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EP1596848A1 - Use of 1-(2-chloroethyl)-1-nitroso-3-(2-hydroxyethyl)-urea for the treatment of pancreatic cancer, soft-tissue sarcoma, testicular tumors, lymphoma, thymoma, wilm's tumors, renal carcinoma, melanoma, lung cancer, intracerebral metastasis, tumors in the head and neck region, and mammary carcinoma - Google Patents

Use of 1-(2-chloroethyl)-1-nitroso-3-(2-hydroxyethyl)-urea for the treatment of pancreatic cancer, soft-tissue sarcoma, testicular tumors, lymphoma, thymoma, wilm's tumors, renal carcinoma, melanoma, lung cancer, intracerebral metastasis, tumors in the head and neck region, and mammary carcinoma

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Publication number
EP1596848A1
EP1596848A1 EP04714277A EP04714277A EP1596848A1 EP 1596848 A1 EP1596848 A1 EP 1596848A1 EP 04714277 A EP04714277 A EP 04714277A EP 04714277 A EP04714277 A EP 04714277A EP 1596848 A1 EP1596848 A1 EP 1596848A1
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EP
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Prior art keywords
tumors
treatment
hecnu
head
carcinomas
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EP04714277A
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German (de)
French (fr)
Inventor
Gerhard Eisenbrand
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Faustus Forschungs Cie Translational Cancer Research GmbH
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Faustus Forschungs Cie Translational Cancer Research GmbH
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Publication of EP1596848A1 publication Critical patent/EP1596848A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/17—Amides, e.g. hydroxamic acids having the group >N—C(O)—N< or >N—C(S)—N<, e.g. urea, thiourea, carmustine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents

Definitions

  • the invention relates to the use of 1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl) urea (hereinafter also "HECNU”) for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, Kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast carcinomas.
  • HECNU 1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl) urea
  • BCNU bis- (2-chloroethyl) -1-nitroso-urea
  • HECNU Clinical phase II studies with HECNU for the treatment of malignant supratentorial gliomas have also been carried out, as described in J. Neuro-Oncology, 6, 211-219 (1988), P. Georges et al. described. HECNU also showed activity here. The favorable toxicity profile compared to other nitrosoureas is particularly emphasized.
  • phase II clinical studies with HECNU for the treatment of malignant, recurrent gliomas by intra-arterial and infra-ophthalmic infusion were carried out, as described in J. Neuro-Oncology, 8, 255-262 (1990), M. Poisson et al. described. This publication only describes the neuro-oncological area.
  • HECNU (1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl urea)
  • pancreatic carcinoma Treating soft tissue sarcoma, testicular tumor, lymphomas, thymomas, Wilms' tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast cancer.
  • the invention is therefore based on the object of treating pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck region, and breast carcinomas.
  • HECNU for use in the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymons, Wilms tumors,
  • Renal carcinomas melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast carcinomas are suitable.
  • HECNU is preferred for the treatment of pancreatic carcinomas, soft tissue sarcomas, lymphomas, thymomas, kidney carcinomas, melanomas, lung tumors, intracerebral metastases and tumors in the head and neck area.
  • HECNU is particularly preferred for the treatment of pancreatic carcinomas, soft tissue sarcomas, lymphomas, kidney carcinomas, melanomas, intracerebral metastases and tumors in the head and neck area.
  • HECNU is very particularly preferred for the treatment of pancreatic carcinomas, lymphomas, melanomas and tumors in the head and neck area. In vitro experiments, animal experiments and clinical studies have shown that HECNU is also very active in the treatment of these cancers.
  • HECNU has the following structural formula
  • HECNU shows - compared to BCNU - a significantly reduced bone marrow, lung and kidney toxicity. It is believed that this is due to the fact that when HECNU is used, no carbamoylation reactions can take place in the body, since no carbamoylating metabolite is formed in the body when it is broken down. In addition, HECNU does not inhibit glutathione reductase in the lungs. It is also a much weaker carcinogen compared to BCNU.
  • the compound can also be administered by simple injection.
  • HECNU shows only a low gastrointestinal toxicity and thus causes little nausea and little vomiting in patients and is better tolerated.
  • the invention also relates to the use of HECNU for the manufacture of a medicament for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms Tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast carcinomas.
  • the invention further relates to a method for the therapeutic and / or prophylactic treatment of a mammal in need of treatment by administering HECNU for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, Tumors in the head and neck area, and breast cancer.
  • HECNU is particularly preferably administered intravenously, but also intramuscularly, intraperitoneally, subcutaneously or orally. External application is also possible. Administration by intravenous injection or intravenous infusion is preferred.
  • HECNU can be carried out in any suitable formulation, provided that the formation or maintenance of sufficient active substance levels is ensured. This can be achieved, for example, by oral or parenteral administration in suitable doses.
  • the pharmaceutical preparation of the active ingredient is advantageously in the form of unit doses which are tailored to the desired administration.
  • a unit dose can be, for example, a tablet, a dragee, a capsule, a suppository or a measured volume of a powder, a granulate, a solution, an emulsion or a suspension.
  • unit dose is understood to mean a physically determined unit which contains an individual amount of the active ingredient in combination with a pharmaceutical carrier and whose active ingredient content is a fraction or a multiple of one corresponds to a single therapeutic dose.
  • a single dose preferably contains the amount of active ingredient which is administered in one application and which usually corresponds to a whole, a half, a third or a quarter of a daily dose. If only a fraction, such as half or a quarter, of the unit dose is required for a single therapeutic administration, the unit dose is advantageously divisible, for example in the form of a tablet with a notch.
  • HECNU in a suitable medicament according to the invention can, if it is carried out in unit doses and for applications e.g. is intended for humans, with about 0.1 to 500 mg, preferably 10 to 200 mg and in particular 50 to 150 mg of active ingredient.
  • the active ingredient (s) are administered in a daily dose of 0.1 to 5, preferably 1 to 3 mg / kg body weight, optionally in the form of several, preferably 1 to 3, single doses to achieve the desired results.
  • a single dose contains the active ingredient (s) in amounts of 0.1 to 5, preferably 1 to 3 mg / kg body weight. Similar doses can be used in oral treatment.
  • HECNU The therapeutic use of HECNU according to the invention in a medicament can take place 1 to 4 times a day at fixed or varying times, for example in each case before meals and / or in the evening.
  • the determination of the required optimal dosage and type of application of HECNU can be done by any specialist based on his specialist knowledge.
  • the dose of HECNU administered to the patient is particularly preferably 60 to 200 mg / m 2 (based on the body surface of the patient), preferably approximately 80 to approximately 150 mg / m 2 , particularly preferably approximately 100 to approximately 120 mg / m 2 .
  • HECNU can take place in the form of medicaments, which as a rule comprise HECNU and non-toxic, pharmaceutically acceptable medicament carriers which are used as
  • Mixing or diluent for example in solid, semi-solid or liquid form or as a coating agent, for example in the form of a
  • Capsule, tablet cover, sachet or other container for the therapeutically active ingredient can be included in a carrier.
  • a carrier can e.g. as an intermediary for the
  • Sweetener as a flavor corrector, as a color or as
  • Tablets dragees e.g. come from gelatin, dispersible powders, granules, aqueous and oily suspensions, emulsions, solutions or syrups.
  • Tablets can contain inert diluents, for example calcium carbonate, calcium phosphate, sodium phosphate or lactose; Granulating and distributing agents, for example corn starch or alginates; Binders, e.g. starch, Gelatin or acacia; and lubricants, for example aluminum or magnesium stearate, talc or silicone oil. They can also be provided with a coating, which can also be designed in such a way that it causes a delayed dissolution and absorption of the pharmaceutical preparation in the gastrointestinal tract, so that, for example, better tolerance, protaction or retardation is achieved.
  • Gelatin capsules can be mixed with a solid, for example calcium carbonate or kaolin, or an oily, for example olive, peanut or paraffin oil,
  • Aqueous suspensions can include suspending agents, e.g.
  • Dispersing and wetting agents e.g. Polyoxyethylene stearate, heptadecaethyleneoxycatanol, polyoxyethylene sorbitol monooleate or lecithin; Preservatives, e.g. Methyl or propyl hydroxybenzoates; Flavoring agents; Sweeteners, e.g. Sucrose, lactose, sodium cyclamate, dextrose, invert sugar syrup.
  • Oily suspensions can e.g. Peanut, olive, sesame, coconut or paraffin oil and thickeners such as e.g. Beeswax, hard paraffin or cetyl alcohol; also sweeteners, flavoring agents and antioxidants.
  • Water-dispersible powders and granules can be used in the use of HECNU in accordance with the invention in a mixture with dispersing, wetting and suspending agents, e.g. the above, as well as with sweeteners, flavorings and colorants.
  • Emulsions can be, for example, olive, peanut or paraffin oil in addition to emulsifiers, such as, for example, acacia, tragacanth, phosphatides, sorbitan monooleate, polyoxyethylene sorbitan monooleate, and sweeteners and Contain flavoring.
  • emulsifiers such as, for example, acacia, tragacanth, phosphatides, sorbitan monooleate, polyoxyethylene sorbitan monooleate, and sweeteners and Contain flavoring.
  • Aqueous solutions can contain preservatives, e.g. Methyl or propyl hydroxybenzoates; Thickener; Flavoring agents;
  • Sweeteners e.g. Contain sucrose, lactose, sodium cyclamate, dextrose, invert sugar syrup, as well as flavorings and colorings.
  • Sterile injectable, aqueous solutions, isotonic saline solutions or other solutions are used for parenteral use of the medicinal substances.
  • pancreatic cancer pancreatic cancer
  • HECNU human tumor xenograft models in the nude mouse
  • human xenograft tumor models in the nude mouse showed good to very good inhibitory effects on tumor growth in a representative spectrum of tumors.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Medicinal Chemistry (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Public Health (AREA)
  • Epidemiology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

The invention relates to the use of 1-(2-chloroethyl)-1-nitroso-3-(2-hydroxyethyl)-urea (henceforth also called HECNU ) for the treatment of pancreatic cancer, soft-tissue sarcoma, testicular tumors, lymphoma, thymoma, Wilm's tumor, renal carcinoma, melanoma, lung cancer, intracerebral metastases, tumors in the head and neck region, and mammary carcinoma.

Description

Verwendung von 1-(2-Chlorethyl)-1-nitroso-3-(2- hydroxyethyl)-urea zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodentumoren, Lymphomen, Thymomen, Wilms Tumoren, Use of 1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl) urea for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors,
Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- undKidney cancer, melanoma, lung tumor, intracerebral metastases, tumors in the head and
Halsbereich, und Mamma-KarzinomenNeck area, and breast cancer
Die Erfindung betrifft die Verwendung von 1-(2-Chlorethyl)-1-nitroso-3-(2- hydroxyethyl)-urea (nachstehend auch "HECNU") zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodentumoren, Lymphomen, Thymomen, Wilms Tumoren, Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- und Halsbereich, und Mamma-Karzinomen.The invention relates to the use of 1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl) urea (hereinafter also "HECNU") for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, Kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast carcinomas.
Es ist bekannt, Bis-(2-chlorethyl)-1-nitroso-urea (nachstehend auch "BCNU") bei der Behandlung verschiedener Krebserkrankungen einzusetzen. BCNU ist zwar lipophil, jedoch wenig wasserlöslich, so dass zusätzliche Lösungsmittel wie Ethanol bei der Applikation verwendet werden müssen. Außerdem hat sich herausgestellt, dass BCNU eine hohe Toxizität gegenüber Knochenmark und Lunge hat und zusätzlich Lungenfibrosen verursachen kann. Daher wurde nach Alternativen zu BCNU gesucht.It is known to use bis- (2-chloroethyl) -1-nitroso-urea (hereinafter also "BCNU") in the treatment of various cancers. BCNU is lipophilic, but not very soluble in water, so that additional solvents such as ethanol have to be used for the application. BCNU has also been shown to be highly toxic to bone marrow and lungs and can also cause pulmonary fibrosis. Therefore alternatives to BCNU were sought.
So wurden verschiedene unsymmetrisch 1 ,3-disubstituierte Nitrosoharnstoffe, wie HECNU, hergestellt, wie beispielsweise in DE 26 23 420 und US 4,150,146 beschrieben. Auch die Antitumorwirkung dieser Verbindungen wurde in zwei Tiermodellen (Rattenleukämie L 5222 und s.c. implantierten Walker Carcinosarkom) getestet. Des weiteren wurden klinische Phase II Studien mit 1-(2-Chloroethyl)-3-(2- hydroxyethyl)-1-nitrosourea (HECNU) in Patienten mit fortgeschrittenem Magen oder Dickdarm-Krebs durchgeführt, wie in Contrib. Oncol. Vol 37, pp. 157-162 (1989), H.H. Fiebig et al. beschrieben. Dabei wurde bei der Behandlung von Magenkarzinomen in 31 % der behandelten Patienten eine partielle Remission beobachtet, wohingegen im kolorektalen Karzinom nur marginale Aktivitäten und Responseraten gezeigt werden konnten.Various asymmetrically 1,3-disubstituted nitrosoureas, such as HECNU, have been produced, as described, for example, in DE 26 23 420 and US Pat. No. 4,150,146. The antitumor activity of these compounds was also tested in two animal models (rat leukemia L 5222 and sc implanted Walker carcinosarcoma). In addition, phase II clinical studies with 1- (2-chloroethyl) -3- (2-hydroxyethyl) -1-nitrosourea (HECNU) were carried out in patients with advanced stomach or colon cancer, as described in Contrib. Oncol. Vol 37, pp. 157-162 (1989), HH Fiebig et al. described. Partial remission was observed in the treatment of gastric carcinoma in 31% of the treated patients, whereas only marginal activities and response rates could be shown in colorectal carcinoma.
Außerdem wurden klinische Phase II Studien mit HECNU zur Behandlung von malignem Hirntumor durchgeführt, wie in Contrib. Oncol. Vol. 37, pp 163-167 (1989), H. Henss et al. beschrieben. Signifikante Antitumoraktivität von HECNU in bösartigen Hirntumoren konnte dabei gezeigt werden.In addition, phase II clinical studies with HECNU for the treatment of malignant brain tumor were carried out, as described in Contrib. Oncol. Vol. 37, pp 163-167 (1989), H. Henss et al. described. Significant antitumor activity of HECNU in malignant brain tumors could be shown.
Auch wurden klinische Phase II Studien mit HECNU zur Behandlung von malignen supratentorialen Gliomen durchgeführt, wie in J. Neuro-Oncology, 6, 211-219 (1988), P. Georges et al. beschrieben. Auch hier zeigte HECNU Aktivität. Betont wird besonders das günstigere Toxizitätsprofil gegenüber anderen Nitrosoharnstoffen.Clinical phase II studies with HECNU for the treatment of malignant supratentorial gliomas have also been carried out, as described in J. Neuro-Oncology, 6, 211-219 (1988), P. Georges et al. described. HECNU also showed activity here. The favorable toxicity profile compared to other nitrosoureas is particularly emphasized.
Zusätzlich wurden klinische Phase II Studien mit HECNU zur Behandlung von malignen, wiederkehrenden Gliomen durch intra-arterielle und infra- ophthalmische Infusion durchgeführt, wie in J. Neuro-Oncology, 8, 255-262 (1990), M. Poisson et al. beschrieben. Auch in dieser Publikation ist lediglich der Neuroonkologische Bereich beschrieben.In addition, phase II clinical studies with HECNU for the treatment of malignant, recurrent gliomas by intra-arterial and infra-ophthalmic infusion were carried out, as described in J. Neuro-Oncology, 8, 255-262 (1990), M. Poisson et al. described. This publication only describes the neuro-oncological area.
Es ist somit bekannt, dass HECNU (1-(2-Chloroethyl)-1-nitroso-3-(2- hydroxyethylhamstoff)) bei den Indikationen Tumorerkrankungen des CNS, sowie in Tumoren des Magens, eine große Aktivität besitzt. Ferner ist auch die geringe Wirksamkeit im Kolonkarzinom beschrieben worden.It is thus known that HECNU (1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl urea)) has great activity in the indications of tumor diseases of the CNS and in tumors of the stomach. The low efficacy in colon cancer has also been described.
Neben den vorstehend genannten Krebsarten besteht jedoch ein zunehmender Bedarf, auch andere Krebsarten, nämlich Pankreaskarzinom, Weichteilsarkom, Hodentumor, Lymphome, Thymome, Wilms Tumoren, Nierenkarzinome, Melanome, Lungentumore, intracerebrale Metastasen, Tumore im Kopf- und Halsbereich, und Mamma-Karzinome, erfolgreich zu behandeln.In addition to the types of cancer mentioned above, there is an increasing need, other types of cancer, namely pancreatic carcinoma, Treating soft tissue sarcoma, testicular tumor, lymphomas, thymomas, Wilms' tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast cancer.
Daher liegt der Erfindung die Aufgabe zugrunde, Pankreaskarzinome, Weichteilsarkome, Hodentumore, Lymphome, Thymome, Wilms Tumore, Melanome, Lungentumore, intracerebrale Metastasen, Tumore im Kopf- und Halsbereich, und Mamma-Karzinome zu behandeln.The invention is therefore based on the object of treating pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck region, and breast carcinomas.
Überraschend hat sich nunmehr herausgestellt, dass HECNU zur Verwendung zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodentumoren, Lymphomen, Thymonen, Wilms Tumoren,Surprisingly, it has now been found that HECNU for use in the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymons, Wilms tumors,
Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- und Halsbereich, und Mamma-Karzinomen geeignet ist.Renal carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast carcinomas are suitable.
Bevorzugt ist die Verwendung von HECNU zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Lymphomen, Thymomen, Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen und Tumoren im Kopf- und Halsbereich.The use of HECNU is preferred for the treatment of pancreatic carcinomas, soft tissue sarcomas, lymphomas, thymomas, kidney carcinomas, melanomas, lung tumors, intracerebral metastases and tumors in the head and neck area.
Besonders bevorzugt ist die Verwendung von HECNU zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Lymphomen, Nierenkarzinomen, Melanomen, intracerebralen Metastasen und Tumoren im Kopf- und Halsbereich.The use of HECNU is particularly preferred for the treatment of pancreatic carcinomas, soft tissue sarcomas, lymphomas, kidney carcinomas, melanomas, intracerebral metastases and tumors in the head and neck area.
Ganz besonders bevorzugt ist die Verwendung von HECNU zur Behandlung von Pankreaskarzinomen, Lymphomen, Melanomen, und Tumoren im Kopf- und Halsbereich. In In-vitro-Experimenten, in Tierversuchen, sowie in klinischen Studien, konnte gezeigt werden, dass HECNU bei der Behandlung dieser Krebserkrankungen ebenfalls eine große Aktivität besitzt.The use of HECNU is very particularly preferred for the treatment of pancreatic carcinomas, lymphomas, melanomas and tumors in the head and neck area. In vitro experiments, animal experiments and clinical studies have shown that HECNU is also very active in the treatment of these cancers.
HECNU hat die folgende StrukturformelHECNU has the following structural formula
und ist, wie vorstehend beschrieben, nach Verfahren, wie in DE 26 23 420 und US 4,150,146 beschrieben, herstellbar.and, as described above, can be produced by methods as described in DE 26 23 420 and US 4,150,146.
HECNU zeigt - im Vergleich zu BCNU - eine deutlich verringerte Knochenmark-, Lungen und Nierentoxizität. Es wird angenommen, dass dies darauf zurückzuführen ist, dass bei der Verwendung von HECNU keine Carbamoylierungsreaktionen im Körper stattfinden können, da bei dessen Abbau im Körper kein carbamoylierender Metabolit gebildet wird. Außerdem hemmt HECNU die Glutathionreduktase in der Lunge nicht. Ferner ist es im Vergleich zu BCNU ein sehr viel schwächeres Karzinogen.HECNU shows - compared to BCNU - a significantly reduced bone marrow, lung and kidney toxicity. It is believed that this is due to the fact that when HECNU is used, no carbamoylation reactions can take place in the body, since no carbamoylating metabolite is formed in the body when it is broken down. In addition, HECNU does not inhibit glutathione reductase in the lungs. It is also a much weaker carcinogen compared to BCNU.
Wegen der guten Wasserlöslichkeit von HECNU kann die Verbindung auch durch einfache Injektion verabreicht werden.Because of the good water solubility of HECNU, the compound can also be administered by simple injection.
Des weiteren zeigt HECNU nur eine geringe gastrointestinale Toxizität und verursacht damit in Patienten nur geringe Übelkeit und wenig Erbrechen und hat eine bessere Verträglichkeit.Furthermore, HECNU shows only a low gastrointestinal toxicity and thus causes little nausea and little vomiting in patients and is better tolerated.
Die Erfindung betrifft auch die Verwendung von HECNU zur Herstellung eines Arzneimittels zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodentumoren, Lymphomen, Thymomen, Wilms Tumoren, Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- und Halsbereich, und Mamma-Karzinomen.The invention also relates to the use of HECNU for the manufacture of a medicament for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms Tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast carcinomas.
Die Erfindung betrifft weiterhin ein Verfahren zur therapeutischen und/oder prophylaktischen Behandlung eines Säugetiers, das einer Behandlung bedarf, durch Verabreichen von HECNU zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodentumoren, Lymphomen, Thymomen, Wilms Tumoren, Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- und Halsbereich, und Mamma-Karzinomen.The invention further relates to a method for the therapeutic and / or prophylactic treatment of a mammal in need of treatment by administering HECNU for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, Tumors in the head and neck area, and breast cancer.
Zur Behandlung der vorstehend genannten Krebserkrankungen wird HECNU besonders bevorzugt intravenös, aber auch intramuskulär, intraperitoneal, subkutan oder peroral verabreicht. Auch eine äußerliche Applikation ist möglich. Bevorzugt ist die Verabreichung durch intravenöse Injektion oder intravenöse Infusion.For the treatment of the above-mentioned cancers, HECNU is particularly preferably administered intravenously, but also intramuscularly, intraperitoneally, subcutaneously or orally. External application is also possible. Administration by intravenous injection or intravenous infusion is preferred.
Die erfindungsgemäße Verwendung von HECNU kann in jeder geeigneten Formulierung durchgeführt werden unter der Voraussetzung, dass die Ausbildung bzw. Aufrechterhaltung von ausreichenden Wirkstoffpegeln gewährleistet ist. Das kann beispielsweise durch orale oder parenterale Gabe in geeigneten Dosen erreicht werden. Vorteilhafterweise liegt die pharmazeutische Zubereitung des Wirkstoffs in Form von Einheitsdosen vor, die auf die gewünschte Verabreichung abgestimmt sind. Eine Einheitsdosis kann zum Beispiel eine Tablette, ein Dragee, eine Kapsel, ein Suppositorium oder eine gemessene Volumenmenge eines Pulvers, eines Granulates, einer Lösung, einer Emulsion oder einer Suspension sein.The use of HECNU according to the invention can be carried out in any suitable formulation, provided that the formation or maintenance of sufficient active substance levels is ensured. This can be achieved, for example, by oral or parenteral administration in suitable doses. The pharmaceutical preparation of the active ingredient is advantageously in the form of unit doses which are tailored to the desired administration. A unit dose can be, for example, a tablet, a dragee, a capsule, a suppository or a measured volume of a powder, a granulate, a solution, an emulsion or a suspension.
Unter "Einheitsdosis" im Sinne der vorliegenden Erfindung wird eine physikalisch bestimmte Einheit verstanden, die eine individuelle Menge des aktiven Bestandteils in Kombination mit einem pharmazeutischen Trägerstoff enthält und deren Wirkstoffgehalt einem Bruchteil oder Vielfachen einer therapeutischen Einzeldosis entspricht. Eine Einzeldosis enthält vorzugsweise die Menge Wirkstoff, die bei einer Applikation verabreicht wird und die gewöhnlich einer ganzen, einer halben, einer drittel oder einer viertel Tagesdosis entspricht. Wenn für eine einzelne therapeutische Verabreichung nur ein Bruchteil, wie die Hälfte oder ein Viertel der Einheitsdosis benötigt wird, ist die Einheitsdosis vorteilhafterweise teilbar, z.B. in Form einer Tablette mit Bruchkerbe.In the context of the present invention, “unit dose” is understood to mean a physically determined unit which contains an individual amount of the active ingredient in combination with a pharmaceutical carrier and whose active ingredient content is a fraction or a multiple of one corresponds to a single therapeutic dose. A single dose preferably contains the amount of active ingredient which is administered in one application and which usually corresponds to a whole, a half, a third or a quarter of a daily dose. If only a fraction, such as half or a quarter, of the unit dose is required for a single therapeutic administration, the unit dose is advantageously divisible, for example in the form of a tablet with a notch.
Die erfindungsgemäßen Verwendung von HECNU in einem geeigneten Arzneimittel kann, wenn sie in Einheitsdosen durchgeführt wird und für Applikationen z.B. am Menschen bestimmt ist, mit etwa 0,1 bis 500 mg, bevorzugt 10 bis 200 mg und insbesondere 50 bis 150 mg Wirkstoff erfolgen.The use of HECNU in a suitable medicament according to the invention can, if it is carried out in unit doses and for applications e.g. is intended for humans, with about 0.1 to 500 mg, preferably 10 to 200 mg and in particular 50 to 150 mg of active ingredient.
Im allgemeinen werden in der Humanmedizin der oder die Wirkstoffe in einer Tagesdosis von 0,1 bis 5, vorzugsweise 1 bis 3 mg/kg Körpergewicht, gegebenenfalls in Form mehrerer, vorzugsweise 1 bis 3 Einzelgaben zur Erzielung der gewünschten Ergebnisse verabreicht. Eine Einzelgabe enthält den oder die Wirkstoffe in Mengen von 0,1 bis 5, vorzugsweise 1 bis 3 mg/kg Körpergewicht. Bei einer oralen Behandlung können ähnliche Dosierungen zur Anwendung kommen.In general, in human medicine the active ingredient (s) are administered in a daily dose of 0.1 to 5, preferably 1 to 3 mg / kg body weight, optionally in the form of several, preferably 1 to 3, single doses to achieve the desired results. A single dose contains the active ingredient (s) in amounts of 0.1 to 5, preferably 1 to 3 mg / kg body weight. Similar doses can be used in oral treatment.
Die erfindungsgemäße therapeutische Verwendung von HECNU in einem Arzneimittel kann 1 bis 4 mal am Tage zu festgelegten oder variierenden Zeitpunkten erfolgen, z.B. jeweils vor den Mahlzeiten und/oder am Abend. Es kann jedoch erforderlich sein, von den genannten Dosierungen abzuweichen, und zwar in Abhängigkeit von der Art, dem Körpergewicht und dem Alter der zu behandelnden Individuen, der Art und Schwere der Erkrankung, der Art der Zubereitung und der Applikation der Arzneimittel, sowie dem Zeitraum bzw. Intervall, innerhalb welchem die Verabreichung erfolgt. So kann es in einigen Fällen ausreichend sein, mit weniger als der oben genannten Menge Wirkstoff auszukommen, während in anderen Fällen die oben angeführte Wirkstoffmenge überschritten werden muss. Es kann sich auch als zweckmäßig erweisen, die Arzneimittel nur einmalig oder im Abstand von mehreren Tagen zu verabreichen.The therapeutic use of HECNU according to the invention in a medicament can take place 1 to 4 times a day at fixed or varying times, for example in each case before meals and / or in the evening. However, it may be necessary to deviate from the doses mentioned, depending on the type, body weight and age of the individuals to be treated, the type and severity of the disease, the type of preparation and administration of the medicament, and the period or interval within which the administration takes place. In some cases it may be sufficient to manage with less than the amount of active ingredient mentioned above, while in other cases the amount of active ingredient listed above must be exceeded. It may also be useful to administer the medication only once or several days apart.
Die Festlegung der erforderlichen optimalen Dosierung und Applikationsart von HECNU kann durch jeden Fachmann aufgrund seines Fachwissens erfolgen.The determination of the required optimal dosage and type of application of HECNU can be done by any specialist based on his specialist knowledge.
Die dem Patienten verabreichte Dosis von HECNU beträgt besonders bevorzugt 60 bis 200 mg/m2 (bezogen auf die Körperoberfläche des Patienten), vorzugsweise etwa 80 bis etwa 150 mg/m2, besonders bevorzugt, etwa 100 bis etwa 120 mg/m2.The dose of HECNU administered to the patient is particularly preferably 60 to 200 mg / m 2 (based on the body surface of the patient), preferably approximately 80 to approximately 150 mg / m 2 , particularly preferably approximately 100 to approximately 120 mg / m 2 .
Die erfindungsgemäße Verwendung von HECNU kann in Form von Arzneimitteln erfolgen, die in der Regel HECNU und nichttoxische, pharmazeutisch verträgliche Arzneimittelträger umfassen, die alsThe use of HECNU according to the invention can take place in the form of medicaments, which as a rule comprise HECNU and non-toxic, pharmaceutically acceptable medicament carriers which are used as
Zumischung oder Verdünnungsmittel, beispielsweise in fester, halbfester oder flüssiger Form oder als Umhüllungsmittel, beispielsweise in Form einerMixing or diluent, for example in solid, semi-solid or liquid form or as a coating agent, for example in the form of a
Kapsel, eines Tablettenüberzugs, eines Beutels oder eines anderen Behältnisses für den therapeutisch aktiven Bestandteil in Anwendung kommen. Ein Trägerstoff kann z.B. als Vermittler für dieCapsule, tablet cover, sachet or other container for the therapeutically active ingredient. A carrier can e.g. as an intermediary for the
Arzneimittelaufnahme durch den Körper, als Formulierungshilfsmittel, alsDrug absorption by the body, as a formulation aid, as
Süßungsmittel, als Geschmackskorrigens, als Farbstoff oder alsSweetener, as a flavor corrector, as a color or as
Konservierungsmittel dienen.Preservatives serve.
Zur oralen Anwendung können z.B. Tabletten Dragees, harte und weiche Kapseln, z.B. aus Gelatine, dispergierbare Pulver, Granulate, wässrige und ölige Suspensionen, Emulsionen, Lösungen oder Sirupe kommen.For oral use e.g. Tablets dragees, hard and soft capsules, e.g. come from gelatin, dispersible powders, granules, aqueous and oily suspensions, emulsions, solutions or syrups.
Tabletten können inerte Verdünnungsmittel, z.B. Caiciumcarbonat, Calciumphosphat, Natriumphosphat oder Laktose; Granulierungs- und Verteilungsmittel, z.B. Maisstärke oder Alginate; Bindemittel, z.B. Stärke, Gelatine oder Akaziengummi; und Gleitmittel, z.B. Aluminium- oder Magnesiumstearat, Talkum oder Silikonöl, enthalten. Sie können zusätzlich mit einem Überzug versehen sein, der auch so beschaffen sein kann, dass er eine verzögerte Auflösung und Resorption der Arzneimittelzubereitung im Gastrointesttnaltrakt bewirkt, so dass z.B. eine bessere Verträglichkeit, Protahierung oder Retardierung erreicht wird. Gelatinekapseln können den Arzneistoff vermischt mit einem festen, z.B. Caiciumcarbonat oder Kaolin, oder einem öligen, z.B. Oliven-, Erdnuss-, oder Paraffinöl,Tablets can contain inert diluents, for example calcium carbonate, calcium phosphate, sodium phosphate or lactose; Granulating and distributing agents, for example corn starch or alginates; Binders, e.g. starch, Gelatin or acacia; and lubricants, for example aluminum or magnesium stearate, talc or silicone oil. They can also be provided with a coating, which can also be designed in such a way that it causes a delayed dissolution and absorption of the pharmaceutical preparation in the gastrointestinal tract, so that, for example, better tolerance, protaction or retardation is achieved. Gelatin capsules can be mixed with a solid, for example calcium carbonate or kaolin, or an oily, for example olive, peanut or paraffin oil,
Verdünnungsmittel enthalten.Contain diluent.
Wässrige Suspensionen können Suspendiermittel, z.B.Aqueous suspensions can include suspending agents, e.g.
Natriumcarboxymethylcellulose, Methylcellulose, Hydroxypropylcellulose, Natriumalginat, Polyvinylpyrrolidon, Traganthgummi oder Akaziengummi; Dispergier- und Benetzungsmittel, z.B. Polyoxyethylenstearat, Heptadecaethylenoxycatanol, Polyoxyethylensorbitolmonooleat oder Lecithin; Konservierungsmittel, z.B. Methyl- oder Propylhydroxybenzoate; Geschmacksmittel; Süßungsmittel, z.B. Saccharose, Laktose, Natriumcyclamat, Dextrose, Invertzuckersirup, enthalten.Sodium carboxymethyl cellulose, methyl cellulose, hydroxypropyl cellulose, sodium alginate, polyvinyl pyrrolidone, tragacanth or acacia; Dispersing and wetting agents, e.g. Polyoxyethylene stearate, heptadecaethyleneoxycatanol, polyoxyethylene sorbitol monooleate or lecithin; Preservatives, e.g. Methyl or propyl hydroxybenzoates; Flavoring agents; Sweeteners, e.g. Sucrose, lactose, sodium cyclamate, dextrose, invert sugar syrup.
Ölige Suspensionen können z.B. Erdnuss-, Oliven-, Sesam-, Kokos- oder Paraffinöl und Verdickungsmittel, wie z.B. Bienenwachs, Hartparaffin oder Cetylalkohol, enthalten; ferner Süßungsmittel, Geschmacksmittel und Antioxidantien.Oily suspensions can e.g. Peanut, olive, sesame, coconut or paraffin oil and thickeners such as e.g. Beeswax, hard paraffin or cetyl alcohol; also sweeteners, flavoring agents and antioxidants.
In Wasser dispergierbare Pulver und Granulate können bei der erfindungsgemäßen Verwendung von HECNU in Mischung mit Dispergier-, Benetzungs- und Suspendiermitteln, z.B. den oben genannten, sowie mit Süßungsmitteln, Geschmacksmitteln und Farbstoffen enthalten.Water-dispersible powders and granules can be used in the use of HECNU in accordance with the invention in a mixture with dispersing, wetting and suspending agents, e.g. the above, as well as with sweeteners, flavorings and colorants.
Emulsionen können z.B. Oliven-, Erdnuss-, oder Paraffinöl neben Emulgiermitteln, wie z.B. Akaziengummi, Traganthgummi, Phosphatiden, Sorbitanmonooleat, Polyoxyethylensorbitanmonooleat, und Süßungs- und Geschmacksmittel enthalten.Emulsions can be, for example, olive, peanut or paraffin oil in addition to emulsifiers, such as, for example, acacia, tragacanth, phosphatides, sorbitan monooleate, polyoxyethylene sorbitan monooleate, and sweeteners and Contain flavoring.
Wässrige Lösungen können Konservierungsmittel, z.B. Methyl- oder Propylhydroxybenzoate; Verdickungsmittel; Geschmacksmittel;Aqueous solutions can contain preservatives, e.g. Methyl or propyl hydroxybenzoates; Thickener; Flavoring agents;
Süßungsmittel, z.B. Saccharose, Laktose, Natriumcyclamat, Dextrose, Invertzuckersirup, sowie Geschmacksmittel und Farbstoffe enthalten.Sweeteners, e.g. Contain sucrose, lactose, sodium cyclamate, dextrose, invert sugar syrup, as well as flavorings and colorings.
Zur parenteralen Anwendung der Arzneistoffe dienen steril injizierbare, wässrige Lösungen, isotonische Salzlösungen oder sonstige Lösungen.Sterile injectable, aqueous solutions, isotonic saline solutions or other solutions are used for parenteral use of the medicinal substances.
Die Erfindung wird nachstehend anhand von Beispielen erläutert.The invention is explained below using examples.
BeispieleExamples
Pankreaskarzinom:pancreatic cancer:
Klinische Studie:Clinical trial:
Phase II: 1/4 PR (44 W) + 1 MR (23 W)Phase II: 1/4 PR (44 W) + 1 MR (23 W)
In einer klinischen Phase II Studie konnte in einem von vier behandelten Patienten mit dem Pankreaskarzinom eine partielle Remission beobachtet werden. In einem weiteren Patienten wurde eine Minor Response festgestellt.In a phase II clinical study, partial remission was observed in one of four patients treated with pancreatic cancer become. A minor response was found in another patient.
Auch in In-vitro-Experimenten, die mit verschiedenen Pankreaslinien durchgeführt worden sind, wurden Hemmwirkungen im niedrigen μg/mL- Bereich festgestellt, wobei eine Hemmwirkung normalerweise schon bei einer HECNU-Konzentration von unter 10 μg/mL erreicht werden konnte.Inhibition effects in the low μg / mL range were also found in in-vitro experiments that were carried out with different pancreatic lines, whereby an inhibition effect could normally be achieved even at a HECNU concentration of less than 10 μg / mL.
Auch für Tumore des Halses und des Kopfes konnte in In-vitro- Experimenten eine Hemmwirkung erreicht werden.An inhibitory effect could also be achieved in tumors of the neck and head in in-vitro experiments.
Ferner wurde die Aktivität von HECNU in einer Reihe von sub-cutan implantierten humanen Tumor-Xenograftmodellβn in der Nacktmaus untersucht. An diesen humanen Xenograft-Tumormodellen in der Nacktmaus konnte in einem repräsentativen Spektrum von Tumoren gute bis sehr gute Hemmwirkung des Tumorwachstums festgestellt werden. Darunter waren Weichteilsarkome, Hodentumore, Thymome, Melanome, Mamma-Karzinome, Tumore der Lunge, Wilms Tumore und Nierenkarzinome. The activity of HECNU in a series of subcutaneously implanted human tumor xenograft models in the nude mouse was also examined. These human xenograft tumor models in the nude mouse showed good to very good inhibitory effects on tumor growth in a representative spectrum of tumors. These included soft tissue sarcomas, testicular tumors, thymomas, melanomas, breast carcinomas, tumors of the lungs, Wilms' tumors and kidney carcinomas.

Claims

Patentansprüche claims
1. Verwendung von 1-(2-Chlorethyl)-1-nitroso-3-(2-hydroxyethyl)-urea (HECNU) zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodentumoren, Lymphomen, Thymomen, Wilms Tumoren, Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- und Halsbereich, und Mamma-Karzinomen.1. Use of 1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl) urea (HECNU) for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast cancer.
2. Verwendung von HECNU zur Herstellung eines Arzneimittels zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodeπtumoren,2. Use of HECNU for the manufacture of a medicament for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors,
Lymphomen, Thymomen, Wilms Tumoren, Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- und Halsbereich, und Mamma-Karzinomen.Lymphomas, thymomas, Wilms' tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head and neck area, and breast carcinomas.
3. Verwendung nach Anspruch 1 oder 2, wobei HECNU zur Behandlung von Pankreaskarzinomen eingesetzt wird.3. Use according to claim 1 or 2, wherein HECNU is used for the treatment of pancreatic carcinomas.
4. Verwendung nach Anspruch 1 oder 2, wobei HECNU zur Behandlung von Lymphomen eingesetzt wird.4. Use according to claim 1 or 2, wherein HECNU is used for the treatment of lymphomas.
5. Verwendung nach Anspruch 1 oder 2, wobei HECNU zur Behandlung von Melanomen eingesetzt wird.5. Use according to claim 1 or 2, wherein HECNU is used for the treatment of melanoma.
6. Verwendung nach Anspruch 1 oder 2, wobei HECNU zur Behandlung von Hals- und Kopftumoren eingesetzt wird.6. Use according to claim 1 or 2, wherein HECNU is used for the treatment of neck and head tumors.
7. Verfahren zur therapeutischen und/oder prophylaktischen Behandlung eines Säugetiers, das einer Behandlung bedarf, durch Verabreichen von HECNU zur Behandlung von Pankreaskarzinomen, Weichteilsarkomen, Hodentumoren, Lymphomen, Thymomen, Wilms Tumoren, Nierenkarzinomen, Melanomen, Lungentumoren, intracerebralen Metastasen, Tumoren im Kopf- und Halsbereϊch, und Mamma-Karzinomen. 7. A method for the therapeutic and / or prophylactic treatment of a mammal in need of treatment by administering HECNU for the treatment of pancreatic carcinoma, soft tissue sarcoma, testicular tumors, lymphomas, thymomas, Wilms tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in the head - and neck area, and breast cancer.
EP04714277A 2003-02-25 2004-02-25 Use of 1-(2-chloroethyl)-1-nitroso-3-(2-hydroxyethyl)-urea for the treatment of pancreatic cancer, soft-tissue sarcoma, testicular tumors, lymphoma, thymoma, wilm's tumors, renal carcinoma, melanoma, lung cancer, intracerebral metastasis, tumors in the head and neck region, and mammary carcinoma Withdrawn EP1596848A1 (en)

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DE10307928A DE10307928A1 (en) 2003-02-25 2003-02-25 Use of 1- (2-chloroethyl) -1-nitroso-3- (2-hydroxyethyl) urea for the treatment of pancreatic carcinomas, soft tissue sarcomas, testicular tumors, lymphomas, thymomas, Wilms tumors, kidney carcinomas, melanomas, lung tumors, intracerebral metastases, tumors in Head and neck area, and breast cancer
PCT/EP2004/001875 WO2004075887A1 (en) 2003-02-25 2004-02-25 Use of 1-(2-chloroethyl)-1-nitroso-3-(2-hydroxyethyl)-urea for the treatment of pancreatic cancer, soft-tissue sarcoma, testicular tumors, lymphoma, thymoma, wilm's tumors, renal carcinoma, melanoma, lung cancer, intracerebral metastasis, tumors in the head and neck region, and mammary carcinoma

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