CN108137585B - 杂环化合物及其应用 - Google Patents
杂环化合物及其应用 Download PDFInfo
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- CN108137585B CN108137585B CN201680061129.0A CN201680061129A CN108137585B CN 108137585 B CN108137585 B CN 108137585B CN 201680061129 A CN201680061129 A CN 201680061129A CN 108137585 B CN108137585 B CN 108137585B
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Abstract
本文提供了式(I)的杂环化合物、包含这种化合物的药物组合物以及它们的治疗应用、用于它们的制备的方法、中间化合物、包含这种化合物的药物组合物以及它们的治疗应用。
Description
相关申请的交叉引用
本申请要求2015年9月21日提交的美国临时申请序列号62/221,508根据35U.S.C.§119(e)的利益,其全文以引用的方式合并入本文中。
背景技术
本发明涉及布罗莫结构域(bromodomain)蛋白和调节布罗莫结构域的化合物及其应用。特定的实施例考虑疾病适应症,这些适应症可以通过本发明的化合物通过布罗莫结构域的调节来治疗。
发明概述
本发明描述了一组选定的化合物,其已经证明了与在较早的研究中的化合物相比优越的药代动力学(pharmacokinetic,PK)。更具体地,本文公开的式I和II的化合物是WO2014/145051的选择性发明。本文公开的式I和II的化合物是与在WO 2014/145051中公开的具体化合物相比在结构上独特的新颖化合物,因为本发明中的化合物具有二(吡啶-2-基)亚甲基部分,其要求如在本发明中定义的R1取代基。相反,在WO 2014/145051中公开的具体化合物具有二(吡啶-2-基)亚甲基部分,其在如在本发明中定义的R1取代基处具有氢。如在本发明中举例说明的,本文公开的新颖化合物已经证明了与在WO 2014/145051中公开的在结构上相似的化合物相比意料之外好得多的PK特性,其中唯一的结构差异在于在WO 2014/145051中公开的化合物不具有如在本发明中定义的R1取代基。
本发明提供了式(I)的化合物:
或其药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物,其中:
R1是氰基、卤素、或任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代的(C1-C3)烷基;并且
当存在的时候,X是卤素。
本发明的另一个实施方式涉及一种药物组合物,其包含式(I)的化合物以及药学上可接受的赋形剂或载体。
本发明的另一个实施方式涉及一种药物组合物,其包含式(I)的化合物以及药学上可接受的赋形剂或载体、以及另一种治疗剂。
另一个实施方式涉及一种调节布罗莫结构域的方法,所述方法包括:向对象施用式(I)的化合物、或包含式(I)的化合物以及药学上可接受的赋形剂或载体的药物组合物。
另一个实施方式涉及一种治疗患有或有风险患有由布罗莫结构域介导的疾病或病症的对象的方法,所述方法包括:向有此需要的对象施用有效量的式(I)的化合物、或包含式(I)的化合物以及药学上可接受的赋形剂或载体的药物组合物。
附图说明
图1显示了如在实施例5中描述的肿瘤体积随时间变化的测量结果。顶部线条所示的肿瘤体积随时间变化的测量代表载体。底部线条所示的肿瘤体积随时间变化的测量代表化合物P-00110mg/kg。中部线条所示的肿瘤体积随时间变化的测量代表化合物Z 10mg/kg。
图2示出了在7天的时间内以10mg/kg的剂量对nu/nu小鼠进行化合物P-001和化合物Z给药时观察到的毒性。底部线条所示的Delta体重测量值随时间测量的变化表示化合物Z。上部线条所示的Delta体重测量值随时间测量的变化表示化合物P-001。
详细描述
I.定义
如本文使用的,除非另有明确表示,否则适用以下定义:
应该注意,在本说明书和附属的权利要求书中使用的,单数形式“一”、“一个”和“该”包含复数指代,除非文中另有明确表示。
如本文使用的,“标准误差”是样本标准偏差除以样本大小的平方根。
“卤素”或“卤代”是指所有卤素,即,氯(Cl)、氟(F)、溴(Br)、或碘(I)。
“氰基”是指基团–CN。
术语“烷基”单独地或作为另一个取代基的一部分是指(除非另有说明)具有指定的碳原子数目(亦即,C1-6是指一至六个碳)的直链或支链烃。代表性的烷基基团包含具有1、2、3、4、5或6个碳原子的直链和支链烷基基团。进一步代表性的烷基基团包含具有1、2或3个碳原子的直链和支链烷基基团。
在说明书全文中使用的“任选的”或“任选地”是指随后描述的事件或情况可能发生或不发生,该描述包含该事件或情况发生的情况以及它不发生的情况。例如,短语“该芳香基团任选地被一个或两个烷基取代基取代”是指该烷基可以存在但不是必须存在,该描述包含了芳香基团被烷基基团取代的情况,以及芳香基团不被烷基基团取代的情况。
如本文中与本发明的化合物一起使用的术语“合成”和相似的术语表示从一个或多个前体材料的化学合成。
“保护基团”是指当被连接至分子口罩中的反应基团时降低或阻止该反应的原子群组。保护基团的例子可以在T.W.Greene andP.G.Wuts,PROTECTIVE GROUPS IN ORGANICCHEMISTRY,(Wiley,4th ed.2006),Beaucage and Iyer,Tetrahedron 48:2223-2311(1992)、和Harrison and Harrison et al.,COMPENDIUM OF SYNTHETIC ORGANICMETHODS,Vols.1-8(John Wiley and Sons.1971-1996)中找到。代表性的氨基保护基团包含甲酰基、乙酰基、三氟乙酰基、苄基、苄氧基羰基(CBZ)、叔丁氧基羰基(Boc)、三甲基甲硅烷基(TMS)、2-三甲基硅烷基-乙磺酰基(SES)、三苯甲基和取代的三苯甲基基团、烯丙氧基羰基、9-芴甲氧羰基(FMOC)、硝基-藜芦氧羰基(NVOC)、三-异丙基硅烷基(TIPS)、苯磺酰基等(还参见Boyle,A.L.(Editor))、氨基甲酸酯、酰胺、N-磺酰基衍生物;通式-C(O)OR的基团,其中R是例如甲基、乙基、叔丁基、苄基、苯乙基、CH2=CHCH2-等;通式-C(O)R’的基团,其中R'是例如甲基、苯基、三氟甲基等;通式-SO2R”的基团,其中R”是例如甲苯基、苯基、三氟甲基、2,2,5,7,8五甲基苯并吡喃-6-基、2,3,6-三甲基-4-甲氧基苯基等,以及含有硅醇基的基团,例如2-三甲基硅基乙氧基甲基、叔丁基二甲基硅烷基、三异丙基甲硅烷基等(CURRENT PROTOCOLS IN NUCLEIC ACID CHEMISTRY,John Wiley and Sons,New York,Volume 1,2000)。
“前药”是指当该前药被施用至哺乳动物对象时,在体内释放根据式(I)的活性母体药物的化合物。通过修饰在式(I)的化合物中存在的官能团通过以下方式制备式(I)的化合物的前药,即该修饰可以在体内裂解以释放母体化合物。通过修饰在化合物中存在的官能团通过以下方式制备前药,即该修饰在常规操作中或在体内裂解以释放母体化合物。前药包含式(I)的化合物,其中式(I)的化合物中的羟基、氨基、羧基和巯基基团被结合至可以在体内被裂解以分别重新生成自由的羟基、氨基或巯基基团的任何基团。前药的例子包含但不限于式(I)的化合物中羟基官能团的酯(例如乙酸盐、甲酸盐和苯甲酸盐衍生物)、酰胺、胍、氨基甲酸酯(例如N,N-二甲基氨基羰基)等。在T.Higuchi and V.Stella,"Pro-drugs as Novel Delivery Systems,"Vol.14of the A.C.S.Symposium Series;"Designof Prodrugs",ed.H.Bundgaard,Elsevier,1985;以及在Bioreversible Carriers inDrug Design,ed.Edward B.Roche,American Pharmaceutical Association andPergamon Press,1987中讨论了前药的制备、选择和使用,每篇文献的全文都以引用的方式并入本文。
“互变异构体”是指通过一个分子的一个原子的质子转移到另一个原子的现象产生的化合物。参看Jerry March,Advanced Organic Chemistry:Reactions,Mechanismsand Structures,Fourth Edition,John Wiley&Sons,pages 69-74(1992)。互变异构体也指平衡状态存在并且容易从一种异构体形式转换至另一种的两个或更多个结构异构体之一。其例子包含酮-烯醇互变异构体(例如丙酮/丙烯-2-醇)、亚胺-烯胺互变异构体等、环-链互变异构体(例如葡萄糖/2,3,4,5,6-五羟基-己醛等)、含有-N=C(H)-NH-环原子排布的杂芳基基团的互变异构形式(例如吡唑、咪唑、苯并咪唑、三唑和四唑)。在化合物包含例如酮或肟基团或芳香部分的时候,互变异构异构现象(“互变异构现象”)会发生。本文所述的化合物可以具有一种或多种互变异构体并因此包含各种异构体。本领域一般技术人员会认识到,其他互变异构的环原子排布是可能的。这些化合物的所有这些异构体形式都明确地被包含在本发明中。
“异构体”是指具有相同的分子式但在特性或其原子的结合顺序或其原子在空间中的排布上不同的化合物。其原子在空间中的排布不同的异构体被称为“立体异构体”。“立体异构体”是指如果它们具有一个或多个不对称中心或具有带不对称取代基的双键就会以不同的立体异构形式存在、并因此能够被生成为单独的立体异构体或生成为混合物的化合物。立体异构体包含对映异构体和非对映异构体。互相不是镜像的立体异构体被称为“非对映异构体”,而互相是不可重叠的镜像的立体异构体被称为“对映异构体”。当化合物具有不对称中心时,例如当它被结合至四个不同的基团时,就可能产生一对对映异构体。对映异构体的特征在于其不对称中心的绝对构型,并且由Cahn和Prelog的R-和S-排序规则描述,或者由被指定为右旋或左旋(即分别被指定为(+)或(-)-异构)的分子旋转偏振光平面的方式描述。手性化合物可以以单一的对映异构体或其混合物而存在。包含同等比例的对映异构体的混合物被称为“外消旋混合物”。除非另有指明,否则本说明书旨在包含单一的立体异构体以及混合物。用于确定立体化学和分离立体异构体的方法在本领域中是公知的(参看在ADVANCED ORGANIC CHEMISTRY,6th edition J.March,John Wiley and Sons,NewYork,2007的第4章中的讨论)。本文要求保护的某些分子可以以不同的对映体和非对映体形式存在。
本发明的化合物还可以在组成该化合物的一个或多个原子上包含非自然比例的原子同位素。例如,所述化合物可以用放射性同位素放射性标记,例如氚(3H)、碘-125(125I)、碳-14(14C)、碳-11(11C)或氟-18(18F)。无论是否是放射性的,本发明的化合物的所有同位素变型都旨在被包含在本发明的范围内。
本专利要求保护的某些分子,可以是分子的一个或多个氢原子被一个或多个氘原子取代(包括全氘化类似物),这些化合物的所有这些变体都是要求保护的。进一步地,应该指出,术语“氘化类似物”是指其中至少一个氢原子已经被氘原子取代的化合物。本文单独地或作为基团的一部分使用的术语“氘化的”是指取代的氘原子。当特定的位置被指示为持有氘(表述为“D”或“氘”)时,应该理解,在该位置的氘的丰度显著大于氘的自然丰度(0.015%)(即,至少50.1%的氘掺入)。
本发明的氘化的类似物可以是完全地或部分地氘取代的衍生物。本发明的氘取代的衍生物可以持有完全地或部分地氘取代的烷基、芳基或杂芳基基团。在一个实施例中,本发明的氘取代的化合物持有完全或部分氘取代的烷基基团,例如-CD3、CD2CD3、-CD2CD2CD3等。在另一个实施例中,本发明的氘取代的化合物持有完全或部分氘取代的芳基,例如苯基(例如C6D5),或者完全或部分氘取代的杂芳基,例如吡唑基-d2、噻唑基-d2、吡啶基-d3等。
本发明还包含同位素标记的本发明的化合物,它们与本文所述的化合物相同,区别在于一个或以上的原子被原子质量或质量数与在自然中通常发现的原子质量或质量数不同的原子取代。可以被结合进本发明的化合物的同位素的例子包含氢、碳、氮、氧、磷、氟和氯的同位素,例如但不限于2H(氘,D)、3H(氚)、11C、13C、14C、15N、18F、31P、32P、35S、36Cl和125I。除非另有说明,否则当一个位置被特别地指定为“H”或“氢”时,该位置应该被理解为具有处于其自然丰度同位素组成的氢或其同位素(例如氘(D)或氚(3H))。一些同位素标记的本发明的化合物(例如用3H和14C标记)在化合物和/或底物组织分布测定中是有用的。氚化的(即3H)和碳-14(即14C)和氟-18(18F)同位素对于它们的制备和检测的简化是有用的。进一步地,具有更重的同位素(例如氘(即2H))的取代基可以提供医疗优势,形成更好的代谢稳定性(例如体内半衰期提高或剂量要求降低)并因此在某些情况下是优选的。同位素标记的本发明的化合物通常可以通过将非同位素标记的试剂替换为同位素标记的试剂、按照与在下文中的方案和实施例中描述的程序相似的程序制备而得。
本发明的一些化合物可以以非溶剂化形式以及溶剂化形式(包含水合形式)存在。“水合物”是指由水分子和溶质的分子或离子结合形成的复合物。“溶剂化物”是指由溶剂分子和溶质的分子或离子组合结合的复合物。溶剂可以是有机化合物、无机化合物或其混合物。溶剂化物旨在包含水合物。溶剂的一些例子包含但不限于甲醇、N,N-二甲基甲酰胺、四氢呋喃、二甲亚砜以及水。通常,溶剂化形式等效于非溶剂化形式并且被包含在本发明的范围内。本发明的一些化合物可以以多个结晶的或无定形形式存在。通常,对于本发明预期的应用来说,所有物理形式都是等效的,并且它们旨在被包含在本发明的范围内。
“固体形式”指适于向预期的动物对象施用以达到治疗目的的药学上有活性的化合物的固体制剂(即非气体或液体制剂)。固体形式包含该化合物的任何复合物,例如盐、共晶体或无定型复合物、以及任何多晶型。固体形式可以是基本上结晶的、半结晶的或基本上无定形的。固体形式可以被直接施用或被使用在制备具有提高的药学特性的适当的组合物中。例如,固体形式可以被用在包含至少一种药学上可接受的载体或赋形剂的剂型中。
术语“药学上可接受的”表示在考虑到将被治疗的疾病或病症以及各自的施用途径时,所述物质不具有将会使理性谨慎的医学从业者避免给患者服用该物质的特性。例如,对于可注射物来说,通常要求这样的物质是基本无菌的。
“药学上可接受的盐”指可以接受来向患者(例如哺乳动物)施用的盐(例如对于给出的剂量方案具有可接受的安全性的盐)。根据在本文描述的化合物上发现的特定取代基,这些盐可以来自药学上可接受的无机碱或有机碱以及来自药学上可接受的无机酸或有机酸。当本发明的化合物包含相对酸性的官能时,可以通过将该化合物的中性形式和足够量的所需碱纯净地或在合适的惰性溶剂中接触,以得到碱加成盐。来自药学上可接受的无机碱的盐包含铝、铵、钙、铜、铁、亚铁、锂、镁、锰、亚锰、钾、钠、锌等的盐。来自药学上可接受的有机碱的盐包含一级、二级、三级和四级胺的盐,其包含取代的胺、环胺、天然存在的胺等,例如精氨酸、甜菜碱、咖啡因、胆碱、N,N'-二苄基乙二胺、二乙胺、2-二乙基氨基乙醇、2-二甲基氨基乙醇、乙醇胺、乙二胺、N-乙基吗啉、N--乙基哌啶、葡糖胺、氨基葡萄糖、组氨酸、哈胺(hydrabamine)、异丙胺、赖氨酸、甲基葡糖胺、吗啉、哌嗪、哌啶、聚胺树脂、普鲁卡因、嘌呤、可可碱、三乙胺、三甲胺、三丙胺、氨基丁三醇、N,N'-二苄基乙二胺、氯普鲁卡因、胆碱、二乙醇胺、葡甲胺(N-甲基-葡糖胺)等。当本发明的化合物包含相对碱性的官能时,可以通过将该化合物的中性形式和足够量的所需酸纯净地或在合适的惰性溶剂中接触,以得到酸加成盐。来自药学上可接受的酸的盐包含乙酸、三氟乙酸、丙酸、抗坏血酸、苯磺酸、苯甲酸、樟脑磺酸、柠檬酸、乙磺酸、富马酸、乙醇酸、葡萄糖酸、葡萄糖醛酸、谷氨酸、马尿酸、氢溴酸、盐酸、羟乙磺酸、乳酸、乳糖酸、马来酸、苹果酸、扁桃酸、甲磺酸、粘酸、萘磺酸、烟酸、硝酸、扑酸(pamoic)、泛酸、磷酸、琥珀酸、硫酸、氢碘酸、碳酸、酒石酸、对甲苯磺酸、丙酮酸、天冬氨酸、苯甲酸、邻氨基苯甲酸、甲磺酸、水杨酸、对羟基苯甲酸、苯乙酸、双羟萘酸(扑酸)、乙基磺酸、苯磺酸、2-羟基乙磺酸、对氨基苯磺酸、硬脂酸、环己胺磺酸、海藻酸、羟基丁酸、半乳糖和半乳糖醛酸等的盐。
还被包含的是氨基酸(例如精氨酸等)的盐,以及有机酸(例如葡萄糖醛酸或半乳糖醛酸等)的盐(参看例如Berge,S.M.et al,“Pharmaceutical Salts,”J.PharmaceuticalScience,1977,66:1-19)。本发明的一些具体化合物同时包含碱性和酸性官能,使得该化合物能够被转换成碱或酸加成盐。
可以通过将盐和碱或酸接触并以常规方法分离母体化合物,重新生成化合物的中性形式。化合物的母体形式在某些物理性质(例如在极性溶剂中的溶解度)上与各种盐形式不同,但在其他方面这些盐对于本发明的目的来说与化合物的母本形式是等价的。
如本文使用的,术语“组合物”指适于给预期的动物对象施用以达到治疗目的的制剂,其含有至少一种药学上有活性的化合物以及至少一种药学上可接受的载体或赋形剂。
“单位剂量形式”是指用于单次施用以治疗患有疾病或医学病症的对象的组合物。每个单位剂量形式通常包含本发明的每个活性成分加上药学上可接受的赋形剂。单位剂量形式的例子是单个片剂、单个胶囊、散装粉末、液体溶液、软膏、霜剂、滴眼剂、栓剂、乳剂或悬浮剂。治疗疾病或病症可能需要单位剂量形式的周期性施用,例如:每日两次或多次一个单位剂量形式、每餐一次、每四小时或其他间隔一次、或每日仅一次。表达“口服的单位剂量形式”表示设计来口服的单位剂量形式。
在本文中,术语“治疗上有效的”或“有效量”表示化合物或该量的化合物当被施用时,足够或有效来预防、缓解或减轻被治疗的疾病、病症或医学病症的一个或多个症状,和/或延长被治疗的对象的生存期。治疗上有效的量会根据化合物、疾病或病症及其严重程度、以及被治疗的哺乳动物的年龄、体重等而变化。通常,对象中的满意结果被表示为在约0.1至约10g/kg对象体重的每日剂量获得。在一些实施例中,每日剂量是约0.10至10.0mg/kg的体重、约1.0至3.0mg/kg的体重、约3至10mg/kg的体重、约3至150mg/kg的体重、约3至100mg/kg的体重、约10至100mg/kg的体重、约10至150mg/kg的体重或约150至1000mg/kg的体重。该剂量可以例如以每日最多四次的分开剂量或者以持续释放的形式被便利地施用。
布罗莫结构域是一族(~110氨基酸)在结构上和进化保守的蛋白相互作用模块,其特异地识别底物蛋白(特别是组蛋白)中存在的乙酰化的赖氨酸。布罗莫结构域作为与染色质重塑、细胞信号传导和转录控制相关的大型多域核蛋白的组分而存在。在46个人类蛋白中发现存在总共61个人类布罗莫结构域。具有已知功能的包含布罗莫结构域的蛋白的例子包含:(i)组蛋白乙酰基转移酶(HATs),包含CREBBP、GCN5、PCAF和TAFII250;(ii)甲基转移酶,例如ASH1L和MLL;(iii)染色质重塑复合物的组分,例如Swi2/Snf2;以及(iv)多种转录调节因子(Florence et al.Front.Biosci.2001,6,D1008-1018)。
如本文使用的,术语“布罗莫结构域介导的”、“BET介导的”、“BRD2介导的”、“BRD3介导的”、“BRD4介导的”和/或“BRDT介导的”疾病或病症是指一个或多个包含布罗莫结构域的蛋白(例如BET蛋白(例如BRD2、BRD3、BRD4和/或BRDT))或其突变体已知在其中起作用的任何疾病或其他有害病症。相应地,本发明的另一个实施方式涉及治疗或减轻一个或多个包含布罗莫结构域的蛋白(例如BET蛋白(例如BRD2、BRD3、BRD4和/或BRDT))或其突变体已知在其中起作用的一种或多种疾病的严重性。例如,其中布罗莫结构域的生物学功能影响疾病或病症的发展和/或过程、和/或其中布罗莫结构域的调节改变发展、过程和/或症状的疾病或病症。布罗莫结构域介导的疾病或病症包含布罗莫结构域抑制提供治疗效益的疾病或病症,例如,其中通过布罗莫结构域抑制剂(包含本文所述的化合物)的治疗向患有或有风险患有该疾病或病症的对象提供治疗效益。术语“布罗莫结构域抑制”、或“布罗莫结构域抑制剂”是指抑制布罗莫结构域与其同源乙酰化蛋白结合的化合物,例如,布罗莫结构域抑制剂是抑制布罗莫结构域结合至乙酰化的赖氨酸残基的化合物。
在本发明中,术语“协同地有效的”或“协同效果”表示当两种或以上治疗上有效的化合物结合使用时,其提供改善的治疗效果,该效果大于各个化合物独自使用时可以预期到的叠加效果。
“实验”是指创造实验条件以及收集有关暴露至具体的实验条件的特定结果的数据。例如,可基于作用于可检测底物的能力来对酶进行实验。一种化合物可基于其结合至特定靶标分子的能力而对其进行实验。
如本文使用,术语“配体”和“调节剂”被等效地使用来表示改变(即增加或减少)靶标生物分子(例如蛋白,例如布罗莫结构域)的活性的化合物。通常,配体或调节剂将会是小分子,其中“小分子”是指分子量为1500道尔顿或更少、或优选1000道尔顿或更少、800道尔顿或更少、或600道尔顿或更少的化合物。因此,“改进的配体”是比参考化合物具有更好的药理学和/或药代动力学性质的化合物,其中“更好”可以由相关领域的技术人员对特定的生物系统或医疗用途而定义。
与靶标和潜在的结合化合物之间的相互作用一起的术语“结合”,表示与通常和蛋白的关联(即非特定结合)相比,潜在的结合化合物与该靶标关联至统计上显著的程度。因此,术语“结合化合物”是指与靶标分子具有统计学上显著关联的化合物。优选地,结合化合物与特定的靶标相互作用的解离常数(KD)为1mM或更少、1μM或更少、100nM或更少、10nM或更少、1nM或更少。
如本文使用,术语“调节”是指改变生物学活性的作用,特别是改变与特定生物分子(例如布罗莫结构域蛋白)相关的生物学活性。例如,特定生物学分子的激动剂或拮抗剂通过提高(例如激动剂、活化剂)或降低(例如拮抗剂、抑制剂)该生物学分子(例如酶)的活性而调节该生物学分子(例如酶)的活性。这种活性通常表示为抑制剂或活化剂相对于例如酶的化合物抑制浓度(IC50)或激发浓度(EC50)。
在使用、测试或筛选是或可能是调节剂的化合物的内容中,术语“接触”是指化合物被使得与特定分子、复合物、细胞、组织、器官或其他指定材料足够接近,从而在该化合物和其他指定材料之间可以发生潜在的结合相互作用和/或化学反应。
如本文使用,术语“对象”是指用本发明所述的化合物治疗的活体,包括但不限于,任何哺乳动物(例如人)、其他灵长类、竞技动物和具有商业利益的动物(例如牛)、家畜(例如马)或宠物(例如狗和猫)。
术语“施用”是指向对象的口服施用、作为栓剂施用、局部接触、静脉内、腹膜内、肌内、病灶内、鼻内或皮下施用、或者缓释装置(例如微型渗透泵)的植入。施用是通过任何途径的,包含胃肠外和经粘膜(例如经颊、舌下、腭、龈、鼻、阴道、直肠或皮)。胃肠外施用包含例如静脉内、肌内、动脉内、皮内、皮下、腹膜内、心室内和颅内。其他传递模式包含但不限于使用脂质体制剂、静脉输液、透皮贴剂等。
本文使用的术语“防止”、“阻止”、“预防”及其语法上的变形是指部分地或完全地延迟或排除疾病或病症和/或一种或多种其伴随的症状的发作或复发、或阻止对象获得或重新获得疾病或病症、或降低对象获得或重新获得疾病或病症或一种或多种其伴随的症状的风险的方法。
与氨基酸或核酸序列一起,术语“纯化的”表示与在现有的组合物(例如细胞培养物)中观察到的比例相比,主题分子包含组合物中显著更高比例的生物分子。相对于在现有组合物中发现的比例,该更高的比例可以是2倍、5倍、10倍或大于10倍。
此外,本文使用的缩写具有如下的相应含义:
II.概述
本发明涉及式(I)、(II)和所有子通式的化合物、在权利要求中描述的化合物、以及本文描述的化合物,它们是布罗莫结构域的调节剂,本发明还涉及这些化合物在治疗疾病或病症中的应用。本文还公开了对于式(I)和(II)的化合物的合成有用的化合物。
III.化合物
在一些实施方式中,本发明提供了式(I)和所有子通式的化合物以及本文公开的化合物、或其药学上可接受的盐、水合物、溶剂化物、互变异构体、同分异构体。
在一个实施方式中,本发明提供了式(I)的化合物:
或其药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物,其中:
R1是氰基、卤素、或任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代的(C1-C3)烷基;并且
当存在的时候,X是卤素。
在式(I)的另一个实施方式中,R1是(C1-C2)烷基、氰基或氟。
在式(I)的另一个实施方式中,R1是甲基、氰基或氟。
在式(I)的另一个实施方式中,R1是(C1-C2)烷基。在式(I)的另一个实施方式中,R1是甲基。在式(I)的另一个实施方式中,R1是氰基。在式(I)的另一个实施方式中,R1是卤素。在式(I)的另一个实施方式中,R1是氟。
在式(I)的另一个实施方式中,R1是(C1-C2)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代。在式(I)的另一个实施方式中,R1是甲基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代。
在式(I)的另一个实施方式中,X不存在。在式(I)的另一个实施方式中,X是卤素。在式(I)的另一个实施方式中,X是氟。在式(I)的另一个实施方式中,X是氯。
在式(I)的另一个实施方式中,R1是(C1-C3)烷基,并且X不存在。在式(I)的另一个实施方式中,R1是(C1-C3)烷基,并且X是卤素。在式(I)的另一个实施方式中,R1是(C1-C3)烷基,并且X是氟。在式(I)的另一个实施方式中,R1是(C1-C3)烷基,并且X是氯。在式(I)的另一个实施方式中,R1是(C1-C2)烷基,并且X不存在。在式(I)的另一个实施方式中,R1是(C1-C2)烷基,并且X是卤素。在式(I)的另一个实施方式中,R1是(C1-C2)烷基,并且X是氟。在式(I)的另一个实施方式中,R1是(C1-C2)烷基,并且X是氯。
在式(I)的另一个实施方式中,R1是(C1-C3)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X不存在。在式(I)的另一个实施方式中,R1是(C1-C3)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是卤素。在式(I)的另一个实施方式中,R1是(C1-C3)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是氟。在式(I)的另一个实施方式中,R1是(C1-C3)烷基,并且X是氯。
在式(I)的另一个实施方式中,R1是(C1-C2)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X不存在。
在式(I)的另一个实施方式中,R1是(C1-C2)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是卤素。在式(I)的另一个实施方式中,R1是(C1-C2)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是氟。在式(I)的另一个实施方式中,R1是(C1-C2)烷基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是氯。
在式(I)的另一个实施方式中,R1是甲基并且X不存在。在式(I)的另一个实施方式中,R1是甲基并且X是卤素。在式(I)的另一个实施方式中,R1是甲基并且X是氟。在式(I)的另一个实施方式中,R1是甲基并且X是氯。
在式(I)的另一个实施方式中,R1是甲基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X不存在。在式(I)的另一个实施方式中,R1是甲基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是卤素。在式(I)的另一个实施方式中,R1是甲基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是氟。在式(I)的另一个实施方式中,R1是甲基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代,并且X是氯。
式(I)的另一个实施方式是式(II)的化合物:
或其药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物,其中:
R1是氰基、卤素、或任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代的(C1-C3)烷基。
在式(II)的另一个实施方式中,R1是(C1-C2)烷基、氰基或氟。
在式(II)的另一个实施方式中,R1是甲基、氰基或氟。
在式(II)的另一个实施方式中,R1是氰基、卤素、或任选地被一个或多个卤素取代的(C1-C2)。在式(II)的另一个实施方式中,R1是氰基、卤素、或任选地被一个或多个卤素取代的甲基。在式(II)的另一个实施方式中,R1是甲基。在式(II)的另一个实施方式中,R1是甲基,任选地被1-3个卤素取代。在式(II)的另一个实施方式中,R1是甲基,任选地被1-3个氯取代。在式(II)的另一个实施方式中,R1是甲基,任选地被1-3个氟取代。在式(II)的另一个实施方式中,R1是氰基。在式(II)的另一个实施方式中,R1是氟。
在式(II)的另一个实施方式中,R1是氰基、卤素、或任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代的(C1-C2)。在式(II)的另一个实施方式中,R1是甲基,其任选地被1至3个独立地选自卤素、甲基、乙基、甲氧基和乙氧基的取代基取代。
式I或II的化合物的另一个实施方式是表I的化合物、或表I中的化合物中的任一个的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物。
表I
本发明的另一个实施方式涉及作为中间化合物的化合物,它们对于合成式(I)、式(II)的化合物、或在表I中列出的化合物是有用的,其中所述中间化合物是下式中的一个:
或其药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物。
有机合成技术
本领域中存在大量有机合成技术可用于构建可能的调节剂。许多这些有机合成方法详细描述于本领域技术人员使用的标准参考来源中。一个这样的参考来源的例子为March,1994,Advanced Organic Chemistry;Reactions,Mechanisms and Structure,NewYork,McGraw Hill。因此,用于合成具有布罗莫结构域功能的潜在调节剂的技术易于被有机化学合成领域的技术人员所获得。
其他化合物形式或衍生物
用于本发明的化合物参考通式和具体化合物来描述。此外,本文所述的化合物可以许多不同形式或衍生物形式存在,所有这些都属于本发明的保护范围。其他形式或衍生物包括,例如,(a)前药和活性代谢物,(b)互变异构体、同分异构体(包括立体异构体和位置异构体)和外消旋混合物,(c)药学上可接受的盐,和(d)固体形式,包括不同晶体形式、多晶型或无定型固体(包括水合物和溶剂化物)以及其他形式。
(a)前药和代谢物
除了本发明的化学式和本文所述的化合物之外,本发明也包括前药(一般是药学上可接受的前药)、活性代谢衍生物(活性代谢产物)和它们的药学上可接受的盐。
前药是在生理条件下代谢或通过溶剂分解作用被转化时产生所需活性化合物的化合物或其药学上可接受的盐。前药包括但不限于活性化合物的酯、酰胺、氨基甲酸酯、碳酸酯、酰脲、溶剂合物或水合物。一般地,前药是无活性的、或其活性低于活性化合物,但能够提供一种或多种有利的处理、给药和/或代谢性质。例如,一些前药是活性化合物的酯;在代谢期间,酯基被切割而产生活性药物。例如,酯包括羧酸基团的酯,或硫基、醇基或酚基的S-酰基或O-酰基衍生物的酯。在本发明中,一个常见的例子是羧酸的烷基酯。前药也可包括变体,其中化合物的-NH基团被酰基化,例如本文所述的化合物的1H-吡咯并[2,3-b]吡啶环的1-位或磺酰胺基团的氮被酰基化,其中酰基的裂解提供了活性药物的游离-NH基团。某些前药被酶促激活,从而产生活性化合物,或者化合物可进一步经历化学反应从而产生活性化合物。前药可在单个步骤中由前药形式转变为活性形式,或者前药可具有一种或多种中间形式,这些中间形式本身可具有活性或是无活性的。
如在The Practice ofMedicinal Chemistry,Ch.31-32(Ed.Wermuth,AcademicPress,San Diego,CA,2001)中所述的,在概念上,前药可以被分为两个非排他的种类:生物前体前药(bioprecursor prodrugs)和载体前药。一般地,生物前体前药是无活性的或者是相比对应的活性药物化合物活性低的化合物,其含有一个或多个保护基团并且通过代谢或溶剂分解作用被转化为活性形式。活性药物形式和任何被释放的代谢产物都应该具有可接受的低毒性。一般地,活性药物化合物的形成涉及下列类型之一的代谢过程或反应:
氧化反应:氧化反应的例子为,但不限于,下述反应:如醇、羰基和酸官能度的氧化,脂族碳的羟基化,脂环碳原子的羟基化,芳族碳原子的氧化,碳碳双键的氧化,含氮官能团的氧化,硅、磷、砷和硫的氧化,氧化性N-脱烷基化,氧化性O-和S-脱烷基化,氧化性脱氨基,以及其它氧化反应。
还原反应:还原反应的例子有(但不限于)下述反应:如羰基官能团的还原、醇官能团和碳碳双键的还原、含氮官能团的还原和其它还原反应。
氧化状态不发生变化的反应:氧化状态下不发生变化的反应的例子有(但不限于)下述反应:如酯和醚的水解、碳氮单键的水解断裂、非芳族杂环的水解裂解、多个键处进行水合和脱水、由脱水反应获得的新的原子键接、水解脱卤化反应、卤化氢分子的去除和其它这类反应。
载体前药是含有运输部分(transport moiety)的药物化合物,例如,所述部分改进摄取和/或向作用位点(一个或多个)的局部输送。对于这种载体前药,期望的是,药物部分和运输部分之间的键是共价键,前药无活性或者相比药物化合物活性低,前药和任何释放的运输部分是可接受地无毒的。对于运输部分意在增强摄取的前药,运输部分的释放通常应该是迅速的。在其它情况下,期望利用提供缓慢释放的部分,例如,一些聚合物或其它部分,如环糊精。(参见,例如,Cheng等,美国专利20040077595号,申请序列号10/656,838,并入本文作为参考)。这种载体前药通常对于经口给予的药物是有利的。在一些情形下,运输部分提供药物的靶定递送,例如该药物可被连接至抗体或抗体片段。例如,载体前药可以被用于改进下列性质中的一种或多种:增加的亲脂性、增加的药理作用持续时间、增加的位点特异性、降低的毒性和不利反应、和/或药物制剂的改进(例如,稳定性、水溶性、不合需要的器官感觉或理化性质的抑制)。例如,通过用亲脂性羧酸酯化羟基,或用醇例如脂族醇酯化羧酸基团,可以增加亲脂性。见前述Wermuth文献。
代谢物(例如,活性代谢物)与上述前药(例如生物前体前药)重叠。因此,这种代谢物是药理学上活性的化合物或进一步代谢为药理学活性化合物的化合物,所述药理学活性化合物是通过在对象体内的代谢过程而得到的衍生物。其中,活性代谢物是这些药理学活性衍生化合物。对于前药,前药化合物通常是无活性的或比代谢产物的活性低。对于活性代谢物,母体化合物可以是活性化合物或者可以是无活性的前药。例如,在一些情形下,一个或多个烷氧基可被代谢成羟基,同时保留了药理学活性,和/或羧基可被酯化(例如葡萄糖醛酸化)。在一些情况下,可具有不止一种代谢物,其中中间代谢物被进一步代谢以提供活性代谢物。例如,在一些情况下,由代谢性葡萄糖醛酸化产生的衍生化合物可以是无活性的或低活性的,并且可被进一步代谢以提供活性代谢物。
可利用本领域已知的常规技术鉴定化合物的代谢物,并使用例如本文所述的测试确定它们的活性。参见,例如,Bertolini et al.,1997,J.Med.Chem.,40:2011-2016;Shanet al.,1997,JPharm Sci 86(7):756-757;Bagshawe,1995,DrugDev.Res.,34:220-230;前述Wermuth文献。
(b)互变异构体、立体异构体和位置异构体
应该理解,一些化合物可以表现出互变异构。在这种情况下,本文中所提供的化学式仅明确地描述了可能的互变异构形式中的一种。因此,应该理解,本文中所提供的所述化学式意在代表所描述的化合物的任何互变异构形式,而不只限于结构式附图所描绘的具体的互变异构形式。
同样,本发明的一些化合物可以作为立体异构体存在,即,它们具有共价结合原子的相同原子连接,但是原子的空间方向不同。例如,化合物可以是包含一个或多个手性中心的旋光立体异构体,因此,可以作为两种或多种立体异构形式存在(例如,对映异构体或非对映异构体)。因此,这样的化合物可以作为单一的立体异构体(即,基本上不含其它立体异构体)、外消旋体、和/或对映异构体和/或非对映异构体的混合物而存在。另一例子是,立体异构体包含几何学异构体,如在双键的相邻碳上的取代基为顺式或反式方向。所有这些单一立体异构体、外消旋体及其混合物都意在被包含在本发明范围内。如果没有相反指明,所有这些立体异构形式被包含在本文提供的化学式中。
在一些实施方案中,本发明的手性化合物处于含有至少80%的单一异构体(60%对映异构体过量(“e.e.”)或非对映异构体过量(“d.e.”))的形式,或至少85%(70%e.e.或d.e.)、90%(80%e.e.或d.e.)、95%(90%e.e.或d.e.)、97.5%(95%e.e.或d.e.)或99%(98%e.e.或d.e.)。如本领域技术人员一般理解,具有一个手性中心的旋光纯化合物是基本上由两种可能的对映异构体中的一种构成的化合物(即,是对映异构纯的),具有一个以上手性中心的旋光纯化合物是非对映异构纯和对映异构纯的化合物。在一些实施方案中,化合物以旋光纯的形式存在,这种旋光纯的形式可通过本领域抑制的方法制备和/或分离(例如,通过重结晶技术、手性合成技术(包括从旋光纯的起始物质开始合成)以及利用手性柱的色谱分离技术)。
(c)药学上可接受的盐
除非另有说明,否则本文的化合物包括该化合物的药学上可接受的盐。因此,本文所述的化合物或在任何权利要求中描述的化合物,可为药学上可接受的盐,或可被配制成药学上可接受的盐。预期的药学上可接受的盐形式包括,但不限于,单、双、三、四盐等。药学上可接受盐在它们被施用的量和浓度下是无毒的。在不阻止其发挥生理效应的情况下,通过改变化合物的物理特性,这样的盐的制备可以便于药理学应用。在物理性质上有用的改变包括降低熔点以便经粘膜给药,以及增加溶解度以便施用更高浓度的药物。本发明的化合物可具有足够酸性的、足够碱性的、或这两种官能基团,因此可与许多无机碱或有机碱、无机酸和有机酸发生反应,从而形成药学上可接受的盐。
药学上可接受的盐包括酸加成盐,例如氯化物、溴化物、碘化物、氢氯化物、乙酸盐、苯乙酸盐、丙烯酸盐、抗坏血酸盐、天冬氨酸盐、苯甲酸盐、2-苯氧基苯甲酸盐、2-乙酰氧基苯甲酸盐、二硝苯甲酸盐、羟基苯甲酸盐、甲氧基苯甲酸盐、甲基苯甲酸盐、碳酸氢盐、丁炔-1,4二酸盐、己炔-1,6-二酸盐、己酸盐、辛酸盐、氯苯甲酸、肉桂酸盐、柠檬酸盐、癸酸盐、甲酸盐、延胡索酸盐、乙醇酸盐、葡糖酸盐、葡萄糖二酸盐、葡萄糖醛酸盐、葡糖-6-磷酸、谷氨酸盐、庚酸盐、己酸盐、羟乙基磺酸盐、异丁酸盐、γ-羟基丁酸盐、苯基丁酸盐、乳酸盐、苹果酸盐、马来酸盐、羟基马来酸盐、甲基马来酸盐、丙二酸盐、扁桃酸盐、烟酸盐、硝酸盐、异烟酸盐、辛酸盐、油酸盐、草酸盐、双羟萘酸盐、磷酸盐、磷酸一氢盐、磷酸二氢盐、正磷酸盐、偏磷酸盐、焦磷酸盐、2-磷酸甘油酸盐、3-磷酸甘油酸盐、邻苯二甲酸盐、丙酸盐、苯基丙酸盐、丙炔酸盐、丙酮酸盐、奎尼酸盐、水杨酸盐、4-氨基水杨酸盐、癸二酸盐、硬脂酸盐、辛二酸盐、琥珀酸盐、硫酸盐、焦硫酸盐、硫酸氢盐、亚硫酸盐、酸式亚硫酸盐、氨基磺酸盐、磺酸盐、苯基磺酸盐(即苯磺酸盐)、乙烷磺酸盐(即乙磺酸盐)、乙烷-1,2-二磺酸盐、2-羟基乙二磺酸盐(即羟乙基磺酸盐)、甲烷磺酸盐(即甲磺酸盐)、萘基-1-磺酸盐、萘基-2-磺酸盐(即萘磺酸盐)、丙磺酸盐、p-甲苯磺酸盐(即甲苯磺酸盐)、二甲苯磺酸盐、环己基氨基磺酸盐、酒石酸盐和三氟乙酸盐。这些药学上可接受的酸加成盐可利用合适的相应酸来制备。
当存在酸性功能基团(如羧酸或苯酚)时,药学上可接受的盐也包括碱加成盐,例如那些含有苄星青霉素、氯普鲁卡因、胆碱、乙醇胺、二乙醇胺、三乙醇胺、叔丁胺、二环己基胺、乙二胺、N,N’-二苄基乙二胺、葡甲胺、羟乙基吡咯烷、哌啶、吗啉、哌嗪、普鲁卡因、铝、钙、铜、铁、锂、镁、锰、钾、锌、钠、铵和单、二或三烷基胺(如二乙胺)或由氨基酸(如L-组氨酸、L-甘氨酸、L-赖氨酸和L-精氨酸)衍生的盐。例如,参见Remington's PharmaceuticalSciences,19th ed.,MackPublishing Co.,Easton,PA,Vol.2,p.1457,1995。这些药学上可接受的碱加成盐可利用合适的相应碱来制备。
通过标准技术,可以制备药学上可接受的盐。例如,将游离碱形式的化合物溶解在合适的溶剂中,例如含有适宜酸的水性溶液或水-醇溶液中,然后蒸发溶液进行分离。在另一个实例中,通过使游离碱和酸在有机溶剂中反应来制备盐。如果特定的化合物是酸,那么可通过任何合适的方法制备期望的药学上可接受的盐,例如使用合适的无机或有机碱来处理该游离酸。
(d)其他化合物形式
如果试剂是固体,本领域技术人员会理解,用于本发明的化合物和盐可以不同晶型或多晶型的形式存在,或可被配制成共晶体,或可为无定型形式,或可为它们的任何组合(例如部分晶型的、部分无定型的、或多晶型的混合物),所有这些都意在被包含在本发明和指定的化学式的范围内。盐由酸/碱加成而形成,即感兴趣的化合物的游离碱或游离酸分别与相应的加成碱或加成酸形成酸/碱反应,产生离子电荷相互作用,而共晶体是一种新的化学物种,其形成在中性化合物之间,产生了该化合物以及在相同晶体结构内的额外的分子种类。
在一些情形下,用于本发明的化合物与酸或碱与酸或碱复合,包括碱加成盐,例如铵盐、二乙胺、乙醇胺、乙二胺、二乙醇胺、叔丁胺、哌嗪、葡甲胺;酸加成盐,例如乙酸盐、乙酰水杨酸盐、苯磺酸盐、右旋樟脑磺酸盐、柠檬酸盐、甲酸盐、延胡索酸盐、戊二酸盐、盐酸盐、马来酸盐、甲磺酸盐、硝酸盐、草酸盐、磷酸盐、琥珀酸盐、硫酸盐、酒石酸盐、硫氰酸盐和甲苯磺酸盐;以及氨基酸,例如丙氨酸、精氨酸、天冬酰胺、天冬氨酸、半胱氨酸、谷氨酰胺、谷氨酸、甘氨酸、组氨酸、异亮氨酸、亮氨酸、赖氨酸、甲硫氨酸、苯丙氨酸、脯氨酸、丝氨酸、苏氨酸、色氨酸、酪氨酸或缬氨酸。在将本发明的化合物与酸或碱结合时,优选形成无定型复合物,而非晶型物质,例如是通常的盐或共晶体。在一些情形下,无定型形式的复合物通过额外的加工而获得,例如通过喷雾干燥、机械化学方法(如辊压)、或与酸或碱混合的母化合物的微波辐射。这些方法也可包括添加进一步稳定复合物的无定型性质的离子的和/或非离子的聚合物体系,包括但不限于,醋酸羟丙甲纤维素琥珀酸酯(HPMCAS)和甲基丙烯酸共聚物(例如L100-55)。这种无定型复合物提供了多种优点。例如,相对游离碱降低熔化温度有利于额外的加工,例如热熔挤出,从而进一步改善化合物的生物医药性质。而且,该无定型复合物是容易粉碎的,这为将固体加入胶囊或片剂形式中提供了改善的压缩。
此外,化学式还意在涵盖所表征结构的水合形式或溶剂化形式以及非水合或非溶剂化形式。例如,所表示的化合物包括水合形式和非水合形式。溶剂化物的其他例子包括与合适溶剂结合的结构,例如异丙醇、乙醇、甲醇、二甲基亚砜、乙酸乙酯、乙酸或乙醇胺。
IV.制剂和给药
在另一个方面,本发明提供包含/包括药学上可接受的载体、赋形剂和/或稀释剂以及本文所述的化合物或其药学上可接受的盐或溶剂化物的药物组合物。在示例性的实施方式中,本发明提供包含/包括本文所述的化合物的药物制剂。在一些实施方式中,本发明提供包含/包括式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个、以及药学上可接受的载体、赋形剂和/或稀释剂的药物组合物。
这些方法和化合物通常会用于人的治疗。但是,它们也可被用来治疗其他动物的类似或相同适应症。本文所述的化合物可通过不同途径给药,包括注射(即肠胃外给药,包括静脉内、腹膜内、皮下和肌内)、口服、经皮、透黏膜、直肠或吸入。这些剂量形式应允许化合物达到靶细胞。其他因素在本领域是熟知的,包括例如毒性等考虑因素以及阻止化合物或组合物发挥其作用的剂量形式。技术和配制通常可在Remington:The ScienceandPractice ofPharmacy,21st edition,Lippincott,Williams andWilkins,Philadelphia,PA,2005中找到(通过引用合并至本文)。
在一些实施方式中,组合物会包含药学上可接受的载体或赋形剂,例如填料、粘合剂、崩解剂、助流剂、润滑剂、络合剂、增溶剂和表面活性剂,它们可被选择以便于通过特定途径给药。载体的例子包括碳酸钙、磷酸钙、各种糖类(如乳糖、葡萄糖或蔗糖)、各类型淀粉、纤维素衍生物、明胶、脂质、脂质体、纳米颗粒等等。载体也包括生理上相容性液体作为溶剂或用于悬浮液,包括例如注射用无菌水溶液(WFI)、生理盐水溶液、葡萄糖溶液、Hank氏溶液、Ringer氏溶液、植物油、矿物油、动物油、聚乙二醇、液体石蜡等等。赋形剂也可包括例如胶态二氧化硅、硅胶、滑石、硅酸镁、硅酸钙、铝硅酸钠、三硅酸镁、粉末状纤维素、粗晶纤维素、羧甲基纤维素、交联羧甲基纤维素钠、苯甲酸钠、碳酸钙、碳酸镁、硬脂酸、硬脂酸铝、硬脂酸钙、硬脂酸镁、硬脂酸锌、硬脂酰醇富马酸钠、消光粉(syloid)、stearowet C、氧化镁、淀粉、羧甲淀粉钠、单硬脂酸甘油酯、二山嵛酸甘油酯、棕榈酰硬脂酸甘油酯、氢化植物油、氢化棉籽油、蓖麻籽油矿物油、聚乙二醇(如PEG 4000-8000)、聚氧乙二醇、泊洛沙姆、聚维酮、交聚维酮、交联羧甲基纤维素钠、藻酸、酪蛋白、甲基丙烯酸二乙烯基苯共聚物、多库酯钠、环糊精(例如2-羟丙基-δ-环糊精)、聚山梨醇酯(如聚山梨醇酯80)、溴棕三甲铵、TPGS(d-α-生育酚聚乙二醇1000琥珀酸酯)、月桂硫酸镁、月桂硫酸钠、聚乙二醇醚、聚乙二醇的二脂肪酸酯、或聚氧乙烯山梨糖醇酐脂肪酸酯(如聚氧乙烯山梨糖醇酐酯)、聚氧乙烯山梨糖醇酐脂肪酸酯、山梨糖醇酐脂肪酸酯(如来自像油酸、硬脂酸或棕榈酸的脂肪酸的山梨糖醇酐脂肪酸酯)、甘露糖醇、木糖醇、山梨醇、麦芽糖、乳糖、乳糖一水合物或喷雾干燥的乳糖、蔗糖、果糖、磷酸钙、磷酸氢钙、磷酸钙、硫酸钙、葡萄糖结合剂、葡聚糖、糊精、右旋糖、醋酸纤维素、麦芽糖糊精、二甲基硅油、聚葡萄糖、壳聚糖、明胶、HPMC(羟丙基甲基纤维素)、HPC(羟丙基纤维素)、羟乙基纤维素等等。
药物制剂可以单位剂量形式呈现,每单位剂量含有预定量的活性组分。这种单位剂量可含有例如0.5mg至1g(优选1mg至700mg,更优选5mg至100mg)的本发明的化合物(游离形式、任何形式的溶剂化物(包括水合物)或盐),含量取决于被治疗的病症、给药途径、患者的年龄、体重和状况。优选的单位剂量制剂是含有日剂量、周剂量、月剂量、它们的子剂量或合适比例的活性组分的那些制剂。而且,这种药物制剂可通过制药领域熟知的任何方法来制备。
药物制剂可被制成适合任何适当途径给药的形式,例如口服(包括胶囊、片剂、充液胶囊、崩解片、立即释放片剂、缓释片剂、控释片剂、口服条带(oral strip)、溶液、糖浆剂、颊含片和舌下片)、直肠、鼻腔、吸入、局部(包括经皮)、阴道或肠胃外(包括皮下、肌内、静脉内或皮内)途径。这些制剂可通过制药领域已知的任何方法制备,例如通过将活性组分与载体、赋形剂或稀释剂联合而制备。通常,用在药物制剂中的载体、赋形剂或稀释剂是“非毒性的”和“惰性的”,前者意思是指以在药物组合物中的量服用它/它们是安全的,后者是指它/它们不会明显地与活性组分反应或导致对活性组分的治疗活性产生不期望的作用。
在一些实施方式中,可使用口服给药。口服给药的药物制剂可被配制成常规口服形式,例如离散单元胶囊、片剂和液体制剂(如糖浆、酏剂和浓缩液滴)。本发明所述的化合物可与固体赋形剂混合,任选地研磨所形成的混合,再加入合适助剂后(如需要的话),加工颗粒混合物以获得例如片剂、包衣片剂、硬胶囊、软胶囊、溶液(例如水性、醇类的、或油类溶液)等等。特别地,合适的赋形剂是填料,例如糖类,包括乳糖、葡萄糖、蔗糖、甘露醇或山梨醇;纤维素制剂,例如玉米淀粉、小麦淀粉、水稻淀粉、马铃薯淀粉、明胶、黄蓍胶、甲基纤维素、羟丙基甲基纤维素、羧甲基纤维素钠(CMC)和/或聚乙烯吡咯烷酮(PVP:聚维酮);油类赋形剂,包括植物油和动物油,例如葵花油、橄榄油或鱼肝油。口服制剂也可含有崩解剂,例如交联聚乙烯吡咯烷酮、琼脂或褐藻酸或其盐(如褐藻酸盐);润滑剂,例如滑石或硬脂酸镁;增塑剂,例如甘油或山梨糖醇;甜味剂,例如蔗糖、果糖、乳糖或阿巴斯甜;天然或人工调味剂,例如薄荷、冬青油或樱桃调味剂;或着色剂或色素,其可用于识别或表征不同剂量或组合,例如单位剂量。本发明还提供了具有合适糖衣的糖衣丸。为此,可使用浓缩的糖溶液,其可任选地含有例如阿拉伯胶、滑石、聚乙烯吡咯烷酮、卡波胶、聚乙二醇和/或二氧化钛、漆溶液(lacquer solutions)和合适的有机溶剂或溶剂混合物。口服液体(例如溶液、糖浆和酏剂)可制备成剂量单元形式,从而给定的量包含预定量的化合物。
可口服的药物制剂包括由明胶制成的推入配合(push-fit)胶囊(“明胶胶囊”)以及由明胶和增塑剂(如甘油或山梨糖醇)制成的软密封胶囊。该推入配合胶囊可含有与填料(例如乳糖)、粘合剂(例如淀粉)和/或润滑剂(例如滑石或硬脂酸镁)和稳定剂(任选)混合的活性组分。在软胶囊中,活性化合物可被溶解或悬浮于合适的液体,例如脂肪油、液体石蜡或液态聚乙二醇。
在一些实施方式中,可使用注射给药(肠胃外给药),例如肌内、静脉内、腹膜内和/或皮下。用于注射的本文所述的化合物可被配制成无菌液体溶液,优选配制成生理上相容性缓冲液或溶液,例如生理盐水溶液、Hank氏溶液或Ringer氏溶液。也可将分散体制备成非水溶液,例如甘油、丙二醇、乙醇、液态聚乙二醇、三醋酸甘油酯和植物油。溶液还可含有防腐剂,例如对羟基苯甲酸甲酯、尼泊金丙酯、异丁醇、苯酚、山梨酸、硫柳汞等等。此外,化合物可被配制成固体形式,包括例如冻干形式,并在使用前被重新溶解或制成悬液。这些制剂可呈现于单位剂量容器或多剂量容器中,例如密封的安瓿和小瓶,并且可被存储在冻干条件下,仅需要在即将使用前加入无菌液体载体(例如注射用水)即可。
在一些实施方式中,可使用经黏膜、局部或经皮给药。在本发明的化合物的这些制剂中,使用了适于穿透屏障的渗透剂。这些渗透剂一般是本领域已知的,包括例如用于经黏膜给药的胆盐和夫西地酸衍生物。此外,清洁剂也可被用来辅助渗透。例如,经黏膜给药可通过鼻腔喷雾或栓剂(直肠或阴道)实现。用于局部给药的本文所述的化合物的组合物可通过选用本领域已知的合适载体而被配制成油、霜剂、乳液、软膏等等。合适的载体包括植物油或矿物油、白凡士林(白色软质石蜡)、支链脂肪或油、动物脂肪和高分子量醇类(大于C12)。在一些实施方式中,选择使活性组分可溶的载体。乳化剂、保湿剂和抗氧化剂以及赋予颜色或香味的试剂(如期望的话)也可被包括在内。局部给药的霜剂优选由矿物油、自乳化蜂蜡和水的混合物制成,在该混合物中混有以小量溶剂(例如油)溶解的活性组分。此外,经皮给药手段可包括透皮贴剂或敷料,例如浸渍了活性组分以及一种或多种本领域已知的载体或稀释剂(任选)的绷带。以经皮递送系统的形式给药,剂量给药在整个给药方案期间将是连续的,而非间歇性的。
在一些实施方式中,化合物被以吸入剂的形式给药。本文所述的化合物可被配制成干粉或合适的溶液、悬浮液或气雾剂。粉末和溶液可使用本领域已知的合适添加剂配制。例如,粉末可包括合适的粉末基底(例如乳糖或淀粉),溶液可包含丙二醇、无菌水、乙醇、氯化钠和其他添加剂(例如酸、碱和缓冲盐)。这些溶液或悬浮液可通过吸入方式经喷雾器、泵送器、雾化器等给药。本文所述的化合物也可与其他吸入疗法结合使用,所述其他吸入疗法例如是皮质类固醇(例如氟替卡松丙酸、丙酸倍氯米松、曲安奈德、布地奈德和糠酸莫米松);β激动剂(例如沙丁胺醇、沙美特罗和福莫特罗);抗胆碱剂(例如异丙托溴铵或噻托溴铵);血管扩张剂(例如treprostinal和伊洛前列素);酶(例如DNA酶);治疗性蛋白质;免疫球蛋白抗体;寡核苷酸(例如单链或双链DNA或RNA、siRNA);抗生素(例如妥布霉素);毒蕈碱受体拮抗剂;白三烯拮抗剂;细胞因子拮抗剂;蛋白酶抑制剂;色甘酸钠(cromolynsodium);nedocril钠;以及色甘酸钠(sodium cromoglycate)。
各种化合物的给药量可通过标准程序测定并考虑例如下列因素:化合物活性(体外活性,例如化合物IC50vs.靶标,或在动物药效模型中的体内活性)、动物模型中药代动力学结果(如生物学半寿期或生物课利用度)、对象的年龄、尺寸和体重、以及对象相关的疾病。这些因子以及其他因子的重要性对于本领域技术人员来说是熟知的。一般而言,剂量会在约0.01至50mg/kg被治对象的范围,或约0.1至20mg/kg被治对象的范围。可使用多重剂量。
本文所述的化合物也可与其他用于治疗相同疾病的疗法联合使用。这种联合使用包括在不同时间给予所述化合物以及一种或多种其他治疗剂,或联合给予所述化合物和一种或多种其他治疗剂。在一些实施方式中,可通过本领域技术人员熟知的方法,对本发明的一种或多种化合物或联合使用的其他治疗剂的剂量进行修改,例如相对于单独使用该化合物或治疗剂减少用药量。
要理解的是,联合使用包括与其他疗法、药物、医学程序等一起使用,其中其他疗法或程序可在不同于本文所述化合物的时间施用(例如在短时间内,如数小时内(如1、2、3、4-24小时内),或在较长时间内(如1-2天、2-4天、4-7天、1-4周)),或与本发明的化合物在相同时间施用。联合使用也包括与施用一次或不频繁施用的疗法或医疗程序(例如手术)一起使用,并在进行所述其他疗法或程序之前或之后的短时间内或较长时间内施用本发明所述的化合物。在一些实施方式中,本发明提供递送本发明所述的化合物和一种或多种其他药物治疗剂,所述其他药物治疗剂通过不同途径给药,或通过相同途径给药。任何给药途径的联合施用包括递送本发明所述的化合物和一种或多种其他药物治疗剂,所述其他药物治疗剂通过相同给药方式以任何制剂形式一起递送,包括将两种化合物化学性地连在一起以使得它们在给药时维持它们的治疗活性的制剂形式。在一个方面,该其他药物疗法可与本文所述的化合物共同施用。共同施用方式的联合使用包括使用共同制剂或化学上结合在一起的化合物的制剂,或在彼此来说短的时间内(如在1小时、2小时、3小时、至多24小时内)以相同或不同途径施用不同制剂形式的两种或多种化合物。单独制剂的共同施用包括通过一个装置的递送而共同施用,例如相同的吸入装置、相同注射器等,或在彼此来说短的时间内由单独的装置施用。通过相同途径给药的本文所述的化合物与一种或多种额外药物治疗剂的共同制剂包括一起制备材料,从而它们可通过一个装置给药,包括结合在一个制剂中的不同化合物,或者被修饰而可化学性地连接但仍维持它们的生物学活性的化合物。这种化学上连接的化合物可具有一个连接体,其在体内被实质性地保持,或者该连接体在体内分解从而将两种活性组分分开。本文公开的化合物可以与本文所述的其他疗法或治疗剂组合用于辅助或新辅助治疗。
V.布罗莫结构域的疾病适应症和调节
与布罗莫结构域相关的示例性疾病
布罗莫结构域蛋白的家族的BET(Bromodomain and Extra Terminal)的成员(BRD2、BRD3、BRD4和BRDT)已经与多种疾病相关,这些疾病包含神经系统疾病、自身免疫和炎性疾病、代谢性疾病(Muller et al.ExpertRev.Mol.Med.2011,Sep 13;13:e29;Prinjhaet al.Trends Pharmacol.Sci.2012,33,146-153;Belkina et al.J.Immunol.2013,190,3670-3678;以及Belkina et al.Nature Rev.Cancer 2012,12,465-477)和癌症(Alsarrajet al.International Journal ofBreast Cancer 2012,1-7;Barbieri et al.Briefingsin Functional Genomics 2013,1-12;Blobel et al.Cancer Cell2011,20,287-288;DangCell 2012,149,22-35)。此外,一些病毒利用这些蛋白将它们的基因组系至宿主细胞染色质,作为病毒复制的过程中的一部分(You et al Cell,2004117,349-60)。
式(I)或(II)的化合物、或本文所述的化合物中的任一个,可用于治疗与涉及表观遗传调控的一种或多种蛋白相关的疾病,该蛋白例如是包含乙酰基-赖氨酸识别基序(即布罗莫结构域)的蛋白(例如BET蛋白,例如BRD2、BRD3、BRD4和/或BRDT),并且例如是与布罗莫结构域的异常表达相关的疾病,该疾病包含细胞增殖性疾病、癌症、慢性自身免疫性、炎性病症等。
如下文所述,布罗莫结构域的存在已经与多种不同类型的癌症和其他疾病及病症相关。布罗莫结构域抑制剂,例如式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个,可用于治疗全身性或组织的炎症、对感染或缺氧的炎性反应、细胞活化和增殖、脂质代谢、纤维化,并可用于预防和治疗病毒感染。
布罗莫结构域抑制剂,例如式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个,可用于治疗慢性自身免疫和炎性病症,例如风湿性关节炎、骨关节炎、急性痛风、牛皮癣、系统性红斑狼疮、多发性硬化、炎性肠病(克罗恩氏病和溃疡性结肠炎)、哮喘、慢性阻塞性气道疾病、肺炎、心肌炎、心包炎、肌炎、湿疹、皮炎、脱发、白癜风、大疱性皮肤病、肾炎、血管炎、动脉粥样硬化、阿尔茨海默病、抑郁症、视网膜炎、葡萄膜炎、巩膜炎、肝炎、胰腺炎、原发性胆汁性肝硬化、硬化性胆管炎、阿狄森氏病、垂体炎、甲状腺炎、I型糖尿病和移植器官的急性排斥反应。
布罗莫结构域抑制剂,例如式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个,可用于预防和治疗急性炎症,包括但不限于例如急性痛风、骨巨细胞动脉炎、肾炎(包括狼疮性肾炎)、器官受累的血管炎(例如肾小球肾炎)、脉管炎(包括巨细胞动脉炎)、韦格纳氏肉芽肿病、结节性多动脉炎、白塞氏病、川畸病、大动脉炎、器官受累的血管炎和移植器官的急性排斥反应。
布罗莫结构域抑制剂,例如式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个,可用于预防和治疗涉及对细菌、病毒(例如疱疹病毒、人类乳头状瘤病毒、腺病毒和痘病毒和其它DNA病毒)、真菌、寄生虫或它们的毒素感染的炎症反应的自身免疫和炎性疾病或病症,例如败血症、脓毒病综合症、脓毒性休克、内毒素血症、全身炎症反应综合症(SIRS)、多器官功能障碍综合症、中毒性休克综合症、急性肺损伤、ARDS(成人呼吸窘迫综合症)、急性肾功能衰竭、暴发性肝炎、烧伤、急性胰腺炎、外科手术后综合症、结节病、赫克斯海默反应、脑炎、脊髓炎、脑膜炎、疟疾和与病毒感染(例如流行性感冒、带状疱疹、单纯性疱疹和冠状病毒)相关的SIRS。
布罗莫结构域抑制剂,例如式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个,可用于预防和治疗与缺血再灌注损伤相关的疾病或病症,包括但不限于心肌梗死、脑血管局部缺血(卒中)、急性冠脉综合症、肾再灌注损伤、器官移植、冠状动脉搭桥术、心肺旁路手术、肺、肾、肝、胃肠或周肢栓塞。
布罗莫结构域抑制剂,例如式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个,可用于预防和治疗高胆固醇血症、动脉粥样硬化和阿尔茨海默氏病。
布罗莫结构域抑制剂,例如式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个,可用于预防和治疗癌症,包括但不限于血液癌、上皮癌(包括肺癌、乳腺癌和结肠癌)、中线癌、间质瘤、肝癌、肾癌、神经瘤、肾上腺癌、腺泡细胞癌、听神经瘤、肢端雀斑样痣黑色素瘤、肢端汗腺瘤、急性嗜酸性粒细胞性白血病、急性类红细胞性白血病、急性淋巴细胞性白血病、急性巨核细胞白血病、急性单核细胞白血病、急性早幼粒细胞白血病、腺癌、腺样囊性癌、腺瘤、腺瘤样牙源性肿瘤、腺鳞癌、脂肪组织肿瘤、肾上腺皮质癌、成人T细胞白血病/淋巴瘤、攻击性NK细胞白血病、AIDS相关淋巴瘤、肺泡状横纹肌肉瘤、腺泡状软组织肉瘤、成釉细胞纤维瘤、间变性大细胞淋巴瘤、甲状腺未分化癌、血管免疫母细胞T细胞淋巴瘤、血管肌脂肪瘤、血管肉瘤、星形细胞瘤、非典型畸胎瘤横纹肌样瘤、B细胞慢性淋巴细胞性白血病、B细胞幼淋巴细胞白血病、B细胞淋巴瘤、基底细胞癌、胆道癌、膀胱癌、胚细胞瘤、骨癌、布伦纳瘤、布朗瘤、伯基特淋巴瘤、乳腺癌、脑癌、癌细胞、原位癌、癌肉瘤、软骨肿瘤、牙骨质瘤、髓样肉瘤、软骨瘤、脊索瘤、绒毛膜癌、脉络丛乳头状瘤、肾透明细胞肉瘤、颅咽管瘤、皮肤T细胞淋巴瘤、子宫颈癌、结肠直肠癌、德戈斯病、促结缔组织增生性小圆细胞肿瘤、弥漫性大B细胞淋巴瘤、胚胎发育不良性神经上皮瘤、无性细胞瘤、胚胎性癌、内分泌腺肿瘤、内胚窦瘤、肠病相关性T细胞淋巴瘤、食管癌、胎中胎、纤维瘤、纤维肉瘤、滤泡性淋巴瘤、滤泡性甲状腺癌、神经节瘤、胃肠癌、生殖细胞瘤、妊娠性绒癌、巨细胞纤维母细胞、骨巨细胞瘤、神经胶质肿瘤、胶质母细胞瘤、神经胶质瘤、脑胶质瘤、胰高血糖素瘤、性腺胚细胞瘤、粒层细胞瘤、男性细胞瘤、胆囊癌、胃癌、毛细胞白血病、血管母细胞瘤、头颈部癌、血管外皮细胞瘤、恶性血液疾病、肝母细胞瘤、肝脾T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、浸润性小叶癌、肠癌、肾癌、喉癌、恶性雀斑样痣、致命性中线癌、白血病、睾丸间质细胞瘤、脂肪肉瘤、肺癌、淋巴管瘤、淋巴管肉瘤、淋巴上皮瘤、淋巴瘤、急性淋巴细胞性白血病、急性骨髓性白血病、慢性淋巴细胞性白血病、肝癌、小细胞肺癌、非小细胞肺癌、MALT淋巴瘤、恶性纤维性组织细胞瘤、恶性外周神经鞘瘤、恶性蝾螈瘤、套细胞淋巴瘤、边缘区B细胞淋巴瘤、肥大细胞白血病、纵隔生殖细胞瘤、乳腺髓样癌、甲状腺髓样癌、髓母细胞瘤、黑素瘤、脑膜瘤、默克尔细胞癌、间皮瘤、转移性尿路上皮癌、苗勒管混合瘤、黏液瘤、多发性骨髓瘤、肌肉组织肿瘤、蕈样肉芽肿、粘液样肉瘤、粘液瘤、粘液肉瘤、鼻咽癌、神经鞘瘤、神经母细胞瘤、神经纤维瘤、神经瘤、结节性黑色素瘤、眼癌、少突星形细胞瘤、少突神经胶质瘤、嗜酸细胞瘤、视神经鞘脑膜瘤、视神经瘤、口腔癌、骨肉瘤、卵巢癌、潘科斯特瘤、乳头状甲状腺癌、副神经节瘤、松果体母细胞瘤、松果体细胞瘤、垂体细胞瘤、垂体腺瘤、垂体瘤、浆细胞瘤、多胚瘤、前体T淋巴细胞淋巴瘤、原发性中枢神经系统淋巴瘤、原发性渗出性淋巴瘤、原发性腹膜癌、前列腺癌、胰腺癌、咽癌、腹膜假黏液瘤、肾细胞癌、肾髓样癌、视网膜母细胞瘤、横纹肌瘤、横纹肌肉瘤、里希特的转型癌、直肠癌、肉瘤、Schwannomatosis瘤、精原细胞瘤、睾丸支持细胞瘤、性索-性腺间质瘤、印戒细胞癌、皮肤癌、小蓝圆细胞瘤、小细胞癌、软组织肉瘤、生长抑素瘤、烟尘疣、脊柱肿瘤、脾边缘区淋巴瘤、鳞状细胞癌、滑膜肉瘤、塞扎里氏病、小肠肿瘤、鳞状细胞癌、胃癌、T细胞淋巴瘤、睾丸癌、卵泡膜细胞瘤、甲状腺癌、移行细胞癌、咽喉癌、脐尿管癌、泌尿生殖器癌、尿路上皮癌、眼色素层黑素瘤、子宫癌、疣状癌、视觉通路胶质瘤、外阴癌、阴道癌、瓦尔登斯特伦巨球蛋白血症、沃辛瘤和维尔姆斯瘤。
布罗莫结构域活性试验
许多不同的布罗莫结构域活性试验可被用来分析活性调节剂和/或测定调节剂对特定布罗莫结构域或群的特异性。除了下述实施例中提到的试验之外,本领域技术人员将知道可被使用的其他试验,并且可修改试验以适应特定的应用。
在一些实施方式中,如在普遍接受的布罗莫结构域活性试验或本文所述的布罗莫结构域活性试验中所测定的,式(I)或(II)的化合物、或在表I中列出的化合物的IC50小于100nM、小于50nM、小于20nM、小于10nM、小于5nM、或小于1nM。在一些实施方式中,测定布罗莫结构域活性的试验包括例如生物化学或细胞学试验,例如实施例6中描述的试验或本领域熟知的试验。
布罗莫结构域的调节
在另一个方面,本发明提供一种调节或抑制布罗莫结构域蛋白的方法。该方法包括向对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中描述的化合物中的任一个;或包含本文所述任何化学式的化合物的组合物,从而调节或抑制布罗莫结构域。在一些实施方式中,所述方法包括在体内或体外将细胞与式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;本文描述的式I或II的所有实施方式;或表I中描述的化合物中的任一个;或包含本文所述任何化学式的化合物的组合物接触。
VI.治疗布罗莫结构域介导的病症的方法
在另一个方面,本发明提供一种治疗患有或有风险患有布罗莫结构域介导的疾病或病症的对象的方法,其中布罗莫结构域的抑制起到作用或提供效益。该方法包括向该对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中描述的化合物中的任一个;或包含本文所述任何化学式的化合物的组合物。在某些实施方式中,该方法包括向对象施用有效量的本文所述的任何一种或多种化合物,并联合施用一种或多种用于所述疾病或病症的其他疗法。在一些实施方式中,该方法包括向对象施用有效量的本文所述的任何一种或多种化合物,并联合施用一种或多种用于所述疾病或病症的治疗剂。
在一些实施方式中,本发明提供一种抑制布罗莫结构域介导的肿瘤细胞的不期望的增殖的方法。该方法包括将肿瘤细胞与有效量的式(I)或(II)的任一个的化合物、或表I中列出的化合物中的任一个、或其药学上可接受的盐、水合物、溶剂化物、互变异构体或同分异构体、或包含本文所述的化合物的组合物接触。在一些情形下,所述肿瘤细胞由BET蛋白、BRD4蛋白或其突变体介导。
在某些实施方式中,本发明提供治疗患者的方法,其中布罗莫结构域(例如BET蛋白或BRD4蛋白)的抑制提供效益。该方法包括向有此需要的患者施用有效量的式(I)或(II)的任一个的化合物、或表I中列出的化合物中的任一个、或其药学上可接受的盐、水合物、溶剂化物、互变异构体或同分异构体、或包含本文所述的化合物的组合物。
在一些实施方式中,本发明提供一种治疗患有或有风险患有布罗莫结构域介导的疾病或病症的对象的方法,所述方法包括向有此需要的对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,并且所述疾病或病症是癌症、自身免疫病症、炎性病症或其组合。
在一些实施方式中,可使用本发明的化合物治疗的疾病或病症包括,但不限于,癌症,例如血液癌、上皮癌(包括肺癌(lung cancer)、乳腺癌(breast cancer)和结肠癌(colon cancer))、中线癌(midline carcinomas)、间质瘤(mesenchyma tumors)、肝癌、肾癌(renal cancer)、神经瘤(neurological tumors)、肾上腺癌(adrenal cancer)、腺泡细胞癌(acinic cell carcinoma)、听神经瘤(acoustic neuroma)、肢端雀斑样痣黑色素瘤(acral lentiginous melanoma)、肢端汗腺瘤(acrospiroma)、急性嗜酸性粒细胞性白血病(acute eosinophilic leukemia)、急性类红细胞性白血病(acute erythroid leukemia)、急性淋巴细胞性白血病(acute lymphoblastic leukemia)、急性巨核细胞白血病(acutemegakaryoblastic leukemia)、急性单核细胞白血病(acute monocytic leukemia)、急性早幼粒细胞白血病(acute promyelocytic leukemia)、腺癌(adenocarcinoma)、腺样囊性癌(adenoid cystic carcinoma)、腺瘤(adenoma)、腺瘤样牙源性肿瘤(adenomatoidodontogenic tumor)、腺鳞癌(adenosquamous carcinoma)、脂肪组织肿瘤(adiposetissue neoplasm)、肾上腺皮质癌(adrenocortical carcinoma)、成人T细胞白血病/淋巴瘤、攻击性NK细胞白血病、AIDS相关淋巴瘤、肺泡状横纹肌肉瘤(alveolarrhabdomyosarcoma)、腺泡状软组织肉瘤(alveolar soft part sarcoma)、成釉细胞纤维瘤(ameloblastic fibroma)、间变性大细胞淋巴瘤(anaplastic large cell lymphoma)、甲状腺未分化癌(anaplastic thyroid cancer)、血管免疫母细胞T细胞淋巴瘤(angioimmunoblastic T-cell lymphoma)、血管肌脂肪瘤(angiomyolipoma)、血管肉瘤(angiosarcoma)、星形细胞瘤(astrocytoma)、非典型畸胎瘤横纹肌样瘤(atypicalteratoid rhabdoid tumor)、B细胞慢性淋巴细胞性白血病(B-cell chronic lymphocyticleukemia)、B细胞幼淋巴细胞白血病(B-cell prolymphocytic leukemia)、B细胞淋巴瘤、基底细胞癌(basal cell carcinoma)、胆道癌(biliary tract cancer)、膀胱癌(bladdercancer)、胚细胞瘤(blastoma)、骨癌、布伦纳瘤(Brenner tumor)、布朗瘤(Brown tumor)、伯基特淋巴瘤(Burkitt's lymphoma)、乳腺癌、脑癌、癌细胞(carcinoma)、原位癌(carcinoma in situ)、癌肉瘤(carcinosarcoma)、软骨肿瘤(cartilage tumor)、牙骨质瘤(cementoma)、髓样肉瘤(myeloid sarcoma)、软骨瘤(chondroma)、脊索瘤(chordoma)、绒毛膜癌(choriocarcinoma)、脉络丛乳头状瘤(choroid plexus papilloma)、肾透明细胞肉瘤(clear-cell sarcoma of the kidney)、颅咽管瘤(craniopharyngioma)、皮肤T细胞淋巴瘤(cutaneous T-cell lymphoma)、子宫颈癌(cervical cancer)、结肠直肠癌(colorectalcancer)、德戈斯病(Degos disease)、促结缔组织增生性小圆细胞肿瘤(desmoplasticsmall round cell tumor)、弥漫性大B细胞淋巴瘤、胚胎发育不良性神经上皮瘤(dysembryoplastic neuroepithelial tumor)、无性细胞瘤(dysgerminoma)、胚胎性癌(embryonal carcinoma)、内分泌腺肿瘤(endocrine gland neoplasm)、内胚窦瘤(endodermal sinus tumor)、肠病相关性T细胞淋巴瘤(enteropathy-associated T-celllymphoma)、食管癌(esophageal cancer)、胎中胎(fetus in fetu)、纤维瘤(fibroma)、纤维肉瘤(fibrosarcoma)、滤泡性淋巴瘤(follicular lymphoma)、滤泡性甲状腺癌(follicular thyroid cancer)、神经节瘤(ganglioneuroma)、胃肠癌(gastrointestinalcancer)、生殖细胞瘤(germ cell tumor)、妊娠性绒癌(gestational choriocarcinoma)、巨细胞纤维母细胞(giant cell fibroblastoma)、骨巨细胞瘤(giant cell tumor ofthebone)、神经胶质肿瘤(glial tumor)、胶质母细胞瘤(glioblastoma multiforme)、神经胶质瘤(glioma)、脑胶质瘤(gliomatosis cerebri)、胰高血糖素瘤(glucagonoma)、性腺胚细胞瘤(gonadoblastoma)、粒层细胞瘤(granulosa cell tumor)、男性细胞瘤(gynandroblastoma)、胆囊癌(gallbladder cancer)、胃癌(gastric cancer)、毛细胞白血病(hairy cell leukemia)、血管母细胞瘤(hemangioblastoma)、头颈部癌(head and neckcancer)、血管外皮细胞瘤(hemangiopericytoma)、恶性血液疾病(hematologicalmalignancy)、肝母细胞瘤(hepatoblastoma)、肝脾T细胞淋巴瘤(hepatosplenic T-celllymphoma)、霍奇金淋巴瘤、非霍奇金淋巴瘤、浸润性小叶癌(invasive lobularcarcinoma)、肠癌(intestinal cancer)、肾癌(kidney cancer)、喉癌(laryngealcancer)、恶性雀斑样痣(lentigo maligna)、致命性中线癌(lethal midline carcinoma)、白血病(leukemia)、睾丸间质细胞瘤(leydig cell tumor)、脂肪肉瘤(liposarcoma)、肺癌(lung cancer)、淋巴管瘤(lymphangioma)、淋巴管肉瘤(lymphangiosarcoma)、淋巴上皮瘤(lymphoepithelioma)、淋巴瘤(lymphoma)、急性淋巴细胞性白血病(acute lymphocyticleukemia)、急性骨髓性白血病(acute myelogenous leukemia)、慢性淋巴细胞性白血病(chronic lymphocytic leukemia)、肝癌(liver cancer)、小细胞肺癌、非小细胞肺癌、MALT淋巴瘤、恶性纤维性组织细胞瘤(malignant fibrous histiocytoma)、恶性外周神经鞘瘤(malignant peripheral nerve sheath tumor)、恶性蝾螈瘤(malignant tritontumor)、套细胞淋巴瘤(mantle cell lymphoma)、边缘区B细胞淋巴瘤(marginal zone B-cell lymphoma)、肥大细胞白血病(mast cell leukemia)、纵隔生殖细胞瘤(mediastinalgerm cell tumor)、乳腺髓样癌(medullary carcinoma ofthe breast)、甲状腺髓样癌(medullary thyroid cancer)、髓母细胞瘤(medulloblastoma)、黑素瘤(melanoma)、脑膜瘤(meningioma)、默克尔细胞癌(merkel cell cancer)、间皮瘤(mesothelioma)、转移性尿路上皮癌(metastatic urothelial carcinoma)、苗勒管混合瘤(mixedMullerian tumor)、黏液瘤(mucinous tumor)、多发性骨髓瘤(multiple myeloma)、肌肉组织肿瘤(muscletissue neoplasm)、蕈样肉芽肿(mycosis fungoides)、粘液样肉瘤(myxoidliposarcoma)、粘液瘤(myxoma)、粘液肉瘤(myxosarcoma)、鼻咽癌(nasopharyngealcarcinoma)、神经鞘瘤(neurinoma)、神经母细胞瘤(neuroblastoma)、神经纤维瘤(neurofibroma)、神经瘤(neuroma)、结节性黑色素瘤(nodular melanoma)、眼癌(ocularcancer)、少突星形细胞瘤(oligoastrocytoma)、少突神经胶质瘤(oligodendroglioma)、嗜酸细胞瘤(oncocytoma)、视神经鞘脑膜瘤(optic nerve sheath meningioma)、视神经瘤(optic nerve tumor)、口腔癌(oral cancer)、骨肉瘤(osteosarcoma)、卵巢癌、潘科斯特瘤(Pancoast tumor)、乳头状甲状腺癌(papillary thyroid cancer)、副神经节瘤(paraganglioma)、松果体母细胞瘤(pinealoblastoma)、松果体细胞瘤(pineocytoma)、垂体细胞瘤(pituicytoma)、垂体腺瘤(pituitary adenoma)、垂体瘤(pituitary tumor)、浆细胞瘤(plasmacytoma)、多胚瘤(polyembryoma)、前体T淋巴细胞淋巴瘤(precursor T-lymphoblastic lymphoma)、原发性中枢神经系统淋巴瘤(primary central nervoussystem lymphoma)、原发性渗出性淋巴瘤(primary effusion lymphoma)、原发性腹膜癌(primary peritoneal cancer)、前列腺癌(prostate cancer)、胰腺癌(pancreaticcancer)、咽癌(pharyngeal cancer)、腹膜假黏液瘤(pseudomyxoma peritonei)、肾细胞癌(renal cell carcinoma)、肾髓样癌(renal medullary carcinoma)、视网膜母细胞瘤(retinoblastoma)、横纹肌瘤(rhabdomyoma)、横纹肌肉瘤(rhabdomyosarcoma)、里希特的转型癌(Richter's transformation)、直肠癌(rectal cancer)、肉瘤(sarcoma)、Schwannomatosis瘤、精原细胞瘤(seminoma)、睾丸支持细胞瘤(Sertoli cell tumor)、性索-性腺间质瘤(sex cord-gonadal stromal tumor)、印戒细胞癌(signet ring cellcarcinoma)、皮肤癌(skin cancer)、小蓝圆细胞瘤(small blue round cell tumors)、小细胞癌(small cell carcinoma)、软组织肉瘤(soft tissue sarcoma)、生长抑素瘤(somatostatinoma)、烟尘疣(soot wart)、脊柱肿瘤(spinal tumor)、脾边缘区淋巴瘤(splenic marginal zone lymphoma)、鳞状细胞癌(squamous cell carcinoma)、滑膜肉瘤(synovial sarcoma)、塞扎里氏病(Sezary's disease)、小肠肿瘤(small intestinecancer)、鳞状细胞癌(squamous carcinoma)、胃癌(stomach cancer)、T细胞淋巴瘤、睾丸癌(testicular cancer)、卵泡膜细胞瘤(thecoma)、甲状腺癌(thyroid cancer)、移行细胞癌(transitional cell carcinoma)、咽喉癌(throat cancer)、脐尿管癌(urachalcancer)、泌尿生殖器癌(urogenital cancer)、尿路上皮癌(urothelial carcinoma)、眼色素层黑素瘤(uveal melanoma)、子宫癌(uterine cancer)、疣状癌(verrucouscarcinoma)、视觉通路胶质瘤(visual pathway glioma)、外阴癌(vulvar cancer)、阴道癌(vaginal cancer)、瓦尔登斯特伦巨球蛋白血症(Waldenstrom's macroglobulinemia)、沃辛瘤(Warthin's tumor)和维尔姆斯瘤(Wilms'tumor)。在某些实施方式中,可使用本发明的化合物治疗的癌症选自腺癌、成人T细胞白血病/淋巴瘤、膀胱癌、胚细胞瘤、骨癌、乳腺癌、脑癌、癌细胞、髓样肉瘤、子宫颈癌、结肠直肠癌、食道癌、胃肠癌、胶质母细胞瘤、神经胶质瘤、胆囊癌、胃癌、头颈癌、霍奇金淋巴瘤、非霍奇金淋巴瘤、肠道癌、肾癌、喉癌、白血病、肺癌、淋巴瘤、肝癌、小细胞肺癌、非小细胞肺癌、间皮瘤、多发性骨髓瘤、眼癌、视神经瘤、口腔癌、卵巢癌、垂体瘤、原发性中枢神经系统淋巴瘤、前列腺癌、胰腺癌、咽癌、肾细胞癌、直肠癌、肉瘤、皮肤癌、脊柱肿瘤、小肠癌、胃癌、T细胞淋巴瘤、睾丸癌、甲状腺癌、咽喉癌、泌尿生殖器癌、尿路上皮癌、子宫癌、阴道癌或维尔姆斯瘤。在其他实施例中,可使用本发明的化合物治疗的癌症或肿瘤包含良性软组织肿瘤、骨肿瘤、脑和脊髓肿瘤、眼睑和眼眶肿瘤、肉芽瘤、脂肪瘤、脑膜瘤、多发性内分泌肿瘤、鼻息肉、垂体肿瘤、泌乳素瘤、假性脑瘤、脂溢性角化病、胃息肉、甲状腺结节、胰腺囊性肿瘤、血管瘤、声带结节、息肉、囊肿、Castleman病、慢性藏毛症、皮肤纤维瘤、皮拉尔囊肿、化脓性肉芽肿和幼年性息肉综合症。在另一个实施例中,可使用本发明的化合物治疗的疾病或病症包括非小细胞肺癌、小细胞肺癌、卵巢癌、黑素瘤、中线癌、乳腺癌、淋巴瘤、成神经细胞瘤(neuroblastoma)或去势抵抗性前列腺癌(castration resistant prostate cancer)、骨髓纤维化(myelofibrosis)、骨髓增生异常综合征(myelodysplastic syndromes)、或急性骨髓性白血病。在另一个实施例中,可使用本发明的化合物治疗的疾病或病症包括非小细胞肺癌、小细胞肺癌、卵巢癌、黑素瘤、成神经细胞瘤和去势抵抗性前列腺癌。
在本发明的另一个实施例中,可使用本发明的化合物治疗的疾病或病症是溶酶体贮积症。溶酶体贮积症的非限制性例子包括:粘脂糖症、α-甘露糖苷贮积症;天冬氨酰基葡萄糖胺尿;巴滕病;β-甘露糖苷贮积症;胱氨酸贮积症;Danon病;法布里病;法伯病;岩藻糖苷贮积症;半乳糖唾液酸贮积症;戈谢病;神经节苷脂贮积症(例如GM1神经节苷脂贮积症和GM2-神经节苷脂贮积症AB变体);克拉伯病;异染性脑白质营养不良;粘多糖贮积症病症(例如MPS 1–Hurler综合征、MPS II–Hunter综合征、MPS III–Sanfilippo(A、B、C、D)、MPS IVA–Morquio、MPS IX–透明质酸酶缺乏症、MPS VI–Maroteaux-Lamy、或MPS VII–Sly综合征);I型粘脂糖症(唾液酸贮积病);II型粘脂糖症(I-Cell病);III型粘脂糖症(假胡尔勒氏多种营养不良);IV型粘脂糖症;多硫酸酯酶缺乏症;A、B、C型尼曼-匹克病;庞贝氏症(糖原贮积症);致密性成骨不全症;桑德霍夫病;辛德勒病;Salla病/唾液酸贮积病;泰-萨克斯病;和沃尔曼病。
在一些实施方式中,本发明提供通过施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,在对象中治疗自身免疫和炎性疾病或病症的方法。可使用本发明的化合物治疗的疾病或病症包括,但不限于,炎性盆腔疾病(inflammatory pelvic disease)、尿道炎(urethritis)、皮肤晒伤(skinsunburn)、鼻窦炎(sinusitis)、肺炎(pneumonitis)、脑炎(encephalitis)、脑膜炎(meningitis)、心肌炎(myocarditis)、肾炎(nephritis)、骨髓炎(osteomyelitis)、肌炎(myositis)、肝炎(hepatitis)、胃炎(gastritis)、肠炎(enteritis)、皮炎(dermatitis)、齿龈炎(gingivitis)、阑尾炎(appendicitis)、胰腺炎(pancreatitis)、胆囊炎(cholecystitis)、丙种球蛋白血症(agammaglobulinemia)、牛皮癣(psoriasis)、变态反应(allergy)、克罗恩氏病(Crohn's disease)、肠易激综合症(irritable bowel syndrome)、溃疡性结肠炎(ulcerative colitis)、斯耶格伦氏病(Sjogren's disease)、组织移植物排斥反应(tissue graft rejection)、移植器官的超急性排斥反应(hyperacute rejectionoftransplanted organs)、哮喘(asthma)、过敏性鼻炎(allergic rhinitis)、慢性阻塞性肺疾病(COPD)、自身免疫性多腺体(polyglandular)疾病(还被称为自身免疫性腺体综合症)、自身免疫性脱发(autoimmune alopecia)、恶性贫血(pernicious anemia)、肾小球肾炎(glomerulonephritis)、皮肤肌炎(dermatomyositis)、多发性硬化(multiplesclerosis)、硬皮病(scleroderma)、血管炎(vasculitis)、自身免疫性溶血和血小板减少的(autoimmune hemolytic and thrombocytopenic)状态、古德帕斯彻综合症(Goodpasture's syndrome)、动脉粥样硬化(atherosclerosis)、阿狄森氏病(Addison'sdisease)、帕金森氏病(Parkinson's disease)、阿尔茨海默氏病(Alzheimer's disease)、I型糖尿病、脓毒性休克(septic shock)、系统性红斑狼疮(SLE)、类风湿性关节炎(rheumatoid arthritis)、牛皮癣关节炎(psoriatic arthritis)、幼年型关节炎(juvenile arthritis)、骨关节炎(osteoarthritis)、慢性特发性血小板减少性紫癜(chronic idiopathic thrombocytopenic purpura)、瓦尔登斯特伦巨球蛋白血症(Waldenstrom macroglobulinemia)、重症肌无力(myasthenia gravis)、桥本氏甲状腺炎(Hashimoto's thyroiditis)、特应性皮炎(atopic dermatitis)、退行性关节病、白癜风(vitiligo)、自身免疫性垂体功能减退症(autoimmune hypopituitarism)、格林-巴利综合症(Guillain-Barre syndrome)、白塞氏病(Behcet's disease)、scleracierma病、蕈样肉芽肿(mycosis fungoides)、急性炎症反应(例如急性呼吸窘迫综合征和局部缺血(ischemia)/再灌注损伤)和格雷夫斯氏病(Graves'disease)。在某些实施方式中,可使用本发明的化合物治疗的疾病或病症包括全身性或组织炎症、对感染或缺氧的炎性反应、细胞活化和增殖、脂质代谢、纤维化和病毒感染。
在一些实施方式中,本发明提供通过向有此需要的对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,治疗患有或有风险患有慢性自身免疫和炎性病症的对象的方法。可使用本发明的化合物治疗的慢性自身免疫和炎性病症包括,但不限于,风湿性关节炎(rheumatoid arthritis)、骨关节炎(osteoarthritis)、急性痛风(acute gout)、牛皮癣(psoriasis,)、系统性红斑狼疮(systemic lupus erythematosus)、多发性硬化(multiple sclerosis)、炎性肠病(克罗恩氏病(Crohn's disease)和溃疡性结肠炎(Ulcerative colitis))、哮喘(asthma)、慢性阻塞性气道疾病(chronic obstructive airways disease)、肺炎(pneumonitis)、心肌炎(myocarditis)、心包炎(pericarditis)、肌炎(myositis)、湿疹(eczema)、皮炎(dermatitis)、脱发(alopecia)、白癜风(vitiligo)、大疱性皮肤病(bullous skindiseases)、肾炎(nephritis)、血管炎(vasculitis)、动脉粥样硬化(atherosclerosis)、阿尔茨海默病(Alzheimer's disease)、抑郁症(depression)、视网膜炎(retinitis)、葡萄膜炎(uveitis)、巩膜炎(scleritis)、肝炎(hepatitis)、胰腺炎(pancreatitis)、原发性胆汁性肝硬化(primary biliary cirrhosis)、硬化性胆管炎(sclerosing cholangitis)、阿狄森氏病(Addison's disease)、垂体炎(hypophysitis)、甲状腺炎(thyroiditis)、I型糖尿病和移植器官的急性排斥反应。在一个实施方式中,所述疾病或病症是败血症、烧伤、胰腺炎、较大创伤、出血或缺血。在另一个实施方式中,可使用本发明的化合物治疗的疾病或病症包括败血症、脓毒病综合症、脓毒性休克或内毒素血症。在另一个实施方式中,可使用本发明的化合物治疗的疾病或病症包括急性或慢性胰腺炎。在另一个实施方式中,可使用本发明的化合物治疗的疾病或病症包括烧伤。
在一些实施方式中,本发明提供通过向有此需要的对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,治疗患有或有风险患有急性炎症的对象的方法。所述急性炎症包括,但不限于,急性痛风、骨巨细胞动脉炎、肾炎(包括狼疮性肾炎)、器官受累的血管炎(例如肾小球肾炎)、脉管炎(包括巨细胞动脉炎)、韦格纳氏肉芽肿病、结节性多动脉炎、白塞氏病、川畸病、大动脉炎、器官受累的血管炎和移植器官的急性排斥反应。
在一些实施方式中,本发明提供通过向有此需要的对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,治疗患有或有风险患有自身免疫和炎性疾病或病症的对象的方法。可使用本发明的化合物治疗的慢性自身免疫和炎性病症涉及对细菌、病毒(例如疱疹病毒、人类乳头状瘤病毒、腺病毒和痘病毒和其它DNA病毒)、真菌、寄生虫或它们的毒素感染的炎症反应,例如败血症、脓毒病综合症、脓毒性休克、内毒素血症、全身炎症反应综合症(SIRS)、多器官功能障碍综合症、中毒性休克综合症、急性肺损伤、ARDS(成人呼吸窘迫综合症)、急性肾功能衰竭、暴发性肝炎、烧伤、急性胰腺炎、外科手术后综合症、结节病、赫克斯海默反应、脑炎、脊髓炎、脑膜炎、疟疾和与病毒感染(例如流行性感冒、带状疱疹、单纯性疱疹和冠状病毒)相关的SIRS。
在一些实施方式中,本发明提供通过向有此需要的对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,治疗患有或有风险患有缺血再灌注损伤的对象的方法。所述缺血再灌注损伤包括,但不限于,心肌梗死、脑血管局部缺血(卒中)、急性冠脉综合症、肾再灌注损伤、器官移植、冠状动脉搭桥术、心肺旁路手术、肺、肾、肝、胃肠或周肢栓塞。
在一些实施方式中,本发明提供通过向有此需要的对象施用有效量的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,治疗患有或有风险患有高胆固醇血症、动脉粥样硬化或阿尔茨海默氏病的对象的方法。
在一些实施方式中,本发明提供在有此需要的动物对象中治疗任何布罗莫结构域介导的疾病或病症(包含任何布罗莫结构域突变体介导的疾病或病症)的方法,其中该方法包括向该对象施用有效量的本文所述的任何一种或多种化合物或本文所述的其任何药物组合物。在某些实施方式中,该方法包括向该对象施用有效量的本文所述的任何一种或多种化合物或本文所述的其任何药物组合物,并联合施用用于治疗该疾病或病症的一种或多种其他疗法。
在一些实施方式中,式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个都是布罗莫结构域抑制剂,并且在普遍接受的布罗莫结构域活性试验中测定的IC50小于500nM、小于100nM、小于50nM、小于20nM、小于10nM、小于5nM或小于1nM。在一些实施方式中,本文所述的化合物相对于布罗莫结构域(例如BET蛋白、BRD2、BRD3或BRD4蛋白)的IC50小于500nM、小于100nM、小于50nM、小于20nM、小于10nM、小于5nM或小于1nM。在一些实施方式中,本文所述的化合物选择性地抑制一种或多种布罗莫结构域(相对于一种或多种其他蛋白而言)。
在一些实施方式中,本发明提供一种抑制布罗莫结构域或突变的布罗莫结构域的方法。该方法包括将式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,与细胞或布罗莫结构域蛋白在体外或体内接触。
在某些实施方式中,本发明提供了式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,在制备治疗本文所述的疾病或病症的药物中的用途。在其他实施方式中,本发明提供了用于治疗本文所述的疾病或病症的式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个。
联合疗法
特别是在本文所述的癌症和其他疾病和病症的治疗中,布罗莫结构域调节剂可有效地与另一种药理学上有活性的化合物结合,或与两种或更多种其他药理学上有活性的化合物结合。在一个实施方式中,所述组合物包括本文所述的任何一种或多种化合物以及对于相同疾病病症治疗上有效的一种或多种化合物,其中这些化合物具有对该疾病病症的协同效果。在一个实施方式中,所述组合物包括对治疗癌症有效的本文所述的一种或多种化合物以及对治疗相同癌症有效的一种或多种其他化合物,其中这些化合物在治疗该癌症方面具有协同性效果。
在一些实施方式中,本发明提供在有此需要的动物对象中治疗布罗莫结构域或突变的布罗莫结构域介导的疾病或病症的方法,其中该方法包括向该对象施用有效量的本文所述的任何一种或多种化合物、或式(I)或(II)的一种或多种化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,并结合施用本文所述的一种或多种其他治疗剂。在某些实施方式中,本发明提供了在有此需要的动物对象中治疗布罗莫结构域或突变的布罗莫结构域介导的疾病或病症的方法,其中该方法包括向该对象施用有效量的式(I)或(II)的任何一种或多种化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,并结合施用用于治疗该疾病或病症的一种或多种其他疗法。
在一些实施方式中,本发明提供一种组合物(例如药物组合物),其包含式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,以及一种或多种其他治疗剂。在一些实施方式中,所述一种或多种其他治疗剂选自烷基化剂,包括但不限于阿多来新(adozelesin)、六甲蜜胺(altretamine)、苯达莫司汀、比折来新(bizelesin)、白消安、卡铂、卡波醌、卡莫氟、卡莫司汀(carmustine)、苯丁酸氮芥(chlorambucil)、顺铂、环磷酰胺、达卡巴嗪(dacarbazine)、雌莫司汀(estramustine)、乙环氧啶、福莫司汀(fotemustine)、赫舒反(hepsulfam)、异环磷酰胺(ifosfamide)、英丙舒凡(improsulfan)、伊洛福芬(irofulven)、洛莫司汀(lomustine)、甘露舒凡、双氯乙基甲胺(mechlorethamine)、美法仑(melphalan)、二溴甘露醇、奈达铂、尼莫司汀、奥沙利铂(oxaliplatin)、哌泊舒凡(piposulfan)、松龙苯芥(prednimustine)、甲苄肼、雷莫司汀、沙铂(satraplatin)、司莫司汀(semustine)、链佐星(streptozocin)、替莫唑胺(temozolomide)、噻替哌(thiotepa)、曲奥舒凡(treosulfan)、三乙撑亚胺苯醌、三亚乙基蜜胺、四硝酸三铂、trofosphamide和尿嘧啶氮芥;抗生素,包括但不限于,阿柔比星、氨柔比星、博来霉素(bleomycin)、更生霉素(dactinomycin)、道诺霉素(daunorubicin)、阿霉素(doxorubicin)、依沙芦星(elsamitrucin)、表柔比星(epirubicin)、伊达比星(idarubicin)、美诺立尔(menogaril)、丝裂霉素(mitomycin)、新制癌菌素(neocarzinostatin)、喷司他丁(pentostatin)、吡柔比星、普卡霉素(plicamycin)、戊柔比星和佐柔比星;抗代谢药,包括但不限于,氨基蝶呤、阿扎胞苷(azacitidine)、硫唑嘌呤、卡培他滨(capecitabine)、克拉屈滨(cladribine)、氯法拉滨(clofarabine)、阿糖孢苷(cytarabine)、地西他滨(decitabine)、氟尿苷(floxuridine)、氟达拉滨(fludarabine)、5-氟尿嘧啶、吉西他滨(gemcitabine)、羟基脲、巯嘌呤、甲氨蝶呤、奈拉滨(nelarabine)、培美曲塞(pemetrexed)、雷替曲塞(raltitrexed)、替加氟-尿嘧啶、硫鸟嘌呤、三甲氧苄二氨嘧啶、三甲曲沙(trimetrexate)和阿糖腺苷;免疫疗法、抗体疗法,包括但不限于,阿仑单抗(alemtuzumab)、贝伐单抗(bevacizumab)、西妥昔单抗(cetuximab)、加利昔单抗(galiximab)、吉妥单抗(gemtuzumab)、帕尼单抗(panitumumab)、帕妥珠单抗(pertuzumab)、利妥昔单抗(rituximab)、brentuximab、托西莫单抗(tositumomab)、曲妥单抗(trastuzumab)、90Y替伊莫单抗(90Y ibritumomab tiuxetan)、易普利姆单抗(ipilimumab)、tremelimumab和抗CTLA-4抗体;激素或激素拮抗剂,包括但不限于,阿那曲唑(anastrozole)、雄激素、布舍瑞林(buserelin)、己烯雌酚(diethylstilbestrol)、依西美坦(exemestane)、氟他胺(flutamide)、氟维司群(fulvestrant)、戈舍瑞林(goserelin)、艾多昔芬(idoxifene)、来曲唑(letrozole)、亮丙瑞林(leuprolide)、甲地孕酮(magestrol)、雷洛昔芬(raloxifene)、它莫西芬(tamoxifen)和托瑞米芬(toremifene);紫杉烷,包括但不限于,DJ-927、多西他赛(docetaxel)、TPI 287、拉洛他赛(larotaxel)、沃塔紫杉醇(ortataxel)、紫杉醇(paclitaxel)、DHA-紫杉醇和特斯紫杉醇(tesetaxel);类维生素A(retinoid),包括但不限于,阿利维A酸、贝沙罗汀(bexarotene)、维甲酰酚胺(fenretinide)、异维甲酸(isotretinoin)和维甲酸;生物碱,包括但不限于,地美可辛、高三尖杉酯碱(homoharringtonine)、长春花碱、长春新碱、长春地辛(vindesine)、长春氟宁(vinflunine)和长春瑞滨(vinorelbine);抗血管生成剂,包括但不限于,AE-941(GW786034,Neovastat)、ABT-510、2-甲氧雌二醇、来那度胺(lenalidomide)和萨力多胺(thalidomide);拓扑异构酶抑制剂,包括但不限于,安吖啶(amsacrine)、贝洛替康(belotecan)、伊多替卡林(edotecarin)、依托泊苷、磷酸依托泊苷、依喜替康(exatecan)、伊立替康(及活性代谢物SN-38(7-乙基-10-羟基-喜树碱))、硫蒽酮、米托蒽醌、匹杉琼(pixantrone)、鲁比替康(rubitecan)、替尼泊苷、拓扑替康(topotecan)和9-氨基喜树碱;激酶抑制剂,包括但不限于,阿西替尼(AG 013736)、达沙替尼(BMS 354825)、埃罗替尼(erlotinib)、吉非替尼(gefitinib)、夫拉平度(flavopiridol)、甲磺酸伊马替尼(imatinib mesylate)、拉帕替尼(lapatinib)、二磷酸莫替沙尼(AMG 706)、尼洛替尼(AMN107)、seliciclib、索拉非尼(sorafenib)、苹果酸舒尼替尼(sunitinib malate)、AEE-788、BMS-599626、UCN-01(7-羟基十字孢碱(hydroxystaurosporine))、威罗菲尼、达拉非尼(dabrafenib)、司美替尼(selumetinib)、LGX818、BGB-283、派西替尼(pexidartinib)(PLX3397)和瓦他拉尼(vatalanib);靶定的信号传导抑制剂,包括但不限于,硼替佐米(bortezomib)、格尔德霉素(geldanamycin)和雷帕霉素;生物反应调节剂,包括但不限于,咪喹莫特(imiquimod)、干扰素-α、白介素-2;和其他化疗剂,包括但不限于3-AP(3-氨基-2-羧基甲醛缩氨基硫脲)、阿曲生坦(altrasentan)、氨鲁米特(氨基glutethimide)、阿那格雷(anagrelide)、天冬酰胺酶、苔藓抑素-1(bryostatin-1)、西仑吉肽(cilengitide)、伊利司莫(elesclomol)、甲磺酸艾日布林(E7389)、依沙比酮(ixabepilone)、氯尼达明(lonidamine)、马索丙考(masoprocol)、米托胍腙(mitoguanazone)、奥利默森(oblimersen)、舒林酸(sulindac)、睾内酯、噻唑呋林、mTOR抑制剂(例如西罗莫司、替西莫司、依维莫司,deforolimus)、PI3K抑制剂(如BEZ235、GDC-0941、XL147、XL765、·BMK120)、Cdk4抑制剂(如PD-332991)、Akt抑制剂、Hsp90抑制剂(如格尔德霉素、根赤壳菌素、坦螺旋霉素(tanespimycin))、法尼基转移酶抑制剂(如替吡法尼(tipifarnib))和芳香酶抑制剂(来曲唑、阿那曲唑、依西美坦)。在一个实施方式中,所述治疗癌症的方法包括向对象施用有效量的组合物,所述组合物包括式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个,结合选自以下的化疗剂:卡培他滨、5-氟尿嘧啶、卡铂、达卡巴嗪、吉非替尼、奥沙利铂、紫杉醇、SN-38、替莫唑胺、长春碱、贝伐单抗、西妥昔单抗、干扰素-α、白细胞介素2或厄洛替尼。在另一个实施方案中,化疗剂是Mek抑制剂。示范性的Mek抑制剂包括但不限于,AS703026、AZD6244(Selumetinib)、AZD8330、BIX 02188、CI-1040(PD184352)、GSK1120212(JTP-74057)、PD0325901、PD318088、PD98059、RDEA119(BAY 869766)、TAK-733和U0126-EtOH。在另一个实施方案中,化疗剂是酪氨酸激酶抑制剂。示范性的酪氨酸激酶抑制剂包括但不限于,AEE788、AG-1478(Tyrphostin AG-1478)、AG-490、阿帕替尼(YN968D1)、AV-412、AV-951(Tivozanib)、阿西替尼、AZD8931、BIBF1120(Vargatef)、BIBW2992(阿法替尼)、BMS794833、BMS-599626、布立尼布(BMS-540215)、丙氨酸布立尼布(BMS-582664)、西地尼布(AZD2171)、大黄根酸(大黄酚)、Crenolanib(CP-868569)、CUDC-101、CYC116、二乳酸多韦替尼(TKI258二乳酸)、E7080、盐酸厄洛替尼(特罗凯、CP-358774、OSI-774、NSC-718781)、Foretinib(GSK1363089、XL880)、吉非替尼(ZD-1839或易瑞沙)、伊马替尼(格列卫)、甲磺酸伊马替尼、Ki8751、KRN 633、拉帕替尼(Tykerb)、利尼伐尼(Linifanib)(ABT-869)、马赛替尼(Masivet、AB1010)、MGCD-265、莫特塞尼(AMG-706)、MP-470、木利替尼(TAK 165)、来那替尼(HKI-272)、NVP-BHG712、OSI-420(去甲基厄洛替尼、CP-473420)、OSI-930、盐酸帕唑帕尼、PD-153035HCl、PD173074、培利替尼(EKB-569)、PF299804、帕纳替尼(AP24534)、PP121、RAF265(CHIR-265)、Raf265衍生物、瑞格非尼(BAY 73-4506)、苯磺酸索拉非尼(多吉美)、苹果酸舒尼替尼(Sutent)、替拉替尼(BAY 57-9352)、TSU-68(SU6668)、凡德他尼(Zactima)、二盐酸瓦他拉尼(PTK787)、WZ3146、WZ4002、WZ8040、奎扎替尼(quizartinib)、卡博替尼(Cabozantinib)、XL647、EGFR siRNA、FLT4siRNA、KDR siRNA、抗糖尿病剂(例如二甲双胍)、PPAR激动剂(罗格列酮、吡格列酮、苯扎贝特、环丙贝特、氯贝丁酯、吉非贝齐、非诺贝特、英格列扎(indeglitazar))、以及DPP4抑制剂(西他列汀、维格列汀、沙格列汀、度格列汀(dutogliptin)、吉格列汀(gemigliptin)、阿格列汀)。在另一个实施例中,所述试剂是EGFR抑制剂。示例性的EGFR抑制剂包含但不限于:AEE-788、AP-26113、BIBW-2992(Tovok)、CI-1033、GW-572016、易瑞沙、LY2874455、RO-5323441、特罗凯(厄洛替尼、OSI-774)、CUDC-101和WZ4002。在另一个实施方式中,用于联合的治疗剂是如在美国专利申请公开号2009/0076046和2011/0112127(其全文出于所有目的以引用的方式并入本文中)中描述的c-Fms和/或c-Kit抑制剂。在一个实施方式中,所述治疗癌症的方法包括向对象施用有效量的组合物,所述组合物包括本文所述的任何一种或多种化合物以及选自以下的化疗剂:卡培他滨、5-氟尿嘧啶、卡铂、达卡巴嗪、吉非替尼、奥沙利铂、紫杉醇、SN-38、替莫唑胺、长春碱、贝伐单抗、西妥昔单抗、干扰素-α、白细胞介素2或厄洛替尼。在一些实施方式中,布罗莫结构域调节剂,特别是式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个,可结合上述一种或多种试剂同时、顺次或单独施用。
在一些实施方式中,本发明提供一种组合物(例如药物组合物),其包含式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,以及一种或多种其他治疗剂。在一些实施方式中,所述一种或多种其他治疗剂选自烷基化剂,包括但不限于阿多来新(adozelesin)、六甲蜜胺(altretamine)、苯达莫司汀、比折来新(bizelesin)、白消安、卡铂、卡波醌、卡莫氟、卡莫司汀(carmustine)、苯丁酸氮芥(chlorambucil)、顺铂、环磷酰胺、达卡巴嗪(dacarbazine)、雌莫司汀(estramustine)、乙环氧啶、福莫司汀(fotemustine)、赫舒反(hepsulfam)、异环磷酰胺(ifosfamide)、英丙舒凡(improsulfan)、伊洛福芬(irofulven)、洛莫司汀(lomustine)、甘露舒凡、双氯乙基甲胺(mechlorethamine)、美法仑(melphalan)、二溴甘露醇、奈达铂、尼莫司汀、奥沙利铂(oxaliplatin)、哌泊舒凡(piposulfan)、松龙苯芥(prednimustine)、甲苄肼、雷莫司汀、沙铂(satraplatin)、司莫司汀(semustine)、链佐星(streptozocin)、替莫唑胺(temozolomide)、噻替哌(thiotepa)、曲奥舒凡(treosulfan)、三乙撑亚胺苯醌、三亚乙基蜜胺、四硝酸三铂、trofosphamide和尿嘧啶氮芥;抗生素,包括但不限于,阿柔比星、氨柔比星、博来霉素(bleomycin)、更生霉素(dactinomycin)、道诺霉素(daunorubicin)、阿霉素(doxorubicin)、依沙芦星(elsamitrucin)、表柔比星(epirubicin)、伊达比星(idarubicin)、美诺立尔(menogaril)、丝裂霉素(mitomycin)、新制癌菌素(neocarzinostatin)、喷司他丁(pentostatin)、吡柔比星、普卡霉素(plicamycin)、戊柔比星和佐柔比星;抗代谢药,包括但不限于,氨基蝶呤、阿扎胞苷(azacitidine)、硫唑嘌呤、卡培他滨(capecitabine)、克拉屈滨(cladribine)、氯法拉滨(clofarabine)、阿糖孢苷(cytarabine)、地西他滨(decitabine)、氟尿苷(floxuridine)、氟达拉滨(fludarabine)、5-氟尿嘧啶、吉西他滨(gemcitabine)、羟基脲、巯嘌呤、甲氨蝶呤、奈拉滨(nelarabine)、培美曲塞(pemetrexed)、雷替曲塞(raltitrexed)、替加氟-尿嘧啶、硫鸟嘌呤、三甲氧苄二氨嘧啶、三甲曲沙(trimetrexate)和阿糖腺苷;免疫疗法、抗体疗法,包括但不限于,阿仑单抗(alemtuzumab)、贝伐单抗(bevacizumab)、西妥昔单抗(cetuximab)、加利昔单抗(galiximab)、吉妥单抗(gemtuzumab)、帕尼单抗(panitumumab)、帕妥珠单抗(pertuzumab)、利妥昔单抗(rituximab)、brentuximab、托西莫单抗(tositumomab)、曲妥单抗(trastuzumab)、90Y替伊莫单抗(90Y ibritumomab tiuxetan)、易普利姆单抗(ipilimumab)、tremelimumab和抗CTLA-4抗体;激素或激素拮抗剂,包括但不限于,阿那曲唑(anastrozole)、雄激素、布舍瑞林(buserelin)、己烯雌酚(di乙基stilbestrol)、依西美坦(exemestane)、氟他胺(flutamide)、氟维司群(fulvestrant)、戈舍瑞林(goserelin)、艾多昔芬(idoxifene)、来曲唑(letrozole)、亮丙瑞林(leuprolide)、甲地孕酮(magestrol)、雷洛昔芬(raloxifene)、它莫西芬(tamoxifen)和托瑞米芬(toremifene);紫杉烷,包括但不限于,DJ-927、多西他赛(docetaxel)、TPI 287、拉洛他赛(larotaxel)、沃塔紫杉醇(ortataxel)、紫杉醇(paclitaxel)、DHA-紫杉醇和特斯紫杉醇(tesetaxel);类维生素A(retinoid),包括但不限于,阿利维A酸、贝沙罗汀(bexarotene)、维甲酰酚胺(fenretinide)、异维甲酸(isotretinoin)和维甲酸;生物碱,包括但不限于,地美可辛、高三尖杉酯碱(homoharringtonine)、长春花碱、长春新碱、长春地辛(vindesine)、长春氟宁(vinflunine)和长春瑞滨(vinorelbine);抗血管生成剂,包括但不限于,AE-941(GW786034,Neovastat)、ABT-510、2-甲氧雌二醇、来那度胺(lenalidomide)和萨力多胺(thalidomide);拓扑异构酶抑制剂,包括但不限于,安吖啶(amsacrine)、贝洛替康(belotecan)、伊多替卡林(edotecarin)、依托泊苷、磷酸依托泊苷、依喜替康(exatecan)、伊立替康(及活性代谢物SN-38(7-乙基-10-羟基-喜树碱))、硫蒽酮、米托蒽醌、匹杉琼(pixantrone)、鲁比替康(rubitecan)、替尼泊苷、拓扑替康(topotecan)和9-氨基喜树碱;激酶抑制剂,包括但不限于,阿西替尼(AG 013736)、达沙替尼(BMS 354825)、埃罗替尼(erlotinib)、吉非替尼(gefitinib)、夫拉平度(flavopiridol)、甲磺酸伊马替尼(imatinib mesylate)、拉帕替尼(lapatinib)、二磷酸莫替沙尼(AMG 706)、尼洛替尼(AMN107)、seliciclib、索拉非尼(sorafenib)、苹果酸舒尼替尼(sunitinib malate)、AEE-788、BMS-599626、UCN-01(7-羟基十字孢碱(hydroxystaurosporine))、威罗菲尼、达拉非尼(dabrafenib)、司美替尼(selumetinib)、悖论破坏剂(paradox breaker)(例如)PLX8394或PLX7904)、LGX818、BGB-283、派西替尼(pexidartinib)(PLX3397)和瓦他拉尼(vatalanib);靶定的信号传导抑制剂,包括但不限于,硼替佐米(bortezomib)、格尔德霉素(geldanamycin)和雷帕霉素;生物反应调节剂,包括但不限于,咪喹莫特(imiquimod)、干扰素-α、白介素-2;和其他化疗剂,包括但不限于3-AP(3-氨基-2-羧基甲醛缩氨基硫脲)、阿曲生坦(altrasentan)、氨鲁米特(氨基glutethimide)、阿那格雷(anagrelide)、天冬酰胺酶、苔藓抑素-1(bryostatin-1)、西仑吉肽(cilengitide)、伊利司莫(elesclomol)、甲磺酸艾日布林(E7389)、依沙比酮(ixabepilone)、氯尼达明(lonidamine)、马索丙考(masoprocol)、米托胍腙(mitoguanazone)、奥利默森(oblimersen)、舒林酸(sulindac)、睾内酯、噻唑呋林、mTOR抑制剂(例如西罗莫司、替西莫司、依维莫司,deforolimus)、INK28、AZD8055、PI3K抑制剂(如BEZ235、GDC-0941、XL147、XL765、BMK120)、Cdk4抑制剂(如PD-332991)、Akt抑制剂、Hsp90抑制剂(如格尔德霉素、根赤壳菌素、坦螺旋霉素(tanespimycin))、法尼基转移酶抑制剂(如替吡法尼(tipifarnib))和芳香酶抑制剂(来曲唑、阿那曲唑、依西美坦)。在一个实施方式中,所述治疗癌症的方法包括向对象施用有效量的组合物,所述组合物包括式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个,结合选自以下的化疗剂:卡培他滨、5-氟尿嘧啶、卡铂、达卡巴嗪、吉非替尼、奥沙利铂、紫杉醇、SN-38、替莫唑胺、长春碱、贝伐单抗、西妥昔单抗、干扰素-α、白细胞介素2或厄洛替尼。在另一个实施方案中,化疗剂是Mek抑制剂。示范性的Mek抑制剂包括但不限于,AS703026、AZD6244(Selumetinib)、AZD8330、BIX 02188、CI-1040(PD184352)、GSK1120212(也被称为曲美替尼或JTP-74057)、考比替尼(cobimetinib)、PD0325901、PD318088、PD98059、RDEA119(BAY869766)、TAK-733和U0126-EtOH。在另一个实施方案中,化疗剂是酪氨酸激酶抑制剂。示范性的酪氨酸激酶抑制剂包括但不限于,AEE788、AG-1478(Tyrphostin AG-1478)、AG-490、阿帕替尼(YN968D1)、AV-412、AV-951(Tivozanib)、阿西替尼、AZD8931、BIBF1120(Vargatef)、BIBW2992(阿法替尼)、BMS794833、BMS-599626、布立尼布(BMS-540215)、丙氨酸布立尼布(BMS-582664)、西地尼布(AZD2171)、大黄根酸(大黄酚)、Crenolanib(CP-868569)、CUDC-101、CYC116、二乳酸多韦替尼(TKI258二乳酸)、E7080、盐酸厄洛替尼(特罗凯、CP-358774、OSI-774、NSC-718781)、Foretinib(GSK1363089、XL880)、吉非替尼(ZD-1839或易瑞沙)、伊马替尼(格列卫)、甲磺酸伊马替尼、Ki8751、KRN 633、拉帕替尼(Tykerb)、利尼伐尼(Linifanib)(ABT-869)、马赛替尼(Masivet、AB1010)、MGCD-265、莫特塞尼(AMG-706)、MP-470、木利替尼(TAK 165)、来那替尼(HKI-272)、NVP-BHG712、OSI-420(去甲基厄洛替尼、CP-473420)、OSI-930、盐酸帕唑帕尼、PD-153035HCl、PD173074、培利替尼(EKB-569)、PF299804、帕纳替尼(AP24534)、PP121、RAF265(CHIR-265)、Raf265衍生物、瑞格非尼(BAY73-4506)、苯磺酸索拉非尼(多吉美)、苹果酸舒尼替尼(Sutent)、替拉替尼(BAY 57-9352)、TSU-68(SU6668)、凡德他尼(Zactima)、二盐酸瓦他拉尼(PTK787)、WZ3146、WZ4002、WZ8040、奎扎替尼(quizartinib)、卡博替尼(Cabozantinib)、XL647、EGFR siRNA、FLT4siRNA、KDRsiRNA、抗糖尿病剂(例如二甲双胍)、PPAR激动剂(罗格列酮、吡格列酮、苯扎贝特、环丙贝特、氯贝丁酯、吉非贝齐、非诺贝特、英格列扎(indeglitazar))、以及DPP4抑制剂(西他列汀、维格列汀、沙格列汀、度格列汀(dutogliptin)、吉格列汀(gemigliptin)、阿格列汀)。在另一个实施例中,所述试剂是EGFR抑制剂。示例性的EGFR抑制剂包含但不限于:AEE-788、AP-26113、BIBW-2992(Tovok)、CI-1033、GW-572016、易瑞沙、LY2874455、RO-5323441、特罗凯(厄洛替尼、OSI-774)、CUDC-101和WZ4002。在另一个实施方式中,用于联合的治疗剂是如在美国专利申请公开号2009/0076046和2011/0112127(其全文出于所有目的以引用的方式并入本文中)中描述的c-Fms和/或c-Kit抑制剂。在一个实施方式中,所述治疗癌症的方法包括向对象施用有效量的组合物,所述组合物包括本文所述的任何一种或多种化合物以及选自以下的化疗剂:卡培他滨、5-氟尿嘧啶、卡铂、达卡巴嗪、吉非替尼、奥沙利铂、紫杉醇、SN-38、替莫唑胺、长春碱、贝伐单抗、西妥昔单抗、干扰素-α、白细胞介素2或厄洛替尼。在一些实施方式中,布罗莫结构域调节剂,特别是式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个,可结合上述一种或多种试剂同时、顺次或单独施用。
在另一个实施方式中,本发明提供一种组合物(例如药物组合物),其包含式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个,以及选自以下的一种或多种其他治疗剂:i)烷基化剂,选自阿多来新(adozelesin)、六甲蜜胺(altretamine)、比折来新(bizelesin)、白消安、卡铂、卡波醌、卡莫司汀(carmustine)、苯丁酸氮芥(chlorambucil)、顺铂、环磷酰胺、达卡巴嗪(dacarbazine)、雌莫司汀(estramustine)、福莫司汀(fotemustine)、赫舒反(hepsulfam)、异环磷酰胺(ifosfamide)、英丙舒凡(improsulfan)、伊洛福芬(irofulven)、洛莫司汀(lomustine)、双氯乙基甲胺(mechlorethamine)、美法仑(melphalan)、奥沙利铂(oxaliplatin)、哌泊舒凡(piposulfan)、司莫司汀(semustine)、链佐星(streptozocin)、替莫唑胺(temozolomide)、噻替哌(thiotepa)和曲奥舒凡(treosulfan);ii)抗生素,选自博来霉素(bleomycin)、更生霉素(dactinomycin)、道诺霉素(daunorubicin)、阿霉素(doxorubicin)、表柔比星(epirubicin)、伊达比星(idarubicin)、美诺立尔(menogaril)、丝裂霉素(mitomycin)、米托蒽醌、新制癌菌素(neocarzinostatin)、喷司他丁(pentostatin)和普卡霉素(plicamycin);iii)抗代谢药,选自阿扎胞苷(azacitidine)、卡培他滨(capecitabine)、克拉屈滨(cladribine)、氯法拉滨(clofarabine)、阿糖孢苷(cytarabine)、地西他滨(decitabine)、氟尿苷(floxuridine)、氟达拉滨(fludarabine)、5-氟尿嘧啶、替加氟(ftorafur)、吉西他滨(gemcitabine)、羟基脲、巯嘌呤、甲氨蝶呤、奈拉滨(nelarabine)、培美曲塞(pemetrexed)、雷替曲塞(raltitrexed)、硫鸟嘌呤和三甲曲沙(trimetrexate);iv)抗体治疗剂,选自阿仑单抗(alemtuzumab)、贝伐单抗(bevacizumab)、西妥昔单抗(cetuximab)、加利昔单抗(galiximab)、吉妥单抗(gemtuzumab)、纳武单抗(nivolumab)、帕尼单抗(panitumumab)、派姆单抗(pembrolizumab)、帕妥珠单抗(pertuzumab)、利妥昔单抗(rituximab)、托西莫单抗(tositumomab)、曲妥单抗(trastuzumab)和90Y替伊莫单抗(90Yibritumomab tiuxetan);v)激素或激素拮抗剂,选自阿那曲唑(anastrozole)、雄激素、布舍瑞林(buserelin)、己烯雌酚(di乙基stilbestrol)、依西美坦(exemestane)、氟他胺(flutamide)、氟维司群(fulvestrant)、戈舍瑞林(goserelin)、艾多昔芬(idoxifene)、来曲唑(letrozole)、亮丙瑞林(leuprolide)、甲地孕酮(magestrol)、雷洛昔芬(raloxifene)、它莫西芬(tamoxifen)和托瑞米芬(toremifene);vi)紫杉烷,选自DJ-927、多西他赛(docetaxel)、TPI 287、紫杉醇(paclitaxel)和DHA-紫杉醇;vii)类维生素A(retinoid),选自阿利维A酸、贝沙罗汀(bexarotene)、维甲酰酚胺(fenretinide)、异维甲酸(isotretinoin)和维甲酸;viii)生物碱,选自依托泊苷(etoposide)、高三尖杉酯碱(homoharringtonine)、替尼泊苷(teniposide)、长春花碱、长春新碱、长春地辛(vindesine)和长春瑞滨(vinorelbine);ix)抗血管生成剂,选自AE-941(GW786034,Neovastat)、ABT-510、2-甲氧雌二醇、来那度胺(lenalidomide)和萨力多胺(thalidomide);x)拓扑异构酶抑制剂,选自安吖啶(amsacrine)、伊多替卡林(edotecarin)、依喜替康(exatecan)、伊立替康、SN-38(7-乙基-10-羟基-喜树碱))、鲁比替康(rubitecan)、拓扑替康(topotecan)和9-氨基喜树碱;xi)激酶抑制剂,选自埃罗替尼(erlotinib)、吉非替尼(gefitinib)、夫拉平度(flavopiridol)、甲磺酸伊马替尼(imatinib mesylate)、拉帕替尼(lapatinib)、索拉非尼(sorafenib)、苹果酸舒尼替尼(sunitinib malate)、AEE-788、AG-013736、AMG 706、AMN107、BMS-354825、BMS-599626、UCN-01(7-羟基十字孢碱(hydroxystaurosporine))、威罗菲尼、达拉非尼(dabrafenib)、曲美替尼(trametinib)、考比替尼(cobimetinib)、司美替尼(selumetinib)和瓦他拉尼(vatalanib);xii)靶定的信号传导抑制剂,选自硼替佐米(bortezomib)、格尔德霉素(geldanamycin)和雷帕霉素;xiii)生物反应调节剂,选自咪喹莫特(imiquimod)、干扰素-α、白介素-2;xiv)IDO抑制剂;和xv)化疗剂,选自3-AP(3-氨基-2-羧基甲醛缩氨基硫脲)、阿曲生坦(altrasentan)、氨鲁米特(氨基glutethimide)、阿那格雷(anagrelide)、天冬酰胺酶、苔藓抑素-1(bryostatin-1)、西仑吉肽(cilengitide)、伊利司莫(elesclomol)、甲磺酸艾日布林(E7389)、依沙比酮(ixabepilone)、氯尼达明(lonidamine)、马索丙考(masoprocol)、米托胍腙(mitoguanazone)、奥利默森(oblimersen)、舒林酸(sulindac)、睾内酯、噻唑呋林、mTOR抑制剂、PI3K抑制剂、Cdk4抑制剂、Akt抑制剂、Hsp90抑制剂、法尼基转移酶抑制剂或芳香酶抑制剂(来曲唑、阿那曲唑、依西美坦);xvi)Mek抑制剂;xvii)酪氨酸激酶抑制剂;xviii)c-Kit突变抑制剂;xix)EGFR抑制剂,或者xx)表观遗传调节剂。在进一步的实施方式中,布罗莫结构域调节剂,特别是式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个,可结合上述一种或多种试剂同时、顺次或单独施用。
表观遗传调节剂包括DNA甲基化剂和通过染色质修饰剂的活性来调节组蛋白和/或蛋白质的翻译后修饰的试剂。表观遗传调节剂的非限制性例子包括:
(a)DNA甲基转移酶(例如氮杂胞苷、地西他滨或zebularine);
(b)组蛋白和蛋白质甲基转移酶,包括但不限于DOT1L抑制剂,例如EPZ004777(7-[5-脱氧-5-[[3-[[[[4-(1,1-二甲基乙基)苯基]氨基]羰基]氨基]丙基](1-甲基乙基)氨基]-β-D-呋喃核糖基]-7H-吡咯并[2,3-d]嘧啶-4-胺),EZH1抑制剂,EZH2抑制剂或EPX5687;
(c)组蛋白脱甲基酶;
(d)组蛋白脱乙酰酶抑制剂(HDAC抑制剂),包括但不限于伏立诺他(vorinostat)、罗米地辛(romidepsin)、西达本胺(chidamide)、帕比司他(panobinostat)、贝利司他(belinostat)、丙戊酸、莫替司他(mocetinostat)、阿贝司他(abexinostat)、恩替司他(entinostat)、瑞米司他(resminostat)、吉维司他(givinostat)或奎替诺司他(quisinostat);
(e)组蛋白乙酰转移酶抑制剂(也称为HAT抑制剂),包括但不限于,C-646(4-[4-[[5-(4,5-二甲基-2-硝基苯基)-2-呋喃基]亚甲基]-4,5-二氢-3-甲基-5-氧代-1H-吡唑-1-基]苯甲酸)、CPTH2(亚环戊基-[4-(4’-氯苯基)噻唑-2-基]肼)、CTPB(N-(4-氯-3-三氟甲基-苯基)-2-乙氧基-6-十五烷基-苯甲酰胺)、garcinol((1R,5R,7R)-3-(3,4-二羟基苯甲酰基)-4-羟基-8,8-二甲基-1,7-双(3-甲基-2-丁烯-1-基)-5-[(2S)-5-甲基-2-(1-甲基乙烯基)-4-己烯-1-基]双环[3.3.1]壬-3-烯-2,9-二酮)、漆树酸、EML 425(5-[(4-羟基-2,6-二甲基苯基)亚甲基]-1,3-双(苯甲基)-2,4,6(1H,3H,5H)-嘧啶三酮)、ISOX DUAL([3-[4-[2-[5-(二甲基-1,2-恶唑-4-基)-1-[2-(吗啉-4-基)乙基]-1H-1,3-苯并二唑l-2-基]乙基]苯氧基]丙基]]二甲基胺)、L002(4-[O-[(4-甲氧基苯基)磺酰基]肟]-2,6-二甲基-2,5-环己二烯-1,4-二酮)、NU 9056(5-(1,2-噻唑-5-基二硫烷基)-1,2-噻唑)、SI-2盐酸盐(1-(2-吡啶基)乙酮2-(1-甲基-1H-苯并咪唑-2-基)腙盐酸盐);或者
(f)其他染色质重塑剂。
在另一个实施方式中,所述表观遗传调节剂是伏立诺他(vorinostat)、罗米地辛(romidepsin)、贝林司他(belinostat)或帕比司他(panobinostat)。
在一些实施方式中,本发明提供了治疗由布罗莫结构域(包括其任何突变)介导的疾病或病症的方法,该方法向对象施用有效量的本发明所述的组合物,该组合物包括本文所述的任何一种或多种化合物以及本文所述的一种或多种其他治疗剂。在其他实施方式中,本发明提供了治疗由布罗莫结构域蛋白或突变的布罗莫结构域蛋白(包括其任何突变)介导的疾病或病症的方法,该方法向对象施用有效量的本发明所述的组合物,该组合物包括本文所述的任何一种或多种化合物以及用于治疗该疾病或病症的一种或多种其他合适的治疗剂。在一个实施方式中,本发明提供了治疗由布罗莫结构域或突变的布罗莫结构域介导的癌症的方法,该方法向对象施用有效量的包括本文所述的任何一种或多种化合物的组合物。在一个实施方式中,本发明提供了治疗由布罗莫结构域介导的癌症的方法,该方法向对象施用有效量的组合物,该组合物包括本文所述的任何一种或多种化合物、以及一种或多种合适的抗癌疗法,例如一种或多种本文所述的化疗药物或药剂。
在一些实施方式中,本发明提供的组合物包括治疗有效量的本发明所述的任何一种或多种化合物以及至少一种药学上可接受的载体、赋形剂和/或稀释剂,包括本文所述的任何两种或更多种化合物的组合。该组合物可进一步包括多种不同的药理学上有活性的化合物,其可包括多种本文所述的化合物。在某些实施方式中,该组合物可以包括本文所述的任何一种或多种化合物以及对相同疾病病症有治疗效果的一种或多种化合物。在一个方面,该组合物包括本文所述的任何一种或多种化合物以及对相同疾病病症有治疗效果的一种或多种化合物,其中这些化合物对该疾病病症具有协同作用。在一个实施方式中,该组合物包括本文所述的对治疗癌症有效的任何一种或多种化合物以及对治疗相同癌症有效的一种或多种其他化合物,而且其中这些化合物对治疗该癌症有协同作用。这些化合物可同时或按顺序给药。
在一些实施方式中,本发明提供了一种组合物(例如药物组合物),其包括式(I)或(II)的化合物、表I中的化合物中的任一个、或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物、或表I中的化合物中的任一个,以及FMS抑制剂(例如奎扎替尼或pexidartinib)。
在一个实施方式中,本发明提供了治疗由布罗莫结构域或突变的布罗莫结构域蛋白介导的疾病或病症的方法,该方法向对象施用有效量的式(I)或(II)的化合物、表I中的化合物中的任一个、或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物、或表I中的化合物中的任一个,以及用于治疗所述疾病或病症的奎扎替尼。
在一些实施方式中,本发明提供了治疗患有本文所述的疾病或病症的对象的方法,所述方法包括向所述对象施用有效量的式(I)或(II)的化合物、表I中的化合物中的任一个、或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物、或表I中的化合物中的任一个,以及突变c-Kit蛋白激酶抑制剂。在另一个实施方式中,所述突变c-Kit蛋白激酶抑制剂选自(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-(3-吡啶基)甲醇、(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-(3-吡啶基)甲酮、N-(3-氨基甲酰基苯基)-2-苯基-1H-吡咯并[2,3-b]吡啶-5-甲酰胺、2-苯基-N-(1H-吡唑-3-基)-1H-吡咯并[2,3-b]吡啶-5-甲酰胺、4-溴-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-1H-吡唑-5-甲酰胺、3-[(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)氨基甲酰基氨基]丙酸乙酯、3,4-二甲基-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-1H-吡唑-5-甲酰胺、4-甲基-3-苯基-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-1H-吡唑-5-甲酰胺、3-环丙基-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-1H-吡唑-5-甲酰胺、5-氟-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-1H-吲唑-3-甲酰胺、N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)嘧啶-4-甲酰胺、3-氟-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)吡啶-2-甲酰胺、3,5-二甲基-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)异恶唑-4-甲酰胺、N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)哒嗪-3-甲酰胺、N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-2H-三唑-4-甲酰胺、3-甲基-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)吡啶-2-甲酰胺、4,5-二甲基-N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)异恶唑-3-甲酰胺、或N-(2-苯基-1H-吡咯并[2,3-b]吡啶-5-基)-1H-吡唑-4-磺酰胺。在另一个实施方式中,式(I)或(II)的化合物、表I中的化合物中的任一个、或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物、或表I中的化合物中的任一个,与在本说明书中描述的用于治疗GIST的突变c-Kit突变抑制剂(包括但不限于一线、二线和新辅助GIST)中的任何一个结合。
在一些实施方式中,本发明提供了一种组合物(例如药物组合物),其包括至少一种药学上可接受的载体或赋形剂、以及表II中的化合物中的任一个、或表II中的化合物中的任一个的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物,以及FMS抑制剂(例如奎扎替尼或派西替尼(pexidartinib)。在一些实施方式中,本发明提供了一种药物组合物,其包括:表II中的化合物中的任一个、或表II中的化合物中的任一个的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;药学上可接受的载体;以及奎扎替尼。
在一些实施方式中,本发明提供了治疗患有或有风险患有布罗莫结构域介导的疾病或病症的对象的方法,所述方法包括向有此需要的对象施用有效量的根据表II的化合物中的任一个、或表II中的化合物中的任一个的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物、或含有表II中的化合物中的任一个或表II中的化合物中的任一个的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物的组合物,以及药学上可接受的赋形剂或载体,结合奎扎替尼。
在一些实施方式中,本发明提供了治疗患有或有风险患有布罗莫结构域介导的疾病或病症的对象的方法,所述方法包括向有此需要的对象施用有效量的药物组合物,其包括:表II中的化合物中的任一个、或表II中的化合物中的任一个的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;至少一种药学上可接受的赋形剂或载体;以及奎扎替尼。
表II
在WO 2014/145051中公开了表II中的化合物,包括如何制备这些化合物的方法,并且WO2014/145051的内容其全文以引用的方式合并入本文中。
在一些实施方式中,本发明提供一种在有此需要的对象中治疗如本文所述的癌症的方法,该方法向该对象施用有效量的本文所述的化合物或包含本文所述的任何一种或多种化合物的组合物,并结合施用对治疗该癌症有效的一种或多种其他疗法或医学程序。其他疗法或医学程序包括合适的抗癌疗法(例如药物疗法、疫苗疗法、基因疗法、光动力疗法)或医学程序(例如手术、辐射治疗、高温加热、骨髓或干细胞移植)。在一个实施方式中,所述一种或多种合适的抗癌疗法或医学程序选自使用化疗剂(如化疗药物)治疗、辐射治疗(例如x射线、γ-射线或电子束、质子束、中子束或α粒子束)、高温加热(如微波、超声、射频消蚀)、疫苗疗法(例如AFP基因肝细胞癌疫苗、AFP腺病毒载体疫苗、AG-858、同种异体GM-CSF分泌乳癌疫苗、树突细胞肽疫苗)、基因疗法(例如Ad5CMV-p53载体、编码MDA7的腺病毒载体、腺病毒5-肿瘤坏死因子α)、光动力疗法(例如氨基乙酰丙酸、莫特沙芬镥)、溶瘤病毒或细菌疗法、手术、或骨髓移植和干细胞移植。在某些实施方式中,本发明提供了在有此需要的患者中治疗癌症的方法,该方法向该患者施用有效量的本文所述的化合物并单独或同时施加本文所述的辐射治疗。在一个实施方式中,本发明提供在有此需要的患者中治疗癌症的方法,该方法向该患者施用有效量的本文所述的化合物,然后进行辐射治疗(例如x射线、γ-射线、或电子束、质子束、中子束或α粒子束)。在另一个实施方式中,本发明提供在有此需要的患者中治疗癌症的方法,该方法向对象施加辐射治疗(例如x射线、γ-射线、或电子束、质子束、中子束或α粒子束),然后向该患者施用有效量的本文所述的化合物。在另一个实施方式中,本发明提供在有此需要的患者中治疗癌症的方法,该方法同时向该患者施用本文所述的化合物和辐射疗法(例如x射线、γ-射线、或电子束、质子束、中子束或α粒子束)。
在另一个方面,本发明提供试剂盒或容器,其包括式(I)或(II)的化合物;或式(I)或(II)的药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物;或表I中的化合物中的任一个;或本文描述的其药物组合物中的任一个。在一些实施方式中,该化合物或组合物被包装在例如小玻璃瓶、瓶子、烧瓶中,其可进一步被包装在例如盒子、包袋或袋子中;该化合物或组合物被美国食品和药品管理局或类似管理机构批准用于施用至哺乳动物(例如人);该化合物或组合物被批准施用于哺乳动物(如人)用于治疗布罗莫结构域蛋白介导的疾病或病症;本文所述的试剂盒或容器可包括使用说明和/或该化合物或组合物适于或被批准用于施用于哺乳动物(如人)以治疗布罗莫结构域介导的疾病或病症的其他说明;并且该化合物或组合物可被包装成单位剂量形式或单剂量形式(例如单剂量片、胶囊或类似物)。
VII.实施例
以下实施例用于说明目的,并不限制要求保护的范围。
本发明范围内的化合物可利用本领域已知的多种反应按以下所述来合成。本领域技术人员也将意识到,可使用替代性的方法来合成本发明的目标化合物,并且本文件中描述的途径并非是穷举性的,而是宽泛地提供了感兴趣化合物的可行的和实际的路径。在一些实施例中,化合物的质谱分析结果可能具有不止一个值,这是由于分子中原子的同位素分布造成的,例如具有溴和氯取代基的化合物。
本领域技术人员也会意识到,在有机化学的标准工作程序中,往往使用酸和碱。如果母化合物具有所需的固有酸度或碱度,在本发明所述的实验程序期间,有时也可产生母化合物的盐。
实施例1A
方案1A
步骤1:6-(3,5-二甲基异恶唑-4-基)-3-碘-1H-吡咯并[3,2-b]吡啶-1-羧酸叔丁酯(2)的制备:向在四氢呋喃(250mL)中的4-(3-碘-1H-吡咯并[3,2-b]吡啶-6-基)-3,5-二甲基异恶唑(1,25.3g,74.6mmol)和DMAP(455mg,3.73mmol)的混合物中,逐滴加入在四氢呋喃(50mL)中的碳酸二叔丁酯(19.54g,89.52mmol)的溶液。将反应混合物在室温下搅拌30分钟并减压浓缩。粗物质通过硅胶柱色谱(0-30%在己烷中的乙酸乙酯)纯化。合并含有产物的级分,减压浓缩,并在高真空下干燥过夜,得到6-(3,5-二甲基异恶唑-4-基)-3-碘-1H-吡咯并[3,2-b]吡啶-1-羧酸叔丁酯(2).MS(ESI)[M+H+]+=440.1。
步骤2:6-(3,5-二甲基异恶唑-4-基)-3-(4-(甲氧基羰基)苯基)-1H-吡咯并[3,2-b]吡啶-1-羧酸叔丁酯(3)的制备:向填充有在甲苯(230mL)和乙醇(70mL)中的6-(3,5-二甲基异恶唑-4-基)-3-碘-1H-吡咯并[3,2-b]吡啶-1-羧酸叔丁酯(2,15.0g,34.15mmol)和(4-甲氧基羰基苯基)硼酸(12.3g,68.32mmol)的压力容器中,加入Na2CO3(51mL,102.5mmol)的2M水溶液,然后加入[1,1′-双(二苯基膦基)二茂铁]二氯化钯(II)(1.25g,1.7mmol)。将所得混合物在氮气下搅拌5分钟。然后将容器密封并在105-110℃加热2.5小时。完成后,将反应混合物冷却至室温,用二氯甲烷(300mL)稀释,并通过硅藻土垫过滤。减压浓缩溶剂并将残余物倒入饱和NaHCO3水溶液(300mL)中并用乙酸乙酯(2x 200mL)萃取。将合并的有机层用水(2x 200mL)和盐水(200mL)洗涤,用Na2SO4干燥,过滤并减压浓缩。将残余物用EtOAc/Et2O/己烷研磨,过滤收集所得固体。用EtOAc/Et2O的混合物洗涤固体,然后在高真空下干燥,得到6-(3,5-二甲基异恶唑-4-基)-3-(4-(甲氧基羰基)苯基)-1H-吡咯并[3,2-b]吡啶-1-羧酸叔丁酯(3).MS(ESI)[M+H+]+=447.48。
步骤3:4-(6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸盐酸甲酯(4)的制备:在0℃下,向在CH2Cl2/MeOH(2:1,350mL)中的6-(3,5-二甲基异恶唑-4-基)-3-(4-(甲氧基羰基)苯基)-1H-吡咯并[3,2-b]吡啶-1-羧酸叔丁酯(3,39.5g,88.3mmol)中,加入在二恶烷(220mL,88mmol)中的4M HCl,并将混合物在环境温度下搅拌2天。过滤收集固体,用冷二氯甲烷(150mL)和二乙醚(3x 100mL)洗涤,然后在高真空下干燥,得到4-(6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸盐酸甲酯(4).MS(ESI)[M+H+]+=347.12。
步骤4:4-(1-(二(吡啶-2-基)甲基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸甲酯(5)的制备:向在THF(20mL)中的4-(6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸盐酸甲酯(4,1.33g,3.47mmol)中,加入碳酸铯(3.39g,10.4mmol)和2-[溴(2-吡啶基)甲基]吡啶(1.04g,4.16mmol)。加热混合物并在70℃下搅拌24小时。LC-MS显示起始材料(4-(6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸盐酸甲酯)仍然存在。然后,向反应混合物中加入额外的2-[溴(2-吡啶基)甲基]吡啶(500mg,2.01mmol),并使其在70℃下再搅拌24小时。将反应混合物倒入水中并用乙酸乙酯萃取。将有机层用水和盐水洗涤,经MgSO4干燥并过滤。在真空下除去挥发物以提供通过硅胶柱色谱法(0-80%在二氯甲烷中的乙酸乙酯)纯化的粗物质。合并含有产物的级分,减压浓缩并在高真空下干燥过夜,得到4-(1-(二(吡啶-2-基)甲基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸甲酯(5).MS(ESI)[M+H+]+=515.56。
步骤5:4-(1-(1,1-二(吡啶-2-基)乙基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸甲酯(P-002)的制备:向在四氢呋喃(15mL)中的4-[1-[二(2-吡啶基)甲基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸甲酯(5,0.36g,0.7mmol)中,加入氢化钠(在矿物油中的60%,0.03g,0.8mmol)。将混合物在室温下搅拌10分钟。然后,加入碘甲烷(0.5g,3.5mmol),并将反应混合物在室温下搅拌20小时。将反应混合物倒入水中并用乙酸乙酯萃取。将有机层用水和盐水洗涤,经MgSO4干燥并过滤。在真空下除去挥发物。通过硅胶柱色谱法((0-100%在二氯甲烷中的乙酸乙酯)纯化粗产物。合并含有产物的级分,减压浓缩并在高真空下干燥过夜,得到4-(1-(1,1-二(吡啶-2-基)乙基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸甲酯(P-002).MS(ESI)[M+H+]+=529.59。
步骤6:4-(1-(1,1-二(吡啶-2-基)乙基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸(P-001)的制备:向在THF(15mL)中的4-[1-[1,1-二(2-吡啶基)乙基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸甲酯(P-002,180mg,0.34mmol)中,加入在水中的1M氢氧化锂(7.5mL)。将反应混合物加热并在50℃下搅拌20小时。将反应混合物与5mL的乙酸一起倒入水中并用乙酸乙酯萃取。将有机层用水和盐水洗涤,经MgSO4干燥并过滤。除去挥发物后,加热回流后将残余物溶于乙腈中。冷却至室温后,使溶液在冰箱中静置过夜。过滤收集产物,得到4-(1-(1,1-二(吡啶-2-基)乙基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸(P-001).MS(ESI)[M+H+]+=515.56。
替代地,可以根据实施例1B合成P-001:
方案1B
步骤1:3,5-二甲基-4-(1H-吡咯并[3,2-b]吡啶-6-基)异恶唑(8):向在二恶烷(2.8L)和水(852mL)中的6(购自Synnovator,Inc.)(196.5g,0.997mol,1当量)、7(购自Oakwood Products,Inc.)(183g,1.296mol,1.3当量)、碳酸钾(413g,2.992mol,3当量)和双(三苯基膦)二氯化钯(II)(34.9g,49.9mmol,114mmol,0.05当量)的悬浮液中,用氮气鼓泡10分钟。将反应混合物在90℃加热过夜,此时LC/MS显示反应完成。反应用乙酸乙酯(4L)和水(4L)稀释。分离各层,使有机层通过硅胶(0.5kg),用另外的乙酸乙酯(2L)冲洗。将滤液减压浓缩并将粗残余物用MTBE(~2L)研磨以得到化合物3。
步骤2:4-(3-碘-1H-吡咯并[3,2-b]吡啶-6-基)-3,5-二甲基异恶唑(2):将N-碘琥珀酰亚胺(198g,882mmol,1.1当量)加入至在乙腈(7.3L)和二甲基乙酰胺(730mL)的混合物中的化合物3(171g,802mmol,1当量)的溶液中。将反应在室温下搅拌过夜,此时LC/MS显示反应完成。减压除去乙腈并将残余物在温水(8L)和饱和硫代硫酸钠(2L)的混合物中浆化。过滤收集固体并用另外的水(2L)洗涤。粗制固体用MTBE(~2L)研磨并在50℃的对流烘箱中干燥两天后得到2。
步骤3:二(吡啶-2-基)甲醇(10):在0℃下将硼氢化钠(27.1g,716mmol,0.38当量)分批加入至在甲醇(7L)中的9(购自RennoteTech Co.,LTD)(350.g,1900mmol,1当量)中。将反应物搅拌1.5小时,此时LCMS表明完全消耗9。将溶液减压浓缩。将残余物溶于1N盐酸(2.56L)中。用固体碳酸氢钠(344g)将pH调节至~8。该溶液用乙酸乙酯(2x 3L)萃取两次。将合并的有机层减压浓缩得到10,其随后用于下一步。
步骤4:2,2'-(溴亚甲基)二吡啶二氢溴酸(11):在室温下将二溴三苯基膦(322.5g,764mmol,2当量)分批加入至在二氯甲烷(1.6L)中的9(71.2g,382mmol,1当量)的溶液中。将反应物在室温下搅拌过夜。在氮气下过滤悬浮液并用二氯甲烷(2x 100mL)洗涤。将固体在40℃下在真空烘箱中干燥3小时,得到11。固体进行吸湿并且不暴露于空气中。
步骤5:4-(1-(二(吡啶-2-基)甲基)-3-碘-1H-吡咯并[3,2-b]吡啶-6-基)-3,5-二甲基异恶唑(12):将11(178.4g,435mmol,1.58当量)悬浮于饱和碳酸氢钠溶液(2L)中并用二氯甲烷(3x 1L)萃取。合并的有机层在减压下浓缩,得到11(108.2g,435mmol,1.58当量)的游离碱。将11(108.2g,435mmol,1.58当量)的游离碱、2(93.5g,276mmol,1当量)和碳酸铯(208g,638mmol,2.3当量)溶于THF(3L)中并回流过夜。该溶液用饱和盐水(3L)稀释。将有机层分离并减压浓缩。将残余物经硅胶(2x 700g)纯化两次,每次用二氯甲烷中的0至100%乙酸乙酯梯度洗脱。将该物质用MTBE(500mL)研磨,得到12。
步骤6:4-(1-(1,1-二(吡啶-2-基)乙基)-3-碘-1H-吡咯并[3,2-b]吡啶-6-基)-3,5-二甲基异恶唑(13):将叔丁醇钾(29.4g,239mmol,1.2当量)分批加入至在无水THF中的12(101.0g,199mmol,1当量)和碘甲烷(37.2mL,597mmol,3当量)的溶液中。将反应物在室温下搅拌过夜。该溶液用饱和盐水(2L)淬灭。将有机层分离并减压浓缩。将残余物在硅胶(1kg)上部分纯化,用二氯甲烷中的0至40%乙酸乙酯梯度洗脱。在相同的AnaLogix柱(220g)上分两次纯化混合级分,每次用二氯甲烷中的0至50%乙酸乙酯洗脱。合并干净的级分,得到13。
步骤7:4-(1-(1,1-二(吡啶-2-基)乙基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸甲酯(P-002):将在二恶烷(730mL)和水(245mL)中的13(73.4g,141mmol,1当量)、和13b(购自Angene International Limited)(50.7g,282mmol,2当量)、和碳酸钾(58.3g,422mmol,3当量)的混合物用氮气鼓泡10分钟。加入[1,1′-双(二苯基膦基)二茂铁]二氯化钯(II)(6.2g,8.4mmol,0.06equiv),并将反应加热至80℃达1.5小时。冷却至室温后,将溶液用THF(500mL)稀释并通过硅藻土(95g)过滤,用另外的THF(600mL)洗涤。将硅藻土垫在二氯甲烷(1L)中浆化并过滤。将两个滤液合并并减压浓缩。将残余物经硅胶(1kg)纯化,用在庚烷中的0至100%乙酸乙酯的梯度洗脱。将混合的级分合并并用MTBE(200mL)研磨。将滤液减压浓缩并在AnaLogix柱(220g)上纯化,用在庚烷中的0至50%乙酸乙酯的梯度洗脱。合并干净的级分,得到P-002。
步骤8:4-(1-(1,1-二(吡啶-2-基)乙基)-6-(3,5-二甲基异恶唑-4-基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸(P-001):将在THF(2.2L)中的P-002(79.2g,150mmol,1当量)和2M氢氧化锂(1.125L,2250mmol,15当量)的溶液,加热至55℃过夜。该溶液用饱和盐水(2L)稀释。用1N盐酸(1.6L)将pH调节至~5。该溶液用乙酸乙酯(2.2L)萃取。将有机层分离,用硫酸钠干燥,减压浓缩。将残余物溶于二氯甲烷(1L)中并过滤除去不溶性颗粒。滤液用乙腈(1L)稀释并浓缩成浓浆液。过滤悬浮液。以相同的方式重复处理滤液,直至没有可分离的物质留下。合并所有固体,得到P-001。
实施例2
步骤1–4-(6-(3,5-二甲基异恶唑-4-基)-1-(氟代二(吡啶-2-基)甲基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸甲酯(P-003)和4-(6-(3,5-二甲基异恶唑-4-基)-1-(氟代二(吡啶-2-基)甲基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸(P-004)的制备:在填充有4-[1-[二(2-吡啶基)甲基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸甲酯(5,0.09g,0.17mmol)和氢氧化钾(150mg,2.68mmol)的小瓶中,加入N,N-二甲基甲酰胺(2mL)。将混合物在室温下搅拌1小时,加入在1mL N,N-二甲基甲酰胺中的N-氟苯磺酰亚胺(100mg,0.315.34mmol)的溶液。将混合物在室温下搅拌2小时。将反应混合物与5mL的乙酸一起倒入水中,然后用乙酸乙酯萃取。将有机层用水和盐水洗涤,经MgSO4干燥并过滤。粗产物通过制备型HPLC纯化。将纯级分合并并在冻干机上干燥,得到4-(6-(3,5-二甲基异恶唑-4-基)-1-(氟代二(吡啶-2-基)甲基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸甲酯(P-003,6mg,7%),MS(ESI)[M+H+]+=533.55;以及4-(6-(3,5-二甲基异恶唑-4-基)-1-(氟代二(吡啶-2-基)甲基)-1H-吡咯并[3,2-b]吡啶-3-基)苯甲酸(P-004),MS(ESI)[M+H+]+=519.52。
实施例3
步骤1–4-[1-[氰基-双(2-吡啶基)甲基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸甲酯(P-005)的制备:向填充有4-[1-[双(2-吡啶基)甲基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸甲酯(5,0.08g,0.16mmol)和氢氧化钾(0.15g,2.67mmol)的小瓶中,加入N,N-二甲基甲酰胺(5mL),并将混合物在室温下搅拌10分钟。然后,将在二氯甲烷中的氰酸苯酯(20%,0.4g,0.67mmol)的溶液加入到该反应中,并在室温下搅拌1小时。LC-MS显示反应没有完成,因此加入另外的氰酸苯酯(20%,0.3克,0.502mmol)。将反应混合物在室温下再搅拌2小时。将反应混合物与5mL的乙酸一起倒入水中并用乙酸乙酯萃取。将有机层用水和盐水洗涤,经MgSO4干燥并过滤。粗物质通过硅胶柱色谱法(在己烷中的0-80%乙酸乙酯)纯化。合并含有产物的级分,减压浓缩并在高真空下干燥过夜,得到4-[1-[氰基-双(2-吡啶基)甲基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸甲酯(P-005).MS(ESI)[M+H+]+=540.57。
步骤2–4-[1-[氰基-双(2-吡啶基)甲基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸(P-006)的制备:使用合适的起始材料,如在实施例1的步骤6中所述地制备产物(P-006,4-[1-[氰基-双(2-吡啶基)甲基]-6-(3,5-二甲基异恶唑-4-基)吡咯并[3,2-b]吡啶-3-基]苯甲酸)。MS(ESI)[M+H+]+=526.54。
本发明的另一个实施方式涉及对于合成权利要求1的化合物有用的化合物,其具有以下化学式中的一个:
或其药学上可接受的盐、溶剂化物、互变异构体、同分异构体或氘化类似物。
实施例4:在化合物P-001和化合物Z之间大鼠PK的对比
使用盒式给药形式测定大鼠PK数据,其中将5种化合物施用至三只大鼠中的每只以用于IV,并且施用至三只大鼠以用于PO。IV剂量为以体积计算1mg/kg每种化合物溶于8.75%聚乙二醇硬脂酸酯(solutol)、8.75%乙醇、12.5%DMSO和70%水中。PO剂量为以体积计算2mg/kg每种化合物溶于1%甲基纤维素水溶液、10%DMSO中。在15分钟、30分钟、1小时、2小时、4小时、8小时和24小时收集血浆IV样品。在30分钟、1小时、2小时、4小时、8小时和24小时收集血浆PO样品。在每种测试物品的标准曲线校准后,通过LC/MS/MS测定血浆药物浓度。还分析了测试物品的剂量溶液并用于计算施用剂量。使用非房室模型使用WinNonLin(v 6.3,Phoenix 64,Pharsight)计算PK参数。
表1和2显示了本公开的化合物P-001和WO 2014/145051中公开的类似结构化合物(化合物Z)在大鼠中静脉内(IV)和口服(PO)施用的比较数据。用括号中的标准误差(SE)表示平均的值。这些数据证实了与化合物Z的大鼠PK相比,化合物P-001的大鼠PK显著改善。
表1
表2
实施例5:使用IPC298异种移植模型的化合物P-001和化合物Z之间的功效比较
处理:在肿瘤接种后第11天,当平均肿瘤大小达到约150mm3时,开始处理/治疗。将小鼠随机分为10个研究组,每组由8只小鼠组成。按照如表3所示的预定的处理方案将测试物品施用于荷瘤小鼠。
表3
处理方案
注:*=n等于动物的数量
**=给药体积:基于小鼠体重调整给药体积(5μL/g)。
肿瘤测量和终点:主要终点是查看肿瘤生长是否可以被延迟或退化。每周两次用卡尺在两个维度上测量肿瘤大小,体积用mm3表示,使用公式:V=0.5a x b2,其中a和b分别是肿瘤的长径和短径。然后将肿瘤大小用于计算肿瘤生长抑制(TGI,百分比)。TGI值是抗肿瘤有效性的指标:TGI=(1-T/C)x 100%。T和C分别是处理组和对照组的相对肿瘤体积的平均值。使用以下公式计算T和C:T=Td/T0x 100%,C=Cd/C0x 100%,其中Td和Cd分别是肿瘤接种后第28天处理组和对照组动物的肿瘤体积;T0和C0分别是治疗开始时处理组和对照组动物的肿瘤体积。
表4和表5和图1中显示了不同时间点不同组的肿瘤体积。化合物P-001单独表现出强的抗肿瘤活性,平均肿瘤大小为99.2mm3(表4),TGI=112%(表5),而化合物Z产生中等的抗肿瘤活性,平均肿瘤大小为141.5mm3(表4),TGI=92%(表5)。
表4
表5
组 | 处理 | 肿瘤大小(第27天,mm<sup>3</sup>) | TGI(%) |
1 | 载体对照 | 336.5±48.4 | - |
2 | 化合物Z(10mg/kg) | 141.5±16.3 | 92 |
3 | 化合物P-001(10mg/kg) | 99.2±13.5 | 112 |
因此,化合物Z产生中等的抗肿瘤活性,而化合物P-001显示出强烈的治疗功效。测试物品被带有肿瘤的动物良好耐受。
实施例5:化合物P-001与化合物Z之间的毒性谱比较
Promonocytic细胞系Ba/F3依赖于IL-3在细胞培养物中生长的增加。然而,工程化来表达全长癌基因的Ba/F3细胞能够使Ba/F3细胞不依赖于因子,但是当通过加入小分子抑制剂来抑制癌基因或下游信号传导时,Ba/F3细胞会发生凋亡。当注射到裸鼠的尾静脉时,因子不依赖性的Ba/F3细胞归巢于脾脏并增殖以引起明显的脾肿大。因子不依赖性的Ba/F3细胞的体内增殖和脾肿大的出现直接依赖于Ba/F3细胞的活性,并且可以通过口服给予有效抑制细胞生长的化合物来阻断。因此,该动物模型可用于确定Ba/F3细胞抑制的有效剂量、评估PK/PD效应以及读出毒性或MTD。
表6提供了实验设计的概述。
表6
图2显示了在7天的时间内向nu/nu小鼠以10mg/kg.给药化合物P-001和化合物Z时观察到的毒性。表7包含给药期间的delta体重变化。
表7
因此,与化合物Z相比,化合物P-001显示出显著改善的毒性特征。如上所见,在该药理学模型中测试的给药期间对化合物P-001没有观察到毒性。化合物Z在给药第2天后显示显著的毒性,并且小鼠在剩余的研究中继续恶化。
实施例6:化合物特征
化合物对任何布罗莫结构域及其突变体的抑制活性对于它们的疾病治疗活性是重要的,但本文所描述的化合物显示出的有利性质使其还可作为药物。
本文所描述的化合物可用于治疗与罗莫结构域蛋白及其突变体相关的疾病。
Alphascreen结合试验
使用Alphascreen结合试验评估式(I)的化合物和布罗莫结构域2、3、4的结合。使用重组的BRD蛋白(乙酰化的Histone 4肽)和AlphaScreenTM技术,定量地测量布罗莫结构域及其乙酰化的靶蛋白之间的相互作用的抑制(Filippakopoulos P et al.2012)。在不存在抑制的情况下,结合至AlphaScreenTM镍螯合物受体珠的BRD蛋白能够与乙酰化的Histone 4肽相互作用,后者被AlphaScreenTM链霉亲和素涂覆的珠固定化。该相互作用使供体和受体珠接近。接近的距离使得由供体珠的激光激发产生的单线态氧到达受体珠并产生发光信号。BRD抑制剂通过抑制BRD–乙酰化的肽相互作用,使得接近信号下降。
如在蛋白表达和纯化部分所描述地,制备并纯化包含N-末端布罗莫结构域(BRD2-BD1(71-194)、BRD3-BD1(24-144)和BRD4-BD1(44-164))或双布罗莫结构域(BRD4-BD12(1-477)、BRD4-BD12(1-472))的重组人类布罗莫结构域。所述肽是人类Histone H41- 21K5AcK8AcK12AcK16Ac-生物素(Anaspec CA,USA)。
用于BRD2、BRD3和BRD4试验的程序:所有组分都是在由50mM HEPES pH 7.5、100mMNaCl、0.01%BSA、0.01%Triton X-100、2mM DTT组成的缓冲液中制备的。将7μL的布罗莫结构域蛋白和7μL的肽加入至Alpha板(PerkinElmer GA,USA)中包含1μL的各种浓度的式(I)的测试化合物或DMSO载体的孔,并在室温下培育1小时。然后加入4μL供体和受体珠混合物至7.5μg/ml的终浓度。在加入珠后30分钟,在Envision光谱仪(λEx 680nm,λEm 520-620nm)上读取Alpha信号。终浓度的布罗莫结构域蛋白和肽如下所示。
试验名称 | BRD蛋白(nM) | 肽(nM) |
BRD2-BD1 | 6 | 41 |
BRD3-BD1 | 4 | 41 |
BRD4-BD1 | 6 | 41 |
BRD2-BD12 | 1 | 10 |
BRD4-BD12 | 3.7 | 37 |
将所有数据标准化至每个板上16个高和16个低对照孔的平均值。然后施加以下公式的四参数曲线拟合:
Y=a+(b-a)/(1+(x/c)^d)
其中“a”是最小值,“b”是最大值,“c”是pIC50而“d”是Hill斜率。
蛋白表达和纯化
在具有N-末端6-组氨酸标记的E.coli细胞(在改性的pET载体中)中表达包含N-末端布罗莫结构域(BRD2-BD1(71-194)、BRD3-BD1(24-144)和BRD4-BD1(44-164))或双布罗莫结构域(BRD4-BD12(1-477)、BRD4-BD12(1-472))的重组人类布罗莫结构域,并使用IMAC(Ni-亲和性)和尺寸排阻色谱步骤的结合来纯化。
使用E.coli菌系BL21-CodonPlus(DE3)(Agilent Technologies CA,USA)表达重组的BRD蛋白。在Terrific Broth(TB)培养基中培养细胞,在37℃,培养至OD600为1.2,此时将温度下降至25℃,用1.0mM异丙基-β-D-硫代半乳糖苷(“IPTG”)诱导蛋白12-18小时,以8000x g离心20分钟收集。细胞重悬于0.1M KPO4pH 8.0,250mM NaCl,10%甘油,0.75%NP-40,25mM咪唑,具有0.2mg/ml溶酶体的5mMβ-巯基乙醇(“BME”),2.0mM苯甲基磺酰氟(“PMSF”),25μg/ml DNA酶I,在冰上培育30分钟,用细胞破碎器(MicroFluidics MA,USA)裂解。以20,000x g离心2小时来使裂解物澄清。蛋白质用Ni-NTA树脂(Life Technologies,USA)捕获。使用25mM Tris-HCl pH 8.3,250mM NaCl,12%甘油和50mM咪唑洗去污染性蛋白质。在3次洗涤步骤之后,使用50mM HEPES pH 7.5,500mM NaCl和400mM咪唑分步洗脱蛋白。利用凝胶过滤柱26/600Superdex 200(GE Biosciences NJ,USA)在50mM HEPES pH 7.5,250mM NaCl中进一步纯化蛋白质。蛋白质被分装并被速冻在液氮中。
肿瘤细胞生长试验
已公开的布罗莫结构域抑制剂JQ1和iBET 151已经在多种癌细胞(例如白血病和淋巴瘤、多发性骨髓瘤细胞、NUT中线癌和成胶质细胞瘤细胞)中显示出活性(Dawson MA etal.2011;Delmore JE 2011;Chen Z et al.2013;Filippakopoulos P et al.2010;MertzJA et al.2011;Ott CJ et al.2012)。在本研究中,我们在不同的癌细胞系中测试化合物。MV-4-11和MOLM-13分别是具有MLL-AF4和MLL-AF9易位的AML细胞系。MM.1S是多发性骨髓瘤细胞系。SK-N-AS、IMR-32和SK-N-BE(2)是神经母细胞瘤细胞系。IMR-32和SK-N-BE(2)细胞系具有MYCN扩增。
从ATCC(IL,USA)取得MV-4-11、MM.1S、IMR-32、SK-N-AS和SK-N-BE(2),从DSMZ(Braunschweig,German)购得MOLM-13。如由其来源所推荐地培养细胞。对于生长抑制研究,将3000个细胞接种在75μL的培养基中的96孔板的孔中。数小时后,将包含式(I)的化合物的生长培养基加入至孔中。将最大浓度为5mM的化合物1:3连续稀释,共8个点滴定,将DMSO作为对照。将1μL等分的每个稀释点加入至249μL生长培养基,并将75μL加入至包含细胞的每个孔,提供处于最大浓度点的10μM化合物。在所有孔中DMSO的终浓度是0.2%。培育细胞72小时,并将25μL的CellTiter Glo试剂(Promega GA,USA)加入至每个孔。振荡平板大约10分钟,并在Tecan微量板读数器上读取化学发光信号。测得的发光直接与细胞数量相关。
将所有数据标准化至每个板上八个DMSO高对照孔的平均值。然后施加以下公式的四参数曲线拟合:
Y=a+(b-a)/(1+(x/c)^d)
其中“a”是最小值,“b”是最大值,“c”是pIC50而“d”是Hill斜率。
这些数据证明,在上述试验中测试的布罗莫结构域抑制剂抑制了肿瘤细胞系中的细胞生长。
Myc报告子试验
在MV-4-11细胞中,BRD2、BRD3和BRD4结合至MYC的启动子区域并调节它的转录(Dawson MA et al.2011)。文献中的布罗莫结构域抑制剂iBET 151能够扰乱BRD4聚集至MYC启动子并随后调低c-myc转录(Dawson MA et al.2011)。Myc蛋白是与强制性伙伴Max杂二聚并且调节对细胞的增殖、分化和凋亡重要的基因的转录的转录因子。该Myc报告子试验被用来监控式(I)的化合物对Myc依赖的基因表达的抑制作用。有效的化合物在Myc驱动的肿瘤中具有潜在性的治疗效果。
MV-4-11Myc报告子细胞系是如下建立的,控制E-box转录响应元件(TRE)(QiagenIL,USA)的最小(m)CMV启动子和串联重复序列,并在2.5μg/ml嘌呤霉素中选择细胞,用表达萤火虫荧光素酶基因的VSV-g假慢病毒感染MV-4-11。
将MV-4-11Myc报告子细胞系保持在包含10%FBS、1%PenStep和2.5μg/ml嘌呤霉素的Iscove's Modified Dulbecco's培养基中。在具有5%CO2的潮湿气氛中在37℃培育细胞。将25000个细胞接种在50μL的培养基中的96孔板中。数小时后,将包含2X化合物的生长培养基加入至孔中。将最大浓度为5mM的化合物1:3连续稀释,共8个点滴定。将1μL等分的每个稀释点加入至249μL生长培养基,并将50μL加入至包含细胞的每个孔,提供处于最大浓度点的10μM化合物。DMSO处理的细胞作为高对照,而10μM JQ1处理的细胞作为低对照。再次培育细胞24小时,并将25μL的CellTiter Glo试剂(Promega GA,USA)加入至每个孔。振荡平板大约2分钟,并在37℃培育0.5小时。在Tecan平板读数器(λex=400nm,λem=505nm)中读取荧光信号。然后将25μL的One-Glo试剂(Promega GA,USA)加入至平板。在Tecan平板读数器上读取化学发光信号。从所有样品中减去没有细胞的孔的值以作为背景校正。背景校正的荧光直接与细胞数量相关,而发光直接与Myc报告子活性相关。
所有数据标准化至每个板上8个高对照和4个低对照孔的平均值。然后施加以下公式的四参数曲线拟合:
Y=a+(b-a)/(1+(x/c)^d)
其中“a”是最小值,“b”是最大值,“c”是pIC50而“d”是Hill斜率。
要理解的是,这些实验的结果可能随着实验条件的改变而改变。在本文所述的条件下测定的抑制水平代表了所测试的化合物在所使用的特定条件下的相对活性。细胞学试验可能因系统的复杂程度以及对实验条件的任何改变的敏感程度而表现出变化。因此,细胞学试验中的一些抑制水平表示这些化合物对那些细胞具有某种抑制活性,但在低于所测试的最大浓度的阈值之下的抑制缺乏并不必然表示该化合物对这些细胞没有抑制活性,仅表示在所测试条件下没有观察到抑制。在一些情况下,这些化合物没有在所有的试验中都进行测试,或者试验结果是无效的。
说明书中引用的所有专利、专利申请和其他参考文献都是本发明所属领域普通技术人员的水平的表示,通过引用将它们以整体形式合并至本文中,包括其中的任何表格和附图,就如同每个参考文献都单独通过引用以其整体形式合并至本文中一样。本文提供的信息仅旨在辅助读者理解。无论是本文提供的信息,还是引用的参考文献,都不被认为是本发明的现有技术。这些参考文献中的每一个都以其全文并且出于所有目的而被合并入本文中。
本领域技术人员会容易意识到,本发明可容易改造而获得本文所述的那些目的和优点以及隐含在本文中的那些目的和优点。在本文中以当前优选实施方式的代表的形式描述的方法、变体和组合物是示例性的,并不意在限制本发明的范围。对于本领域技术人员来说,可对它们做出改变或将其用于其他用途,但这都包括在如所附权利要求定义的本发明的范围内。
虽然本发明已参照具体的实施方式公开,但显然的是,本领域其他技术人员可设计本公开的其他实施方式和变化,而不脱离本发明的真正精神和范围。
此外,当以马库什群组或其他替代物组群形式描述本发明的一些特征或方面时,本领域技术人员会意识到,本发明也以该马库什群组或其他群组的任何单个成员或成员的子群组的形式被描述。
而且,除非有相反表示,否则当实施方式中提供了各种数量值时,通过取任何两个不同的值作为一个范围值的端点,来描述其他实施方式。这些范围值也在本发明的范围之内。
Claims (26)
2.一种药物组合物,其包含权利要求1所述的化合物以及药学上可接受的赋形剂或载体。
3.一种药物组合物,其包含权利要求1所述的化合物以及另一种治疗剂。
4.权利要求1所述的化合物或权利要求2或3所述的药物组合物在制备用于调节布罗莫结构域的药物中的应用。
5.权利要求1所述的化合物或权利要求2或3所述的药物组合物在制备用于治疗由布罗莫结构域介导的疾病或病症的药物中的应用。
6.根据权利要求5所述的应用,其中所述疾病或病症是癌症、自身免疫性病症、炎性病症、对病毒感染的炎症反应或其组合。
7.根据权利要求6所述的应用,其中所述癌症选自:肺癌、乳腺癌、结肠癌、中线癌、间质瘤、肝肿瘤、肾癌、神经瘤、肾上腺癌、腺泡细胞癌、听神经瘤、肢端雀斑样痣黑色素瘤、肢端汗腺瘤、急性嗜酸性粒细胞性白血病、急性类红细胞性白血病、急性淋巴细胞性白血病、急性骨髓性白血病(acute myeloid leukemia)、急性单核细胞白血病、急性早幼粒细胞白血病、腺癌、腺样囊性癌、腺瘤、腺瘤样牙源性肿瘤、腺鳞癌、脂肪组织肿瘤、肾上腺皮质癌、成人T细胞白血病/淋巴瘤、攻击性NK细胞白血病、AIDS相关淋巴瘤、肺泡状横纹肌肉瘤、腺泡状软组织肉瘤、成釉细胞纤维瘤、间变性大细胞淋巴瘤、甲状腺未分化癌、血管免疫母细胞T细胞淋巴瘤、血管肌脂肪瘤、血管肉瘤、星形细胞瘤、非典型畸胎瘤横纹肌样瘤、B细胞慢性淋巴细胞性白血病、B细胞幼淋巴细胞白血病、B细胞淋巴瘤、基底细胞癌、胆道癌、膀胱癌、胚细胞瘤、骨癌、布伦纳瘤、布朗瘤、伯基特淋巴瘤、脑癌、癌细胞、原位癌、癌肉瘤、软骨肿瘤、牙骨质瘤、髓样肉瘤、软骨瘤、脊索瘤、绒毛膜癌、脉络丛乳头状瘤、肾透明细胞肉瘤、颅咽管瘤、皮肤T细胞淋巴瘤、子宫颈癌、结肠直肠癌、德戈斯病、促结缔组织增生性小圆细胞肿瘤、弥漫性大B细胞淋巴瘤、胚胎发育不良性神经上皮瘤、无性细胞瘤、胚胎性癌、内分泌腺肿瘤、内胚窦瘤、肠病相关性T细胞淋巴瘤、食管癌、胎中胎、纤维瘤、纤维肉瘤、滤泡性淋巴瘤、滤泡性甲状腺癌、神经节瘤、胃肠癌、生殖细胞瘤、妊娠性绒癌、巨细胞纤维母细胞、骨巨细胞瘤、神经胶质肿瘤、胶质母细胞瘤、神经胶质瘤、脑胶质瘤、胰高血糖素瘤、性腺胚细胞瘤、粒层细胞瘤、男性细胞瘤、胆囊癌、胃癌、毛细胞白血病、血管母细胞瘤、头颈部癌、血管外皮细胞瘤、恶性血液疾病、肝母细胞瘤、肝脾T细胞淋巴瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、浸润性小叶癌、肠癌、肾癌、喉癌、恶性雀斑样痣、致命性中线癌、白血病、睾丸间质细胞瘤、脂肪肉瘤、肺癌、淋巴管瘤、淋巴管肉瘤、淋巴上皮瘤、淋巴瘤、急性淋巴细胞性白血病、慢性淋巴细胞性白血病、肝癌、小细胞肺癌、非小细胞肺癌、MALT淋巴瘤、恶性纤维性组织细胞瘤、恶性外周神经鞘瘤、恶性蝾螈瘤、套细胞淋巴瘤、边缘区B细胞淋巴瘤、肥大细胞白血病、纵隔生殖细胞瘤、乳腺髓样癌、甲状腺髓样癌、髓母细胞瘤、黑素瘤、脑膜瘤、默克尔细胞癌、间皮瘤、转移性尿路上皮癌、苗勒管混合瘤、黏液瘤、多发性骨髓瘤、肌肉组织肿瘤、蕈样肉芽肿、粘液样肉瘤、粘液瘤、粘液肉瘤、鼻咽癌、神经鞘瘤、神经母细胞瘤、神经纤维瘤、神经瘤、结节性黑色素瘤、眼癌、少突星形细胞瘤、少突神经胶质瘤、嗜酸细胞瘤、视神经鞘脑膜瘤、视神经瘤、口腔癌、骨肉瘤、卵巢癌、潘科斯特瘤、乳头状甲状腺癌、副神经节瘤、松果体母细胞瘤、松果体细胞瘤、垂体细胞瘤、垂体腺瘤、垂体瘤、浆细胞瘤、多胚瘤、前体T淋巴细胞淋巴瘤、原发性中枢神经系统淋巴瘤、原发性渗出性淋巴瘤、原发性腹膜癌、前列腺癌、胰腺癌、咽癌、腹膜假黏液瘤、肾细胞癌、肾髓样癌、视网膜母细胞瘤、横纹肌瘤、横纹肌肉瘤、里希特的转型癌、直肠癌、肉瘤、Schwannomatosis瘤、精原细胞瘤、睾丸支持细胞瘤、性索-性腺间质瘤、印戒细胞癌、皮肤癌、小蓝圆细胞瘤、小细胞癌、软组织肉瘤、生长抑素瘤、烟尘疣、脊柱肿瘤、脾边缘区淋巴瘤、鳞状细胞癌、滑膜肉瘤、塞扎里氏病、小肠肿瘤、鳞状细胞癌、胃癌、T细胞淋巴瘤、睾丸癌、卵泡膜细胞瘤、甲状腺癌、移行细胞癌、咽喉癌、脐尿管癌、泌尿生殖器癌、尿路上皮癌、眼色素层黑素瘤、子宫癌、疣状癌、视觉通路胶质瘤、外阴癌、阴道癌、瓦尔登斯特伦巨球蛋白血症、沃辛瘤和维尔姆斯瘤。
8.根据权利要求6所述的应用,其中所述自身免疫性病症或炎性病症选自:炎性盆腔疾病、尿道炎、皮肤晒伤、鼻窦炎、肺炎、脑炎、脑膜炎、心肌炎、肾炎、骨髓炎、肌炎、肝炎、胃炎、肠炎、皮炎、齿龈炎、阑尾炎、胰腺炎、胆囊炎、丙种球蛋白血症、牛皮癣、变态反应、克罗恩氏病、肠易激综合症、溃疡性结肠炎、斯耶格伦氏病、组织移植物排斥反应、移植器官的超急性排斥反应、哮喘、过敏性鼻炎、慢性阻塞性肺疾病、自身免疫性多腺体疾病、自身免疫性脱发、恶性贫血、肾小球肾炎、皮肤肌炎、多发性硬化、硬皮病、血管炎、自身免疫性溶血和血小板减少的状态、古德帕斯彻综合症、动脉粥样硬化、阿狄森氏病、帕金森氏病、阿尔茨海默氏病、I型糖尿病、脓毒性休克、系统性红斑狼疮、类风湿性关节炎、牛皮癣关节炎、幼年型关节炎、骨关节炎、慢性特发性血小板减少性紫癜、瓦尔登斯特伦巨球蛋白血症、重症肌无力、桥本氏甲状腺炎、特应性皮炎、退行性关节病、白癜风、自身免疫性垂体功能减退症、格林-巴利综合症、白塞氏病、scleracierma病、蕈样肉芽肿、急性炎症反应、格雷夫斯氏病和对冠状病毒感染的炎症反应。
9.根据权利要求6所述的应用,其中所述急性炎症反应是急性呼吸窘迫综合征或局部缺血/再灌注损伤。
10.根据权利要求6所述的应用,其中所述自身免疫性病症或炎性病症选自:风湿性关节炎、骨关节炎、急性痛风、牛皮癣、系统性红斑狼疮、多发性硬化、炎性肠病、哮喘、慢性阻塞性气道疾病、肺炎、心肌炎、心包炎、肌炎、湿疹、皮炎、脱发、白癜风、大疱性皮肤病、肾炎、血管炎、动脉粥样硬化、阿尔茨海默病、抑郁症、视网膜炎、葡萄膜炎、巩膜炎、肝炎、胰腺炎、原发性胆汁性肝硬化、硬化性胆管炎、阿狄森氏病、垂体炎、甲状腺炎、I型糖尿病和移植器官的急性排斥反应。
11.根据权利要求10所述的应用,其中所述炎性肠病是克罗恩氏病或溃疡性结肠炎。
12.根据权利要求6所述的应用,其中所述癌症是非小细胞肺癌、小细胞肺癌、卵巢癌、黑素瘤、中线癌、乳腺癌、淋巴瘤、成神经细胞瘤、或去势抵抗性前列腺癌、骨髓纤维化、骨髓增生异常综合征、或急性骨髓性白血病。
13.根据权利要求6所述的应用,所述药物用于与奎扎替尼(quizartinib)一起施用。
14.根据权利要求6所述的应用,所述药物用于与一种或多种另外的治疗剂一起施用,所述一种或多种另外的治疗剂是以下中的一种或多种:
i)烷基化剂,选自阿多来新(adozelesin)、六甲蜜胺(altretamine)、比折来新(bizelesin)、白消安(busulfan)、卡铂(carboplatin)、卡波醌(carboquone)、卡莫司汀(carmustine)、苯丁酸氮芥(chlorambucil)、顺铂(cisplatin)、环磷酰胺(cyclophosphamide)、达卡巴嗪(dacarbazine)、雌莫司汀(estramustine)、福莫司汀(fotemustine)、赫舒反(hepsulfam)、异环磷酰胺(ifosfamide)、英丙舒凡(improsulfan)、伊洛福芬(irofulven)、洛莫司汀(lomustine)、双氯乙基甲胺(mechlorethamine)、美法仑(melphalan)、奥沙利铂(oxaliplatin)、哌泊舒凡(piposulfan)、司莫司汀(semustine)、链佐星(streptozocin)、替莫唑胺(temozolomide)、噻替哌(thiotepa)和曲奥舒凡(treosulfan);
ii)抗生素,选自博来霉素(bleomycin)、更生霉素(dactinomycin)、道诺霉素(daunorubicin)、阿霉素(doxorubicin)、表柔比星(epirubicin)、伊达比星(idarubicin)、美诺立尔(menogaril)、丝裂霉素(mitomycin)、米托蒽醌(mitoxantrone)、新制癌菌素(neocarzinostatin)、喷司他丁(pentostatin)和普卡霉素(plicamycin);
iii)抗代谢药,选自阿扎胞苷(azacitidine)、卡培他滨(capecitabine)、克拉屈滨(cladribine)、氯法拉滨(clofarabine)、阿糖孢苷(cytarabine)、地西他滨(decitabine)、氟尿苷(floxuridine)、氟达拉滨(fludarabine)、5-氟尿嘧啶(5-fluorouracil)、替加氟(ftorafur)、吉西他滨(gemcitabine)、羟基脲(hydroxyurea)、巯嘌呤(mercaptopurine)、甲氨蝶呤(methotrexate)、奈拉滨(nelarabine)、培美曲塞(pemetrexed)、雷替曲塞(raltitrexed)、硫鸟嘌呤(thioguanine)和三甲曲沙(trimetrexate);
iv)抗体治疗剂,选自阿仑单抗(alemtuzumab)、贝伐单抗(bevacizumab)、西妥昔单抗(cetuximab)、加利昔单抗(galiximab)、吉妥单抗(gemtuzumab)、纳武单抗(nivolumab)、帕尼单抗(panitumumab)、派姆单抗(pembrolizumab)、帕妥珠单抗(pertuzumab)、利妥昔单抗(rituximab)、托西莫单抗(tositumomab)、曲妥单抗(trastuzumab)和90Y替伊莫单抗(90Yibritumomab tiuxetan);
v)激素或激素拮抗剂,选自阿那曲唑(anastrozole)、雄激素(androgens)、布舍瑞林(buserelin)、己烯雌酚(diethylstilbestrol)、依西美坦(exemestane)、氟他胺(flutamide)、氟维司群(fulvestrant)、戈舍瑞林(goserelin)、艾多昔芬(idoxifene)、来曲唑(letrozole)、亮丙瑞林(leuprolide)、甲地孕酮(magestrol)、雷洛昔芬(raloxifene)、它莫西芬(tamoxifen)和托瑞米芬(toremifene);
vi)紫杉烷,选自DJ-927、多西他赛(docetaxel)、TPI 287、紫杉醇(paclitaxel)和DHA-紫杉醇;
vii)类维生素A,选自阿利维A酸(alitretinoin)、贝沙罗汀(bexarotene)、维甲酰酚胺(fenretinide)、异维甲酸(isotretinoin)和维甲酸(tretinoin);
viii)生物碱,选自依托泊苷(etoposide)、高三尖杉酯碱(homoharringtonine)、替尼泊苷(teniposide)、长春花碱(vinblastine)、长春新碱(vincristine)、长春地辛(vindesine)和长春瑞滨(vinorelbine);
ix)抗血管生成剂,选自AE-941(GW786034,Neovastat)、ABT-510、2-甲氧雌二醇(2-methoxyestradiol)、来那度胺(lenalidomide)和萨力多胺(thalidomide);
x)拓扑异构酶抑制剂,选自安吖啶(amsacrine)、伊多替卡林(edotecarin)、依喜替康(exatecan)、伊立替康(irinotecan)、SN-38(7-乙基-10-羟基-喜树碱)、鲁比替康(rubitecan)、拓扑替康(topotecan)和9-氨基喜树碱(9-aminocamptothecin);
xi)激酶抑制剂,选自埃罗替尼(erlotinib)、吉非替尼(gefitinib)、夫拉平度(flavopiridol)、甲磺酸伊马替尼(imatinib mesylate)、拉帕替尼(lapatinib)、索拉非尼(sorafenib)、苹果酸舒尼替尼(sunitinib malate)、AEE-788、AG-013736、AMG 706、AMN107、BMS-354825、BMS-599626、UCN-01(7-羟基十字孢碱(7-hydroxystaurosporine))、威罗菲尼(vemurafenib)、达拉非尼(dabrafenib)、曲美替尼(trametinib)、考比替尼(cobimetinib)、司美替尼(selumetinib)和瓦他拉尼(vatalanib);
xii)靶定的信号传导抑制剂,选自硼替佐米(bortezomib)、格尔德霉素(geldanamycin)和雷帕霉素(rapamycin);
xiii)生物反应调节剂,选自咪喹莫特(imiquimod)、干扰素-α、白介素-2;
xiv)IDO抑制剂;和
xv)化疗剂,选自3-AP(3-氨基-2-羧基甲醛缩氨基硫脲)、阿曲生坦(altrasentan)、氨鲁米特(aminoglutethimide)、阿那格雷(anagrelide)、天冬酰胺酶(asparaginase)、苔藓抑素-1(bryostatin-1)、西仑吉肽(cilengitide)、伊利司莫(elesclomol)、甲磺酸艾日布林(eribulin mesylate)(E7389)、依沙比酮(ixabepilone)、氯尼达明(lonidamine)、马索丙考(masoprocol)、米托胍腙(mitoguanazone)、奥利默森(oblimersen)、舒林酸(sulindac)、睾内酯(testolactone)、噻唑呋林(tiazofurin)、mTOR抑制剂、PI3K抑制剂、Cdk4抑制剂、Akt抑制剂、Hsp90抑制剂、法尼基转移酶抑制剂或芳香酶抑制剂(阿那曲唑(anastrozole)、来曲唑(letrozole)、依西美坦(exemestane));
xvi)Mek抑制剂;
xvii)酪氨酸激酶抑制剂;
xviii)c-Kit突变抑制剂;
xix)EGFR抑制剂,或者
xx)表观遗传调节剂。
15.根据权利要求14所述的应用,其中所述一种或多种另外的治疗剂是选自以下的表观遗传调节剂:
(a)DNA甲基转移酶;
(b)组蛋白或蛋白质甲基转移酶;
(c)组蛋白脱甲基酶;
(d)组蛋白脱乙酰酶抑制剂;
(e)组蛋白乙酰转移酶;和
(f)其他染色质重塑剂。
16.根据权利要求14所述的应用,其中所述表观遗传调节剂是组蛋白脱乙酰酶抑制剂,选自:伏立诺他(vorinostat)、罗米地辛(romidepsin)、西达本胺(chidamide)、帕比司他(panobinostat)、贝利司他(belinostat)、丙戊酸、莫替司他(mocetinostat)、阿贝司他(abexinostat)、恩替司他(entinostat)、瑞米司他(resminostat)、吉维司他(givinostat)、以及奎替诺司他(quisinostat)。
17.根据权利要求14所述的应用,其中所述一种或多种另外的治疗剂是酪氨酸激酶抑制剂,选自:阿帕替尼(apatinib)、tivozanib、阿西替尼(axitinib)、vargatef、阿法替尼(afatinib)、丙氨酸布立尼布(brivanib alaninate)、西地尼布(cediranib)、大黄根(chrysophanic)、大黄酚(chrysophanol)、crenolanib、多韦替尼(dovitinib)、盐酸厄洛替尼(erlotinib hydrochloride)、foretinib、吉非替尼(gefitinib)、伊马替尼(imatinib)、甲磺酸伊马替尼(imatinib mesylate)、拉帕替尼(lapatinib)、利尼伐尼(linifanib)、马赛替尼(masitinib)、莫特塞尼(motesanib)、木利替尼(mubritinib)、来那替尼(neratinib)、帕唑帕尼(pazopanib)、培利替尼(pelitinib)、帕纳替尼(ponatinib)、瑞格非尼(regorafenib)、苯磺酸索拉非尼(sorafenib tosylate)、苹果酸舒尼替尼(sunitinibmalate)、替拉替尼(telatinib)、凡德他尼(vandetanib)、二盐酸瓦他拉尼(vatalanibdihydrochloride)、奎扎替尼(quizartinib)、派西替尼(pexidartinib)、或者卡博替尼(cabozantinib)。
18.根据权利要求14所述的应用,其中所述疾病或病症是慢性淋巴细胞性白血病。
19.根据权利要求14所述的应用,其中所述疾病或病症是眼色素层黑素瘤。
20.根据权利要求19所述的应用,其中所述一种或多种另外的治疗剂是MEK抑制剂。
21.根据权利要求14所述的应用,其中所述疾病或病症是急性骨髓性白血病。
22.根据权利要求21所述的应用,其中所述一种或多种另外的治疗剂是奎扎替尼(quizartinib)。
23.根据权利要求14所述的应用,其中所述疾病或病症是卵巢癌。
24.根据权利要求21所述的应用,其中所述药物用于与阿扎胞苷一起施用。
25.根据权利要求23所述的应用,其中所述药物用于与卡铂(carboplatin)一起施用。
26.根据权利要求7所述的应用,其中所述疾病或病症是滑膜肉瘤。
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