WO2023155182A1 - 一种低服用剂量高药物暴露量的索拉非尼或多纳非尼口服制剂及其应用 - Google Patents
一种低服用剂量高药物暴露量的索拉非尼或多纳非尼口服制剂及其应用 Download PDFInfo
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- WO2023155182A1 WO2023155182A1 PCT/CN2022/077001 CN2022077001W WO2023155182A1 WO 2023155182 A1 WO2023155182 A1 WO 2023155182A1 CN 2022077001 W CN2022077001 W CN 2022077001W WO 2023155182 A1 WO2023155182 A1 WO 2023155182A1
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- WIPO (PCT)
- Prior art keywords
- sorafenib
- donafenib
- povidone
- copovidone
- polyethylene glycol
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- A61K9/146—Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers with organic macromolecular compounds
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Definitions
- the present invention relates to the field of pharmaceutical preparation technology and material science, and in particular to a new self-assembled system reconstructed with a self-assembled polymer material after a molecular-level pharmaceutical composition is released in the body, breaking Sorafenib or Donafenib
- the accumulation of molecules formed by the interaction between molecules can reduce the premature metabolism of drugs by CYP3A4/A5/CYP2/P-gp in the digestive tract, reduce the toxic and side effects of the gastrointestinal tract before the drug is absorbed into the system, and use a lower dosage of Sola Oral formulations of fenib or donafenib achieve their therapeutic use.
- Nexavar Sorafenib Tosylate Tablets is the first multi-target oral tumor molecular targeted drug jointly developed by Bayer AG and Onyx AG for the treatment of advanced liver cancer, renal cell carcinoma and thyroid cancer. Since the drug was launched in 2007 as the first-line drug for the systemic treatment of advanced hepatocellular carcinoma, the systemic treatment of hepatocellular carcinoma has undergone significant changes. Sorafenib can act on tumor cells and tumor blood vessels at the same time, and inhibit tumor growth through mechanisms such as anti-cell proliferation, promotion of cell apoptosis, and inhibition of angiogenesis.
- Sorafenib plays an anti-cell proliferation effect by inhibiting c-Raf kinase and downstream signal transduction, hindering the phosphorylation process of MEK and ERK, and reducing the phosphorylation level of ERK; on the other hand, Sorafenib inhibits vascular endothelial Cell growth factor receptor-2 (VEGFR-2), vascular endothelial growth factor receptor-3 (VEGFR-3), and platelet-derived growth factor receptor- ⁇ (PDGFR- ⁇ ), which inhibit the activation of tyrosine kinase receptors Anti-angiogenic activity due to autophosphorylation process.
- VEGFR-2 vascular endothelial Cell growth factor receptor-2
- VEGFR-3 vascular endothelial growth factor receptor-3
- PDGFR- ⁇ platelet-derived growth factor receptor- ⁇
- eIF4E phosphorylation process of initiation factor-4E
- Sorafenib is an oral multikinase inhibitor of the bisaryl urea class with the chemical name 4- ⁇ 4-[3-(4-chloro-3-trifluoromethyl-phenyl)ureide]-benzene Oxygen)-pyridine-2-carboxylic acid methylamine, the relative molecular mass is 464.8.
- the active ingredient used in Nexavar sorafenib tablets is the tosylate salt of sorafenib, and the molecular formula is C 21 H 16 ClF 3 N 4 O 3 ⁇ C 7 H 8 O 3 S See formula (2).
- the structure of Sorafenib is as follows:
- Donafenil is a sorafenib deuterated drug developed by Suzhou Zergen Pharmaceutical Co., Ltd., China. Its chemical name is 4-(- ⁇ 3-[4-chloro-3-(trifluoromethyl)phenyl]urea Base ⁇ phenoxy)n-(methyl-d3)pyridine-2-carboxamide-4-toluenesulfonate, the difference in its chemical structure and the physical and chemical properties of Sorafenib are shown in the following table 1;
- the two are identical except for the methyl group connected by the amide bond.
- the deuterated group has great influence on drug intramolecular interaction, intermolecular interaction, drug pKa, hydrophobicity (LogP), number of hydrogen donors, number of hydrogen acceptors, number of rotatable chemical bonds, and action sites of metabolic enzymes in vivo etc. have no influence, therefore, the two are all the same except for the hydrogen methyl or deuterium methyl in the structure. Therefore, the following uses Sorafenib as an example for illustration.
- Donafenib Tosylate Tablets was announced and approved for marketing in June 2021 by the China National Medical Products Administration as a Class 1 innovative drug in China.
- the marketed product is called Zeproxen, and the listed dosage form is a tablet with a specification of 100 mg. Take 2 tablets (200 mg) each time, twice a day, 400 mg.
- sorafenib or donafenib are BCS IV drugs, which are low solubility and low permeability drugs.
- the average relative bioavailability of Sorafenib Tosylate Tablets is only 38%-49%. Therefore, the specification of Sorafenib Sorafenib Tosylate Tablets is 200mg, take two tablets each time, twice a day, and the maximum daily dosage is 800mg.
- Sorafenib Tosylate Tablets indicate that the metabolism of Sorafenib is mediated by CYP3A4/A5 and CYP2C8/D6 of P450 enzymes, and the metabolite produced by it is N-oxide Sorafenib Ni. Sorafenib is also a substrate of the efflux pump P-gp.
- CYP3A4/A5 CYP2C8/D enzymes and P-gp are widely distributed in human intestinal mucosal epithelial cells. Therefore, this is another main reason for the high variability of sorafenib absorption in vivo and low oral bioavailability .
- Clinical high-dose administration may make up for the high PK variation caused by P450 enzymes, but it will not make up for the high PK variation caused by solubility problems.
- the steady-state plasma (plasma) concentration of Sorafenib was 881-12,526 ng/mL, and the incidence of main adverse reactions was as follows: diarrhea (76.5%), hand-foot syndrome (68.99%), fatigue (55.32 %), these severe adverse reactions are all related to the plasma concentration of Sorafenib.
- the blood drug concentration of the patients with serious adverse reactions all exceeds 10000ng/ml, and these serious adverse reactions will decrease with the dose reduction or drug withdrawal. This shows that these serious side effects are related to the dosage.
- TTF, PFS and OS were 4.7 months, 4.7 months and 5.3 months respectively; when 1.40 ⁇ g/mL ⁇ sorafenib Cthrough ⁇ 3.45 ⁇ g/mL, TTF, PFS and OS were 13.1 months, 15.8 months and 17.8 months respectively [TTF, PFS and OS of Lenvatinib Mesylate Capsules (LENVIMA) were 8.9 months, 7.4 months and 13.6 months respectively]; sorafenib trough concentration ⁇ At 3.45 ⁇ g/mL, TTF, PFS and OS were 2.4 months, 8.9 months and 9.5 months, respectively.
- US20090203709 discloses a pharmaceutical dosage form comprising a solid dispersion product consisting of at least one tyrosine kinase inhibitor, at least one pharmaceutically acceptable polymer and at least one pharmaceutically acceptable solubilizer.
- the solubilizer is selected from polyol fatty acid esters, polyalkoxylated polyol fatty acid esters, polyalkoxylated fatty alcohol ethers, tocopherol compounds and mixtures thereof; and simultaneously discloses the method for preparing the above-mentioned drugs
- a method of dosage form comprising preparing a homogeneous melt of at least one tyrosine kinase inhibitor, at least one pharmaceutically acceptable polymer and at least one pharmaceutically acceptable solubilizer and then allowing the melt to solidify to obtain Solid dispersion product.
- CN107115317 discloses a pharmaceutical composition, which comprises Sorafenib and at least one high molecular polymer and solubilizer to form an amorphous hybrid nanoparticle; the composition further comprises at least one pharmaceutically acceptable Solubilizer selected from polyethylene caprolactam-polyvinyl acetate-polyethylene glycol copolymer, d-alpha-tocopheryl polyethylene glycol 1000 succinate (TPGS1000) and hydrogenated castor oil such as PEG-40 Hydrogenated castor oil or PEG-35 hydrogenated castor oil.
- TPGS1000 polyethylene caprolactam-polyvinyl acetate-polyethylene glycol copolymer
- TPGS1000 d-alpha-tocopheryl polyethylene glycol 1000 succinate
- hydrogenated castor oil such as PEG-40 Hydrogenated castor oil or PEG-35 hydrogenated castor oil.
- WO2006026501A1 discloses a composition comprising sorafenib and/or salts, hydrates and solvates thereof in the form of a solid dispersion.
- the matrix of the solid dispersion is at least one polymer selected from polyvinylpyrrolidone, copovidone, hydroxypropylcellulose, hydroxypropylmethylcellulose, polyethylene glycol or polyethylene oxide.
- CN105126111A discloses a sorafenib molecular level pharmaceutical composition, which comprises: active ingredients selected from sorafenib, sorafenib salts, sorafenib derivatives or prodrugs thereof At least one; and a polymer co-solvent, the polymer co-solvent has a vinyl acetate group, such as VA64, polyethylene caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer.
- active ingredients selected from sorafenib, sorafenib salts, sorafenib derivatives or prodrugs thereof At least one; and a polymer co-solvent, the polymer co-solvent has a vinyl acetate group, such as VA64, polyethylene caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer.
- the main function is to make the sorafenib molecules in the solution easy to quickly undergo molecular accumulation through intermolecular interactions, and form a stable solid supramolecular self-assembly system.
- Figure 2 From the perspective of drug developers, this kind of supramolecular self-assembly system formed by ⁇ - ⁇ stacking is the most difficult to break.
- existing technical means such as dispersion technology, co-crystal, and salt-forming technologies can instantly break this
- the supramolecular self-assembly structure involved in ⁇ - ⁇ stacking cannot maintain the stability on the time axis required for practical applications.
- AAPS Pharm Sci Tech (2022) 23:16 reviewed the existing technologies to solve the solubility of poorly soluble drugs, but none of these technologies can solve the pain points in the clinical application of Sorafenib's current marketed products.
- sorafenib or donafenib molecular level pharmaceutical composition Compared with Sorafenib Tosylate Tablets, the in vitro dissolution rate of sorafenib or donafenib molecular level pharmaceutical composition has been improved to a certain extent in the prior art, but the following problems exist:
- the disintegration time is greatly prolonged, and for To improve disintegration, it is necessary to add a large amount of preparation excipients, resulting in a larger volume and weight of the contents of the tablet or capsule.
- the amount of carrier in the dispersion on the one hand, the solubilization effect is not significant, and also reduces the dissolution, as shown in Example 2 in the patent WO2006026501A1, on the other hand, it will also lead to the formation of incomplete solid dispersion from the perspective of the preparation process (crystal form The drug cannot be fully converted to the amorphous form).
- sorafenib crystalline drug once there are crystal nuclei of sorafenib crystalline drug, the drug will crystallize rapidly in a short period of time during the subsequent storage process or lead to poor stability, and even cannot be developed and marketed as a real product. Therefore, how to break through the limitations of the existing technology, aiming at the objective fact that sorafenib tosylate tablets have a large clinical dosage and high unit preparation specifications, how to develop a drug with good stability and bioavailability with the least amount of carrier or auxiliary materials It is not an easy task to develop a new generation of sorafenib therapeutic drug with high patient compliance. This is also a serious limitation of prior art;
- the sorafenib solid dispersion pharmaceutical composition prepared by a polymer carrier initially has a higher dissolution rate and dissolution rate, but due to the intermolecular interaction of sorafenib, molecular accumulation occurs rapidly in the solution to form a supramolecular
- the self-assembled system precipitates out quickly, eventually resulting in a very low concentration of Sorafenib molecules in the solution (pH1.0: 0.0034mg/ml, pH4.5: 0.00013mg/ml);
- Surfactant at least 10 times lower than the amount of surfactant in sorafenib tosylate quality control dissolution medium
- pH 6.8 phosphate buffer as the dissolution medium in the dissolution test, 37 ° C, 2h ⁇ 4h
- the cumulative dissolution rate drops to substantially the same as that of Nexavar Sorafenib Tablets, even lower (the spring effect often said in the prior open technology), which leads to the in vivo bioavailability of the pharmaceutical composition of the
- Solid dispersion plus co-solvent or carrier with CYP3A4 or P-gp inhibitory effect such as tocopherol compounds, polyol fatty acid esters, polyalkoxylated fatty alcohol ethers, hydrogenated castor oil and other co-solvents or enzymes Inhibitors
- CYP3A4 or P-gp inhibitory effect such as tocopherol compounds, polyol fatty acid esters, polyalkoxylated fatty alcohol ethers, hydrogenated castor oil and other co-solvents or enzymes Inhibitors
- Amorphous sorafenib with poor thermodynamic stability is easily induced by cosolvents to accelerate nucleation and crystallization and precipitate in large quantities, thus failing to achieve the purpose of greatly improving the bioavailability of the drug and reducing the dosage.
- hydrogenated castor oil and tocopherol have inhibitory effects on CYP3A4 or P-gp, their specificity is not strong, and they need to be added in larger dosages to have certain effects.
- deuterated intermediates are used in the preparation of donafenib raw materials, and the price of deuterated intermediates is significantly higher than that of non-deuterated intermediates, therefore, the oral absorption efficiency of donafenib preparations is improved and the unit The amount of active ingredient (API) in the preparation cost is of great significance to reduce the unit preparation cost and reduce the adverse reactions of donafenib preparation products.
- API active ingredient
- the technical problem solved by the present invention is to provide a Sorafenib or Donafenib oral preparation, the Sorafenib or Donafenib oral preparation provided by the application can be taken in low doses, and has good physical and chemical stability, Low C max , AUC 0-t variation, better curative effect and safety, and improved patient compliance.
- Sorafenib or Donafenib oral formulations including: Sorafenib or Donafenib molecular level pharmaceutical composition, self-assembled polymer materials and other Pharmaceutically acceptable excipients, the state of the sorafenib or donafenib molecular level pharmaceutical composition is a molecular level solid dispersion, solid solution, polymer nanoparticle, self-microemulsion, nanoemulsion or molecular level mixture ;
- the self-assembled polymer material is selected from povidone+hydroxypropyl cellulose, low-viscosity povidone+high-viscosity povidone, povidone+copovidone, povidone+polyvinylcaprolactam-polyvinyl acetate Ester-polyethylene glycol graft copolymer, povidone + hydroxypropyl methylcellulose acetate succinate, povidone + hydroxypropyl methylcellulose, povidone + cellulose acetate, povidone + Croscarmellose Sodium, Povidone + Polyethylene Glycol, Povidone + Low-Substituted Hydroxypropyl Cellulose, Povidone + Hypromellose Phthalate, Povidone +Methacrylic acid-ethyl acrylate copolymer, povidone+methacrylic acid-methyl acrylate copolymer, copovidone+hydroxypropyl cellulose, copovidone+polyvinyl caprolactam-poly
- the self-assembled polymer material is 10-50wt% of the molecular level pharmaceutical composition of sorafenib or donafenib.
- the hydroxypropyl methylcellulose is HPMC E5 or HPMCK100LV;
- the self-assembled macromolecular material is povidone, copovidone, polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymerization
- the molecular material is a composite self-assembly of one of the polyethylene caprolactam-polyvinyl acetate-polyethylene glycol graft copolymers and the strongly hydrophobic hydroxypropyl methylcellulose acetate succinate H type and HPMCK100LV
- the composite ratio is (1-10):1.
- the acetyl group substitution amount of the hydroxypropyl methylcellulose acetate succinate is 6-16%, and the succinyl group substitution amount is 4-16%.
- the povidone is povidone with an average molecular weight of 34,000-1,300,000 or a composite of povidone with an average molecular weight of 34,000 and 1,300,000 povidone at a ratio of 1:1-1:0.1.
- the unit dose of the molecular level pharmaceutical composition of sorafenib or donafenib contains 20-69 mg of sorafenib or donafenib.
- the molecular level pharmaceutical composition of Sorafenib or Donafenib comprises Sorafenib or Donafenib, or its salt, hydrate, solvate, hydrate or solvate of the salt, and Carrier;
- the carrier is selected from copovidone, povidone, polyethylene caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer, povidone+hydroxypropyl methylcellulose acetate succinate, poly Povidone + hydroxypropyl methylcellulose, low viscosity povidone + high viscosity povidone, povidone + copovidone, povidone + polyvinyl caprolactam - polyvinyl acetate - polyethylene glycol graft Copolymer, copovidone + hydroxypropyl methylcellulose acetate succinate, copovidone + polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copo
- the Sorafenib or Donafenib, or its salt, hydrate, solvate, salt hydrate or solvate is the pharmaceutical composition of the Sorafenib or Donafenib molecular level 30 ⁇ 60wt% of.
- the dosage form of the oral preparation of sorafenib or donafenib is tablet, suspension, granule or capsule.
- the adjuvant of the tablet includes a filler, a disintegrant, a glidant or a lubricant;
- the filler is selected from one or both of microcrystalline cellulose and silicified microcrystalline cellulose, and the
- the disintegrant is selected from croscarmellose sodium, the glidant is selected from silicon dioxide, and the lubricant is selected from one or both of magnesium stearate and sodium stearyl fumarate.
- the content of the filler is 30-45wt% of the tablet
- the content of the disintegrant is 5-15wt% of the tablet
- the content of the glidant is 3-5wt% of the lubricant
- the content of the lubricant is 1-5wt% of the tablet.
- the application also provides the preparation of the oral preparation of Sorafenib or Donafenib for the treatment or alleviation of hepatocellular carcinoma, breast cancer, primary malignant liver tumor, cholangiocarcinoma, renal cell carcinoma, recurrent or Refractory solid tumors, central nervous system solid tumors, metastatic non-small cell lung cancer, unresectable hepatocellular carcinoma, thyroid cancer, pancreatic cancer, salivary adenoid cystic carcinoma, undifferentiated thyroid cancer, refractory differentiated type Thyroid cancer, adenoid cystic carcinoma, advanced endometrial cancer, anaplastic thyroid cancer, rectal cancer, colon cancer, unresectable stage III or IV melanoma, leukemia, acute myelogenous leukemia, all solid tumors or various Drug application in advanced solid tumors.
- the application provides a Sorafenib or Donafenib oral preparation, which includes Sorafenib or Donafenib molecular level pharmaceutical composition, self-assembled macromolecular materials and other auxiliary materials, wherein the self-assembled high Molecular materials use two specific polymer materials as composite self-assembly building units.
- the two polymer materials and sorafenib molecules are coordinated and regulated to rebuild a reversible self-assembly system based on weak intermolecular interactions, improving While Sorafenib or Donafenib solubility, stability, also reduced CYP3A4/5, CYP2C8/D6 and P-gp to the early metabolism and efflux of drug, make the new Sorafenib or more Oral formulations of nalfenib can be taken at lower doses to obtain higher drug exposure, and have safety, less incidence of side effects, low C max , AUC 0-t variation, low weight/volume, rapid disintegration, Both physical and chemical stability are good, even if the moisture content is as high as 5%, it can still maintain stable characteristics.
- Fig. 1 is the schematic diagram of the three-dimensional structure of Sorafenib of the present invention
- Fig. 2 is the single crystal structure schematic diagram of sorafenib and donafenib intermolecular interaction of the present invention
- Fig. 3 is a curve diagram of regulation and control of SLFN molecular stacking by high-concentration single polymer self-assembled building blocks in the embodiment of the present invention
- Fig. 4 is the synergistic control curve graph of copovidone composite macromolecule self-assembly building unit to sorafenib molecular packing in the embodiment of the present invention
- Fig. 5 is the synergistic regulation and control curve diagram of low-viscosity povidone composite macromolecule self-assembly building unit to Sorafenib molecular packing in the embodiment of the present invention
- Fig. 6 is the synergistic control curve graph of HPMC AS compound macromolecular self-assembly construction unit to Sorafenib molecular packing in the embodiment of the present invention
- Fig. 7 is the synergistic control curve of sorafenib molecular stacking of HPMC composite macromolecule self-assembly construction unit in the embodiment of the present invention.
- Figure 8 is a graph showing the synergistic regulation of the molecular packing of Sorafenib by the PEG composite macromolecule self-assembly construction unit in the embodiment of the present invention.
- Fig. 9 is a graph showing the synergistic control of the molecular packing of Sorafenib by the HPMCAS-H composite polymer self-assembly construction unit in the embodiment of the present invention.
- Figure 10 is a graph showing the synergistic regulation of the molecular packing of sorafenib by the HPMCAS-L composite polymer self-assembly building unit in the embodiment of the present invention
- Fig. 11 is a graph showing the synergistic regulation of sorafenib molecular packing by HPMCE5 composite polymer self-assembly building blocks in an embodiment of the present invention
- Fig. 12 is the bar graph of the influence-6h of the self-assembled building blocks compounded by HPMC E5 and other macromolecules in different proportions on the synergistic regulation and stability of Sorafenib molecular packing in the embodiment of the present invention
- Fig. 13 is the drug-time curves of different preparations and reference preparations in healthy subjects in the examples of the present invention.
- this application aims to solve the problems of large-scale insoluble, high variation in the body, molecular accumulation of drug molecules themselves, oral drugs due to intestinal P450 enzyme/P-
- the problem of high variation or low bioavailability of drug absorption caused by gp thereby providing innovative solutions and innovative ideas for maximizing the effectiveness and safety of drugs
- the application specifically provides a Sorafenib or Oral preparations of donafenib, which use composite self-assembled building blocks, combined with molecular level pharmaceutical composition technology, so that the obtained oral preparations of sorafenib or donafenib can be taken in low doses, that is, only Nexavar 10%-35% of the dosage of sorafenib sulfonate tablet (Nexavar) can achieve the same therapeutic effect as its ideal therapeutic effect or obtain it with 40%-60% of the dosage of existing donafenib tablet Higher
- the embodiment of the present invention discloses a low-dose oral preparation of Sorafenib or Donafenib, including: a pharmaceutical composition at the molecular level of Sorafenib or Donafenib, a self-assembled polymer material and As other pharmaceutically acceptable excipients, the state of the sorafenib or donafenib molecular level pharmaceutical composition is solid dispersion, solid solution, polymer nanoparticle, self-microemulsion, nanoemulsion or molecular level mixture;
- the self-assembled polymer material described in this application can also be called a composite self-assembled building block, which is selected from povidone + hydroxypropyl cellulose, low-viscosity povidone + high-viscosity povidone, povidone + copolymerization Povidone, povidone + polyethylene caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer, povidone + hydroxypropyl methylcellulose acetate succinate, povidone + hydroxypropyl methyl Cellulose, povidone + cellulose acetate, povidone + croscarmellose sodium, povidone + polyethylene glycol, povidone + low-substituted hydroxypropyl cellulose, povidone + hydroxypropyl cellulose Promellose phthalate, povidone + methacrylic acid-ethyl acrylate copolymer, povidone + methacrylic acid-methyl acrylate copolymer, copovidone
- the application provides an oral preparation of Sorafenib or Donafenib, wherein the composite self-assembly building unit is 10-50wt% of the molecular level pharmaceutical composition of Sorafenib, more specifically, the composite The self-assembled building unit is 20-40 wt% of the pharmaceutical composition at molecular level of sorafenib or donafenib.
- the pharmaceutical composition at the molecular level of Sorafenib or Donafenib exists in the form of solid dispersions, solid solvents, polymer nanoparticles, self-microemulsions, nanoemulsions or molecular level mixtures;
- the Sorafenib Or the pharmaceutical composition of donafenib molecular level comprises sorafenib or donafenib, or its salt, hydrate, solvate, hydrate or solvate of salt, and carrier.
- the Sorafenib or Donafenib, or its salt, hydrate, solvate, hydrate or solvate of the salt is the drug at the molecular level of the Sorafenib or Donafenib 30-60wt% of the composition, more specifically, the sorafenib or its salt, hydrate, solvate, hydrate or solvate of the salt is the molecular level of the sorafenib or donafenib 35 ⁇ 55wt% of the pharmaceutical composition.
- the carrier is selected from a polymer carrier that can provide hydrogen acceptors and has a certain proportion of hydrophobic groups and or a combination of at least two polymer carriers
- the carrier is specifically selected from copovidone, povidone, polyethylene caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer (Soluplus), povidone and hydroxypropyl methylcellulose acetate succinate ( HPMCAS), povidone and hydroxypropyl methylcellulose, low viscosity povidone and high viscosity povidone, povidone and copovidone, povidone and polyvinyl caprolactam-polyvinyl acetate-polyethylene Glycol graft copolymer, copovidone and hydroxypropyl methylcellulose acetate succinate, copovidone and polyethylene caprolactam-polyvinyl acetate-poly
- the hydroxypropyl methylcellulose in the composite self-assembly building unit is preferably E series or K series, E series is more preferably a low-viscosity model, K series is more preferably K100LV, and the composite self-assembly
- the construction unit is one of povidone, copovidone, polyethylene caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer and strongly hydrophobic hydroxypropyl methylcellulose acetate succinate and HPMC
- the acetyl group substitution amount of the hydroxypropyl methylcellulose acetate succinate is 6-16%, and the succinyl group substitution amount is 4-16%; more specifically, the acetyl group substitution amount is 10-14%, The succinyl substitution amount is 4-8%.
- the povidone is povidone with an average molecular weight of 34,000-1,300,000 or a composite of povidone with an average molecular weight of 34,000 and 1,300,000 povidone at a ratio of 1:1-1:0.1.
- the composite self-assembly building unit is specifically selected from PVP VA64+HPMCAS H type, PVP VA64+HPMCAS M type, PVP VA64+Soluplus, PVP VA64+HPMC, PVP K90+HPMCAS, PVP K90+HPMC, PVP K25+PVP K90, PVP K30+PVP K90, low viscosity HPMC+PVP VA64, PVP K90+HPMC K100LV, + povidone, HPMCAS H type + Soluplus, HPMCAS M type +, HPMCAS L type + Soluplus, HPMC ( Low viscosity) + povidone, HPMC (low viscosity) + copovidone or HPMC (low viscosity) + HPMCAS (high hydrophobicity).
- the way of adding the composite self-assembled building blocks can be internal or external, or one internal or one external.
- the composite self-assembled building blocks can be added to the coating, such as powder coating, pellet coating, etc. coating or tablet coating.
- the dosage of the pharmaceutical composition at the molecular level of Sorafenib is 10% ⁇ 35% of the dosage of Nexavar tablet (Nexavar), preferably 12.5% ⁇ 30%;
- the unit preparation specification is 20mg ⁇ 69mg, which is equivalent to Nexavar tablet (Nexavar) 200mg, preferably 25mg, 30mg, 50mg or 60mg;
- the unit preparation specification is 50 ⁇ 140mg, which is equivalent to Nexavar tablet (Nexavar)
- the single dose is 400 mg, preferably 50 mg, 60 mg, 100 mg or 120 mg.
- the dosage of the pharmaceutical composition at the molecular level of donafenil is 40% to 60% of the dosage of donafenib tosylate tablets of Zeprosen, Preferably 45% to 55%; unit preparation specifications are preferably 25mg, 30mg, 40mg, 45mg, 50mg and 55mg, which is equivalent to taking a single dose of 100mg Zeprosen Donafenib Tosylate Tablets, preferably 50mg, 60mg;
- the single dose of Zeprosen Donafenib Tosylate Tablets is 200mg, preferably 80mg, 90mg, 100mg or 110mg.
- the dosage form of described Sorafenib or Donafenib oral preparation is tablet, suspension, granule or capsule;
- the adjuvant of described tablet comprises filler, disintegrant, glidant or lubricant;
- the filler is selected from one or both of microcrystalline cellulose and silicified microcrystalline cellulose, the disintegrant is selected from croscarmellose sodium, and the glidant is selected from silicon dioxide , the lubricant is selected from one or both of magnesium stearate and sodium stearyl fumarate.
- the content of the filler is 30-45wt% of the tablet, preferably 30-40wt%; the content of the disintegrant is 5-15wt% of the tablet, preferably 5-10wt%; The content of the glidant is 3-5% by weight of the tablet, and the content of the lubricant is 1-5% by weight of the tablet.
- the disintegration time of the tablet is ⁇ 5min.
- the present invention also provides the application of the preparation comprising the Sorafenib composition in the preparation of a drug for treating tumors;
- the tumors are specifically hepatocellular carcinoma, breast cancer, primary malignant liver tumors, cholangiocarcinoma, renal cell carcinoma, Recurrent or refractory solid tumors, solid tumors of the central nervous system, metastatic non-small cell lung cancer, unresectable hepatocellular carcinoma, thyroid cancer, pancreatic cancer, adenoid cystic carcinoma of the salivary gland, undifferentiated thyroid cancer, refractory Sexually differentiated thyroid cancer, adenoid cystic carcinoma, advanced endometrial cancer, anaplastic thyroid cancer, rectal cancer, colon cancer, unresectable stage III or IV melanoma, leukemia, acute myeloid leukemia, and all entities Tumors, various advanced solid tumors.
- the preparation provided by the present invention can be used alone or in combination with other drugs for the treatment of the above tumors; other drugs are preferably PD-1 inhibitors, Venetoclax and/or Decitabine, combined with TACE and/or Iodion-125 seeds brachytherapy, Combined therapy with Drug-eluting bead transarterial chemoembolization, combined with pembrolizumab, combined with tolipanumab, combined with Atezolizumab, combined with Atezolizumab+Bevacizumab, combined with TACE+Tilelizumab, combined with Recombinant Human Adenovirus Type 5 injection, combined with MTL-CEBPA, combined Vemurafenib, in combination with Oxaliplatin and 5-fluorouracil, Eribulin, Doripalimab, Gemox or Everolimus, in combination with Doxorubicin and Lipiodol, in combination with Oxaliplatin, Raltitrexed, and Epirubicin,
- the low-dose sorafenib or donafenib oral preparations included in the research of the present invention can be used in combination with PD-1 inhibitors, such as Camrelizumab, as a first-line treatment drug for advanced liver cancer
- PD-1 inhibitors such as Camrelizumab
- TACE therapy is injection of chemotherapy drugs (doxorubicin and lipiodol), oral sorafenib or donafenib, 50-120mg each time, twice a day.
- chemotherapy drugs doxorubicin and lipiodol
- oral sorafenib or donafenib 50-120mg each time, twice a day.
- sorafenib or donafenib oral preparations containing the research of the present invention and toripalimab is used for the treatment of unresectable hepatocellular carcinoma and portal vein tumor thrombus.
- sorafenib Or Donafenil 50-120mg each time, once a day or twice a day.
- the low-dose sorafenib or donafenib oral preparations containing the research of the present invention are used in combination with pembrolizumab monoclonal antibody for adults with advanced hepatocellular carcinoma.
- pembrolizumab is injected intravenously, and the injection is completed within 30 minutes. From the 1st to the 21st day, 100-120 mg of sorafenib or donafenib was taken orally twice a day, and a course of treatment was repeated every three weeks.
- Combination of low-dose sorafenib or donafenib oral preparations containing the research of the present invention and Hepatic arterial infusion chemotherapy is used for the treatment of hepatocellular carcinoma, sorafenib or more Nafenib 50-120mg orally each time, twice a day.
- each oral administration of sorafenib or donafenib is 50-120 mg twice a day.
- the low-dose Sorafenib or Donafenib oral preparation containing the research of the present invention is used in combination with Vemurafenib for the treatment of pancreatic cancer.
- TACE therapy is injection of chemotherapy drugs (Oxaliplatin 200mg, raltitrexed 4mg, epirubicin 20mg in cTACE or 70mg in dTACE), Oral sorafenib or donafenib, 50-120mg each time, twice a day.
- chemotherapy drugs Oxaliplatin 200mg, raltitrexed 4mg, epirubicin 20mg in cTACE or 70mg in dTACE
- Oral sorafenib or donafenib 50-120mg each time, twice a day.
- the low-dose Sorafenib or Donafenib oral preparations containing the research of the present invention are used in combination with Venetoclax and Decitabine for the treatment of adult acute myeloid leukemia (FLT3-ITD allelic ratio is high), at the first of each treatment cycle -5 days, intravenous injection of decitabine 20mg/m 2 , and oral venetoclax 100mg at the same time, and gradually increased to 400mg (28 days), the end of a treatment cycle.
- the low-dose Sorafenib or Donafenib oral preparations containing the research of the present invention are used for acute leukemia attack, relapse and hematopoietic stem cell transplantation, each oral Sorafenib or Donafenib 100-120mg, twice a day, If you can't tolerate it, you can reduce the dose to 50mg ⁇ 240mg per day.
- sorafenib or donafenib oral formulations containing the research of the present invention and HAIC 130mg/m 2 Oxaliplatin, and 2400mg/m 2 5-fu or 85mg/m 2 Oxaliplatin, and 2400mg/m 2 5-fu ) in combination for the treatment of advanced inoperable hepatocellular carcinoma, sorafenib or donafenib is taken orally, 100-120 mg each time, twice a day.
- the self-assembled macromolecular material in the sorafenib or donafenib oral preparations provided by the application adopts two specific macromolecular materials to be compounded as a composite self-assembled building unit, and the two self-assembled macromolecular materials are combined with sorafenib
- the coordinated regulation of guest molecules prevents the original molecular accumulation of Sorafenib or Donafenib molecules due to intermolecular interactions, and rebuilds a new self-assembly system with composite self-assembly building units in a new microenvironment
- the obtained oral preparation can reduce the early degradation or efflux of drugs by P450 enzymes CYP3A4/A5, CYP2D6, CYP2C8 or P-gp in the gastrointestinal mucosal epithelial cells during the absorption process, and can also reduce the drug from the molecular level composition Due to the interaction between sorafenib molecules, molecular accumulation occurs rapidly after medium and
- sorafenib as an example, but it is applicable to all donafenib.
- Sorafenib or Sorafenib tosylate add a small amount of dimethyl sulfoxide to dissolve and dilute with acetonitrile to make a high-concentration stock solution containing about 50 mg of Sorafenib per 1 ml to ensure that Sorafenib Nitrogen is dispersed in the solution at the molecular level;
- a pH6.8 phosphate buffer solution containing 0.1% sodium dodecyl sulfate (SDS) is used as the base medium (pH6.8 phosphate + 0.1% SDS), and the preparation of the base medium is in accordance with the technical guidelines for the dissolution test of oral solid preparations Prepare; Take macromolecular material povidone (PVP) PVP K25, PVP K30, PVP K90; Copolyvidone (copolymer of vinylpyrrolidone-vinyl acetate), such as PVP VA64; Succinate (HPMCAS), such as HPMCAS H type (methoxyl content 22%-26%, hydroxypropoxyl content 6%-10%, acetyl content 10%-14%, succinyl content 4%-8% ) (or equivalent models), HPMCAS MG (methoxy content 21% to 25%, hydroxypropoxy content 5% to 9%, acetyl content 7% to 11%, succinyl content 10% to 14% ) (or equivalent models),
- 0.5%-Povidone PVP K25-K90, polymer of N-vinylpyrrolidinone), 0.5%-Copolyvidone (PVPVA64), 0.5%-Soluplus, 0.5%-HPMCAS H type (acetyl 10% ⁇ 14%, Succinyl 4% ⁇ 8%) all have good regulating effect on sorafenib molecular accumulation, and the concentration of sorafenib in the self-assembled system measured at 6h is 208.61 ⁇ g/mL ⁇ 759.31 ⁇ g/mL, all significantly higher than The concentration (5.61 ⁇ g/mL) measured in the basic medium 6h, compared with the basic medium, the self-assembly system constructed by 0.5% Soluplus and 0.5% HPMCAS H type has a higher encapsulation efficiency of Sorafenib, which is 75.9% respectively and 63.4%, which can be increased by at least 100 times, and the self-assembly system constructed by 0.5% Soluplus and 0.5%
- Ni molecules compete for the opportunity to form hydrogen bonds, while the strong hydrophobic interaction plays a decisive role.
- sorafenib molecules gradually pile up, but the solution concentration of sorafenib in the self-assembled system is still 34-55% of that of the basic medium measured at 6 hours. times, and the high molecular weight K90 is better than K25, K30 and VA64 in regulating the molecular packing of sorafenib. It is speculated that the high viscosity K90 limits the thermal movement of the sorafenib molecule itself and reduces the formation of hydrogen bonds between molecules. Opportunity.
- 0.5%-copolyvidone (such as PVP VA64) is a copolymer of Vinyl acetate-N-vinylpyrrolidinone, wherein N-vinylpyrrolidinone accounts for about 60% in the copolymer, and Vinyl acetate accounts for about 40%. Therefore, the same mass fraction of copolyvidone The hydrophobicity of ketone is better than that of povidone series. At the same time, the density of hydrogen acceptors provided by copovidone is different from that of povidone. The oil-water partition coefficient LogP of Sorafenib molecule is about 5.6, which is highly hydrophobic.
- HPMC AS 0.5%-Hydroxypropylmethylcellulose acetate succinate
- HPMC AS 0.5%-Hydroxypropylmethylcellulose acetate succinate
- H type 4% to 8% of succinyl, 10% to 14% of acetyl
- L type (14% of succinyl).
- M type is between the two, hydroxypropyl methylcellulose acetate succinate can provide hydrogen acceptor and hydrogen donor at the same time, its succinyl and weak Basic drugs can also produce ionic interactions. While producing hydrophobic interactions with hydrophobic drugs, they form a stable supramolecular self-assembly system with aqueous solution under appropriate pH conditions. The synergistic regulation effect of L-type or M-type is stronger and can maintain stability for a long time. Specifically shown in Figure 3.
- Sorafenib when Sorafenib is prepared into a pharmaceutical composition at the molecular level, such as solid dispersion, solid solution, polymer nanoparticle, self-microemulsion, nanoemulsion or molecular level mixture, it is necessary to solve the molecular structure of Sorafenib. It is easy to form a supramolecular self-assembly system and become a solid, which affects drug absorption.
- the polymer material selected as a supramolecular self-assembly building block has a certain number of hydrogen acceptors and hydrogen donor groups.
- the special structure and strong hydrophobic characteristics of the molecule must also provide sufficient hydrophobic and ionic interactions, so as to maintain the balance between the subsystem and the entire supramolecular system, so that more sorafenib molecules can be stably encapsulated in the new supermolecular system for a long time.
- the constructed supramolecular self-assembly system The constructed supramolecular self-assembly system.
- each polymer material has its maximum daily safe dosage as a pharmaceutical excipient, especially for long-term medication.
- the content of a certain polymer material in the prescription is too high (0.5% mass fraction, intestinal juice is calculated as 250mL , the unit preparation contains about 125 mg of excipients. If you need to take 2 preparation units each time, twice a day, the amount of the carrier will be 500 mg per day, which cannot be achieved by many excipients) which will lead to the preparation process, dissolution, and disintegration behavior , physical stability, and chemical stability changes often fail to achieve the desired results. Therefore, on the basis of the above research, the inventors found that the composite application of two or more polymer materials with different properties as the building blocks of the supramolecular self-assembly system will achieve unexpected results.
- the specific scheme and experimental results are as follows:
- Copovidone taking PVP VA64 as an example, compared with Soluplus or HPMCAS H type, it lacks hydrophilic groups and hydrogen donor groups. Weaker than Soluplus. In addition to the characteristics of copovidone, the povidone series has poorer hydrophobic effect than copovidone.
- 0.25%-(PVP-VA64) combined with 0.25% HPMCAS H type or HPMCAS M type or Soluplus can significantly make up for the deficiency of PVP VA64 alone, and the concentration of Sorafenib in the self-assembled system measured at 6h is 700 ⁇ g /mL; the same 0.25%-(PVP-VA64) combined with hydrophilic HPMC also has a significant synergistic effect on the molecular packing of sorafenib, and the concentration of sorafenib in the self-assembled system was maintained at 335 ⁇ 458 ⁇ g/mL; significantly higher than the effect of any single polymer material in the composite carrier.
- the effect of the 0.25%-(PVP-VA64/PVP+HPMC) series of composite self-assembled building units is also significantly better than that of any polymer material with a high quality fraction alone.
- the synergistic regulation ability is very poor, compared with the basic medium, there is basically no difference; and the effect of 0.25%-(PVP-VA64/PVP+HPMC) is significantly better than 0.5%-PVP VA64, 0.5%-PVP and 0.5%- HPMC, in the 0.25% (PVP-VA64+HPMC) group, although the low-viscosity HPMC and high-viscosity HPMC combined with copovidone were significantly better than those used alone, but the combination of low-viscosity HPMC and PVP VA64 had no effect on Solar
- the synergistic control effect of fennel molecular packing is significantly better than that of high viscosity HPMC K100LV. In the 0.25% (PVP+HPMC) group, the synergistic regulation effect of PVP K25 on
- Soluplus is compounded with povidone, copovidone, HPMCAS series, and HPMC series as the building blocks of supramolecular self-assembly. On the premise that the respective mass fractions are reduced by half, the synergistic effect achieved by the high mass fraction of Soluplus is still maintained. It provides a new idea to solve the problems of large dosage of Soluplus, poor formability and influence on the stability of active ingredients.
- Table 4 is the performance data table of HPMCAS series (hydrophobic acetyl group, hydrophilic succinyl group with different content) and other polymer materials composite application to construct supramolecular self-assembly system;
- HPMCAS L type is compounded with copovidone and povidone. The two can learn from each other and work synergistically. The effect of the effect is far beyond the effect of any single polymer material. Combining 0.25% HPMCAS L type with 0.25% Soluplus reduces the dosage of each, improves the feasibility of the preparation process, and can regulate the drug release in vivo according to the designed release behavior. According to the E series of hydroxypropyl methylcellulose, the general methoxyl content is about 29%, and the hydroxypropyl content is about 12%.
- sorafenib Its structure has a higher number of hydrogen donors and acceptors than HPMCAS, and is more hydrophilic than HPMCAS , Therefore, the single application has no ability to regulate the formation of sorafenib molecular packing.
- HPMCAS is compounded with more hydrophobic povidone, copovidone, and Soluplus
- the number of hydrogen donors and acceptors in the system is changed, and the constructed system is also more hydrophobic, but with the incubation time
- sorafenib slowly accumulated in the supramolecular system constructed by low-viscosity povidone, copovidone and HPMC, while high-viscosity povidone was still growing slowly until 6h.
- HPMC takes the E series as an example.
- the average content of methoxyl group is about 29%, and the average content of hydroxypropyl group is 10%.
- HPMCAS has more hydrophilic groups, and its hydrophobicity is worse than HPMCAS.
- the mass fraction of the compound crystal inhibitor is 1:2, which can significantly improve its solubilization and crystal inhibitory ability.
- 0.5% povidone, HPMCAS-H and 0.25% HPMCE5 are used in combination, and more hydrophobic excipients can enhance the anti-corrosion effect.
- the dissolution and inhibition of crystallization of Sorafenib, but 0.5% copovidone and Soluplus did not show more obvious advantages, see Figure 11 and Figure 12 for details.
- HPLC analysis method is as follows:
- sorafenib (SLFN)/sorafenib tosylate (TSSLFN) into methanol-dichloromethane (1:3) mixed solvent, stir and dissolve at 30-33°C, the main ingredient: mixed solvent is 1:100; Then add the carrier to dissolve, the amount of carrier is the main ingredient: the carrier is 1:1; spray drying: the inlet air temperature is 120°C, the outlet air temperature is set at 60°C, and nitrogen is used as the carrier gas.
- copovidone under the condition of low carrier ratio, copovidone, povidone, copovidone+HPMCAS, HPMC E5 and Soluplus can be used as carriers to form molecular level pharmaceutical compositions.
- Preparation process Prepare molecular level pharmaceutical composition (SD) according to Example 2, mix SD, self-assembled building blocks, filling agent half of the prescription amount, disintegrant, and lubricant half of the prescription amount, dry granulate, add Filler, glidant, and lubricant half of the remaining prescription amount are mixed evenly and compressed into tablets.
- Tablet sample prescription is as shown in table 7;
- Dissolution test paddle method, 0.1% sodium dodecyl sulfate (SDS) pH 6.8 phosphate buffer solution 900mL, 100rpm, 37°C.
- Sampling and sample processing method take 10mL, filter with PES filter membrane (25mm in diameter, 0.45 ⁇ m in diameter), discard 8mL of filtrate, take 1-2mL of further filtrate, and add 10mL of medium into the dissolution vessel. Filtered samples are sent to analytical dilution for detection. Take 1 tablet (200mg) for the reference preparation (RLD), and 4 tablets (200mg) for the self-made preparation.
- the dissolution test is carried out by HPLC method, and the dissolution results are shown in the table below;
- Preparation process Prepare a solid dispersion (SD) according to Example 2, mix SD, crystal inhibitor, filler in half the prescription amount, disintegrant, and lubricant in half the prescription amount, dry granulate, add the remaining half of the prescription The amount of fillers, glidants, and half of the prescription amount of lubricants are mixed evenly and compressed into tablets. Moisture determination was monitored according to the first method of 0831 in the fourth general rule of the Chinese Pharmacopoeia 2020 edition.
- Tablet formulations are prepared in the table below.
- Hardness Tested with a tablet hardness tester, 6 tablets were tested, and the average value was taken; disintegration time: tested with a disintegration tester, 6 tablets were tested, and the average value was taken; CTF-aniline, total impurities: detected by HPLC method; crystals Content: detected by Raman spectroscopy, the results are shown in Table 10; the investigation condition of the stability experiment is 40°C ⁇ 2°C/RH75% ⁇ 5% in an accelerated test box.
- the tablet for stability investigation adopts aluminum-plastic composite film plus double aluminum packaging.
- the tablet filler microcrystalline cellulose and silicified microcrystalline cellulose are obviously better than lactose and mannitol; the dosage range is 30-45% of the total weight of the tablet.
- the disintegrating agent is preferably croscarmellose sodium, and the consumption accounts for 5% to 15% of the total weight of the tablet; the tablet also contains a lubricant, preferably magnesium stearate, sodium stearyl fumarate, more preferably for magnesium stearate.
- the preparation prepared by the preferred prescription can disintegrate rapidly within 5 minutes.
- the filler is microcrystalline cellulose, silicified microcrystalline cellulose, and the disintegrant is a tablet of croscarmellose sodium. Under the condition of RH75%, it was stored with packaging for 90 days, and no molecular accumulation occurred.
- the polymer material of the self-assembled building unit can be added when preparing the tablet core, or added to the coating material, or can be added at the same time.
- Preparation process Prepare molecular level pharmaceutical composition (SD) according to Example 2, mix SD, polymer material of self-assembled building unit, filler, disintegrant, and lubricant of half prescription quantity evenly, dry For granulation, add the remaining half of the prescription amount of filler, glidant, and half of the prescription amount of lubricant, mix evenly, compress into tablets, and coat. Prepare tablets according to the prescription in the table.
- SD molecular level pharmaceutical composition
- Dissolution test paddle method, 0.1% sodium dodecyl sulfate (SDS) pH 6.8 phosphate buffer solution 900mL, 100rpm, 37°C.
- Sampling and sample processing method take 10mL, filter with PES filter membrane (25mm in diameter, 0.45 ⁇ m in diameter), discard 8mL of filtrate, take 1-2mL of further filtrate, and add 10mL of medium into the dissolution vessel. After filtering, the samples were tested after equipotential dilution. Take 1 tablet (200mg) for the reference preparation (RLD), and 4 tablets (200mg) for the self-made preparation. The dissolution results are shown in the table below;
- Dissolution test paddle method, 0.1% sodium dodecyl sulfate (SDS) pH 6.8 phosphate buffer solution 900mL, 100rpm, 37°C.
- Sampling and sample processing method take 10mL, filter with PES filter membrane (25mm in diameter, 0.45 ⁇ m in diameter), discard 8mL of filtrate, take 1-2mL of further filtrate, and add 10mL of medium into the dissolution vessel. After filtering, the sample solution was diluted in equal ratio for detection. Take 1 tablet (200mg) for the reference preparation (RLD), and 4 tablets (200mg) for the self-made preparation. The dissolution results are shown in the table below.
- the sorafenib molecular level pharmaceutical composition was prepared according to the spray drying method in Example 2, and the pharmaceutical composition SD was powder-coated with the prescription in the following table, and then the excipients were added according to the prescription in Table 8 to prepare tablets. Prepare the powder coating according to the prescription in the table below;
- Dissolution test paddle method, 0.1% sodium dodecyl sulfate (SDS) pH 6.8 phosphate buffer solution 900mL, 100rpm, 37°C.
- Sampling and sample processing method take 10mL, filter with PES filter membrane (25mm in diameter, 0.45 ⁇ m in diameter), discard 8mL of filtrate, take 1-2mL of further filtrate, and add 10mL of medium into the dissolution vessel. Filtered samples are sent to analytical dilution for detection. Take 1 tablet (200mg) for the reference preparation (RLD), and 4 tablets (200mg) for the self-made preparation. The dissolution results are shown in the table below.
- SD uses a coating material containing self-assembled building units for powder coating, sorafenib enters the solution after dissolution, and the self-assembled polymer material in the coating layer has entered the system at the outermost layer , still has a good synergistic regulation effect on the molecular accumulation of sorafenib.
- Embodiment 7 self-microemulsion preparation
- Lipolysis buffer Tris maleate buffer (0.474g/L), anhydrous calcium chloride (0.208g/L), NaCl aqueous solution (8.766g/L, ultrapure water), use 5mol/L NaOH to adjust the pH to 6.5.
- Lipolysis medium L- ⁇ -phosphatidylcholine (PC) (0.576g/L), sodium taurodeoxycholate (1.565g/L) was added to the buffer, the medium was stirred overnight to ensure complete dissolution of PC.
- PC L- ⁇ -phosphatidylcholine
- sodium taurodeoxycholate 1.565g/L
- Trypsin solution Add 3 g of ground porcine pancreatic juice into 15 ml of lipolysis buffer, use 5 mol/L of NaOH to adjust the pH to 6.5, use a magnetic stirrer to stir the mixture for 10 minutes, and centrifuge the mixture in equal parts (5 °C, 10 minutes), and the supernatant was taken for lipolysis experiment.
- Detection of trypsin activity Before the start of the lipolysis experiment, tributyrin was used as the enzyme substrate to measure the activity of trypsin. Adding an excess of tributyrin ensures that the reaction rate is proportional to the enzyme concentration.
- tributyrin in 35 ml of lipolysis medium can be lipolyzed by 1.5 ⁇ l of trypsin. Enzyme activity must be greater than 900U/mg.
- Lipolysis test Take a prescription sample equivalent to 50mg of SLFN and add it to a 37°C lipolysis medium with a volume of 36ml. After stirring for 10 minutes, 4 ml of trypsin solution was added. Samples (approximately 1 ml) were taken periodically throughout the test (approximately 1 hour) and mixed with 4-bromophenylboronic acid (lipase inhibitor). The samples were centrifuged at 37°C, and the supernatant was taken for detection after dilution.
- Sampling times were: 10 minutes and 0 minutes before enzyme addition (dispersion phase), 5, 15, 30 and 60 minutes after enzyme addition (digestion phase).
- the self-microemulsion with the addition of self-assembled building unit materials can still maintain the synergistic regulation of the molecular accumulation of sorafenib during the lipase digestion process; while the prescription F75 without crystal inhibitors prolongs over time, Sorafenib molecular accumulation gradually increased.
- Preparation process Prepare molecular level pharmaceutical composition SD according to Example 2 (replace Sorafenib with Donafenib in Example 2), SD, self-assembled building blocks, filling agent half of the prescription amount, disintegrant, Mix half of the prescription amount of lubricant evenly, dry granulate, add the remaining half of the prescription amount of filler, glidant, and half of the prescription amount of lubricant, mix evenly, and compress into tablets. Tablet sample prescriptions are shown in Tables 20 and 21;
- Dissolution test paddle method, 0.1% sodium dodecyl sulfate (SDS) pH 6.8 phosphate buffer solution 900mL, 100rpm, 37°C.
- Sampling and sample processing method take 10mL, filter with PES filter membrane (25mm in diameter, 0.45 ⁇ m in diameter), discard 8mL of filtrate, take 1-2mL of further filtrate, and add 10mL of medium into the dissolution vessel. Filtered samples are sent to analytical dilution for detection. Take 1 tablet (200mg) for the reference preparation (RLD), and 4 tablets (200mg) for the self-made preparation.
- Dissolution testing adopts HPLC method to detect, and the dissolution results are shown in the table below;
- F76 is a comparative example prepared in Example 1 of the reference patent CN103301067B.
- Example F44 50 mg, T1
- Example F33 50 mg, T2
- the reference preparation Nexavar specification 200 mg, R
- Subjects 12 healthy Chinese males or females aged 18-65 (including 5 females).
- Administration route and administration frequency After fasting overnight for at least 10 hours, the subject took 240mL aqueous solution on an empty stomach the next morning, 1 tablet of the reference preparation, 2 tablets each of T1 and T2. The cleaning period is 10 days.
- Blood collection time points before administration (0h), 0.5h, 1h, 1.5h, 2h, 2.5h, 3h, 3.5h, 4h, 6h, 8h, 12h, 16h, 24h, 36h, 48h, 72h after administration , 96h.
- the blood drug concentration was detected by LC/MS/MS method, and the pharmacokinetic parameters (AUC 0-t , AUC 0- ⁇ , C max , T 1/2 , T max and the arithmetic mean of these parameters ( ⁇ SD) and geometric mean), and carry out relative bioavailability analysis, the results are as follows in Table 1, Table 2 and Figure 13.
- T1 administration of 50 mg is equivalent to the reference preparation Nexavar 200 mg
- T2 administration of 60 mg is equivalent to the reference preparation Nexavar 200 mg
- Cmax and AUC variability of T1 and T2 preparations were lower than those of the reference preparation.
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Abstract
一种索拉非尼或多纳非尼的口服制剂,包括索拉非尼或多纳非尼分子水平混合物、自组装高分子材料和其他药用辅料。口服制剂的制药应用。口服制剂中的两种自组装高分子材料与索拉非尼或多纳非尼分子协同调控,使口服制剂在吸收过程中减少胃肠道粘膜上皮细胞中P450酶的CYP3A4/A5、CYP2D6、CYP2C8或P-gp对药物的提前降解或外排,也能降低药物从分子水平组合物中快速溶出后因快速堆积而降低吸收,可在服用更低剂量达到相同疗效,降低了剂量相关的副作用,物理和化学稳定性好。
Description
本发明涉及药物制剂技术和材料学领域,尤其涉及一种分子水平药物组合物在体内释放后与自组装高分子材料重新构建一种新的自组装系统,打破索拉非尼或多纳非尼分子之间的相互作用而形成的分子堆积,减少消化道中CYP3A4/A5/CYP2/P-gp对药物的提前代谢,降低药物吸收进入系统前的胃肠道毒副作用,采用更低服用剂量索拉非尼或多纳非尼口服制剂实现其治疗上的应用。
Nexavar甲苯磺酸索拉非尼片是由德国拜耳公司与Onyx公司联合开发的用于治疗晚期肝癌、肾细胞癌和甲状腺癌的第一个多靶点口服肿瘤分子靶向药物。该药物自2007年作为晚期肝细胞癌系统治疗的一线药物上市以来,肝细胞癌系统治疗发生了显著的变化。索拉非尼可同时作用于肿瘤细胞和肿瘤内血管,通过抗细胞增殖、促进细胞凋亡、抑制血管生成等机制而发挥抑制肿瘤生长的作用。索拉非尼一方面通过抑制c-Raf激酶及下游信号传导、阻碍MEK和ERK的磷酸化过程、降低ERK磷酸化水平,发挥抗细胞增殖的作用;另一方面索拉非尼通过抑制血管内皮细胞生长因子受体-2(VEGFR-2)、血管内皮细胞生长因子受体-3(VEGFR-3)和血小板衍生生长因子受体-β(PDGFR-β),抑制络氨酸激酶受体的自身磷酸化过程而发挥抗血管生成的。它具有双重的抗肿瘤作用:既可通过阻断由RAF/MEK/ERK介导的细胞信号传导通路而直接抑制肿瘤细胞的增殖,还可通过抑制VEGFR和血小板衍生生长因子(PDGF)受体而阻断肿瘤新生血管的形成;同时抑制起始因子-4E(eIF4E)的磷酸化过程、下调体内抗凋亡蛋白Mcl-1的水平,发挥促细胞凋亡的作用。
索拉非尼是一种双芳基脲类口服多激酶抑制剂,其化学名为4-{4-[3-(4-氯-3-三氟甲基-苯基)酰脲]-苯氧基}-吡啶-2-羧酸甲胺,相对分子质量为464.8。Nexavar索拉非尼片使用的活性成分为索拉非尼的甲苯磺酸盐,分子式为C
21H
16ClF
3N
4O
3·C
7H
8O
3S见式(2)。索拉非尼结构如下:
多纳非尼为中国苏州泽璟制药有限公司开发的索拉非尼氘代药物,其化学名为4-(-{3-[4-氯-3-(三氟甲基)苯基]脲基}苯氧基)n-(甲基-d3)吡啶-2-甲酰胺-4-甲苯磺酸盐,其与索拉非尼化学结构上的差异及物理化学性质见下表1;
表1索拉非尼与多纳非尼结构与性质区别表
由表1可知,二者除酰胺键相连的甲基不同,其他均完全相同。且氘代化的基团对药物分子内相互作用、分子间相互作用、药物pKa、疏水性(LogP)、氢供体数、氢受体数、可旋转的化学键数量、体内代谢酶作用位点等均无影响,因此,二者除结构上的氢甲基或氘甲基不同,其他全部相同。因此,以下以索拉非尼为例进行说明。
甲苯磺酸多纳非尼片于2021在中国作为1类创新药于2021年6月被中国国家药监局公布批准上市。上市商品名为泽普生,上市的剂型为片剂,规格为100mg,每次服用2片(200mg),一天两次,400mg。
根据生物药剂学分类系统,索拉非尼或多纳非尼均为BCS I
V类药物,为低溶解性低渗透性药物。根据多吉美甲苯磺酸索拉非尼片的说明书,与口服溶液相比,甲苯磺酸索拉非尼片剂的平均相对生物利用度仅为38%~49%。因此,多吉美甲苯磺酸索拉非尼片的规格为200mg,每次服用两片,一日两次,日最大服用剂量为800mg。根据Nexavar索拉非尼片说明书,健康志愿者口服100mg
14C放射性标记的索拉非尼口服溶液,给药剂量的77%经粪便排出,并且排泄物中原型药物占51%以上,由此说明Nexavar甲苯磺酸索拉非尼片口服生物利用度低的一个原因之一可以归因于药物自身溶解度问题,有一半以上给 药剂量的药物因为溶解度原因而经粪便直接排出体外。而实际临床用药剂量单次给药为400mg,400mg给药剂量中有多少药物原型经粪便直接排出体外目前尚无数据。
AAPS J.2019 Jan 9,21(2):15、AAPS J.2019 Oct 21;21(6):107、Chem Biol Interact.2021 Apr 1;338:109401、Xenobiotica 2016 Jul;46(7):651-658及多吉美甲苯磺酸索拉菲尼片的说明书中指出:索拉非尼的代谢受P450酶的CYP3A4/A5、CYP2C8/D6介导,其产生的代谢产物为N-氧化索拉非尼。索拉非尼也是外排泵P-gp底物。而这些CYP3A4/A5、CYP2C8/D酶和P-gp在人的肠黏膜上皮细胞中广泛分布的,因此,这也是导致索拉非尼体内吸收高变异、口服生物利用度低的另外一个主要原因。Clin Cancer Res2005披露的索拉非尼临床试验结果显示:索拉非尼人体药代动力学参数具有高的个体变异性,口服200mg(Bid)或400mg(Bid),连续服用7天,达到稳态时Cmax和AUC
0-12h的变异系数分别为:200mg(Bid),8.6%及16.9%;400mg(Bid),106.7%及90.5%%。因此,对于难溶性药物,病人消化道环境(pH、食物、酶、消化液的多少)及药物口服后由胃进入到肠道的过程对索拉非尼吸收影响非常大。临床大剂量给药可能会弥补P450酶造成的高PK变异,但不会弥补溶解度问题造成的高PK变异。Oncotarget,2017,Vol.8,(26),pp:43458-43469披露一项由94个肾细胞癌病人开展的临床试验,其中组1(n=74)口服400mg索拉非尼片(Bid),组2(n=18)口服600mg索拉非尼片(Tid);组3(n=2)口服400mg索拉非尼片(Qd)。治疗2周后,索拉非尼稳态血药(血浆)浓度为881~12,526ng/mL,主要不良反应的发生率如下:腹泻(76.5%)、手足综合症(68.99%)、疲劳(55.32%),这些严重不良反应均与索拉非尼的血药浓度有关。发生严重不良反应的病人的血药浓度均超过10000ng/ml,而且这些严重的不良反应会随着给药剂量降低或停药而减少。这说明,这些严重的副作用均与给药剂量相关。Cancer Chemotherapy and Pharmacology(2020)86:129–139研究了索拉非尼的系统暴露量对晚期肝细胞癌病人响应、有效性和安全性的影响。研究结果显示:报道了甲苯磺酸索拉非尼片给药剂量0.4g(一日两次)与给药剂量0.2g(一日两次)相比,3级、4级严重不良反应显著增加,且其很多3级、4级严重不良反应与索拉非尼Cthrough谷浓度浓度具有显著的相关性,当索拉非尼谷浓度浓度超过3.45μg/ml时,3级以上严重不良反应(ALT升高、AST升高、酯酶升高、 手足综合征、高血压等)发生率为72.7%,低于3.45μg/ml时,3级以上严重不良反应发生率为26.7%。甲苯磺酸索拉非尼片高PK变异对药物的疗效[治疗失败时间(TTF)、无进展生存期(PFS)和整体存活率(OS)]具有显著的影响。当索拉非尼谷浓度<1.40μg/mL时,TTF、PFS及OS分别为4.7月、4.7月及5.3月;当1.40μg/mL≤索拉非尼Cthrough<3.45μg/mL时,TTF、PFS及OS分别为13.1月、15.8月及17.8月[甲磺酸仑伐替尼胶囊(LENVIMA)的TTF、PFS及OS分别为8.9月、7.4月及13.6月];索拉非尼谷浓度≥3.45μg/mL时,TTF、PFS及OS分别为2.4月、8.9月及9.5月。长期亚治疗浓度(谷浓度低于1.40μg/mL)会导致治疗反应差,并诱发耐药性,是癌症化疗失败的常见原因,而过高的治疗浓度(≥3.45μg/mL)又会导致严重不良反应成倍增加,最终因无法耐受严重不良反应而放弃治疗(TTF为2.4月),且整体存活率OS及无进展生存期显著下降。
上述研究结果表明,采用索拉非尼进行治疗时,临床监测PK参数,对降低因药物PK高变异造成的严重毒性和无效具有重要的意义,因此,开发一种低PK变异的索拉非尼新一代治疗药物具有重要的意义。现有技术为了提高索拉非尼制剂产品的口服生物利用度,降低临床用药剂量,解决PK高变异等棘手的世界性难题进行了大量的实验研究及挑战,但至今Nexavar甲苯磺酸索拉非尼片的核心专利已经失效,尚未有一款新的、超越现有上市药物的新产品进入商业化。
US20090203709披露了一种药物剂型,该药物剂型包含具有至少一种酪氨酸激酶抑制剂、至少一种药学上可接受的聚合物和至少一种药学上可接受的增溶剂组成的固体分散产物。其中,增溶剂选自多元醇脂肪酸酯、聚烷氧基化多元醇脂肪酸酯、聚烷氧基化脂肪醇醚、生育酚化合物及其混合物;同时披露了用于制备以上提及的药物剂型的方法,包括制备至少一种酪氨酸激酶抑制剂、至少一种药学上可接受的聚合物和至少一种药学上可接受的增溶剂的均匀熔融体,然后允许该熔融体固化而获得固体分散产物。
CN107115317披露了一种药物组合物,其包含索拉非尼和至少一种高分子聚合物及增溶剂,形成一种无定形杂化纳米颗粒;该组合物进一步包含至少一种药学上可接受的增溶剂,所述增溶剂选自聚乙烯己内酰胺-聚乙酸乙烯酯-聚乙二醇共聚物、d-α-生育酚聚乙二醇1000琥珀酸酯(TPGS1000)和氢化蓖麻 油例如PEG-40氢化蓖麻油或PEG-35氢化蓖麻油。该文献披露了一种用于生产以上药物组合物的制备方法为超临界流体法。
WO2006026501A1披露了一种包含索拉非尼和/或其盐、水合物和溶剂化物的组合物,其形式为固体分散体。所述固体分散体的基质为至少一种选自聚乙烯吡咯烷酮、共聚维酮、羟丙基纤维素、羟丙基甲基纤维素、聚乙二醇或聚环氧乙烷的聚合物。
CN105126111A披露了一种索拉非尼分子水平药物组合物,其包含:活性成份,所述活性成份为选自索拉非尼、索拉非尼盐、索拉非尼衍生物或其前药的至少一种;以及高分子助溶剂,所述高分子助溶剂具有乙酸乙烯酯基团,如VA64、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物。
Acta Cryst.(2011).C67,o29–o32、ACS Omega.2021 Mar 2;6(8):5532–5547报道了甲苯磺酸索拉非尼单晶的结构及索拉非尼分子结构中的二芳基脲与二甲基亚砜通过分子间协同调控构建超分子自组装系统。索拉非尼的化学结构中含有二芳基脲,二芳基脲中两个芳基平面的平面化为索拉非尼分子间形成强的π-π堆积、疏水效应、氢键作用贡献了主要作用,使的索拉非尼分子在溶液中很容易通过分子间相互作用快速发生分子堆积,并形成稳定的固体超分子自组装系统。如附图2所示。从药物研发者的角度,这种π-π堆积参与形成的超分子自组装系统是最难打破的,现有的技术手段如分散体技术、共晶、成盐等技术虽能瞬时打破这种π-π堆积参与的超分子自组装结构,但却不能维持实际应用所需要的时间轴上的稳定。AAPS Pharm Sci Tech(2022)23:16综述了解决难溶性药物溶解度的现有技术,但目前采用这些技术都不能解决索拉非尼当前上市产品临床应用中的痛点。ACS Appl.Mater.Interfaces 2019,11,43996-44006、Molecular Pharmaceutics,2015,12(3):922-931、Scientifc Reports|(2021)11:874分别报道了由索拉非尼/姜黄素/PEG-VES(PEG-维生素E共聚物)、索拉非尼/Indocyanine以及索拉非尼与多肽等构建的自组装系统来提高索拉非尼的疗效及生物利用度,但这些研究目前仍止步于学术研究,对于产品转化仍有很大的距离。
现有技术对索拉非尼或多纳非尼分子水平药物组合物的体外溶出度与多吉美甲苯磺酸索拉非尼片相比均有一定程度的提高,但存在以下问题:
1)人体中生物利用度提高幅度并没有体外溶出度那样显著:如WO2018211336A2,在健康志愿者中同参比制剂多吉美甲苯磺酸索拉非尼片相比,可提高口服生物利用度一倍左右,(Cmax、AUC
72h,T/R分别为194.32%和199.58%)专利中并未披露受试者的例数及自制品及参比制剂的服药剂量,根据多吉美甲苯磺酸索拉非尼片或泽普生甲苯磺酸多纳非尼片的说明书,该技术解决了部分溶解度问题;
2)无人体生物利用度显著提高的数据:只有比格犬或大鼠中生物利用度数据,如CN106667916B其实施例在大鼠中AUC是口服混悬剂的2.24倍;CN105126111A,其最优处方比模拟市售制剂在比格犬中Cmax和AUC分布提高85%、78%。众所共知,在大鼠或比格犬中可以提高生物利用度,在人体中未必能提高,大量试验证实二者没有必然联系,而要证实人体中是否可行,需进行大量试验且花费大量资金;另一方面,以上公开的技术,即使在大鼠和比格犬体内也只能提高一倍左右,与药物临床用药安全性需求相比,仍是微不足道;
3)只有体外溶出度数据,无人体内数据:如CN107115317、CN104888228A、WO2006026501A1,均只提供了索拉非尼体外溶出数据;医药学专业人员均知道,体外溶出实验尤其是针对难溶性药物,溶出介质体积、介质中为提高溶出度而加入的表面活性剂的浓度不同,最终测定的溶出行为与溶出结果会有很大不同,能提高体外溶出度并不能证实在人体内就能显著提高生物利用度;
4)市售甲苯磺酸索拉非尼片规格为200mg,推荐的每次服用剂量为400mg,规格较大,服用剂量也很大,而要制备固体分散体时需加入质量比几倍于活性成分用量的载体,如专利WO2006026501A1中,高分子材料聚维酮K25用到活性成分5倍的情况下,溶出才能达到35%,导致即使按目标100mg规格制备出的剂型处方中,只固体分散体组合物的量就达到600mg,而常用的固体分散体载体大部分具有粘合剂作用,或者会形成凝胶,导致制剂成型难度较大,如片剂、胶囊剂崩解时间大大延长,而为了改善崩解,需加入大量制剂辅料,导致片剂或胶囊内容物体积、重量较大,做成的制剂不利于患者服用,导致顺应性差,同时也使得改良后的产品成本很高;而减少固体分散体中载体的用量,一方面增溶效果不显著,同时也会降低溶出,如专利WO2006026501A1中实施例2所示,另一方面从制备工艺角度也会导致形成固体分散体不完全 (晶型药物不能全部转化为无定型)。这种情况下,一旦有索拉非尼晶型药物的晶核存在,后续贮藏过程药物会在很短的时间内迅速析晶或者导致稳定性变差,甚至无法作为真正产品开发上市。因此,如何突破现有技术的局限性,针对甲苯磺酸索拉非尼片临床用药剂量大,单位制剂规格高的客观事实,如何用最少的载体或辅料用量开发出稳定性好、生物利用度高、病人顺应性好的索拉非尼新一代治疗药物并非是一件容易的事情。这也是现有技术存在的一个严重的局限性;
5)固体分散体、固溶体和纳米晶制剂对水分敏感,水分含量高会加速药物成核、结晶析出及化学降解,导致制剂稳定性变差。加之索拉非尼本身稳定性较差,容易降解生成诱变杂质CTF-苯胺,制备成固体分散体后更易产生CTF-苯胺。CTF-苯胺的结构见式(3):
6)采用高分子载体制备的索拉非尼固体分散体药物组合物,开始有较高的溶出速率和溶出度,但由于索拉非尼分子间相互作用,溶液中快速发生分子堆积形成超分子自组装系统而快速析出,最终导致溶液中索拉非尼分子浓度非常低(pH1.0:0.0034mg/ml、pH4.5:0.00013mg/ml);在含0.1%十二烷基硫酸钠做表面活性剂(比甲苯磺酸索拉非尼质控溶出介质中表面活性剂用量低至少10倍)的pH6.8磷酸盐缓冲液作为溶出介质的溶出实验中,37℃,2h~4h时,累积溶出度下降到与多吉美索拉非尼片基本一致,甚至更低(现有公开技术中常说的弹簧效应),从而导致固体分散体的药物组合物体内生物利用度提高的并不显著;
7)固体分散体再加助溶剂或具有CYP3A4或P-gp抑制作用的载体,如生育酚类化合物、多元醇脂肪酸酯、聚烷氧基化脂肪醇醚以及氢化蓖麻油等助溶剂或酶抑制剂,由于这些助溶剂熔点较低,制剂生产过程产热会提高了生产工艺的难度,另一方面会导致索拉非尼固体分散体的物理稳定性降低,药物组合物在长期贮存过程中热力学稳定性不好的无定形索拉非尼容易受助溶剂诱导而加速成核结晶而大量析出,从而无法达到大幅度提高药物的生物利用度,降低给药剂量的目的。另外,氢化蓖麻油和生育酚虽对CYP3A4或P-gp有抑制 作用,但特异性不强,需要加入较大的用量才会有一定效果。
8)中国专利CN103301066B、CN103301067B公开了江苏泽璟制药多纳非尼制剂组合物专利,可以看出多纳非尼上市产品采用固体分散体技术提高其溶解度并将口服生物利用度在索拉非尼的基础上提高了一倍,因此,将临床用药剂量在多吉美甲苯磺酸索拉非尼片的基础上降低了一半。由于多纳非尼原料药制备过程中采用了氘代化中间体,而氘代中间体的价格显著高于非氘代中间体,因此,提高多纳非尼制剂产品的口服吸收效率,降低单位制剂成本的活性成分(API)用量对降低单位制剂成本、降低多纳非尼制剂产品的不良反应具有重要意义。
以上问题的存在,导致针对Nexavar甲苯磺酸索拉非尼片的新一代产品一直无法进入产业化而用于临床。
发明内容
本发明解决的技术问题在于提供一种索拉非尼或多纳非尼口服制剂,本申请提供的索拉非尼或多纳非尼口服制剂可低剂量服用,且物理和化学稳定性好,低C
max、AUC
0-t变异,具有更好的疗效和安全性,同时也提高了病人的顺应性。
有鉴于此,本申请提供了一种低服用剂量索拉非尼或多纳非尼口服制剂,包括:索拉非尼或多纳非尼分子水平的药物组合物、自组装高分子材料和其他药学上可接受的辅料,所述索拉非尼或多纳非尼分子水平药物组合物的状态为分子水平的固体分散剂、固溶体、聚合物纳米粒、自微乳、纳米乳或分子水平混合物;
所述自组装高分子材料选自聚维酮+羟丙基纤维素、低粘度聚维酮+高粘度聚维酮、聚维酮+共聚维酮、聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、聚维酮+羟丙基甲基纤维素、聚维酮+醋酸纤维素、聚维酮+交联羧甲基纤维素钠、聚维酮+聚乙二醇、聚维酮+低取代羟丙基纤维素、聚维酮+羟丙甲纤维素邻苯二甲酸酯、聚维酮+甲基丙烯酸-丙烯酸乙酯共聚物、聚维酮+甲基丙烯酸-丙烯酸甲酯共聚物、共聚维酮+羟丙基纤维素、共聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、共聚维酮+羟 丙基甲基纤维素、共聚维酮+醋酸纤维素、共聚维酮+交联羧甲基纤维素钠或钙、共聚维酮+聚乙二醇、共聚维酮+低取代羟丙基纤维素、共聚维酮+羟丙甲纤维素邻苯二甲酸酯、共聚维酮+甲基丙烯酸-丙烯酸乙酯共聚物、共聚维酮+甲基丙烯酸-丙烯酸甲酯共聚物、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素醋酸琥珀酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+低取代羟丙基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+交联羧甲基纤维素钠或钙、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+聚乙二醇、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙甲纤维素邻苯二甲酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+甲基丙烯酸-丙烯酸乙酯共聚物、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+甲基丙烯酸-丙烯酸甲酯共聚物。
优选的,所述自组装高分子材料为所述索拉非尼或多纳非尼分子水平的药物组合物的10~50wt%。
优选的,所述羟丙基甲基纤维素为HPMC E5或HPMCK100LV;所述自组装高分子材料为聚维酮、共聚维酮、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物和强疏水性的羟丙基甲基纤维素醋酸琥珀酸酯H型中的一种和HPMC E5的复合自组装高分子材料,复合比例为(1~10):1;所述自组装高分子材料为所述聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物和强疏水性的羟丙基甲基纤维素醋酸琥珀酸酯H型中的一种和HPMCK100LV的复合自组装高分子材料,复合比例为(1~10):1。
优选的,所述羟丙基甲基纤维素醋酸琥珀酸酯的乙酰基取代量为6~16%,琥珀酰基取代量为4~16%。
优选的,所述聚维酮为平均分子量为34000~1300000或平均分子量34000的聚维酮与1300000聚维酮按1:1~1:0.1比例复合的聚维酮。
优选的,所述索拉非尼或多纳非尼分子水平的药物组合物的单位剂量中含索拉非尼或多纳非尼20~69mg。
优选的,所述索拉非尼或多纳非尼分子水平的药物组合物包括索拉非尼或多纳非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物,和载体;所 述载体选自共聚维酮、聚维酮、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、聚维酮+羟丙甲基纤维素、低粘度的聚维酮+高粘度聚维酮、聚维酮+共聚维酮、聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、共聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮+羟丙甲基纤维素、共聚维酮+聚乙二醇、共聚维酮+羟丙基纤维素、共聚维酮+醋酸纤维素;聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙甲基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素醋酸琥珀酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+聚维酮或聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+共聚维酮。
优选的,所述索拉非尼或多纳非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物为所述索拉非尼或多纳非尼分子水平的药物组合物的30~60wt%。
优选的,所述索拉非尼或多纳非尼口服制剂的剂型为片剂、混悬剂、颗粒剂或胶囊剂。
优选的,所述片剂的辅料包括填充剂、崩解剂、助流剂或润滑剂;所述填充剂选自微晶纤维素和硅化微晶纤维素中的一种或两种,所述崩解剂选自交联羧甲基纤维素钠,所述助流剂选自二氧化硅,所述润滑剂选自硬脂酸镁和硬脂富马酸钠中的一种或两种。
优选的,所述填充剂的含量为所述片剂的30~45wt%,所述崩解剂的含量为所述片剂的5~15wt%,所述助流剂的含量为所述片剂的3~5wt%,所述润滑剂的含量为所述片剂的1~5wt%。
本申请还提供了所述的索拉非尼或多纳非尼口服制剂在制备用于治疗或减轻肝细胞癌、乳腺癌、原发性恶性肝肿瘤、胆管癌、肾细胞癌、复发性或难治性实体瘤、中枢神经实体瘤、转移性非小细胞肺癌、手术无法切除的肝细胞癌、甲状腺癌、胰腺癌、涎腺腺样囊性癌、未分化甲状腺癌、难治性分化型甲状腺癌、腺样囊性癌、晚期子宫内膜癌、间变性甲状腺癌、直肠癌、结肠癌、不能切除的III期或IV期黑色素瘤、白血病、急性骨髓性白血病、所有实体瘤或各种晚期实体瘤药物中的应用。
本申请提供了一种索拉非尼或多纳非尼口服制剂,其包括索拉非尼或多纳 非尼分子水平的药物组合物、自组装高分子材料和其他辅料,其中,自组装高分子材料采用特定的两种高分子材料复合作为复合自组装构建单元,两种高分子材料与索拉非尼分子协同调控,重新构建一个可逆的、基于分子间弱相互作用的自组装系统,提高索拉非尼或多纳非尼溶解度、稳定性的同时,也降低了CYP3A4/5、CYP2C8/D6及P-gp对药物的提前代谢与外排,使得到的新的索拉非尼或多纳非尼口服制剂可在更低剂量下服用,获得更高的药物暴露量,且具有安全、副作用发生率更少,低C
max、AUC
0-t变异,低重量/体积、快速崩解、物理和化学稳定性均好,即使水分含量高达5%仍能保持稳定的特点。
图1为本发明索拉非尼立体结构示意图;
图2为本发明索拉非尼及多纳非尼分子间相互作用的单晶结构示意图;
图3为本发明实施例中高浓度单一高分子自组装构建单元对SLFN分子堆积的调控曲线图;
图4为本发明实施例中共聚维酮复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图5为本发明实施例中低粘度聚维酮复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图6为本发明实施例中HPMC AS复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图7为本发明实施例中HPMC复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图8为本发明实施例中PEG复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图9为本发明实施例中HPMCAS-H复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图10为本发明实施例中HPMCAS-L复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图11为本发明实施例中HPMCE5复合高分子自组装构建单元对索拉非尼分子堆积的协同调控曲线图;
图12为本发明实施例中HPMC E5与其他高分子按不同比例复合成的自组装构建单元对索拉非尼分子堆积的协同调控及稳定性的影响-6h的柱形图;
图13为本发明实施例中不同制剂与参比制剂在健康受试者药-时曲线图。
为了进一步理解本发明,下面结合实施例对本发明优选实施方案进行描述,但是应当理解,这些描述只是为进一步说明本发明的特征和优点,而不是对本发明权利要求的限制。
鉴于现有技术中索拉非尼或多纳非尼固体制剂存在的诸多问题,本申请针对大规格难溶、体内高变异、药物分子本身分子堆积问题、口服药物因肠道P450酶/P-gp引起的药物吸收高变异或低生物利用度问题,从而最大限度提高药物的有效性和安全性提供了创新的解决方案和创新思路,由此,本申请具体提供了一种索拉非尼或多纳非尼口服制剂,其通过采用复合自组装构建单元,同时结合分子水平药物组合物技术,使得到的索拉非尼或多纳非尼口服制剂可低剂量服用,即仅用多吉美甲苯磺酸索拉非尼片剂(Nexavar)给药剂量的10%~35%即可达到与其理想治疗效果相同的治疗效果或者用现有多纳非尼片给药剂量的40%~60%获得更高的药物暴露量;其同时具有更安全、副作用发生率更少,低C
max、AUC
0-t变异,低重量/体积、快速崩解,物理和化学稳定性均好,并且即使水分含量高达5%仍能保持稳定的制剂。具体的,本发明实施例公开了一种低服用剂量索拉非尼或多纳非尼口服制剂,包括:索拉非尼或多纳非尼分子水平的药物组合物、自组装高分子材料和其他药学上可接受的辅料,所述索拉非尼或多纳非尼分子水平的药物组合物的状态为固体分散剂、固溶体、聚合物纳米粒、自微乳、纳米乳或分子水平混合物;
本申请所述自组装高分子材料,也可称为复合自组装构建单元,其选自聚维酮+羟丙基纤维素、低粘度聚维酮+高粘度聚维酮、聚维酮+共聚维酮、聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、聚维酮+羟丙基甲基纤维素、聚维酮+醋酸纤维素、聚维酮+交联羧甲基纤维素钠、聚维酮+聚乙二醇、聚维酮+低取代羟丙基纤维素、聚维酮+羟丙甲纤维素邻苯二甲酸酯、聚维酮+甲基丙烯酸-丙烯酸乙酯共聚物、聚维酮+甲基丙烯酸-丙烯酸甲酯共聚物、共聚维酮+羟丙基纤维素、共聚维酮+ 聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、共聚维酮+羟丙基甲基纤维素、共聚维酮+醋酸纤维素、共聚维酮+交联羧甲基纤维素钠或钙、共聚维酮+聚乙二醇、共聚维酮+低取代羟丙基纤维素、共聚维酮+羟丙甲纤维素邻苯二甲酸酯、共聚维酮+甲基丙烯酸-丙烯酸乙酯共聚物、共聚维酮+甲基丙烯酸-丙烯酸甲酯共聚物、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素醋酸琥珀酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+低取代羟丙基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+交联羧甲基纤维素钠或钙、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+聚乙二醇、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙甲纤维素邻苯二甲酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+甲基丙烯酸-丙烯酸乙酯共聚物、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+甲基丙烯酸-丙烯酸甲酯共聚物。
本申请提供了一种索拉非尼或多纳非尼口服制剂,其中的复合自组装构建单元为所述索拉非尼分子水平药物组合物的10~50wt%,更具体地,所述复合自组装构建单元为所述索拉非尼或多纳非尼分子水平的药物组合物的20~40wt%。
所述索拉非尼或多纳非尼分子水平的药物组合物以固体分散剂、固溶剂、聚合物纳米粒、自微乳、纳米乳或分子水平混合物的形式存在;所述索拉非尼或多纳非尼分子水平的药物组合物包括索拉非尼或多纳非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物,和载体。
在本申请中,所述索拉非尼或多纳非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物为所述索拉非尼或多纳非尼分子水平的药物组合物的30~60wt%,更具体地,所述索拉非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物为所述索拉非尼或多纳非尼分子水平的药物组合物的35~55wt%。
在索拉非尼或多纳非尼分子水平的药物组合物中,所述载体选自能提供氢受体并具有一定比例的疏水基团的高分子载体和或至少两种高分子载体的组 合载体,具体选自共聚维酮、聚维酮、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物(Soluplus)、聚维酮与羟丙基甲基纤维素醋酸琥珀酸酯(HPMCAS)、聚维酮与羟丙甲基纤维素、低粘度的聚维酮与高粘度聚维酮、聚维酮与共聚维酮、聚维酮与聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮与羟丙基甲基纤维素醋酸琥珀酸酯、共聚维酮与聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮与羟丙甲基纤维素(HPMC)、共聚维酮与聚乙二醇(PEG)、共聚维酮与羟丙基纤维素、共聚维酮与醋酸纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物与羟丙甲基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物与羟丙基甲基纤维素醋酸琥珀酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物与聚维酮、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物与共聚维酮;更具体地,所述载体选自PVP K30、HPC LF、HPMC E5、VA64、PVP K25+K90、PVP K25+VA64、PVP K30+HPMC AS、PVP K90+HPMC AS、Soluplus或VA64+HPMC AS。在具体实施例中,所述索拉非尼或多纳非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物与所述载体的质量比为1:1。
在本申请中,所述复合自组装构建单元中的羟丙基甲基纤维素优选为E系列或K系列,E系列更优选为低粘度型号,K系列更优选为K100LV,所述复合自组装构建单元为聚维酮、共聚维酮、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物和强疏水性的羟丙基甲基纤维素醋酸琥珀酸酯中的一种和HPMC E的复合自组装构建单元,复合比例为(1~10):1;所述复合自组装构建单元为所述聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物和强疏水性的羟丙基甲基纤维素醋酸琥珀酸酯中的一种和HPMC K100LV的复合自组装构建单元,复合比例为(1~10):1。所述羟丙基甲基纤维素醋酸琥珀酸酯的乙酰基取代量为6~16%,琥珀酰基取代量为4~16%;更具体地,所述乙酰基取代量为10~14%,所述琥珀酰基取代量为4~8%。在抑晶剂中,所述聚维酮为平均分子量为34000~1300000或平均分子量34000的聚维酮与1300000聚维酮按1:1~1:0.1比例复合的聚维酮。
在具体实施例中,所述复合自组装构建单元具体选自PVP VA64+HPMCAS H型、PVP VA64+HPMCAS M型、PVP VA64+Soluplus、PVP VA64+HPMC、PVP K90+HPMCAS、PVP K90+HPMC、PVP K25+PVP K90、 PVP K30+PVP K90、低粘度的HPMC+PVP VA64、PVP K90+HPMC K100LV、+聚维酮、HPMCAS H型+Soluplus、HPMCAS M型+、HPMCAS L型+Soluplus、HPMC(低粘度)+聚维酮、HPMC(低粘度)+共聚维酮或HPMC(低粘度)+HPMCAS(高疏水性)。
在本申请中,复合自组装构建单元的加入方式可以为内加,也可以为外加,或者一个内加、一个外加,复合自组装构建单元可以加入包衣中,如粉末包衣、微丸包衣或片剂包衣。
在本申请所述索拉非尼口服制剂中,所述索拉非尼分子水平的药物组合物的每次用量为多吉美片剂(Nexavar)给药剂量的10%~35%,优选为12.5~30%;单位制剂规格为20mg~69mg,相当于多吉美片剂(Nexavar)200mg,优选为25mg、30mg、50mg或60mg;单位制剂规格为50~140mg,相当于多吉美片剂(Nexavar)单次服药剂量400mg,优选为50mg、60mg、100mg或120mg。
本申请所述多纳非尼口服制剂中,所述多纳非尼分子水平的药物组合物的每次用量为泽普生甲苯磺酸多纳非尼片给药剂量的40%~60%,优选45%~55%;单位制剂规格优选为25mg、30mg、40mg、45mg、50mg和55mg,相当于服用泽普生甲苯磺酸多纳非尼片单次剂量100mg,优选为50mg、60mg;相当于泽普生甲苯磺酸多纳非尼片单次剂量200mg,优选为80mg、90mg、100mg或110mg。
所述索拉非尼或多纳非尼口服制剂的剂型为片剂、混悬剂、颗粒剂或胶囊剂;所述片剂的辅料包括填充剂、崩解剂、助流剂或润滑剂;所述填充剂选自微晶纤维素和硅化微晶纤维素中的一种或两种,所述崩解剂选自交联羧甲基纤维素钠,所述助流剂选自二氧化硅,所述润滑剂选自硬脂酸镁和硬脂富马酸钠中的一种或两种。所述填充剂的含量为所述片剂的30~45wt%,优选为30~40wt%;所述崩解剂的含量为所述片剂的5~15wt%,优选为5~10wt%;所述助流剂的含量为所述片剂的3~5wt%,所述润滑剂的含量为所述片剂的1~5wt%。本申请中,所述片剂的崩解时间≤5min。
本发明还提供了上述包含索拉非尼组合物的制剂在制备治疗肿瘤药物中的应用;所述肿瘤具体为肝细胞癌、乳腺癌、原发性恶性肝肿瘤、胆管癌、肾细胞癌、复发性或难治性实体瘤、中枢神经实体瘤、转移性非小细胞肺癌、手术无法切除的肝细胞癌、甲状腺癌、胰腺癌、涎腺腺样囊性癌、未分化甲状腺 癌、难治性分化型甲状腺癌、腺样囊性癌、晚期子宫内膜癌、间变性甲状腺癌、直肠癌、结肠癌、不能切除的III期或IV期黑色素瘤、白血病、急性骨髄性白血病、以及所有实体瘤、各种晚期实体瘤。
本发明提供的制剂可单药或与其他药物联合使用用于上述肿瘤的治疗;其他药物优选为PD-1抑制剂、Venetoclax和/或Decitabine、与TACE和/或Iodion-125 seeds brachytherapy联合治疗、与Drug-eluting bead transarterial chemoembolization联合治疗、联合派姆单抗、联合托利帕单抗、联合Atezolizumab、联合Atezolizumab+Bevacizumab、联合TACE+Tilelizumab、联合Recombinant Human Adenovirus Type 5 injection、联合MTL-CEBPA、联合Vemurafenib、联合Oxaliplatin和5-氟尿嘧啶、艾日布林、多瑞帕利单抗、Gemox或依维莫司、与Doxorubicin和Lipiodol联用、与Oxaliplatin、Raltitrexed及Epirubicin联用、与Toripalima联用、与PD-1mAb联用、与Hydroxychloroquine联用、与CVM-1118联用、与Hepatic Artery Infusion Chemotherapy(Oxaliplatin,fluorouracil,and leucovorin)联用、与Hepatic Artery Infusion Chemotherapy(Irinotecan,Oxaliplatin,fluorouracil,and leucovorin)联用与YIV-906联用、与Tislelizumab联用。
进一步拓宽索拉非尼或多纳非尼单药或联合用药或联合疗法在各疾病治疗领域的临床应用:
如:所述包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂作为晚期肝癌的一线治疗药物,可与PD-1抑制剂,如卡瑞利珠单抗(Camrelizumab)联合使用,第一天静注卡瑞利珠单抗200mg,两周一次;第二天开始口服该药物组合物索拉非尼或多纳非尼50mg-120mg,一天两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与TACE疗法联合治疗肝细胞癌,TACE疗法为注射化疗药物(doxorubicin and lipiodol),口服索拉非尼或多纳非尼,每次50-120mg,一日两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Toripalimab联合应用,用于不能切除的肝细胞癌、门静脉癌栓的治疗,根据患者cohort A或cohort B,索拉非尼或多纳非尼每次50-120mg,一天一次或一天两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与SBRT+TACE顺序治疗不能切除的肝细胞癌、门静脉癌栓,口服索拉非尼或多纳非尼每次 100-120mg,一日两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Hydroxychloroquine(HCQ)联合应用治疗肝细胞癌,索拉非尼或多纳非尼一日两次,每次100-120mg;Hydroxychloroquine(HCQ)口服400mg,一天一次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Pembrolizumab单抗联用用于成年人晚期肝细胞癌,治疗第一天,静注Pembrolizumab,30分钟内完成注射,在治疗的第1~第21每次口服索拉非尼或多纳非尼100-120mg,一天两次,每三周重复一个疗程。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与CVM-1118联用,用于晚期肝细胞癌的治疗,CVM-1118口服150mg或200mg,一日两次,索拉非尼或多纳非尼每次口服50-120mg,一日两次,28天为一个治疗周期。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Hepatic arterial infusion chemotherap(Oxaliplatin,fluorouracil,and leucovorin)联合应用,用于肝细胞癌的治疗,索拉非尼或多纳非尼每次口服50-120mg,一日两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Hepatic arterial infusion chemotherapy(Irinotecan,Oxaliplatin,fluorouracil,and leucovorin)联合应用,用于肝细胞癌的治疗,索拉非尼或多纳非尼每次口服50-120mg,一日两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与DEB-TACE联合治疗肝细胞癌,索拉非尼或多纳非尼每次口服50-120mg,一日两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与YIV-906联合治疗HBV感染的晚期肝细胞癌患者,28天为一个治疗周期,每次口服索拉非尼或多纳非尼50-120mg,一日两次,连服28天,每周4天服YIV-906,一天两次,每次600mg,停三天。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与TACE、Tislelizumab联合应用治疗无法手术的肝细胞癌,第一个TACE治疗后第3-7天口服索拉非尼或多纳非尼100-120mg每次,一天两次,同时静注Tislelizumab,每三周一次,每次200mg;根据临床结果决定TACE治疗重复几次,Tislelizumab的治疗一直持续到24个月。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Vemurafenib联 用用于胰腺癌的治疗,口服Vemurafenib 720mg,一天两次,每天早上服用索拉非尼或多纳非尼100-120mg,每天下午服用索拉非尼50-60mg;
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与MTL-CEBPA联合应用治疗病毒感染引起的肝细胞癌,每周静脉注射MTL-CEBPA 130mg/m
2,连续给药三周停一周,同时口服索拉非尼或多纳非尼每次100-120mg,一天两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与TACE、Tilelizumab联合治疗BCLC Stage C肝细胞癌,先启动TACE治疗,TACE治疗一周内静注Tilelizumab 240mg,每三周一次;TACE治疗一周内启动口服索拉非尼或多纳非尼每次100-120mg,一天两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Atezolizumab联合应用治疗无法手术的晚期肝细胞癌,在治疗周期的第1天及第21天静脉滴注Atezolizumab1200mg,治疗周期内每天口服索拉非尼或多纳非尼,每次100-120mg,一天两次,如有效可重复治疗多个疗程,直至病情进展或无法耐受。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与TACE疗法联合治疗肝细胞癌,TACE疗法为注射化疗药物(Oxaliplatin 200mg,raltitrexed 4mg,epirubicin 20mg in cTACE或者70mg in dTACE),口服索拉非尼或多纳非尼,每次50-120mg,一日两次。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与TACE疗法联合治疗无法手术的肝细胞癌,在施行第一个TACE治疗后的3-7天,口服索拉非尼或多纳非尼100-120mg,一天两次。根据临床治疗结果决定TACE的重复次数及索拉非尼的治疗,直至疾病进展或病人无法耐受。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与Venetoclax和Decitabine联用用于成人急性髓系白血病(FLT3-ITD allelic比偏高)治疗,在每个治疗周期的第1-5天,静脉注射decitabine 20mg/m
2,同时口服Venetoclax100mg,并逐渐加量至400mg(28天),一个治疗周期结束。如病人伴有高FLT3-ITD allelic比,在每个治疗周期的第三天,开始服用索拉非尼或多纳非尼,每次100-120mg,一天两次,直至28天一个治疗周期结束。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂用于急性白血病 发作、复发及造血干细胞移植,每次口服索拉非尼或多纳非尼100-120mg,一天两次,如无法耐受可减量至50mg~240mg每天。
包含本发明研究的低剂量索拉非尼或多纳非尼口服制剂与HAIC(130mg/m
2Oxaliplatin,and 2400mg/m
2 5-fu或85mg/m
2Oxaliplatin,and 2400mg/m
25-fu)联用,用于晚期无法手术的肝细胞癌的治疗,索拉非尼或多纳非尼口服,每次100-120mg,一日两次。
本申请提供的索拉非尼或多纳非尼口服制剂中的自组装高分子材料采用特定的两种高分子材料复合作为复合自组装构建单元,两种自组装高分子材料与索拉非尼客体分子协同调控,阻止索拉非尼或多纳非尼分子原有的因分子间相互作用而形成的分子堆积,在新的微环境中与复合自组装构建单元重新构建新的自组装系统,使得到的口服制剂在吸收过程中减少胃肠道粘膜上皮细胞中P450酶的CYP3A4/A5、CYP2D6、CYP2C8或P-gp对药物的提前降解或外排,同时也能降低药物从分子水平组合物中快速溶出后由于索拉非尼分子间的相互作用而快速发生分子堆积而降低吸收。因此,可在更低剂量下服用,且具有安全、副作用发生率更少,低C
max、AUC
0-t变异,低重量/体积、快速崩解、物理和化学稳定性均好,即使水分含量高达5%仍能保持良好的物理化学稳定性。
为了进一步理解本发明,下面结合实施例对本发明提供的低服用剂量索拉非尼或多纳非尼口服制剂及其应用进行详细说明,本发明的保护范围不受以下实施例的限制。
根据索拉非尼化学结构中可发生分子间相互作用的基团如图2所示,均与酰胺所连甲基没有关系,因此,无论是索拉非尼还是多纳非尼,分子间相互作用、索拉非尼或多纳非尼与自组装构建单元中高分子材料的有效基团的相互作用类型、作用强弱、分子识别均是一致的。
因此,如下以索拉非尼为例进行说明,但对多纳非尼全部适用。
实施例1 自组装构建单元的筛选
称取索拉非尼或甲苯磺酸索拉非尼各适量,分别加少量二甲基亚砜溶解并用乙腈稀释制成每1ml约含索拉非尼50mg的高浓度贮备溶液,确保索拉非尼以分子水平分散于溶液中;
以含0.1%十二烷基硫酸钠(SDS)的pH6.8磷酸盐缓冲溶液作为基础介质 (pH6.8磷酸盐+0.1%SDS),基础介质的配制按照口服固体制剂溶出度试验技术指导原则进行配制;称取高分子材料聚维酮(PVP)PVP K25、PVP K30、PVP K90;共聚维酮(乙烯基吡咯烷酮-醋酸乙烯酯的共聚物),如PVP VA64;醋酸羟丙甲基纤维素琥珀酸酯(HPMCAS),如HPMCAS H型(甲氧基含量22%~26%、羟丙氧基含量6%~10%,乙酰基含量10%~14%、琥珀酰基含量4%~8%)(或与其相当的型号)、HPMCAS MG(甲氧基含量21%~25%、羟丙氧基含量5%~9%,乙酰基含量7%~11%、琥珀酰基含量10%~14%)(或与其相当的型号)、HPMCAS LG(甲氧基含量20%~24%、羟丙氧基含量5%~9%,乙酰基含量5%~9%、琥珀酰基含量14%~18%)(或与其相当的型号),颗粒型或粉末型;羟丙甲基纤维素,如HPMCE5、K100LV;聚乙二醇,如PEG 8000、Soluplus等各适量,用pH6.8磷酸盐+0.1%SDS溶解制成不同浓度的介质,备用。
分别量取50ml上述基础介质或含一定质量百分比作为自组装构建单元的高分子材料的基础介质,置100ml具塞三角瓶中,于37℃摇床中振摇温育至37℃,分别向各具塞三角瓶中加入索拉非尼贮备液1.0ml(1000μg/mL),37℃超声分散均匀后,转入37℃恒温振荡摇床,并于0.5h、1h、2h、3h、4h和6h取样,37℃,13000rpm离心,取上清液适量,加稀释剂50%-乙腈稀释,HPLC法检测含不同自组装构建单元的介质构建的系统中仍以分子状态存在的索拉非尼的浓度,结果见下表1:
索拉非尼分子的立体结构及单晶结构见图1所示,其中羧酸甲胺上的N4氢与吡啶上的N3容易形成分子内氢键,而脲基的N1、N2上氢很容易与另外一个分子上的羧酸甲胺的O1形成分子间氢键、疏水效应、π-π堆积,从而造成索拉非尼分子在溶液中溶解后通过分子间相互作用快速形成分子堆积,并最终形成固体超分子自组装系统而从溶液中析出,如图2所示。
表2不同系统中温育不同时间溶液中索拉非尼的浓度变化数据表
根据以上结果及图1可知,与基础介质(不含自组装构建单元)相比,除0.5%-HPMC K100LV外,其他高分子材料做构建单元单独应用对溶液中索拉非尼分子堆积的发生均有一定的调控作用,但随着温育时间延长,分子热运动增加,分子间形成氢键的作用机会加大,分子堆积会随时间延长而增多。0.5%-聚维酮(PVP K25-K90,N-vinylpyrrolidinone的聚合物)、0.5%-共聚维酮(PVPVA64)、0.5%-Soluplus、0.5%-HPMCAS H型(乙酰基10%~14%,琥珀酰基4%~8%)均对索拉非尼分子堆积有较好的调控作用,6h测得自组装系统中索拉非尼浓度为208.61μg/mL~759.31μg/mL,均显著高于基础介质6h测得的浓度(5.61μg/mL),与基础介质相比,0.5%Soluplus及0.5%HPMCAS H型构建的自组装系统对索拉非尼的包封率较高,分别为75.9%及63.4%,可提高至少100倍,且0.5%Soluplus及0.5%HPMCAS H型构建的自组装系统随时间延长,包封的药物呈缓慢上升趋势,这与Soluplus及HPMCAS H型除与索拉非尼分子竞争形成氢键的机会,同时较强的疏水作用起决定性作用。其他聚维酮系列、共聚维酮系列随着温育时间延长,索拉非尼分子逐渐发生分子堆积,但6h测得自组装系统中索拉非尼的溶液浓度依然是基础介质的34~55倍,且 高分子量的K90的对索拉非尼分子堆积的调控作用优于K25、K30及VA64,推测高粘度的K90限制了索拉非尼分子本身的热运动,降低了分子间形成氢键的机会。
0.5%-共聚维酮(如PVP VA64)为Vinyl acetate-N-vinylpyrrolidinone的共聚物,其中N-vinylpyrrolidinone在共聚物中约占60%,Vinyl acetate约占40%,因此,相同质量分数的共聚维酮的疏水性优于聚维酮系列,同时共聚维酮可提供的氢受体的密度与聚维酮有所不同,索拉非尼分子的油水分配系数LogP约为5.6,高度疏水,因此,0.5%-PVP VA64对调控索拉非尼分子堆积的作用优于聚维酮系列低粘度的K25、K30,但后期维持自组装系统稳定性的能力略差于K90。
0.5%-聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物(Soluplus),与共聚维酮相比,除增加了13%的亲水基团PEG6000,同时59%乙烯内酰胺基团及30%乙酸乙烯酯基团的疏水性优于聚乙烯吡咯烷酮烷酮及共聚维酮,即提供疏水相互作用,同时亲水基团与索拉非尼分子竞争氢键作用,因此由Soluplus参与构建的超分子自组装系统对索拉非尼分子堆积的协同调控能力最强,且构建的超分子自组装系统最稳定,包封率也最高。
0.5%-羟丙基甲基纤维素醋酸琥珀酸酯(HPMC AS)是羟丙基甲基纤维素(HPMC)的醋酸和琥珀酸混合酯,随着琥珀酰基依次增加,乙酰基依次减少,其疏水性逐渐减弱,根据琥珀酰基和乙酰基的取代量一般有三种商业化规格,如H型(琥珀酰基为4%~8%、乙酰基10%~14%)而L型(琥珀酰基为14%~18%、乙酰基5%~9%),M型介于二者之间,羟丙基甲基纤维素醋酸琥珀酸酯能同时提供氢受体与氢供体,其琥珀酰基与弱碱性药物还可产生离子相互作用,其与疏水性药物产生疏水作用的同时,与水溶液在合适的pH条件下形成稳定的超分子自组装系统,因此,其H型对索拉非尼分子堆积的协同调控作用较L型或M型强且能长时间维持稳定。具体如图3所示。
综上,当索拉非尼制备成分子水平的药物组合物,如固体分散体、固溶体、聚合物纳米粒、自微乳、纳米乳或分子水平混合物后,要解决索拉非尼分子自身结构易形成超分子自组装系统而变成固体,影响药物吸收,选择作为超分子自组装构建单元的高分子材料除具有一定数量的氢受体、氢供体的基团外,针对索拉非尼分子的特殊结构及强疏水特征,还要提供足够的疏水作用和离子作 用,这样才能维持子系统与整个超分子系统的平衡,使更多的索拉非尼分子长时间稳定地包封在新构建的超分子自组装系统中。
但每一种高分子材料作为药用辅料均有其最大日安全用量,尤其对于长期服用的药物,另外,某一种高分子材料在处方中含量过高(0.5%质量分数,肠液按250mL计算,单位制剂中含辅料约125mg,如每次需要服用2个制剂单位,一天两次,则每天服用该载体量将为500mg,很多辅料都无法达到)又会导致制备工艺、溶出、崩解行为、物理稳定性、化学稳定性的改变,往往无法达到预期的结果。因此,在上述研究的基础上,发明人发现两种或两种以上不同属性的高分子材料复合应用共同作为超分子自组装系统的构建单元应用会取得意想不到的效果。具体方案及实验结果如下:
表3复合自组装构建单元系统在不同时间后索拉非尼含量数据表1
根据上述结果,当降低一半共聚维酮、聚维酮或Soluplus的用量,并与其他高分子材料按质量比1:1复合使用时,除显著降低了单一高分子材料的日用量,同时也发现了意想不到的协同调控效果,具体详见图4~7。
共聚维酮,以PVP VA64为例,其与Soluplus或HPMCAS H型相比,缺少亲水性基团,同时缺少氢供体基团,另外与索拉非尼相比,其提供的疏水作用要弱于Soluplus。聚维酮系列的除具有共聚维酮的特性外,其疏水作用差于共聚维酮。0.25%-(PVP-VA64)与0.25%的HPMCAS H型或HPMCAS M型或Soluplus复合使用,均可显著弥补单独PVP VA64的不足,6h测得自组装系统中索拉非尼的浓度均在700μg/mL;同样0.25%-(PVP-VA64)与亲水性的HPMC复合也具有显著的协同调控索拉非尼分子堆积的作用,6h测得自组装系统中索拉非尼的浓度维持在335~458μg/mL;显著高于复合载体中任何单一高分子材料所能达到的作用效果。0.25%PVPVA64与0.25%PEG8000复合,由于PEG8000的高度亲水性,与0.5%-PVPVA64相比,对索拉非尼分子堆积的协同调控作用显著降低。
聚维酮系列,低粘度的以PVP K25为例,高粘度的以PVP K90为例;0.25%(PVP+HPMCAS)、0.25%(PVP+HPMC)系列均显著优于高质量分数的任何一种高分子材料单独应用,尤其是显著优于0.5%-HPMCAS M及L或 0.5%-PVP VA64或0.5%-PVP或0.5%HPMCE5、0.5%HPMC K100LV;根据各高分子材料结构中的亲水、疏水基团以及提供氢受体、供体的能力,复合自组装构建单元弥补了单一高分子材料和商业化可用高分子材料的局限,可根据药物自身结构及分子间相互作用的列别,合理进行复合。更让人意想不到的是低粘度的PVPK25、K30与高粘度的PVP K90复合使用,对索拉非尼的分子堆积协同调控作用显著优于单独一种高分子材料的作用效果。0.25%-PVP(K25+K90)从0.5h~6h,索拉非尼均能维持在718~630μg/mL,而0.5%-PVPK25、0.5%-PVP K90做自组装构建单元,6h测得系统中索拉非尼浓度为209~310μg/mL。
0.25%-(PVP-VA64/PVP+HPMC)系列复合自组装构建单元的作用效果也显著优于高质量分数的任何一种高分子材料单独应用,0.5%的HPMC对索拉非尼分子堆积的协同调控能力很差,与基础介质相比,基本无差异;而0.25%-(PVP-VA64/PVP+HPMC)复合后的效果显著优于0.5%-PVP VA64、0.5%-PVP及0.5%-HPMC,在0.25%(PVP-VA64+HPMC)组,其中低粘度HPMC和高粘度HPMC与共聚维酮复合使用后虽均显著优于单独应用,但低粘度的HPMC与PVP VA64复合后对索拉非尼分子堆积的协同调控效果显著优于高粘度的HPMC K100LV。在0.25%(PVP+HPMC)组,PVP K25对高、低粘度的HPMC协同调控效果基本一致。
但是,并非所有的高分子材料复合应用都具有对索拉非尼分子堆积的协同调控效果,例如聚维酮、共聚维酮、Soluplus与PEG8000复合,与基础介质相当。如图8所示。
Soluplus与聚维酮、共聚维酮、HPMCAS系列、HPMC系列复合作为超分子自组装的构建单元,各自质量分数降低一半的前提下,仍然保持了Soluplus高质量分数所能达到的协同作用效果。为解决Soluplus用量大、成型性差及对活性成分稳定性影响等问题提供了新的思路。
0.25%-PVP K90与低疏水基团的HPMCAS系列或HPMC复合应用,也显示出显著的协同调控效果,HPMCAS系列高亲水含量的琥珀酰基(L型、M型)为索拉非尼提供了离子作用,同时也能够与索拉非尼分子间易形成氢键的基团竞争作用从而破坏了其原有的自组装系统,PVP K90一方面弥补了HPMCAS(L型、M型)、HPMC疏水性不足造成的缺陷,同时也降低了分子 热运动而相互接触的机会,减少了分子间氢键的形成,0.25%-PVP K90+0.25%-HPMC K100LV的作用效果也证实了这点,但高分子材料上的氢供体或受体与索拉非尼分子间竞争氢键作用和疏水效果更显著。
表4为HPMCAS系列(疏水性乙酰基、亲水的琥珀酰基含量不同)与其他高分子材料复合应用构建超分子自组装系统的性能数据表;
表4不同复合自组装构建单元在不同时间后索拉非尼含量数据表2
由表4可知,HPMCAS系列与其他高分子材料复合应用表现出显著的选择性,0.25%-HPMCAS H型(琥珀酰基为4%~8%、乙酰基10%~14%)与聚维酮、共聚维酮、Soluplus降低质量分数后复合使用,仍然维持原来高质量分数时达到的较高的增溶抑晶效果,6h时测得自组装系统中索拉非尼的浓度约为793~818μg/mL,包封率高达81.8%;当0.25%-HPMCAS H型与等质量分数的亲水性的高分子材料复合时,协同调控能力随着时间延长逐渐降低。 HPMCAS L型与相同质量分数的HPMCAS M型组合后,构建的复合自组装构建单元的疏水性乙酰基约为6%~10%,亲水的琥珀酰基约为12%~16%,其所能达到的协同调控效果与HPMCAS H型相当,并远超过0.5%-HPMCAS L型或0.5%-HPMCAS M型单独应用,这对制剂产品开发来讲非常重要,可以根据二者的不同配比调节产品的体内溶出和释放特性。HPMCAS L型与共聚维酮、聚维酮复合,二者可以互相取长补短,协同作用,作用结果均远超出任何一种高分子材料单独应用的效果。0.25%HPMCAS L型与0.25%Soluplus复合,降低各自用量的同时,提高了制剂工艺可行性,同时可以调控药物的在体内按照设计的释放行为进行释药。根据羟丙甲基纤维素E系列,一般甲氧基含量约为29%,羟丙基含量约为12%,其结构上氢供体、受体数量较HPMCAS高,与HPMCAS相比更亲水,因此,单独应用对索拉非尼分子堆积的形成没有调控能力。但当HPMCAS与疏水性更强的聚维酮、共聚维酮、Soluplus复合后,改变了体系中氢供体数和受体数,同时也使构建的系统更疏水,但随着温育时间的延长,如温育6小时时,低粘度的聚维酮、共聚维酮与HPMC复合构建的超分子系统中索拉非尼出现缓慢堆积,而高粘度的聚维酮直到6h还在缓慢增长。0.25%-HPMC(低粘度)与相同质量分数的聚维酮、共聚维酮、HPMCAS中高疏水性型号复合应用均具有显著协同调控作用,作用结果优于单独的任何一种所能达到的调控效果。具体如图9、10所示。
HPMC以E系列为例,其甲氧基的平均含量约为29%,羟丙基的平均含量为10%,与HPMCAS相比,亲水基团更多,疏水性差于HPMCAS,因此,增加疏水性复合抑晶剂的质量分数如1:2,可显著提高其增溶抑晶能力,其中0.5%的聚维酮、HPMCAS-H与0.25%HPMCE5复合使用,加大更疏水性辅料可增强对索拉非尼的溶解和抑制析晶作用,但0.5%共聚维酮与Soluplus并未显示出更明显的优势,详见图11及图12。
HPLC分析方法如下:
采用Agilent1260高效液相色谱法,四元低压梯度泵、柱温箱、自动进样器、紫外检测器、在线脱气机,参数如表5所示;
表5 HPLC分析方法参数数据表
实施例2 低载体用量分子水平药物组合物的制备
将索拉非尼(SLFN)/甲苯磺酸索拉非尼(TSSLFN)加入甲醇-二氯甲烷(1:3)混合溶剂,30~33℃搅拌溶解,主药:混合溶剂为1:100;再加入载体溶解,载体用量为主药:载体为1:1;喷雾干燥:进风温度120℃,出风温度设定60℃,氮气为载气。
表6不同载体及不同载体与主药比例制备的分子水平药物组合物DSC检测结果数据表
根据以上结果,在低载体比例条件下,以共聚维酮、聚维酮、共聚维酮+HPMCAS、HPMC E5、Soluplus为载体可形成分子水平药物组合物。
实施例3 片剂样品制备
制备工艺:按实施例2制备分子水平药物组合物(SD),将SD、自组装构建单元、处方量一半的填充剂、崩解剂、处方量一半的润滑剂混合均匀,干法制粒,加入剩余处方量一半的填充剂、助流剂、处方量一半的润滑剂,混合均匀,压片。片剂样品处方如表7所示;
表7片剂样品处方(mg/片)
表7片剂样品处方(mg/片)-续表
表8片剂处方-其他辅料用量(mg/片)
溶出检测:桨法,0.1%十二烷基硫酸钠(SDS)的pH6.8磷酸盐缓冲溶液900mL,100rpm,37℃。取样和样品处理方法:取10mL,用PES滤膜(直径25mm,孔径0.45μm)过滤,弃去滤液8mL,取续滤液1~2mL,并补10mL介质于溶出杯中。过滤后样品送至分析稀释后进行检测。参比制剂(RLD)投1片(200mg),自制制剂投4片(200mg)。溶出度检测采用HPLC法进行检测,溶出结果见下表;
表9片剂处方溶出结果数据表
由以上结果可知,处方F1~F42的累积溶出度均远高于RLD和F43(低主药含量分子水平药物组合物);并且在制剂中复合自组装构建单元对索拉非尼分子堆积的协同调控效果更好。
实施例4 片剂辅料、水分对片剂硬度、崩解、制剂稳定性考察
制备工艺:按实施例2制备固体分散体(SD),将SD、抑晶剂、一半处方量的填充剂、崩解剂、一半处方量的润滑剂混合均匀,干法制粒,加入剩余一半处方量的填充剂、助流剂、一半处方量的润滑剂,混合均匀,压片。水分测定按中国药典2020版四部通则0831第一法进行监测。
片剂处方制备见下表。
表10片剂不同辅料处方
表10片剂不同辅料处方-续表
硬度:采用片剂硬度仪进行检测,检测6片,取均值;崩解时间:采用崩解试验仪进行试验,检测6片,取均值;CTF-苯胺、总杂:采用HPLC法检测;结晶物含量:采用拉曼光谱法检测,结果如表10所示;稳定性实验的考察条件为40℃±2℃/RH75%±5%的加速实验箱中考察。进行稳定性考察的片剂 采用铝塑复合膜外加双铝包装。
表11片剂辅料、水分对片剂硬度、崩解、稳定性考察数据表
由以上数据可知,片剂填充剂微晶纤维素、硅化微晶纤维素明显好于乳糖、甘露醇;用量范围为占片剂总重的30~45%。崩解剂优选为交联羧甲基纤维素钠,用量占片剂总重的5~15%;片剂中还含有润滑剂,优选为硬脂酸镁、硬脂富马酸钠,更优选为硬脂酸镁。优选处方制备的制剂可在5min内快速崩解。
根据以上数据,在高水分条件下,采用填充剂为微晶纤维素、硅化微晶纤维素,崩解剂为交联羧甲基纤维素钠的片剂,索拉非尼片经40℃/RH75%条件下带包装放置90天,未发生分子堆积。
实施例5 包衣片制备
将自组装构建单元的高分子材料可以在制备片芯时加入,或加入包衣材料中,或可以同时加入。制备工艺:按实施例2制备分子水平药物组合物(SD),将SD、自组装构建单元的高分子材料、一半处方量的填充剂、崩解剂、一半处方量的润滑剂混合均匀,干法制粒,加入剩余一半处方量的填充剂、助流剂、一半处方量的润滑剂,混合均匀,压片,包衣。按下表处方制备片剂。
表12包衣片处方组成数据表
溶出检测:桨法,0.1%十二烷基硫酸钠(SDS)的pH6.8磷酸盐缓冲溶液900mL,100rpm,37℃。取样和样品处理方法:取10mL,用PES滤膜(直径25mm,孔径0.45μm)过滤,弃去滤液8mL,取续滤液1~2mL,并补10mL介质于溶出杯中。过滤后样品经等比稀释后进行检测。参比制剂(RLD)投1片(200mg),自制制剂投4片(200mg)。溶出结果见下表;
表13包衣片溶出结果数据表
由以上结果可知,不管是片芯内加自组装构建高分子材料,还是包衣中加入,还是二者同时加入,都均有明显效果。
实施例6 微丸制备
制备工艺:将索拉非尼、VA64用二氯甲烷甲醇(3:1)混合溶解溶解,采用流化床进行微丸层积上药,然后再喷包衣层,所得微丸装入胶囊,每粒胶囊含索拉非尼50mg。按下表处方制备微丸;
表14微丸处方组成数据表(mg)
溶出检测:桨法,0.1%十二烷基硫酸钠(SDS)的pH6.8磷酸盐缓冲溶液900mL,100rpm,37℃。取样和样品处理方法:取10mL,用PES滤膜(直径25mm,孔径0.45μm)过滤,弃去滤液8mL,取续滤液1~2mL,并补10mL介质于溶出杯中。过滤后样品溶液进行等比稀释后进行检测。参比制剂(RLD)投1片(200mg),自制制剂投4粒(200mg)。溶出结果见下表。
表15包衣片溶出结果数据表
由以上结果可知,微丸采用共沉淀法制备分子水平药物组合物,外加含有自组装构建单元的高分子材料包衣,也具有明显的协同调控溶出后索拉非尼分子堆积的作用。
实施例7 粉末包衣
按实施例2喷雾干燥法制备索拉非尼分子水平药物组合物,将药物组合物SD用下表处方进行粉末包衣,再按表8处方加入辅料制备片剂。按照下表处方制备粉末包衣;
表16粉末包衣处方组成数据表(mg)
溶出检测:桨法,0.1%十二烷基硫酸钠(SDS)的pH6.8磷酸盐缓冲溶液900mL,100rpm,37℃。取样和样品处理方法:取10mL,用PES滤膜(直径25mm,孔径0.45μm)过滤,弃去滤液8mL,取续滤液1~2mL,并补10mL介质于溶出杯中。过滤后样品送至分析稀释后进行检测。参比制剂(RLD)投1片(200mg),自制制剂投4粒(200mg)。溶出结果见下表。
表17包衣片溶出结果数据表
由以上结果可知,SD采用含有自组装构建单元的包衣材料进行粉末包衣,索拉非尼溶出后进入溶液中,在包衣层中的自组装高分子材料在最外层已经进入系统中,对索拉非尼分子堆积仍具有较好的协同调控作用。
实施例7 自微乳制备
将油酸乙酯、聚氧乙烯蓖麻油、乙醇按比例混合均匀,形成空白自微乳,加入索拉非尼溶解,再加入自组装构建单元,混合均匀,即得。按下表制备自微乳。
表18自微乳处方数据表(mg)
脂解试验:
脂解缓冲液:Tris maleate缓冲液(0.474g/L),无水氯化钙(0.208g/L),NaCl水溶液(8.766g/L,超纯水),使用5mol/L的NaOH调解pH至6.5。脂解介质:L-α-磷脂酰胆碱(PC)(0.576g/L),将牛去氧胆酸钠(1.565g/L)加入缓冲液中,搅拌介质并过夜保证PC完全溶解。胰酶溶液:将3g研磨过的猪胰脏液加入到15ml脂解缓冲液中,使用5mol/L的NaOH调解pH至6.5,使用磁力搅拌器搅拌混合物10分钟,将混合物等分后离心(5℃,10分钟),取上清液进行脂解实验。胰酶酶活的检测:在脂解实验开始之前,使用三丁酸甘油酯作为酶底物测定胰酶的酶活。加入过量的三丁酸甘油酯确保反应速率与酶浓度成正比。为此,500μl三丁酸甘油酯在35ml脂解介质中(不加入磷脂酰胆碱)可以被1.5μl胰酶脂解。酶活必须大于900U/mg。脂解试验:取相当于SLFN 50mg的处方样品,加入到体积为36ml的37℃脂解介质中。搅拌10分钟后,加入4ml胰酶溶液。整个测试过程(约1小时)定期取样(约1ml),将样品与4-溴苯硼酸(脂肪酶抑制剂)混合。样品在37℃下离心,取上清液用稀释液后检测。
取样时间为:在酶加入前的10分钟和0分钟(分散阶段),在酶加入后5、15、30和60分钟(消化阶段)。
表19自微乳脂解试验结果数据表
由以上结果可知,加入自组装构建单元材料的自微乳,在脂肪酶消化过程中仍可维持对索拉非尼分子堆积的协同调控;而未加抑晶剂的处方F75则随时间延长,索拉非尼分子堆积逐渐增多。
实施例8 多纳非尼制剂
制备工艺:按实施例2制备分子水平药物组合物SD(将实施例2索拉非尼用多纳非尼替代),将SD、自组装构建单元、处方量一半的填充剂、崩解剂、处方量一半的润滑剂混合均匀,干法制粒,加入剩余处方量一半的填充剂、助流剂、处方量一半的润滑剂,混合均匀,压片。片剂样品处方如表20、21所示;
表20片剂样品处方(mg/片)
表21片剂处方-其他辅料用量(mg/片)
溶出检测:桨法,0.1%十二烷基硫酸钠(SDS)的pH6.8磷酸盐缓冲溶液900mL,100rpm,37℃。取样和样品处理方法:取10mL,用PES滤膜(直径25mm,孔径0.45μm)过滤,弃去滤液8mL,取续滤液1~2mL,并补10mL介质于溶出杯中。过滤后样品送至分析稀释后进行检测。参比制剂(RLD)投1片(200mg),自制制剂投4片(200mg)。溶出度检测采用HPLC法进行检 测,溶出结果见下表;
表22片剂处方溶出结果数据表
F76为参考专利CN103301067B实施例1制备的比较例。
根据以上结果可知,本发明制备的样品F77、F78、F79溶出明显高于F76。
实施例9 健康志愿者PK试验
采用实施例F44(50mg,T1)、实施例F33(50mg,T2)样品,参比制剂多吉美(规格200mg,R)进行空腹PK试验。
受试者:18~65岁健康中国男性或女性12例(其中女性5例)。
单中心、随机、三制剂、三周期、三交叉设计。
给药途径及给药频率:受试者禁食过夜至少10小时后,次日早晨空腹以240mL水溶液送服,参比制剂1片,T1、T2各2片。清洗期10天。
取血时间点:给药前(0h)、给药后0.5h、1h、1.5h、2h、2.5h、3h、3.5h、4h、6h、8h、12h、16h、24h、36h、48h、72h、96h。
采用LC/MS/MS方法检测血药浓度,采用Phoenix WinNonlin 7.0计算药代动力学参数(AUC
0-t、AUC
0-∞、C
max、T
1/2、T
max及这些参数的算术平均(±SD)和几何平均),并进行相对生物利用度分析,结果如下表1、表2和图13。
表23人体PK试验结果数据表1
表24人体PK试验结果数据表2
试验药物 | Ln[Cmax(ng/mL)] | Ratio_%Ref | Tmax(h) | Ln[AUC 0-∞(ng*h/mL)] | Ratio_%Ref_ |
T1-100mg | 2555.57 | 210.77 | 3.71 | 55724.34 | 200.98 |
T2-100mg | 2135.40 | 200.98 | 3.72 | 45774.93 | 165.10 |
RLD-200mg | 1212.51 | -- | 4.23 | 27726.01 | -- |
根据以上结果可知,T1给药50mg与参比制剂多吉美200mg等效,T2给药60mg与参比制剂多吉美200mg等效。而且T1、T2制剂的Cmax、AUC变异性均低于参比制剂。这意味着采用本发明提供的技术方案开发的产品未来临床应用,可用200mg(Bid)替代多吉美甲苯磺酸索拉非尼片及仿制药800mg(Bid),或多纳非尼片400mg(Bid)。
以上实施例的说明只是用于帮助理解本发明的方法及其核心思想。应当指出,对于本技术领域的普通技术人员来说,在不脱离本发明原理的前提下,还可以对本发明进行若干改进和修饰,这些改进和修饰也落入本发明权利要求的保护范围内。
对所公开的实施例的上述说明,使本领域专业技术人员能够实现或使用本发明。对这些实施例的多种修改对本领域的专业技术人员来说将是显而易见的,本文中所定义的一般原理可以在不脱离本发明的精神或范围的情况下,在其它实施例中实现。因此,本发明将不会被限制于本文所示的这些实施例,而是要符合与本文所公开的原理和新颖特点相一致的最宽的范围。
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- 一种低服用剂量索拉非尼或多纳非尼口服制剂,包括:索拉非尼或多纳非尼分子水平的药物组合物、自组装高分子材料和其他药学上可接受的辅料,所述索拉非尼或多纳非尼分子水平药物组合物的状态为分子水平的固体分散剂、固溶体、聚合物纳米粒、自微乳、纳米乳或分子水平混合物;所述自组装高分子材料选自聚维酮+羟丙基纤维素、低粘度聚维酮+高粘度聚维酮、聚维酮+共聚维酮、聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、聚维酮+羟丙基甲基纤维素、聚维酮+醋酸纤维素、聚维酮+交联羧甲基纤维素钠、聚维酮+聚乙二醇、聚维酮+低取代羟丙基纤维素、聚维酮+羟丙甲纤维素邻苯二甲酸酯、聚维酮+甲基丙烯酸-丙烯酸乙酯共聚物、聚维酮+甲基丙烯酸-丙烯酸甲酯共聚物、共聚维酮+羟丙基纤维素、共聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、共聚维酮+羟丙基甲基纤维素、共聚维酮+醋酸纤维素、共聚维酮+交联羧甲基纤维素钠或钙、共聚维酮+聚乙二醇、共聚维酮+低取代羟丙基纤维素、共聚维酮+羟丙甲纤维素邻苯二甲酸酯、共聚维酮+甲基丙烯酸-丙烯酸乙酯共聚物、共聚维酮+甲基丙烯酸-丙烯酸甲酯共聚物、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素醋酸琥珀酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+低取代羟丙基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+交联羧甲基纤维素钠或钙、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+聚乙二醇、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙甲纤维素邻苯二甲酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+甲基丙烯酸-丙烯酸乙酯共聚物、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+甲基丙烯酸-丙烯酸甲酯共聚物。
- 根据权利要求1所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述自组装高分子材料为所述索拉非尼或多纳非尼分子水平的药物组合物的10~50wt%。
- 根据权利要求1所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述羟丙基甲基纤维素为HPMC E5或HPMCK100LV;所述自组装高分子材料为聚维酮、共聚维酮、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物和强疏水性的羟丙基甲基纤维素醋酸琥珀酸酯H型中的一种和HPMC E5的复合自组装高分子材料,复合比例为(1~10):1;所述自组装高分子材料为所述聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物和强疏水性的羟丙基甲基纤维素醋酸琥珀酸酯H型中的一种和HPMCK100LV的复合自组装高分子材料,复合比例为(1~10):1。
- 根据权利要求1或3所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述羟丙基甲基纤维素醋酸琥珀酸酯的乙酰基取代量为6~16%,琥珀酰基取代量为4~16%。
- 根据权利要求1或3所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述聚维酮为平均分子量为34000~1300000或平均分子量34000的聚维酮与1300000聚维酮按1:1~1:0.1比例复合的聚维酮。
- 根据权利要求1所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述索拉非尼或多纳非尼分子水平的药物组合物的单位剂量中含索拉非尼或多纳非尼20~69mg。
- 根据权利要求1所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述索拉非尼或多纳非尼分子水平的药物组合物包括索拉非尼或多纳非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物,和载体;所述载体选自共聚维酮、聚维酮、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、聚维酮+羟丙甲基纤维素、低粘度的聚维酮+高粘度聚维酮、聚维酮+共聚维酮、聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮+羟丙基甲基纤维素醋酸琥珀酸酯、共聚维酮+聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物、共聚维酮+羟丙甲基纤维素、共聚维酮+聚乙二醇、共聚维酮+羟丙基纤维素、共聚维酮+醋酸纤维素;聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙甲基纤维素、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+羟丙基甲基纤维素醋酸琥珀酸酯、聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+聚维酮或聚乙烯己内酰胺-聚醋酸乙烯酯-聚乙二醇接枝共聚物+共聚维酮。
- 根据权利要求7所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述索拉非尼或多纳非尼、或其盐、水合物、溶剂化物、盐的水合物或溶剂化物为所述索拉非尼或多纳非尼分子水平的药物组合物的30~60wt%。
- 根据权利要求1所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述索拉非尼或多纳非尼口服制剂的剂型为片剂、混悬剂、颗粒剂或胶囊剂。
- 根据权利要求9所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述片剂的辅料包括填充剂、崩解剂、助流剂或润滑剂;所述填充剂选自微晶纤维素和硅化微晶纤维素中的一种或两种,所述崩解剂选自交联羧甲基纤维素钠,所述助流剂选自二氧化硅,所述润滑剂选自硬脂酸镁和硬脂富马酸钠中的一种或两种。
- 根据权利要求10所述的索拉非尼或多纳非尼口服制剂,其特征在于,所述填充剂的含量为所述片剂的30~45wt%,所述崩解剂的含量为所述片剂的5~15wt%,所述助流剂的含量为所述片剂的3~5wt%,所述润滑剂的含量为所述片剂的1~5wt%。
- 权利要求1~11任一项所述的索拉非尼或多纳非尼口服制剂在制备用于治疗或减轻肝细胞癌、乳腺癌、原发性恶性肝肿瘤、胆管癌、肾细胞癌、复发性或难治性实体瘤、中枢神经实体瘤、转移性非小细胞肺癌、手术无法切除的肝细胞癌、甲状腺癌、胰腺癌、涎腺腺样囊性癌、未分化甲状腺癌、难治性分化型甲状腺癌、腺样囊性癌、晚期子宫内膜癌、间变性甲状腺癌、直肠癌、结肠癌、不能切除的III期或IV期黑色素瘤、白血病、急性骨髓性白血病、所有实体瘤或各种晚期实体瘤药物中的应用。
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