional features or components.
• R 1 can be selected from hydrogen, halogen, a substituted or unsubstituted C 1 -C6 alkyl, a substituted or unsubstituted C 1 -C6 haloalkyl, a substituted or unsubstituted C3-C6 cycloalkyl, a substituted or unsubstituted C 1 -C6 alkoxy, an unsubstituted mono-Ci-C6 alkylamine and an unsubstituted di-Ci-C6 alkylamine; each R 2 can be independently selected from halogen, a substituted or unsubstituted C 1 -C6 alkyl, a substituted or unsubstituted C 1 -C6 haloalkyl and
• the compound of Formula (A) or a pharmaceutically acceptable salt thereof can be a compound of the structure: or a pharmaceutically acceptable salt thereof.
• m is 2.
• R 1 can be halogen, for example, fluoro, chloro, bromo or iodo. In some embodiments, R 1 can be fluoro. In some embodiments, R 1 can be chloro. In some embodiments, R 1 can be hydrogen.
• R 1 can be a substituted or unsubstituted Ci- C 6 alkyl.
• R 1 can be a substituted C 1 -C6 alkyl.
• R 1 can be an unsubstituted C 1 -C6 alkyl.
• suitable Ci- C 6 alkyl groups include, but are not limited to methyl, ethyl, n-propyl, isopropyl, n- butyl, isobutyl, tert-butyl, pentyl (branched and straight-chained) and hexyl (branched and straight-chained).
• R 1 can be an unsubstituted methyl or an unsubstituted ethyl.
• R 1 can be a substituted or unsubstituted Ci- C6 haloalkyl, for example, a substituted or unsubstituted mono-halo C1-C6 alkyl, a substituted or unsubstituted di-halo C1-C6 alkyl, a substituted or unsubstituted tri ⁇ halo C1-C6 alkyl, a substituted or unsubstituted tetra-halo C1-C6 alkyl or a substituted or unsubstituted penta-halo C1-C6 alkyl.
• R 1 can be an unsubstituted C1-C6 haloalkyl, for example, -CHF2, -CF3, -CFI2CF3 or -CF2CFI3.
• R 1 can be a substituted or unsubstituted monocyclic or bicyclic C3-C6 cycloalkyl.
• R 1 can be a substituted monocyclic C3-C6 cycloalkyl.
• R 1 can be an unsubstituted monocyclic C3-C6 cycloalkyl.
• suitable monocyclic or bicyclic C3-C6 cycloalkyl groups include, but are not limited to cyclopropyl, cyclobutyl, cyclopentyl, [1.1.1] bicyclopentyl and cyclohexyl.
• R 1 can be a substituted or unsubstituted Ci- C6 alkoxy.
• R 1 can be a substituted C1-C6 alkoxy.
• R 1 can be an unsubstituted C1-C6 alkoxy.
• suitable C1-C6 alkoxy groups include, but are not limited to methoxy, ethoxy, n- propoxy, isopropoxy, n-butoxy, isobutoxy, tert-butoxy, pentoxy (branched and straight-chained) and hexoxy (branched and straight-chained).
• R 1 can be an unsubstituted methoxy or an unsubstituted ethoxy.
• R 1 can be an unsubstituted mono-Ci-C6 alkylamine, for example, methylamine, ethylamine, n-propylamine, isopropylamine, n-butylamine, isobutylamine, tert-butylamine, pentylamine (branched and straight- chained) and hexylamine (branched and straight-chained).
• R 1 can be methylamine or ethylamine.
• R 1 can be an unsubstituted di-Ci-C6 alkylamine.
• each C1-C6 alkyl in the di-Ci-C6 alkylamine is the same. In other embodiments, each C1-C6 alkyl in the di-Ci-C6 alkylamine is different.
• suitable di-Ci-C6 alkylamine groups include, but are not limited to di- methylamine, di-ethylamine, (methyl)(ethyl)amine, (methyl)(isopropyl)amine and (ethyl)(isopropyl)amine.
• m can be 0. When m is 0, those skilled in the art understand that the ring to which R 2 is attached is unsubstituted. In some embodiments, m can be 1. In some embodiments, m can be 2. In some embodiments, m can be 3.
• one R 2 can be an unsubstituted C 1 -C6 alkyl (for example, methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, tert-butyl, pentyl (branched and straight-chained) and hexyl (branched and straight-chained)) and any other R 2 , if present, can be independently selected from halogen (for example, fluoro or chloro), a substituted or unsubstituted C 1 -C6 alkyl (such as those described herein), a substituted or unsubstituted C 1 -C6 haloalkyl (such as those described herein) and a substituted or unsubstituted monocyclic or bicyclic C3-C6 cycloalkyl (such as those described herein).
• each R 2 can be independently selected from an unsubstituted C 1 -C6 alkyl (for
• m can be 2; and each R 2 can be geminal. In some embodiments, m can be 2; and each R 2 can be vicinal. In some embodiments, m can be 2; and each R 2 can be an unsubstituted methyl. In some embodiments, m can be 2; and each R 2 can be a geminal unsubstituted methyl.
• two R 2 groups can be taken together with the atom(s) to which they are attached to form a substituted or unsubstituted monocyclic C3-C6 cycloalkyl.
• two R 2 groups can be taken together with the atom(s) to which they are attached to form a substituted monocyclic C3-C6 cycloalkyl, such as those described herein.
• two R 2 groups can be taken together with the atom(s) to which they are attached to form an unsubstituted monocyclic C3-C6 cycloalkyl, such as those described herein.
• two R 2 groups can be taken together with the atom to which they are attached to form an unsubstituted cyclopropyl.
• two R 2 groups can be taken together with the atom(s) to which they are attached to form a substituted or unsubstituted monocyclic 3 to 6 membered heterocyclyl.
• two R 2 groups can be taken together with the atom(s) to which they are attached to form a substituted monocyclic 3 to 6 membered heterocyclyl.
• two R 2 groups can be taken together with the atom(s) to which they are attached to form an unsubstituted monocyclic 3 to 6 membered monocyclic heterocyclyl.
• the substituted monocyclic 3 to 6 membered heterocyclyl can be substituted on one or more nitrogen atoms.
• Suitable substituted or unsubstituted monocyclic 3 to 6 membered heterocyclyl groups include, but are not limited to azidirine, oxirane, azetidine, oxetane, pyrrolidine, tetrahydrofuran, imidazoline, pyrazolidine, piperidine, tetrahydropyran, piperazine, morpholine, thiomorpholine and dioxane.
• R 4 can be NO2. In some embodiments, R 4 can be cyano. In some embodiments, R 4 can be halogen.
• R 4 can be an unsubstituted C1-C6 haloalkyl, such as those described herein. In some embodiments, R 4 can be -CF3.
• R 4 can be S(0)R 6 . In some embodiments, R 4 can be SO2R 6 . In some embodiments, R 4 can be SO2CF3.
• R 6 can be a substituted or unsubstituted Ci- C6 alkyl.
• R 6 can be a substituted C1-C6 alkyl, such as those described herein.
• R 6 can be an unsubstituted C1-C6 alkyl, such as those described herein.
• R 6 can be a substituted or unsubstituted monocyclic or bicyclic C3-C6 cycloalkyl.
• R 6 can be a substituted monocyclic or bicyclic C3-C6 cycloalkyl.
• R 6 can be an unsubstituted monocyclic or bicyclic C3-C6 cycloalkyl.
• suitable monocyclic or bicyclic C3-C6 cycloalkyl groups include, but are not limited to cyclopropyl, cyclobutyl, cyclopentyl, [1.1.1] bicyclopentyl and cyclohexyl.
• R 6 can be a substituted or unsubstituted Ci- C 6 haloalkyl, such as those described herein.
• R 6 can be -CF 3 .
• R 5 can be - ⁇ -(Alk ⁇ n-R 7 .
• X 1 can be -0-.
• X 1 can be -S-.
• X 1 can be
• Aik 1 can be unsubstituted -(CH2) I -4-* for which "*" represents the point of attachment to R 7 . In some embodiments, Aik 1 can
• Aik 1 can be a substituted jj C-1-C4 aikyiene * f or w j C h « * » represents the point of attachment to R 7 .
• Aik 1 can be a substituted methylene, a substituted ethylene, a substituted propylene or a substituted butylene.
• Aik 1 can be mono-substituted, di-substituted or tri -substituted.
• Aik 1 can be mono-substituted with a halogen (such as fluoro or chloro) or unsubstituted C 1 -C 3 alkyl, such as those described herein. In other embodiments, Aik 1 can be mono-substituted unsubstituted C 1 -C 3 haloalkyl, such as those described herein. In some embodiments, Aik 1 can be mono-substituted with fluoro or unsubstituted methyl. In some embodiments, Aik 1 can be di-substituted with one fluoro and one unsubstituted C 1 -C 3 alkyl, such as those described herein.
• a halogen such as fluoro or chloro
• Aik 1 can be di-substituted with one unsubstituted C 1 -C 3 haloalkyl, such as those described herein, and one unsubstituted C 1 -C 3 alkyl, such as those described herein. In some embodiments, Aik 1 can be di-substituted with one fluoro and one unsubstituted methyl. In some embodiments, Aik 1 can be di- substituted with two independently selected unsubstituted C 1 -C 3 alkyl groups, such as those described herein. In some embodiments, Aik 1 can be di-substituted with unsubstituted methyl. [0085] In some embodiments, Aik 1 can be selected from:
• n can be 0. When n is 0, those skilled in the art understand that X 1 is directly connected to R 7 . In some embodiments, n can be 1.
• R 7 can be a substituted or unsubstituted mono-substituted amine group.
• R 7 can be an amino group mono- substituted with a substituted or unsubstituted C1-C6 alkyl, a substituted or unsubstituted C 2 -C 6 alkenyl, a substituted or unsubstituted C 2 -C 6 alkynyl, a substituted or unsubstituted monocyclic or bicyclic C 3 -C 6 cycloalkyl, a substituted or unsubstituted monocyclic or bicyclic C 6 -C 10 aryl, a substituted or unsubstituted monocyclic or bicyclic 5 to 10 membered heteroaryl, a substituted or unsubstituted monocyclic or bicyclic 3 to 10 membered heterocyclyl, a substituted or unsubstituted monocyclic or bicyclic C 3 -C 6
• Suitable mono-substituted amine groups include, but are not limited to -NH(methyl), -NH(isopropyl), -NH(cyclopropyl), -NH(phenyl), -NH(benzyl) and -NH(pyridine-3-yl).
• R 7 can be a substituted or unsubstituted di- substituted amine group.
• R 7 can be an amino group substituted with two substituents independently selected from a substituted or unsubstituted C 1 -C 6 alkyl, a substituted or unsubstituted C 2 -C 6 alkenyl, a substituted or unsubstituted C 2 - C 6 alkynyl, a substituted or unsubstituted monocyclic or bicyclic C3-C6 cycloalkyl, a substituted or unsubstituted monocyclic or bicyclic C6-C 1 0 aryl, a substituted or unsubstituted monocyclic or bicyclic 5 to 10 membered heteroaryl, a substituted or unsubstituted monocyclic or bicyclic 3 to 10 membered heterocyclyl, a substituted or unsubstituted monocyclic or bicyclic C3-
• the two substituents can be the same. In other embodiments the two substituents can be different.
• suitable di-substituted amine groups include, but are not limited to, -N(methyl)2, -N(ethyl)2, -N(isopropyl)2, -N(benzyl)2, -N(ethyl)(methyl), -N(isopropyl)(methyl), -N(ethyl)(isopropyl), -N(phenyl)(methyl) and -N(benzyl)(methyl).
• R 7 can be selected from a substituted or unsubstituted N-carbamyl, a substituted or unsubstituted C-amido and a substituted or unsubstituted N-amido.
• R 7 can be a substituted or unsubstituted C3- C10 cycloalkyl. In some embodiments, R 7 can be a substituted or unsubstituted C3-C6 cycloalkyl. In some embodiments, R 7 can be a substituted or unsubstituted monocyclic C3-C10 cycloalkyl. In other embodiments, R 7 can be a substituted or unsubstituted bicyclic C3-C10 cycloalkyl, for example, a bridged, fused or spiro C3-C10 cycloalkyl.
• Suitable substituted or unsubstituted monocyclic or bicyclic C3-C10 cycloalkyl groups include, but are not limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl, cyclononyl, cyclodecyl, spiro[3.3]heptyl, spiro[2.3]hexyl, spiro[3.4]octyl, spiro[3.5]nonyl, spiro[3.6]decyl, spiro[2.4]heptyl, spiro[4.4]nonyl, spiro[4.5]decyl, spiro[2.5]octyl, spiro[3.5]nonyl, bicyclo[l.l.l]pentyl, bicyclo[2.1.1]hexyl, bicyclo[2.2.1
• R 7 can be a substituted or unsubstituted C6- Cio spirocycloalkyl. In some embodiments, R 7 can be a substituted C6-C10 spirocycloalkyl. In other embodiments, R 7 can be an unsubstituted C6-C10 spirocycloalkyl. In some embodiments, R 7 can be a substituted or unsubstituted - cyclopropyl-cyclobutyl spiroalkyl,
• -cyclopropyl-cyclopentyl spiroalkyl -cyclopropyl-cyclohexyl spiroalkyl, cyclopropyl-cycloheptyl spiroalkyl, -cyclopropyl-cyclooctyl spiroalkyl, -cyclobutyl- cyclopropyl spiroalkyl, -cyclobutyl-cyclobutyl spiroalkyl, -cyclobutyl-cyclopentyl spiroalkyl,
• R 7 can be a substituted or unsubstituted 3 to 10 membered heterocyclyl. In some embodiments, R 7 can be a substituted 3 to 10 membered heterocyclyl. In other embodiments, R 7 can be an unsubstituted 3 to 10 membered heterocyclyl. In some embodiments, R 7 can be a substituted or unsubstituted monocyclic 3 to 10 membered heterocyclyl. In other embodiments, R 7 can be a substituted or unsubstituted bicyclic 5 to 10 membered heterocyclyl, for example, a fused, bridged or spiro 5 to 10 membered heterocyclyl.
• Suitable substituted or unsubstituted 3 to 10 membered heterocyclyl groups include, but are not limited to, azidirine, oxirane, azetidine, oxetane, pyrrolidine, tetrahydrofuran, imidazoline, pyrazolidine, piperidine, tetrahydropyran, piperazine, morpholine, thiomorpholine, dioxane, 2-azaspiro[3.3]heptane, 2-oxaspiro[3.3]heptane, 2,6- diazaspiro[3.3]heptane, 2-oxa-6-azaspiro[3.3]heptane, 2-azaspiro[3.4]octane, 6- oxaspiro[3.4]octane, 6-oxa-2-azaspiro[3.4]octane, 7-oxa-2-azaspiro[3.5]nonane, 7- oxaspiro[
• the substituted or unsubstituted monocyclic or bicyclic 3 to 10 membered heterocyclyl can be connected to the rest of the molecule through a nitrogen atom. In other embodiments, the substituted or unsubstituted monocyclic or bicyclic 3 to 10 membered heterocyclyl can be connected to the rest of the molecule through a carbon atom. In some embodiments, the substituted monocyclic or bicyclic 3 to 10 membered heterocyclyl can be substituted on one or more nitrogen atoms.
• R 7 can be a substituted or unsubstituted 6 to 10 membered spiro heterocyclyl. In some embodiments, R 7 can be a substituted 6 to 10 membered spiro heterocyclyl. In other embodiments, R 7 can be an unsubstituted 6 to 10 membered spiro heterocyclyl.
• R 7 can be a substituted or unsubstituted azaspirohexane, azaspiroheptane, azaspirooctane, oxaspirohexane, oxaspiroheptane, oxaspirooctane, diazaspirohexane, diazaspiroheptane, diazaspirooctane, dioxaspirohexane, dioxaspiroheptane, dioxaspirooctane, oxa-azaspirohexane, oxa-azaspiroheptane or oxa-azaspirooctane.
• Suitable substituted or unsubstituted 3 to 10 membered heterocyclyl groups include, but are not limited to, 2-azaspiro[3.3]heptane, 2-oxaspiro[3.3]heptane, 2,6- diazaspiro[3.3]heptane, 2-oxa-6-azaspiro[3.3]heptane, 2-azaspiro[3.4]octane, 6- oxaspiro[3.4]octane, 6-oxa-2-azaspiro[3.4]octane, 7-oxa-2-azaspiro[3.5]nonane, 7- oxaspiro[3.5] nonane and 2-oxa-8-azaspiro[4.5]decane.
• the substituted or unsubstituted 6 to 10 membered spiro heterocyclyl can be connected to the rest of the molecule through a nitrogen atom. In other embodiments, the substituted or unsubstituted 6 to 10 membered spiro heterocyclyl can be connected to the rest of the molecule through a carbon atom. In some embodiments, the substituted 6 to 10 membered spiroheterocyclyl can be substituted on one or more nitrogen atoms.
• R 7 can be hydroxy or amino.
• R 7 can be unsubstituted. In other embodiments, R 7 can be substituted. In some embodiments, R 7 can be substituted with 1 or 2 substituents independently selected from an unsubstituted C1-C6 alkyl (such as those described herein), an unsubstituted C1-C6 alkoxy (such as those described herein), fluoro, chloro, hydroxy and -SC>2-(unsubstituted C1-C6 alkyl).
• the C 1 -C 6 alkoxy, C 3 -C 10 cycloalkyl, 3 to 10 membered heterocyclyl, mono- substituted amine group, di-substituted amine group, N-carbamyl, C-amido and N- amido groups of R 7 can be substituted with 1 or 2 substituents independently selected from any of the aforementioned substituents.
• R 7 can be any organic radical
• R 7 can be V
• R 7 can be ⁇ or In some embodiments R 7 can be .
• R 7 can be or
• R 7 can be In some embodiments R 7 can be .
• R 7 can be or In some embodiments R 7 can be
• R 7 can be , such as
• the compound of Formula (A), or a pharmaceutically acceptable salt thereof can be selected from a compound of Formula (AA), Formula (BB), Formula (CC) and Formula (DD):
• Examples of compounds of the Formula (A) include the following: pharmaceutically acceptable salt of any of the foregoing.
• Compounds of the Formula (A), along with pharmaceutically acceptable salts thereof, can be prepared as described in WO 2019/139902, WO 2019/139900, WO 2019/139907 and WO 2019/139899, which are each hereby incorporated by reference in their entireties.
• compounds of the Formula (A) are Bcl-2 inhibitors.
• a compound of the Formula (A) can be used as a monotherapy for the treatment of amyloidosis.
• a compound of Formula (A) can be used without another active ingredient.
• a compound of the Formula (A) is used in a combination of compounds for the treatment of amyloidosis.
• a compound of the Formula (A), or a pharmaceutically acceptable salt thereof is used in combination with one or more other compounds of the Formula (A), or a pharmaceutically acceptable salt thereof, for the treatment of amyloidosis.
• one or more compounds of the Formula (A), or a pharmaceutically acceptable salt thereof are used in combination with another amyloidosis treatment.
• the combination of compounds includes, in addition to an effective amount of a compound of Formula (A), an effective amount of one or more of Compound (B), or a pharmaceutically acceptable salt thereof.
• the one or more of Compound (B) is a corticosteroid, or a pharmaceutically acceptable salt thereof.
• corticosteroids include hydrocortisone, hydrocortisone acetate, cortisone acetate, tixocortol pivalate, prednisolone, methylprednisolone, prednisone, beclometasone, betamethasone, dexamethasone, fluocortolone, halometasone, mometasone, Amcinonide, budesonide, desonide, fluocinolone acetonide, fluocinonide, halcinonide, triamcinolone acetonide, alclometasone dipropionate, betamethasone dipropionate, betamethasone valerate, clobetasol propionate, clobetasone butyrate, fluprednidene acetate, mometas
• the one or more of Compound (B) can be a proteasome inhibitor, or a pharmaceutically acceptable salt thereof.
• proteasome inhibitors include bortezomib, carfilzomib, and ixazomib.
• the one or more of Compound (B) can be a corticosteroid, a proteasome inhibitor, or a pharmaceutically acceptable salt of any of the foregoing.
• the one or more of Compound (B) can be a corticosteroid and a proteasome inhibitor, or a pharmaceutically acceptable salt of any of the foregoing.
• a compound of the Formula (A), including pharmaceutically acceptable salts thereof can be administered prior to all of Compound (B), or a pharmaceutically acceptable salt thereof.
• a compound of the Formula (A), including pharmaceutically acceptable salts thereof can be administered prior to at least one Compound (B), or a pharmaceutically acceptable salt thereof.
• a compound of the Formula (A), including pharmaceutically acceptable salts thereof can be administered concomitantly with Compound (B), or a pharmaceutically acceptable salt thereof.
• a compound of the Formula (A), including pharmaceutically acceptable salts thereof can be administered subsequent to the administration of at least one Compound (B), or a pharmaceutically acceptable salt thereof. In some embodiments, a compound of the Formula (A), including pharmaceutically acceptable salts thereof, can be administered subsequent to the administration of all Compound (B), or a pharmaceutically acceptable salt thereof.
• a combination as described herein of a compound of the Formula (A), including pharmaceutically acceptable salts thereof, and one or more of Compound (B), or pharmaceutically acceptable salts thereof can decrease the number and/or severity of side effects that can be attributed to a compound described herein, such as Compound (B), or a pharmaceutically acceptable salt thereof.
• Using a combination of compounds described herein can results in additive, synergistic or strongly synergistic effect for the treatment of amyloidosis.
• a combination of compounds described herein can result in an effect that is not antagonistic.
• a combination as described herein of two or more compounds of the Formula (A), including pharmaceutically acceptable salts thereof can result in an additive effect for the treatment of amyloidosis.
• a combination as described herein of two or more compounds of the Formula (A), including pharmaceutically acceptable salts thereof can result in a synergistic effect.
• a combination as described herein of two or more compounds of the Formula (A), including pharmaceutically acceptable salts thereof can result in a strongly synergistic effect.
• a combination as described herein of two or more compounds of the Formula (A), including pharmaceutically acceptable salts thereof is not antagonistic.
• a combination as described herein of a compound of the Formula (A), including pharmaceutically acceptable salts thereof, and one or more of Compound (B), or pharmaceutically acceptable salts thereof can result in an additive effect for the treatment of amyloidosis.
• a combination as described herein of a compound of the Formula (A), including pharmaceutically acceptable salts thereof, and one or more of Compound (B), or pharmaceutically acceptable salts thereof can result in a synergistic effect.
• a combination as described herein of a compound of the Formula (A), including pharmaceutically acceptable salts thereof, and one or more of Compound (B), or pharmaceutically acceptable salts thereof can result in a strongly synergistic effect.
• a combination as described herein of a compound of the Formula (A), including pharmaceutically acceptable salts thereof, and one or more of Compound (B), or pharmaceutically acceptable salts thereof is not antagonistic.
• the term "antagonistic” means that the activity of the combination of compounds is less compared to the sum of the activities of the compounds in combination when the activity of each compound is determined individually (i.e., as a single compound).
• the term “synergistic effect” means that the activity of the combination of compounds is greater than the sum of the individual activities of the compounds in the combination when the activity of each compound is determined individually.
• the term “additive effect” means that the activity of the combination of compounds is about equal to the sum of the individual activities of the compounds in the combination when the activity of each compound is determined individually.
• a potential advantage of utilizing a combination as described herein may be a reduction in the required amount(s) of the compound(s) that is effective in treating a disease condition disclosed herein compared to when each compound is administered as a monotherapy.
• the amount of Compound (B), or a pharmaceutically acceptable salt thereof, used in a combination described herein can be less compared to the amount of Compound (B), or a pharmaceutically acceptable salt thereof, needed to achieve the same reduction in a disease marker when administered as a monotherapy.
• Another potential advantage of utilizing a combination as described herein is that the use of two or more compounds having different mechanisms of action can create a higher barrier to the development of resistance compared to when a compound is administered as monotherapy.
• Additional advantages of utilizing a combination as described herein may include little to no cross resistance between the compounds of a combination described herein; different routes for elimination of the compounds of a combination described herein; and/or little to no overlapping toxicities between the compounds of a combination described herein.
• Compounds of the Formula (A), including pharmaceutically acceptable salts thereof, can be provided in a pharmaceutical composition for the treatment of amyloidosis.
• Compound (B), including pharmaceutically acceptable salts thereof, can be provided in a pharmaceutical composition.
• compositions refers to a mixture of one or more compounds and/or salts disclosed herein with other chemical components, such as diluents, carriers and/or excipients.
• the pharmaceutical composition facilitates administration of the compound to an organism.
• Pharmaceutical compositions can also be obtained by reacting compounds with inorganic or organic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, and salicylic acid.
• Pharmaceutical compositions will generally be tailored to the specific intended route of administration.
• a "carrier” refers to a compound that facilitates the incorporation of a compound into cells or tissues.
• DMSO dimethyl sulfoxide
• a "diluent” refers to an ingredient in a pharmaceutical composition that lacks appreciable pharmacological activity but may be pharmaceutically necessary or desirable.
• a diluent may be used to increase the bulk of a potent drug whose mass is too small for manufacture and/or administration. It may also be a liquid for the dissolution of a drug to be administered by injection, ingestion or inhalation.
• a common form of diluent in the art is a buffered aqueous solution such as, without limitation, phosphate buffered saline that mimics the pH and isotonicity of human blood.
• an "excipient” refers to an essentially inert substance that is added to a pharmaceutical composition to provide, without limitation, bulk, consistency, stability, binding ability, lubrication, disintegrating ability etc., to the composition.
• stabilizers such as anti-oxidants and metal-chelating agents are excipients.
• the pharmaceutical composition comprises an anti-oxidant and/or a metal-chelating agent.
• a "diluent” is a type of excipient.
• compounds of the Formula (A), including pharmaceutically acceptable salts thereof can be provided in a monotherapy pharmaceutical composition for the treatment of amyloidosis.
• Compound (B), along with pharmaceutically acceptable salts thereof can be provided in a pharmaceutical composition that includes a compound of the Formula (A), including pharmaceutically acceptable salts thereof.
• Compound (B), along with pharmaceutically acceptable salts thereof can be administered in a pharmaceutical composition that is separate from a pharmaceutical composition that includes a compound of the Formula (A), including pharmaceutically acceptable salts thereof.
• compositions described herein can be administered to a human patient per se, or in pharmaceutical compositions where they are mixed with other active ingredients, as in combination therapy, or carriers, diluents, excipients or combinations thereof. Proper formulation is dependent upon the route of administration chosen. Techniques for formulation and administration of the compounds described herein are known to those skilled in the art.
• compositions disclosed herein may be manufactured in a manner that is itself known, e.g., by means of conventional mixing, dissolving, granulating, dragee-making, levigating, emulsifying, encapsulating, entrapping or tableting processes. Additionally, the active ingredients are contained in an amount effective to achieve its intended purpose. Many of the compounds used in the pharmaceutical combinations disclosed herein may be provided as salts with pharmaceutically compatible counterions.
• compounds of the Formula (A), including pharmaceutically acceptable salts thereof can be administered orally.
• compounds of the Formula (A), including pharmaceutically acceptable salts thereof can be provided to a subject by the same route of administration as Compound (B), along with pharmaceutically acceptable salts thereof.
• compounds of the Formula (A), including pharmaceutically acceptable salts thereof can be provided to a subject by a different route of administration as Compound (B), along with pharmaceutically acceptable salts thereof.
• a targeted drug delivery system for example, in a liposome coated with a tissue-specific antibody.
• the liposomes will be targeted to and taken up selectively by the organ. For example, intranasal or pulmonary delivery to target a respiratory disease or condition may be desirable.
• the compositions may, if desired, be presented in a pack or dispenser device which may contain one or more unit dosage forms containing the active ingredient.
• the pack may for example comprise metal or plastic foil, such as a blister pack.
• the pack or dispenser device may be accompanied by instructions for administration.
• the pack or dispenser may also be accompanied with a notice associated with the container in form prescribed by a governmental agency regulating the manufacture, use, or sale of pharmaceuticals, which notice is reflective of approval by the agency of the form of the drug for human or veterinary administration.
• Such notice for example, may be the labeling approved by the U.S. Food and Drug Administration for prescription drugs, or the approved product insert.
• Compositions that can include a compound and/or salt described herein formulated in a compatible pharmaceutical carrier may also be prepared, placed in an appropriate container, and labeled for treatment of an indicated condition.
• an effective amount of a compound of the Formula (A), including pharmaceutically acceptable salts thereof, can be used to treat amyloidosis.
• amyloidosis is selected from the group consisting of amyloid light- chain (AL) amyloidosis, amyloid type A (AA) amyloidosis, dialysis-related amyloidosis (DRA), familial or hereditary amyloidosis, age-related (senile) systemic amyloidosis, organ-specific amyloidosis and combinations thereof.
• a subject can have an amyloidosis that has not been previously treated.
• amyloidosis following amyloidosis treatment, a subject can relapse or have reoccurrence of the amyloidosis.
• the terms "relapse” and “reoccurrence” are used in their normal sense as understood by those skilled in the art.
• the amyloidosis can be a recurrent amyloidosis.
• the subject has relapsed after a previous treatment for AL amyloidosis.
• a "subject” refers to an animal that is the object of treatment, observation or experiment.
• Animal includes cold- and warm-blooded vertebrates and invertebrates such as fish, shellfish, reptiles and, in particular, mammals.
• “Mammal” includes, without limitation, mice, rats, rabbits, guinea pigs, dogs, cats, sheep, goats, cows, horses, primates, such as monkeys, chimpanzees, and apes, and, in particular, humans.
• the subject can be human.
• the subject can be a child and/or an infant, for example, a child or infant with a fever.
• the subject can be an adult.
• treat do not necessarily mean total cure or abolition of the disease or condition. Any alleviation of any undesired signs or symptoms of the disease or condition, to any extent can be considered treatment and/or therapy. Furthermore, treatment may include acts that may worsen the subject's overall feeling of well-being or appearance.
• an effective amount of compound, salt or composition can be the amount needed to prevent, alleviate or ameliorate symptoms of the disease or condition, or prolong the survival of the subject being treated. This response may occur in a tissue, system, animal or human and includes alleviation of the signs or symptoms of the disease or condition being treated. Determination of an effective amount is well within the capability of those skilled in the art, in view of the disclosure provided herein.
• the effective amount of the compounds disclosed herein required as a dose will depend on the route of administration, the type of animal, including human, being treated and the physical characteristics of the specific animal under consideration. The dose can be tailored to achieve a desired effect, but will depend on such factors as weight, diet, concurrent medication and other factors which those skilled in the medical arts will recognize.
• an effective amount of a compound is the amount that results in the reduction, alleviation or disappearance of one or more symptoms caused by the amyloidosis.
• the amount of compound, salt and/or composition required for use in treatment will vary not only with the particular compound or salt selected but also with the route of administration, the nature and/or symptoms of the disease or condition being treated and the age and condition of the patient and will be ultimately at the discretion of the attendant physician or clinician.
• dosages may be calculated as the free base.
• the useful in vivo dosage to be administered and the particular mode of administration will vary depending upon the age, weight, the severity of the affliction, the mammalian species treated, the particular compounds employed and the specific use for which these compounds are employed.
• the determination of effective dosage levels can be accomplished by one skilled in the art using routine methods, for example, human clinical trials, in vivo studies and in vitro studies.
• useful dosages of a compound of Formulae (A) and/or (B), or pharmaceutically acceptable salts of the foregoing can be determined by comparing their in vitro activity, and in vivo activity in animal models. Such comparison can be done by comparison against an established amyloidosis treatment.
• Dosage amount and interval may be adjusted individually to provide plasma levels of the active moiety which are sufficient to maintain the modulating effects, or minimal effective concentration (MEC).
• MEC minimal effective concentration
• the MEC will vary for each compound but can be estimated from in vivo and/or in vitro data. Dosages necessary to achieve the MEC will depend on individual characteristics and route of administration. However, HPLC assays or bioassays can be used to determine plasma concentrations. Dosage intervals can also be determined using MEC value.
• Compositions should be administered using a regimen which maintains plasma levels above the MEC for 10-90% of the time, preferably between 30-90% and most preferably between 50-90%. In cases of local administration or selective uptake, the effective local concentration of the drug may not be related to plasma concentration.
• the attending physician would know how to and when to terminate, interrupt or adjust administration due to toxicity or organ dysfunctions. Conversely, the attending physician would also know to adjust treatment to higher levels if the clinical response were not adequate (precluding toxicity).
• the magnitude of an administrated dose in the management of the disorder of interest will vary with the severity of the disease or condition to be treated and to the route of administration. The severity of the disease or condition may, for example, be evaluated, in part, by standard prognostic evaluation methods. Further, the dose and perhaps dose frequency, will also vary according to the age, body weight and response of the individual patient. A program comparable to that discussed above may be used in veterinary medicine.
• Compounds, salts and compositions disclosed herein can be evaluated for efficacy and toxicity using known methods.
• the toxicology of a particular compound, or of a subset of the compounds, sharing certain chemical moieties may be established by determining in vitro toxicity towards a cell line, such as a mammalian, and preferably human, cell line. The results of such studies are often predictive of toxicity in animals, such as mammals, or more specifically, humans.
• the toxicity of particular compounds in an animal model such as mice, rats, rabbits, dogs or monkeys, may be determined using known methods.
• the efficacy of a particular compound may be established using several recognized methods, such as in vitro methods, animal models, or human clinical trials. When selecting a model to determine efficacy, the skilled artisan can be guided by the state of the art to choose an appropriate model, dose, route of administration and/or regime.
• MM cell lines were selected that contain a t(ll;14) translocation (i.e. KMS-12BM) or do not contain a t(l 1; 14) translocation (i.e. OPM-2). It is understood that compound activity in MM models is predictive of activity in amyloidosis (e.g. AL amyloidosis) models and/or patients.
• TGI Tumor growth inhibition
• the single agent activity of Compound (A) was assessed in a KMS- 12-BM mouse model, as shown in Figure 2.
• Mice were inoculated with KMS-12-BM cells subcutaneously on the right flank with the single cell suspension of 95% viable tumor cells (1 x 10 7 ) in 200 pL RPMI-1640 Matrigel mixture (1:1 ratio) without serum for the tumor development.
• the treatment was started when the mean tumor size reached approximately 200 mm 3 , with individual tumor size ranging from 180-220 mm 3 .
• Animals were randomly distributed into treatment groups of 10 animals each and dosed with either vehicle or Compound (A) at 100 mg/kg administered by oral gavage once a day.
• T d and C d are the mean tumor volumes of the treated and control animals, and To and Co are the mean tumor volumes of the treated and control animals at the start of the experiment.
• Figure 2 depicts the mean tumor volume results of the study, which shows that administration of single agent treatment of Compound (A) resulted in tumor growth inhibition and 62.8% TGI efficacy after 14 days.
• the compound(s) administered to the animals include Compound (A) at 100 mg/kg p.o. qd x 21 (squares), dexamethasone at 1 mg/kg IP at 5 days on 2 days off (triangles), and Compound (A) at 100 mg/kg p.o. qd x 21 + dexamethasone at 1 mg/kg at 5 days on 2 days off (open circles, bottom line).
• Tumor volumes were evaluated twice per week to calculate tumor volume over time, and mice were weighed twice per week as a surrogate for signs of toxicity.
• Td and Cd are the mean tumor volumes of the treated and control animals, and To and Co are the mean tumor volumes of the treated and control animals at the start of the experiment.
• Figure 3 shows that single agent treatment of Compound (A) or dexamethasone resulted in tumor growth inhibition of 62.8% and 22.5%, respectively, on day 14.
• the combination of Compound (A) and dexamethasone resulted in TGI of 73.1% on day 14, which is an improved efficacy relative to the single agent treatments.
• the combination effect of Compound (A) with bortezomide was studied in a KMS-12-BM mouse model, as shown in Figure 4.
• mice were inoculated with KMS-12-BM cells subcutaneously on the right flank with the single cell suspension of 95% viable tumor cells (1 x 10 7 ) in 200 pL RPMI-1640 Matrigel mixture (1:1 ratio) without serum for the tumor development.
• the treatment was started when the mean tumor size reached approximately 200 mm 3 , with individual tumor size ranging from 180-220 mm 3 .
• Animals were randomly distributed into treatment groups of 10 animals each and each grouping was dosed with vehicle or indicated compound(s) at indicated dosage and frequency as provided in Figure 4. As shown in Figure 4, the compound(s) administered to the animals include Compound A at 50 mg/kg p.o.
• TGI Tumor growth inhibition
• Td and Cd are the mean tumor volumes of the treated and control animals, and To and Co are the mean tumor volumes of the treated and control animals at the start of the experiment.
• Figure 4 shows that single agent treatment of Compound A or bortezomib resulted in tumor growth inhibition of 48.7% and 46.5%, respectively, on day 14.
• the combination of Compound A and bortezomib resulted in TGI of 77.3% on day 14, which is an improved efficacy relative to the single agent treatments.

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