WO2024092116A1 - Association d'inhibiteurs de tead et d'inhibiteurs d'egfr et utilisations associées - Google Patents

Association d'inhibiteurs de tead et d'inhibiteurs d'egfr et utilisations associées Download PDF

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WO2024092116A1
WO2024092116A1 PCT/US2023/077898 US2023077898W WO2024092116A1 WO 2024092116 A1 WO2024092116 A1 WO 2024092116A1 US 2023077898 W US2023077898 W US 2023077898W WO 2024092116 A1 WO2024092116 A1 WO 2024092116A1
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cancer
ring
inhibitor
tead
aliphatic
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PCT/US2023/077898
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English (en)
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Lan Xu
Mihir RAJURKAR
Daniel Hidalgo
Marta Sanchez-Martin
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Ikena Oncology, Inc.
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Publication of WO2024092116A1 publication Critical patent/WO2024092116A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4164—1,3-Diazoles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents

Definitions

  • the present disclosure relates to TEAD inhibitors, compositions thereof, and use of a TEAD inhibitor in combination with a EGFR inhibitor for delaying and/or preventing cancer resistant to a EGFR inhibitor.
  • Yes-associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) are transcriptional co-activators of the Hippo pathway network and regulate cell proliferation, migration, and apoptosis. Inhibition of the Hippo pathway promotes YAP/TAZ translocation to the nucleus, wherein YAP/TAZ interact with TEAD transcription factors and coactivate the expression of target genes and promote cell proliferation. Hyperactivation of YAP and TAZ and/or mutations in one or more members of the Hippo pathway network have been implicated in numerous cancers.
  • the present disclosure provides a method for delaying and/or preventing development of cancer resistance to an EGFR inhibitor in a patient, comprising administering to the patient a therapeutically effective amount of a TEAD inhibitor, or a pharmaceutical composition thereof, and an EGFR inhibitor.
  • the present disclosure provides a method for preventing and/or inhibiting the development of persister cells (e.g., EGFRi resistant persister cells) in a patient in need of cancer treatment, comprising administering to the patient a therapeutically effective amount of a TEAD inhibitor, or a pharmaceutical composition thereof, and an EGFR inhibitor.
  • persister cells e.g., EGFRi resistant persister cells
  • a TEAD inhibitor is selected from those as described herein.
  • an EGFR inhibitor is selected from those as described herein.
  • a cancer is selected from those as described herein.
  • FIG. 1A demonstrates strong TEAD-reporter activation in response to osimertimib (Osi) in PC9 cells in a concentration dependent manner.
  • FIG. IB demonstrates strong TEAD-reporter activation in response to osimertimib (Osi) in Hl 975 cells in a concentration dependent manner.
  • FIG. 2 A demonstrates cell viability effect in PC9 cells following osimertimib (Osi) treatment.
  • FIG. 2B demonstrates normalized TEAD-reporter expressionin PC9 cells following osimertimib (Osi) treatment.
  • FIG. 3A demonstrates inhibition of EGFRi Osimertinib-induced TEAD-reporter expression by T-A-32 in PC9 cells.
  • FIG. 3B demonstrates inhibition of EGFRi Osimertinib-induced TEAD-reporter expression by T-A-32 in H1975 cells.
  • FIG. 3C demonstrates inhibition of xenograph tumors by T-A-32, osimertinib (Osi), and the combination in PC9 cells.
  • FIG. 3D demonstrates inhibition of xenograph tumors by T-A-32, osimertinib (Osi), and the combination in H1975 cells.
  • FIG. 4A demonstrates concurrent treatment of PC9TL cells with a TEAD inhibitor, T- A-32, and osimertimib (Osi) prevents emergence of osimertimib-refractory persister cells.
  • FIG. 4B demonstrates treatment of PC9TL cells with a TEAD inhibitor, T-A-32, after emergence of Osimertinib attenuates expansion of Osimertinib-refractory persister cells.
  • a combination of a TEAD inhibitor and an EGFR inhibitor demonstrated unexpected effects in preventing and/or inhibiting the development of persister cells (e.g., EGFRi resistant persister cells) in cancer.
  • a TEAD inhibitor is selected from those as described herein.
  • an EGFR inhibitor is selected from those as described herein.
  • a cancer is selected from those as described herein.
  • aliphatic or “aliphatic group”, as used herein, means a straight-chain (z.e., unbranched) or branched, substituted or unsubstituted hydrocarbon chain that is completely saturated or that contains one or more units of unsaturation, or a monocyclic hydrocarbon or bicyclic hydrocarbon that is completely saturated or that contains one or more units of unsaturation, but which is not aromatic (also referred to herein as “carbocycle,” “cycloaliphatic” or “cycloalkyl”), that has a single point of attachment to the rest of the molecule.
  • aliphatic groups contain 1-6 aliphatic carbon atoms.
  • aliphatic groups contain 1-5 aliphatic carbon atoms. In other embodiments, aliphatic groups contain 1-4 aliphatic carbon atoms. In still other embodiments, aliphatic groups contain 1-3 aliphatic carbon atoms, and in yet other embodiments, aliphatic groups contain 1-2 aliphatic carbon atoms.
  • “cycloaliphatic” (or “carbocycle” or “cycloalkyl”) refers to a monocyclic C 3 -C 6 hydrocarbon that is completely saturated or that contains one or more units of unsaturation, but which is not aromatic, that has a single point of attachment to the rest of the molecule.
  • a carbocyclic ring may be a 5-12 membered bicyclic, bridged bicyclic, or spirocyclic ring.
  • Suitable aliphatic groups include, but are not limited to, linear or branched, substituted or unsubstituted alkyl, alkenyl, alkynyl groups and hybrids thereof such as (cycloalkyl)alkyl, (cycloalkenyl)alkyl or (cycloalkyl)alkenyl.
  • bridged bicyclic refers to any bicyclic ring system, i.e. carbocyclic or heterocyclic, saturated or partially unsaturated, having at least one bridge.
  • a “bridge” is an unbranched chain of atoms or an atom or a valence bond connecting two bridgeheads, where a “bridgehead” is any skeletal atom of the ring system which is bonded to three or more skeletal atoms (excluding hydrogen).
  • a bridged bicyclic group has 7-12 ring members and 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • bridged bicyclic groups are well known in the art and include those groups set forth below where each group is attached to the rest of the molecule at any substitutable carbon or nitrogen atom. Unless otherwise specified, a bridged bicyclic group is optionally substituted with one or more substituents as set forth for aliphatic groups. Additionally or alternatively, any substitutable nitrogen of a bridged bicyclic group is optionally substituted. Exemplary bridged bicyclics include:
  • lower alkyl refers to a C 1-4 straight or branched alkyl group.
  • exemplary lower alkyl groups are methyl, ethyl, propyl, isopropyl, butyl, isobutyl, and tert-butyl.
  • lower haloalkyl refers to a C1-4 straight or branched alkyl group that is substituted with one or more halogen atoms.
  • heteroatom means one or more of oxygen, sulfur, nitrogen, phosphorus, or silicon (including, any oxidized form of nitrogen, sulfur, phosphorus, or silicon; the quaternized form of any basic nitrogen or; a substitutable nitrogen of a heterocyclic ring, for example N (as in 3,4-dihydro-277-pyrrolyl), NH (as in pyrrolidinyl) or NR + (as in N-substituted pyrrolidinyl)).
  • bivalent C 1-8 (or C 1-6 ) saturated or unsaturated, straight or branched, hydrocarbon chain refers to bivalent alkylene, alkenylene, and alkynylene chains that are straight or branched as defined herein.
  • alkylene refers to a bivalent alkyl group.
  • An “alkylene chain” is a polymethylene group, z.e., -(CH 2 ) n -, wherein n is a positive integer, preferably from 1 to 6, from 1 to 4, from 1 to 3, from 1 to 2, or from 2 to 3.
  • a substituted alkylene chain is a polymethylene group in which one or more methylene hydrogen atoms are replaced with a substituent. Suitable substituents include those described below for a substituted aliphatic group.
  • alkenylene refers to a bivalent alkenyl group.
  • a substituted alkenylene chain is a polymethylene group containing at least one double bond in which one or more hydrogen atoms are replaced with a substituent. Suitable substituents include those described below for a substituted aliphatic group.
  • cyclopropylenyl refers to a bivalent cyclopropyl group of the following structure:
  • halogen means F, Cl, Br, or I.
  • aryl used alone or as part of a larger moiety as in “aralkyl,” “aralkoxy,” or aryloxyalkyl,” refers to monocyclic or bicyclic ring systems having a total of five to fourteen ring members, wherein at least one ring in the system is aromatic and wherein each ring in the system contains 3 to 7 ring members.
  • aryl may be used interchangeably with the term “aryl ring.”
  • aryl refers to an aromatic ring system which includes, but not limited to, phenyl, biphenyl, naphthyl, anthracyl and the like, which may bear one or more substituents.
  • aryl is a group in which an aromatic ring is fused to one or more non-aromatic rings, such as indanyl, phthalimidyl, naphthimidyl, phenanthridinyl, or tetrahydronaphthyl, and the like.
  • heteroaryl and “heteroar-,” used alone or as part of a larger moiety, e.g., “heteroaralkyl,” or “heteroaralkoxy,” refer to groups having 5 to 10 ring atoms, preferably 5, 6, or 9 ring atoms; having 6, 10, or 14 ⁇ electrons shared in a cyclic array; and having, in addition to carbon atoms, from one to five heteroatoms.
  • heteroatom refers to nitrogen, oxygen, or sulfur, and includes any oxidized form of nitrogen or sulfur, and any quaternized form of a basic nitrogen.
  • Heteroaryl groups include, without limitation, thienyl, furanyl, pyrrolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, oxazolyl, isoxazolyl, oxadiazolyl, thiazolyl, isothiazolyl, thiadiazolyl, pyridyl, pyridazinyl, pyrimidinyl, pyrazinyl, indolizinyl, purinyl, naphthyridinyl, and pteridinyl.
  • heteroaryl and “heteroar-”, as used herein, also include groups in which a heteroaromatic ring is fused to one or more aryl, cycloaliphatic, or heterocyclyl rings, where the radical or point of attachment is on the heteroaromatic ring.
  • Nonlimiting examples include indolyl, isoindolyl, benzothienyl, benzofuranyl, dibenzofuranyl, indazolyl, benzimidazolyl, benzthiazolyl, quinolyl, isoquinolyl, cinnolinyl, phthalazinyl, quinazolinyl, quinoxalinyl, 4H-quinolizinyl, carbazolyl, acridinyl, phenazinyl, phenothiazinyl, phenoxazinyl, tetrahydroquinolinyl, tetrahydroisoquinolinyl, and pyrido[2,3-b]-1,4-oxazin-3(4H)-one.
  • heteroaryl group may be mono- or bicyclic.
  • heteroaryl may be used interchangeably with the terms “heteroaryl ring,” “heteroaryl group,” or “heteroaromatic,” any of which terms include rings that are optionally substituted.
  • heteroarylkyl refers to an alkyl group substituted by a heteroaryl, wherein the alkyl and heteroaryl portions independently are optionally substituted.
  • heterocycle As used herein, the terms “heterocycle,” “heterocyclyl,” “heterocyclic radical,” and “heterocyclic ring” are used interchangeably and refer to a stable 5- to 7-membered monocyclic or 7-10-membered bicyclic heterocyclic moiety that is either saturated or partially unsaturated, and having, in addition to carbon atoms, one or more, preferably one to four, heteroatoms, as defined above.
  • nitrogen includes a substituted nitrogen.
  • the nitrogen in a saturated or partially unsaturated ring having 0-3 heteroatoms selected from oxygen, sulfur or nitrogen, the nitrogen may be N (as in 3,4-dihydro- 2H -pyrrolyI ), NH (as in pyrrolidinyl), or + NR (as in N-substituted pyrrolidinyl).
  • a heterocyclic ring can be attached to its pendant group at any heteroatom or carbon atom that results in a stable structure and any of the ring atoms can be optionally substituted.
  • saturated or partially unsaturated heterocyclic radicals include, without limitation, tetrahydrofuranyl, tetrahydrothiophenyl pyrrolidinyl, piperidinyl, pyrrolinyl, tetrahydroquinolinyl, tetrahydroisoquinolinyl, decahydroquinolinyl, oxazolidinyl, piperazinyl, dioxanyl, dioxolanyl, diazepinyl, oxazepinyl, thiazepinyl, morpholinyl, and quinuclidinyl.
  • heterocycle used interchangeably herein, and also include groups in which a heterocyclyl ring is fused to one or more aryl, hctcroaryl, or cycloaliphatic rings, such as indolinyl, 3H-indolyl, chromanyl, phenanthridinyl, or tetrahydroquinolinyl.
  • a heterocyclic ring may be a 5-12 membered bicyclic, bridged bicyclic, or spirocyclic ring.
  • heterocyclylalkyl refers to an alkyl group substituted by a heterocyclyl, wherein the alkyl and heterocyclyl portions independently are optionally substituted.
  • partially unsaturated refers to a ring moiety that includes at least one double or triple bond.
  • partially unsaturated is intended to encompass rings having multiple sites of unsaturation, but is not intended to include aryl or heteroaryl moieties, as herein defined.
  • compounds of the disclosure may contain “optionally substituted” moieties.
  • substituted whether preceded by the term “optionally” or not, means that one or more hydrogens of the designated moiety are replaced with a suitable substituent.
  • an “optionally substituted” group may have a suitable substituent at each substitutable position of the group, and when more than one position in any given structure may be substituted with more than one substituent selected from a specified group, the substituent may be either the same or different at every position.
  • Combinations of substituents envisioned by this disclosure are preferably those that result in the formation of stable or chemically feasible compounds.
  • stable refers to compounds that are not substantially altered when subjected to conditions to allow for their production, detection, and, in certain embodiments, their recovery, purification, and use for one or more of the purposes disclosed herein.
  • Suitable monovalent substituents on a substitutable carbon atom of an “optionally substituted” group are independently halogen; -(—CH) 0-4 R°; -(—CH) 0-4 OR°; -O(CH 2 ) 0-4 R°, -O-
  • R° may be substituted as defined below and is independently hydrogen, C 1-6 aliphatic, -CH 2 Ph, -O(CH 2 ) 0 - 1 Ph, -CH 2 -(5-6 membered heteroaryl ring), or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or, notwithstanding the definition above, two independent occurrences of R°, taken together with their intervening atom(s), form a 3-12-membered saturated, partially unsaturated, or aryl mono- or bicyclic ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, which may be substituted as defined below.
  • Suitable monovalent substituents on R° are independently halogen, -(CH 2 ) 0-2 R • , -(haloR • ), -(CH 2 ) 0-2 OH, -(CH 2 ) 0-2 OR • , -(CH 2 ) 0-2 CH(OR • ) 2 ; -O(haloR • ), -CN, -N 3 , -(CH 2 ) 0 - 2 C(O)R • , -(CH 2 ) 0-2 C(O)OH, -(CH 2 ) 0-2 C(O)OR • , -(CH 2 ) 0-2 SR • , -(CH 2 ) 0-2 SH, -(CH 2 ) 0-2 NH 2 , - (CH 2 ) 0-2 NHR • , -(CH 2
  • Suitable divalent substituents that are bound to vicinal substitutable carbons of an “optionally substituted” group include: -O(CR* 2 ) 2 3O-, wherein each independent occurrence of R* is selected from hydrogen, C 1-6 aliphatic which may be substituted as defined below, or an unsubstituted 5 6 membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Suitable substituents on the aliphatic group of R* include halogen, -R • , -(haloR • ), -OH, -OR • , -O(haloR'), -CN, -C(O)OH, -C(O)OR • , -NH 2 , -NHR • , -NR • 2 , or -NO 2 , wherein each R • is unsubstituted or where preceded by “halo” is substituted only with one or more halogens, and is independently C1-4 aliphatic, -CH 2 Ph, -O(CH 2 ) 0-1 Ph, or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Suitable substituents on a substitutable nitrogen of an “optionally substituted” group include -R ⁇ -NR ⁇ 2 , -C(O)R ⁇ , -C(O)OR ⁇ , -C(O)C(O)R ⁇ , C(O)CH 2 C(O)R ⁇ , -S(O) 2 R ⁇ , -S(O) 2 NR ⁇ 2 , -C(S)NR ⁇ 2 , -C(NH)NR ⁇ 2 , or -N(R ⁇ )S(O) 2 R ⁇ ; wherein each R 1 ' is independently hydrogen, C 1-6 aliphatic which may be substituted as defined below, unsubstituted -Oph, or an unsubstituted 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or, notwithstanding the definition above, two independent
  • Suitable substituents on the aliphatic group of R' are independently halogen, - R • , -(haloR • ), -OH, -OR • , -O(haloR • ), -CN, -C(O)OH, -C(O)OR • , -NH 2 , -NHR • , -NR • 2 , or -NO 2 , wherein each R • is unsubstituted or where preceded by “halo” is substituted only with one or more halogens, and is independently C 1-4 .
  • the term “pharmaceutically acceptable salt” refers to those salts which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio.
  • Pharmaceutically acceptable salts are well known in the art. For example, S. M. Berge et al.et al.et al., describe pharmaceutically acceptable salts in detail in J. Pharmaceutical Sciences, 1977, 66, 1-19, incorporated herein by reference.
  • Pharmaceutically acceptable salts of the compounds of this disclosure include those derived from suitable inorganic and organic acids and bases.
  • Examples of pharmaceutically acceptable, nontoxic acid addition salts are salts of an amino group formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid or with organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid
  • organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • salts include adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptonate, glycerophosphate, gluconate, hemisulfate, heptanoate, hexanoate, hydroiodide, 2- hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate, pamoate, pectinate
  • Salts derived from appropriate bases include alkali metal, alkaline earth metal, ammonium, and N + (C 1-4 alkyl) 4 salts.
  • Representative alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like.
  • Further pharmaceutically acceptable salts include, when appropriate, nontoxic ammonium, quaternary ammonium, and amine cations formed using counterions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, loweralkyl sulfonate and aryl sulfonate.
  • structures depicted herein are also meant to include all isomeric (e.g., enantiomeric, diastereomeric, and geometric (or conformational)) forms of the structure; for example, the R and S configurations for each asymmetric center, Z and E double bond isomers, and Z and E conformational isomers. Therefore, single stereochemical isomers as well as enantiomeric, diastereomeric, and geometric (or conformational) mixtures of the present compounds are within the scope of the disclosure. Unless otherwise stated, all tautomeric forms of the compounds of the disclosure are within the scope of the disclosure.
  • structures depicted herein are also meant to include compounds that differ only in the presence of one or more isotopically enriched atoms.
  • compounds having the present structures including the replacement of hydrogen by deuterium or tritium, or the replacement of a carbon by a 13 C- or 14 C-cnrichcd carbon arc within the scope of this disclosure.
  • Such compounds are useful, for example, as analytical tools, as probes in biological assays, or as therapeutic agents in accordance with the present disclosure.
  • the term “provided compound” refers to any TEAD inhibitor genus, subgenus, and/or species set forth herein.
  • TEAD inhibitor or “TEAD antagonist” are defined as a compound that binds to and/or inhibits TEAD with measurable affinity. In some embodiments, inhibition in the presence of a TEAD inhibitor or a TEAD antagonist is observed in a dose-dependent manner.
  • the measured signal (e.g., signaling activity or biological activity) is at least about 5%, at least about 10%, at least about 15%, at least about 20%, at least about 25%, at least about 30%, at least about 35%, at least about 40%, at least about 45%, at least about 50%, at least about 55%, at least about 60%, at least about 65%, at least about 70%, at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%, or at least about 100% lower than the signal measured with a negative control under comparable conditions.
  • an inhibitor has an IC 50 and/or binding constant of less than about 100 ⁇ M, less than about 50 ⁇ M, less than about 1 ⁇ M, less than about 500 nM, less than about 100 nM, less than about 10 nM, or less than about 1 nM.
  • TEAD degrader is defied as a compound that comprises a target protein ligand, i.e., TEAD, covantly bound via a linker to an E3 ligase ligand.
  • TEAD degrader functions by initiating formation of a ternary complex between the target protein, degrader, and E3 ligase, resulting in polyubiquitination of the target protein and subsequent degradation by the 26S proteasome.
  • measurable affinity and “measurably inhibit,” as used herein, means a measurable change or inhibition in TEAD activity between a sample comprising a compound of the present disclosure, or composition thereof, and TEAD, and an equivalent sample comprising TEAD, in the absence of said compound, or composition thereof.
  • the terms “persister cell” or “persister cancer cell” are defined as a small subpopulation of cancer cells that maintain viability under anti-cancer targeted therapy treatments, in particular, as used herein, a treatment with an EGFR inhibitor. More particularly, it refers to cancer cells that have a tolerance or resistance to even high concentrations of a treatment of an EGFR inhibitor.
  • the resistance displayed by a cell may be acquired, for example by prior exposure to an agent, (i.e., an EGFR inhibitor), or may be inherent or innate.
  • Common phenotypic features of persister cancer cells include, for example, slow cell-cycling and proliferative capacity, and reversible biological capacity.
  • a persister cell or persister cancer cell is a EGFRi resistant persister cell.
  • an “EGFR inhibitor” refers to any inhibitor or blocker or antagonist that binds to and/or inhibits epidermal growth factor receptor (EGFR).
  • an EGFR inhibitor is selected from those as described in Ayati et al., “A review on progression of epidemial growth factor receptor (EGFR) inhibitors as an efficient approach in cancer targeted therapy,” Bioorganic Chemistry 2020, 99: 103811, the contents of which are incorporated herein by reference in their entirety.
  • an EGFR inhibitor is selected from cetuximab, necitumumab, panitumumab, zalutumumab, nimotuzumab, and matuzumab.
  • an EGFR inhibitor is cetuximab. In some embodiments, an EGFR inhibitor is necitumumab. In some embodiments, an EGFR inhibitor is panitumumab. In some embodiments, an EGFR inhibitor is zalutumumab. In some embodiments, an EGFR inhibitor is nimotuzumab. In some embodiments, an EGFR inhibitor is matuzumab.
  • an EGFR inhibitor is selected from osimertinib, gefitinib, erlotinib, lapatinib, neratinib, vandetanib, afatinib, brigatinib, dacomitinib, and icotinib.
  • an EGFR inhibitor is osimertinib.
  • an EGFR inhibitor is gefitinib.
  • an EGFR inhibitor is erlotinib.
  • an EGFR inhibitor is lapatinib.
  • an EGFR inhibitor is neratinib.
  • an EGFR inhibitor is vandetanib. In some embodiments, an EGFR inhibitor is afatinib. In some embodiments, an EGFR inhibitor is brigatinib. In some embodiments, an EGFR inhibitor is dacomitinib. In some embodiments, an EGFR inhibitor is icotinib.
  • an EGFR inhibitor is a “1st generation EGFR tyrosine kinase inhibitor” (“1st generation TKI”).
  • a 1 st generation TKI refers to reversible EGFR inhibitors, such as gefitinib and erlotinib, which are effective in first-line treatment of, for example, NSCLC harboring EGFR activating mutations, such as deletions in exon 19 and exon 21 L858R mutation.
  • an EGFR inhibitor is a “2nd generation EGFR tyrosine kinase inhibitor” (“2nd generation TKI”).
  • a 2 nd generation TKI refers to covalent irreversible EGFR inhibitors, such as afatinib and dacomitib, which are effective in first-line treatment of NSCLC harboring EGFR activating mutations, such as deletions in exon 19 and exon 21 L858R mutation.
  • an EGFR inhibitor is a “3rd generation EGFR tyrosine kinase inhibitor” (“3rd generation TKI”).
  • a 3rd generation TKI refers to covalent irreversible EGFR inhibitors, such as osimertinib and lazertinib, which are selective to the EGFR activating mutations, such as deletions in exon 19 and exon 21 L858R, alone or in combination with T790M mutation, and have lower inhibitory activity against wild-type EGFR.
  • the terms “about” or “approximately” have the meaning of within 20% of a given value or range. In some embodiments, the term “about” refers to within 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, or 1% of a given value.
  • the present disclosure provides a method for treating cancer in a patient comprising administering to the patient a therapeutically effective amount of a TEAD inhibitor and an EGFR inhibitor.
  • the present disclosure provides a use of a TEAD inhibitor for the treatment of cancer in combination with an EGFR inhibitor. In some embodiments, the present disclosure provides a use of a TEAD inhibitor in the manufacture of a medicament for the treatment of cancer, wherein the medicament is for use in combination with an EGFR inhibitor. In some embodiments, the present disclosure provides a use of a TEAD inhibitor in the manufacture of a medicament for the treatment of cancer, wherein the medicament is for use in combination with an EGFR inhibitor. In some embodiments, a medicament comprises a TEAD inhibitor, or a pharmaceutical composition thereof. In some embodiments, a pharmaceutical composition comprising a TEAD inhibitor is as described herein.
  • the present disclosure provides a method for delaying and/or preventing development of cancer resistance to an EGFR inhibitor in a patient, comprising administering to the patient a therapeutically effective amount of a TEAD inhibitor, or a pharmaceutical composition thereof, and an EGFR inhibitor.
  • the present disclosure provides a method for preventing and/or inhibiting the development of persister cells in a patient in need of cancer treatment, comprising administering to the patient a therapeutically effective amount of a TEAD inhibitor, or a pharmaceutical composition thereof, and an EGFR inhibitor.
  • a cancer is selected from those as described herein.
  • a cancer is an EGFR mutant resistant cancer.
  • a cancer is a lung cancer.
  • a cancer is an EGFR mutant resistant lung cancer.
  • a cancer is a non-small cell lung cancer (NSCLC).
  • NSCLC non-small cell lung cancer
  • a cancer is an EGFR mutant resistant NSCLC.
  • a TEAD inhibitor is a compound capable of binding to one or more of TEAD1, TEAD2, TEAD3, or TEAD4.
  • a TEAD inhibitor is a compound capable of binding to TE ADl. In some embodiments, a TEAD inhibitor is a compound capable of binding to TEAD2. In some embodiments, a TEAD inhibitor is a compound capable of binding to TEAD3. In some embodiments, a TE AD inhibitor is a compound capable of binding to TEAD4. [0065] In some embodiments, a TEAD inhibitor is a compound as described in Pobbati et al., “Targeting the Central Pocket in Human Transcription Factor TEAD as a Potential Cancer Therapeutic Strategy,” Structure 2015, 23, 2076-2086; Gibault et al., “Targeting Transcriptional Enhanced Associate Domains (TEADs),” J. Med. Chem.
  • the TEAD inhibitor is selected from those described in WO 2020/243415, the contents of which are herein incorporated by reference in their entirety. In certain embodiments, the TEAD inhibitor is selected from those described in WO 2020/243423, the contents of which are herein incorporated by reference in their entirety. In certain embodiments, the TEAD inhibitor is selected from those described in U.S. Patent No. 11 ,274,082, the contents of which arc herein incorporated by reference in their entirety. In certain embodiments, the TEAD inhibitor is selected from those described in WO 2022/120353, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is selected from those described in WO 2022/120354, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is a TEAD degrader.
  • the TEAD degrader is selected from those described in WO 2022/120355, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is selected from those described in WO 2022/159986, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is selected from those described in WO 2023/060227, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is from those described in WO 2023/114984, the contents of which are herein incorporated by reference in their entirety.
  • a TEAD inhibitor is selected from the compounds as described herein. In some embodiments, a TEAD inhibitor is administered at about 1 mg/kg to about 100 mg/kg of subject body weight per day, one or more times a day. In some embodiments, a TEAD inhibitor is administered at about 1 mg/kg to about 10 mg/kg, or about 10 mg/kg to about 25 mg/kg, or about 25 mg/kg to about 50 mg/kg, or about 50 mg/kg to about 75 mg/kg, or about 75 mg/kg to about 100 mg/kg of subject body weight per day, one or more times a day.
  • a TEAD inhibitor is administered at about 2.5 mg/kg to about 90 mg/kg, or about 5 mg/kg to about 80 mg/kg, or about 7.5 mg/kg to about 70 mg/kg, or about 10 mg/kg to about 50 mg/kg, or about 12.5 mg/kg to about 40 mg/kg, or about 15 mg/kg to about 30 mg/kg of subject body weight per day, one or more times a day.
  • a TEAD inhibitor is administered at about 2.5 mg/kg, about 5 mg/kg, about 7.5 mg/kg, about 10 mg/kg, about 15 mg/kg, about 20 mg/kg, about 25 mg/kg, about 30 mg/kg, about 35 mg/kg, about 40 mg/kg, about 50 mg/kg, about 60 mg/kg, about 70 mg/kg, about 75 mg/kg, about 80 mg/kg, or about 85 mg/kg of subject body weight per day, one or more times a day.
  • an EGFR inhibitor is selected from cetuximab, necitumumab, panitumumab, zalutumumab, nimotuzumab, and matuzumab.
  • an EGFR inhibitor is cetuximab.
  • an EGFR inhibitor is necitumumab.
  • an EGFR inhibitor is panitumumab.
  • an EGFR inhibitor is zalutumumab.
  • an EGFR inhibitor is nimotuzumab.
  • an EGFR inhibitor is matuzumab.
  • an EGFR inhibitor is selected from osimertinib, gefitinib, erlotinib, lapatinib, neratinib, vandetanib, afatinib, brigatinib, dacomitinib, and icotinib.
  • an EGFR inhibitor is osimertinib.
  • an EGFR inhibitor is gefitinib.
  • an EGFR inhibitor is erlotinib.
  • an EGFR inhibitor is lapatinib.
  • an EGFR inhibitor is neratinib.
  • an EGFR inhibitor is vandetanib. In some embodiments, an EGFR inhibitor is afatinib. In some embodiments, an EGFR inhibitor is brigatinib. In some embodiments, an EGFR inhibitor is dacomitinib. In some embodiments, an EGFR inhibitor is icotinib.
  • an EGFR inhibitor is a “1st generation EGFR tyrosine kinase inhibitor” (1st generation TKI).
  • a 1 st generation TKI refers to reversible EGFR inhibitors, such as gefitinib and erlotinib, which are effective in first-line treatment of NSCLC harboring EGFR activating mutations such as deletions in exon 19 and exon 21 L858R mutation.
  • an EGFR inhibitor is a “2nd generation EGFR tyrosine kinase inhibitor” (2nd generation TKI).
  • a 2 nd generation TKI refers to covalent irreversible EGFR inhibitors, such as afatinib and dacomitib, which are effective in first-line treatment of NSCLC harboring EGFR activating mutations such as deletions in exon 19 and exon 21 L858R mutation.
  • an EGFR inhibitor is a “3rd generation EGFR tyrosine kinase inhibitor” (3rd generation TKI).
  • a 3rd generation TKI refers to covalent irreversible EGFR inhibitors, such as osimertinib and lazertinib, which are selective to the EGFR activating mutations, such as deletions in exon 19 and exon 21 L858R, alone or in combination with T790M mutation, and have lower inhibitory activity against wild-type EGFR.
  • a TEAD inhibitor is selected from those as described in WO 2017/053706, WO 2017/111076, WO 2018/204532, WO 2018/235926, US 20190010136, WO 2019/040380, WO 2019/113236, WO 2019/222431, WO 2019/232216, WO 2020/051099, WO 2020/081572, WO 2020/097389, WO 2020/190774, or WO 2020/214734, the contents of each of which are herein incorporated by reference in their entireties.
  • the TEAD inhibitor is selected from those described in WO 2020/243415, the contents of which arc herein incorporated by reference in their entirety.
  • the TEAD inhibitor is selected from those described in WO 2020/243423, the contents of which are herein incorporated by reference in their entirety. In certain embodiments, the TEAD inhibitor is selected from those described in U.S. Patent 11,274,082, the contents of which are herein incorporated by reference in their entirety. In certain embodiments, the TEAD inhibitor is selected from those described in WO 2022/120353, the contents of which are herein incorporated by reference in their entirety. In certain embodiments, the TEAD inhibitor is selected from those described in WO 2022/120354, the contents of which are herein incorporated by reference in their entirety. In certain embodiments, the TEAD inhibitor is a TEAD degrader.
  • the TEAD degrader is selected from those described in WO 2022/120355, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is selected from those described in WO 2022/159986, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is selected from those described in WO 2023/060227, the contents of which are herein incorporated by reference in their entirety.
  • the TEAD inhibitor is from those described in WO 2023/114984, the contents of which are herein incorporated by reference in their entirety.
  • a TEAD inhibitor is a compound of Formula A or a pharmaceutically acceptable salt thereof, wherein
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with -O-, -CH(OR)-, -CH(SR)-, - CH(N(R) 2 )-, -C(O)-, -C(O)O-, -OC(O)-, -N(R)-, -C(O)N(R)-, -(R)NC(O)-, -OC(O)N(R)-, - (R)NC(O)O-, -N(R)C(O)N(R)-, -S-, -SO-, -SO 2 -, -SO 2 N(R)-, -(R)NSO 2 -, -C(S)-, -C(S)O-, - OC(S)-, -C(S)N(R)-, -(R)NC(S)-, or
  • Ring A is an optionally substituted ring selected from phenyl, a 4-, 5-, or 6-membered saturated or partially unsaturated monocyclic carbocyclic ring, a 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1 -2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 8- 10 membered bicyclic aromatic ring, or a 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur;
  • Ring B is an optionally substituted ring selected from phenyl, a 4-, 5-, or 6-membered saturated or partially unsaturated monocyclic carbocyclic ring, a 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 8- 10 membered bicyclic aromatic ring, a 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur;
  • R w is an optionally substituted 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur; and each R is independently -H or optionally substituted -C 1-6 aliphatic.
  • a TEAD inhibitor is a compound of Formula A-1: or a pharmaceutically acceptable salt thereof, wherein
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with -O-, -CH(OR)-, -CH(SR)-, - CH(N(R) 2 )-, -C(O)-, -C(O)O-, -OC(O)-, -N(R)-, -C(O)N(R)-, -(R)NC(O)-, -OC(O)N(R)-, - (R)NC(O)O-, -N(R)C(O)N(R)-, -S-, -SO-, -SO 2 -, -SO 2 N(R)-, -(R)NSO 2 -, -C(S)-, -C(S)O-, - OC(S)-, -C(S)N(R)-, -(R)NC(S)-, or
  • Ring A is a 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, a 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a 5-6 membered monocyclic hctcroaromatic ring having 1, 2, 3, or 4 hctcroatoms independently selected from nitrogen, oxygen, or sulfur, wherein Ring A is optionally substituted 1-2 times by -halogen, -CN, -NO 2 , or -C 1-6 aliphatic substituted 0-6 times by - halogen, -CN, or -NO 2 ;
  • R 2 is -H, or an optionally substituted 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur;
  • R 3 is -H
  • R 4 is -H, halogen, -S(O) 2 N(R) 2 , -S(O)N(R) 2 , or -C(O)N(R) 2 ;
  • R 6 is -H or -C 1-6 aliphatic substituted 0-6 times by -halogen, -CN, or -NO 2 ; and each R is independently -H or optionally substituted -C 1-6 aliphatic.
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with - O-, -CH(OR)-, -CH(SR)-, -CH(N(R) 2 )-, -C(O)-, -C(O)O-, -OC(O)-, -N(R)-, -C(O)N(R)-, - (R)NC(O)-, -OC(O)N(R)-, -(R)NC(O)O-, -N(R)C(O)N(R)-, -S-, -SO-, -SO 2 -, -SO 2 N(R)-, - (R)NSO 2 -, -C(S)-, -C(S)O-, -OC(S)-, -C(S)N(R)-, -(R)
  • L 1 is a covalent bond, or a C 1-6 bivalent straight or branched hydrocarbon chain wherein 1 , 2, or 3 methylene units of the chain are independently and optionally replaced with -O-, -CH(OR)-, -CH(SR)-, -CH(N(R) 2 )-, -C(O)-, -C(O)O-, -OC(O)-, -N(R)-, - C(O)N(R)-, -(R)NC(O)-, -OC(O)N(R)-, -(R)NC(O)O-, -N(R)C(O)N(R)-, --sS-, -SO-, -SO 2 -, - SO 2 N(R)-, -(R)NSO 2 -, -C(S)-, -C(S)O-, -OC(S)-, -C(S)
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with - O-, -CH(OR)-, -CH(N(R) 2 )-, -C(O)-, -C(O)O-, -OC(O)-, -N(R)-, -C(O)N(R)-, -(R)NC(O)-, - OC(O)N(R)-, -(R)NC(O)O-, or -N(R)C(O)N(R)-.
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are optionally replaced with -CH(SR)-, -S-, -SO-, -SO 2 -, -SO 2 N(R)-, -(R)NSO 2 -, -C(S)-, -C(S)O-, -OC(S)-, -C(S)N(R)-, -(R)NC(S) or (R)NC(S)N(R)-.
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with - O-, -S-, or -N(R)-.
  • L i 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with - CH(OR)-, -CH(SR)-, or -CH(N(R) 2 )-.
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with - C(O)-, -C(O)O-, -OC(O)-, -SO-, -SO 2 -, -C(S)-, -C(S)O-, or -OC(S)-.
  • L 1 is C 1-6 bivalent straight or branched hydrocarbon chain wherein 1, 2, or 3 methylene units of the chain are independently and optionally replaced with - C(O)N(R)-, -(R)NC(O)-, -OC(O)N(R)-, -(R)NC(O)O-, -N(R)C(O)N(R)-, -SO 2 N(R)-, -(R)NSO 2 -, -C(S)N(R)-, -(R)NC(S)-, or -(R)NC(S)N(R)-.
  • L 1 is -O-, -CH(OR)-, -CH(SR)-, -CH(N(R) 2 )-, -C(O)-, -C(O)O- , -OC(O)-, -N(R)-, -C(O)N(R)-, -(R)NC(O)-, -OC(O)N(R)-, -(R)NC(O)O-, -N(R)C(O)N(R)-, -S-, -SO-, -SO 2 -, -SO 2 N(R)-, -(R)NSO 2 -, -C(S)-, -C(S)O-, -OC(S)-, -C(S)N(R)-, -(R)NC(S) or (R)NC(S)N(R)-.
  • L 1 is -O-, -CH(OR)-, -CH(N(R) 2 )-, -C(O)-, -C(O)O-, -OC(O) -N(R)-, -C(O)N(R)-, -(R)NC(O)-, -OC(O)N(R)-, -(R)NC(O)O-, or -N(R)C(O)N(R)-.
  • L 1 is -CH(SR)-, -S-, -SO-, -SO 2 -, -SO 2 N(R)-, -(R)NSO 2 -, -C(S)- , -C(S)O-, -OC(S)-, -C(S)N(R)-, -(R)NC(S)-, or -(R)NC(S)N(R)-.
  • L 1 is -O-, -S-, or -N(R)-. In some embodiments, L 1 is -O-. In some embodiments, L 1 is -S-. In some embodiments, L 1 is -N(R)-. In some embodiments, L 1 is - NH-.
  • L 1 is -CH(OR)-, -CH(SR)-, or -CH(N(R) 2 )-. In some embodiments, L 1 is -CH(OR)-. In some embodiments, L 1 is -CH(SR)-. In some embodiments, L 1 is -CH(N(R) 2 )-.
  • L 1 is -C(O)-, -C(O)O-, -OC(O)-, -SO-, -SO 2 -, -C(S)-, -C(S)O-, or -OC(S)-.
  • L 1 is -C(O)-.
  • L 1 is -C(O)O-.
  • L 1 is -OC(O)-.
  • L 1 is -SO-.
  • L 1 is -SO 2 - .
  • L 1 is -C(S)-.
  • L 1 is -C(S)O-.
  • L 1 is -OC(S)-.
  • L 1 is -C(O)N(R)-, -(R)NC(O)-, -OC(O)N(R)-, -(R)NC(O)O-, - N(R)C(O)N(R)-, -SO 2 N(R)-, -(R)NSO 2 -, -C(S)N(R)-, -(R)NC(S)-, or -(R)NC(S)N(R)-.
  • L 1 is -C(O)N(R)-.
  • L 1 is -(R)NC(O)-.
  • L 1 is -OC(O)N(R)-. In some embodiments, L 1 is -(R)NC(O)O-. In some embodiments, L 1 is - N(R)C(O)N(R)-. In some embodiments, L 1 is -SO 2 N(R)-. Tn some embodiments, L 1 is -(R)NSO 2 - . In some embodiments, L 1 is -C(S)N(R)-. In some embodiments, L 1 is -(R)NC(S)-. or In some embodiments, L 1 is -(R)NC(S)N(R)-.
  • L 1 is -CH 2 -, -CH(CH 3 )-, -NH-CH 2 -, -NH-CH(CH 3 )-, -C(O)- NH-, or -N(CH 3 )-. In some embodiments, wherein L 1 is NH-CH 2 -.
  • L 1 is ,
  • L 1 is selected from those depicted in Table A, below.
  • Ring A is a 4 5-, or 6- membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, a 4- 5-, or 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a 5-6 membered monocyclic heteroaromatic ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, wherein Ring A is optionally substituted 1-2 times by halogen, -CN, -NO 2 , or -C 1-6 aliphatic substituted 0-6 times by halogen, -CN, or -NO 2 .
  • Ring A is an optionally substituted ring selected from phenyl, a 4-, 5-, or 6-membered saturated or partially unsaturated monocyclic carbocyclic ring, a 4-, 5 or
  • 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1 , 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 8-10 membered bicyclic aromatic ring, or a 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Ring A is optionally substituted phenyl. In some embodiments, Ring A is optionally substituted 4-, 5-, or 6-membered saturated or partially unsaturated monocyclic carbocyclic ring. In some embodiments, Ring A is phenyl, optionally substituted 1-2 times by — C 1-6 aliphatic substituted 0-6 times by halogen. In some embodiments, Ring A is optionally substituted 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Ring A is optionally substituted 5-6 membered monocyclic hetero aromatic ring having 1, 2, 3, or 4 hctcroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, Ring A is optionally substituted 8-10 membered bicyclic aromatic ring. In some embodiments, Ring A is optionally substituted 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Ring A is optionally substituted phenyl, a 6-membered monocyclic heteroaromatic ring having 1 or 2 nitrogen, or a 10-membered bicyclic hetero aromatic ring having 1-2 nitrogen.
  • Ring A is optionally substituted
  • Ring A is optionally substituted 1-2 times by -halogen, -CN, - NO 2 , -C 1-6 aliphatic, or -O-C 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -O-C 1-6 aliphatic is independently substituted 0-6 times by -halogen, -CN, or -NO 2 .
  • Ring A is optionally substituted 1-2 times by halogen, -CN, -NO 2 , -C 1-6 aliphatic, or -O-C 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -O-C 1-6 aliphatic is independently substituted 0, 1, 2, 3, 4, 5, or 6 times by halogen, -CN, or -NO 2 .
  • Ring A is optionally substituted 1-2 times by halogen, -C 1-6 aliphatic, or -O-C 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -O-C 1-6 aliphatic is independently substituted 1, 2, 3, 4, 5, or 6 times by halogen.
  • Ring A is a 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic carbocyclic ring. In some embodiments, Ring A is cyclohexyl. In some embodiments, Ring A is phenyl. In some embodiments, Ring A is a 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, Ring A is a 5-6 membered monocyclic heteroaromatic ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Ring A is a 8-10 membered bicyclic aromatic ring. In some embodiments, Ring A is a 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Ring A is optionally substituted 1-2 times by halogen, -CN, - NO 2 , or -C 1-6 aliphatic substituted 0, 1 , 2, 3, 4, 5, or 6 times by halogen, -CN, or -NO 2 .
  • Ring A is optionally substituted 1-2 times by halogen, or -C 1-6 aliphatic substituted 0, 1, 2, 3, 4, 5, or 6 times by halogen.
  • Ring A is selected from wherein each of R 1 and R 7 is independently as described herein.
  • Ring A is selected from [00105]
  • R 1 is -H, -halogen, -CN, -N0 2 , -C 1-6 aliphatic, or -O-C 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -O-C 1-6 aliphatic is substituted 0, 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 1 is unsubstituted -O-C 1-6 aliphatic.
  • R 1 is -OCH 3 .
  • R 1 is -O-C 1-6 aliphatic substituted 1, 2,
  • R 1 is -O-C 1-3 aliphatic substituted 1, 2, 3,
  • R 1 is -O-C 1-6 aliphatic substituted 1, 2, 3, 4,
  • R 1 is -OCF 3 . In some embodiments, R 1
  • R 1 is -H, -halogen, -CN, -NO 2 , or -C 1-6 aliphatic substituted 0,
  • R 1 is -H. In some embodiments, R 1 is -halogen. In some embodiments, R 1 is -F. In some embodiments, R 1 is -Cl. In some embodiments, R 1 is -Br. In some embodiments, R 1 is -CN. In some embodiments, R 1 is -NO 2 . In some embodiments, R 1 is unsubstituted -C 1-6 aliphatic. In some embodiments, R 1 is - CH 3 . In some embodiments, R 1 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -halogen.
  • R 1 is -C 1-3 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -halogen. In some embodiments, R 1 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F. In some embodiments, R 1 is -C 1-3 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F. In some embodiments, R 1 is -CF 3 . In some embodiments, R 1 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -CN. In some embodiments, R 1 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -NO 2 .
  • R 7 is -H, -halogen, -CN, -NO 2 , -C 1-6 aliphatic, or -O-C 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -O-C 1-6 aliphatic is substituted 0, 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 7 is unsubstituted -O-C 1-6 aliphatic.
  • R 7 is -OCH 3 .
  • R 7 is -O-C 1-6 aliphatic substituted 1, 2,
  • R 7 is -O-C 1-3 aliphatic substituted 1, 2, 3,
  • R 7 is -O-C 1-6 aliphatic substituted 1, 2, 3, 4,
  • R 7 is -OCF 3 . In some embodiments, R 7 is .
  • R 7 is -H, -halogen, -CN, -NO 2 , or -C 1-6 aliphatic substituted 0,
  • R 7 is -H. In some embodiments, R 7 is -halogen. In some embodiments, R 7 is -F. In some embodiments, R 7 is -Cl. In some embodiments, R 7 is -Br. In some embodiments, R 7 is -CN. In some embodiments, R 7 is -NO 2 . In some embodiments, R 7 is unsubstituted -C 1-6 aliphatic. In some embodiments, R 1 is - CH 3 . In some embodiments, R 7 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -halogen.
  • R 7 is -C 1-3 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -halogen. In some embodiments, R 7 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F. In some embodiments, R 7 is -C 1-3 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F. In some embodiments, R 7 is -CF 3 . In some embodiments, R 7 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -CN. In some embodiments, R 7 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -NO 2 .
  • Ring A is
  • Ring A is , or F
  • Ring A is selected from those depicted in Table A, below.
  • Ring B is an optionally substituted ring selected from phenyl, a 4-, 5 or 6-membered saturated or partially unsaturated monocyclic carbocyclic ring, a
  • Ring B is optionally substituted phenyl. In some embodiments, Ring B is optionally substituted 4-, 5-, or 6-membered saturated or partially unsaturated monocyclic carbocyclic ring.
  • Ring B is optionally substituted 4-, 5-, or 6- membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, Ring B is optionally substituted 5-6 membered monocyclic hetero aromatic ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, Ring B is optionally substituted 8-10 membered bicyclic aromatic ring. In some embodiments, Ring B is optionally substituted 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Ring B is optionally substituted phenyl or a 6-membered monocyclic heteroaromatic ring having 1 or 2 nitrogen.
  • Ring B is optionally substituted
  • Ring B is optionally substituted 1-4 times by halogen, - S(O) 2 N(R) 2 , -S(O)N(R) 2 , -C(O)N(R) 2 , -C(O)OR, -C 1-6 aliphatic, or -O-C 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -O-C 1-6 aliphatic is independently substituted 0-6 times by halogen, - CN, or -NO 2 .
  • Ring B is optionally substituted 1-4 times by -F, -Cl, -Br-, - S(O) 2 NHCH 3 , -S(O)NHCH 3 , -C(O)N(CH 3 ) 2 , -C(O)NHCH 3 , -C(O)OH, -C(O)OCH 3 , -CH 3 , - OCH 3 , or -C(CH 3 ) 3 .
  • Ring B is
  • Ring B is selected from those depicted in Table A, below.
  • R 2 is -H, or an optionally substituted 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. [00121] In some embodiments, R 2 is -H.
  • R 2 is an optionally substituted 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R 2 is a 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, optionally substituted 1-3 times by -C 1-6 alkyl. [00123] In some embodiments, R 2 is , wherein R is as described herein. In some embodiments, R 2 is , wherein R is as described herein.
  • R 2 is . In some embodiments, R 2 is
  • R 2 is an optionally substituted 5-membered ring having 1, 2, 3, NH or 4 nitrogen. In some embodiments, R 2 is selected from , and In some embodiments, R 2 is
  • R 2 is ,
  • R 2 is selected from those depicted in Table A, below.
  • R 3 is -H.
  • R 3 is . In some embodiments, R 3 is or
  • R 3 is selected from those depicted in Table A, below.
  • R 4 is -H, halogen, -S(O) 2 N(R) 2 , -S(O)N(R) 2 , or - C(O)N(R) 2 .
  • R 4 is -H, halogen, -S(O) 2 N(R) 2 , -S(O)N(R) 2 , -C(O)N(R) 2 , or -
  • R 4 is -H.
  • R 4 is halogen. In some embodiments, R 4 is -F. In some embodiments, R 4 is -Cl. In some embodiments, R 4 is -Br.
  • R 4 is -S(O) 2 N(R) 2 , -S(O)N(R) 2 , or -C(O)N(R) 2 . In some embodiments, R 4 is -S(O) 2 N(R) 2 . In some embodiments, R 4 is -S(O)N(R) 2 . In some embodiments, R 4 is -C(O)N(R) 2 . In some embodiments, R 4 is -S(O) 2 NHCH 3 . In some embodiments, R 4 is — S(O) 2 NHR.
  • R 4 is -S(O)NHCH 3 , -C(O)N(CH 3 ) 2 , -C(O)NHCH 3 , -C(O)OH, or -C(O)OCH 3 .
  • R 4 is . In some embodiments, R 4 is
  • R 4 is selected from those depicted in Table A, below.
  • R 6 is -H or -C 1-6 aliphatic substituted 0, 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 6 is -H, -halogen, -CN, -NO 2 , -C 1-6 aliphatic, -OC 1-6 aliphatic, or a 4-, 5 , or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur optionally substituted 1-3 times by -C 1-6 aliphatic or -OC 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -OC 1-6 aliphatic is independently substituted 0, 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 6 is H. In some embodiments, R 6 is -F. In some embodiments, R 6 is -Cl. In some embodiments, R 6 is -Br. In some embodiments, R 6 is -CN. In some embodiments, R 6 is -NO 2 .
  • R 6 is -C 1-6 aliphatic, substituted 0, 1, 2, 3, 4, 5, or 6 times by - halogen, -CN, or -NO 2 .
  • R 6 is unsubstituted -C 1-6 aliphatic.
  • R 6 is -CH 3 .
  • R 6 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 6 is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F.
  • R 6 is -C 1-3 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F.
  • R 6 is -CF 3 .
  • R 6 is -OC 1-6 aliphatic, substituted 0, 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 6 is unsubstituted -OC 1-6 aliphatic.
  • R 6 is -OCH 3 .
  • R 6 is -OC 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 6 is -OC 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F.
  • R 6 is -OC 1-3 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F.
  • R 6 is -OCF 3 .
  • R 6 is a 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur optionally substituted 1-3 times by -C 1-6 aliphatic or -OC 1-6 aliphatic, wherein each of -C 1-6 aliphatic and -OC 1-6 aliphatic is independently substituted 0, 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R 6 is a 5-membered ring having 1, 2, 3, or 4 nitrogen optionally substituted 1-3 times by -C 1-6 aliphatic.
  • R 6 is
  • R 6 is selected from those depicted in Table A, below.
  • R w is an optionally substituted 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • R w is an optionally substituted 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R w is a 4-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, optionally substituted 1-3 times by -C 1-6 alkyl.
  • R w is , wherein R is as described herein.
  • R w is ' , wherein R is as described herein.
  • R w iiss aa 44.-, 5-, or 6- membered ring having 1, 2, 3, or 4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, optionally substituted 1-3 times by -C 1-6 alkyl.
  • R w is an optionally substituted 5 -membered ring having 1 , 2, 3, or 4 nitrogen. Tn some embodiments, R w is
  • R w is
  • R w is
  • R w is selected from those depicted in Table A, below.
  • R is independently -H or optionally substituted -C 1-6 aliphatic.
  • R is -H.
  • R is optionally substituted -C 1-6 aliphatic.
  • R is unsubstituted -C 1-6 aliphatic.
  • R is CH 3 .
  • R is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -halogen, -CN, or -NO 2 .
  • R is -C 1-6 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F.
  • R is -C 1-3 aliphatic substituted 1, 2, 3, 4, 5, or 6 times by -F.
  • R is -CF 3 .
  • R is selected from those depicted in Table A, below.
  • a TEAD inhibitor is a compound of Formula A-2: or a pharmaceutically acceptable salt thereof, wherein each of R 1 , R 2 , R 3 , R 4 , R 6 , R 7 , and L 1 is independently as defined and described in embodiments in Section of TEAD Inhibitors of
  • the present disclosure provides a compound of Formula A-2, or a pharmaceutically acceptable salt thereof, wherein:
  • L 1 is -O- or -S-;
  • R 1 is -C 1-6 aliphatic substituted 0, 1, 2, 3, 4, 5, or 6 times by halogen
  • R 2 is an optionally substituted 5-membered aromatic ring having 1, 2, 3, or 4 nitrogen;
  • R 3 is -H
  • R 4 is -S(O) 2 N(R) 2 ; -S(O)N(R) 2 , or -C(O)N(R) 2 , each R independently is selected -H and optionally substituted -C 1-6 aliphatic;
  • R 6 is -H or -C 1-6 aliphatic substituted 0, 1, 2, 3, 4, 5, or 6 times by halogen
  • R 7 is -H
  • L 1 is -NH-
  • R 1 is -C 1-6 aliphatic substituted 1 , 2, 3, 4, 5, or 6 times by halogen
  • R 2 is an optionally substituted 5-membered aromatic ring having 1, 2, 3, or 4 nitrogen;
  • R 3 is -H
  • R 4 is -S(O) 2 N(R) 2 , -S(O)N(R) 2 , or -C(O)N(R) 2 , each R independently is selected from
  • R 6 is -C 1-6 aliphatic
  • R 7 is -H.
  • a TEAD inhibitor is a compound of Formula:
  • each of X is independently C or N, and each of Ring A, R w , R 1 , R 2 , R 3 , R 4 , R 6 , R 7 , and L 1 is independently as defined and described in embodiments in the section of TEAD Inhibitors of Formulae A, and A-1 to A-50.
  • a TEAD inhibitor is a compound of Formula A, or a pharmaceutically acceptable salt thereof, wherein Ring A is phenyl, a 6-membered monocyclic heteroaromatic ring having 1 or 2 nitrogen, or a 10-membered bicyclic heteroaromatic ring having 1-2 nitrogen; Ring B is phenyl or a 6-membered monocyclic heteroaromatic ring having 1 or 2 nitrogen; and each of R w and L 1 is as defined above and described in embodiments herein, both singly and in combination.
  • a TEAD inhibitor is a compound selected from the following: i. Formula (A-19) or (A-20): wherein L 1 is a C 2-6 bivalent straight or branched hydrocarbon chain wherein 1 methylene unit of the chain is replaced with -N(R)-, and each of R 2 , R 4 , R 6 , and R is independently as defined and described in embodiments in the section of TEAD Inhibitors of Formulae A, and A-1 to A-50; ii.
  • a TEAD inhibitor is selected from those listed in Table A, or a pharmaceutically acceptable salt thereof.
  • treatment refers to reversing, alleviating, delaying the onset of, or inhibiting the progress of a disease, or one or more symptoms thereof, as described herein.
  • treatment can be administered after one or more symptoms have developed.
  • treatment can be administered in the absence of symptoms.
  • treatment can be administered to a susceptible individual prior to the onset of symptoms (e.g., in light of a history of symptoms and/or in light of genetic or other susceptibility factors). Treatment can also be continued after symptoms have resolved, for example to prevent, or delay their recurrence.
  • a patient or subject "in need of prevention,” “in need of treatment,” or “in need thereof,” refers to one, who by the judgment of an appropriate medical practitioner (e.g., a doctor, a nurse, or a nurse practitioner in the case of humans; a veterinarian in the case of nonhuman mammals), would reasonably benefit from a given treatment or therapy.
  • an appropriate medical practitioner e.g., a doctor, a nurse, or a nurse practitioner in the case of humans; a veterinarian in the case of nonhuman mammals
  • a "therapeutically effective amount” or “therapeutically effective dosage” of a drug or therapeutic agent, such as a TEAD inhibitor and an EGFR inhibitor, is any amount of the drug that, when used alone or in combination with another therapeutic agent, protects a patient or subject against the onset of a disease, such as cancer, or promotes disease regression evidenced by a decrease in severity of disease symptoms, an increase in frequency and duration of disease symptom-free periods, or a prevention of impairment or disability due to the disease affliction.
  • a therapeutic agent such as a TEAD inhibitor and an EGFR inhibitor
  • TEAD inhibitor and an EGFR inhibitor to promote disease regression can be evaluated using a variety of methods known to the skilled practitioner, such as in human subjects during clinical trials, in animal model systems predictive of efficacy in humans, or by assaying the activity of the agent in in vitro assays.
  • a therapeutically effective amount of the drug when used alone or in combination, promotes cancer regression to the point of eliminating the cancer.
  • promote(s) cancer regression means that administering an effective amount of the drug, alone or in combination with one or more additional anti-neoplastic agent, results in a reduction in tumor growth or size, necrosis of the tumor, a decrease in severity of at least one disease symptom, an increase in frequency and duration of disease symptom-free periods, or a prevention of impairment or disability due to the disease affliction.
  • the terms “effective” and “effectiveness” with regard to a treatment includes both pharmacological effectiveness and physiological safety. Pharmacological effectiveness refers to the ability of the drug to promote cancer regression in the patient.
  • Physiological safety refers to the level of toxicity, or other adverse physiological effects at the cellular, organ and/or organism level (adverse effects) resulting from administration of the drug.
  • the terms “therapeutic benefit” or “benefit from therapy” refers to an improvement in one or more of overall survival, progression-free survival, partial response, complete response, and overall response rate and can also include a reduction in cancer or tumor growth or size, a decrease in severity of disease symptoms, an increase in frequency and duration of disease symptom-free periods, or a prevention of impairment or disability due to the disease affliction.
  • patient or "subject” as used herein, means an animal, preferably a mammal, and most preferably a human.
  • An EGFR inhibitor can be administered separately from a TEAD inhibitor, as part of a multiple dosage regimen.
  • an EGFR inhibitor may be part of a single dosage form, mixed together with an TEAD inhibitor in a single composition. If administered as a multiple dosage regime, an EGFR inhibitor and a TEAD inhibitor can be administered simultaneously, sequentially or within a period of time from one another, for example within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or 24 hours from one another.
  • an EGFR inhibitor and a TEAD inhibitor are administered as a multiple dosage regimen with greater than 24 hours apart.
  • an EGFR inhibitor and a TEAD inhibitor are administered within a period of time from one another, for example within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 days from one another.
  • an EGFR inhibitor is administered prior to a TEAD inhibitor.
  • an EGFR inhibitor is administered 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 days prior to a TEAD inhibitor.
  • an EGFR inhibitor is administered 5 days prior to the a TEAD inhibitor.
  • the term “combination,” “combined,” and related terms refers to the simultaneous or sequential administration of therapeutic agents in accordance with this disclosure.
  • a TEAD inhibitor can be administered with an EGFR inhibitor simultaneously or sequentially in separate unit dosage forms or together in a single unit dosage form.
  • the present disclosure provides a single unit dosage form comprising a TEAD inhibitor, an EGFR inhibitor, and a pharmaceutically acceptable carrier, adjuvant, or vehicle.
  • the present disclosure provides a single unit dosage form comprising a TEAD inhibitor and an EGFR inhibitor and a pharmaceutically acceptable carrier, adjuvant, or vehicle.
  • compositions are provided.
  • the present disclosure provides a pharmaceutical composition comprising a TEAD inhibitor, and a pharmaceutically acceptable carrier, adjuvant, or vehicle.
  • the amount of a TEAD inhibitor in compositions of this disclosure is such that is effective to measurably inhibit TEAD, or a variant or mutant thereof, in a biological sample or in a patient.
  • a TEAD inhibitor is selected from those as described herein.
  • a composition of this disclosure is formulated for administration to a patient in need of such composition.
  • a composition of this disclosure is formulated for oral administration to a patient.
  • compositions of this disclosure refers to a nontoxic carrier, adjuvant, or vehicle that does not destroy the pharmacological activity of the compound with which it is formulated.
  • Pharmaceutically acceptable carriers, adjuvants or vehicles that may be used in the compositions of this disclosure include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethylcellulose, polyacrylates, waxes, polyethylene- polyoxypropylene
  • compositions of the present disclosure can be administered orally, parenterally, by inhalation spray, topically, rectally, nasally, buccally, vaginally or via an implanted reservoir.
  • administering refers to the physical introduction of a composition comprising a therapeutic agent to a subject, using any of the various methods and delivery systems known to those skilled in the art.
  • a route of administration for a TEAD inhibitor is oral administration.
  • a route of administration for an EGFR inhibitor is intravenous, intramuscular, subcutaneous, intraperitoneal, spinal or other parenteral routes of administration, for example, by injection or infusion.
  • parenteral administration means modes of administration other than enteral and topical administration, usually by injection, and includes, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intralymphatic, intralesional, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid, intraspinal, epidural and intrasternal injection and infusion, as well as in vivo electroporation.
  • Other non- parenteral routes include an oral, topical, epidermal or mucosal route of administration, for example, intranasally, vaginally, rectally, sublingually or topically.
  • Administering can also be performed, for example, once, a plurality of times, and/or over one or more extended periods.
  • Sterile injectable forms of the compositions of this disclosure can be aqueous or oleaginous suspension. These suspensions can be formulated according to techniques known in the art using suitable dispersing or wetting agents and suspending agents.
  • the sterile injectable preparation can also be a sterile injectable solution or suspension in a non- toxic parenterally acceptable diluent or solvent, for example as a solution in 1,3-butanediol.
  • a non- toxic parenterally acceptable diluent or solvent for example as a solution in 1,3-butanediol.
  • the acceptable vehicles and solvents that can be employed are water, Ringer’s solution and isotonic sodium chloride solution.
  • sterile, fixed oils are conventionally employed as a solvent or suspending medium.
  • any bland fixed oil can be employed including synthetic mono- or diglycerides.
  • Fatty acids such as oleic acid and its glyceride derivatives are useful in the preparation of injectables, as are natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions.
  • These oil solutions or suspensions can also contain a long-chain alcohol diluent or dispersant, such as carboxymethyl cellulose or similar dispersing agents that are commonly used in the formulation of pharmaceutically acceptable dosage forms including emulsions and suspensions.
  • Other commonly used surfactants such as Tweens, Spans and other emulsifying agents or bioavailability enhancers which are commonly used in the manufacture of pharmaceutically acceptable solid, liquid, or other dosage forms can also be used for the purposes of formulation.
  • compositions of this disclosure can be orally administered in any orally acceptable dosage form including, but not limited to, capsules, tablets, aqueous suspensions or solutions.
  • carriers commonly used include lactose and com starch.
  • Lubricating agents such as magnesium stearate, are also typically added.
  • useful diluents include lactose and dried cornstarch.
  • aqueous suspensions are required for oral use, the active ingredient is combined with emulsifying and suspending agents. If desired, certain sweetening, flavoring or coloring agents can also be added.
  • compositions of this disclosure can be administered in the form of suppositories for rectal administration.
  • suppositories can be prepared by mixing the agent with a suitable non-irritating excipient that is solid at room temperature but liquid at rectal temperature and therefore will melt in the rectum to release the drug.
  • suitable non-irritating excipient include cocoa butter, beeswax and polyethylene glycols.
  • compositions of this disclosure can also be administered topically, especially when the target of treatment includes areas or organs readily accessible by topical application, including diseases of the eye, the skin, or the lower intestinal tract. Suitable topical formulations are readily prepared for each of these areas or organs.
  • Topical application for the lower intestinal tract can be effected in a rectal suppository formulation (see above) or in a suitable enema formulation. Topically- transdermal patches can also be used.
  • compositions can be formulated in a suitable ointment containing the active component suspended or dissolved in one or more carriers.
  • Carriers for topical administration of compounds of this disclosure include, but are not limited to, mineral oil, liquid petrolatum, white petrolatum, propylene glycol, polyoxyethylene, polyoxypropylene compound, emulsifying wax and water.
  • provided pharmaceutically acceptable compositions can be formulated in a suitable lotion or cream containing the active components suspended or dissolved in one or more pharmaceutically acceptable carriers.
  • Suitable carriers include, but are not limited to, mineral oil, sorbitan monostearate, polysorbate 60, cetyl esters wax, cetearyl alcohol, 2-octyldodecanol, benzyl alcohol and water.
  • compositions can be formulated as micronized suspensions in isotonic, pH adjusted sterile saline, or, preferably, as solutions in isotonic, pH adjusted sterile saline, either with or without a preservative such as benzylalkonium chloride.
  • the pharmaceutically acceptable compositions can be formulated in an ointment such as petrolatum.
  • compositions of this disclosure can also be administered by nasal aerosol or inhalation.
  • Such compositions are prepared according to techniques well- known in the art of pharmaceutical formulation and can be prepared as solutions in saline, employing benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, fluorocarbons, and/or other conventional solubilizing or dispersing agents.
  • compositions of this disclosure are formulated for oral administration. Such formulations can be administered with or without food.
  • compositions of this disclosure are administered without food. In other embodiments, pharmaceutically acceptable compositions of this disclosure arc administered with food.
  • compositions varies depending upon the host treated, the particular mode of administration.
  • provided compositions should be formulated so that a dosage of between 0.01 - 100 mg/kg body weight/day of a TEAD inhibitor can be administered to a patient receiving these compositions.
  • the therapeutic agents can act synergistically. Therefore, the amount of each therapeutic agents in such compositions may be less than that required in a monotherapy utilizing only that therapeutic agent. In some embodiments, the amount of each therapeutic agent in the compositions comprising multiple therapeutic agents ranges from about 50% to 100% of the amount normally present in a composition comprising that agent as the only therapeutically active agent. In some embodiments, an EGFR inhibitor is administered at a dosage of about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, or about 95% of the amount normally administered for that agent. As used herein, the phrase “normally administered” means the amount an FDA approved therapeutic agent is approved for dosing per the FDA label insert.
  • a specific dosage and treatment regimen for any particular patient depends upon a variety of factors, including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, rate of excretion, drug combination, and the judgment of the treating physician and the severity of the particular disease being treated.
  • the amount of a compound of the present disclosure in the composition also depends upon the particular compound in the composition.
  • the present disclosure provides a method for delaying and/or preventing development of cancer resistance to an EGFR inhibitor in a patient, comprising administering to the patient a therapeutically effective amount of a TEAD inhibitor, or a pharmaceutical composition thereof, and an EGFR inhibitor.
  • a "cancer,” as used herein, refers a broad group of various diseases characterized by the uncontrolled growth of abnormal cells in the body. Unregulated cell division and growth divide and grow results in the formation of malignant tumors that invade neighboring tissues and can also metastasize to distant parts of the body through the lymphatic system or bloodstream.
  • a cancer to be treated in the present disclosure includes, but is not limited to, a hematological cancer, a lymphoma, a myeloma, a leukemia, a neurological cancer, skin cancer, breast cancer, a prostate cancer, a colorectal cancer, lung cancer, head and neck cancer, a gastrointestinal cancer, a liver cancer, a pancreatic cancer, a genitourinary cancer, a bone cancer, renal cancer, and a vascular cancer.
  • a cancer is mediated by activation of transcriptional coactivator with PDZ binding motif/Yes-associated protein transcription coactivator (TAZ/YAP).
  • a cancer is mediated by modulation of the interaction of YAP/TAZ with TEAD (e.g.,TEADl, TEAD2, TEAD3, and/or TEAD4).
  • the cancer is characterized by or associated with increased TEAD (e.g.,TEADl, TEAD2, TEAD3, and/or TEAD4) expression and/or increased TEAD (e.g.,TEADl, TEAD2, TEAD3, and/or TEAD4) activity.
  • the cancer is a cancer in which YAP is localized in the nucleus of the cancer cells.
  • the cancer is characterized or associated with a genetic alteration in one or more Hippo pathway genes.
  • genetic alteration in one or more Hippo pathway genes refers to that certain percentage of cells in a sample, such as a tumor sample, having a detectable amount of genetic alteration in one or more Hippo pathway genes.
  • a genetic alteration in a gene can refer, for example, to a loss-of-function mutation in the gene (including, for example, frameshifts, nonsense mutations and splicing mutations), a change in gene copy number (including, for example, copy gain, amplification, copy loss, or deletion), or a fusion of the gene with another gene, such as, for example, a TAZ-CAMTA1 fusion or YAP1-TFE3 fusion.
  • genetic alteration in Hippo pathway genes refers to that about 5%, about 10%, about 15%, about 20%, about 25%, about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 96%, about 97%, about 98%, about 99%, or 100% of cells, such as tumor cells, in a sample have at least about three copies of genetically altered Hippo pathway genes, at least about four copies of genetically altered Hippo pathway genes, at least about five copies of genetically altered Hippo pathway genes, at least about six copies of genetically altered Hippo pathway genes, at least about seven copies of genetically altered Hippo pathway genes, at least about eight copies of genetically altered Hippo pathway genes, at least about nine copies of genetically altered Hippo pathway genes, at least about ten copies of genetically altered Hippo pathway genes, at least about eleven copies of genetically altered Hippo pathway genes, at least about twelve copies of genetically altered Hippo pathway genes,
  • genetic alteration in Hippo pathway genes refers to that about 10% tumor cells in a sample have at least about 15 copies of genetically altered Hippo pathway genes. In some embodiments, genetic alteration in Hippo pathway genes refers to that about 40% tumor cells in a sample have at least about 4 copies of genetically altered Hippo pathway genes. In some embodiments, genetic alteration in Hippo pathway genes refers to that about 10% tumor cells in a sample have at least about four copies of genetically altered Hippo pathway genes.
  • a Hippo pathway gene is NF2.
  • the genetic alteration in the one or more Hippo pathway genes is NF2 deficiency.
  • NF2 deficiency refers to NF2 loss of function mutations.
  • NF2 deficiency refers to NF2 copy losses or deletions.
  • NF2 deficiency refers to absent or very low NF2 mRNA expression.
  • a Hippo pathway gene is YAP1.
  • the genetic alteration in the one or more Hippo pathway genes is YAP1 amplification.
  • the genetic alteration in the one or more Hippo pathway genes is a YAP1 fusion, such as a YAP1-TFE3 fusion.
  • a Hippo pathway gene is TAZ.
  • the genetic alteration in the one or more Hippo pathway genes is TAZ amplification.
  • the genetic alteration in the one or more Hippo pathway genes is a TAZ fusion, such as a TAZ-CAMTA1 fusion.
  • a Hippo pathway gene is LATS 1/2.
  • the genetic alteration in the one or more Hippo pathway genes is LATS 1/2 copy number loss or deletion.
  • a Hippo pathway gene is MST1/2.
  • a Hippo pathway gene is BAP1.
  • a cancer is characterized by a mutant G ⁇ -protein.
  • a mutant G ⁇ -protein is selected from G12, G13, Gq, G11, Gi, Go, and Gs.
  • a mutant G ⁇ -protein is G 12.
  • a mutant G ⁇ -protein is G13.
  • a mutant G ⁇ -protein is Gq.
  • a mutant G ⁇ -protein is G11 .
  • a mutant G ⁇ -protein is Gi.
  • a mutant G ⁇ -protein is Go.
  • G ⁇ -protein is Gs.
  • the cancer is lung cancer, thyroid cancer, ovarian cancer, colorectal cancer, prostate cancer, cancer of the pancreas, cancer of the esophagus, liver cancer, breast cancer, skin cancer, mesothelioma, or epithelioid hemangioendothelioma, or EHE.
  • the cancer is mesothelioma, such as malignant mesothelioma.
  • the cancer is EHE.
  • the lung cancer is non-small cell lung cancer (NSCLC).
  • the cancer is a solid tumor. In some embodiments, the cancer is a locally advanced or metastatic solid tumor.
  • the cancer is an EGFR mutant cancer.
  • the EGFR mutant cancer harbors the EGFR L858R mutation.
  • the EGFR mutant cancer harbors the EGFR T790M mutation.
  • the EGFR mutant cancer harbors the EGFR C797S mutation.
  • the EGFR mutant cancer comprises an EGFR 19 deletion.
  • Cancer includes, in some embodiments, without limitation, leukemias (e.g., acute leukemia, acute lymphocytic leukemia, acute myelocytic leukemia, acute myeloblastic leukemia, acute promyelocytic leukemia, acute myelomonocytic leukemia, acute monocytic leukemia, acute erythroleukemia, chronic leukemia, chronic myelocytic leukemia, chronic lymphocytic leukemia), polycythemia vera, lymphoma (e.g., Hodgkin’s disease or non-Hodgkin’s disease), Waldenstrom's macroglobulinemia, multiple myeloma, heavy chain disease, and solid tumors such as sarcomas and carcinomas (e.g., fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcom
  • the cancer is glioma, astrocytoma, glioblastoma multiforme (GBM, also known as glioblastoma), medulloblastoma, craniopharyngioma, ependymoma, pinealoma, hemangioblastoma, aaccoouussttiicc neuroma, oligodendroglioma, schwannoma, neurofibrosarcoma, meningioma, melanoma, neuroblastoma, or retinoblastoma.
  • GBM glioblastoma multiforme
  • medulloblastoma craniopharyngioma
  • ependymoma pinealoma
  • hemangioblastoma aaccoouussttiicc neuroma
  • oligodendroglioma schwannoma
  • neurofibrosarcoma meningioma
  • the cancer is acoustic neuroma, astrocytoma (e.g. Grade I - Pilocytic Astrocytoma, Grade II - Low-grade Astrocytoma, Grade III - Anaplastic Astrocytoma, or Grade IV - Glioblastoma (GBM)), chordoma, CNS lymphoma, craniopharyngioma, brain stem glioma, ependymoma, mixed glioma, optic nerve glioma, subependymoma, medulloblastoma, meningioma, metastatic brain tumor, oligodendroglioma, pituitary tumors, primitive neuroectodermal (PNET) tumor, or schwannoma.
  • astrocytoma e.g. Grade I - Pilocytic Astrocytoma, Grade II - Low-grade Astrocytoma, Grade III - Anaplastic Astrocytoma, or Grade IV - G
  • the cancer is a type found more commonly in children than adults, such as brain stem glioma, craniopharyngioma, ependymoma, juvenile pilocytic astrocytoma (IP A), medulloblastoma, optic nerve glioma, pineal tumor, primitive neuroectodermal tumors (PNET), or rhabdoid tumor.
  • the patient is an adult human. In some embodiments, the patient is a child or pediatric patient.
  • Cancer includes, in another embodiment, without limitation, mesothelioma, hepatobilliary (hepatic and billiary duct), bone cancer, pancreatic cancer, skin cancer, cancer of the head or neck, cutaneous or intraocular melanoma, ovarian cancer, colon cancer, rectal cancer, cancer of the anal region, stomach cancer, gastrointestinal (gastric, colorectal, and duodenal), uterine cancer, carcinoma of the fallopian tubes, carcinoma of the endometrium, carcinoma of the cervix, carcinoma of the vagina, carcinoma of the vulva, Hodgkin’s Disease, cancer of the esophagus, cancer of the small intestine, cancer of the endocrine system, cancer of the thyroid gland, cancer of the parathyroid gland, cancer of the adrenal gland, sarcoma of soft tissue, cancer of the urethra, cancer of the penis, prostate cancer, testicular cancer, chronic or acute leukemia, chronic myeloid leukemia, lymph
  • the cancer is selected from hepatocellular carcinoma, ovarian cancer, ovarian epithelial cancer, or fallopian tube cancer; papillary serous cystadenocarcinoma or uterine papillary serous carcinoma (UPSC); prostate cancer; testicular cancer; gallbladder cancer; hepatocholangiocarcinoma; soft tissue and bone synovial sarcoma; rhabdomyosarcoma; osteosarcoma; chondrosarcoma; Ewing sarcoma; anaplastic thyroid cancer; adrenocortical adenoma; pancreatic cancer; pancreatic ductal carcinoma or pancreatic adenocarcinoma; gastrointestinal stromal tumor (GIST); lymphoma; squamous cell carcinoma of the head and neck (SCCHN); salivary gland cancer; glioma, or brain cancer; neurofibromatosis- 1 associated malignant peripheral nerve sheath tumors (MPNST
  • the cancer is selected from hepatocellular carcinoma (HCC), hepatoblastoma, colon cancer, rectal cancer, ovarian cancer, ovarian epithelial cancer, fallopian tube cancer, papillary serous cystadenocarcinoma, uterine papillary serous carcinoma (UPSC), hepatocholangiocarcinoma, soft tissue and bone synovial sarcoma, rhabdomyosarcoma, osteosarcoma, anaplastic thyroid cancer, adrenocortical adenoma, pancreatic cancer, pancreatic ductal carcinoma, pancreatic adenocarcinoma, glioma, neurofibromatosis- 1 associated malignant peripheral nneerrvvee sheath tumors (MPNST), Waldenstrom’s macroglobulinemia, or medulloblastoma.
  • HCC hepatocellular carcinoma
  • hepatoblastoma colon cancer
  • rectal cancer ovarian cancer
  • the cancer is a solid tumor, such as a sarcoma, carcinoma, or lymphoma.
  • Solid tumors generally comprise an abnormal mass of tissue that typically does not include cysts or liquid areas.
  • the cancer is selected from renal cell carcinoma, or kidney cancer; hepatocellular carcinoma (HCC) or hepatoblastoma, or liver cancer; melanoma; breast cancer; colorectal carcinoma, or colorectal cancer; colon cancer; rectal cancer; anal cancer; lung cancer, such as non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC); ovarian cancer, ovarian epithelial cancer, ovarian carcinoma, or fallopian tube cancer; papillary serous cystadenocarcinoma or uterine papillary serous carcinoma (UPSC); prostate cancer; testicular cancer; gallbladder cancer; hepatocholangiocarcinoma; soft tissue and bone synovial sarcoma; rhabdomyos
  • the cancer is selected from renal cell carcinoma, hepatocellular carcinoma (HCC), hepatoblastoma, colorectal carcinoma, colorectal cancer, colon cancer, rectal cancer, anal cancer, ovarian cancer, ovarian epithelial cancer, ovarian carcinoma, fallopian tube cancer, papillary serous cystadenocarcinoma, uterine papillary serous carcinoma (UPSC), hepatocholangiocarcinoma, soft tissue and bone synovial sarcoma, rhabdomyosarcoma, osteosarcoma, chondrosarcoma, anaplastic thyroid cancer, adrenocortical carcinoma, pancreatic cancer, pancreatic ductal carcinoma, pancreatic adenocarcinoma, glioma, brain cancer, neurofibromatosis- 1 associated malignant peripheral nerve sheath tumors (MPNST), Waldenstrom’s macroglobulinemia, or medulloblastoma
  • HCC hepato
  • the cancer is selected from hepatocellular carcinoma (HCC), hepatoblastoma, colon cancer, rectal cancer, ovarian cancer, ovarian epithelial cancer, ovarian carcinoma, fallopian tube cancer, papillary serous cystadenocarcinoma, uterine papillary serous carcinoma (UPSC), hepatocholangiocarcinoma, soft tissue and bone synovial sarcoma, rhabdomyosarcoma, osteosarcoma, anaplastic thyroid cancer, adrenocortical carcinoma, pancreatic cancer, pancreatic ductal carcinoma, pancreatic adenocarcinoma, glioma, neurofibromatosis- 1 associated malignant peripheral nneerrvvee sheath tumors (MPNST), Waldenstrom’s macroglobulinemia, or medulloblastoma.
  • HCC hepatocellular carcinoma
  • hepatoblastoma colon cancer
  • rectal cancer ovarian
  • the cancer is hepatocellular carcinoma (HCC). In some embodiments, the cancer is hepatoblastoma. In some embodiments, the cancer is colon cancer. In some embodiments, the cancer is rectal cancer. In some embodiments, the cancer is ovarian cancer, or ovarian carcinoma. In some embodiments, the cancer is ovarian epithelial cancer. In some embodiments, the cancer is fallopian tube cancer. In some embodiments, the cancer is papillary serous cystadenocarcinoma. In some embodiments, the cancer is uterine papillary serous carcinoma (UPSC). In some embodiments, the cancer is hepatocholangiocarcinoma.
  • HCC hepatocellular carcinoma
  • the cancer is hepatoblastoma. In some embodiments, the cancer is colon cancer. In some embodiments, the cancer is rectal cancer. In some embodiments, the cancer is ovarian cancer, or ovarian carcinoma. In some embodiments, the cancer is ovarian epithelial cancer. In some embodiments,
  • the cancer is soft tissue and bone synovial sarcoma. In some embodiments, the cancer is rhabdomyosarcoma. In some embodiments, the cancer is osteosarcoma. In some embodiments, the cancer is anaplastic thyroid cancer. In some embodiments, the cancer is adrenocortical carcinoma. In some embodiments, the cancer is pancreatic cancer, or pancreatic ductal carcinoma. In some embodiments, the cancer is pancreatic adenocarcinoma. In some embodiments, the cancer is glioma. In some embodiments, the cancer is malignant peripheral nerve sheath tumors (MPNST). In some embodiments, the cancer is neurofibromatosis-1 associated MPNST.
  • MPNST peripheral nerve sheath tumors
  • the cancer is Waldenstrom’s macroglobulinemia. In some embodiments, the cancer is medulloblastoma. [00210] In some embodiments, the cancer is Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Adrenocortical Carcinoma, Anal Cancer, Appendix Cancer, Atypical Teratoid/Rhabdoid Tumor, Basal Cell Carcinoma, Bile Duct Cancer, Bladder Cancer, Bone Cancer, Brain Tumor, Astrocytoma, Brain and Spinal Cord Tumor, Brain Stem Glioma, Central Nervous System Atypical Teratoid/Rhabdoid Tumor, Central Nervous System Embryonal Tumors, Breast Cancer, Bronchial Tumors, Burkitt Lymphoma, Carcinoid Tumor, Carcinoma of Unknown Primary, Central Nervous System Cancer, Cervical Cancer, Childhood Cancers, Chordoma, Chronic Lymphocytic Leukemia (C
  • the cancer is selected from bladder cancer, breast cancer (including TNBC), cervical cancer, colorectal cancer, chronic lymphocytic leukemia (CLL), diffuse large B-cell lymphoma (DLBCL), esophageal adenocarcinoma, glioblastoma, head and neck cancer, leukemia (acute and chronic), low-grade glioma, lung cancer (including adenocarcinoma, non-small cell lung cancer, and squamous cell carcinoma), Hodgkin's lymphoma, non-Hodgkin lymphoma (NHL), melanoma, multiple myeloma (MM), ovarian cancer, pancreatic cancer, prostate cancer, renal cancer (including renal clear cell carcinoma and kidney papillary cell carcinoma), and stomach cancer.
  • CLL chronic lymphocytic leukemia
  • DLBCL diffuse large B-cell lymphoma
  • esophageal adenocarcinoma esophageal adenocar
  • the cancer is small cell lung cancer, non-small cell lung cancer, colorectal cancer, multiple myeloma, acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), pancreatic cancer, liver cancer, hepatocellular cancer, neuroblastoma, other solid tumors or other hematological cancers.
  • AML acute myeloid leukemia
  • ALL acute lymphoblastic leukemia
  • pancreatic cancer liver cancer, hepatocellular cancer, neuroblastoma, other solid tumors or other hematological cancers.
  • the cancer is small cell lung cancer, non-small cell lung cancer (NSCLC), colorectal cancer, multiple myeloma, or AML.
  • NSCLC non-small cell lung cancer
  • the present disclosure further features methods and compositions for the diagnosis, prognosis and treatment of viral-associated cancers, including human immunodeficiency virus (HIV) associated solid tumors, human papilloma virus (HPV)-16 positive incurable solid tumors, and adult T-cell leukemia, which is caused by human T-cell leukemia virus type I (HTLV-I) and is a highly aggressive form of CD4+ T-cell leukemia characterized by clonal integration of HTLV-
  • the methods or uses described herein inhibit or reduce or arrest or ameliorate the growth or spread of a cancer or tumor.
  • the tumor is treated by arresting, reducing, or inhibiting further growth of the cancer or tumor.
  • the methods or uses described herein increase or potentiate or activate one or more immune responses to inhibit or reduce or arrest or ameliorate the growth or spread of a cancer or tumor.
  • the cancer or tumor is treated by reducing the size (e.g., volume or mass) of the cancer or tumor by at least 5%, at least 10%, at least 25%, at least 50%, at least 75%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% relative to the size of the cancer or tumor prior to treatment.
  • cancers or tumors are treated by reducing the quantity of the cancers or tumors in the patient by at least 5%, at least 10%, at least 25%, at least 50%, at least 75%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% relative to the quantity of cancers or tumors prior to treatment.
  • a patient treated using the methods or uses described herein exhibits progression-free survival of at least about one month, at least about 2 months, at least about 3 months, at least about 4 months, at least about 5 months, at least about 6 months, at least about 7 months, at least about 8 months, at least about 9 months, at least about 10 months, at least about 11 months, at least about one year, at least about eighteen months, at least about two years, at least about three years, at least about four years, or at least about five years after the treatment is initiated.
  • a patient treated using the methods or uses described herein exhibits an overall survival of at least about one month, at least about 2 months, at least about 3 months, at least about 4 months, at least about 5 months, at least about 6 months, at least about 7 months, at least about 8 months, at least about 9 months, at least about 10 months, at least about
  • I I months at least about one year, at least about 14 months, at least about 16 months, at least about 18 months, at least about 20 months, at least about 22 months, at least about two years, at least about three years, at least about four years, or at least about five years after the treatment is initiated.
  • a patient treated using the methods or uses described herein exhibits an objective response rate (ORR) of at least about 15%, at least about 20%, at least about 25%, at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, or about 100%.
  • ORR objective response rate
  • the compounds and compositions as described herein can be administered using any amount and any route of administration effective for treating or lessening the severity of a cancer. The exact amount required varies from subject to subject, depending on the species, age, and general condition of the subject, the severity of the disease or condition, the particular agent, its mode of administration, and the like.
  • Dosage unit form refers to a physically discrete unit of agent appropriate for the patient to be treated. It will be understood, however, that the total daily usage of the compounds and compositions of the present disclosure is decided by the attending physician within the scope of sound medical judgment.
  • the specific effective dose level for any particular patient or organism will depend upon a variety of factors including the disorder being treated and the severity of the disorder; the activity of the specific compound employed; the specific composition employed; the age, body weight, general health, sex and diet of the patient; the time of administration, route of administration, and rate of excretion of the specific compound employed; the duration of the treatment; drugs used in combination or coincidental with the specific compound employed, and like factors well known in the medical arts.
  • patient or “subject,” as used herein, means an animal, preferably a mammal, and most preferably a human.
  • compositions of this disclosure can be administered to humans and other animals orally, rectally, parenterally, intracisternally, intravaginally, intraperitoneally, topically (as by powders, ointments, or drops), bucally, as an oral or nasal spray, or the like, depending on the severity of the disease or disorder being treated.
  • a TEAT) inhibitor can be administered orally or parenterally at dosage levels of about 0.01 mg/kg to about 50 mg/kg and preferably from about 1 mg/kg to about 25 mg/kg, of subject body weight per day, one or more times a day, to obtain the desired therapeutic effect.
  • Liquid dosage forms for oral administration include, but are not limited to, pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs.
  • the liquid dosage forms may contain inert diluents commonly used in the art such as, for example, water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, dimethylformamide, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofurfuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof.
  • the oral compositions can also include
  • Injectable preparations for example, sterile injectable aqueous or oleaginous suspensions may be formulated according to the known art using suitable dispersing or wetting agents and suspending agents.
  • the sterile injectable preparation may also be a sterile injectable solution, suspension or emulsion in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol.
  • the acceptable vehicles and solvents that may be employed are water, Ringer’s solution, U.S.P. and isotonic sodium chloride solution.
  • sterile, fixed oils arc conventionally employed as a solvent or suspending medium.
  • any bland fixed oil can be employed including synthetic mono- or diglycerides.
  • fatty acids such as oleic acid are used in the preparation of injectables.
  • Injectable formulations can be sterilized, for example, by filtration through a bacterial- retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable medium prior to use.
  • delayed absorption of a parenterally administered compound form is accomplished by dissolving or suspending the compound in an oil vehicle.
  • injectable depot forms are made by forming microencapsule matrices of the compound in biodegradable polymers such as polylactide- polyglycolide. Depending upon the ratio of compound to polymer and the nature of the particular polymer employed, the rate of compound release can be controlled. Examples of other biodegradable polymers include poly(orthoesters) and poly (anhydrides). Depot injectable formulations are also prepared by entrapping the compound in liposomes or microemulsions that are compatible with body tissues.
  • compositions for rectal or vaginal administration are preferably suppositories which can be prepared by mixing the compounds of this disclosure with suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.
  • suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.
  • Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules.
  • the active compound is mixed with at least one inert, pharmaceutically acceptable excipient or carrier such as sodium citrate or dicalcium phosphate and/or a) fdlers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, c) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cety
  • Solid compositions of a similar type can also be employed as fillers in soft and hard- filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.
  • the solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art. They can optionally contain opacifying agents and can also be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner. Examples of embedding compositions that can be used include polymeric substances and waxes. Solid compositions of a similar type can also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polethylene glycols and the like.
  • the active compounds can also be in micro-encapsulated form with one or more excipients as noted above.
  • the solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings, release controlling coatings and other coatings well known in the pharmaceutical formulating art.
  • the active compound may be admixed with at least one inert diluent such as sucrose, lactose or starch.
  • Such dosage forms may also comprise, as is normal practice, additional substances other than inert diluents, e.g., tableting lubricants and other tableting aids such a magnesium stearate and microcrystalline cellulose.
  • the dosage forms may also comprise buffering agents. They may optionally contain opacifying agents and can also be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner.
  • buffering agents include polymeric substances and waxes.
  • Dosage forms for topical or transdermal administration of a compound of this disclosure include ointments, pastes, creams, lotions, gels, powders, solutions, sprays, inhalants or patches.
  • the active component is admixed under sterile conditions with a pharmaceutically acceptable carrier and any needed preservatives or buffers as may be required.
  • Ophthalmic formulation, ear drops, and eye drops are also contemplated as being within the scope of this disclosure.
  • the present disclosure contemplates the use of transdermal patches, which have the added advantage of providing controlled delivery of a compound to the body.
  • Such dosage forms can be made by dissolving or dispensing the compound in the proper medium.
  • Absorption enhancers can also be used to increase the flux of the compound across the skin. The rate can be controlled by either providing a rate controlling membrane or by dispersing the compound in a polymer matrix or gel.
  • TEAD inhibitors described herein can be produced by organic synthesis methods known to one of ordinary skill in the art. Additionally, certain TEAD inhibitors can be prepared as described in Pobbati et al. , “Targeting the Central Pocket in Human Transcription Factor TEAD as a Potential Cancer Therapeutic Strategy,” Structure 2015, 23, 2076-2086; Gibault et al., “Targeting Transcriptional Enhanced Associate Domains (TEADs),” J. Med. Chem.
  • PC9 and Hl 975 NSCLC cells were stably transduced with a Luciferase expressing reporter (BPS Biosciences, Catalog no. 79833), expression of which is regulated by a promoter carrying 4 copies of the TEAD-responsive element (sequence: 5'-ACATTCCA-3'). This reporter is representative of the output of TEAD-transcriptional activity).
  • Cells successfully transduced with the reporter were selected using puromycin (1 ug/ml) because of the presence of a puromycin resistance cassette in the reporter transgene.
  • Example 2 Timeline of Cell viability effect, and TEAD-reporter activation by osimertinib
  • PC9 cells carrying the TEAD-luciferase reporter were seeded at a density of 5000/well in 96 well cell culture plates. Cells were treated with 10 nM Osimertinib for 24 h, 72 h or 120 h.
  • Cell viability (FIG. 2A) (using Promega cell titer gio kit Catalog no. G9241), and TEAD-luciferase reporter expression (FIG. 2B) was quantified in parallel. Normalized values are represented for Cell viability as compared to DMSO control. Normalized Luciferase reporter expression is calculated by dividing the average of raw luciferase values by the average of raw cell viability (CTG) values. Fold normalized luciferase expression is calculated by normalizing to DMSO control.
  • Example 3 Immunofluorescence for YAP in PC9 cells in response to EGFR inhibitors.
  • NSCLC non-small cell lung cancer
  • Osimertinib 24 hours post-seeding, and treated for 120 hours. Immunofluorescence was conducted with YAP antibody 120 hours later. Please refer to the attached Immunofluorescence staining protocol).
  • T-A-32 inhibits osimertinib-induced TEAD reporter activation in a concentration-dependent manner but not basal TEAD-reporter activity (dotted line, DMSO treated).
  • Vehicle 1 was used to dissolve T-A-32.
  • Vehicle 2 was used to dissolve Osimertinib.
  • Example 4 The Effects of a TEAD Inhibitor T-A-32 against Osimertinib-refractory persister cells
  • Lentiviral transduction Lentiviral transduction using the IncuCyte Cell Cycle
  • Green/Red Lentivirus Reagent (Sartorius, Catalog no. 4779) was performed according to manufacturer’s instructions and using 8 pg/rnL polybrene final concentration. Fresh growth media was replenished after 24 h lentiviral transduction. Cell Cycle Green/Red expression was monitored for an additional 24 h using the S3 IncuCyte Live-Cell Analysis system.
  • IncuCyte imaging and analysis Transduced cells were imaged every 12 h for 20 days using the IncuCyte 2019B Rev2 software with a Green/Red 4614 optical module standard scan, acquiring Phase, Green (300 ms acquisition time) and Red (400 ms acquisition time) channels at a 10X objective and imaging a total of 962.1mm 2 of the well area, using a 6-well plate (Nunclon Delta Surface, Thermo Fisher Scientific, Cat No. 140675).
  • Top-Hat segmentation Radius 100.00 Threshold (GCU): 2.0 Edge Split On Hole Fill ( ⁇ m 2 ): 0 Adjust Size (pixels): 0 Area filter ( ⁇ m 2 ): 0 Eccentricity Filter: 0 Mean Intensity Filter: 0 Integrated Intensity Filter: 0
  • Osimertinib and TEAD inhibitor T-A-32 first-line treatment Using PC9TL FUCCI Green/Red cells (Pl 8), seeded 200,000 cells per well in a 6-well tissue culture plate (Nunclon Delta Surface, Thermo Fisher Scientific, Catalog no. 140675). Cells were imaged every 12h for 20 days using S3 IncuCyte Live-Cell Analysis system (refer to IncuCyte imaging and analysis). After 24h in culture, added Osimertinib (Selleckchem, Catalog no. S7297,) and T-A-32 at a 1 ⁇ M final concentration. Used DMSO (Sigma, Catalog no. D2650-100 ML) for no treatment sample. Treatments and growth media was replenished every 3-4 days. See FIG. 4A.
  • Osimertinib and TEAD inhibitor T-A-32 treatment after emergence of persister cells Using PC9TL FUCCI Green/Red cells (P 18), seeded 200,000 cells per well in a 6-well tissue culture plate (Nunclon Delta Surface, Thermo Fisher Scientific, Catalog no. 140675). Cells were imaged every 12h for 20 days using S3 IncuCyte Live-Cell Analysis system (refer to IncuCyte imaging and analysis). After 24h in culture, added Osimertinib (Selleckchem, Catalog no. S7297). After 5 days in culture with Osimertinib pressure, added T-A-32 at a 1 ⁇ M final concentration. Used DMSO (Sigma, Catalog no. D2650-100ML) for no treatment sample.

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Abstract

La présente divulgation concerne des inhibiteurs de TEAD et des procédés d'utilisation associés.
PCT/US2023/077898 2022-10-26 2023-10-26 Association d'inhibiteurs de tead et d'inhibiteurs d'egfr et utilisations associées WO2024092116A1 (fr)

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