TW201924683A - 用於治療骨髓增生性贅瘤的低劑量組合療法 - Google Patents
用於治療骨髓增生性贅瘤的低劑量組合療法 Download PDFInfo
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- TW201924683A TW201924683A TW107144094A TW107144094A TW201924683A TW 201924683 A TW201924683 A TW 201924683A TW 107144094 A TW107144094 A TW 107144094A TW 107144094 A TW107144094 A TW 107144094A TW 201924683 A TW201924683 A TW 201924683A
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Abstract
本申請案係關於使用與低劑量Pim抑制劑N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺組合之JAK1/JAK2抑制劑魯索替尼治療骨髓增生性贅瘤,其中該組合在低劑量Pim抑制劑下出乎意料地具有協同作用。
Description
本發明係關於使用與低劑量Pim抑制劑N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺組合之JAK1/JAK2抑制劑魯索替尼(ruxolitinib)治療骨髓增生性贅瘤,其中該組合在低劑量Pim抑制劑下出乎意料地具有協同作用。
在患有經典費城染色體陰性(Ph-) 骨髓增生性贅瘤 (MPN)之大部分患者中發現Janus激酶2 (JAK2)中之活化的V617F突變為開發JAK2之醫藥抑制劑提供了強大的推動力,以2011年監管批准JAK1/2抑制劑魯索替尼用於患有骨髓纖維化(MF)之患者及2014年用於患有羥基尿素 (HU)抗性/耐受性真性紅血球增多症 (PV) 之患者達到高潮。魯索替尼在患有與JAK2突變狀態無關之MF之患者中的活性係一個重大觀察結果,該結果由MPN中JAK-信號轉導子及轉錄活化因子(STAT)路徑之普遍活化的發現證明是正確的。
然而,因為JAK2信號傳導未受到長期抑制且在以JAK2抑制劑治療之患者中沒有觀察到分子緩解,所以需要新穎療法來改善患者治療結果。本申請案係有關於此需要及其他需要。
本申請案尤其提供治療有需要之患者的骨髓增生性贅瘤的方法,其包含投與該患者N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及魯索替尼或其醫藥學上可接受之鹽。
本申請案進一步提供治療有需要之患者的骨髓增生性贅瘤的方法,其包含投與該患者約5毫克/天至約100毫克/天劑量之N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及治療有效量之魯索替尼或其醫藥學上可接受之鹽。
本申請案亦提供治療有需要之患者的骨髓增生性贅瘤的方法,其包含投與該患者約5毫克/天至約100毫克/天劑量之N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及約10毫克/天至約50毫克/天劑量之魯索替尼或其醫藥學上可接受之鹽。
本申請案進一步提供本文所述之劑量的化合物的用途,其用於製造用以治療骨髓增生性贅瘤的藥劑。
本申請案亦提供用於治療骨髓增生性贅瘤的本文所述劑量之化合物。
一或多個實施例之詳情在以下說明中闡述。其他特徵、目的及優勢將自說明書及申請專利範圍顯而易見。
對於術語「例如」及「諸如」及其語法等效物而言,除非另外明確說明,否則片語「但不限於」應理解為跟隨。
如本文所用,除非上下文另外明確說明,否則單數形式「一個/種(a/an)」、及「該/該等(the)」包括複數指示物。
如本文所用,術語「約」意謂「近似」(例如,所指示值加或減約10%)。
本發明係關於與PIM抑制劑組合之JAK1/JAK2抑制劑魯索替尼的用途,其用於治療骨髓增生性贅瘤。已經出人意料地發現極低劑量之PIM抑制劑與低於IC50
且遠低於PIM抑制劑的含量之魯索替尼具有協同作用。
魯索替尼,即 (3R)-3-環戊基-3-[4-(7H-吡咯并[2,3-d]嘧啶-4-基)-1H-吡唑-1-基]丙腈為JAK1及JAK2之抑制劑 。魯索替尼之IC50
藉由在1 mM ATP時下文之檢定A量測且發現在JAK1及JAK2時小於10 nM。魯索替尼可以藉由2006年12月12日申請之US 7,598,257 (實例67)中所述之程序製得,其全文以引用的方式併入本文中。魯索替尼磷酸鹽可以如US 2008/0312259中所述製備,其全文以引用的方式併入本文中。
N-{(7R)-4-[(3R
,4R
,5S
)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊二烯并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺(下文之化合物1)為Pim1、Pim2及Pim3之抑制劑。化合物1可以如美國專利9,200,004或US 2017/0121310中所述製備,該等專利中每一者之全文以引用的方式併入本文中。化合物1之IC50
藉由下文檢定B中之程序量測且發現在Pim1、Pim2及Pim3時為≤ 100 nM。化合物1之磷酸鹽、二鹽酸鹽、鹽酸鹽、順丁烯二酸鹽、己二酸鹽、氫溴酸鹽、(R)-(-)-杏仁酸鹽、水楊酸鹽、苯甲酸鹽、苯磺酸鹽、L-焦麩胺酸鹽、甲磺酸鹽、(1S)-(+)-10-樟腦磺酸鹽、反丁烯二酸鹽、硫酸鹽、L-酒石酸鹽及D-酒石酸鹽可以如US 2017/0121310中所述製備,其全文以引用的方式併入本文中。化合物1之二鹽酸鹽及磷酸鹽之IC50
藉由下文檢定B中之程序量測且發現在Pim1、Pim2及Pim3時為< 35 nM。化合物1
因此,本申請案提供一種治療有需要之患者的骨髓增生性贅瘤的方法,其包含投與該患者N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及魯索替尼或其醫藥學上可接受之鹽。
本申請案進一步提供一種治療有需要之患者的骨髓增生性贅瘤的方法,其包含投與該患者約2毫克/天至約160毫克/天劑量之N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及治療有效量之魯索替尼或其醫藥學上可接受之鹽。
本申請案進一步提供一種治療有需要之患者的骨髓增生性贅瘤的方法,其包含投與該患者約2毫克/天至約100毫克/天劑量之N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及治療有效量之魯索替尼或其醫藥學上可接受之鹽。
本申請案進一步提供一種治療有需要之患者的骨髓增生性贅瘤的方法,其包含投與該患者約5毫克/天至約100毫克/天劑量之N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及治療有效量之魯索替尼或其醫藥學上可接受之鹽。
本申請案亦提供一種治療有需要之患者的骨髓增生性贅瘤的方法,包含投與該患者約5毫克/天至約100毫克/天劑量之N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及約10毫克/天至約50毫克/天劑量之魯索替尼或其醫藥學上可接受之鹽。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約5毫克/天至約100毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約8毫克/天至約80毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約8毫克/天至約70毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約8 mg至約60毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約8毫克/天至約50毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約8毫克/天至約40毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約8毫克/天至約30毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約8毫克/天至約20毫克/天。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約2 mg BID至約50 mg BID。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約4 mg BID至約40 mg BID。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約4 mg BID至約35 mg BID。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約4 mg至約30 mg BID。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約4 mg BID至約25 mg BID。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約4 mg BID至約20 mg BID。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約4 mg BID至約15 mg BID。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之劑量為約4 mg BID至約10 mg BID。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約10毫克/天至約30毫克/天。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約10毫克/天至約50毫克/天。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約10毫克/天至約30毫克/天。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約10毫克/天。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約20毫克/天。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約30毫克/天。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約5 mg BID至約25 mg BID。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約5 mg BID至約15 mg BID。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約5 mg BID。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約10 mg BID。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為約15 mg BID。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽之劑量為魯索替尼磷酸鹽。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽選自N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺之磷酸鹽、二鹽酸鹽、鹽酸鹽、順丁烯二酸鹽、己二酸鹽、氫溴酸鹽、(R)-(-)-杏仁酸鹽、水楊酸鹽、苯甲酸鹽、苯磺酸鹽、L-焦麩胺酸鹽、甲磺酸鹽、(1S)-(+)-10-樟腦磺酸鹽、反丁烯二酸鹽、硫酸鹽、L-酒石酸鹽及D-酒石酸鹽。
在一些實施例中,N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽為N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺之磷酸鹽。
在一些實施例中,骨髓增生性贅瘤選自真性紅血球增多症 (PV)、原發性血小板增多症(ET)、原發性骨髓纖維化、慢性骨髓性白血病 (CML)、慢性骨髓單核細胞性白血病 (CMML)、嗜伊紅血球增多症候群(HES)、系統性肥大細胞病 (SMCD)、慢性嗜中性粒細胞性白血病(CNL)及慢性嗜伊紅血球性白血病。
在一些實施例中,骨髓增生性贅瘤選自真性紅血球增多症 (PV)。
在一些實施例中,骨髓增生性贅瘤選自原發性血小板增多症(ET)。
在一些實施例中,骨髓增生性贅瘤選自原發性骨髓纖維化。
在一些實施例中,骨髓增生性贅瘤为骨髓纖維化。
在一些實施例中,魯索替尼或其醫藥學上可接受之鹽及N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽係經口投與。
前述實施例意欲以任何適合的組合加以組合如同該等實施例為多項從屬申請專利範圍(例如,與魯索替尼個別劑量有關之實施例,與PIM抑制劑(化合物1)個別劑量有關之實施例,與鹽形式有關之實施例,與骨髓增生性贅瘤個別類型有關之實施例,及與經口投與有關之實施例可以任何組合加以組合)。為簡潔起見,該等組合在本文中不單獨列出。
所有化合物及其醫藥學上可接受之鹽均可連同諸如水及溶劑之其他物質一起發現(例如,水合物及溶劑合物)或可經分離。當處於固態時,本文所描述之化合物及其鹽可以各種形式存在,且可(例如)呈溶劑合物(包括水合物)之形式。化合物可處於任何固態形式,諸如多晶型物或溶劑合物,因此除非另外清楚地指示,否則本說明書中提及化合物及其鹽應理解為包涵任何固態形式之化合物。
片語「醫藥學上可接受」在本文中係用以指在合理醫學判斷之範疇內適用於與人類及動物組織相接觸而無過度毒性、刺激、過敏反應或其他問題或併發症、與合理的益處/風險比相稱之彼等化合物、材料、組合物及/或劑型。
本發明亦包括本文所述之化合物的醫藥學上可接受之鹽。術語「醫藥學上可接受之鹽」係指所公開化合物之衍生物,其中母體化合物藉由將現存酸或鹼部分轉化為其鹽形式來改質。醫藥學上可接受之鹽之實例包括但不限於鹼性殘基(諸如胺)之無機酸或有機酸鹽;酸性殘基(諸如羧酸)之鹼鹽或有機鹽;及其類似物。本發明之醫藥學上可接受之鹽包括母體化合物之(例如)自非毒性無機酸或有機酸形成之非毒性鹽。本發明之醫藥學上可接受之鹽可藉由習知化學方法自含有鹼性或酸性部分之母體化合物合成。一般而言,此等鹽可藉由使此等化合物之遊離酸或鹼形式與化學計量之量的適當鹼或酸在水中或在有機溶劑中或在兩者之混合物中反應來製備;一般而言,如乙醚、乙酸乙酯、醇(例如甲醇、乙醇、異丙醇或丁醇)或乙腈(MeCN)之非水性介質較佳。適合鹽之列表可見於Remington's Pharmaceutical Sciences
, 第17版, (Mack Publishing Company, Easton, 1985), 第1418頁, Berge等人,J. Pharm. Sci.
,1977
,66
(1), 1-19及in Stahlet al
.,Handbook of Pharmaceutical Salts: Properties, Selection, and Use
, (Wiley, 2002)。在一些實施例中,本文所描述之化合物包括N
-氧化物形式。
本文所述之劑量係基於游離鹼。
可互換使用之術語「個體」或「患者」係指任何動物,包括哺乳動物,較佳為小鼠、大鼠、其他齧齒動物、兔、狗、貓、豬、牛、綿羊、馬或靈長類動物,且最佳為人類。
片語「治療有效量」係指在組織、系統、動物、個體或人類中引發研究人員、獸醫、醫學醫生或其他臨床醫師所尋求之生物反應或醫學反應的活性化合物或醫藥劑之量。
術語「治療(treating或treatment)」係指以下中之一或多者:(1)抑制疾病;例如在正經歷或顯示疾病、病狀或病症之病理或症狀之個體中抑制疾病、病狀或病症(亦即,遏制病理及/或症狀之進一步發展);及(2)改善疾病;例如在正經歷或顯示疾病、病狀或病症之病理或症狀之個體中改善疾病、病狀或病症(亦即,逆轉病理及/或症狀),諸如降低疾病之嚴重程度。在一個實施例中,治療(treating或treatment)包括預防或降低發展疾病之風險;例如,在可易患疾病、病狀或病症但尚未經歷或顯示該疾病之病理或症狀之個體中預防或降低發展該疾病、病狀或病症之風險。術語「BID」意謂每日兩次。其他組合
癌細胞生長及存活可受多個信號傳導路徑影響。因此,組合在激酶中展現不同偏好之不同激酶抑制劑(其調節該等激酶之活性)來治療此等病狀係適用的。靶向一個以上信號傳導路徑(或既定信號傳導路徑中所涉及之一個以上生物分子)可降低細胞群中出現抗藥性之可能性及/或降低治療之毒性。
因此,該等方法可以進一步包含投與一或多種其他激酶。例如,本發明化合物可與以下激酶之一或多種抑制劑組合用於治療癌症:Akt1、Akt2、Akt3、TGF-βR、PKA、PKG、PKC、CaM-激酶、磷酸化酶激酶、MEKK、ERK、MAPK、mTOR、EGFR、HER2、HER3、HER4、INS-R、IGF-1R、IR-R、PDGFαR、PDGFβR、CSFIR、KIT、FLK-II、KDR/FLK-1、FLK-4、flt-1、FGFR1、FGFR2、FGFR3、FGFR4、c-Met、Ron、Sea、TRKA、TRKB、TRKC、FLT3、VEGFR/Flt2、Flt4、EphA1、EphA2、EphA3、EphB2、EphB4、Tie2、Src、Fyn、Lck、Fgr、Btk、Fak、SYK、FRK、JAK、ABL、ALK及B-Raf。此外,本發明之Pim抑制劑可與和PIK3/Akt/mTOR信號傳導路徑相關之激酶的抑制劑組合,該等激酶諸如PI3K、Akt (包括Akt1、Akt2及Akt3)及mTOR激酶。
該等方法可以進一步用於與其他治療方法組合使用,例如化學療法、輻射或手術。該等化合物可與一或多種抗癌藥物(諸如化學治療劑)組合投與。例示性化學治療劑包括以下中之任一者:阿巴瑞克(abarelix)、阿地白介素(aldesleukin)、阿侖單抗(alemtuzumab)、阿利維A酸(alitretinoin)、別嘌呤醇(allopurinol)、六甲蜜胺(altretamine)、阿那曲唑(anastrozole)、三氧化二砷(arsenic trioxide)、天冬醯胺酸酶(asparaginase)、阿紮胞苷(azacitidine)、貝伐單抗(bevacizumab)、貝沙羅汀(bexarotene)、博萊黴素(bleomycin)、bortezombi、硼替佐米(bortezomib)、靜脈劑型白消安(busulfan intravenous)、口服劑型白消安(busulfan oral)、卡普睾酮(calusterone)、卡培他濱(capecitabine)、卡鉑(carboplatin)、卡莫司汀(carmustine)、西妥昔單抗(cetuximab)、苯丁酸氮芥(chlorambucil)、順鉑(cisplatin)、克拉屈濱(cladribine)、氯法拉濱(clofarabine)、環磷醯胺(cyclophosphamide)、阿糖胞苷(cytarabine)、達卡巴嗪(dacarbazine)、放線菌素D (dactinomycin)、達肝素鈉(dalteparin sodium)、達沙替尼(dasatinib)、柔紅黴素(daunorubicin)、地西他濱(decitabine)、地尼白介素(denileukin)、地尼白介素-毒素連接物(denileukin diftitox)、右雷佐生(dexrazoxane)、多西他賽(docetaxel)、多柔比星(doxorubicin)、丙酸屈他雄酮(dromostanolone propionate)、依庫珠單抗(eculizumab)、表柔比星(epirubicin)、埃羅替尼(erlotinib)、雌莫司汀(estramustine)、磷酸依託泊苷(etoposide phosphate)、依託泊苷(etoposide)、依西美坦(exemestane)、檸檬酸芬太尼(fentanyl citrate)、非格司亭(filgrastim)、氟尿苷(floxuridine)、氟達拉濱(fludarabine)、氟尿嘧啶(fluorouracil)、氟維司群(fulvestrant)、吉非替尼(gefitinib)、吉西他濱(gemcitabine)、吉妥珠單抗奧佐米星(gemtuzumab ozogamicin)、乙酸戈舍瑞林(goserelin acetate)、乙酸組氨瑞林(histrelin acetate)、替伊莫單抗(ibritumomab tiuxetan)、伊達比星(idarubicin)、異環磷醯胺(ifosfamide)、甲磺酸伊馬替尼(imatinib mesylate)、干擾素α 2a (interferon alfa 2a)、伊立替康(irinotecan)、二甲苯磺酸拉帕替尼(lapatinib ditosylate)、來那度胺(lenalidomide)、來曲唑(letrozole)、甲醯四氫葉酸(leucovorin)、乙酸亮丙瑞林(leuprolide acetate)、左旋咪唑(levamisole)、洛莫司汀(lomustine)、氮芥(meclorethamine)、乙酸甲地孕酮(megestrol acetate)、美法侖(melphalan)、巰基嘌呤(mercaptopurine)、甲氨蝶呤(methotrexate)、甲氧沙林(methoxsalen)、絲裂黴素C (mitomycin C)、米托坦(mitotane)、米托蒽醌(mitoxantrone)、苯丙酸南諾龍(nandrolone phenpropionate)、奈拉濱(nelarabine)、諾菲單抗(nofetumomab)、奧沙利鉑(oxaliplatin)、紫杉醇(paclitaxel)、帕米膦酸鹽(pamidronate)、帕尼單抗(panitumumab)、培門冬酶(pegaspargase)、聚乙二醇非格司亭(pegfilgrastim)、培美曲塞二鈉(pemetrexed disodium)、噴司他丁(pentostatin)、哌泊溴烷(pipobroman)、普卡黴素(plicamycin)、丙卡巴肼(procarbazine)、奎納克林(quinacrine)、拉布立酶(rasburicase)、利妥昔單抗(rituximab)、魯索替尼、索拉非尼(sorafenib)、鏈佐星(streptozocin)、舒尼替尼(sunitinib)、蘋果酸舒尼替尼(sunitinib maleate)、他莫昔芬(tamoxifen)、替莫唑胺(temozolomide)、替尼泊苷(teniposide)、睾內酯(testolactone)、沙利度胺(thalidomide)、硫鳥嘌呤(thioguanine)、硫替派(thiotepa)、托泊替康(topotecan)、托瑞米芬(toremifene)、托西莫單抗(tositumomab)、曲妥珠單抗(trastuzumab)、維甲酸(tretinoin)、尿嘧啶氮芥(uracil mustard)、戊柔比星(valrubicin)、長春鹼(vinblastine)、長春新鹼(vincristine)、長春瑞濱(vinorelbine)、伏立諾他(vorinostat)及唑來膦酸鹽(zoledronate)。
本發明之Pim抑制劑可進一步與一或多種消炎劑、類固醇、免疫抑制劑或治療性抗體組合使用。
當向患者投與一種以上醫藥劑時,其可同時、順序或組合(例如,對於兩種以上藥劑而言)投與。組合物
該等化合物可以醫藥組合物形式投與。此等組合物可以醫藥技術中熟知之方式製備,且可視指示局部治療抑或全身治療及欲治療之區域而定,藉由多種途徑投與。投與可為表面(包括經皮、表皮、眼部及黏膜,包括鼻內遞送、經陰道遞送及經直腸遞送)、經肺(例如藉由吸入或吹入散劑或氣霧劑,包括藉由噴霧器;氣管內或鼻內)、經口或非經腸。非經腸投與包括靜脈內、動脈內、皮下、腹膜內肌肉內或注射或輸注;或顱內,例如鞘內或室內投與。非經腸投與可呈單次團注劑形式,或可(例如)藉由連續灌注泵。用於表面投與之醫藥組合物及調配物可包括經皮貼片、軟膏劑、洗劑、乳膏劑、凝膠劑、滴劑、栓劑、噴霧劑、液體及散劑。習知醫藥載劑、水性、粉末或油性基質、增稠劑及其類似物可為必需或可需的。
該等醫藥組合物亦可含有與一或多種醫藥學上可接受之載劑(賦形劑) 組合的作為活性成分之化合物或其醫藥學上可接受之鹽。在一些實施例中,該組合物適用於表面投與。在製備本發明組合物時,活性成分通常與賦形劑混合、由賦形劑稀釋、或包封在此載劑內,呈(例如)膠囊、囊劑、紙或其他容器形式。當賦形劑充當稀釋劑時,其可為充當活性成分之媒劑、載劑或介質之固體、半固體或液體材料。因此,組合物可呈以下形式:錠劑、丸劑、散劑、口含錠、囊劑、扁囊劑、酏劑、懸浮液、乳液、溶液、糖漿、氣霧劑(呈固體形式或於液體介質之中)、軟膏劑(其含有(例如)多達10重量%的活性化合物)、軟明膠膠囊及硬明膠膠囊、栓劑、無菌可注射溶液及無菌包裝的散劑。
在製備調配物時,活性化合物可在與其他成分組合之前進行研磨以提供適當粒徑。若活性化合物大體上不可溶,則其可研磨至小於200目之粒徑。若活性化合物大體上為水溶性,則可藉由研磨調整粒徑以在調配物中提供大體上均勻的分佈,例如約40目。
可使用已知研磨程序(諸如濕磨)來研磨化合物以獲得適於錠劑形成及其他調配物類型之粒徑。本發明化合物之細碎(奈米顆粒)製劑可藉由此項技術中已知之方法來製備,參見例如WO 2002/000196。
適合賦形劑之一些實例包括乳糖、葡萄糖、蔗糖、山梨糖醇、甘露糖醇、澱粉、阿拉伯膠、磷酸鈣、海藻酸鹽、黃蓍膠、明膠、矽酸鈣、微晶纖維素、聚乙烯吡咯啶酮、纖維素、水、糖漿及甲基纖維素。調配物可另外包括:潤滑劑,諸如滑石、硬脂酸鎂及礦物油;潤濕劑;乳化劑及懸浮劑;防腐劑,諸如羥基苯甲酸甲酯及羥基苯甲酸丙酯;及甜味劑及調味劑。本發明組合物可經調配以使活性成分在藉由使用此項技術中已知之程序投與患者之後快速、持續或延遲釋放。
在一些實施例中,醫藥組合物包含矽化微晶纖維素(SMCC)及至少一種本文所描述之化合物或其醫藥學上可接受之鹽。在一些實施例中,矽化微晶纖維素包含約98 w/w%微晶纖維素及約2 w/w%二氧化矽。
在一些實施例中,組合物為持續釋放組合物,其包含至少一種本文所描述之化合物或其醫藥學上可接受之鹽,及至少一種醫藥學上可接受之載劑。在一些實施例中,組合物包含至少一種本文所描述之化合物或其醫藥學上可接受之鹽,及至少一種選自微晶纖維素、單水合乳糖、羥丙基甲基纖維素及聚氧化乙烯之組分。在一些實施例中,組合物包含至少一種本文所描述之化合物或其醫藥學上可接受之鹽,及微晶纖維素、單水合乳糖及羥丙基甲基纖維素。在一些實施例中,組合物包含至少一種本文所描述之化合物或其醫藥學上可接受之鹽,及微晶纖維素、單水合乳糖及聚氧化乙烯。在一些實施例中,組合物進一步包含硬脂酸鎂或二氧化矽。在一些實施例中,微晶纖維素為Avicel PH102™。在一些實施例中,單水合乳糖為Fast-flo 316™。在一些實施例中,羥丙基甲基纖維素為羥丙基甲基纖維素2208 K4M (例如,Methocel K4 M Premier™)及/或羥丙基甲基纖維素2208 K100LV (例如,Methocel K00LV™)。在一些實施例中,聚氧化乙烯為聚氧化乙烯WSR 1105 (例如,Polyox WSR 1105™)。
用於調配醫藥組合物之組分具有高純度且大體上不含潛在有害之污染物(例如,至少國家食品級,一般至少分析級且更通常至少醫藥級)。尤其對於人類消耗而言,組合物較佳在如美國食品與藥品管理局(the U.S. Food and Drug Administration)之適用條例中所定義之優良製造規範標準(Good Manufacturing Practice standards)下製造或調配。例如,適合調配物可為無菌及/或大體上等滲及/或完全符合美國食品與藥品管理局之所有優良製造操作條例。
活性化合物可在寬劑量範圍內有效且一般以醫藥學上有效量投與。然而應瞭解,化合物之實際投與量通常將由醫師根據相關情況確定,該等相關情況包括欲治療之病狀、所選投藥途徑、投與之實際化合物,個別患者之年齡、體重及反應,患者症狀之嚴重程度,及其類似情況。
本發明化合物之治療劑量可根據以下而變化:例如進行治療之特定用途、化合物之投藥方式、患者健康及狀況,及處方醫師之判斷。醫藥組合物中本發明化合物之比例或濃度可視許多因素而變化,該等因素包括劑量、化學特徵(例如,疏水性)及投藥途徑。
對於製備諸如錠劑之固體組合物,將主要活性成分與醫藥賦形劑混合以形成含有本發明化合物之均質混合物的固體預調配組合物。當將此等預調配組合物稱作均質時,活性成分通常均勻分散於組合物中,使得該組合物可容易地再分成同等有效單位劑型,諸如錠劑、丸劑及膠囊。接著將此固體預調配物細分成以上所描述類型之單位劑型,該等單位劑型含有(例如)約0.1 mg至約1000 mg本發明活性成分。
本發明之錠劑或丸劑可經包覆包衣或以其他方式混配以提供給予作用延長之優勢之劑型。例如,該錠劑或丸劑可包含內部劑量及外部劑量組分,後者呈包覆前者之外包體形式。兩種組分可由用於抵抗胃中之崩解且允許內部組分完整進入十二指腸或延遲釋放之腸溶層分離。多種物質可用於此等腸溶層或包衣,此等物質包括多種聚合酸及聚合酸與諸如蟲膠(shellac)、十六醇及乙酸纖維素之物質之混合物。
可併有本發明之化合物及組合物以便經口或藉由注射投與之液體形式包括水溶液、經適合調味之糖漿、水性或油性懸浮液,及具有可食油,諸如棉籽油、芝麻油、椰子油或花生油的經調味之乳液,以及酏劑及類似醫藥媒劑。
用於吸入或吹入之組合物包括在醫藥學上可接受之水性或有機溶劑中之溶液及懸浮液,或其混合物,及散劑。液體或固體組合物可含有如上所述之醫藥學上可接受之適合賦形劑。在一些實施例中,該等組合物藉由經口或經鼻呼吸途徑投與以達成局部或全身性作用。組合物可藉由使用惰性氣體霧化。霧化溶液可直接自霧化裝置呼吸,或霧化裝置可連接於面罩、帷罩或間歇式正壓呼吸機。溶液、懸浮液或散劑組合物可經口或經鼻自以適當方式遞送調配物之裝置投與。
表面調配物可含有一或多種習知載劑。在一些實施例中,軟膏劑可含有水及一或多種選自(例如)液狀石蠟、聚氧乙烯烷基醚、丙二醇、白Vaseline®
(石油膏)及其類似物之疏水性載劑。乳膏之載劑組合物可基於水與甘油及一或多種其他組分之組合,該等其他組分例如甘油單硬脂酸酯、PEG-甘油單硬脂酸酯及十六十八醇。凝膠可使用與其它組分適當組合之異丙醇及水來調配,該等其他組分諸如(例如)甘油、羥乙基纖維素及其類似物。
向患者投與之化合物或組合物之量將視所投與之物、投藥目的(諸如防治或治療)、患者狀態、投藥方式及其類似因素而變化。在治療應用中,組合物可以足以治癒或至少部分遏制疾病及其併發症之症狀的量投與已罹患該疾病之患者。有效劑量將視以下而定:所治療之疾病病況,以及主治醫師根據諸如疾病嚴重程度,患者之年齡、體重及一般狀況及其類似因素之因素所作的判斷。
投與患者之組合物可呈上述醫藥組合物形式。此等組合物可藉由習知滅菌技術來滅菌,或可無菌過濾。水溶液可經封裝以原樣使用,或凍乾,經凍乾製劑在投與之前與無菌水性載劑組合。化合物製劑之pH通常將在3與11之間、更佳為5至9且最佳為7至8。應瞭解,使用某些前述賦形劑、載劑或穩定劑將引起形成醫藥鹽。套組
本申請案亦包括適用的醫藥套組,該等套組包括一或多個容器,其含有包含治療有效量之化合物或其任一實施例的醫藥組合物。該等套組可進一步包括一或多種各種習知醫藥套組組分,諸如具有一或多種醫藥學上可接受載劑的容器,其他容器等,如熟習此項技術者顯而易見。指示欲投與組分之數量、投藥準則及/或混合該等組分之準則的呈插頁或者標籤形式之說明書亦包括於套組中。
本發明將藉助於特定實例更詳細地加以描述。提供以下實例以達成說明性目的,且不欲以任何方式限制本發明。熟習此項技術者應容易瞭解可改變或修改以生成基本上相同結果之多種非關鍵性參數。根據本文所描述之至少一種檢定,發現實例之化合物為Pim激酶抑制劑。實例 實例 A :活體外 JAK 激酶檢定
根據Park等人,Analytical Biochemistry 1999
,269
, 94-104中所述之以下活體外檢定測試本文化合物對JAK目標之抑制活性。使用桿狀病毒在昆蟲細胞中表現人類JAK1 (a.a. 837-1142)、JAK2 (a.a. 828-1132)及JAK3 (a.a. 781-1124)之催化域且加以純化。藉由量測生物素化肽之磷酸化來分析JAK1、JAK2或JAK3之催化活性。藉由均質時間解析螢光(homogenous time resolved fluorescence;HTRF)偵測磷酸化肽。在含有於具有100 mM NaCl、5 mM DTT及0.1 mg/mL(0.01%)BSA之50 mM Tris(pH 7.8)緩衝液中之酶、ATP及500 nM肽的40 μL反應中量測化合物針對各激酶之IC50
。 對於1 mM IC50
量測值,反應中之 ATP濃度為1 mM。反應在室溫下進行1小時,接著以檢定緩衝液(Perkin Elmer, Boston, MA)中之20 mL 45 mM EDTA, 300 nM SA-APC, 6 nM Eu-Py20停止。與經銪標記抗體結合40分鐘且在PHERA star盤讀取器(BMG, Cary, NC)上量測HTRF信號。藉由在實例A檢定中以1 mM ATP測試化合物獲得JAK1及/或JAK2抑制劑之資料。實例 B. Pim 酶檢定
Pim-1及Pim-3激酶檢定:在25℃下在白色384孔聚苯乙烯板中進行20 µL反應持續1小時,該等板點漬有存於檢定緩衝液(50 mM Tris,pH 7.5,0.01% Tween-20,5 mM MgCl2
,0.01% BSA,5 mM DTT)中之0.8 µL化合物/DMSO,含有0.05 µM經生物素標記之BAD肽受質(AnaSpec 62269)、1 mM ATP及2.5 pM (Pim-1,Invitrogen PV3503)或1.25 pM (Pim-3,Millipore 14-738)酶。藉由添加10 µL STOP緩衝液(150 mM Tris,pH=7.5,150 mM NaCl,75 mM EDTA,0.01% Tween-20,0.3% BSA)終止反應,該緩衝液補充有稀釋666倍之磷酸化-Bad (Ser112)抗體(細胞信號傳導9291)及各自15 µg/mL之抗生蛋白鏈菌素供體珠粒(PerkinElmer 6760002)連同蛋白質-A受體珠粒(PerkinElmer 6760137)。在減少光照下進行STOP緩衝液補充珠粒及終止反應。在終止反應之前,將具有珠粒之STOP緩衝液在黑暗中在室溫下預培育1小時。在終止反應之後,將板在黑暗中在室溫下培育1小時,隨後在減少光照下於PHERAstar FS板讀取器(BMG Labtech)上讀取。
Pim-2激酶檢定:在25℃下在白色384孔聚苯乙烯板中進行20 µL反應持續2小時,該等板點漬有於檢定緩衝液(50 mM Tris,pH 7.5,0.01% Tween-20,5 mM MgCl2
,0.01% BSA,5 mM DTT)中之0.8 µL化合物/DMSO,含有0.05 µM經螢光素標記之CREBtide肽受質(Invitrogen PV3508)、1 mM ATP及1 nM酶(Invitrogen PV3649)。藉由添加具有30 mM EDTA及1.5 nM LanthaScreen Tb-CREB pSer133抗體(Invitrogen PV3566)之10 µL TR-FRET稀釋緩衝液(Invitrogen PV3574)來終止反應。在室溫下培育30分鐘之後,在PHERAstar FS板讀取器(BMG Labtech)上讀取板。
當在以上所公開之檢定條件下針對PIM激酶活性進行測試時,認為具有2 µM或更小之IC50
之本發明化合物具有活性。
雖然以上活體外檢定係在1 mM ATP下進行,但亦可利用Km
條件針對效力及對抗PIM標靶之活體外活性來評價化合物,其中ATP濃度設定為Km
值且該檢定對PIM抑制活性更敏感。實例 C. Pim 細胞檢定
根據以下細胞檢定中之至少一者針對PIM之抑制活性測試一或多種本發明化合物。當在以下所公開之細胞檢定條件下針對PIM激酶活性進行測試時,具有10 µM或更小之IC50
之本發明化合物將且被認為具有活性。Pim 細胞增殖檢定
KG-1A細胞係購自ATCC (Manassas, VA)且KMS.12.BM細胞係購自NIBIO, JCRB細胞庫(Tokyo,Japan)且維持在所推薦之培養基中,該等培養基分別為RPMI 10% FBS (補充有10%胎牛血清之Roswell Park Memorial Institute 1640培養基)及IMDM 20% FBS (具有20%胎牛血清之伊思考夫改良之杜爾貝可培養基(Iscove's Modified Dulbecco's Medium) (MDM)) (Mediatech, Manassas, VA)。為了量測測試化合物之抗增殖活性,在存在或不存在測試化合物之濃度範圍下將兩種細胞株與培養基(2×103
個細胞/孔/於200 mL中)一起塗在96孔聚苯乙烯超低結合(Costar®
)中。在4天之後,接著將於培養基中之[3
H]-胸苷,1 µCi/10 µL/孔(PerkinElmer, Boston, MA)添加至細胞培養物持續另外16小時,之後藉由用具有水之Packard微板收集器經由0.3%聚乙烯亞胺預濕潤之玻璃纖維GF/B濾板(Packard Bioscience/PerkinElmer, Boston, MA)過濾來分離經合併之放射活性。藉由用TopCount®
閃爍計數器(PerkinElmer)進行液體閃爍計數來量測該板。藉由使用GraphPad Prism®
5.0軟體擬合抑制百分比相對於抑制劑濃度對數的曲線進行IC50
測定。Pim pBAD 信號傳導檢定
KG-1A細胞係購自ATCC (Manassas, VA)且KMS.12.BM細胞係購自NIBIO, JCRB細胞庫(Tokyo, Japan)且分別維持在所推薦之培養基RPMI 10% FBS及IMDM 20% FBS (Mediatech, Manassas, VA)中。為了量測化合物之pBAD抑制活性,將兩種細胞株與培養基(對於KG1A為1×106
個細胞/孔/100 mL及對於KMS12BM為4×105
個細胞/孔/於 100 mL中)一起塗在96孔V底聚苯乙烯板(Matrix, Thermo Fisher, USA)中且在37℃下培育30分鐘以正規化來自處理之細胞信號傳導。在適當濃度範圍下添加測試化合物且對於KMS.12.BM細胞進一步培育2.5小時且對於KG1-A細胞進一步培育4小時。將平板在2000 RPM下離心10分鐘且吸出上清液。將100 µL溶解緩衝液與蛋白酶抑制劑(Cell Signaling Technologies, Danver, MA, Sigma, St Louis MO, EMD, USA)添加至該等球粒料,充分混合且置於冰上30分鐘。溶菌液在-80℃下冷凍隔夜。為了量測pBAD活性,利用細胞信號傳導ELISA (酶聯免疫吸附檢定)套組(細胞信號傳導路徑掃描磷光體pBAD ELISA)。根據ELISA方案測試50 µL溶菌液且在SpectraMax®
M5板讀取器(Molecular Devices, Sunnyvale, CA)上藉由軟體進行資料分析。藉由使用GraphPad Prism®
5.0軟體擬合抑制百分比相對於抑制劑濃度對數的曲線進行IC50
測定。實例 1 : Pim 抑制劑 - 化合物 1 與魯索替尼協同以抑制 MPN 模型細胞生長
BaF3/EpoR/JAK2-V617F、UKE1及SET2細胞未經處理(僅DMSO-媒劑)或以魯索替尼(Rux)或化合物1及此等兩者一起 (Rux+PIMi)處理。BaF3/EpoR/JAK2-V617F細胞之結果展示於圖1(A)中;UKE1細胞之結果展示於圖1(B)中;且SET2細胞之結果展示於圖1(C)中。在72小時藉由CellTiter-Glo進行協同研究。使用Bliss獨立模型之組合的預期生長%由點線指示:更低的生長%量測值指示協同作用。實例 2 :化合物 1 與魯索替尼協同誘發細胞凋亡。
以DMSO、魯索替尼、化合物1(PIMi)或此等兩者一起處理UKE1及SET2細胞。使用FITC 膜聯蛋白V及PI對細胞進行染色且藉由流動式細胞測量術進行分析。誤差條指示標準偏差(s.d.)。使用Prism (GraphPad Software, Inc.)藉由單因素ANOVA計算p值。UKE1細胞之結果展示於圖2(A)中;且SET2細胞之結果展示於圖2(B)中。實例 3 :藉由化合物 1 抑制 JAK2-V617F(+) MPN 造血祖細胞之贅瘤紅血球系群落形成及魯索替尼與極低劑量 PIMi 之組合的協同抑制
在DMSO-媒劑、50 nM 魯索替尼(Rux)、20 nM 或5 nM 化合物1(PIMi)或組合之兩種藥物存在下,將來自MPN患者之外周血單核細胞(PV, JAK2-V617F +)塗於含有細胞因子但不具有紅血球生成素(Epo)的甲基纖維素中。12天后對Epo獨立性紅血球系群落計分。結果展示於圖3中。使用Bliss獨立模型之組合的預期生長%由具有點線之透明條狀物指示。更低的生長%量測值指示協同作用。
未經處理(僅DMSO)或以所指示濃度之化合物1(PIMi)或魯索替尼處理之MPN患者粒細胞的免疫印跡分析。結果展示於圖4中。
此等結果指示化合物1與魯索替尼在1 nM、5 nM及20 nM 化合物1時具有協同作用是出人意料的。實例 4 :協同作用轉換為人類劑量
在37℃下將來自患者之血漿樣本與KMS12BM細胞株一起離體培育2.5小時。自該等細胞製備全細胞溶菌液且使用ELISA確定pBAD之水準。呈現在80 mg BID 化合物1之第一週期第8天給藥後第24小時(圖5(A))及時程(圖5(B))中之資料(76%的平均抑制)。圖5(A) 中之結果指示在65 mg BID時達到化合物1之低谷IC50
。依次,在外加以化合物1離體處理之KMS-12-BM細胞的全血樣本中量測到BAD磷酸化作用時,化合物1 具有134 nM之IC50
。因此,65 mg BID化合物1 導致在此全血檢定中134 nM之IC50
。因為此等全血檢定中之結果不同於實例3中之檢定,因此必須在全血檢定中調整化合物1之蛋白質結合。
因此,在0.3 μM至10 μM範圍內之人類血清(活體外)中確定化合物1之蛋白質結合。化合物1展現高蛋白質結合。對於人類,平均活體外血清未結合部分(fu)為7.0%。對於蛋白質結合判定,利用來自Harvard Apparatus (Holliston, MA) 之Multi-Equilibrium Dialyzer System™及diachema膜。使樣本蛋白質沉澱,矩陣匹配,接著離心分離。轉移上清液且使用LC-MS/MS分析。將透析後緩衝液中最終峰面積比除以透析後血清中最終峰面積比,對體積位移進行校正,計算得到活體外樣本之未結合部分百分比。
實例3中之檢定涉及將來自血液之細胞塗於培養基中。由於培養基中之蛋白質含量,培養基中化合物1之游離部分為58%。假定線性劑量反應曲線,使用7%及58%之血清游離部分及培養基游離部分將實例3中之結果轉換為人類劑量。此舉可藉由如下進行:計算蛋白質結合經調整之活性為(培養基中游離之細胞活性*%)/血清中游離%—例如,對於IC50
為1 nM之細胞活性,則(1 nM* 58%) / 7% = 8.3 nM —活性的8.3倍位移。表 1
實例3中之50 nM 魯索替尼對應於約15 mg BID 之劑量的魯索替尼。通常,5-25 mg BID範圍內之劑量的魯索替尼將期望具有協同作用。
因此,41 nM及8.3 nM之蛋白質結合經調整之活性對應於化合物1之IC23
及IC5.7
。出人意料地在化合物1之如此低劑量下—充分低於IC50
的MPN細胞中觀察到與魯索替尼之協同作用。
除本文所述之彼等修改之外,本發明之各種修改亦將為熟習此項技術者根據以上描述顯而易知。該等修改亦意欲落入所附申請專利範圍的範圍內。在本申請案中引用之各參考文獻(包括但不限於所有專利、專利申請案及揭示案)係以引用的方式全部併入本文中。
圖1(A、B及C) 分別針對未經處理之細胞或以魯索替尼(Rux)或化合物1(PIMi),及以此等兩者一起(Rux+PIMi)處理之細胞描繪BaF3/EpoR/JAK2-V617F、UKE1及SET2細胞中的生長%。
圖2 (A及B) 描繪以媒劑(DMSO)、魯索替尼、化合物1(PIMi)或兩種藥物一起處理之UKE1及SET2細胞中膜聯蛋白V+%。
圖3描繪在DMSO-媒劑、50 nM 魯索替尼(Rux)、20 nM或5 nM化合物1(PIMi)或組合之兩種藥物存在下MPN患者(PV,JAK2-V617F +)的外周血單核細胞中之生長%。12天后對Epo獨立性紅血球系群落進行計分。結果展示於圖3中。使用Bliss獨立模型之組合的預期生長%由具有點線之透明條狀物指示。更低的生長%量測值指示協同作用。
圖4描繪未經處理(僅DMSO)或以所指示濃度之化合物1(PIMi)或魯索替尼處理之MPN患者粒細胞的免疫印跡分析。
圖5(A) 描繪給予化合物1後第24小時患者血漿樣本的pBAD抑制%。
圖5(B)描繪對於80 mg BID化合物1而言第1週期第8天患者血漿樣本的pBAD抑制%。
Claims (30)
- 一種治療有需要之患者之骨髓增生性贅瘤的方法,包含向該患者投與約5毫克/天至約100毫克/天劑量之N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽,及治療有效量之魯索替尼(ruxolitinib)或其醫藥學上可接受之鹽。
- 如申請專利範圍第1項之方法,其中該魯索替尼或其醫藥學上可接受之鹽為魯索替尼磷酸鹽。
- 如申請專利範圍第1項或第2項之方法,其中該N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽選自N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺之磷酸鹽、二鹽酸鹽、鹽酸鹽、順丁烯二酸鹽、己二酸鹽、氫溴酸鹽、(R)-(-)-杏仁酸鹽、水楊酸鹽、苯甲酸鹽、苯磺酸鹽、L-焦麩胺酸鹽、甲磺酸鹽、(1S)-(+)-10-樟腦磺酸鹽、反丁烯二酸鹽、硫酸鹽、L-酒石酸鹽及D-酒石酸鹽。
- 如申請專利範圍第1項或第2項之方法,其中該N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽為N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺之磷酸鹽。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約8毫克/天至約80毫克/天。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約8毫克/天至約60毫克/天。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約8毫克/天至約50毫克/天。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約8毫克/天至約40毫克/天。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約8毫克/天至約20毫克/天。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約2 mg BID至約50 BID。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約4 mg BID至約40 BID。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約4 mg BID 至約30 mg BID。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約4 mg BID 至約25 mg BID。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約4 mg BID 至約20 mg BID。
- 如申請專利範圍第1項至第4項中任一項之方法,其中N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽之該劑量為約4 mg BID 至約10 mg BID。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約10毫克/天至約50毫克/天。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約10毫克/天至約30毫克/天。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約10毫克/天。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約20毫克/天。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約30毫克/天。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約5 mg BID至約25 mg BID。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約5 mg BID 至約15 mg BID。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約5 mg BID。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約10 mg BID。
- 如申請專利範圍第1項至第15項中任一項之方法,其中魯索替尼或其醫藥學上可接受之鹽之該劑量為約15 mg BID。
- 如申請專利範圍第1項至第25項中任一項之方法,其中該骨髓增生性贅瘤選自真性紅血球增多症 (PV)、原發性血小板增多症(ET)、原發性骨髓纖維化、慢性骨髓性白血病 (CML)、慢性骨髓單核細胞性白血病 (CMML)、嗜伊紅血球增多症候群(HES)、系統性肥大細胞病 (SMCD)、慢性嗜中性粒細胞性白血病(CNL)及慢性嗜伊紅血球性白血病。
- 如申請專利範圍第1項至第25項中任一項之方法,其中該骨髓增生性贅瘤選自真性紅血球增多症 (PV)。
- 如申請專利範圍第1項至第25項中任一項之方法,其中該骨髓增生性贅瘤選自原發性血小板增多症(ET)。
- 如申請專利範圍第1項至第25項中任一項之方法,其中該骨髓增生性贅瘤選自原發性骨髓纖維化。
- 如申請專利範圍第1項至第29項中任一項之方法,其中該魯索替尼或其醫藥學上可接受之鹽,及該N-{(7R)-4-[(3R,4R,5S)-3-胺基-4-羥基-5-甲基哌啶-1-基]-7-羥基-6,7-二氫-5H-環戊并[b]吡啶-3-基}-6-(2,6-二氟苯基)-5-氟吡啶-2-甲醯胺或其醫藥學上可接受之鹽係經口投與。
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| US10596161B2 (en) | 2020-03-24 |
| WO2019113487A1 (en) | 2019-06-13 |
| AR113922A1 (es) | 2020-07-01 |
| US20190175578A1 (en) | 2019-06-13 |
| US20200179364A1 (en) | 2020-06-11 |
| US11278541B2 (en) | 2022-03-22 |
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