TW201815392A - 用於癌症治療之考比西他 (cobicistat) - Google Patents
用於癌症治療之考比西他 (cobicistat) Download PDFInfo
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- TW201815392A TW201815392A TW106126377A TW106126377A TW201815392A TW 201815392 A TW201815392 A TW 201815392A TW 106126377 A TW106126377 A TW 106126377A TW 106126377 A TW106126377 A TW 106126377A TW 201815392 A TW201815392 A TW 201815392A
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- cancer
- anticancer agent
- protein
- inhibitors
- receptor
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Abstract
本發明描述用於藉由共同投與考比西他(cobicistat)與抗癌劑來治療患有表現CYP3A酶之癌症患者之方法及組合物。
Description
本文描述用於藉由共同投與選擇性CYP3A抑制劑與抗癌劑來治療患有表現CPY3A酶之癌症的患者之方法及用途。
考比西他(cobicistat)係用於治療HIV之組合治療中之CYP3A抑制劑。考比西他描述於WO 2008/010921中,該文獻以引用之方式併入本文中。因為對抗癌劑缺乏敏感性的患者之數目逐漸增長,所以需要可增強現有治療之功效的治療方案。
本發明之一個實施例提供一種治療患有癌症的患者之方法,其包含投與考比西他及抗癌劑。在一特定實施例中,癌症及/或抗癌劑描述如下。 另一實施例提供一種用於治療患有癌症的患者之方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,癌症包含表現CYP3A酶的細胞,且在投與考比西他之後細胞中抗癌劑之濃度增加。在另一實施例中,癌症包含過度表現CYP3A酶之細胞。 另一實施例提供一種用於增強抗癌劑在患有癌症的患者中之作用之方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,癌症包含表現CYP3A酶的細胞,且在投與考比西他之後細胞中抗癌劑之作用增大。在另一實施例中,癌症包含過度表現CYP3A酶之細胞。 另一實施例提供一種用於降低抗癌劑在患有癌症的患者中之代謝方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,癌症包含表現CYP3A酶之細胞,且在投與考比西他之後細胞中抗癌劑之代謝降低。在另一實施例中,癌症包含過度表現CYP3A酶之細胞。 本發明之另一實施例提供一種用於提高患有癌症的患者對抗癌劑之敏感性之方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,考比西他提高對抗癌劑之敏感性。 另一實施例提供一種醫藥組合物,其包含(a)抗癌劑;(b)考比西他;及(c)載劑。
以下定義用於整個本說明書中: 「抗癌劑」係指能夠治療或預防癌症之藥劑。下文提供供本文使用之一系列抗癌劑。應理解,提及「抗癌劑」包括一或多種不同抗癌劑。 「考比西他」係指1,3-噻唑-5-基甲基(2R,5R)-(5-{[(2S)-2-[甲基{2-(丙-2-基)-1,3-噻唑-4-基]甲基}胺甲醯基)胺基]]-4-(嗎啉-4-基)丁醯胺基}-1,6-二苯基丁-2-基)胺甲酸酯)且已展示為CYP3A酶、CYP3A4及CYP3A5之基於機制的抑制劑,具有比利托那韋(ritonavir)更大的特異性。Xu等人,ACS Med. Chem. Lett. (2010), 1,第209-13頁。考比西他之結構顯示如下,如式Ia:如本文所使用,術語「共同投與」係指在彼此24小時週期內投與兩種或更多種藥劑,例如,作為臨床治療方案之一部分。在其他實施例中,「共同投與」係指在彼此2小時內投與兩種或更多種藥劑。在其他實施例中,「共同投與」係指在彼此30分鐘內投與兩種或更多種藥劑。在其他實施例中,「共同投與」係指在彼此之15分鐘內投與兩種或更多種藥劑。在其他實施例中,「共同投與」係指作為單個調配物之一部分或作為藉由相同或不同途徑投與之多個調配物同時投與。 「IC95
」或「EC95
」係指達成95%之最大期望作用所需之抑制濃度,在抗癌劑之情況下其係抑制與目標癌症相關之癌細胞株或酶(例如激酶活性)。此值使用評估表現目標或重組蛋白(例如激酶)之癌細胞株之濃度依賴型抑制之活體外分析而獲得。 「使對抗癌劑之敏感性增加X倍」係指相比於在無考比西他存在下投與抗癌劑之情況,考比西他成X倍地提高抗癌劑之期望作用之能力(例如IC50
或其他功效度量)。較佳地,「X倍」係2倍、或1.5倍、或3倍、或甚至5倍。 如本文所使用,「TI」或「治療指數」係指用於未增強治療之中值有效劑量(ED50 - U
)與當與考比西他共同投與時抗癌劑之中值有效劑量(ED50 - cobi
)之間的比率。因此,展現1或更小之TI的藥物不得益於考比西他共同投與。本文所提供之給藥方案為抗癌劑提供大於1之TI。 如本文所使用,CYP3A酶(例如CYP3A4及/或CY3A5)之「過度表現」係指相比於在正常組織或正常細胞株中,在腫瘤或癌症細胞株中特定CYP3A酶以較大表現量表現。各種細胞株之表現概況描繪於圖1及圖2中。過度表現可經由細胞株之生檢/測試來測定,以相比於細胞株之已知標準表現量(例如於圖1及圖2中所反映的及此項技術中已知的彼等)來測定表現量。應理解,過度表現(overexpression/overexpressing)涵蓋於表現(expression/expressing)。如本文所使用,表現(expression/expressing) CYP3A表示CYP3A存在於細胞中,CYP3A可藉由考比西他抑制。 「治療有效量」係指將預防病狀或將在一定程度上緩解經治療病症之一或多個症狀的所投與化合物之量。適用於本文中之醫藥組合物包括活性成分含量足以達成所欲目的之組合物。治療有效量之確定完全在熟習此項技術者之能力範圍內,尤其根據本文中所提供之詳細揭示內容來確定。如本文所使用,治療係指疾病之抑制、減輕、消除或緩解以及預防。 本發明亦提供一種用於治療或預防疾病、病症及病狀之方法。疾病、病症或病狀之實例包括(但不限於)癌症或與癌症相關之疾病、病症或病狀。 活性劑,包括考比西他及/或抗癌劑,可以任何習知方式投與人類。雖然活性劑可以化合物形式投與,但其較佳以醫藥組合物投與。鹽、載劑或稀釋劑應在與其他成分相容且對其接受者無害之意義上可接受。用於經口投與之載劑或稀釋劑之實例包括:玉米澱粉、乳糖、硬脂酸鎂、滑石、微晶纖維素、硬脂酸、普維酮、交聯普維酮、磷酸氫二鈣、羥基乙酸澱粉鈉、羥基丙基纖維素(例如低取代羥基丙基纖維素)、羥丙基甲基纖維素(例如羥丙基甲基纖維素2910)及月桂基硫酸鈉。 醫藥組合物可藉由任何適合方法製備,諸如藥學領域中熟知之方法,例如描述於Gennaro
等人,Remington's Pharmaceutical Sciences (第18版,Mack Publishing Co., 1990),尤其第8部分:Pharmaceutical Preparations and their Manufacture中之方法。此類方法包括使化合物與載劑或稀釋劑及視情況一或多種附加成分引入組合之步驟。此類附加成分包括本領域中習知之成分,諸如填充劑、結合劑、賦形劑、崩解劑、潤滑劑、著色劑、調味劑、甜味劑、防腐劑(例如抗微生物防腐劑)、懸浮劑、增稠劑、乳化劑及/或潤濕劑。 實際上,欲投與之各化合物(例如本文所描述之化合物)之量在每公斤體重約0.001至100 mg範圍內,此總劑量一次性給藥或分次給藥。各化合物可單獨投與或與一或多種其他藥物(例如本文所揭示之化合物及組合)組合投與。較佳地,考比西他以150 mg每天一次(QD)投與。一般而言,各化合物將以調配物與一或多種醫藥學上可接受之賦形劑聯合投與。賦形劑之選擇在很大程度上將視諸如特定投藥模式、賦形劑對溶解性及穩定性之影響及劑型性質的因素而定。 適用於遞送本文所描述之化合物及其製備方法之醫藥組合物對熟習此項技術者將顯而易見。此類組合物及其製備方法可見於例如Remington ' s Pharmaceutical Sciences
,第19版(Mack Publishing Company, 1995)。抗癌劑 :
如本文所描述,將考比西他與一或多種抗癌劑使用或組合,抗癌劑包括:化學治療劑、抗癌劑、抗血管生成劑、抗纖維化劑、免疫治療劑、治療性抗體、雙特異性抗體及「抗體樣」治療蛋白(諸如DARTs®、Duobodies®、Bites®、XmAbs®、TandAbs®、Fab衍生物)、抗體-藥物結合物(antibody-drug conjugate;ADC)、放射線治療劑、抗腫瘤劑、抗增生劑、溶瘤病毒、諸如CRISPR (包括CRISPR Cas9)之基因修飾劑或編輯劑、鋅指核酸酶或合成核酸酶(TALEN)、嵌合抗原受體(chimeric antigen receptor;CAR) T細胞免疫治療劑或其任何組合。此等抗癌劑可呈化合物、抗體、多肽或多核苷酸之形式。在一個實施例中,本申請案提供包含考比西他及額外抗癌劑之產物作為組合製劑同時、分別或依序用於治療,例如治療由PI3K同功異型物介導之疾病、病症或病狀之方法。 應理解,抗癌劑之描述中無一者包括考比西他自身。 舉例而言,抗癌劑尤其包括以下中之任一者:5-氟尿嘧啶、阿法替尼(afatinib)、阿普利定(aplidin)、阿紮立平(azaribine)、阿那曲唑(anastrozole)、蒽環黴素、阿西替尼(axitinib)、AVL-101、AVL-291、苯達莫司汀(bendamustine)、博萊黴素(bleomycin)、硼替佐米(bortezomib)、伯舒替尼(bosutinib)、苔蘚抑素-1 (bryostatin-1)、白消安(busulfan)、刺孢黴素(calicheamycin)、喜樹鹼(camptothecin)、卡鉑(carboplatin)、10-羥基喜樹鹼、卡莫司汀(carmustine)、塞來昔布(celecoxib)、氯芥苯丁酸(chlorambucil)、順鉑、COX-2抑制劑、伊立替康(irinotecan)(CPT-11)、SN-38、卡鉑(carboplatin)、克拉屈濱(cladribine)、喜樹鹼衍生物(camptothecans)、克唑替尼(crizotinib)、環磷醯胺、阿糖胞苷、達卡巴嗪(dacarbazine)、達沙替尼(dasatinib)、戴那西里(dinaciclib)、多西他賽(docetaxel)、放線菌素D (dactinomycin)、道諾黴素(daunorubicin)、DM1、DM3、DM4、小紅莓(doxorubicin)、2-吡咯啉小紅莓(2-PDox)、2-PDox之前藥形式(前-2-PDox)、氰基-N-嗎啉基小紅莓、小紅莓葡萄糖醛酸苷、內皮抑制素、表柔比星葡萄糖醛酸苷(epirubicin glucuronide)、埃羅替尼(erlotinib)、雌莫司汀(estramustine)、表葉毒素(epidophyllotoxin)、埃羅替尼、恩替諾他(entinostat)、雌激素受體結合劑、依託泊苷(etoposide)(VP16)、依託泊苷葡萄糖醛酸苷、磷酸依託泊苷、依西美坦(exemestane)、芬戈莫德(fingolimod)、氟尿苷(floxuridine)(FUdR)、3′,5′-O-二油醯基-FudR (FUdR-dO)、氟達拉濱(fludarabine)、氟他胺(flutamide)、法呢基-蛋白轉移抑制劑(farnesyl-protein transferase inhibitors)、夫拉平度(flavopiridol)、福他替尼(fostamatinib)、加利特皮(ganetespib)、GDC-0834、GS-1101、吉非替尼(gefitinib)、吉西他濱(gemcitabine)、羥基脲(hydroxyurea)、依魯替尼(ibrutinib)、艾達黴素(idarubicin)、艾代拉里斯(idelalisib)、異環磷醯胺、伊馬替尼(imatinib)、拉帕替尼(lapatinib)、來那度胺(lenolidamide)、甲醯四氫葉酸(leucovorin)、LFM-A13、洛莫司汀(lomustine)、氮芥、美法侖(melphalan)、巰嘌呤、6-巰嘌呤、甲胺喋呤(methotrexate)、米托蒽醌(mitoxantrone)、光神黴素(mithramycin)、絲裂黴素(mitomycin)、米托坦(mitotane)、單甲基阿瑞他汀F (monomethylauristatin F)(MMAF)、單甲基阿瑞他汀D (MMAD)、單甲基阿瑞他汀E (MMAE)、溫諾平(navelbine)、來那替尼(neratinib)、尼羅替尼(nilotinib)、亞硝基脲、奧拉帕尼(olaparib)、普卡黴素(plicomycin)、丙卡巴肼(procarbazine)、太平洋紫杉醇(paclitaxel)、PCI-32765、噴司他汀(pentostatin)、PSI-341、雷諾昔芬(raloxifene)、司莫司汀(semustine)、SN-38、索拉非尼(sorafenib)、鏈脲菌素(streptozocin)、SU11248、舒尼替尼(sunitinib)、他莫昔芬(tamoxifen)、替莫唑胺(temazolomide)、反鉑、沙立度胺(thalidomide)、硫鳥嘌呤、噻替派(thiotepa)、替尼泊苷(teniposide)、拓朴替康(topotecan)、尿嘧啶氮芥(uracil mustard)、瓦他拉尼(vatalanib)、長春瑞賓(vinorelbine)、長春鹼(vinblastine)、長春新鹼(vincristine)、長春花生物鹼及ZD1839或其醫藥學上可接受之鹽。下文進一步論述額外藥劑及分組。靶向物
抗癌劑包括(但不限於)抑制劑、促效劑、拮抗劑、配位體、調節劑、刺激物、阻斷劑、基因、配位體、受體、蛋白之活化因子或抑制因子,諸如: 腺苷受體(諸如A2B、A2a、A3)、阿貝爾森鼠白血病病毒(Abelson murine leukemia viral)致癌基因同源物1基因(ABL,諸如ABL1)、乙醯基-CoA羧化酶(諸如ACC1/2)、促腎上腺皮質激素受體(ACTH)、活化CDC激酶(ACK,諸如ACK1)、腺苷脫胺酶、腺苷酸環化酶、ADP核糖基環化酶-1、氣溶素(Aerolysin)、血管收縮素原(AGT)基因、鼠胸腺瘤病毒(murine thymoma viral)致癌基因同源物1 (AKT)蛋白激酶(諸如AKT1、AKT2、AKT3)、AKT1基因、鹼性磷酸酯酶、α1腎上腺素受體、α2腎上腺素受體、α酮戊二酸去氫酶(KGDH)、胺基肽酶N、精胺酸脫亞胺酶、β腎上腺素受體、退行性淋巴瘤激酶受體、退行性淋巴瘤激酶(ALK,諸如ALK1)、Alk-5蛋白激酶、AMP活化蛋白激酶、雄激素受體、血管生成素(諸如配位體-1、配位體-2)、脂蛋白元A-I (APOA1)基因、細胞凋亡信號調節激酶(ASK,諸如ASK1)、細胞凋亡誘導因子、細胞凋亡蛋白(諸如1、2)、精胺酸酶(I)、天冬醯胺酶、星狀同源物1(ASTE1)基因、共濟失調毛細血管擴張症及Rad 3相關的(ATR)絲胺酸/蘇胺酸蛋白激酶、Axl酪胺酸激酶受體、芳香酶、極光蛋白激酶(諸如1、2)、基礎免疫球蛋白(Basigin)、斷點團簇區域(BCR)蛋白及基因、B細胞淋巴瘤2 (BCL2)基因、Bcl2蛋白、Bcl2結合組分3、BCL2L11基因、桿狀病毒IAP重複蛋白5 (Baculoviral IAP repeat containing 5;BIRC5)基因、B-Raf原癌基因(BRAF)、Brc-Abl酪胺酸激酶、β鏈蛋白、B淋巴細胞抗原CD19、B淋巴細胞抗原CD20、B淋巴細胞刺激物配位體、B淋巴細胞細胞黏著分子、骨成形性蛋白-10配位體、骨成形性蛋白-9配位體調節劑、短尾畸型(Brachyury)蛋白、緩激肽受體、布魯東氏(Bruton's)酪胺酸激酶(BTK)、含有溴域(Bromodomain)及外部域(BET)溴域的蛋白(諸如BRD2、BRD3、BRD4)、調鈣蛋白、調鈣蛋白依賴型蛋白激酶(CaMK,諸如CAMKII)、癌症睪丸抗原2、癌症睪丸抗原NY-ESO-1、大麻素受體(諸如CB1、CB2)、碳酸酐酶、半胱天冬酶8細胞凋亡相關半胱胺酸肽酶CASP8-類FADD調控因子、半胱天冬酶(諸如半胱天冬酶-3、半胱天冬酶-7、半胱天冬酶-9)、半胱天冬酶補充域蛋白-15、組織蛋白酶G、趨化細胞素(C-C模體)受體(諸如CCR2、CCR4、CCR5)、CCR5基因、趨化細胞素CC21配位體、分化團簇(CD),諸如CD4、CD27、CD29、CD30、CD33、CD37、CD40、CD40配位體受體、CD40配位體、CD40LG基因、CD44、CD45、CD47、CD49b、CD51、CD52、CD55、CD58、CD66e、CD70基因、CD74、CD79、CD79b、CD79B基因、CD80、CD95、CD99、CD117、CD122、CDw123、CD134、CDw137、CD158a、CD158b1、CD158b2、CD223、CD276抗原;絨毛膜促性腺素、週期蛋白G1、週期蛋白D1、週期蛋白依賴型激酶(CDK,諸如CDK1、CDK1B、CDK2-9)、酪蛋白激酶(CK,諸如CKI、CKII)、c-Kit (酪胺酸蛋白激酶Kit或CD117)、c-Met (肝細胞生長因子受體(HGFR))、 CDK活化激酶(CAK)、核查點激酶(諸如CHK1、CHK2)、膽囊收縮素CCK2受體、密連蛋白(諸如6、18)、群集素、互補序列C3、COP9信號體子單元5、群落刺激因子1受體(CSF-1)、CSF2基因、群集素(CLU)基因、結締組織生長因子、環加氧酶(諸如1、2)、癌症/睪丸抗原1B (CTAG1)基因、細胞毒性T淋巴細胞蛋白4 (CTLA-4)受體、CYP2B1基因、半胱胺酸棕櫚醯基轉移酶豪豬、細胞介素傳信-1、細胞介素傳信-3、細胞色素P450 11B2、細胞色素P450還原酶、細胞色素P450 3A4、細胞色素P450 17A1、細胞色素P450 17、細胞色素P450 2D6,(只要抗癌或細胞色素修飾劑係除考比西他之外的某物),細胞質異檸檬酸去氫酶、胞嘧啶脫胺酶、胞嘧啶DNA甲基轉移酶、細胞毒性T淋巴細胞蛋白-4、趨化細胞素(C-X-C模體)受體(諸如CXCR4、CXCR1及CXCR2)、δ樣蛋白配位體(諸如3、4)、去氧核糖核酸酶、Dickkopf-1配位體、二氫嘧啶去氫酶、DNA結合蛋白(諸如HU-β)、DNA依賴型蛋白激酶、DNA旋轉酶、DNA甲基轉移酶、DNA聚合酶(諸如α)、DNA導引酶、盤狀域受體(discoidin domain receptor;DDR,諸如DDR1)、DDR2基因、二氫葉酸還原酶(DHFR)、二肽基肽酶IV、L-多巴色素互變異構酶、dUTP焦磷酸酶、類棘皮動物微管蛋白4、表皮生長因子受體(EGFR)基因、EGFR酪胺酸激酶受體、真核轉譯啟動因子5A (EIF5A)基因、彈性蛋白酶、延長因子1 α2、延長因子2、內皮因子、核酸內切酶、內質蛋白(Endoplasmin)、內皮唾酸蛋白(Endosialin)、內皮抑制素、內皮素(諸如ET-A、ET-B)、栽斯特(zeste)同源物2之強化子(EZH2)、表皮生長因子、表皮生長因子受體(EGFR)、上皮細胞黏著分子(EpCAM)、蝶素(Ephrin;EPH)酪胺酸激酶(諸如Epha3、Ephb4)、蝶素B2配位體、後生因子(Epigen)、Erb-b2 (v-erb-b2;鳥有核紅血球白血病病毒致癌基因同源物2)酪胺酸激酶受體、Erb-b3酪胺酸激酶受體、Erb-b4酪胺酸激酶受體、胞外信號調節的激酶(ERK)、 E選擇蛋白、雌二醇17 β去氫酶、雌激素受體(諸如α、β)、雌激素相關受體、外輸蛋白1、胞外信號相關激酶(諸如1、2)、因子(諸如Xa、VIIa)、Fas配位體、脂肪酸合成酶、鐵蛋白局部黏著斑激酶(FAK,諸如FAK2)、纖維母細胞生長因子(FGF,諸如FGF1、FGF2、FGF4)、FGF-2配位體、FGF-5配位體、纖維結合蛋白、Fms-相關酪胺酸激酶3 (Flt3)、法尼酯x受體(farnesoid x receptor;FXR)、葉酸、葉酸轉運子1、葉酸受體(諸如α)、葉酸水解酶前列腺特異膜抗原1 (FOLH1)、成對鹼性胺基酸分裂酶(FURIN)、FYN酪胺酸激酶、半乳糖苷基轉移酶、半乳糖凝集素-3、糖皮質激素誘發之TNFR相關蛋白GITR受體、糖皮質激素、β葡糖苷酸酶、麩胺酸羧肽酶II、麩醯胺酸酶、麩胱甘肽S-轉移酶P、磷脂醯肌醇蛋白聚糖3 (Glypican 3;GPC3)、肝糖合成酶激酶(glycogen synthase kinase;GSK,諸如3-β)、粒細胞群落刺激因子(GCSF)配位體、粒細胞巨噬細胞群落刺激因子(GM-CSF)受體、促性腺激素釋放激素(GNRH)、生長因子受體結合蛋白2 (GRB2)、分子伴隨蛋白groEL2基因、Grp78 (78 kDa葡萄糖調節蛋白)鈣結合蛋白、印記母系表現的轉錄(Imprinted Maternally Expressed Transcript)(H19)基因、熱穩定腸毒素受體、肝素酶、肝細胞生長因子、熱休克蛋白基因、熱休克蛋白(諸如27、70、90 α、β)、豪豬蛋白、HERV-H LTR關聯蛋白2、己醣激酶、酪胺酸蛋白激酶HCK、組胺H2受體、組蛋白去乙醯酶(HDAC,諸如1、2、3、6、10、11)、組蛋白H1、組蛋白H3、組蛋白甲基轉移酶(DOT1L)、人類白血球抗原(HLA)、HLA I級抗原(A-2α)、HLA II級抗原、同源匣蛋白質NANOG、促分裂原活化蛋白激酶激酶激酶激酶1 (MAP4K1,HPK1)、HSPB1基因、人類乳頭狀瘤病毒(諸如E6、E7)蛋白、玻尿酸酶、玻尿酸、低氧誘導性因子-1 α、細胞間黏著分子1 (ICAM-1)、免疫球蛋白(諸如G、G1、G2、 K、M)、吲哚胺2,3-二加氧酶(IDO,諸如IDO1)、吲哚胺吡咯2,3-二加氧酶1抑制劑、I-κ-B激酶(IKK,諸如IKKβe)、免疫球蛋白Fc受體、免疫球蛋白γ Fc受體(諸如I、III、IIIA)、介白素1配位體、介白素2配位體、介白素-2、IL-2基因、IL-1 α、IL-1 β、IL-2、IL-2受體α子單元、IL-3受體、IL-4、IL-6、IL-7、IL-8、IL-12、IL-15、IL-12基因、IL-17、介白素13受體α2、介白素-29配位體、介白素-1受體相關激酶4 (IRAK4)、類胰島素生長因子(諸如1、2)、胰島素受體、整合素α-V/β-3、整合素α-V/β-5、整合素α-V/β-6、整合素α-5/β-1、整合素α-4/β-1、整合素α-4/β-7、干擾素誘導性蛋白缺乏黑素瘤2 (AIM2)、干擾素(諸如α、α2、βγ)、干擾素I型受體、異檸檬酸去氫酶(諸如IDH1、IDH2)、Janus激酶(JAK、諸如JAK1、JAK2)、Jun N末端激酶、激酶插入域受體(Kinase insert domain receptor;KDR)、類殺手細胞Ig受體、親吻肽(Kisspeptin) (KiSS-1)受體、v-kit Hardy-Zuckerman 4貓科肉瘤病毒致癌基因同源物(KIT)酪胺酸激酶、KIT基因、類驅動蛋白蛋白KIF11、激肽釋放酶相關肽酶3 (KLK3)基因、Kirsten大鼠肉瘤病毒致癌基因同源物(KRAS)基因、乳鐵蛋白、淋巴細胞活化基因3蛋白(LAG-3)、溶酶體相關膜蛋白家族(LAMP)基因、羊毛甾醇-14去甲基酶、LDL受體相關蛋白-1、白三烯A4水解酶、李斯特菌溶胞素(Listeriolysin)、L-選擇蛋白、促黃體激素受體、解離酶淋巴細胞抗原75、離胺酸去甲基酶(諸如KDM1、KDM2、KDM4、KDM5、KDM6、A/B/C/D)、淋巴細胞功能抗原-3受體、淋巴細胞特異蛋白酪胺酸激酶(LCK)、淋巴細胞趨化因子、Lyn (Lck/Yes新式)酪胺酸激酶、溶血磷脂酸-1 (Lysophosphatidate-1)受體、離胺醯氧化酶蛋白(LOX)、類離胺醯氧化酶蛋白(LOXL,諸如LOXL2)、離胺醯氧化酶同源物2、巨噬細胞遷移抑制因子、黑素瘤抗原家族A3 (MAGEA3)基因、MAGEC1基因、MAGEC2基因、穹窿體主蛋白(Major vault protein)、醯胺化丙胺酸豐富蛋白激酶C受質(myristoylated alanine-rich protein kinase C substrate;MARCKS)蛋白、Melan-A (MART-1)黑素瘤抗原、Mas相關G-蛋白偶合受體、基質金屬蛋白酶(MMP,諸如MMP2、MMP9)、骨髓細胞白血病1 (MCL1)基因、Mcl-1分化蛋白、巨噬細胞群落刺激因子(MCSF)配位體、黑素瘤相關抗原(諸如1、2、3、6)、黑色素細胞刺激激素配位體、黑色素細胞蛋白Pmel 17、膜銅胺氧化酶、間皮素、代謝型麩胺酸受體1、促分裂原活化蛋白激酶(MEK,諸如MEK1、MEK2)、肝細胞生長因子受體(
MET)基因、MET酪胺酸激酶、甲硫胺酸胺基肽酶-2、促分裂原激活蛋白激酶(MAPK)、Mdm2 p53-結合蛋白、Mdm4蛋白、金屬還原酶STEAP1 (前列腺六跨膜上皮抗原1)、轉移抑素、甲基轉移酶、粒線體3酮脂醯CoA硫解酶、MAPK活化蛋白激酶(諸如MK2)、 mTOR (雷帕黴素(rapamycin)之機制目標(絲胺酸/蘇胺酸激酶)、mTOR複合物(諸如1、2)、黏蛋白(諸如1、5A、16)、mut T同源物(MTH,諸如MTH1)、Myc原癌基因蛋白、NAD ADP核糖基轉移酶、利尿鈉肽受體C、神經細胞黏著分子1、神經激肽受體、神經纖毛蛋白2 (Neuropilin 2)、氧化氮合成酶、核因子(NF) κ B、NF κ B激活蛋白、神經激肽1 (NK1)受體、NK細胞受體、NK3受體、NKG2 A B激活NK受體、NIMA相關激酶9 (NEK9)、去甲腎上腺素轉運子、Notch (諸如Notch-2受體、Notch-3受體)、核仁磷酸蛋白退行性淋巴瘤激酶(NPM-ALK)、 2,5-寡腺苷酸合成酶、核紅細胞系2-相關因子2、核仁素、核仁磷酸蛋白、鄰甲基鳥嘌呤DNA甲基轉移酶、鳥胺酸去羧酶、乳清酸磷酸核糖轉移酶、孤核激素受體NR4A1、類鴉片受體(諸如δ)、骨鈣化素、破骨細胞分化因子、骨橋蛋白、OX-40 (腫瘤壞死因子受體超家族成員4 TNFRSF4、或CD134)受體、2酮戊二酸去氫酶、嘌呤型受體P2X配位體選通的離子通道7 (P2X7)、副甲狀腺激素配位體、p53腫瘤抑制因子蛋白、P3蛋白、計劃性細胞死亡1 (PD-1)、原癌基因絲胺酸/蘇胺酸蛋白激酶(PIM,諸如PIM-1、PIM-2、PIM-3)、多ADP核糖聚合酶(PARP、諸如PARP1、2及3)、p38激酶、p38 MAP激酶、血小板衍生生長因子(PDGF,諸如α、β)、P-糖蛋白(諸如1)、血小板衍生生長因子(PDGF,諸如α、β)、PKN3基因、P-選擇蛋白、磷脂醯肌醇3-激酶(PI3K)、肌醇磷脂3-激酶(PI3K,諸如α、δ、γ)、磷酸化酶激酶(PK)、胎盤生長因數、多效性抗藥性轉運子、叢蛋白B1、類Polo激酶1、過氧化體增殖物活化受體(PPAR,諸如α、δ、γ)、黑素瘤中優先表現抗原(PRAME)基因、可能轉錄因子PML、計劃性細胞死亡配位體1抑制劑(PD-L1)、黃體酮受體、前列腺特異性抗原、前列腺酸磷酸酯酶、前列腺素受體(EP4)、蛋白酶體、蛋白法呢基轉移酶、蛋白激酶(PK,諸如A、B、C)、蛋白E7、蛋白酪胺酸激酶、蛋白酪胺酸磷酸酯酶β、類polo激酶(PLK)、PLK1基因、戊烯基結合蛋白(PrPB)、原卟啉原氧化酶、saposin前體(PSAP)基因、磷酸酯酶及張力蛋白同源物(PTEN)、嘌呤核苷磷酸化酶、丙酮酸激酶(PYK)、丙酮酸去氫酶(PDH)、丙酮酸去氫酶激酶、Raf蛋白激酶(諸如1、B)、RAF1基因、Ras GTP酶、Ras基因、5-α還原酶、RET基因、Ret酪胺酸激酶受體、視網膜胚細胞瘤相關蛋白、視黃酸受體(諸如γ)、類視色素X受體、Rheb(大腦中富集的Ras同源物) GTP酶、Pho (Ras同源物)相關蛋白激酶2、核糖核酸酶、核糖核苷酸還原酶(諸如M2子單元)、 核糖體蛋白S6激酶、核糖核酸聚合酶(諸如I、II)、Ron (Recepteur d'Origine Nantais)酪胺酸激酶、ROS1 (ROS原癌基因1,受體酪胺酸激酶)基因、Ros1酪胺酸激酶、Runt相關轉錄因子3、S100鈣結合蛋白A9、Sarco內質網鈣ATP酶、γ分泌酶、分泌性捲曲相關蛋白-2、信號蛋白-4D、SL細胞介素配位體、絲胺酸蛋白酶、傳信淋巴細胞性活化分子 (
SLAM)家族成員7、脾酪胺酸激酶(SYK)、Src酪胺酸激酶、腫瘤進展基因座2 (TPL2)、絲胺酸/蘇胺酸激酶(STK)、信號轉導及轉錄(STAT,諸如STAT-1、STAT-3、STAT-5)、半胱天冬酶之第二粒線體衍生活化因子(SMAC)蛋白、平滑(SMO)受體、磷酸鈉共轉運體2B、碘化鈉共轉運體、生長抑素受體(諸如1、2、3、4、5)、音蝟因子蛋白(Sonic hedgehog protein)、特異蛋白1 (Sp1)轉錄因子、神經鞘磷脂合成酶、神經鞘胺醇-1-磷酸受體-1、神經鞘胺醇激酶(諸如1、2)、SRC基因、STAT3基因、前列腺之六跨膜上皮抗原(STEAP)基因、類固醇硫酸酯酶、干擾素基因刺激物蛋白、干擾素基因刺激物(STING)受體、基質細胞衍生因子1配位體、SUMO (類小泛素修飾因子)、超氧化歧化酶、存活素蛋白、突觸蛋白3、多配體蛋白聚糖-1、突觸核蛋白α、絲胺酸/蘇胺酸蛋白激酶(TBK,諸如TBK1)、TATA匣結合蛋白相關因子核糖核酸聚合酶I子單元B(
TAF1B)基因、T細胞表面糖蛋白CD8、T細胞CD3糖蛋白ζ鏈、T細胞分化抗原CD6、T細胞表面糖蛋白CD28、Tec蛋白酪胺酸激酶、Tek酪胺酸激酶受體、端粒酶、肌腱蛋白、端粒酶逆轉錄酶(TERT)基因、轉形生長因子(TGF,諸如β)激酶、TGF β2配位體、含有T細胞免疫球蛋白及黏蛋白域的-3(
TIM-3)、組織因子、腫瘤壞死因子(TNF,諸如α、β)、TNF相關細胞凋亡誘導配位體、TNFR1相關死亡域蛋白、TNFSF9基因、TNFSF11基因、滋胚層糖蛋白(TPBG)基因、運鐵蛋白、肌旋蛋白受體激酶、(Trk)受體(諸如TrkA、TrkB、TrkC)、滋胚層糖蛋白、胸苷酸合成酶、具有類免疫球蛋白及類EGF域的酪胺酸激酶(TIE)受體、鐸樣(Toll-like)受體(TLR諸如1-13)、拓樸異構酶(諸如I、II、III)、腫瘤蛋白53 (TP53)基因、轉錄因子、轉移酶、轉形生長因子TGF-β受體激酶、轉麩胺醯胺酶、位移相關蛋白、跨膜糖蛋白NMB、腫瘤壞死因子13C受體、胸苷激酶、胸苷磷酸化酶、胸苷酸合成酶、胸腺素(諸如α1)、甲狀腺激素受體、Trop-2鈣信號轉導子、促甲狀腺激素受體、色胺酸5-羥化酶、酪胺酸酶、酪胺酸激酶(TK)、酪胺酸激酶受體、酪胺酸蛋白激酶ABL1抑制劑、槽結合激酶(TBK)、血小板生成素受體、TNF相關細胞凋亡誘導配位體(TRAIL)受體、微管蛋白、腫瘤抑制因子候選物2 (TUSC2)基因酪胺酸羥化酶、泛素結合酶E2I (UBE2I、UBC9)、泛素、泛素羧基水解酶同功酶L5、泛素硫酯酶14、脲酶、尿激酶纖維蛋白溶酶原活化物、Uteroglobin、香草素VR1、血管細胞黏著蛋白1、血管內皮生長因子受體(VEGFR)、T細胞活化之V域Ig抑制因子(VISTA)、VEGF-1受體、VEGF-2受體、VEGF-3受體、VEGF-A、VEGF-B、波形蛋白、維生素D3受體、原癌基因酪胺酸蛋白激酶Yes、Wee-1蛋白激酶、威爾姆斯氏(Wilms')腫瘤蛋白、威爾姆斯氏腫瘤抗原1、細胞凋亡蛋白之連接X的抑制子、鋅指蛋白轉錄因子或其任何組合。 如本文中所用,術語「化學治療劑」或「化學治療」(或在用化學治療劑治療之情況下之「化學療法」)意欲涵蓋適用於治療癌症之任何非蛋白質(亦即非肽)化合物。作用機制
抗癌劑包括由其作用機制或類別界定之藥劑,包括 - 抗代謝物/抗癌劑,諸如嘧啶類似物氟尿苷、卡培他濱(capecitabine)、阿糖胞苷、CPX-351 (脂質阿糖胞苷、道諾黴素(daunorubicin))、TAS-118; - 嘌呤類似物、葉酸拮抗劑(諸如普拉曲沙(pralatrexate))及相關抑制劑; - 抗增生/抗有絲分裂劑,包括天然產物,諸如長春花生物鹼(長春鹼、長春新鹼)及諸如紫杉烷(太平洋紫杉醇、多西他賽(docetaxel))之微管、長春鹼、諾考達唑(nocodazole)、埃博黴素(epothilone)、長春瑞賓(NAVELBINE®
)、及表鬼臼毒素(epipodophyllotoxins)(依託泊苷、替尼泊苷); - DNA破壞劑,諸如放線菌素、安吖啶、白消安、卡鉑、氯芥苯丁酸、順鉑、環磷醯胺(CYTOXAN®
)、放線菌素D、道諾黴素、小紅莓、表柔比星、異環磷醯胺、美法侖、二氯甲二乙胺、絲裂黴素C、米托蒽醌、亞硝基脲、丙卡巴肼、紫杉醇、紫杉德(Taxotere)、替尼泊苷、依託泊苷及三伸乙基硫代磷醯胺; - DNA低甲基化劑,諸如瓜地西他濱(guadecitabine)(SGI-110) - 抗生素,諸如放線菌素D、道諾黴素、小紅莓、艾達黴素、蒽環黴素、米托蒽醌、博萊黴素、普卡黴素(plicamycin)(光神黴素),及; - 酶,諸如系統地代謝L-天冬醯胺且剝奪不具有合成其自身天冬醯胺之能力的細胞之L-天冬醯胺酶; - 抗血小板劑; - 標靶Bcl-2之DNAi寡核苷酸,諸如PNT2258; - 活化或再活化潛伏人類免疫缺乏病毒(HIV)的藥劑,諸如帕比諾他(panobinostat)或羅米地辛(romidepsin) - 天冬醯胺酶刺激物,諸如克立他酶(crisantaspase)(Erwinase®)及GRASPA (ERY-001、ERY-ASP); - pan-Trk、ROS1及ALK抑制劑,諸如恩曲替尼(entrectinib) - 退行性淋巴瘤激酶(ALK)抑制劑,諸如艾樂替尼(alectinib) - 抗增生/抗有絲分裂的烷基化劑,諸如氮芥環磷醯胺及類似物(美法侖、氯芥苯丁酸、六甲蜜胺及噻替派)、烷基亞硝基脲(卡莫司汀)及類似物、鏈脲菌素及三氮烯(達卡巴嗪); - 抗增生/抗有絲分裂的抗代謝物,諸如葉酸類似物(甲胺喋呤); - 鉑配位複合物(順鉑、奧沙利鉑(oxiloplatinim)及卡鉑)、丙卡巴肼、羥脲、米托坦及胺麩精(aminoglutethimide); - 激素、激素類似物(雌激素、他莫昔芬、戈舍瑞林(goserelin)、比卡魯胺(bicalutamide)及尼魯胺(nilutamide))及芳香酶抑制劑(來曲唑(letrozole)及阿那曲唑(anastrozole)); - 抗凝劑,諸如肝素、合成肝素鹽及其他凝血酶之抑制劑; - 纖維蛋白溶解劑,諸如組織纖維蛋白溶酶原活化因子、鏈球菌激酶、尿激酶、阿司匹林(aspirin)、雙嘧達莫(dipyridamole)、噻氯匹定(ticlopidine)及克羅匹多(clopidogrel); - 抗遷移劑; - 抗分泌劑(布瑞汀(breveldin)); - 免疫抑制劑他克莫司(tacrolimus)、西羅莫司(sirolimus)、硫唑嘌呤及黴酚酸酯; - 化合物(TNP-470、金雀異黃酮)及生長因子抑制劑(血管內皮生長因子抑制劑,及 - 纖維母細胞生長因子抑制劑,諸如FPA14; - 血管收縮素受體阻斷劑、氧化氮供體; - 反股寡核苷酸,諸如AEG35156; - DNA干擾寡核苷酸,諸如PNT2258、AZD-9150 - 抗體,諸如曲妥珠單抗(trastuzumab)及利妥昔單抗(rituximab); - 抗HER3抗體,諸如LJM716 - 抗HER2抗體,諸如馬格妥昔單抗(margetuximab) - 抗HLA-DR抗體,諸如IMMU-114 - 抗IL-3抗體,諸如JNJ-56022473 - 抗OX40抗體,諸如MEDI6469 - 抗EphA3抗體,諸如KB-004 - 抗CD20抗體,諸如歐比妥珠單抗(obinutuzumab) - 抗計劃性細胞死亡蛋白1 (抗PD-1)抗體,諸如納武單抗(nivolumab) (OPDIVO®、BMS-936558、MDX-1106)、派立珠單抗(pembrolizumab)(KEYTRUDA®、MK-3477、SCH-900475、蘭利珠單抗(lambrolizumab)、CAS登記號1374853-91-4)、皮立珠單抗(pidilizumab)及抗計劃性死亡配位體1 (抗PD-L1)抗體,諸如BMS-936559、阿特珠單抗(atezolizumab)(MPDL3280A、德瓦魯單抗(durvalumab)(MEDI4736)、艾維路單抗(avelumab)(MSB0010718C)及MDX1105-01 - CXCR4拮抗劑,諸如BL-8040 - CXCR2拮抗劑,諸如AZD-5069 - GM-CSF抗體,諸如朗齊魯單抗(lenzilumab) - 選擇性雌激素受體負調控因子(SERD),諸如氟維司群(fulvestrant)(Faslodex®) - 轉形生長因子β (TGF-β)激酶拮抗劑,諸如高倫替布(galunisertib) - 雙特異性抗體,諸如MM-141 (IGF-1/ErbB3)、MM-111 (Erb2/Erb3)、JNJ-64052781 (CD19/CD3) - 突變選擇性EGFR抑制劑,諸如PF-06747775、EGF816、ASP8273、ACEA-0010、BI-1482694 - α-酮戊二酸去氫酶(KGDH)抑制劑,諸如CPI-613 - XPO1抑制劑,諸如賽林西爾(selinexor)(KPT-330) - 異檸檬酸去氫酶2 (IDH2)抑制劑,諸如恩那西尼(enasidenib)(AG-221),及IDH1抑制劑,諸如AG-120及AG-881 (IDH1及IDH2)。 - 標靶介白素-3受體(IL-3R)之藥劑,諸如SL-401 - 精胺酸脫亞胺酶刺激物,諸如派格胺酶(pegargiminase)(ADI-PEG-20) - 抗體-藥物結合物,諸如MLN0264 (抗GCC、鳥苷酸環化酶C)、T-DM1 (曲妥珠單抗恩他新(trastuzumab emtansine)、卡得西拉(Kadcycla))、米拉珠單抗-小紅莓(hCD74-DOX)、貝倫妥單抗維多汀(brentuximab vedotin)、DCDT2980S、保納珠單抗維多汀(polatuzumab vedotin)、SGN-CD70A、SGN-CD19A、奧英妥珠單抗(inotuzumab ozogamicin)、洛瓦妥珠單抗美坦辛(lorvotuzumab mertansine)、SAR3419、埃塞妥珠單抗戈維特坎(isactuzumab govitecan) - 抗密連蛋白18.2抗體,諸如IMAB362 - β鏈蛋白抑制劑,諸如CWP-291 - CD73拮抗劑,諸如MEDI-9447; - c-PIM抑制劑,諸如PIM447 - BRAF抑制劑,諸如達拉非尼( dabrafenib)、維羅非尼(vemurafenib) - 神經鞘胺醇激酶2 (SK2)抑制劑,諸如Yeliva® (ABC294640) - 細胞週期抑制劑,諸如司美替尼(selumetinib)(MEK1/2)、沙帕他濱(sapacitabine) - AKT抑制劑,諸如MK-2206、伊巴替布(ipatasertib)、阿福替布(afuresertib) - 抗CTLA-4(細胞毒性T-淋巴細胞蛋白-4)抑制劑,諸如曲美單抗(tremelimumab) - c-MET抑制劑,諸如AMG-337、灑沃替尼(savolitinib)、提瓦替尼(tivantinib)(ARQ-197)、卡普尼布(capmatinib)、特普替尼(tepotinib) - CSF1R/KIT及FLT3之抑制劑,諸如PLX3397 - 激酶抑制劑,諸如凡德他尼(vandetanib); - E選擇蛋白拮抗劑,諸如GMI-1271 - 分化誘導劑,諸如維甲酸; - 表皮生長因子受體(EGFR)抑制劑,諸如奧希替尼(osimertinib)(AZD-9291) - 拓樸異構酶抑制劑(小紅莓、道諾黴素、放線菌素D、安尼平苷(eniposide)、表柔比星、依託泊苷、艾達黴素、伊立替康、米托蒽醌、匹蒽醌(pixantrone)、索布佐生(sobuzoxane)、拓朴替康及伊立替康、MM-398 (脂質伊立替康)、沃薩洛辛(vosaroxin)及皮質類固醇(皮質酮、地塞米松(dexamethasone)、羥皮質酮、甲基潑尼松龍(methylprednisolone)、潑尼松(prednisone)及潑尼松龍(prednisolone)); - 生長因子信號轉導激酶抑制劑; - 功能障礙誘導劑; - 核苷類似物,諸如DFP-10917 - Axl抑制劑,諸如BGB-324 - BET抑制劑,諸如INCB-054329,添加吉利德之(Gilead's)化合物 - PARP抑制劑,諸如奧拉帕尼、如卡帕瑞(rucaparib)、維利帕尼(veliparib) - 蛋白酶體抑制劑,諸如依薩佐米(ixazomib)、卡非佐米(carfilzomib)(Kyprolis®) - 麩醯胺酸酶抑制劑,諸如CB-839 - 疫苗,諸如肽疫苗TG-01 (RAS)、細菌載體疫苗(諸如CRS-207/GVAX)、自體Gp96疫苗、樹突狀細胞疫苗、Oncoquest-L疫苗、DPX-Survivac、ProstAtak、DCVAC、ADXS31-142 - 抗癌幹細胞,諸如登西珠單抗(demcizumab)(抗DLL4、δ樣配位體4、Notch路徑)、那帕布新(napabucasin)(BBI-608) - 平滑(SMO)受體抑制劑,諸如Odomzo® (索尼德吉(sonidegib),先前LDE-225)、LEQ506、維莫德吉(vismodegib)(GDC-0449)、BMS-833923、格萊德吉(glasdegib)(PF-04449913)、LY2940680及伊曲康唑(itraconazole); - 干擾素α配位體調節劑,諸如干擾素α-2b、干擾素α-2a生物類似物(Biogenomics)、羅派干擾素(ropeginterferon)α-2b (AOP-2014,P-1101,PEG IFN α-2B)、穆提非隆(Multiferon)(阿法耐提(Alfanative),Viragen)、干擾素α 1b、羅擾素-A (Roferon-A)(Canferon,Ro-25-3036)、干擾素α-2a後續生物製劑(拜斯度(Biosidus))(Inmutag,Inter 2A)、干擾素α-2b後繼生物製劑(Biosidus(拜斯度)-Bioferon(拜非隆)、Citopheron(斯托非隆)、Ganapar(嘎納帕))(Beijing Kawin Technology-卡非隆(Kaferon))(AXXO干擾素α-2b)、阿法菲酮(Alfaferone)、聚乙二醇化干擾素α-1b、聚乙二醇化干擾素α-2b後續生物製劑(Amega)、重組人類干擾素α-1b、重組人類干擾素α-2a、重組人類干擾素α-2b、維托珠單抗(veltuzumab)-IFN α 2b結合物、Dynavax(SD-101)及干擾素α-n1 (霍莫非隆(Humoferon)、SM-10500、蘇米非隆(Sumiferon)); - 干擾素γ配位體調節劑,諸如干擾素γ (OH-6000、奧格瑪100 (Ogamma 100)); - IL-6受體調節劑,諸如托西利單抗(tocilizumab)、思圖昔單抗(siltuximab)、AS-101 (CB-06-02、IVX-Q-101); - 端粒酶調節劑,諸如特托莫肽(tertomotide)(GV-1001,HR-2802,Riavax)及伊美司他(GRN-163,JNJ-63935937) - DNA甲基轉移酶抑制劑,諸如替莫唑胺(temozolomide)(CCRG-81045)、地西他濱、瓜地西他濱(S-110,SGI-110)、KRX-0402及阿紮胞苷(azacitidine); - DNA旋轉酶抑制劑,諸如匹蒽醌及索布佐生; - Bcl-2家族蛋白抑制劑ABT-263、維奈托克(venetoclax)(ABT-199)、ABT-737及AT-101; - Notch抑制劑,諸如LY3039478、他瑞妥單抗(tarextumab)(抗Notch2/3)、BMS-906024 - 抗肌肉抑制素抑制劑,諸如蘭豆珠單抗(landogrozumab) - 玻尿酸酶刺激物,諸如PEGPH-20 - Wnt路徑抑制劑,諸如SM-04755、PRI-724 - γ分泌酶抑制劑,諸如PF-03084014 - IDO抑制劑,諸如因多莫得(indoximod) - Grb-2 (生長因子受體結合蛋白-2)抑制劑BP1001 (脂質Grb-2) - TRAIL路徑誘導化合物,諸如ONC201 - 局部黏著斑激酶抑制劑,諸如VS-4718、得法替尼(defactinib) - 豪豬抑制劑,諸如薩瑞德吉(saridegib)、索尼德吉(LDE225)、格萊德吉及維莫德吉 - 極光激酶抑制劑,諸如阿立塞替(alisertib)(MLN-8237) - HSPB1活性調節劑(熱休克蛋白27,HSP27),諸如溴夫定(brivudine)、阿帕森(apatorsen) - ATR抑制劑,諸如AZD6738及VX-970 - mTOR抑制劑,諸如薩盤塞替(sapanisertib) - Hsp90抑制劑,諸如AUY922 - 鼠雙微體(mdm2)致癌基因抑制劑,諸如DS-3032b - CD137促效劑,諸如優瑞路單抗(urelumab) - 抗KIR單株抗體,諸如利瑞路單抗(lirilumab)(IPH-2102) - 抗原CD19抑制劑,諸如MOR208、MEDI-551、AFM-11 - CD44結合劑,諸如A6 - CYP17抑制劑,諸如VT-464、ASN-001、ODM-204。 - RXR促進劑,諸如IRX4204 - TLR (鐸樣(Toll-like)受體)促進劑,諸如IMO-8400 - 豪豬/平滑(hh/Smo)拮抗劑,諸如塔拉德吉(taladegib) - 免疫調節劑,諸如補充C3調節劑,諸如因普拉姆PGG (Imprime PGG) - 腫瘤內免疫腫瘤學藥劑,諸如G100 (TLR4促效劑) - IL-15促進劑,諸如ALT-803 - EZH2 (栽斯特(zeste)同源物2之強化子)抑制劑,諸如塔茲托斯塔(tazemetostat) - 溶瘤病毒,諸如派拉瑞普(pelareorep)及塔里莫基因拉赫瑞普維克(talimogene laherparepvec)) - DOT1L (組蛋白甲基轉移酶)抑制劑,諸如皮諾托斯塔(pinometostat)(EPZ-5676) - 毒素,諸如霍亂毒素(Cholera toxin)、蓖麻毒素、假單胞菌外毒素(Pseudomonas exotoxin)、百日咳博特氏菌(Bordetella pertussis)腺苷酸環化酶毒素、白喉毒素及半胱天冬酶活化劑; - 及染色體。 - DNA質體,諸如BC-819 - PLK 1、2及3之PLK抑制劑,諸如沃納塞替(volasertib)(PLK1)。 -細胞凋亡信號調節激酶 ( ASK ) 抑制劑:
ASK抑制劑包括ASK1抑制劑。ASK1抑制劑之實例包括但不限於,描述於WO 2011/008709 (Gilead Sciences)及WO 2013/112741 (Gilead Sciences)中之ASK1抑制劑。 -布魯東氏酪胺酸激酶 ( BTK ) 抑制劑 :
BTK抑制劑之實例包括(但不限於):(S)-6-胺基-9-(1-(丁-2-炔醯基)吡咯啶-3-基)-7-(4-苯氧基苯基)-7H-嘌呤-8(9H)-酮、阿卡替尼(acalabrutinib)(ACP-196)、BGB-3111、HM71224、依魯替尼(ibrutinib)、M-2951、ONO-4059、PRN-1008、斯派替尼(spebrutinib)(CC-292)、TAK-020。 -週期蛋白依賴型激酶 ( CDK ) 抑制劑:
CDK抑制劑包括CDK 1、2、3、4、6及9之抑制劑,諸如阿貝力布(abemaciclib)、阿昔迪布(alvocidib)(HMR-1275、夫拉平度(flavopiridol))、AT-7519、FLX-925、LEE001、帕泊昔布(palbociclib)、利伯西利(ribociclib)、瑞戈替布(rigosertib)、賽林西爾、UCN-01及TG-02。 - -盤狀結構 域受體 ( DDR ) 抑制劑 :
DDR抑制劑包括DDR1及/或DDR2之抑制劑。DDR抑制劑之實例包括(但不限於)揭示於WO 2014/047624 (Gilead Sciences)、US 2009-0142345 (Takeda Pharmaceutical)、US 2011-0287011 (Oncomed Pharmaceuticals)、WO 2013/027802 (Chugai Pharmaceutical)及WO 2013/034933 (Imperial Innovations)中之DDR抑制劑。 - -組蛋白去乙醯酶 ( HDAC ) 抑制劑 :
HDAC抑制劑之實例包括(但不限於)阿貝諾他(abexinostat)、ACY-241、AR-42、BEBT-908、貝林諾他(belinostat)、CKD-581、CS-055 (HBI-8000)、CUDC-907、恩替諾他(entinostat)、吉韋諾他(givinostat)、莫塞諾他(mocetinostat)、帕比諾他、普拉諾他(pracinostat)、奎西諾他(quisinostat)(JNJ-26481585)、雷米諾他(resminostat)、瑞科諾他(ricolinostat)、SHP-141、丙戊酸酸(VAL-001)、伏立諾他(vorinostat)。 - -Janus 激酶 ( JAK ) 抑制劑 :
JAK抑制劑抑制JAK1、JAK2及/或JAK3。JAK抑制劑之實例包括(但不限於)AT9283、AZD1480、巴瑞替尼(baricitinib)、BMS-911543、非達替尼(fedratinib)、費勾替尼(filgotinib)(GLPG0634)、甘都替尼(gandotinib)(LY2784544)、INCB039110、來他替尼(lestaurtinib)、莫羅替尼(momelotinib)(CYT0387)、NS-018、帕瑞替尼(pacritinib)(SB1518)、皮非替尼(peficitinib)(ASP015K)、盧佐替尼(ruxolitinib)、(tofacitinib)(先前塔索替尼(tasocitinib))及XL019。 - -類離胺 醯氧化酶蛋白 ( LOXL ) 抑制劑 :
LOXL抑制劑包括LOXL1、LOXL2、LOXL3、LOXL4及/或LOXL5之抑制劑。LOXL抑制劑之實例包括(但不限於)描述於WO 2009/017833(Arresto Biosciences)中之抗體。LOXL2抑制劑之實例包括(但不限於)描述於WO 2009/017833 (Arresto Biosciences)、WO 2009/035791 (Arresto Biosciences)及WO 2011/097513 (Gilead Biologics)中之抗體。 - -基質金屬 蛋白酶 ( MMP ) 抑制劑:
MMP抑制劑包括MMP1至10之抑制劑。MMP9抑制劑之實例包括(但不限於)馬立馬司他(marimastat)(BB-2516)、西派馬司他(cipemastat)(Ro 32-3555)及描述於WO 2012/027721 (Gilead Biologics)中之MMP9抑制劑。 - -促分裂原活化蛋白激酶 ( MEK ) 抑制劑:
MEK抑制劑包括安卓奎諾爾(antroquinonol)、畢尼替尼(binimetinib)、考比替尼(cobimetinib)(GDC-0973、XL-518)、MT-144、司美替尼(selumetinib)(AZD6244)、索拉非尼、曲美替尼(trametinib)(GSK1120212)、阿普羅塞替(uprosertib)+曲美替尼。 - - 磷脂醯肌醇3-激酶( PI3K
)抑制劑:PI3K抑制劑包括PI3Kγ、PI3Kδ、PI3Kβ、PI3Kα及/或pan-PI3K之抑制劑。PI3K抑制劑之實例包括(但不限於)ACP-319、AEZA-129、AMG-319、AS252424、BAY 10824391、BEZ235、布帕昔布(buparlisib)(BKM120)、BYL719 (艾培昔布(alpelisib))、CH5132799、考班昔布(copanlisib)(BAY 80-6946)、杜維昔布(duvelisib)、GDC-0941、GDC-0980、GSK2636771、GSK2269557、艾代拉里斯(Zydelig®)、IPI-145、IPI-443、KAR4141、LY294002、Ly-3023414、MLN1117、OXY111A、PA799、PX-866、RG7604、瑞戈替布、RP5090泰尼昔布(taselisib)、TG100115、TGR-1202、TGX221、WX-037、X-339、X-414、XL147 (SAR245408)、XL499、XL756、渥曼青黴素(wortmannin)、ZSTK474及描述於WO 2005/113556 (ICOS)、WO 2013/052699 (Gilead Calistoga)、WO 2013/116562 (Gilead Calistoga)、WO 2014/100765 (Gilead Calistoga)、WO 2014/100767 (Gilead Calistoga)及WO 2014/201409 (Gilead Sciences)中之化合物。 - -脾酪胺酸激酶 ( SYK ) 抑制劑:
SYK抑制劑之實例包括(但不限於)6-(1H-吲唑-6-基)-N-(4-N-嗎啉基苯基)咪唑并[1,2-a]吡嗪-8-胺、BAY-61-3606、瑟杜替尼(cerdulatinib)(PRT-062607)、恩妥替尼(entospletinib)、福他替尼(fostamatinib)(R788)、HMPL-523、NVP-QAB 205 AA、R112、R343、塔馬替尼(tamatinib)(R406)及描述於US 8450321 (Gilead Connecticut)中之SYK抑制劑及描述於U.S. 2015/0175616中之SYK抑制劑。 -酪胺酸激酶抑制劑 ( TKIs ) :
TKIs可標靶表皮生長因子受體(EGFR)及用於纖維母細胞生長因子(FGF)、血小板衍生生長因子(PDGF)及血管內皮生長因子(VEGF)之受體。TKI之實例包括(但不限於)阿法替尼、伯舒替尼、布加替尼(brigatinib)、卡博替尼(cabozantinib)、克諾拉尼(crenolanib)、達可替尼(dacomitinib)、達沙替尼、多韋替尼(dovitinib)、E-6201、埃羅替尼、吉非替尼、吉爾替尼(gilteritinib)(ASP-2215)、HM61713、埃克替尼(icotinib)、伊馬替尼、KX2-391 (Src)、拉帕替尼、來他替尼、米哚妥林(midostaurin)、尼達尼布(nintedanib)、奧希替尼(osimertinib)(AZD-9291)、普納替尼(ponatinib)、普子替尼(poziotinib)、喹雜替尼(quizartinib)、拉多替尼(radotinib)、羅西替尼(rociletinib)、舒尼替尼及TH-4000。 其他抗癌劑包括:烷基化劑,諸如噻替派及環磷醯胺(CYTOXAN®
);烷基磺酸酯,諸如白消安、英丙舒凡(improsulfan)及哌泊舒凡(piposulfan);氮丙啶,諸如苯佐替派(benzodepa)、卡波醌(carboquone)、美妥替派(meturedepa)及烏瑞替派(uredepa);伸乙亞胺及甲基三聚氰胺,其包括六甲蜜胺、三伸乙基蜜胺、三伸乙基磷醯胺、三伸乙基硫代磷醯胺及三羥甲蜜胺(trimethylolomelamine);多聚乙醯,尤其布拉他辛(bullatacin)及布拉他辛酮(bullatacinone);喜樹鹼,其包括合成模擬拓朴替康;苔蘚抑素、卡利斯他汀(callystatin);CC-1065,包括其阿多來新(adozelesin)、卡折來新(carzelesin)及比折來新(bizelesin)合成類似物;念珠藻素(cryptophycin),尤其念珠藻素1及念珠藻素8;尾海兔素(dolastatin);多卡米辛(duocarmycin),其包括合成類似物KW-2189及CBI-TMI;軟珊瑚醇(eleutherobin);5-氮胞苷;水鬼蕉鹼(pancratistatin);沙考地汀(sarcodictyin);海綿抑素(spongistatin);氮芥,諸如氯芥苯丁酸、萘氮芥(chlornaphazine)、環磷醯胺、葡磷醯胺、艾沃醯胺(evofosfamide)、苯達莫司汀(bendamustine)、雌莫司汀(estramustine)、異環磷醯胺(ifosfamide)、氮芥、氮芥氧化物氫氯化物、美法侖、新恩比興(novembichin)、膽固醇對苯乙酸氮芥(phenesterine)、潑尼氮芥(prednimustine)、氯乙環磷醯胺(trofosfamide)及尿嘧啶氮芥;亞硝基脲,諸如卡莫司汀、氯脲黴素、福莫司汀(foremustine)、洛莫司汀(lomustine)、尼莫司汀(nimustine)及雷莫司汀(ranimustine);抗生素,諸如烯二炔抗生素(例如卡奇黴素(calicheamicin),尤其卡奇黴素γII及卡奇黴素φI1)、達內黴素(dynemicin)(包括達內黴素A)、雙膦酸鹽(諸如氯屈膦酸鹽(clodronate)、埃斯培拉黴素(esperamicin))、新制癌菌素發色團及相關色素蛋白烯二炔抗生素色素體、阿克拉黴素(aclacinomycins)、放線菌素、安麯黴素(authramycin)、偶氮絲胺酸(azaserine)、博萊黴素、放線菌素C、卡拉比星(carabicin)、洋紅黴素(carminomycin)、嗜癌菌素(carzinophilin)、色黴素(chromomycins)、放線菌素D、道諾黴素、地托比星(detorubicin)、6-重氮-5-側氧基-L-正白胺酸、小紅莓(包括N-嗎啉基-小紅莓、氰基-N-嗎啉基-小紅莓、2-吡咯啉基-小紅莓及去氧小紅莓(deoxydoxorubicin))、表柔比星(epirubicin)、依索比星(esorubicin)、艾達黴素、麻西羅黴素(marcellomycin)、絲裂黴素(諸如絲裂黴素C)、黴酚酸(mycophenolic acid)、諾加黴素(nogalamycin)、橄欖黴素、培洛黴素(peplomycin)、泊非羅黴素(porfiromycin)、嘌呤黴素(puromycin)、三鐵阿黴素(quelamycin)、羅多比星(rodorubicin)、鏈黑黴素(streptonigrin)、鏈脲菌素、殺結核菌素(tubercidin)、烏苯美司(ubenimex)、淨司他汀(zinostatin)及左柔比星(zorubicin);抗代謝物,諸如甲胺喋呤及5-氟尿嘧啶(5-FU);葉酸類似物,諸如黛莫蝶呤(demopterin)、甲胺喋呤、蝶羅呤(pteropterin)及曲美沙特(trimetrexate);嘌呤類似物,諸如氟達拉濱、6-巰嘌呤、硫咪嘌呤及硫鳥嘌呤;嘧啶類似物,諸如安西他濱(ancitabine)、阿紮胞苷、6-氮尿苷、卡莫氟(carmofur)、阿糖胞苷、雙去氧尿苷、去氧氟尿苷、依諾他濱及氟尿苷;雄激素,諸如卡魯睾酮(calusterone)、屈他雄酮丙酸根(dromostanolone propionate)、環硫雄醇(epitiostanol)、美雄烷(mepitiostane)及睾內酯(testolactone);抗腎上腺,諸如胺麩精、米托坦及曲洛司坦(trilostane); 葉酸補充劑,諸如亞葉酸;放射性治療劑,諸如鐳223;新月毒素(trichothecenes),尤其T-2毒素、弗納庫林A (verracurin A)、桿孢菌素A (roridin A)及胺癸叮(anguidine);類紫杉醇,諸如太平洋紫杉醇(TAXOL®
)、阿布拉生(abraxane)、多烯紫杉醇(docetaxel)(TAXOTERE®
)、卡巴利他索(cabazitaxel)、BIND-014;鉑類似物,諸如順鉑及卡鉑、NC-6004奈米鉑;乙醯葡醛酯;醛磷醯胺糖苷;胺基乙醯丙酸;恩尿嘧啶(eniluracil);安吖啶(amsacrine); hestrabucil;比生群(bisantrene);艾達曲克(edatraxate);得弗伐胺(defofamine);秋水仙胺(demecolcine);亞胺醌(diaziquone);艾弗美辛(elformthine);依利醋銨(elliptinium acetate);埃博黴素;依託格魯(etoglucid);硝酸鎵;羥脲;磨菇多糖(lentinan);甲醯四氫葉酸;氯尼達明(lonidamine);類美登素(maytansinoids),諸如美登素(maytansine)及安絲菌素(ansamitocins);米托胍腙(mitoguazone);米托蒽醌;莫哌達醇(mopidamol);二胺硝吖啶(nitracrine);噴司他汀;蛋氨氮芥(phenamet);吡柔比星(pirarubicin);洛索蒽醌(losoxantrone);氟嘧啶;醛葉酸;鬼臼酸(podophyllinic acid);2-乙基醯肼;丙卡巴肼;多醣-K (PSK);雷佐生(razoxane);根瘤菌素(rhizoxin);西索菲蘭(sizofiran);鍺螺胺(spirogermanium);細交鏈孢菌酮酸(tenuazonic acid);曲貝替定(trabectedin)、三亞胺醌(triaziquone);2,2',2''-三尤胺(2,2',2''-tricUorotriemylamine);胺基甲酸乙脂;長春地辛(vindesine);達卡巴嗪;甘露氮芥(mannomustine);二溴甘露醇;二溴衛矛醇(mitolactol);哌泊溴烷(pipobroman);加西托星(gacytosine);阿拉伯糖苷(arabinoside)(「Ara-C」);環磷醯胺;thiopeta;氯芥苯丁酸;吉西他濱 (GEMZAR®
);6-硫代鳥嘌呤;巰嘌呤;甲胺喋呤;長春鹼;鉑;依託泊苷 (VP-16);異環磷醯胺;米托蒽醌;長春新鹼;長春瑞賓(NAVELBINE®
);諾凡特龍(novantrone);替尼泊苷;依達曲沙(edatrexate);柔紅黴素(daunomycin);胺基喋呤;希羅達(xeoloda);伊班膦酸鹽(ibandronate);CPT-11;拓樸異構酶抑制劑RFS 2000;二氟甲基鳥胺酸(DFMO);類視黃素,諸如視黃酸;卡培他濱;FOLFIRI (氟尿嘧啶、甲醯四氫葉酸及伊立替康);及以上各者中之任一者之醫藥學上可接受之鹽、酸或衍生物。抗激素劑
抗激素劑亦包括在抗癌劑之定義中,諸如用以調節或抑制腫瘤上之激素作用的抗雌激素及選擇性雌激素受體調節劑(SERM)、芳香化酶之抑制劑、抗雄激素及以上各者中之任一者之醫藥學上可接受之鹽、酸或衍生物。 抗雌激素及SERM之實例包括例如他莫昔芬(包括NOLVADEXTM
)、雷諾昔芬、曲洛昔芬(droloxifene)、4-羥基他莫昔芬、曲沃昔芬(trioxifene)、雷洛昔芬(keoxifene)、LY117018、奧那司酮(onapristone)及托瑞米芬(toremifene)(FARESTON®
)。 芳香化酶之抑制劑調節腎上腺中之雌激素生產。實例包括4(5)-咪唑、胺麩精、乙酸甲地孕酮(megestrol acetate)(MEGACE®
)、依西美坦、福美司坦(formestane)、法屈唑(fadrozole)、伏羅唑(vorozole)(RIVISOR®
)、來曲唑(letrozole)(FEMARA®
)及阿那曲唑(anastrozole)(ARIMIDEX®
)。 抗雄激素之實例包括阿帕魯胺(apalutamide)、阿比特龍(abiraterone)、恩雜魯胺(enzalutamide)、氟他胺(flutamide)、加利特龍(galeterone)、尼魯胺(nilutamide)、比卡魯胺(bicalutamide)、亮丙立德(leuprolide)、戈舍瑞林、ODM-201、APC-100、ODM-204。 黃體酮受體拮抗劑之實例包括奧那司酮。抗血管生成劑
抗血管生成劑包括(但不限於)類視黃素酸及其衍生物、2-甲氧雌二醇、ANGIOSTATIN®
、ENDOSTATIN®
、瑞戈非尼(regorafenib)、納卡拉尼(necuparanib)、蘇拉明(suramin)、角鯊胺(squalamine)、金屬蛋白酶-1之組織抑制劑、金屬蛋白酶-2之組織抑制劑、纖維蛋白溶酶原活化因子抑制劑-1、纖維蛋白溶酶原活化因子抑制劑-2、軟骨源抑制劑(cartilage-derived inhibitor)、太平洋紫杉醇(白蛋白結合型太平洋紫杉醇(nab-paclitaxel))、血小板因子4、硫酸魚精蛋白(鯡精蛋白)、硫酸鹽化幾丁質衍生物(由皇後蟹殼製備)、硫酸鹽化多醣肽聚糖複合物(sp-pg)、星形孢菌素(staurosporine)、包括脯胺酸類似物之基質代謝之調節劑(諸如l-氮雜環丁烷-2-羧酸(LACA)、順羥基脯胺酸、d,I-3,4-脫氫脯胺酸、硫脯胺酸)、α,α'-聯吡啶,β-胺基丙腈反丁烯二酸酯、4-丙基-5-(4-吡啶基)-2(3h)-噁唑酮、甲胺喋呤、米托蒽醌、肝素、干擾素、2巨球蛋白-血清、雞金屬蛋白酶-3之抑制劑(ChIMP-3)、胰凝乳蛋白酶抑制劑(chymostatin)、β-環糊精十四硫酸酯、艾珀黴素(eponemycin)、煙黴素(fumagillin)、硫代蘋果酸金鈉、d-青黴胺(d-penicillamine)、β-1-抗膠原酶-血清、α-2-抗纖維蛋白溶酶、比生群、氯苯紮利二鈉(lobenzarit disodium)、正-2-羧苯基-4-氯鄰胺基苯甲酸二鈉或「CCA」、沙力度胺(thalidomide)、血管生成抑制性類固醇、羧基胺基咪唑、金屬蛋白酶抑制劑(諸如BB-94)、S100A9之抑制劑(諸如他喹莫德(tasquinimod))。其他抗血管生成劑包括抗體,較佳針對此等血管生成生長因子之單株抗體:β-FGF、α-FGF、FGF-5、VEGF同功異型物、VEGF-C、HGF/SF及Ang-1/Ang-2。抗纖維化劑
抗纖維化劑包括(但不限於)諸如β-胺基丙腈(BAPN)之化合物,以及揭示於與離胺醯氧化酶之抑制劑及其在治療與膠原蛋白之異常沈積相關之疾病及病狀中之用途相關的US 4965288中之化合物及揭示於與抑制LOX以治療各種病理性纖維化病況之化合物相關的US 4997854中之化合物,該等申請案以引用之方式併入本文中。其他例示性抑制劑描述於與諸如2-異丁基-3-氟-烯丙胺、2-異丁基-3-氯-烯丙胺或2-異丁基-3-溴-烯丙胺之化合物相關的US 4943593中;US 5021456、US 5059714、US 5120764、US 5182297、與2-(1-萘基氧基甲基)-3-氟烯丙胺相關之US 5252608中;及US 2004-0248871中,該等申請案以引用之方式併入本文中。 例示性抗纖維化劑亦包括與離胺醯氧化酶之活性位點之羰基反應的一級胺,且更尤其在結合羰基之後生成共振穩定化產物的一級胺,諸如以下一級胺:乙二胺、肼、苯肼及其衍生物;胺脲及脲衍生物;胺基腈,諸如BAPN或2-硝基乙胺;不飽和或飽和鹵胺,諸如2-溴基-乙胺、2-氯乙胺、2-三氟乙胺、3-溴丙胺及P-鹵基苄胺;及硒基高半胱胺酸內酯。 其他抗纖維化劑係滲透或不滲透細胞之銅螯合劑。例示性化合物包括阻斷源自藉由離胺醯氧化酶使離胺醯殘基及羥離胺醯殘基氧化去胺之醛衍生物的間接抑制劑。實例包括硫醇胺(尤其D-青黴胺)及其類似物,諸如2-胺基-5-巰基-5-甲基己酸、D-2-胺基-3-甲基-3-((2-乙醯胺基乙基)二硫基)丁酸、對-2-胺基-3-甲基-3-((2-胺基乙基二硫基)丁酸、硫化鈉-4-((對-1-二甲基-2-胺基-2-羧基乙基)二硫基)丁烷、2-乙醯胺基乙基-2-乙醯胺基乙硫醇磺酸鹽及三水合鈉-4-巰基丁烷亞磺酸鹽。免疫治療劑
免疫治療劑包括且不限於適合於治療患者之治療性抗體。治療性抗體之一些實例包括辛圖珠單抗(simtuzumab)、阿巴伏單抗(abagovomab)、阿達木單抗(adecatumumab)、阿夫妥珠單抗(afutuzumab)、阿侖單抗(alemtuzumab)、阿妥莫單抗(altumomab)、阿瑪西單抗(amatuximab)、麻安莫單抗(anatumomab)、阿西莫單抗(arcitumomab)、巴維昔單抗(bavituximab)、貝妥莫單抗(bectumomab)、貝伐單抗(bevacizumab)、比伐珠單抗(bivatuzumab)、布林莫單抗(blinatumomab)、貝倫妥單抗(brentuximab)、坎妥珠單抗(cantuzumab)、卡妥索單抗(catumaxomab)、西妥昔單抗(cetuximab)、西他土珠單抗(citatuzumab)、西妥木單抗(cixutumumab)、克里伏妥珠單抗(clivatuzumab)、康納木單抗(conatumumab)、達土木單抗(daratumumab)、德珠單抗(drozitumab)、杜力戈圖單抗(duligotumab)、杜氏圖單抗(dusigitumab)、地莫單抗(detumomab)、達西珠單抗(dacetuzumab)、達洛圖單抗(dalotuzumab)、迪奴圖單抗(dinutuximab)、依美昔單抗(ecromeximab)、埃羅妥珠單抗(elotuzumab)、艾米貝珠單抗(emibetuzumab)、恩斯土昔單抗(ensituximab)、鄂托默單抗(ertumaxomab)、埃達珠單抗(etaracizumab)、伐吐珠單抗(farletuzumab)、費拉妥珠單抗(ficlatuzumab)、非吉單抗(figitumumab)、法蘭土單抗(flanvotumab)、浮土西單抗(futuximab)、加尼圖單抗(ganitumab)、吉妥珠單抗(gemtuzumab)、吉瑞昔單抗( girentuximab)、格雷巴土木單抗(glembatumumab)、布突默單抗(ibritumomab)、伊戈伏單抗(igovomab)、伊姆加土珠單抗(imgatuzumab)、因達西單抗(indatuximab)、伊諾妥珠單抗(inotuzumab)、英妥木單抗(intetumumab)、伊派利單抗(ipilimumab)(YERVOY®、MDX-010、BMS-734016及MDX-101)、伊妥木單抗(iratumumab)、拉貝珠單抗(labetuzumab)、來沙木單抗(lexatumumab)、林妥珠單抗(lintuzumab)、洛瓦土珠單抗(lorvotuzumab)、魯卡木單抗(lucatumumab)、馬帕木單抗(mapatumumab)、馬妥珠單抗(matuzumab)、米拉珠單抗(milatuzumab)、明瑞莫單抗(minretumomab)、米妥莫單抗(mitumomab)、莫格利珠單抗(mogamulizumab)、莫昔土莫單抗(moxetumomab)、帕蘇多托克斯(pasudotox)、納納土單抗(narnatumab)、那莫單抗(naptumomab)、萊西單抗(necitumumab)、尼妥珠單抗(nimotuzumab)、諾非單抗(nofetumomab)、歐比妥珠單抗、奧卡拉珠單抗(ocaratuzumab)、奧伐木單抗(ofatumumab)、奧拉單抗(olaratumab)、奧那組單抗(onartuzumab)、奧普珠單抗(oportuzumab)、奧戈伏單抗(oregovomab)、帕尼單抗(panitumumab)、帕薩珠單抗(parsatuzumab)、帕特里土單抗(patritumab)、潘妥莫單抗(pemtumomab)、帕妥珠單抗(pertuzumab)、平妥單抗(pintumomab)、普托木單抗(pritumumab)、拉克莫單抗(racotumomab)、拉德瑞單抗(radretumab)、雷莫蘆單抗(ramucirumab)(Cyramza®)、里樂木單抗(rilotumumab)、利妥昔單抗(rituximab)、羅妥木單抗(robatumumab)、薩馬里珠(samalizumab)、沙妥莫單抗(satumomab)、西羅珠單抗(sibrotuzumab)、思圖昔單抗(siltuximab)、索利托單抗(solitomab)、他卡珠單抗(tacatuzumab)、他普莫單抗(taplitumomab)、泰納莫單抗(tenatumomab)、泰普洛單抗(teprotumumab)、替加珠單抗(tigatuzumab)、托西莫單抗(tositumomab)、曲妥珠單抗(trastuzumab)、ABP-980、土庫珠單抗(tucotuzumab)、尤比昔單抗(ubilituximab)、維托珠單抗(veltuzumab)、沃爾希珠單抗(vorsetuzumab)、伏妥莫單抗(votumumab)、紮魯姆單抗(zalutumumab)、CC49、OBI-833及3F8。利妥昔單抗可用於治療惰性B細胞癌症,其包括邊緣區淋巴瘤、WM、CLL及小淋巴細胞性淋巴瘤。利妥昔單抗與化學治療劑之組合尤其有效。 例示性治療性抗體可進一步用放射性同位素粒子,諸如銦-111、釔-90 (90Y-克里伏妥珠單抗)或碘-131標記或與其組合。癌症基因療法及細胞治療包括將正常基因插入至癌細胞中以替代突變或改變之基因;基因修飾以使突變基因靜默;用以直接殺滅癌細胞之基因方法;包括經輸注設計以替代大部分患者自身免疫系統以增強對癌細胞之免疫反應或活化患者自身免疫系統(T細胞或自然殺手細胞)以殺滅癌細胞或發現且殺滅癌細胞的免疫細胞;改變細胞活性以進一步改變對癌症之內源性免疫反應之基因方法。非限制性實例係基因p53之阿爾貞圖賽-L (Algenpantucel-L)(2胰臟細胞株)、西普魯塞-T (Sipuleucel-T)、SGT-53脂質奈米傳遞(scL);T細胞治療,諸如CD19 CAR-T替薩魯塞-T(tisagenlecleucel-T)(CTL019)、KTE-C19、JCAR015、BXP-501;活化同種異體自然殺手細胞CNDO-109-AANK、LFU-835造血幹細胞。癌症類型
本文中所治療之患者及癌症包括伯基特氏(Burkitt's)淋巴瘤、霍奇金氏(Hodgkin's)淋巴瘤、非霍奇金氏淋巴瘤(NHL)、惰性非霍奇金氏淋巴瘤(iNHL)、難治性iNHL、多發性骨髓瘤(MM)、慢性骨髓性白血病(CML)、急性淋巴細胞性白血病(ALL)、B細胞ALL、急性骨髓白血病(AML)、慢性淋巴細胞性白血病(CLL)、小淋巴細胞性淋巴瘤(SLL)、骨髓發育不良症候群(MDS)、骨髓增生性疾病(MPD)、套細胞淋巴瘤(MCL)、濾泡性淋巴瘤(FL)、瓦爾登斯特倫氏(Waldestrom's)巨球蛋白血症(WM)、T細胞淋巴瘤、B細胞淋巴瘤、彌漫性大B細胞淋巴瘤(DLBCL)或邊緣區淋巴瘤(MZL)。在一個實施例中,癌症係微小殘留病灶(MRD)。在另外實施例中,癌症係選自霍奇金氏淋巴瘤、非霍奇金氏淋巴瘤(NHL)、惰性非霍奇金氏淋巴瘤(iNHL)及難治性iNHL。在某個實施例中,癌症係惰性非霍奇金氏淋巴瘤(iNHL)。在一些實施例中,癌症係難治性iNHL。在一個實施例中,癌症係慢性淋巴細胞性白血病(CLL)。在其他實施例中,癌症係彌漫性大B細胞淋巴瘤(DLBCL)。 在某些實施例中,癌症係選自由以下組成之群的實體腫瘤:胰臟癌;膀胱癌;結腸直腸癌;乳癌,其包括轉移性乳癌;前列腺癌,其包括雄激素依賴型及雄激素獨立型前列腺癌;腎(kidney)或腎(renal)癌,其包括例如轉移性腎細胞癌;肝細胞癌;肺癌,其包括例如非小細胞肺癌(NSCLC)、細支氣管肺泡癌(BAC)及肺之腺癌;卵巢癌,其包括例如進展性上皮或原發性腹膜癌;宮頸癌;胃癌;食道癌;頭頸癌,其包括例如頭頸部之鱗狀細胞癌;黑素瘤;神經內分泌癌,其包括轉移性神經內分泌腫瘤;腦瘤,其包括例如神經膠質瘤、退行性少突神經膠質瘤、成年人多形性神經膠母細胞瘤及成年人退行性星形細胞瘤;骨癌;及軟組織肉瘤、肝癌(hepatic carcinoma)、直腸癌、陰莖癌、外陰癌、甲狀腺癌、唾液腺癌、子宮內膜或子宮癌、肝癌(hepatoma)、肝細胞癌、肝癌(liver cancer)、包括胃腸癌的胃(gastric)或胃(stomach)癌、腹膜之癌、肺之鱗狀癌、胃食管癌、膽道癌、膽囊癌、結腸直腸/闌尾癌、鱗狀細胞癌(例如上皮鱗狀細胞癌)。 可使用所提供的治療方法中之任一者治療不同階段的癌症。舉例而言,癌症階段包括(但不限於)早期的、晚期的、局部晚期的、緩解期的、難治性、在緩解之後復發的及進展性癌症。個體
可使用所提供的治療方法中之任一者治療已診斷患有或疑似患有癌症之個體(例如人類)。如本文所使用,個體係指哺乳動物,其包括例如人類。 在一些實施例中,個體可係展現一或多種與癌症或過度增生性疾病相關症狀的人類。在一些實施例中,個體可為展現一或多種與癌症相關症狀的人類。在一些實施例中,個體處於癌症之早期階段。在其他實施例中,個體處於癌症之晚期階段。 在某些中,個體可為有發生癌症或過度增生性疾病風險,或在基因上或以其他方式傾向於(例如風險因子)發生癌症或過度增生性疾病,已經診斷或尚未經診斷之人類。如本文所使用,「有風險之」個體係有發生癌症風險的個體。在進行本文所描述之治療方法之前,個體可能已患有或可能未患有可偵測疾病,且可能已展現或可能未展現可偵測疾病。有風險之個體可具有一或多種所謂的風險因子,其係與本文所描述之癌症發生相關的可量測參數。具有一或多種此等風險因子之個體發生癌症之概率高於不具有此等風險因子之個體。此等風險因子可包括例如年齡、性別、種族、飲食、先前疾病之病史、前驅疾病之存在、基因(例如遺傳)因素及環境暴露。在一些實施例中,有癌症風險之個體包括例如有親戚已經歷該疾病之個體及其風險係藉由基因或生物化學標記物分析確定之個體。 另外,個體可為經受一或多種標準療法,諸如化學療法、放射線療法、免疫療法、手術或其組合之人類。因此,可在施與化學療法、放射線療法、免疫療法、外科手術或其組合之前、期間或之後投與一或多種激酶抑制劑。 在某些實施例中,個體可為(i)實質上對至少一種化學療法治療為難治的或(ii)在化學療法治療後復發或為(i)及(ii)兩者之人類。在一些實施例中,個體對至少兩種、至少三種或至少四種化學療法治療(包括標準或實驗化學療法)為難治的。淋巴瘤或白血病組合療法
一些抗癌劑適用於治療淋巴瘤或白血病。此等藥劑包括阿地介白素、阿昔迪布、抗新普拉通(antineoplaston) AS2-1、抗新普拉通A10、抗胸腺細胞球蛋白、三水合阿米福汀(amifostine trihydrate)、胺基喜樹鹼、三氧化二砷、β阿立辛(beta alethine)、Bcl-2家族蛋白抑制劑ABT-263、維奈托克(ABT-199)、BMS-345541、硼替佐米(VELCADE®
)、卡非佐米(Kyprolis®)、維羅非尼(Zelboraf®)、Omr-IgG-am (WNIG,Omrix)、苔蘚抑素1、白消安、卡鉑、坎帕斯-1H、CC-5103、卡莫司汀、卡泊芬淨乙酸鹽(caspofungin acetate)、氯法拉濱、順鉑、克拉屈濱、氯芥苯丁酸、薑黃素、環孢靈(cyclosporine)、環磷醯胺、阿糖胞苷、地尼介白素迪夫托斯(denileukin diftitox)、地塞米松(dexamethasone)、DT-PACE (地塞米松、沙力度胺、順鉑、小紅莓、環磷醯胺及依託泊苷)、多西他賽、海兔毒素10、小紅莓、鹽酸小紅莓、恩紮妥林(enzastaurin)、依泊汀α (epoetin alfa)、依託泊苷、依維莫司(everolimus)(RAD001)、非瑞替尼(fenretinide)、非格司亭(filgrastim)、美法侖、美司鈉(mesna)、夫拉平度、氟達拉濱、格爾德黴素(geldanamycin)(17-AAG)、異環磷醯胺、鹽酸伊立替康、伊沙匹隆(ixabepilone)、來那度胺(REVLIMID®
,CC-5013)、淋巴激素活化殺手細胞、美法侖、甲胺喋呤、米托蒽醌鹽酸鹽、莫特沙芬釓(motexafin gadolinium)、黴酚酸嗎啉乙酯(motexafin gadolinium)、奈拉濱(nelarabine)、奧利默森(oblimersen)、奧巴克拉(obatoclax)(GX15-070)、奧利默森、奧曲肽乙酸酯(octreotide acetate)、ω-3脂肪酸、奧沙利鉑(oxaliplatin)、太平洋紫杉醇帕泊昔布(PD0332991)、聚乙二醇化脂質鹽酸小紅莓、派非格司亭、噴司他汀、哌立福新(perifosine)、潑尼松龍、潑尼松、R-羅斯維汀(R-roscovitine )(塞利希布(seliciclib),CYC202)、重組干擾素α、干擾素α-2b、重組介白素-12、重組介白素-11、重組flt3配位體、重組人類血小板生成素、利妥昔單抗、沙格司亭、西地那非檸檬酸鹽(sildenafil citrate)、辛伐他汀(simvastatin)、西羅莫司(sirolimus)、苯乙烯基碸、他克莫司(tacrolimus)、坦螺旋黴素(tanespimycin)、坦羅莫司(temsirolimus)(CCl-779)、沙力度胺、治療性同種異體淋巴細胞、噻替派、替吡法尼(tipifarnib)、硼替佐米(VELCADE®
,PS-341)、長春新鹼、長春新鹼硫酸鹽、長春瑞賓酒石酸氫鹽、SAHA (辛二醯苯胺異羥肟酸或辛二醯基、苯胺及異羥肟酸)、FR (氟達拉濱及利妥昔單抗)、CHOP (環磷醯胺、小紅莓、長春新鹼及潑尼松)、CVP (環磷醯胺、長春新鹼及潑尼松)、FCM (氟達拉濱、環磷醯胺及米托蒽醌)、FCR (氟達拉濱、環磷醯胺及利妥昔單抗)、hyperCVAD (超分割環磷醯胺、長春新鹼、小紅莓、地塞米松、甲胺喋呤及阿糖胞苷)、ICE (異環磷醯胺、卡鉑及依託泊苷)、MCP (米托蒽醌、氯芥苯丁酸、及潑尼松龍)、R-CHOP (利妥昔單抗及CHOP)、R-CVP (利妥昔單抗及CVP)、R-FCM (利妥昔單抗及FCM)、R-ICE (利妥昔單抗及ICE)及R-MCP (利妥昔單抗及MCP)。 一種經改良方法係放射免疫療法,其中單株抗體與放射性同位素粒子,諸如銦-111、釔-90及碘-131組合。組合療法之實例包括(但不限於)碘-131托西莫單抗(BEXXAR®
)、釔-90布突默單抗泰澤坦(ibritumomab tiuxetan)(ZEVALIN®
)及BEXXAR®
與CHOP。 上述療法可補充有幹細胞移植或治療或與其組合。治療性程序包括周邊血液幹細胞移植、自體造血幹細胞移植、自體骨髓移植、抗體療法、生物療法、酶抑制劑療法、全身照射、幹細胞輸注、在幹細胞支持下之骨髓消融、經活體外處理之周邊血液幹細胞移植、臍帶血移植、免疫酶技術、低LET鈷-60 γ射線療法、博萊黴素、習知手術、輻射療法及非清髓性同種異體造血幹細胞移植。非霍奇金氏淋巴瘤組合療法
非霍奇金氏淋巴瘤(NHL),尤其起源於B細胞之非霍奇金氏淋巴瘤之治療包括使用單株抗體、標準化學治療方法(例如CHOP、CVP、FCM、MCP及類似方法)、放射免疫療法及其組合,尤其抗體療法與化學療法之整合。 用於NHL/B細胞癌症之治療的未結合的單株抗體之實例包括利妥昔單抗、阿侖單抗、人類或人源化抗CD20抗體、盧米西單抗(lumiliximab)、抗TNF相關之細胞凋亡誘導配位體(抗TRAIL)、貝伐單抗、加利昔單抗、依帕珠單抗(epratuzumab)、SGN-40及抗CD74。 用於NHL/B細胞癌症之治療的實驗抗體藥劑之實例包括:奧伐木單抗、ha20、PRO131921、阿侖單抗、加利昔單抗、SGN-40、CHIR-12.12、依帕珠單抗、盧米西單抗、阿泊珠單抗(apolizumab)、米拉珠單抗及貝伐單抗。 用於NHL/B細胞癌症之化學療法的標準方案之實例包括:CHOP、FCM、CVP、MCP、R-CHOP、R-FCM、R-CVP及R-MCP。 用於NHL/B細胞癌症之放射免疫療法之實例包括釔-90布突默單抗泰澤坦(ZEVALIN®
)及碘-131托西莫單抗(BEXXAR®
)。套細胞淋巴瘤組合療法
用於套細胞淋巴瘤(MCL)之治療性治療包括諸如CHOP、hyperCVAD及FCM之組合化學療法。此等方案亦可補充有單株抗體利妥昔單抗以形成組合療法R-CHOP、hyperCVAD-R及R-FCM。上述療法之任一者可與幹細胞移植或ICE組合以治療MCL。 治療MCL之替代方法係免疫療法。一種免疫療法使用如利妥昔單抗之單株抗體。另一種使用癌症疫苗,諸如GTOP-99,其係基於個別患者之腫瘤之基因組成。 治療MCL之經改良方法係放射免疫療法,其中將單株抗體與放射性同位素粒子,諸如碘-131托西莫單抗(BEXXAR®
)及釔-90布突默單抗泰澤坦(ZEVALIN®
)組合。在另一實例中,BEXXAR®
係用於與CHOP依序治療。 治療MCL之其他方法包括結合高劑量化學療法之自體幹細胞移植、投與諸如硼替佐米(VELCADE®
或PS-341)之蛋白酶體抑制劑或投與諸如沙力度胺的抗血管生成劑,尤其與利妥昔單抗組合。 另一治療方法係投與導致Bcl-2蛋白降解且增加癌細胞對化學療法之敏感性的藥物,諸如奧利默森,與其他化學治療劑組合。 其他治療方法包括投與mTOR抑制劑,其可導致細胞生長之抑制甚至細胞死亡。非限制性實例係西羅莫司、坦羅莫司(TORISEL®
,CCI-779)、CC-115、CC-223、SF-1126、PQR-309、沃塔力絲(voxtalisib)、GSK-2126458及坦羅莫司組合RITUXAN®
、VELCADE®
或其他化學治療劑。 已揭示用於MCL之其他近期療法。此類實例包括夫拉平度、帕泊昔布(PD0332991)、R-羅斯維汀(塞利希布,CYC202)、苯乙烯基碸、奧巴克拉(GX15-070)、TRAIL、抗TRAIL死亡受體DR4及DR5抗體、坦羅莫司(TORISEL®
,CCl-779)、依維莫司(RAD001)、BMS-345541、薑黃素、SAHA、沙力度胺、來那度胺(REVLIMID®
,CC-5013)及格爾德黴素(17-AAG)。瓦爾登斯特倫氏 (Waldenstrom ' s) 巨球蛋白血症組合療法
用於治療瓦爾登斯特倫巨球蛋白血症(WM)之治療劑包括:哌立福新、硼替佐米(VELCADE®
)、利妥昔單抗、CC-5103、沙力度胺、依帕珠單抗(hLL2-抗CD22人源化抗體)、辛伐他汀、恩紮妥林、坎帕斯-1H (campath-1H)、地塞米松、DT-PACE、奧利默森、抗新普拉通A10、抗新普拉通AS2-1、阿侖單抗、β阿立辛、環磷醯胺、鹽酸小紅莓、潑尼松、長春新鹼硫酸鹽、氟達拉濱、非格司亭、美法侖、重組干擾素α、卡莫司汀、順鉑、環磷醯胺、阿糖胞苷、依託泊苷、美法侖、海兔毒素10、銦-111單株抗體MN-14、釔-90人源化依帕珠單抗、抗胸腺細胞球蛋白、白消安、環孢靈、甲胺喋呤、黴酚酸嗎啉乙酯、治療性同種異體淋巴細胞、釔-90布突默單抗泰澤坦、西羅莫司、他克莫司、卡鉑、噻替派、太平洋紫杉醇、阿地介白素、多西他賽、異環磷醯胺、美司鈉、重組介白素-11、重組介白素-12、Bcl-2家族蛋白抑制劑ABT-263、地尼介白素迪夫托斯、坦螺旋黴素、依維莫司、派非格司亭伏立諾他、阿昔迪布、重組flt3配位體、重組人類血小板生成素、淋巴激素活化殺手細胞、三水合阿米福汀、胺基喜樹鹼、鹽酸伊立替康、卡泊芬淨乙酸鹽、氯法拉濱、阿法依泊汀、奈拉濱、噴司他汀、沙格司亭、長春瑞賓酒石酸氫鹽、WT-1模擬肽疫苗、WT1 126-134肽疫苗、非瑞替尼、伊沙匹隆、奧沙利鉑、單株抗體CD19 (諸如替薩魯塞-T、CART-19、CTL-019)、單株抗體CD20、ω-3脂肪酸、米托蒽醌鹽酸鹽、奧曲肽乙酸鹽、托西莫單抗、碘-131托西莫單抗、莫特沙芬釓、三氧化二砷、替吡法尼、自體人類腫瘤衍生HSPPC-96、維托珠單抗、苔蘚抑素1、聚乙二醇化脂質鹽酸小紅莓及其任何組合。 用於治療WM之治療性程序之實例包括周邊血液幹細胞移植、自體造血幹細胞移植、自體骨髓移植、抗體療法、生物療法、酶抑制劑療法、全身照射、幹細胞輸注、在幹細胞支持下之骨髓消融、經活體外處理之周邊血液幹細胞移植、臍帶血移植、免疫酶技術、低LET鈷-60 γ射線療法、博萊黴素、習知手術、輻射療法及非清髓性同種異體造血幹細胞移植。彌漫性大 B 細胞淋巴瘤組合療法
用於治療彌漫性大B細胞淋巴瘤(DLBCL)之治療劑包括環磷醯胺、小紅莓、長春新鹼、潑尼松、抗CD20單株抗體、依託泊苷、博萊黴素、所列出的用於WM的諸多藥劑及其任何組合,諸如ICE及R-ICE。慢性淋巴細胞性白血病組合療法
用於治療慢性淋巴細胞性白血病(CLL)之治療劑之實例包括氯芥苯丁酸、環磷醯胺、氟達拉濱、噴司他汀、克拉屈濱、小紅莓、長春新鹼、潑尼松、潑尼松龍、阿侖單抗、所列出的用於WM的諸多藥劑,及包括以下常用組合方案之組合化學療法及化學免疫療法:CVP、R-CVP、ICE、R-ICE、FCR及FR。骨髓纖維化組合療法
骨髓纖維化抑制劑包括(但不限於)豪豬抑制劑、組蛋白去乙醯酶(HDAC)抑制劑及酪胺酸激酶抑制劑。豪豬抑制劑之非限制性實例係薩瑞德吉及維莫德吉。 HDAC抑制劑之實例包括(但不限於)普拉諾他及帕比諾他。 酪胺酸激酶抑制劑之非限制性實例係來他替尼、伯舒替尼、伊馬替尼、吉爾替尼、拉多替尼及卡博替尼。過度增生性病症組合療法
可使用吉西他濱、白蛋白結合型太平洋紫杉醇及吉西他濱/白蛋白結合型太平洋紫杉醇與JAK抑制劑及/或PI3Kδ抑制劑來治療過度增生性病症。 在實例之以下描述中,描述本發明可實踐的特定實施例。此等實施例經足夠詳細地描述以使熟習此項技術者能夠實踐本發明。可使用其他實施例,且可在不脫離本發明之範疇的情況下進行邏輯及其他改變。因此,以下詳細描述不應理解為具有限制性意義,且本發明之範疇僅藉由所附申請專利範圍以及此類申請專利範圍授權的等效物之完整範疇界定。 應理解,表現CYP3A酶之癌細胞可係由於增加的對細胞的壓力而導致的癌症病變之結果及/或投與/接觸抗癌劑之結果(亦即不由癌症本身引起而是由治療引起)。 本發明之一個實施例提供一種用於治療患有癌症的患者之方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,癌症包含表現CYP3A酶之細胞,且在投與考比西他之後細胞中抗癌劑之濃度增加。在另一實施例中,癌症包含過度表現CYP3A酶之細胞。 另一實施例提供一種用於增強抗癌劑在患有癌症的患者中之作用之方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,癌症包含表現CYP3A酶之細胞,且在投與考比西他之後細胞中抗癌劑之作用增大。在另一實施例中,癌症包含過度表現CYP3A酶之細胞。 另一實施例提供一種用於減小抗癌劑在患有癌症的患者中之代謝之方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,癌症包含表現CYP3A酶之細胞,且在投與考比西他之後細胞中抗癌劑之代謝減小。在另一實施例中,癌症包含過度表現CYP3A酶之細胞。 本發明之另一實施例提供一種用於提高患有癌症的患者對抗癌劑之敏感性之方法,其包含向該患者投與:(a)抗癌劑;及(b)考比西他;其中,考比西他提高對抗癌劑之敏感性。在另一實施例中,該增加係至少2倍或1.5倍或3倍或5倍。更特定而言,2倍。在另一實施例中,癌症包含過度表現CYP3A酶之細胞。 在另一實施例中,CYP3A酶係CYP3A4。在另一實施例中,癌症係肝癌、胰臟癌、乳癌、腎癌、結腸癌、肺癌、子宮癌、膀胱癌、胸腺癌、前列腺癌、甲狀腺癌、膀胱癌、食道癌、子宮頸癌、肉瘤或包含在表現TP53中功能增加之突變的細胞株的癌症。 在另一實施例中,CYP3A酶係CYP3A5。在另一實施例中,癌症係乳癌、胰臟癌、甲狀腺癌、腎癌、子宮頸癌或皮膚癌。 在另一實施例中,抗癌劑係選自由以下組成之群:5-氟尿嘧啶、阿法替尼、阿普利定、阿紮立平、阿那曲唑、蒽環黴素、阿西替尼、AVL-101、AVL-291、苯達莫司汀、博萊黴素、硼替佐米、伯舒替尼、苔蘚抑素-1、白消安、刺孢黴素、喜樹鹼、卡鉑、10-羥基喜樹鹼、卡莫司汀、塞來昔布、氯芥苯丁酸、順鉑、COX-2抑制劑、伊立替康(CPT-11)、SN-38、卡鉑、克拉屈濱、喜樹鹼衍生物、克唑替尼、環磷醯胺、阿糖胞苷、達卡巴嗪、達沙替尼、戴那西里、多西他賽、放線菌素D、道諾黴素、DM1、DM3、DM4、小紅莓、2-吡咯啉小紅莓(2-PDox)、2-PDox之前藥形式(前-2-PDox)、氰基-N-嗎啉基小紅莓、小紅莓葡萄糖醛酸苷、內皮抑制素、表柔比星葡萄糖醛酸苷、埃羅替尼、雌莫司汀、表葉毒素、埃羅替尼、恩替諾特、雌激素受體結合劑、依託泊苷(VP16)、依託泊苷葡萄糖醛酸苷、磷酸依託泊苷、依西美坦、芬戈莫德、氟尿苷(FUdR)、3',5'-O-二油醯基-FudR (FUdR-dO)、氟達拉濱、氟他胺、法呢基-蛋白轉移酶抑制劑、夫拉平度、福他替尼、加利特皮(ganetespib)、GDC-0834、GS-1101、吉非替尼、吉西他濱、羥脲、依魯替尼、艾達黴素、艾代拉里斯、異環磷醯胺、伊馬替尼、拉帕替尼、來那度胺、甲醯四氫葉酸、LFM-A13、洛莫司汀、氮芥、美法侖、巰嘌呤、6-巰嘌呤、甲胺喋呤、米托蒽醌、光神黴素、絲裂黴素、米托坦、單甲基阿瑞他汀F (MMAF)、單甲基阿瑞他汀D (MMAD)、單甲基阿瑞他汀E (MMAE)、溫諾平、來那替尼、尼羅替尼、亞硝基脲、奧拉帕尼、普卡黴素、丙卡巴肼、太平洋紫杉醇、PCI-32765、噴司他汀、PSI-341、雷諾昔芬、司莫司汀、SN-38、索拉非尼、鏈脲菌素、SU11248、舒尼替尼、他莫昔芬、替莫唑胺、反鉑、沙力度胺、硫鳥嘌呤、噻替派、替尼泊苷、拓朴替康、尿嘧啶氮芥、瓦他拉尼、長春瑞賓、長春鹼、長春新鹼、長春花生物鹼及ZD1839;或其醫藥學上可接受之鹽。 在另一實施例中,抗癌劑係多西他賽。在另一實施例中,抗癌劑係太平洋紫杉醇。 在另一實施例中,考比西他及抗癌劑以各別劑型投與患者。在另一實施例中,考比西他及抗癌劑作以固定劑量組合投與患者。 在另一實施例中,考比西他按一天一次投與患者。在另一實施例中,考比西他按一天兩次投與患者。在另一實施例中,考比西他按每隔一天一次投與患者。 在另一實施例中,抗癌劑之治療指數(TI)大於1或1.1或1.2或1.3或1.4或1.5或1.6或1.7或1.8或1.9或2或2.5或3或4或5。 在另一實施例中,患者未對HIV進行治療。 另一實施例提供一種醫藥組合物,其包含(a)抗癌劑;(b)考比西他;及(c)載劑。 另一實施例提供(a)抗癌劑;及(b)考比西他用於治療患有癌症的患者之用途,該癌症包含表現CYP3A酶之細胞且在投與考比西他之後細胞中之抗癌劑之濃度增加。另一實施例提供(a)抗癌劑;及(b)考比西他在製造用以治療患有癌症的患者的藥劑中之用途,該癌症包含表現CYP3A酶之細胞且在投與考比西他之後細胞中之抗癌劑之濃度增加。另一實施例提供(a)抗癌劑;及(b)考比西他用於增加患有癌症的患者對抗癌劑之敏感性之用途。在另一實施例中,考比西他增大對抗癌劑之敏感性至少2倍。另一實施例提供(a)抗癌劑;及(b)考比西他用於減小抗癌劑之代謝之用途。 另一實施例提供(a)抗癌劑;及(b)考比西他用於增強抗癌劑在患有癌症的患者中之作用之用途,其包含向該患者投與,其中該癌症包含表現CYP3A酶之細胞,且在投與考比西他之後細胞中抗癌劑之作用增大。另一實施例提供(a)抗癌劑;及(b)考比西他在製造用以增強抗癌劑在患有癌症的患者中之作用的藥劑中之用途,其包含向該患者投與,其中該癌症包含表現CYP3A酶之細胞且在投與考比西他之後細胞中之抗癌劑之作用增加。另一實施例提供(a)抗癌劑;及(b)考比西他在製造用以增加患有癌症的患者對抗癌劑之敏感性的藥劑中之用途。在另一實施例中,考比西他增大對抗癌劑之敏感性至少2倍。另一實施例提供(a)抗癌劑;及(b)考比西他在製造用以減小抗癌劑之代謝的藥劑中之用途。 細胞色素P
450 (CYP)係在正常生理狀況中之藥物代謝所涉及的關鍵酶。由於CYP可活化某些前藥而產生有效藥劑,故其活性已用於藥物研發中。CYP亦使藥物代謝成非活性形式。在某些癌細胞株中,CYP以其基本態或響應於細胞壓力表現,從而對標靶特定細胞株之藥物具有明顯作用。此表現可為腫瘤之內在屬性或在治療性治療時誘發。特定言之,已顯示CYP3A5在不同次型之胰管腺癌(PDAC)細胞中表現且誘導,導致對若干化學治療劑之敏感性缺乏或減弱。Noll
等人,Nat. Medicine,第22(3)卷,2016年3月。據顯示,對PDAC之抗藥性由標靶細胞的抗癌劑之加速代謝產生。 標靶CYP活性具挑戰性且可對已經患有衰弱性疾病的患者產生更大毒性。對非特異性CYP抑制劑或抑制在內源性化合物(脂肪酸、維生素、類固醇等)之代謝中所涉及的CYP的藥劑尤其如此。因為癌症患者通常服用各種不同藥物,其中諸多為CYP受質,所以抑制之選擇性對於治療而言很重要。另外,某些CYP以高組織特異性受限方式表現。標靶此等CYP可引起系統性毒性減小。 目前已知超過57種活性人類P
450基因及58種偽基因。Rodriguez - Antona
等人Oncogene
(2006) 25, 1679-1691。大多數多形性CYP係在CYP2B6
(48對偶基因)、CYP2C9
(32)、CYP2D6
(92)及CYP3A4
(34)上。考慮CYP2A6 、 CYP2B6 、 CYP2C9 、 CYP2C19
及CYP2D6
基因之可變性,可見大多數功能性多形現象。因此,找到單個在抑制特異CYP方面具有選擇性而又強力且有效的藥劑係困難的。實例 實例 1. 細胞製備。
所有細胞株均獲自美國菌種保存中心(American Type Culture Collection;ATCC) Manassas, Virginia (US)。母體細胞庫及工作細胞庫(MCB及WCB)藉由於ATCC推薦之培養基中繼代培養及冷凍方案(www.atcc.org)而製得。用於分析之細胞株原料自WCB製得。MCB、WCB及分析原料分別在ATCC瓶之3個、6個及9個通道內製得。化合物製備。
在經校準天平上稱量參考化合物之固體粉末且將其溶解於100% DMSO中。DMSO樣品儲存於室溫下。在實驗當天,將化合物原料用100% DMSO中以3.16倍步驟稀釋以得到9點稀釋系列。將此物進一步用pH 7.4的20 mM無菌Hepes緩衝液稀釋31.6倍。將5 μL之容積轉移至細胞中以產生在3.16×10- 5
M 至3.16×10- 9
M範圍內的測試濃度,一式兩份。在培育期間在所有孔中之最終DMSO濃度係0.4%。若化合物顯示極強力活性,則擴大測試範圍以確保可重複量測出完全的劑量-反應曲線。細胞增殖分析 。
將分析原料解凍,且用ATCC推薦之培養基稀釋且根據所用細胞株以每孔200至3200細胞之濃度於45 μL培養基中分配於384孔盤中。對於所用各細胞株使用最佳細胞密度。板之邊緣填充有磷酸鹽緩衝生理鹽水。將經接種細胞在37℃下在5% CO2
之潮濕氛圍中培育。在24小時之後,添加5 μL之化合物稀釋液且將盤再進一步培育120小時。在120小時之後,添加25 μL之ATPlite 1Step™ (PerkinElmer)溶液至各孔中,且隨後振盪2分鐘。在於暗處培育10分鐘之後,經Envision多模式讀取器(PerkinElmer)記錄發光。對照組 T = 0 信號。
在平行盤上,分配45 μL細胞且在37℃下在5% CO2
之潮濕氛圍中培育。在24小時之後,混合5 μL含DMSO的Hepes緩衝液與25 μL ATPlite 1Step™溶液,在培育10分鐘之後量測發光(=發光 t = 0
)。參考化合物。
在各別盤上量測參考化合物小紅莓之IC50
。整理出IC50
趨向。若IC50
不符合標準(偏離歷史平均值0.32至3.16倍),則分析無效。細胞生長控制。
所有細胞株之細胞倍增時間自未經處理細胞之t=0小時及t=120小時的生長信號來計算。若倍增時間不符合標準(偏離歷史平均0.5至2.0倍),則分析無效。最大信號。
對於各細胞株,在存在0.4% DMSO下在無化合物之下培育120小時之後記錄最大發光DMSO (=發光 未經處理, t = 120h
)。數據分析 IC50
藉由使用IDBS XLfit 5進行非線性回歸來計算。120小時後之生長百分比(%
生長)如下計算:100% × (發光 t = 120
/發光 未經處理, t = 120h
)。此藉由以下4-參數對數曲線擬合10
log化合物濃度(conc
):生長 %
=底部
+(頂部
-底部
)/(1+10( logIC50 -conc) × hill
),其中hill
係希爾係數,且底部
及頂部
係該分析中化合物允許的漸進最小及最大細胞生長。NCI60 參數 LD50
,即50%之細胞死亡的濃度,係其中發光 t = 120h
= ½ ×發光 t = 0h
的濃度。GI50
,即50%生長抑制之濃度,係其中細胞生長為半最大的濃度。此濃度係與信號相關之濃度:((發光 未經處理, t = 120h
-發光 t = 0
)/2)+發光 t = 0
。R.H. Shoemaker (2006),
Nature Reviews Cancer 6: 814-823。藥物敏感性。
以三種方式分析細胞株之『經修飾的』及『天然類型』組之間的10
log IC50
差異。首先,對於十八種最常見遺傳變化,個別細胞株之藥物敏感性呈瀑布樣顯現。其次,在統計方案R中用II型方差分析來分析最常出現且最已知的癌症基因之更大子集(總計38個)。第三,在R中藉由雙邊同方差t-測試分析全套114個癌症基因。 將來自方差分析及t-測試之p值進行本傑明-霍赫貝格(Benjamini-Hochberg)多重測試校正,且僅錯誤發現率小於20%之基因關聯視為顯著。38-基因分析之結果以火山形曲線顯現。對38個癌症基因的II型方差分析係與對114個癌症基因之同方差t-測試不同的測試,意謂關聯之顯著性可能不同。關於Oncolines™之額外信息描述於J . C . M . Uitdehaag
等人( 2014 )
, PLoS ONE 9: e92146中。結果
:研究之結果反映在表1中。表 1
NA:數據不產生可量測的IC50以給出治療之間的對比。 相比於僅投與主要藥物,共同投與考比西他大體上增加所測試的諸多細胞株對主要藥物之敏感性。在所有實驗中,平均起來,考比西他增加敏感性2.9倍,其中最大增加8.7倍。敏感性之最高平均增加出現於膀胱、骨骼及前列腺之癌細胞中。在來自血液、中樞神經系統、乳腺、結腸及皮膚之癌細胞中亦發現廣泛活性。多西他賽、長春鹼及長春新鹼經增強達最大程度。 本文所引用之文章、專利及參考文獻之內容以引用之方式併入。
圖 1
描繪正常組織中之相對CYP3A4表現(上部條)對比腫瘤中之CYP3A4表現(下部條)。表現概況在腫瘤中變化最大,其中特定腫瘤過度表現CYP3A4 (例如描繪結腸直腸腺癌之「點」)。在一些腫瘤(例如胰臟癌)中,相比於正常細胞株,大多數腫瘤過度表現CYP3A4。圖 2
描繪正常組織中之相對CYP3A5表現(上部條)對比腫瘤中之CYP3A5表現(下部條)。正如CYP3A4之情況,表現概況在腫瘤中變化最大,其中特定腫瘤過度表現CYP3A5 (例如延伸至子宮頸鱗狀細胞癌及子宮頸內腺癌之腫瘤水準之右側的條)。在一些細胞株(例如腎臟癌)中,相比於正常細胞株,大多數腫瘤過度表現CYP3A5。
Claims (18)
- 一種(a)抗癌劑與(b)考比西他(cobicistat)之用途,其係用於製造用以治療患有癌症的患者之藥劑,其中該癌症包含表現CYP3A酶之細胞且在投與考比西他之後該等細胞中該抗癌劑之濃度增加。
- 一種(a)抗癌劑與(b)考比西他之用途,其係用於製造用以增強抗癌劑在患有癌症的患者中作用的藥劑,其中該癌症包含表現CYP3A酶之細胞且在投與考比西他之後在該等細胞中該抗癌劑之作用增加。
- 一種(a)抗癌劑與(b)考比西他之用途,其係用於製造用以增加患有癌症的患者對抗癌劑之敏感性的藥劑,其中考比西他使對該抗癌劑之敏感性增大至少2倍。
- 一種(a)抗癌劑與(b)考比西他之用途,其係用於製造用以降低抗癌劑在患有癌症的患者中代謝的藥劑,其中該癌症包含表現CYP3A酶之細胞且在投與考比西他之後在該等細胞中該抗癌劑之代謝降低。
- 如請求項3或4之用途,其中該癌症包含過度表現該CYP3A酶之細胞。
- 如請求項1至4中任一項之用途,其中該CYP3A酶係CYP3A4。
- 如請求項1至4中任一項之用途,其中該CYP3A酶係CYP3A5。
- 如請求項1至4中任一項之用途,其中該癌症係肝癌、胰臟癌、乳癌、腎癌、結腸癌、肺癌、子宮癌、膀胱癌、胸腺癌、前列腺癌、甲狀腺癌、膀胱癌、食道癌、子宮頸癌、肉瘤,或包含表現TP53中功能增加突變的細胞株的癌症。
- 如請求項8之用途,其中該癌症係乳癌、胰臟癌、甲狀腺癌、腎癌、子宮頸癌或皮膚癌。
- 如請求項1至4中任一項之用途,其中該抗癌劑係選自由以下組成之群:5-氟尿嘧啶、阿法替尼(afatinib)、阿普利定(aplidin)、阿紮立平(azaribine)、阿那曲唑(anastrozole)、蒽環黴素、阿西替尼(axitinib)、AVL-101、AVL-291、苯達莫司汀(bendamustine)、博萊黴素(bleomycin)、硼替佐米(bortezomib)、伯舒替尼(bosutinib)、苔蘚抑素-1 (bryostatin-1)、白消安(busulfan)、刺孢黴素(calicheamycin)、喜樹鹼(camptothecin)、卡鉑(carboplatin)、10-羥基喜樹鹼、卡莫司汀(carmustine)、塞來昔布(celecoxib)、氯芥苯丁酸(chlorambucil)、順鉑、COX-2抑制劑、伊立替康(irinotecan)(CPT-11)、SN-38、卡鉑(carboplatin)、克拉屈濱(cladribine)、喜樹鹼衍生物(camptothecans)、克唑替尼(crizotinib)、環磷醯胺、阿糖胞苷、達卡巴嗪(dacarbazine)、達沙替尼(dasatinib)、戴那西里(dinaciclib)、多西他賽(docetaxel)、放線菌素D (dactinomycin)、道諾黴素(daunorubicin)、DM1、DM3、DM4、小紅莓(doxorubicin)、2-吡咯啉小紅莓(2-PDox)、2-PDox之前藥形式(前-2-PDox)、氰基-N-嗎啉基小紅莓、小紅莓葡萄糖醛酸苷(glucuronide)、內皮抑制素、表柔比星葡萄糖醛酸苷(epirubicin glucuronide)、埃羅替尼(erlotinib)、雌莫司汀(estramustine)、表鬼臼毒素(epidophyllotoxin)、埃羅替尼、恩替諾特(entinostat)、雌激素受體結合劑、依託泊苷(etoposide)(VP16)、依託泊苷葡萄糖醛酸苷、磷酸依託泊苷、依西美坦(exemestane)、芬戈莫德(fingolimod)、氟尿苷(floxuridine)(FUdR)、3',5'-O-二油醯基-FudR (FUdR-dO)、氟達拉賓(fludarabine)、氟他胺(flutamide)、法呢基-蛋白轉移抑制劑(farnesyl-protein transferase inhibitors)、夫拉平度(flavopiridol)、福他替尼(fostamatinib)、加利特皮(ganetespib)、GDC-0834、GS-1101、吉非替尼(gefitinib)、吉西他濱(gemcitabine)、羥脲、依魯替尼(ibrutinib)、艾達黴素(idarubicin)、艾代拉里斯(idelalisib)、異環磷醯胺、伊馬替尼(imatinib)、拉帕替尼(lapatinib)、來那度胺(lenolidamide)、甲醯四氫葉酸(leucovorin)、LFM-A13、洛莫司汀(lomustine)、氮芥(mechlorethamine)、美法侖(melphalan)、巰嘌呤、6-巰嘌呤、甲胺喋呤(methotrexate)、米托蒽醌(mitoxantrone)、光神黴素(mithramycin)、絲裂黴素(mitomycin)、米托坦(mitotane)、單甲基阿瑞他汀F (monomethylauristatin F)(MMAF)、單甲基阿瑞他汀D (MMAD)、單甲基阿瑞他汀E (MMAE)、溫諾平(navelbine)、來那替尼(neratinib)、尼羅替尼(nilotinib)、亞硝基脲、奧拉帕尼(olaparib)、普卡黴素(plicomycin)、丙卡巴肼(procarbazine)、太平洋紫杉醇(paclitaxel)、PCI-32765、噴司他汀(pentostatin)、PSI-341、雷諾昔酚(raloxifene)、司莫司汀(semustine)、SN-38、索拉非尼(sorafenib)、鏈脲菌素(streptozocin)、SU11248、舒尼替尼(sunitinib)、他莫昔芬(tamoxifen)、替莫唑胺(temazolomide)、反鉑(transplatinum)、沙立度胺(thalidomide)、硫鳥嘌呤、噻替派(thiotepa)、替尼泊苷(teniposide)、拓朴替康(topotecan)、尿嘧啶氮芥(uracil mustard)、瓦他拉尼(vatalanib)、長春瑞賓(vinorelbine)、長春鹼(vinblastine)、長春新鹼(vincristine)、長春花生物鹼及ZD1839;或其醫藥學上可接受之鹽。
- 如請求項1至4中任一項之用途,其中該抗癌劑係選自由以下組成之群:多西他賽、長春鹼及長春新鹼;或其醫藥學上可接受之鹽。
- 如請求項1至4中任一項之用途,其中考比西他及該抗癌劑係以各別劑型投與該患者。
- 如請求項1至4中任一項之用途,其中考比西他係按一天一次投與該患者。
- 如請求項1至4中任一項之用途,其中考比西他及該抗癌劑係以固定劑量組合投與該患者。
- 如請求項1至4中任一項之用途,其中該抗癌劑之治療指數(TI)大於1。
- 如請求項1至4中任一項之用途,其中該抗癌劑之TI大於2。
- 如請求項1至4中任一項之用途,其中該患者未對HIV進行治療。
- 一種醫藥組合物,其包含(a)抗癌劑;(b)考比西他;及(c)載劑。
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| CN115643797A (zh) * | 2020-04-30 | 2023-01-24 | 天境生物科技(上海)有限公司 | 包含抗cd47抗体的药物组合物 |
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| US20180036289A1 (en) | 2018-02-08 |
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