US20040138121A1 - Method and composition for preventing and treating solid tumors - Google Patents

Method and composition for preventing and treating solid tumors Download PDF

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US20040138121A1
US20040138121A1 US10/691,915 US69191503A US2004138121A1 US 20040138121 A1 US20040138121 A1 US 20040138121A1 US 69191503 A US69191503 A US 69191503A US 2004138121 A1 US2004138121 A1 US 2004138121A1
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endothelin
tumor
antagonist
agonist
breast
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Anil Gulati
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University of Illinois System
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Priority to US10/691,915 priority Critical patent/US20040138121A1/en
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Publication of US20040138121A1 publication Critical patent/US20040138121A1/en
Priority to US11/360,236 priority patent/US8217010B2/en
Assigned to THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS reassignment THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: GULATI, ANIL
Priority to US11/460,202 priority patent/US7976835B2/en
Priority to US11/461,961 priority patent/US20070032422A1/en
Priority to US11/845,648 priority patent/US8394757B2/en
Priority to US12/101,008 priority patent/US8026216B2/en
Priority to US12/390,376 priority patent/US8030278B2/en
Assigned to DONEHEW FUND LIMITED PARTNERSHIP reassignment DONEHEW FUND LIMITED PARTNERSHIP SECURITY AGREEMENT Assignors: EndogenX, Inc.
Priority to US13/220,373 priority patent/US8349802B2/en
Priority to US13/220,358 priority patent/US8440620B2/en
Priority to US13/491,408 priority patent/US8703709B2/en
Priority to US13/707,807 priority patent/US8642026B2/en
Priority to US13/711,519 priority patent/US8729023B2/en
Priority to US13/761,043 priority patent/US8957014B2/en
Abandoned legal-status Critical Current

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Definitions

  • the present invention relates to the prevention and treatment of solid tumors, such as breast tumors, in a mammal, either by administration of therapeutically effective amounts of an endothelin agonist and a chemotherapeutic drug, or by administration of a therapeutically effective amount of an endothelin antagonist.
  • breast cancer The development of a breast cancer is a complex process involving a combination of factors, such as environmental and genetic factors.
  • One extensively studied breast tumor model is the chemically induced rat mammary carcinogenesis model (Refs. 9, 18, 19, 39, 54).
  • Chemically induced mammary tumorigenesis in rats is the model most closely resembling a human cancer (40).
  • Chemically induced rat mammary carcinogenesis typically is achieved by administration of 7,12-dimethylbenzene(a)anthracene (DMBA) (37) or N-methylnitrosourea (MNU) (37).
  • DMBA 7,12-dimethylbenzene(a)anthracene
  • MNU N-methylnitrosourea
  • Tumors induced by DMBA or MNU have different morphological characteristics. In particular, tumors induced by MNU are more localized at the breast and are less likely to metastasize (25). Therefore, MNU often is chosen as the chemical agent for the specific induction of breast tumors in rats.
  • These breast tumors can be benign with fibroadenomas and papillomas, or they can be malignant (54).
  • Rats have six pairs of mammary glands, one in the cervical region, two in the thoracic region, one in the abdominal region, and two in the ingual region (4, 54). Virgin rats treated with MNU develop more tumors in the thoracic region than the abdominal region (41).
  • tumor vasculature has been studied extensively. Tumors greater than a few millimeters in size require a constant nutrient supply, and, therefore, have their own vascular bed and blood flow (10). Recruitment of new vasculature from preexisting blood vessels is termed “angiogenesis.” Without constant nourishment from these developing blood vessels, the tumors become hypoxic and subsequently die. Therefore, tumor vasculature has been a target of cancer therapy for a considerable time (10).
  • Tumor blood vessels develop substantially differently from normal vasculature, and have different properties.
  • Single layered epithelial cells are the first hastily formed tumor blood vessels. It has been suggested that these blood vessels are recruited when the tumor secretes certain growth factors, like vascular endothelial growth factor (VEGF), in response to hypoxic conditions (23). These newly formed tumor blood vessels do not have a smooth muscle layer or innervation (29, 36, 57).
  • VEGF vascular endothelial growth factor
  • Tumors also incorporate mature blood vessels that possess all their autoregulatory functions (29).
  • Normal tissue vascular tone is governed by a host of endogenous factors like H + , K + , Ca 2+ , pO 2 , pCO 2 , nitric oxide (NO), as well as other regulatory substances like endothelin (ET-1) (24, 46).
  • ET-1 is a potent vasoconstrictor and contributes significantly in regulating vascular tone (61).
  • ET B receptors are found on stromal fibroblast cells (5, 34). Endothelins have been found to be mitogenic to fibroblasts (53), melanocytes, vascular smooth muscle, and endothelium (3, 35, 52).
  • Investigators have shown an increase in ET-1, ET-3, and ET B receptor expression in breast carcinomas (1). It has been shown that both ET-1 and ET-3 cause an increase in VEGF, which is an important angiogenic factor (35).
  • VEGF an important angiogenic factor
  • the present invention is directed to the effect of endothelin antagonists and endothelin agonists on systemic hemodynamics and blood circulation in solid tumor tissues.
  • the present invention also is directed to the use of endothelin agonists and endothelin antagonists in the treatment of solid tumors.
  • the present invention is directed to administration of therapeutically effective amounts of an endothelin agonist and a chemotherapeutic agent to an individual in need thereof in the treatment of a solid tumor.
  • the present invention also is directed to administration of a therapeutically effective amount of an endothelin antagonist to an individual in need thereof in the prevention and treatment of a solid tumor, such as a breast tumor.
  • ET is a powerful regulator of blood flow.
  • ET A receptors have been found to be vasoconstrictors, and ET B receptors have been found to be vasodilators.
  • an ET B receptor antagonist can block the increased blood flow to breast tumor tissue induced by ET-1.
  • an endothelin antagonist particularly an ET B receptor antagonist, is useful to prevent the growth of breast or other solid tumors having ET B receptors regulating their blood flow.
  • ET B receptors are vasodilators, it has been found that an ET B receptor agonist, in combination with a chemotherapeutic agent, is useful in the treatment of a solid tumor, such as those found in breast cancer. In this embodiment, the ET B receptor agonist more effectively delivers the chemotherapeutic agent to the breast tumor resulting in an enhanced treatment.
  • one aspect of the present invention is to provide a method of treating solid tumors comprising administering to a mammal in need thereof a therapeutically effective amount of an endothelin agonist and a chemotherapeutic agent.
  • Another aspect of the present invention is to provide a composition comprising an endothelin agonist, in particular an ET B agonist.
  • the composition is useful in the treatment of solid tumors.
  • the endothelin agonist is used in conjunction with a chemotherapeutic agent.
  • the present invention also is directed to compositions containing an endothelin agonist, and to methods of administering the endothelin agonist, in conjunction with a chemotherapeutic agent, to treat solid tumors.
  • Still another aspect of the present invention is to provide a composition comprising an endothelin agonist, a second therapeutic agent useful in the treatment of a solid tumor, and an excipient.
  • Still another aspect of the present invention is to provide a method of preventing or treating solid tumors comprising administering to a mammal in need thereof a therapeutically effective amount of an endothelin antagonist.
  • the endothelin antagonist can be an endothelin B antagonist or a mixed endothelin A/B antagonist.
  • the endothelin antagonist comprises a specific endothelin B (ET B ) antagonist.
  • the endothelin antagonist optionally is used in conjunction with an angiogenesis inhibitor, radiation treatment, or both.
  • Another aspect of the present invention is to provide a composition comprising an endothelin antagonist, in particular an ET B antagonist, to an individual in need thereof.
  • the composition is useful in the prevention and treatment of solid tumors.
  • Another aspect of the present invention is to provide a composition comprising an endothelin antagonist, a second therapeutic agent useful in the prevention or treatment of a solid tumor, and an excipient.
  • Yet another aspect of the present invention is to provide an article of manufacture for human pharmaceutical use, comprising (a) a container, and (b1) a packaged composition comprising an endothelin agonist and, optionally, (b2) a packaged composition comprising a second therapeutic agent useful in the treatment of a solid tumor, and (c) a package insert containing directions for use of the composition or compositions administered simultaneously or sequentially, in the treatment of a solid tumor.
  • the endothelin agonist is an ET B receptor agonist and the second therapeutic agent is a chemotherapeutic agent.
  • Another aspect of the present invention is to provide an article of manufacture for human pharmaceutical use, comprising (a) a container, (b1) a packaged composition comprising an endothelin antagonist and, optionally, (b2) a packaged composition comprising a second therapeutic agent useful in the treatment of a solid tumor, and (c) a package insert containing directions for use of the composition or compositions, administered simultaneously or sequentially, in the prevention or treatment of a solid tumor.
  • the endothelin antagonist is an ET B receptor antagonist
  • the second therapeutic agent is an angiogenesis inhibitor, radiation treatment, or both.
  • FIG. 1 contains bar graphs showing the effect of ET-1 on systemic hemodynamics of saline-treated and MNU-treated, tumor-bearing rats;
  • FIG. 2 contains bar graphs showing the effect of ET-1 on blood flow and regional vascular resistance in the breast tissue of saline-treated and MNU-treated rats;
  • FIG. 3 contains plots showing the effect of ET-1 on perfusion, CMBC, and velocity of blood cells in breast tissue of saline-treated and tumor tissue of MNU-treated rats;
  • FIG. 4 contains plots showing the effect of BQ788 on ET-1-induced changes in blood perfusion, CMBC, and velocity of blood cells in breast tissue of saline-treated and tumor tissue of MNU-treated rats;
  • FIG. 5 contains plots showing the effect of IRL1620 on paclitaxel-induced changes in tumor perfusion.
  • the present invention is directed to compositions and methods of preventing and treating solid tumors, including breast tumors.
  • the present invention is directed to pharmaceutical compositions comprising either (a) an endothelin agonist and, optionally, a chemotherapeutic agent or (b) an endothelin antagonist, and optionally, angiogenesis inhibitor.
  • the present invention also is directed to articles of manufacture comprising an endothelin antagonist and an optional angiogenesis inhibitor, packaged separately or together, and an insert having instructions for using these active agents to prevent or treat a solid tumor.
  • the present invention is directed articles of manufacture comprising an endothelin agonist and a chemotherapeutic agent, packaged separately or together, and an insert having instructions for using these active agents to treat a solid cancerous tumor.
  • One method disclosed herein utilizes an endothelin agonist and a chemotherapeutic agent in the treatment of a solid tumor.
  • the agonist and chemotherapeutic agent can be administered in sufficient amounts, simultaneously or sequentially, to achieve the desired therapeutic effect.
  • Another method disclosed herein utilizes an endothelin antagonist, optionally with an angiogenesis inhibitor, in the treatment of solid tumors.
  • the antagonist and angiogenesis inhibitor can be administered in sufficient amounts, simultaneously or sequentially, to achieve the desired effect.
  • treatment includes preventing, retarding the progression of, shrinking, or eliminating a solid tumor.
  • treatment includes both medical therapeutic and/or prophylactic administration, as appropriate.
  • container means any receptacle and closure therefor suitable for storing, shipping, dispensing, and/or handling a pharmaceutical product.
  • the term “insert” means information accompanying a pharmaceutical product that provides a description of how to administer the product, along with the safety and efficacy data required to allow the physician, pharmacist, and patient to make an informed decision regarding use of the product.
  • the package insert generally is regarded as the “label” for a pharmaceutical product.
  • prodrug means compounds that transform rapidly in vivo to a compound useful in the invention, for example, by hydrolysis.
  • a thorough discussion of prodrugs is provided in Higuchi et al., Prodrugs as Novel Delivery Systems, Vol. 14, of the A.C.S.D. Symposium Series, and in Roche (ed.), Bioreversible Carriers in Drug Design , American Pharmaceutical Association and Pergamon Press, 1987.
  • Endothelin is a vasoactive substance known to modulate blood flow and also has mitogenic properties. Endothelin is present in large concentrations in breast carcinoma tissues compared to normal breast tissue. In accordance with the present invention, it has been shown that a subtype of endothelin receptor (ET B ) also is increased in breast cancer. Endothelin acts on ET B receptors to produce vascular dilation and increase in blood flow to the breast tumor tissue. Importantly, it also has been found that an ET B receptor antagonist can block the increase in tumor blood flow induced by endothelin.
  • ET B endothelin receptor
  • a selective ET B receptor antagonist e.g., BQ788, can be used to block endothelin-induced vasodilation in the breast tumor tissue, and cut off or reduce the blood supply and nutrient supply needed for the breast tumor to grow.
  • An ET B antagonist can be used alone, or in combination with an angiogenesis inhibitor, like thalidomide, that inhibits the formation of new blood vessels in the tumor tissue. Once the blood supply and nutrient supply to the tumor tissue are reduced, the growth of the tumor also is reduced.
  • chemotherapeutic agents have cytotoxic properties that are targeted to destroy cancer cells, but in the process inflict considerable damage to the body's normal physiological systems. It would be of great advantage, therefore, to selectively deliver chemotherapeutic agents to the tumor tissue. Accordingly, an ET B receptor agonist that selectively increases blood supply to the tumor can increase the delivery and efficacy of the chemotherapeutic agent. Therefore, ET B receptor agonists can selectively increase the delivery of chemotherapeutic agents, like tamoxifen, to a breast tumor and increase efficacy of the chemotherapeutic agent.
  • ET-1 endothelin-1
  • breast carcinoma tissues i.e., 11.95 pg/mg tissue
  • normal breast tissue i.e., 0.12 pg/mg tissue
  • ET-1, ET-3, and ET B receptor expression is increased in breast cancer (grade III, strong staining compared to negative staining in controls) (Alanen et al., Histopathology, 36(2):161-167 (2000)). It also has been found that ET-1 produces an increase in blood flow to the breast tumor by stimulating ET B receptors. BQ788, an ET B receptor antagonist, completely blocked ET-1 induced increase in tumor blood flow. Because breast tumor tissue has enhanced ET B receptor expression, an ET B receptor antagonist can be used to selectively decrease breast tumor blood supply, and an ET B receptor agonist can be used to increase blood flow to the breast tumor tissue.
  • an ET B receptor agonist in combination with a chemotherapeutic agent decreases breast tumor growth.
  • an ET B receptor antagonist, either alone or in combination with an angiogenesis inhibitor significantly decreases the breast tumor growth.
  • an ET B receptor agonist in combination with a chemotherapeutic agent also can be used to treat or prevent other solid tumors, including, but not limited to, ovarian cancer, colon carcinoma, Kapoli's sarcoma, breast cancer, and melanomas.
  • An endothelin antagonist, alone or in combination with an angiogenesis inhibitor, also can be used in the treatment and prevention of solid tumors.
  • a solid tumor is treated using an endothelin agonist in conjunction with a chemotherapeutic agent.
  • the endothelin agonist notably an ET B agonist
  • the ET B agonist therefore, provides a more selective target for the chemotherapeutic agent and improves the chemotherapeutic effect of the agent.
  • ET B agonists useful in the present invention include, but are not limited, to, ET-1, ET-2, ET-3, BQ3020, IRL1620, sarafotoxin S6c, [Ala 1, 3, 11, 15 ]ET-1, and mixtures thereof.
  • endothelin agonists stimulate ET B receptors and dilate tumor blood vessels, thereby increasing delivery of the chemotherapeutic agent to the tumor.
  • Endothelin agonists also increase blood perfusion of the solid tumor, and thereby increase oxygenation of the tissue. Improved oxygenation is known to enhance the therapeutic action of chemotherapeutic agents.
  • the mitogenic action of endothelin also can help increase the action of chemotherapeutic agents, when administered together.
  • the mitogenic action of an endothelin agonist can improve incorporation of chemotherapeutic agents in the dividing cells, and increase the efficacy of the chemotherapeutic agents.
  • the ET B agonist is used in conjunction with a chemotherapeutic agent.
  • the ET B agonist enhances the therapeutic benefit of chemotherapy treatment, including induction chemotherapy and primary (neoadjuvant) chemotherapy.
  • chemotherapy is frequently indicated as an adjuvant to surgery in the treatment of a cancer.
  • the goal of chemotherapy in the adjuvant setting is to reduce the risk of recurrence and enhance disease-free survival when the primary tumor has been controlled.
  • Chemotherapy is utilized as a treatment adjuvant for a cancer, frequently when the disease is metastatic.
  • An ET B agonist therefore, is particularly useful following surgery in the treatment of a solid tumor in combination with chemotherapy.
  • Chemotherapeutic agents that can be used in the present method include, but are not limited to, alkylating agents, antimetabolites, hormones and antagonists thereof, radioisotopes, antibodies, as well as natural products, and mixtures thereof.
  • an ET B agonist can be administered with antibiotics, such as doxorubicin and other anthracycline analogs, nitrogen mustards, such as cyclophosphamide, pyrimidine analogs such as 5-fluorouracil, cisplatin, hydroxyurea, taxol and its natural and synthetic derivatives, and the like.
  • the ET B agonist can be administered in conjunction with leuprolide or goserelin (synthetic peptide analogs of LH-RH).
  • leuprolide or goserelin synthetic peptide analogs of LH-RH.
  • Alkylating agents Nitrogen mustards mechlorethamine cyclophosphamide ifosfamide melphalan chlorambucil Nitrosoureas carmustine (BCNU) lomustine (CCNU) semustine (methyl-CCNU) Ethylenimine/Methylmelamine thriethylenemelamine (TEM) triethylene thiophosphoramide (thiotepa) hexamethylmelamine (HMM, altretamine) Alkyl sulfonates busulfan Triazines dacarbazine (DTIC) Antimetabolites Folic Acid analogs methotrexate trimetrexate Pyrimidine analogs 5-fluorouracil fluorodeoxyuridine gemcitabine cytosine arabinoside (AraC, cytarabine) 5-azacytidine 2,2′-difluorodeoxycytidine Purine analogs 6-mercaptopurine 6-thioguanine azathioprine 2′-deoxy
  • chemotherapeutic agents that are particularly useful in conjunction with an ET B agonist include, for example, adriamycin, camptothecin, carboplatin, cisplatin, daunorubicin, doxorubicin, interferon (alpha, beta, gamma), interleukin 2, irinotecan, docetaxel, paclitaxel, topotecan, and therapeutically effective analogs and derivatives of the same.
  • an endothelin antagonist utilized in the method and composition can be any ET B receptor antagonist known in the art.
  • ET B receptors are potent vasodilators.
  • ET B antagonists inhibit the activity of ET B , and are used to restrict blood flow.
  • ET B antagonists useful in the present invention can be selective ET B antagonists or balanced ET A /ET B antagonists.
  • ET B receptor antagonists, and balanced ET A /ET B antagonists, useful in the treatment and/or prevention of solid tumors are set forth in Appendices A through C herein. Additional useful endothelin antagonists can be found in U.S. Patent Application Publication No. US 2002/0082285 A1, incorporated herein by reference.
  • ET B antagonists useful in the present invention include, but are not limited to, atrasentan, tezosentan, bosentan, sitaxsentan, enrasentan, Ro468443, TBC10950, TBC10894, A192621, A308165, SB209670, SB217242, A182086, (s)-Lu302872, J-104132, TAK-044, Sarafotoxin 56c, IRL2500, RES7011, Aselacins A, B, and C, Ro470203, Ro462005, sulfamethoxazole, cochinmicin I, II, and III, L749329, L571281, L754142, J104132, CGS27830, A182086, PD142893, PD143296, PD145065, PD156252, PD159020, PD160672, PD160874, TM-ET-1, IRL3630, Ro485695, L
  • BQ-788 is a preferred specific endothelin B antagonist, and is the sodium salt of N-cis-2,6-dimethylpiperidinocarbonyl-L-gamma-methylleucyl-D-1-methoxycarbonyl triptophanyl-DNIe (see Proc. Natl. Acad. Sci. USA, 91:4892-4896 (1994)).
  • a compound that inhibits the formation of endogenous endothelin also can be used as the endothelin antagonist in the present invention.
  • Such compounds are useful because they prevent endothelin formation and, therefore, decrease the activity of endothelin receptors.
  • One class of such compounds is the endothelin converting enzyme (ECE) inhibitors.
  • ECE inhibitors include, but are not limited to, CGS34225 (i.e., N-((1-((2-(S)(acetylthio)-1-oxopentyl)-amino)-1-cyclopentyl)-carbonyl-S-4-phenylphenyl-alanine methyl ester) and phosphoramidon (i.e., N-(1-rhamnopyranosyloxyhydroxyphosphinyl)-Leu-Trp).
  • CGS34225 i.e., N-((1-((2-(S)(acetylthio)-1-oxopentyl)-amino)-1-cyclopentyl)-carbonyl-S-4-phenylphenyl-alanine methyl ester
  • phosphoramidon i.e., N-(1-rhamnopyranosyloxyhydroxyphosphinyl)-Leu-Trp
  • the ET B receptor antagonist can be used in conjunction with an angiogenesis inhibitor.
  • angiogenesis is the generation of new vasculature from preexisting blood vessels.
  • An angiogenesis inhibitor retards or eliminates the generation of new vasculature.
  • angiogenesis inhibitor known in the art can be used with an ET B antagonist in the present method.
  • angiogenesis inhibitors include, but are not limited to, thalidomide, marimastat, COL-3, BMS-275291, squalamine, 2-ME, SU6668, neovastat, Medi-522, EMD121974, CAI, celecoxib, interleukin-12, IM862, TNP470, avastin, gleevac, herceptin, and mixtures thereof.
  • an ET B antagonist and an optional angiogenesis inhibitor are administered to an individual in need thereof to treat a solid tumor by restricting blood flow and inhibiting the formation of new vasculature
  • the individual also can be treated using radiation therapy and/or a radiosensitizer.
  • radiosensitizer is defined as a compound administered to a human or other animal in a therapeutically effective amount to increase the sensitivity of cells to electromagnetic radiation and/or to promote the treatment of diseases that are treatable with electromagnetic radiation. Radiosensitizers can be administered in conjunction with an ET B antagonist and optional angiogenesis inhibitor.
  • electromagnetic radiation and “radiation” as used herein include, but are not limited to, radiation having the wavelength of 10-20 to 100 meters.
  • Preferred embodiments of the present invention employ the electromagnetic radiation of gamma-radiation (10-20 to 10-13 m), X-ray radiation (10-12 to 10-9 m), ultraviolet light (10 nm to 400 nm), visible light (400 nm to 700 nm), infrared radiation (700 nm to 1.0 mm), and microwave radiation (1 mm to 30 cm).
  • radiosensitizers activated by electromagnetic radiation, e.g., X-rays.
  • X-ray-activated radiosensitizers include, but are not limited to, the following: metronidazole, misonidazole, desmethylmisonidazole, pimonidazole, etanidazole, nimorazole, mitomycin C, RSU 1069, SR 4233, EO9, RB 6145, nicotinamide, 5-bromodeoxyuridine (BUdR), 5-iododeoxyuridine (IUdR), bromodeoxycytidine, fluorodeoxyuridine (FUdR), hydroxyurea, cisplatin, and therapeutically effective analogs and derivatives of the same.
  • metronidazole misonidazole
  • desmethylmisonidazole pimonidazole
  • etanidazole nimorazole
  • mitomycin C RSU 1069
  • Photodynamic therapy (PDT) of cancers employs visible light as the radiation activator of the sensitizing agent.
  • photodynamic radiosensitizers include, but are not limited to, hematoporphyrin derivatives, PHOTOFRIN®, benzoporphyrin derivatives, NPe6, tin etioporphyrin (SnET2), pheoborbide-a, bacteriochlorophyll-a, naphthalocyanines, phthalocyanines, zinc phthalocyanine, and therapeutically effective analogs and derivatives of the same.
  • VEGF vascular endothelial growth factor
  • ET-1 vasoactive substances like endothelin-1
  • cytokines vascular endothelial growth factor
  • VEGF vascular endothelial growth factor
  • ET-1 vasoactive substances like endothelin-1
  • cytokines cytokines
  • ET-1 produces an increase in blood flow to the breast tumor by stimulating ET B receptors.
  • BQ788 an ET B receptor antagonist, completely blocked an ET-1 induced increase in tumor blood flow.
  • breast tumor tissue has enhanced ET B receptor expression, an ET B receptor antagonist can be used to decrease blood supply selectively to tumor tissue.
  • an ET B receptor agonist increases blood supply to tumor tissue, thereby facilitating administration of a chemotherapeutic drug to the tumor.
  • an ET B receptor agonist can be used in combination with a chemotherapeutic agent in the treatment of a solid tumor, like a breast tissue.
  • most chemotherapeutic agents have cytotoxic properties and are targeted to destroying cancer cells.
  • ET B receptor agonists that selectively increase blood supply to the tumor therefore can increase the delivery and efficacy of chemotherapeutic agents.
  • ET B receptor antagonists can be used in the treatment of a breast cancer either alone or in combination with an angiogenesis inhibitor.
  • Angiogenesis inhibitors prevent the formation of new blood vessels needed for the growth of the tumor. Therefore, a combination of an angiogenesis inhibitor with an ET B receptor antagonist, which selectively decreases the blood supply to breast tumor tissue, significantly decreases tumor growth.
  • an ET B receptor agonist in combination with a chemotherapeutic agent decreases solid tumor growth.
  • an ET B receptor antagonist, either alone or in combination with an angiogenesis inhibitor significantly decreases solid tumor growth.
  • mice Female Sprague Dawley rats (Harlan Co., Madison, Wis.) weighing 180-200 grams (g) were used. All animals were housed, three to a cage, in a temperature controlled room (23 ⁇ 1° C.), humidity (50 ⁇ 10%), and artificial light (0600-1800 hr). The animals were given food and water ad libitum. The experiments were conducted after the animals had been acclimatized to the environment for at least four days.
  • N-methylnitrosourea was purchased from Ash Stevens Inc., Detroit, Mich.
  • BQ788 N-cis2,6-dimethylpiperidinocarbonyl-L-gamma-methylleucyl-D-1-methoxycarbonyltrptophanyl-D-Nle
  • IRL1620 IRL1620
  • E-1 Endothelin-1
  • BQ788 was dissolved in saline and ET-1 was dissolved in 0.1% albumin.
  • MNU 50 mg/kg, i.p.
  • saline 1 ml/kg, i.p.
  • Rats were anesthetized with urethane (1.5 g/kg, i.p.) (Sigma Chemicals, St. Louis, Mo.).
  • the left femoral vein was cannulated (PE 50 tubing, Clay Adams, Parsipanny, N.J.) for drug administration.
  • the left femoral artery was cannulated, and was used for withdrawal of reference blood samples.
  • the right femoral artery was cannulated and connected to a Gould P23 ID pressure transducer for recording the blood pressure on a Grass P7D polygraph (Grass Instrument Co., Quincy, Mass., USA) through a 7PI preamplifier.
  • the heart rate (HR) was recorded through a 7P4B Grass tachograph (Grass Instrument Co., Quincy, Mass.) triggered from blood pressure signals.
  • the blood perfusion to the mammary gland of the rats was measured using laser Doppler flowmetry.
  • the animals were shaved around the nipples and the skin surrounding the mammary glands was dissected out.
  • a standard model fiber optic probe was secured to the mammary artery and connected to a Periflux PF2b 4000 Laser Doppler Flowmetry (Perimed KB, Sweden). The time constant was set to 1.5 seconds, and the band width was set to 4 KHz.
  • MNU and saline treatments were performed as intraperitoneal (i.p.) injections three months prior to the study. Rats were palpated regularly starting four weeks after the treatments. Once tumors reached an optimal size (i.e., 4-8 mm in diameter), the experiments were initiated. Systemic hemodynamic and regional circulation parameters were determined at baseline, 30, 60, and 120 minutes after starting ET-1 (50 ng/kg/min) infusion. Because ET-1 infusion was performed for 30 minutes, the 30-minute data shows the effect of ET-1, and the 60- and 120-minute data indicates duration of the ET-1 effect.
  • ET-1 50 ng/kg/min
  • Rats were anesthetized with urethane (1.5 g/kg, i.p.) (Sigma Chemicals, St. Louis, Mo.). All surgical areas were shaved and cleaned with alcohol swabs.
  • the left femoral vein was cannulated (PE 50 tubing, Clay Adams, Parsipanny, N.J.) for drug administration.
  • the left femoral artery was cannulated (PE 50 tubing) and was used for withdrawal of reference blood sample in microsphere studies using a withdrawal pump (Model 22, Harvard Apparatus, South Natick, Mass.).
  • the right femoral artery was cannulated (PE 50 tubing) and connected to a Gould P23 ID pressure transducer for recording the blood pressure on a Grass P7D polygraph (Grass Instrument Co., Quincy, Mass., USA) through a 7PI preamplifier.
  • the heart rate (HR) was recorded through a 7P4B Grass tachograph (Grass Instrument Co., Quincy, Mass.) triggered from blood pressure signals.
  • the right carotid artery was exposed and a PE 50 tubing was guided through the common carotid artery into the left ventricle.
  • the animals were sacrificed with an overdose of pentobarbital sodium. All tissues and organs were dissected out, weighed, and placed in vials. The radioactivity in the standards, the blood samples, and the tissue samples were counted in a Packard Minaxi Auto-Gamma 5000 series gamma counter (Packard Instruments Co., Downers Grove, Ill.) with preset windows discriminating the isotope energies.
  • a Packard Minaxi Auto-Gamma 5000 series gamma counter Packard Instruments Co., Downers Grove, Ill.
  • cardiac output (CO) ((radioactivity injected x withdrawal rate of arterial blood)/radioactivity in sampled arterial blood)
  • stroke volume (SV) (CO/HR)
  • total peripheral resistance (TPR) (mean arterial pressure (MAP)/CO)
  • MAP mean arterial pressure
  • MAP/regional blood flow The data were calculated using computer programs described in the literature (45).
  • FIG. 3 shows the changes in perfusion, concentration of moving blood cells (CMBC), and velocity of red blood cells (RBC) in the breast tissue of tumor-bearing and normal rats.
  • CMBC moving blood cells
  • RBC red blood cells
  • CMBC in tumor-bearing rats increased significantly (54%; p ⁇ 0.05) at 60 minutes post ET-1 administration as compared to normal rats.
  • CMBC returned to baseline at 120 minutes after ET-1 administration.
  • the velocity of RBC increased significantly (252%; p ⁇ 0.05) at 30 minutes post ET-1 administration compared to normal rats.
  • FIG. 4 shows the effect of BQ788 on changes induced by ET-1 in blood perfusion, CMBC, and velocity of RBC in tumor-bearing and normal rats, respectively.
  • Blood perfusion in the breast tissue of normal rats did not change significantly after BQ788 administration or ET-1 infusion.
  • perfusion in the breast tumor tissue of tumor-bearing rats decreased significantly at 30 (25.25 ⁇ 5.7%; P ⁇ 0.05) and 60 minutes (25.17 ⁇ 2.8%; P ⁇ 0.05) following ET-1 infusion in BQ788 pretreated rats.
  • Pretreatment with BQ788 attenuated the increase in perfusion induced by ET-1 in tumor-bearing rats. No difference between the perfusion in breast tissue of tumor-bearing rats and normal rats was observed following ET-1 administration in BQ788 pretreated rats.
  • CMBC in tumor-bearing rats was significantly higher than the baseline CMBC of breast tissue of normal rats (42.4%; P ⁇ 0.05).
  • BQ788 infusion no difference between CMBC of tumor-bearing and normal rats was observed.
  • no difference in velocity of RBC between the two groups was observed.
  • ET-1 stimulates angiogenesis by promoting production of VEGF.
  • ET-1 is a powerful vasoconstrictor (61).
  • ET-1 belongs to a family of peptides approximately 21 amino acids long. At least three forms of ET receptors exist, and are known as ET A , ET B , and ET C .
  • ET A has a higher affinity for ET-1, but ET B has equal affinity for both ET-1 and ET-3 (2, 17, 42).
  • ET-1 has complex cardiovascular effects.
  • ET A receptors are responsible for the vasoconstrictor responses
  • ET B receptors are responsible for the vasodilatory actions of ET-1.
  • ET-1 administration resulted in an increase in blood flow to the skin tumors possibly due to the vasodilatory actions of ET B (6). Similar results in blood flow to the breast tumor of rats are expected because of an increase in ET-1 and ET B in breast tumors.
  • ET-1 Infusion of 50 ng/kg/min of ET-1 caused a biphasic response in blood pressure, i.e., an immediate but short lasting decrease followed by a sustained increase. These results are in accordance with previous studies (20, 30, 38, 56). ET-1 produced a marked pressor response in both normal and tumor-bearing rats, which was accompanied by a significant decrease in SV and CO. TPR significantly increased in both normal and tumor-bearing rats and may explain the observed pressor response.
  • BQ788 i.e., N-cis-2,6-dimethylpiperidinocarbonyl-L-gamma-methylleucyl-D-1-methoxycarbonyltrptophanyl-D-Nle
  • BQ788 inhibits binding to ET B receptors with an IC 50 value of 1.2 nM.
  • BQ788 was used to determine the role of ET B receptors in ET-1 induced vasodilation in the breast tumor. This result suggests that ET-1-induced vasodilatory responses are mediated through ET B receptors. Expression of ET B receptors is significantly higher in the endothelial cells than in the smooth muscle cells, and is regulated by various growth factors and cytokines (49). Normal breast tissue has a higher level of ET B than ET A receptors (1), and it is theorized, but not relied upon, that during breast cancer, ET B receptors are overexpressed and contribute to maintaining blood flow to the tumor tissue.
  • the present tests clearly demonstrate that the infusion of ET-1 produced an increase in blood flow and a decrease in vascular resistance of the breast tumor tissue, and that this increase in blood flow can be blocked by an ET B receptor antagonist, e.g., BQ788.
  • an ET B receptor antagonist e.g., BQ788.
  • ET B receptor antagonists play a role in reducing blood supply to the breast tumor tissue, and thereby prevent and/or reduce growth of the breast tumor, and solid tumors in general.
  • ET B antagonists like BQ788, can prevent or treat solid tumors.
  • ET B antagonists optionally can be combined with an angiogenesis inhibitor to potentiate the effects of the ET B antagonist.
  • the ET B antagonist, optional angiogenesis inhibitor, ET B agonist, and chemotherapeutic agent can be formulated in suitable excipients for oral administration or for parenteral administration. Such excipients are well known in the art.
  • the active ingredients typically are present in such a composition in an amount of about 0.1% to about 75% by weight.
  • compositions containing the active ingredients are suitable for administration to humans or other mammals.
  • the pharmaceutical compositions are sterile, and contain no toxic, carcinogenic, or mutagenic compounds that would cause an adverse reaction when administered.
  • Administration of the pharmaceutical composition can be performed before, during, or after the onset of solid tumor growth.
  • a method of the present invention can be accomplished using active ingredients as described above, or as a physiologically acceptable salt, derivative, prodrug, or solvate thereof.
  • the active ingredients can be administered as the neat compound, or as a pharmaceutical composition containing either or both entities.
  • the active ingredients can be administered by any suitable route, for example by oral, buccal, inhalation, sublingual, rectal, vaginal, intracisternal through lumbar puncture, transurethral, nasal, percutaneous, i.e., transdermal, or parenteral (including intravenous, intramuscular, subcutaneous, and intracoronary) administration.
  • Parenteral administration can be accomplished using a needle and syringe, or using a high pressure technique, like POWDERJECTTM.
  • compositions include those wherein the active ingredients are administered in an effective amount to achieve their intended purpose. More specifically, a “therapeutically effective amount” means an amount effective to prevent development of, to eliminate, to retard the progression of, or to reduce the size of a solid tumor. Determination of a therapeutically effective amount is well within the capability of those skilled in the art, especially in light of the detailed disclosure provided herein.
  • a “therapeutically effective dose” refers to that amount of the active ingredients that results in achieving the desired effect. Toxicity and therapeutic efficacy of such active ingredients can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., determining the LD 50 (the dose lethal to 50% of the population) and the ED 50 (the dose therapeutically effective in 50% of the population). The dose ratio between toxic and therapeutic effects is the therapeutic index, which is expressed as the ratio between LD 50 and ED 50 . A high therapeutic index is preferred. The data obtained can be used in formulating a range of dosage for use in humans. The dosage of the active ingredients preferably lies within a range of circulating concentrations that include the ED 50 with little or no toxicity. The dosage can vary within this range depending upon the dosage form employed, and the route of administration utilized.
  • the amount of pharmaceutical composition administered is dependent on the subject being treated, on the subject's weight, the severity of the affliction, the manner of administration, and the judgment of the prescribing physician.
  • oral dosages of active ingredients individually generally are about 10 to about 200 mg daily for an average adult patient (70 kg), typically divided into two to three doses per day.
  • individual tablets or capsules contain about 0.1 to about 50 mg active ingredients, in a suitable pharmaceutically acceptable vehicle or carrier, for administration in single or multiple doses, once or several times per day.
  • Dosages for intravenous, buccal, or sublingual administration typically are about 0.1 to about 10 mg/kg per single dose as required.
  • the physician determines the actual dosing regimen that is most suitable for an individual patient, and the dosage varies with the age, weight, and response of the particular patient.
  • the above dosages are exemplary of the average case, but there can be individual instances in which higher or lower dosages are merited, and such are within the scope of this invention.
  • compositions for use in accordance with the present invention thus can be formulated in a conventional manner using one or more physiologically acceptable carriers comprising excipients and auxiliaries that facilitate processing of the active ingredients into preparations which can be used pharmaceutically.
  • compositions can be manufactured in a conventional manner, e.g., by conventional mixing, dissolving, granulating, dragee-making, emulsifying, encapsulating, entrapping, or lyophilizing processes. Proper formulation is dependent upon the route of administration chosen.
  • the composition typically is in the form of a tablet, capsule, powder, solution, or elixir.
  • the composition can additionally contain a solid carrier, such as a gelatin or an adjuvant.
  • the tablet, capsule, and powder contain about 5% to about 95% of an active ingredients, and preferably from about 25% to about 90% active ingredients.
  • a liquid carrier such as water, petroleum, or oils of animal or plant origin
  • the liquid form of the composition can further contain physiological saline solution, dextrose or other saccharide solutions, or glycols.
  • the composition When administered in liquid form, the composition contains about 0.5% to about 90% by weight of active ingredients, and preferably about 1% to about 50% of active ingredients.
  • composition When a therapeutically effective amount of the active ingredients is administered by intravenous, cutaneous, or subcutaneous injection, the composition is in the form of a pyrogen-free, parenterally acceptable aqueous solution.
  • parenterally acceptable aqueous solution having due regard to pH, isotonicity, stability, and the like, is within the skill in the art.
  • a preferred composition for intravenous, cutaneous, or subcutaneous injection typically contains, in addition to an isotonic vehicle.
  • Suitable active ingredients can be readily combined with pharmaceutically acceptable carriers well-known in the art. Such carriers enable the active agents to be formulated as tablets, pills, dragees, capsules, liquids, gels, syrups, slurries, suspensions and the like, for oral ingestion by a patient to be treated.
  • Pharmaceutical preparations for oral use can be obtained by adding the active ingredients with a solid excipient, optionally grinding the resulting mixture, and processing the mixture of granules, after adding suitable auxiliaries, if desired, to obtain tablets or dragee cores.
  • Suitable excipients include, for example, fillers and cellulose preparations. If desired, disintegrating agents can be added.
  • the active ingredients can be formulated for parenteral administration by injection, e.g., by bolus injection or continuous infusion.
  • Formulations for injection can be presented in unit dosage form, e.g., in ampules or in multidose containers, with an added preservative.
  • the compositions can take such forms as suspensions, solutions, or emulsions in oily or aqueous vehicles, and can contain formulatory agents such as suspending, stabilizing, and/or dispersing agents.
  • compositions for parenteral administration include aqueous solutions of the active agent in water-soluble form. Additionally, suspensions of the active ingredients can be prepared as appropriate oily injection suspensions. Suitable lipophilic solvents or vehicles include fatty oils or synthetic fatty acid esters. Aqueous injection suspensions can contain substances which increase the viscosity of the suspension. Optionally, the suspension also can contain suitable stabilizers or agents that increase the solubility of the compounds and allow for the preparation of highly concentrated solutions. Alternatively, a present composition can be in powder form for constitution with a suitable vehicle, e.g., sterile pyrogen-free water, before use.
  • a suitable vehicle e.g., sterile pyrogen-free water
  • the active ingredients also can be formulated in rectal compositions, such as suppositories or retention enemas, e.g., containing conventional suppository bases.
  • the active ingredients also can be formulated as a depot preparation.
  • Such long-acting formulations can be administered by implantation (for example, subcutaneously or intramuscularly) or by intramuscular injection.
  • the active ingredients can be formulated with suitable polymeric or hydrophobic materials (for example, as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.
  • the active ingredients can be administered orally, buccally, or sublingually in the form of tablets containing excipients, such as starch or lactose, or in capsules or ovules, either alone or in admixture with excipients, or in the form of elixirs or suspensions containing flavoring or coloring agents.
  • excipients such as starch or lactose
  • capsules or ovules either alone or in admixture with excipients, or in the form of elixirs or suspensions containing flavoring or coloring agents.
  • Such liquid preparations can be prepared with pharmaceutically acceptable additives, such as suspending agents.
  • the active ingredients also can be injected parenterally, for example, intravenously, intramuscularly, subcutaneously, or intracoronarily.
  • the active ingredients are best used in the form of a sterile aqueous solution which can contain other substances, for example, salts, or monosaccharides, such as mannitol or glucose, to make the solution isotonic with blood.
  • a sterile aqueous solution which can contain other substances, for example, salts, or monosaccharides, such as mannitol or glucose, to make the solution isotonic with blood.
  • the active ingredients are administered as a suitably acceptable formulation in accordance with normal veterinary practice.
  • the veterinarian can readily determine the dosing regimen and route of administration that is most appropriate for a particular animal.
  • the angiogenesis inhibitor like the ET B antagonist, is administered in an effective amount to perform its intended function.
  • the angiogenesis inhibitor can be administered by any suitable means, typically using a composition containing the angiogenesis inhibitor.
  • the angiogenesis inhibitor can be administered simultaneously with the ET B antagonist, or prior to or after ET B antagonist administration.
  • the ET B antagonist and optional angiogenesis inhibitor also can be administered in conjunction with radiation treatment of the solid tumor and an optional radiosensitizer.
  • the solid tumor can be treated by administration of therapeutically effective amounts of an ET B agonist and a chemotherapeutic agent.
  • Administration of the ET B agonist and chemotherapeutic agent can be performed as described above for the ET B antagonist and angiogenesis inhibitor.

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US11/460,202 US7976835B2 (en) 2002-10-24 2006-07-26 Methods and compositions for preventing and treating solid tumors
US11/461,961 US20070032422A1 (en) 2002-10-24 2006-08-02 Methods, compositions and articles of manufacture for contributing to the treatment of cancers
US11/845,648 US8394757B2 (en) 2002-10-24 2007-08-27 Sensitization of tumor cells to radiation therapy through the administration of endothelin agonists
US12/101,008 US8026216B2 (en) 2002-10-24 2008-04-10 Methods and compositions for contributing to the treatment of cancers
US12/390,376 US8030278B2 (en) 2002-10-24 2009-02-20 Methods, compositions and articles of manufacture for contributing to the treatment of cancers
US13/220,373 US8349802B2 (en) 2002-10-24 2011-08-29 Methods and compositions for contributing to the treatment of cancers
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US13/491,408 US8703709B2 (en) 2002-10-24 2012-06-07 Methods, compositions and articles of manufacture for contributing to the treatment of solid tumors
US13/707,807 US8642026B2 (en) 2002-10-24 2012-12-07 Methods and compositions for contributing to the treatment of cancers
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US8648108B2 (en) 2001-11-01 2014-02-11 Spectrum Pharmaceuticals, Inc. Medical compositions for intravesical treatment of bladder cancer
US8957014B2 (en) 2002-10-24 2015-02-17 Spectrum Pharmaceuticals, Inc. Sensitization of tumor cells to radiation therapy through administration of endothelin agonists
US8349802B2 (en) 2002-10-24 2013-01-08 Spectrum Pharmaceuticals, Inc. Methods and compositions for contributing to the treatment of cancers
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US20050288310A1 (en) * 2004-06-04 2005-12-29 Chemgenex Pharmaceuticals, Inc. Methods of treating cellular proliferative disease using naphthalimide and PARP-1 inhibitors
US8980222B2 (en) * 2004-11-22 2015-03-17 The Board Of Trustees Of The University Of Illinois Diagnostic use of endothelin ETB receptor agonists and ETA receptor antagonists in tumor imaging
US20080260634A1 (en) * 2004-11-22 2008-10-23 Anil Gulati Diagnostic Use of Endothelin Etb Receptor Agonists and Eta Receptor Antagonists in Tumor Imaging
US20090163570A1 (en) * 2006-02-09 2009-06-25 Dorla Mirejovsky Bladder cancer treatment and methods
US20100004166A1 (en) * 2006-03-23 2010-01-07 Richard Pittner Endothelin and Endothelin Receptor Agonists in the Treatment of Metabolic Diseases
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US7976835B2 (en) 2011-07-12
CN1729012A (zh) 2006-02-01
CA2502848A1 (fr) 2004-05-06
JP2006508086A (ja) 2006-03-09
US20060257362A1 (en) 2006-11-16
JP5075927B2 (ja) 2012-11-21
WO2004037235A3 (fr) 2004-07-22
CN1729012B (zh) 2013-05-22
EP1556073B1 (fr) 2016-01-06
CA2502848C (fr) 2012-10-02
EP1556073A2 (fr) 2005-07-27

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