WO2015156409A1 - 抗癌剤および副作用軽減剤 - Google Patents
抗癌剤および副作用軽減剤 Download PDFInfo
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- WO2015156409A1 WO2015156409A1 PCT/JP2015/061296 JP2015061296W WO2015156409A1 WO 2015156409 A1 WO2015156409 A1 WO 2015156409A1 JP 2015061296 W JP2015061296 W JP 2015061296W WO 2015156409 A1 WO2015156409 A1 WO 2015156409A1
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- anticancer
- arctigenin
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Definitions
- the present invention relates to a novel anticancer agent and a side effect reducing agent for reducing side effects caused by components having anticancer activity.
- pancreatic cancer is one of the intractable cancers, and the 5-year survival rate of all patients is estimated to be 2-3%.
- the number of patients who die from pancreatic cancer has increased rapidly by approximately 2.5 times over the last 20 years, with 2009 statistics showing 26,791 deaths from pancreatic cancer.
- the number of occurrences and deaths is almost the same, accounting for 6% of cancer deaths in Japan, and the fifth in cancer deaths by region, after lung, stomach, large intestine, and liver.
- Surgical excision is the only treatment that can be expected to be cured.
- pancreatic cancer is found in many patients with advanced cancer (stage III + IV), it is actually possible to remove the pancreas. It is said to be about 10-20% of all cancer patients.
- the median survival time for each stage was about 12-30 months for Stage I and II, 9-11 months for Stage III, and 5-6 months for Stage IV. It is thought that there is almost no possibility of doing.
- pancreatic cancer-derived cells such as PANC-1, AsPC-1, BxPC-1 and KP-3 have been found to be highly resistant even under extreme nutrient starvation conditions.
- PANC-1 pancreatic cancer-derived cells
- AsPC-1 AsPC-1
- BxPC-1 BxPC-1
- KP-3 KP-3
- Non-patent Document 1 a pancreatic cancer cell line PANC-1 was used to screen for substances capable of canceling the viability of tumor cells in an undernutrition state, it was reported that architigenin was effective (Non-patent Document 1; Incorporated by reference in its entirety).
- Cancer stem cells are cells that have self-renewal ability and pluripotency, and have a strong tumor-forming ability to form cancer at a high rate even from a small number of cells.
- Tumor tissue is rapidly expanded and many immature blood vessels are formed in the tissue, resulting in circulatory failure and hypoxia / nutrition, as well as anticancer drug delivery. It is pointed out that this will also have an effect.
- cancer stem cells are a major obstacle to cancer treatment because they are resistant to many anticancer drugs and radiation and cause metastasis. It is known that many are induced in a small microenvironment.
- Anticancer agents generally have many side effects such as weight loss, organ weight loss, skin and mucous membrane inflammation, hair loss, diarrhea, and cytopenias.
- Gemcitabine an anticancer agent for pancreatic cancer, is also known to cause side effects such as myelosuppression and liver damage. Therefore, there is a demand for the development of anticancer agents that have not only superior anticancer activity but also fewer side effects.
- An object of the present invention is to provide an anticancer agent and a side effect reducing agent that have higher anticancer activity and can reduce side effects.
- the inventors of the present invention when administered in combination with umbogen extract containing architigenin and gemcitabine to mice transplanted with human pancreatic cancer cells, not only suppressed tumor weight increase, but also compared with untreated group and single administration group Intratumoral ratio of CD44 + , CD24 + , CD326 + cells (triple positive) and CD133 + , CD44 + cells (double positive) reported as pancreatic cancer stem cell fraction is significantly reduced I found it. In addition, it was found that the side effects observed when gemcitabine was administered alone were recovered when administered in combination. Furthermore, the present inventors have found that the overall survival time is significantly prolonged by administering gobo-bovine extract and gemcitabine in combination to pancreatic cancer-bearing mice.
- arctigenin vascular li endothelial growth factor
- the neovascularization of immature blood vessels is suppressed, while the hypoxic / low-nutrient intratumoral region formed by immature blood vessels is necrotized, resulting in blood flow in the tumor tissue. It has been found to normalize, and this is thought to improve the drug delivery properties of components having anticancer activity into tumor tissue.
- Angiogenesis in tumor tissue is induced by release of angiogenic factors from cancer cells, tumor stromal cells, etc. by stimulating hypoxia, low glucose, growth factors, and the like.
- angiogenic factors such as VEGF (vascular li endothelial growth factor) that induce such angiogenesis are abundant.
- This inhibitory antibody drug for VEGF is angiogenesis in the tumor.
- bevacizumab affects not only tumor blood vessels but also normal blood vessels, side effects such as bleeding and blood clots are problematic.
- hypoxia associated with subsequent vascular regression causes cancer cells to become malignant again. ing.
- Arctigenin shrinks the tissues containing cancer cells and cancer stem cells that survive in the hypoxic / low nutrient environment of the tumor tissue, and as a result, blood vessels induced under this hypoxic / low nutrient condition. It is thought to suppress the release of nascent factors. Therefore, archigenin is thought to improve drug delivery into the tumor of components having anticancer activity because it can selectively normalize intratumoral blood vessels. This effect is thought to be due to the killing of malignant cancer cells and cancer stem cells by transferring argigengenin to the hypoxic / hypotrophic region of the tumor tissue through interstitial fluid and lymph fluid leaked from the capillaries.
- architigenin enhances the effects of bevacizumab even in combination with bevacizumab, a VEGF inhibitor.
- mice transplanted with human colorectal cancer cells were administered with gobo-bovine extract containing arctigenin and bevacizumab, an existing anticancer agent for colorectal cancer, resulting in an increase in tumor weight compared to the untreated group and the single administration group. It was found that it was more strongly suppressed.
- the tumor tissue under high-grade hypoxia and undernutrition environment is necrotic, and by inhibiting immature intravascular tumor formation, ulcer formation in the tissue is suppressed. (See FIG. 2). This indicates that intratumoral blood flow has been improved, and that delivery of an anticancer drug administered in combination is also improved.
- arctigenin enhances the effects of components having anticancer action by these actions.
- the present invention provides an anticancer agent in which arctigenin and an ingredient having anticancer activity other than arctigenin are combined.
- the present invention also provides the anticancer agent as a compounding agent.
- the present invention also provides an anticancer agent which is a kit comprising the above anticancer agent comprising a preparation containing arctigenin and a preparation containing a component having anticancer activity.
- the present invention provides an anticancer agent wherein arctigenin is a burdock extract in the above anticancer agent.
- the present invention also provides a preparation for co-administration in combination with an ingredient having anti-cancer activity other than arctigenin, which contains arctigenin as an active ingredient.
- the present invention also provides a side effect reducing agent for reducing side effects caused by components having anti-cancer activity other than arctigenin, which contains arctigenin as an active ingredient.
- the present invention also provides an intratumoral blood vessel normalizing agent comprising archigenin as an active ingredient.
- the present invention also provides an agent for enhancing drug delivery to a tumor tissue of an ingredient having anticancer activity, which contains archigenin as an active ingredient.
- the present invention by administering arctigenin together with a component having anticancer activity other than arctigenin, tumor growth can be suppressed and the ratio of cancer stem cells in the tumor can be decreased, and higher anticancer activity is exhibited. Moreover, according to the present invention, side effects of conventional anticancer agents can be reduced. Furthermore, according to the present invention, the overall survival time can be extended as compared with the case where a conventional anticancer agent is administered alone.
- variation of the tumor size by the existing chemotherapeutic agent with respect to a pancreatic cancer model, an arguchigenin-rich burdock extract, and these combination The figure which shows the fluctuation
- the anticancer agent of the present invention is a combination of arctigenin and an ingredient having anticancer activity other than arctigenin as active ingredients.
- the anticancer agent of the present invention is a combination of an ingredient having an anticancer activity other than archigenin as an active ingredient and archigenin as an enhancer of drug delivery to the tumor tissue of the ingredient. That is, the anticancer agent of the present invention is a concomitant agent administered in combination with archigenin and a component having anticancer activity.
- the anticancer agent of the present invention is a drug having an anticancer activity and contains archigenin as an active ingredient.
- the anticancer action of the anticancer agent of the present invention includes not only an action of suppressing or reducing the number of cancer cells, but also an action of reducing the number of cancer stem cells.
- Cancer stem cells are cells having stem cell properties among cancer cells, and have the ability to self-replicate and the ability to supply progenitor cells. Cancer stem cells have the ability to supply cancer cells and reconstruct tumor tissue.
- the anticancer agent of the present invention not only suppresses the growth of cancer cells, but also contributes to the prevention of cancer onset, metastasis and recurrence by reducing the number of cancer stem cells.
- cancer stem cells Various markers are known for cancer stem cells.
- CD44 + , CD24 + and CD326 + cells triple positive
- cancer stem cells with excellent tumorigenicity Among cancer stem cells in the tumor, CD133 + and CD44 + cells (double positive) are cancer stem cells with extremely high metastatic potential.
- cancer stem cells are thought to exist in a peculiar microenvironment of hypoxia and nutrition.
- many immature tumor blood vessels induced by oxygen deficiency, sugar deficiency signals, etc. are formed, which tends to cause circulatory insufficiency, resulting in poor delivery of anticancer drugs, making it difficult for anticancer drugs to be effective. Yes. Therefore, it is considered that the anticancer drug is likely to be effective if the cancer cells in the deficient region including immature blood vessels are removed and the blood flow is normalized by inhibiting angiogenesis.
- “combination” of arctigenin and a component having anti-cancer activity other than arctigenin is to provide them as a combination agent, to provide a drug containing each of them as a kit, and in combination Including use.
- the term “in combination with” an anticancer activity component other than architigenin means that archigenin is administered before, simultaneously with, or after administration of the component having anticancer activity. As long as both arctigenin and a component having anticancer activity other than arctigenin are used, their administration order and dosage form are not limited.
- Such administration forms include, for example, administration of a single preparation obtained by simultaneously formulating arctigenin and a component having anticancer activity, and obtainment by separately formulating arctigenin and a component having anticancer effect 2 Co-administration of two types of preparations by the same route of administration, administration of architigenin and components having anticancer activity separately, administration of two types of formulations at the same route of administration, archigenin and anticancer Simultaneous administration of two types of preparations obtained by separately formulating active ingredients with different administration routes, different administration of two kinds of preparations obtained by separately formulating archigenin and components having anticancer activity Examples include administration with a time difference in the route.
- the component having anticancer activity other than arctigenin may be any drug having anticancer activity, and for example, an existing anticancer agent can be used.
- the component having anticancer activity used in the present invention has, for example, anticancer activity against the following cancers: breast cancer, prostate cancer, pancreatic cancer, gastric cancer, lung cancer, colon cancer, rectal cancer, colon cancer, small intestine cancer, esophageal cancer.
- Duodenal cancer Duodenal cancer, tongue cancer, pharyngeal cancer, salivary gland cancer, brain tumor, schwannoma, liver cancer, kidney cancer, gallbladder cancer, bile duct cancer, pancreatic cancer, liver cancer, endometrial cancer, cervical cancer, ovarian cancer, bladder cancer , Urethral cancer, skin cancer, hemangioma, malignant lymphoma, malignant melanoma, thyroid cancer, parathyroid cancer, nasal cavity cancer, sinus cancer, bone tumor, hemangiofibroma, retinal sarcoma, penile cancer, testicular tumor, childhood solid cancer Kaposi's sarcoma, maxillary sinus tumor, fibrous histiocytoma, leiomyosarcoma, rhabdomyosarcoma, leukemia.
- the component having an anticancer activity has an anticancer activity against pancreatic cancer and colon cancer.
- the component having anticancer activity is not particularly limited as long as it is a compound that contributes to suppression of cancer cell proliferation or metastasis, killing of cancer cells, or suppression of cancer cell generation.
- the component having anticancer activity may act on cancer cells either directly or indirectly.
- the components having anticancer activity used in the present invention can be, for example, cancer antibiotics, platinum preparations, alkylating agents, antimetabolites, plant alkaloids, molecular targeted therapeutic agents and hormonal agents. It is not limited to.
- the components having anticancer activity used in combination with the present invention include, for example, 6-mercaptopurine, AC-T therapy, AC therapy, CAF therapy, CMF therapy, FOLFIRINOX therapy, FOLFIRI therapy, FOLFOX therapy, IRIS therapy, L -Asparaginase, TS-1, UFT, XELOX therapy, actinomycin, aclarubicin, asparaginase, anastrozole, abiraterone, afatinib, affinitac, amrubicin sputum, alectinib, idarubicin, ipilimab, ifosfamide, ibrituminob, ibrutinibinobutimaid , Interferon ⁇ , interferon ⁇ , interferon- ⁇ , exemestane, ethynyl, etoposide, enocitabine, epirubicin, everolimus, eribulin, er
- the anticancer agent of the present invention can obtain a more excellent anticancer effect by combining arctigenin and a component having anticancer activity other than arctigenin, and can reduce side effects due to the component having anticancer activity. It has the effect of being able to.
- -Side effects caused by components having an anti-cancer effect are not suitable for the purpose of treatment or have an adverse effect on the living body, and include generally recognized side effects.
- side effects caused by anti-cancer components include skin inflammation, mucosal inflammation, hair loss, diarrhea, loss of appetite, general malaise, pain, dyspnea, nausea, vomiting, fever, olfactory loss, organ damage, stroma Symptoms such as pneumonia, organ failure and myelosuppression.
- mental distress such as anxiety, agitation, loss of interest, dullness, insomnia, alienation, fear, adaptation disorder, depression and delirium associated with these physical disorders are also side effects of ingredients with anticancer effects. included.
- the anticancer agent of the present invention can particularly reduce organ damage such as bone marrow suppression and liver damage.
- the “reduction” of the side effect of an anti-cancer component means that the burden on the living body and pain caused by the administration of the anti-cancer component are reduced and lightened. Further, “reducing” a side effect means that the side effect is directed toward normalization. “Reducing” side effects includes not only improving and treating side effects once they occur, but also preventing, suppressing, and preventing side effects before they occur.
- the anticancer agent of the present invention may contain archigenin so that the daily dose is 10 to 2000 mg per adult.
- the component which has an anticancer action can be contained in an anticancer agent so that it may become a dosage which can exhibit an anticancer action.
- the dose that can exert the anticancer effect varies depending on the component having the anticancer effect and can be appropriately set.
- the component having anticancer activity is gemcitabine, it may be contained in the anticancer agent so that the daily dose is 500 to 2000 mg / mm 2 .
- the component having anticancer activity is bevacizumab (eg, Avastin)
- it may be contained in the anticancer agent so that the daily dose is 5 to 30 mg / kg.
- Arctinigenin is not particularly limited, but may be administered 1 to 7 days a week.
- arctigenin may be administered daily or 5 or 6 times a week.
- the component having anticancer activity is not particularly limited, but may be administered 0 to 7 days a week.
- the component having anticancer activity may be administered once a week.
- a formulation containing archigenin and a formulation containing a component having anticancer activity may be administered at the same time.
- the preparation containing the component having anticancer action may be administered first, followed by the preparation containing archigenin, and the preparation containing archigenin may be administered first, and then the ingredient having anticancer action may be added.
- the containing formulation may be administered.
- the time difference When administered at a time difference, the time difference varies depending on the dosage form, method of administration, type of component having anti-cancer activity, etc., but administration of a preparation containing archigenin is carried out every day and contains components having anti-cancer activity other than archigenin
- the formulation to be administered may be administered every 1 to 28 days, every 1 to 14 days, or every 1 to 7 days.
- a preparation containing a component having an anticancer activity other than arctigenin may be administered first.
- the ingredient having anticancer activity other than architigenin is gemcitabine
- 10 to 2000 mg of architigenin per day for an adult is administered for 5 to 6 days per week, and 500 to 2000 mg / day per day.
- mm 2 gemcitabine may be administered once a week. More preferably, 100 to 500 mg of architigenin per day is administered for 5 to 6 days a week, and gemcitabine of 1000 mg / mm 2 or more per day may be administered once or more a week.
- bevacizumab eg, Avastin
- 10 to 2000 mg of architigenin per day per adult is administered for 5 to 6 days per week, and per day 5-30 mg / kg bevacizumab may be administered once a week. More preferably, 100 to 500 mg of architigenin per day is administered for 5 to 6 days a week, and 15 mg / kg or more of bevacizumab may be administered once or more per week.
- Arctigenin may be derived from a plant containing arctigenin.
- Plants containing arctigenin are not particularly limited.
- burdock sprouts, leaves, rhizomes, burdock
- safflower cornflower
- American thistle sorghum (Cirsium thistle)
- cardon sandy thistle, anchocolate
- Ayokorengyo ginseng
- Forsythia syringae, sesame, maple convolvulus, cinchiku himehagi, dung beetle katsura, taikakazura, munintakekakazura, himetakekakazura, tokyo oleander, keteka quail, rhododendron, okterade, yamazakuru Including Mexican cypress and kaya.
- burdock especially burdock
- forsythia are preferred because of their high arc
- Burdock is stipulated by the Japanese bureau 16 as the fruit of the burdock Arctium lappa Linne.
- burdock is a herbal medicine prescribed for Ginkakusan, Gakufu-Dokuto, Shifufu-san, etc., and is classified as a component essence used exclusively as a medicine.
- the burdock contains about 7% arctiin, which is classified as a lignan glycoside, and about 0.6% of its aglycone, arctigenin.
- a burdock extract obtained using a method for producing a burdock extract described later can be used. Therefore, productivity at the time of manufacture can be improved, and an anticancer agent can be prepared inexpensively and easily. Moreover, also when using plants other than burdock, it is possible to easily obtain an extract containing arctigenin by using the production method described later.
- the extract powder obtained by the method for producing a burdock extract described later contains a high content of arctigenin. Therefore, if an extract powder obtained by this method for producing burdock extract is used, an anticancer agent having an excellent effect can be obtained as compared with a conventional burdock extract.
- the anticancer agent of the present invention may further contain arctiin.
- Arctiin may be derived from a plant containing arctiin, for example from burdock, burdock sprout, forsythia, or forsythia. That is, the anticancer agent of the present invention may further contain arctiin contained in this burdock extract by containing an extract from a plant containing arctigenin, for example, a burdock extract obtained from burdock.
- the anticancer agent of the present invention may contain archigenin and archtiin so that the weight ratio of archigenin / arctiin is 0.7 or more.
- the weight ratio of archigenin / arctiin is not particularly limited, but may be 1.3 or less.
- the anticancer agent of the present invention may contain a burdock extract containing 3% or more of arctigenin. Such a burdock extract can be obtained by a method for producing a burdock extract described later.
- the anticancer agent of the present invention can provide a higher anticancer effect than the case of containing the conventional burdock extract by containing the burdock extract obtained by the method for producing the burdock extract described later.
- the anticancer agent of the present invention can further contain an optional component.
- the anticancer agent of the present invention can be provided in a form containing a pharmaceutically acceptable base, carrier, excipient, binder, disintegrant, lubricant, colorant and the like.
- Examples of carriers and excipients used for anticancer agents include lactose, glucose, sucrose, mannitol, dextrin, potato starch, corn starch, calcium carbonate, calcium phosphate, calcium sulfate and crystalline cellulose.
- binder examples include starch, gelatin, syrup, tragacanth gum, polyvinyl alcohol, polyvinyl ether, polyvinyl pyrrolidone, hydroxypropyl cellulose, methyl cellulose, ethyl cellulose, carboxymethyl cellulose, and the like.
- disintegrant examples include starch, agar, gelatin powder, crystalline cellulose, calcium carbonate, sodium hydrogen carbonate, sodium alginate, sodium carboxymethylcellulose, and carboxymethylcellulose calcium.
- examples of lubricants include magnesium stearate, hydrogenated vegetable oil, talc and macrogol.
- the colorant any colorant allowed to be added to a pharmaceutical product can be used.
- Anticancer agents may be sucrose, gelatin, purified shellac, gelatin, glycerin, sorbitol, ethylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, polyvinylpyrrolidone, cellulose phthalate, hydroxypropylmethylcellulose phthalate, methyl methacrylate and It may be coated with one or more layers with an acrylic acid polymer or the like.
- a pH adjuster a buffer, a stabilizer, a solubilizer, and the like may be added to the anticancer agent as necessary.
- anticancer agent can be provided as a preparation of any form.
- anticancer agents include tablets such as sugar-coated tablets, buccal tablets, coated tablets and chewable tablets, capsules including troches, pills, powders and soft capsules, granules, suspensions, emulsions and dry syrups as orally administered preparations It can be a syrup, as well as a liquid such as an elixir.
- anti-cancer agents are for parenteral administration, such as intravenous injection, subcutaneous injection, intraperitoneal injection, intramuscular injection, transdermal administration, nasal administration, pulmonary administration, enteral administration, buccal administration, and transmucosal administration.
- the formulation for administration of can be an injection, a transdermal absorption tape, an aerosol, a suppository and the like.
- an extract from a plant or the like since the extract has a peculiar taste, it can be used as a preparation for masking the extract or a film coating agent coated with a coating agent. .
- the anticancer agent of the present invention may be a compounding agent in which arctigenin and a component having anticancer activity are mixed, or may be a kit in which preparations containing each of them are combined.
- the anticancer agent of the present invention is a compounding agent
- architigenin and the component having an anticancer action can be formulated into a compounding agent by a usual method of mixing a plurality of drugs into a compounding agent.
- the compounding agent may further contain an optional component other than architigenin and a component having anticancer activity.
- the optional component any component that can be contained in the above-described anticancer agent can be used.
- the form of the compounding agent can be any form such as liquid, solid, semi-solid and powder.
- the blending ratio of arctigenin and the component having anticancer activity can be set to an appropriate blending ratio capable of exhibiting the respective effects.
- the preparation containing archigenin and the preparation containing a component having anticancer action are in the same form. It may be a different form.
- the preparation containing archigenin and the preparation containing a component having anticancer activity may be the same or different preparations.
- both a preparation containing archigenin and a preparation containing a component having an anticancer activity may be an oral administration preparation or a parenteral administration preparation, or a preparation containing archigenin is an oral administration preparation and has an anticancer action.
- the preparation containing the component having may be a parenteral preparation.
- the preparation containing archigenin and the preparation containing a component having anticancer activity may further contain any component other than archigenin and a component having anticancer activity, respectively.
- any component that can be contained in the above-described anticancer agent can be used.
- Test Examples 1 and 2 which will be described later, when architigenin and an existing anti-cancer component are administered in combination, the ratio of cancer stem cells in the tumor is reduced compared to when the anti-cancer component is administered alone It was shown that Further, in Test Example 3 described later, it is shown that side effects caused when architigenin and a component having an existing anticancer activity are administered in combination are administered when the component having an anticancer activity is administered alone. It was done. Therefore, the anticancer agent of the present invention has higher anticancer activity and can reduce side effects caused by components having anticancer activity.
- the anticancer agent of the present invention can be used as a medicament for treating or improving cancer by suppressing tumor growth and decreasing the ratio of cancer stem cells in the tumor.
- the anticancer agent of the present invention can treat any cancer depending on the type of component having anticancer activity. For example, when gemcitabine is used as a component having anticancer activity, it can be used as a medicament for treating or improving pancreatic cancer. When bevacizumab (such as Avastin) is used as a component having anticancer activity, It can be used as a medicament for treating or improving colorectal cancer.
- the present invention also includes a preparation for coadministration in combination with a component having anticancer activity other than architigenin, which contains architigenin as an active ingredient.
- the preparation of the present invention can have the same configuration as the preparation containing archigenin described in the above-described anticancer agent. This preparation can be used, for example, as a part of the anticancer agent described above.
- the component having an anticancer action to be combined with the preparation of the present invention the component having the anticancer action described in the above-mentioned anticancer agent, for example, an existing anticancer agent can be used.
- the preparation of the present invention can obtain an anticancer effect superior to that of administering argigeninin and a component having an anticancer activity by being administered in combination with a component having an anticancer activity other than architigenin. At the same time, side effects caused by components having an anticancer effect can be reduced.
- the preparation of the present invention may be in the form of a food for a sick person, a health food, a functional food, a food for specified health use, a dietary supplement, a supplement, and the like.
- the extract powder obtained by the method for producing a burdock extract described later can be used as it is.
- the present invention also includes a side effect reducing agent for reducing side effects caused by components having anticancer activity other than arctigenin.
- the side effect reducing agent of the present invention contains arctigenin as an active ingredient.
- the side effect reducing agent of the present invention can be in the same formulation form, dose and administration method as the formulation containing arctigenin described in the anticancer agent described above.
- the side effect reducing agent of the present invention may be mixed with a component having anticancer activity to constitute a compounding agent.
- the side effect reducing agent of the present invention can reduce side effects caused by components having anticancer activity by being administered in combination with components having anticancer activity other than arctigenin.
- the component having anticancer activity can be a component having anticancer activity as described in the above-described anticancer agent, for example, an existing anticancer agent.
- the side effect can be a side effect as described in the above anticancer agent, and in particular, it may be an organ disorder such as bone marrow suppression and liver disorder.
- the present invention also includes an intratumoral blood vessel normalizing agent that normalizes blood vessels in the tumor.
- tumor or “tumor tissue” refers to a cell group composed of a plurality of tumor cells, and includes, for example, a tissue mass formed by the growth of tumor cells.
- normalizing blood vessels in a tumor refers to suppressing the formation of immature blood vessels formed in a tumor tissue and improving or normalizing blood flow in the tumor. Immature blood vessels in tumor tissue are formed by angiogenesis induced by angiogenic factors released from tumor cells, tumor stromal cells, etc. under hypoxia and nutrition. By forming immature blood vessels, the tumor tissue becomes circulatory insufficiency, resulting in hypoxia and malnutrition and poor delivery of the anticancer drug.
- the intratumoral vascular normalizing agent of the present invention suppresses the formation of immature blood vessels by reducing tumor tissue in a hypoxic and hypotrophic environment and suppressing angiogenesis in the tumor, thereby preventing blood in the tumor tissue.
- the flow can be improved.
- the intratumoral blood vessel normalizing agent of the present invention can sufficiently deliver an anticancer agent or the like into the tumor by improving blood flow in the tumor.
- the intratumoral blood vessel normalizing agent of the present invention contains arctigenin as an active ingredient.
- the intratumoral vascular normalizing agent of the present invention can be in the same formulation form, dosage and administration method as the formulation containing architigenin described in the above-mentioned anticancer agent.
- the intratumoral blood vessel normalizing agent of the present invention may be mixed with a component having anticancer activity to constitute a compounding agent.
- the intratumoral vascular normalizing agent of the present invention improves the blood flow in the tumor by administering it in combination with a component having anticancer activity other than arctigenin, resulting in a tumor having a component having anticancer activity. Delivery to tissue can be enhanced.
- the component having anticancer activity can be a component having anticancer activity as described in the above-described anticancer agent, for example, an existing anticancer agent.
- the present invention also includes an agent for enhancing drug delivery to tumor tissues of components having anti-cancer activity other than arctigenin.
- drug delivery means that a drug is delivered, transmitted or transported to a tumor tissue, or that a drug is taken into a tumor tissue.
- enhancing drug delivery refers to increasing the amount of drug delivered or increasing the rate of delivery.
- the enhancer of the present invention suppresses or eliminates the development of a hypoxic / hypotrophic tumor region in which many immature blood vessels exist, and on the other hand, suppresses the generation of new blood vessels from existing blood vessels. Can improve tumor blood flow and enhance the delivery of drugs to tumor tissue.
- the enhancer of the present invention when administered in combination with a drug, can deliver more drug to the tumor tissue or deliver the drug to the tumor tissue at a faster rate than when the drug is administered alone. That is, the enhancer of the present invention can enhance the uptake of the drug into the tumor tissue.
- the enhancer of the present invention contains arctigenin as an active ingredient.
- the enhancer of the present invention can be in the same formulation form, dose and administration method as the formulation containing arctigenin described in the anticancer agent described above.
- the enhancer of this invention may be mixed with the component which has an anticancer action, and may comprise a compounding agent.
- the enhancer of the present invention can enhance delivery of a component having an anticancer activity to a tumor tissue by being administered in combination with a component having an anticancer activity other than architigenin.
- the component having anticancer activity can be a component having anticancer activity as described in the above-described anticancer agent, for example, an existing anticancer agent.
- the invention also encompasses methods for treating, ameliorating or preventing cancer.
- the method of treating, ameliorating or preventing cancer of the present invention comprises the step of administering to a subject a combination of an effective amount of arctigenin and an effective amount of an ingredient having anticancer activity other than arctigenin.
- the present invention also includes a method for reducing side effects.
- the method for reducing side effects of the present invention is a method for reducing side effects caused by a component having anticancer activity other than arctigenin, and includes a step of administering an effective amount of arctigenin to a subject.
- the administering step in the method for reducing side effects of the present invention may be administered to a subject in combination of an effective amount of archigenin and an effective amount of a component having anticancer activity other than archigenin.
- the present invention also includes a method for normalizing blood vessels in a tumor.
- the method for normalizing blood vessels in a tumor of the present invention comprises the step of administering to a subject an effective amount of arctigenin.
- the administering step in the method for normalizing blood vessels in a tumor of the present invention may be administered to a subject in combination of an effective amount of archigenin and an effective amount of a component having anticancer activity other than archigenin.
- the present invention also includes a method for enhancing drug delivery to a tumor tissue of a component having anticancer activity.
- the method of enhancing drug delivery of an anti-cancer component of the present invention to tumor tissue includes the step of administering to a subject an effective amount of archigenin.
- the administering step is performed by combining an effective amount of archigenin and an effective amount of a component having anticancer activity other than archigenin. May be administered.
- archigenin and the component having anticancer activity other than archigenin may be a compounding agent.
- a preparation containing arctigenin and a preparation containing a component having anticancer activity may be administered separately.
- arctigenin may be a burdock extract.
- the effective amount of arctigenin is an amount effective for treating, ameliorating or preventing cancer of the administration subject, an amount effective for normalizing blood vessels in the tumor, or an anticancer activity.
- an effective amount of a component having an anticancer activity refers to an amount effective for treating, ameliorating or preventing a cancer to be administered.
- the “subject” to be administered includes humans, non-human mammals and non-mammals.
- the mode of administration is oral administration or parenteral administration, for example, intravenous injection, subcutaneous injection, intraperitoneal injection, intramuscular injection, transdermal administration, nasal administration, transpulmonary administration, enteral administration, oral cavity. It can be internal administration and transmucosal administration.
- architigenin and the component having anticancer activity are prepared as an orally-administered preparation such as a sugar-coated tablet, a buccal tablet, a coated tablet and a chewable tablet, a capsule containing a troche, pill, powder and soft capsule, granule It can be administered as a liquid agent such as an agent, suspension, emulsion, syrup including dry syrup, and elixir.
- archigenin and the component having anticancer activity can be administered as a parenteral administration agent, for example, by injection, transdermal absorption tape, aerosol, suppository or the like.
- the argigeninin and the anticancer component administered in the method of the present invention can be administered at any dose, for example, as a dose generally taken as a Chinese medicine or an anticancer agent, to be administered once or multiple times.
- Can do for example, archigenin used in the method of the present invention can be administered so that the daily dose is 10 to 2000 mg per adult.
- action can be administered in the dosage which can exhibit an anticancer effect
- the component having an anticancer activity is bevacizumab (such as Avastin), the daily dose may be 5 to 30 mg / kg.
- a gobo cow extract suitable for the anticancer agent, preparation and side effect reducing agent of the present invention is produced through a herbal medicine cutting process, an extraction process (enzyme conversion process and an extraction process using an organic solvent), a solid-liquid separation process, a concentration process, and a drying process. Is done.
- the raw burdock In the crude drug cutting process, the raw burdock is cut into a size suitable for extraction. Herbal medicines that are raw materials have various sizes, shapes, and hardness such as various parts of plants, minerals, and animals, and cutting according to their characteristics is necessary.
- the burdock can be cut using any means known to those skilled in the art. For example, a commercially available cutting machine can be used.
- the activity of ⁇ -glucosidase which is an enzyme inherent in the burdock, is measured in advance, and a suitable burdock can be selected.
- a suitable burdock can be selected.
- p-nitrophenyl- ⁇ -D-glucopyranoside C 12 H 15 NO 8 : molecular weight 301.25
- SIGMA-ALDRICH p-nitrophenyl- ⁇ -D-glucopyranoside
- the enzyme activity can be measured.
- the amount of enzyme that produces 1 micromole of p-nitrophenol per minute can be expressed as 1 unit (U).
- a burdock having a ⁇ -glucosidase activity inherent in the burdock for example, 0.4 U / g or more, preferably 1 U / g or more can be used.
- 0.4 U / g hydrolysis becomes insufficient, the weight ratio of archigenin decreases, and a desired burdock extract cannot be obtained efficiently.
- a burdock cut to an arbitrary particle size can be used. It is considered that the smaller the particle size of the cut burdock, the more the enzyme conversion is promoted and the extract yield is increased. On the other hand, if the particle size is too small, the enzyme conversion may be too fast, making process control difficult, and hindering accurate solid-liquid separation in subsequent steps.
- the burdock is cut to a particle size of 9.5 mm or less, for example, through a 9.5 mm sieve.
- the particle size of the burdock passes through the whole 9.5 mm sieve, for example, 60 to 100% is distributed on the 0.85 mm sieve. It is desirable to cut so that 65 to 80% is distributed on a screen of mm.
- extraction process is the most important process in terms of quality in the crude drug extract powder manufacturing process. This extraction step determines the quality of the herbal extract powder.
- extraction is carried out in two steps, an enzyme conversion step and an extraction step with an organic solvent.
- the enzyme conversion step is an important step in the method for producing a burdock extract suitable for the present invention.
- the enzyme conversion step is a step of converting arctiin contained in burdock into argtigenin by ⁇ -glucosidase, which is an enzyme inherent in burdock.
- the burdock cut material prepared in the above step is maintained at an appropriate temperature to cause ⁇ -glucosidase to act, thereby causing the reaction from arctiin to arctigenin.
- an arbitrary solution such as water is added to the cut burdock and stirred at a temperature of about 30 ° C., so that the burdock can be maintained at an arbitrary temperature.
- the cut burdock is kept at a temperature around 30 ° C., for example, at a temperature between 20 and 50 ° C.
- a temperature around 30 ° C.
- hydrolysis becomes insufficient
- the weight ratio of arctigenin decreases, and a desired burdock extract cannot be efficiently obtained.
- the temperature is higher than 50 ° C.
- the enzyme is deactivated, the weight ratio of archigenin decreases, and a desired burdock extract cannot be efficiently obtained.
- the holding time is not particularly limited as long as it is held at the above temperature, and for example, it can be held for about 30 minutes.
- the temperature between 20 ° C. and 50 ° C., regardless of the holding time, an appropriate amount of arctiin can be enzymatically converted to arctigenin, and a burdock extract suitable for the present invention can be obtained.
- the extraction step with an organic solvent is a step of extracting arctigenin and arctiin from burdock using any appropriate organic solvent. That is, it is a step of extracting a burdock extract by adding an appropriate solvent in a state where the content of archigenin is increased by the enzyme conversion step.
- a suitable solvent is added to the burdock extract, and the burdock extract is extracted by heating and stirring for a suitable time.
- the burdock extract can be extracted using any extraction method known to those skilled in the art, such as heating reflux, drip extraction, immersion extraction, or pressure extraction.
- arctigenin is sparingly soluble in water
- the yield of arctigenin can be improved by adding an organic solvent.
- Any organic solvent can be used as the organic solvent.
- alcohols such as methanol, ethanol and propanol, and acetone can be used.
- ethanol it is preferable to use ethanol as the organic solvent in the method for producing a burdock extract suitable for the present invention.
- the heating and stirring can be performed at an arbitrary temperature.
- a temperature of 80 ° C. or higher, for example, 80 to 90 is used. Hold at a temperature between 0 ° C.
- the time for heating and stirring is not particularly limited as long as heating and stirring is performed at the above temperature. By stirring and heating for about 30 minutes, for example, 30 to 60 minutes, architigenin and arctiin can be extracted from the burdock into the solvent. .
- the yield of arctigenin and arcthiin increases as the heating and stirring time increases. However, if the heating and stirring time is long, a lot of unnecessary oils and fats are dissolved, and the load of the concentration process is increased. Therefore, what is necessary is just to determine the time of heat stirring suitably according to a condition.
- the yield of arctigenin and arctiin increases as the amount of ethanol increases, so that the solubility of arctigenin and arctiin increases.
- the burdock extract can be simultaneously sterilized and sterilized by heating and stirring in this step.
- Solid-liquid separation process is a step of separating the burdock that has been extracted from the extract.
- Solid-liquid separation can be performed using any method known to those skilled in the art. Examples of the solid-liquid separation method include a filtration method, a sedimentation method, and a centrifugal separation method. Industrially, a centrifugal separation method is desirable.
- the concentration step is a step of removing the solvent from the burdock extract prior to drying. Removal of the solvent from the burdock extract can be performed using any method known to those skilled in the art. However, it is preferable that the extract from the burdock obtained by the above process is not exposed to a higher temperature for a longer time. For example, by using the vacuum concentration method, it is possible to concentrate the burdock extract without being exposed to a high temperature for a long time.
- the concentration of the burdock extract can be concentrated to a concentration at which a burdock extract having a desired concentration can be obtained. For example, it is desirable to concentrate to the extent that drying can be appropriately performed in the following drying process. In addition, when the burdock extract is dried into a powder formulation in the following steps, it is desirable to concentrate to a concentration at which appropriate formulation characteristics can be obtained.
- dextrin can be added to the burdock extract obtained in this concentration step in order to prevent arctigenin and arctiin from adhering to the production apparatus.
- the amount of dextrin added is preferably about 15 to 30% with respect to the solid content of the concentrate, for example.
- Drying process It is a step of finishing the burdock extract obtained by the above step into a powder form. Drying can be performed using any method known to those skilled in the art. For example, freeze drying and spray drying are known as drying methods. The former is generally used at the laboratory level and the latter is used at the mass production level.
- burdock extract containing a high content of arctigenin can be obtained.
- This method for producing burdock extract must include a step of performing enzyme conversion at a temperature of 20 ° C. to 50 ° C., but does not need to include all of the other steps.
- the above-described production process makes it possible to obtain a burdock extract with a high concentration of arctigenin at low cost and in a simple manner. Therefore, by using the burdock extract obtained by this method, the anticancer agent, the preparation and the side effect reducing agent of the present invention can be produced inexpensively and easily.
- the arguchigenin concentration of the burdock extract obtained by the above manufacturing process is high, the total amount of anticancer agent, formulation and side effect reducing agent per day should be reduced compared to the case of using the conventional burdock extract. Can do. Therefore, the burden on the patient can be reduced.
- Example 1 A burdock extract containing arctigenin was prepared by the following method.
- the burdock (enzyme activity: 7.82 U / g) was cut and the whole 9.5 mm sieve was passed through a 0.85 mm sieve to confirm that 75% remained.
- mice 1 ⁇ 10 6 cells of human pancreatic cancer cell Suit2 were transplanted subcutaneously into BALB / cAJc1-nu / nu mice (Claire Japan). On the 21st day of transplantation, the transplanted mice were divided into 4 groups: (a) untreated group, (b) gobo cow extract administered group, (c) bevacizumab administered group, and (d) gemcitabine administered group, and treatment was continued for 4 weeks. did.
- the burdock extract mice were fed with 0.5% (w / w) of the burdock extract of Example 1 in the diet. When the daily food intake of the mouse is calculated as 3 to 5 g, arctigenin is administered at 15 to 25 mg / animal / day.
- Bevacizumab was administered intraperitoneally at a dose of 5 mg / kg once a week using 100 mg / 4 ml (Chugai Pharmaceutical) for intravenous infusion.
- Gemcitabine was intraperitoneally administered 100 mg / kg twice a week using a gemcitabine preparation for infusion (Eli Lilly and Company).
- tumor size The average tumor size in each group 4 weeks after the start of treatment was (a) 228 mm 2 in the untreated group, (b) 189 mm 2 in the gobo cow extract administration group, (c) 56 mm 2 in the bevacizumab administration group, and (d) gemcitabine administration group was 68mm 2.
- FIG. 1 is a graph showing the average value of the signal intensity every 30 seconds when the signal intensity at 0 seconds after gadolinium DTPA intravenous injection is taken as 100.
- An increase in the signal intensity of gadolinium DTPA within the tumor tissue means uptake of gadolinium DTPA into the tumor tissue.
- the degree of uptake of gadolinium DTPA into the tumor tissue is an indicator of the blood flow state in the tumor tissue.
- the poor blood flow region of the tumor tissue may be reduced by the administration of archigenin-containing burdock extract and the rich blood flow region may remain. Therefore, it is suggested that administration of archigenin provides an environment in which the drug is easily delivered into the tumor tissue. Therefore, it is suggested that by administering the anticancer agent together with archigenin, drug delivery of the anticancer agent to the tumor tissue is enhanced, and as a result, the efficacy of the anticancer agent is enhanced.
- FIG. 2 shows the ratio (%) of mice with ulcers in the tumor for the untreated group (Control) and the respective administration groups.
- the 50% ulcer formation rate was 8 days in the untreated group, 20 days in the gobobull extract administration group, 10 days in the bevacizumab administration group, and 24 days in the combination administration group. Therefore, in the burdock extract administration group and the combination administration group, an inhibitory effect on ulcer formation in the tumor was observed compared with the untreated group and the bevacizumab administration group.
- the effect of suppressing ulcer formation was observed compared to the untreated group, but it was transient. This effect is thought to be due to the angiogenesis inhibitory action of bevacizumab.
- a gobo cow extract was administered in combination with bevacizumab, inhibition of ulcer formation was enhanced. This is thought to be due to the combined improvement of the blood flow improvement effect by the anti-hypoxia / hypotrophic region and the angiogenesis inhibition by the gobo cow extract treatment in contrast to the blood flow improvement effect on the tumor by bevacizumab alone .
- the combined administration with arctigenin can remarkably reduce the hypoxic and hypotrophic region, and is expected to suppress the malignant transformation of cancer.
- mice transplanted with human pancreatic cancer cells Human pancreatic cancer cells Miapaca-2 (ATCC CRL 1420) 5 ⁇ 10 6 cells / 200 ⁇ l were transplanted subcutaneously into the armpits of BALB / cAJcl nu / nu mice (CLEA Japan). Thereafter, the mice were reared for about 2 to 3 weeks, and those having a size of about 100 mm 3 were selected and used as treatment target mice.
- mice to be treated There are four groups of mice to be treated: (a) untreated group, (b) gemcitabine administration group, (c) burdock extract administration group, and (d) burdock extract and gemcitabine administration group (combination administration group)
- the treatment was continued for 4 weeks.
- the burdock extract 250 mg / kg (25 mg / kg or more as archigenin) of the burdock extract of Example 1 was orally administered every day (5 times a week).
- Gemcitabine was administered intraperitoneally twice weekly at 150 mg / kg using an infusion gemcitabine preparation (Eli Lilly).
- tumor weight After the treatment test, the tumor weight was measured for each administration group. As a result, the tumor weight after the treatment test was 2.05 g in the untreated group, 1.24 g in the gemcitabine administration group, 0.98 g in the burdock extract administration group, and 0.82 g in the combination administration group. Therefore, in all of the gemcitabine administration group, the burdock extract administration group and the combination administration group, suppression of tumor weight of about 40 to 60% was observed as compared with the untreated group.
- the ratio was determined by treating cells in the tumor with TruStain fcX (mouse, biolegend), removing dead cells with Sytox-Red (Invitrogen), and removing mouse-derived cells with mouse lineage cocktail (biolegend), anti-H2 Excluding -Kd (biolegend), the ratio was 2.5 ⁇ 10 4 in the remaining pancreatic cancer cells.
- the results of evaluating the ratio of CD44 + , CD24 + and CD326 + cells (triple positive) in the tumor after the treatment test are shown in FIG.
- the lower table in FIG. 4 shows the ratios of 4 specimens and their averages.
- the ratio of CD44 + , CD24 + , CD326 + cells (triple positive) was 1.4% in the untreated group, 1.6% in the gemcitabine group, 1.0% in the burdock extract group, and 0.4% in the combination group It was. Therefore, in the combination administration group of burdock bovine extract and gemcitabine, a significant decrease in the intratumoral ratio of triple positive cancer stem cells was observed compared to the untreated group and the single administration group.
- burdock bovine extract and gemcitabine can suppress tumor growth and reduce the intratumoral ratio of pancreatic cancer stem cells that can cause tumor recurrence, distant metastasis, and emergence of anticancer drug resistance. Indicated. Therefore, it was shown that the combination agent of burdock bovine extract and gemcitabine has significantly higher anticancer activity than expected from the effect when each of these is administered alone.
- Example 4 The 5-year survival rate after diagnosis of pancreatic cancer is less than 5% in 2013, and the average survival time is only 4-6 months. This is an extremely low value compared to other cancers, and effective measures are required.
- Example 3 described above the combined treatment of arguchigenin-rich burdock extract and gemcitabine for the pancreatic tumor transplantation model showed a tendency to suppress tumor growth compared to single agent treatment. Therefore, a model of orthotopic transplantation of pancreatic cancer to mouse pancreas was created as a model closer to the actual lesion, and the effect of combined treatment with gemcitabine and gobo-bovine extract on the survival rate was evaluated.
- mice After transplantation, mice were treated with the non-treated group (Non treat), the gobobull extract containing 10% arctigenin (Kracie Pharmaceutical, GBS-01) 250 mg / kg orally administered daily (GBS-01), 150 mg / kg gemcitabine (Eli Treatment was continued until all mice died, divided into 7 groups of 4 groups: a group administered Lily) twice a week (Gemcitabine) and a group administered together (Combination).
- MST median survival
- Pancreatic cancer cells, PANC-1 (ATCC No. CRL-1469) cells were cultured in glucose-free medium (DMEM (SIGMA) + 5% dialyzed fetal calf serum +4 mM Glutamine +10 mM HEPES) as shown in Table 1 below. It was treated with the various drugs indicated, arctigenin (purified product, lot: AG-STD1, Kracie Pharmaceutical) and combinations thereof. Each of the various drugs used a quarter concentration of 50% cell death concentration (LD 50 ) (killing rate less than 15%). Arctigenin was used in dilution series from 1 nM to 3000 nM. After treatment for 18 to 24 hours, the number of viable cells was measured with Cell Counting Kit (Dojin Chemical).
- Table 1 below shows the LD 50 reduction ratio with respect to the treatment with archigenin alone when various drugs are treated with archigenin. When each drug was treated with architigenin in combination, a decrease in LD 50 was observed as compared to architigenin alone and drug alone.
- arctigenin has a broad potentiating effect on drugs that have a damaging effect on cancer cells by various mechanisms in the treatment of types of cancer, such as pancreatic cancer, where the inside of the tumor is likely to become starved. It was shown to have.
- the prepared transplanted mice are divided into untreated groups, existing anticancer drug administration groups that are various anti-cancer components, burdock extract administration groups, and these combination administration groups, and each group has 5 to 6 tumors. The treatment was continued for about 4 weeks.
- CBDCA carboplatin
- doxorubicin Doxorubicin, Kyowa Hakko, 10 mg / kg abdominal administration twice a week
- oxaliplatin Oxaliplatin, Yakult, 8 mg
- Everolimus Everolimus, Novartis, 5 mg / kg orally 5 times a week
- Bortezomib Bortezomib, Janssen Pharma, 1 mg / kg twice a week
- Irinotecan Yakult , 25 mg / kg twice a week by intraperitoneal administration
- hydroxychloroquine Sephy, 100 mg / kg by intraperitoneal administration five times a week.
- the burdock extract used was a burdock extract (Kracie Pharmaceutical, GBS-01) containing 10% arctigenin, and 750 mg / kg was orally administered 5 days a week
- carboplatin and oxaliplatin are 2.3 to 2.1 times (P ⁇ 0.05) compared to single drug and 1.8 to 1.9 times (P ⁇ 0.05) compared to single drug.
- a decrease in tumor size was observed.
- the tumor size was reduced 2.1 times (P ⁇ 0.05) compared to the burdock bovine extract alone and 1.5 times the tumor size compared to the anticancer agent alone.
- doxorubicin the tumor size was reduced by about 1.4 times compared to the gobo-bovine extract alone and 1.5 times (P ⁇ 0.05) compared with the anticancer agent alone.
- Everolimus showed a 2.1-fold reduction in tumor size (P> 0.05) compared to the burdock extract alone and a 1.4-fold reduction in tumor size compared to the anticancer agent alone.
- Bortezomib was found to have a 1.8-fold (P ⁇ 0.05) reduction in tumor size compared to the gobo-bovine extract alone and 1.4-fold compared to the anticancer agent alone.
- Hydrochloroquine a treatment for malaria and autoimmune diseases, showed a 1.9-fold decrease in tumor size compared to gobo-bovine extract alone and 2.5-fold (P ⁇ 0.05) compared to anticancer agent alone (P ⁇ 0.05) ( (See Figure 6.)
- argotigenin-rich burdock extract is a drug that can be expected to have a strong antitumor effect when combined with existing anticancer drugs having various medicinal mechanisms.
- Bevacizumab has the effect of suppressing angiogenesis and inhibiting tumor growth and metastasis by inhibiting the action of vascular endothelial growth factor (VEGF).
- VEGF vascular endothelial growth factor
- Administration of bevacizumab can inhibit tumor angiogenesis and create a hypoxic / hypotrophic environment.
- architigenin exerts an anti-tumor effect on hypoxic / hypotrophic tumors when combined with architigenin. It was thought to do.
- arctigenin has a remarkable effect on pancreatic tumor stem cells that are resistant to hypoxia and nutrition at the individual mouse level. As shown in Test Example 1, it was shown that arctigenin can enhance the decrease in cancer stem cells when used in combination with gemcitabine.
- Colorectal cancer has been reported to be resistant to hypoxia / nutrition in the same way as pancreatic cancer, and since there are many patients, evaluation of the effects of bevacizumab and burdock extract on colon cancer tumor cells in combination with bevacizumab I decided to do it.
- tumor weight After the treatment test, the tumor weight was measured for each administration group. As a result, the tumor weight after the treatment test was 2.51 g in the untreated group, 1.33 g in the bevacizumab administration group, 1.25 g in the burdock extract administration group, and 0.68 g in the combination administration group. Therefore, in any of the bevacizumab administration group, the burdock extract administration group and the combination administration group, suppression of an increase in tumor weight was observed as compared with the untreated group. Moreover, in the combination administration group, the increase in tumor weight was more strongly suppressed than when administered alone.
- the cancer cells are then recovered from the tumor tissue and the ratio of CD133 + , CD44 + cells in the tumor after the treatment trial is measured using a double positive marker for CD133 and CD44 on a FACS ARIA II flow cytometer (BD bioscience) was used to evaluate.
- the ratio is determined by treating cells in the tumor with TruStain fcX (mouse, biolegend), removing dead cells with Sytox-Red (Invitrogen), and removing mouse-derived cells with mouse lineage cocktail (biolegend), anti Excluding -H2-Kd (biolegend), the ratio of remaining 2.5 ⁇ 10 4 pancreatic cancer cells was used.
- the ratio of CD133 + , CD44 + cells (double positive) in the tumor after the treatment test was 0.16% in the untreated group, 0.552% in the bevacizumab group, 0.304% in the gobobull extract group, and the combination group It was 0.056%. Therefore, a decrease in the ratio of cancer stem cells in the tumor was observed in the combination administration group compared to the untreated group and the single administration group.
- burdock bovine extract and bevacizumab can suppress tumor growth and reduce the intratumoral ratio of colon cancer stem cells that can cause tumor recurrence, distant metastasis, and emergence of anticancer drug resistance. Indicated. Further, in Test Example 2 described above, a life-prolonging effect was shown by the combined use of gobobushi and bevacizumab. Therefore, it was shown that the combination agent of burdock cow extract and bevacizumab has significantly higher anticancer activity than expected from the effect when each of these is administered alone.
- SCR-ICR mice (6 weeks old female) (SLC) are administered in combination with (a) untreated group, (b) gemcitabine administration group, (c) gobo cow extract administration group, and (d) gobo cow extract and gemcitabine Six animals were used in each of the four groups (group administration group). Each therapeutic agent was continuously administered to each group for 7 weeks.
- the burdock extract was orally administered 250 mg / kg of the burdock extract of Example 1 (25 mg / kg as archigenin) five times a week.
- Gemcitabine was administered intraperitoneally at a dose of 100 mg / kg once a week using an infusion gemcitabine preparation (Eli Lilly and Company).
- FIG. 7 shows the results of weight measurement and weight / body weight ratio (%) of kidney, liver, spleen and lung in each group. As shown in FIG. 7, in the gemcitabine administration group, the weight / body weight ratio (%) of the liver and spleen was reduced by about 20% compared to the untreated group. On the other hand, in the combination group, this tendency to recover was observed.
- the white blood cell count was slightly below the standard range for 10-week-old females of SLC-ICR mice in the gemcitabine administration group, and a decrease of about 50% was observed compared to the untreated group.
- the decrease was reduced to about 75% compared to the untreated group, and was generally within the standard range.
- the red blood cell count was also slightly below the standard range in the gemcitabine administration group, and a decrease of about 87% was observed compared to the untreated group. On the other hand, it was recognized that when the gobobull extract and gemcitabine were administered in combination, the value recovered to the same level as in the untreated group.
- the platelet count was increased by about 110% in the burdock extract administration group compared to the untreated group.
- the gemcitabine administration group a decrease of about 70% was observed compared to the untreated group. It was found that the combination of gobobull extract and gemcitabine recovered to about 92% of the untreated group.
- AST and ALT which are liver injury markers, were increased by 46% and 102%, respectively, in the gemcitabine administration group compared to the untreated group, and AST particularly deviated from the standard range.
- the increase was suppressed by about 18% and 38%, respectively, compared with the untreated group, and was generally within the standard range.
- burdock extract and gemcitabine were not observed. Rather, it was suggested that the combined administration can have the effect of reducing side effects such as bone marrow suppression and liver damage by gemcitabine alone.
- the present invention can be suitably used for medicines for treating or improving cancer, foods for cancer prevention, and the like.
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Abstract
Description
本発明の抗癌剤は、有効成分として、アルクチゲニンと、アルクチゲニン以外の抗癌作用を有する成分とを組み合わせたものである。換言すれば、本発明の抗癌剤は、有効成分として、アルクチゲニン以外の抗癌作用を有する成分と、当該成分の腫瘍組織への薬剤送達の増強剤としてのアルクチゲニンとを組み合わせたものである。すなわち、本発明の抗癌剤は、アルクチゲニンと抗癌作用を有する成分とを併用して投与する併用剤である。
本発明は、アルクチゲニンを有効成分として含有する、アルクチゲニン以外の抗癌作用を有する成分と組み合わせて併用投与するための製剤をも包含する。本発明の製剤は、上述した抗癌剤において説明したアルクチゲニンを含む製剤と同様の構成であることができる。この製剤は、たとえば上述した抗癌剤の一部として使用することが可能である。
本発明はまた、アルクチゲニン以外の抗癌作用を有する成分による副作用を軽減するための副作用軽減剤をも包含する。本発明の副作用軽減剤は、アルクチゲニンを有効成分として含有する。本発明の副作用軽減剤は、上述した抗癌剤において説明したアルクチゲニンを含む製剤と同様の製剤形態、用量および投与方法であることができる。また、本発明の副作用軽減剤は、抗癌作用を有する成分と混合されて配合剤を構成してもよい。
本発明はまた、腫瘍内の血管を正常化する、腫瘍内血管正常化剤をも包含する。
本発明はまた、アルクチゲニン以外の抗癌作用を有する成分の腫瘍組織への薬剤送達の増強剤をも包含する。
本発明はまた、癌を治療、改善または予防する方法をも包含する。本発明の癌を治療、改善または予防する方法は、アルクチゲニンの有効量と、アルクチゲニン以外の抗癌作用を有する成分の有効量とを組み合わせて対象に投与する工程を含む。
本発明の抗癌剤、製剤および副作用軽減剤に適したゴボウシ抽出物は、生薬切裁工程、抽出工程(酵素変換工程および有機溶媒による抽出工程)、固液分離工程、濃縮工程および乾燥工程を経て製造される。
生薬切裁工程では、原料とするゴボウシを抽出に適した大きさに切裁する。原料となる生薬は、植物の様々な部位や鉱物、動物など種々の大きさ、形状、固さがあり、その特質に応じた切裁が必要となる。ゴボウシは、当業者に公知の任意の手段を使用して切裁することができる。たとえば、市販の切裁機を使用することができる。
抽出工程は、生薬抽出物粉末製造工程中で、品質上最も重要な工程である。この抽出工程により、生薬抽出物粉末の品質が決まる。本発明の抗癌剤に用いるのに適したゴボウシ抽出物の製造方法では、ゴボウシ抽出物を抽出するために、酵素変換工程と有機溶媒による抽出工程の2段階に分けて抽出を行う。
酵素変換工程は、本発明に適したゴボウシ抽出物の製造方法において重要な工程である。酵素変換工程は、ゴボウシに内在する酵素であるβ-グルコシダーゼにより、ゴボウシに含まれているアルクチインをアルクチゲニンに酵素変換する工程である。
有機溶媒による抽出工程は、任意の適切な有機溶媒を使用して、ゴボウシからアルクチゲニンおよびアルクチインを抽出する工程である。すなわち、上記の酵素変換工程によりアルクチゲニンが高含量となった状態で、適切な溶媒を添加して、ゴボウシ抽出物を抽出する工程である。たとえば、ゴボウシ抽出物に適切な溶媒を添加して、適切な時間加熱攪拌してゴボウシ抽出物を抽出する。また、加熱攪拌以外にも、加熱還流、ドリップ式抽出、浸漬式抽出または加圧式抽出法などの当業者に公知の任意の抽出法を使用して、ゴボウシ抽出物を抽出することができる。
固液分離工程は、抽出の終わったゴボウシを抽出液から分離する工程である。固液分離は、当業者に公知の任意の方法を使用して行うことができる。固液分離法には、たとえば濾過法、沈降法および遠心分離法などがある。工業的には、遠心分離法が望ましい。
濃縮工程は、乾燥に先立ちゴボウシ抽出液から溶媒を除去する工程である。ゴボウシ抽出液からの溶媒の除去は、当業者に公知の任意の方法を使用して行うことができる。しかし、上記工程によって得られたゴボウシからの抽出液が、さらに高温に長時間曝されることがないようにすることが好ましい。たとえば、減圧濃縮法を使用することにより、高温に長時間曝されることなく、ゴボウシ抽出液を濃縮することができる。
上記工程によって得られたゴボウシ抽出物を粉末状に仕上げる工程である。乾燥は、当業者に公知の任意の方法を使用して行うことができる。たとえば、乾燥法として、凍結乾燥および噴霧乾燥などが知られているが、実験室レベルであれば前者、量産レベルであれば後者を用いるのが一般的である。
以下の方法により、アルクチゲニンを含有するゴボウシエキスを調製した。
アルクチゲニン含有ゴボウシエキス、ベバシズマブおよびゲムシタビンの反復投与による腫瘍内の血流を評価した。ベバシズマブとして、アバスチンを用いた。
治療開始4週間後の各群の平均腫瘍サイズは、(a)未治療群が228mm2、(b)ゴボウシエキス投与群が189mm2、(c)ベバシズマブ投与群が56mm2、および(d)ゲムシタビン投与群が68mm2であった。
治療開始4週間後に、各群のマウス腫瘍組織におけるガドリニウムDTPAの取り込みを評価した。ガドリニウムDTPAを急速静注した後120秒まで、9.4テスラMRI装置(BIOSPEC 94/20USR)を用いて、腫瘍のダイナミック造影T1強調画像(時間分解能1.8-5.3秒)を撮影した。この画像から、腫瘍組織内のガドリニウムDTPAのシグナル強度を測定した。図1は、ガドリニウムDTPA静注後0秒のシグナル強度を100としたときの、30秒ごとのシグナル強度の平均値を示すグラフである。腫瘍組織内のガドリニウムDTPAのシグナル強度の増加は、腫瘍組織内へのガドリニウムDTPAの取り込みを意味する。腫瘍組織内へのガドリニウムDTPAの取り込みの度合いは、腫瘍組織内の血流状態の指標となる。
図1に示すように、ガドリニウムDTPA静注後90~120秒において、ゴボウシエキス投与群における治療後の腫瘍組織中心部のシグナル強度は、118.1 ± 13.7%まで増加した。一方、未治療群では、90~120秒において102.6 ± 3.4%であり、増加しなかった。したがって、ゴボウシエキス投与群では、未治療群と比較して血流が良い傾向であった(P <0.05, t-test)。また、抗腫瘍効果が見られたゲムシタビン治療群では、未治療群と同様に腫瘍組織中心部のシグナル強度が増加していなかった。一方、血管新生阻害作用を持つベバシズマブ治療群では、シグナル強度が増加する傾向にあった。
腫瘍が増大する過程においては、増大した腫瘍組織全体にわたって栄養や酸素が血管を通して供給されていなければならない。しかしながら、多くの腫瘍においては、未熟な血管形成のため、これらが十分に供給されておらず、部分的な組織壊死を起こし、組織が潰瘍状になる部位が発生すると考えられている。そこで、前述のゴボウシエキスの腫瘍内血流正常化効果を組織状態から検証するため、それぞれの治療後の腫瘍組織における潰瘍形成を観察した。
5週間にわたり、腫瘍組織に対し、ゴボウシエキスの単独投与、ベバシズマブの単独投与およびゴボウシエキスとベバシズマブの併用投与を実施した。未治療群(Control)およびそれぞれの投与群について、腫瘍に潰瘍を生じたマウスの比率(%)を図2に示す。図2に示すように、50%潰瘍形成率は、未治療群が8日、ゴボウシエキス投与群が20日、ベバシズマブ投与群が10日、併用投与群が24日であった。したがって、ゴボウシエキス投与群および併用投与群では、未治療群およびベバシズマブ投与群と比較して、腫瘍における潰瘍形成の抑制効果が認められた。ベバシズマブ投与群では、未治療群と比較して潰瘍形成の抑制効果が認められたが、一過性であった。この効果は、ベバシズマブの持つ血管新生阻害作用による効果と考えられる。一方、ベバシズマブに加えてゴボウシエキスを併用投与した場合、潰瘍形成の阻害が増強された。これは、ベバシズマブ単剤での腫瘍に対する血流改善効果に対して、ゴボウシエキス治療による低酸素・低栄養領域の形成抑制と血管新生抑制による血流改善効果が、併用増強されたためであると考えられる。このように、アルクチゲニンとの併用投与により、低酸素および低栄養状態にある領域を顕著に縮小することができるため、癌の悪性化を抑制することが期待される。
上述した治療を5週間継続した後に、治療を中止し、生存期間の追跡を実施した。各群における生存率を図3に示した。その結果、50%生存期間は、図3に示すように未治療群が103日、ゴボウシエキス投与群が114日、ベバシズマブ投与群が107日、併用投与群が137日であった。したがって、併用投与群では、未治療群および単独投与群と比較して、それぞれ33%および20-28%の生存期間延長効果が認められた。
ゴボウシエキスおよびゲムシタビンの併用投与による抗腫瘍効果を調べた。
ヒト膵臓癌細胞Miapaca-2(ATCC CRL 1420)5×106 Cells/200μlを、BALB/cAJcl nu/nuマウス(日本クレア)の脇下皮下に移植した。その後、約2~3週間飼育し、100mm3程度になったものを選別し、治療対象マウスとした。
治療対象マウスを、(a)未治療群、(b)ゲムシタビン投与群、(c)ゴボウシエキス投与群、並びに(d)ゴボウシエキスおよびゲムシタビンを併用して投与する群(併用投与群)、の4つの群に分け、4週間治療を継続した。ゴボウシエキスは、実施例1のゴボウシエキスの250mg/kg(アルクチゲニンとして25mg/kg以上)を連日(週5回)、経口投与した。ゲムシタビンは、点滴用ゲムシタビン製剤(イーライリリー社)を使用して、150mg/kgを週2回、腹腔内投与した。
治療試験後、各投与群について腫瘍重量を測定した。その結果、治療試験後の腫瘍重量は、未治療群では2.05g、ゲムシタビン投与群では1.24g、ゴボウシエキス投与群では0.98g、および併用投与群では0.82gであった。したがって、ゲムシタビン投与群、ゴボウシエキス投与群および併用投与群のいずれにおいても、未治療群と比較して、40~60%程度の腫瘍重量の抑制が認められた。
治療試験後の腫瘍組織から癌細胞を回収し、CD24、CD44およびESA(CD326)の3重陽性マーカー並びにCD133およびCD44の2重陽性マーカーを使用して、治療試験後の腫瘍内のCD44+, CD24+, CD326+細胞(3重陽性)およびCD133+, CD44+細胞(2重陽性)の比率を評価した。評価には、FACS ARIA IIフローサイトメーター(BD bioscience)を用いた。CD44+, CD24+, CD326+細胞(3重陽性)は、腫瘍内の癌幹細胞のうち、造腫瘍能に優れた癌幹細胞であり、CD133+, CD44+細胞(2重陽性)は、極めて転移性の高い癌幹細胞である。比率は、腫瘍内に存在する細胞をTruStain fcX(mouse, biolegend)で処理後、死細胞をSytox-Red(Invitrogen)で除き、また、マウス由来の細胞をmouse lineage cocktail(biolegend), anti-H2-Kd(biolegend)で除き、残った2.5X104の膵臓癌細胞における比率とした。
膵臓癌の診断後の5年生存率は2013年時点で5%を切っており、またその平均生存時間は、4-6ヶ月に止まっている。これは他の癌に比べて極端に低い数値であり、有効な対策が求められている。上述した実施例3において、膵臓腫瘍移植モデルに対するアルクチゲニン高含有ゴボウシエキスとゲムシタビンとの併用治療により、単剤治療に比べて腫瘍の増大抑制傾向が認められた。そこで、より実際の病巣に近いモデルとして、マウス膵臓への膵臓癌同所移植モデルを作製し、ゲムシタビンおよびゴボウシエキスによる併用治療が生存率に与える影響を評価した。
ヒト膵臓癌細胞Miapaca-2細胞を5×106cells/50μlにて高濃度マトリゲル溶液(BD bioscience)に懸濁した。8週齢、メスのBALB/cAJcl-nu/nu(日本クレア)を麻酔下に開腹し、上記細胞懸濁液を膵臓組織へ注入および固化させた後、縫合・閉腹した。
移植後のマウスを、未治療群(Non treat)、10%アルクチゲニンを含むゴボウシエキス(クラシエ製薬、GBS-01)250mg/kgを連日経口投与する群(GBS-01)、150mg/kgのゲムシタビン(イーライリリー社)を週2回腹腔投与する群(Gemcitabine)、およびこれらを併用投与する群(Combination)の4群各7匹に分け、マウスがすべて死亡するまで治療を継続した。
生存率は、Kaplan-Mayer法を使って生存率曲線および生存率中央値MSTを計算および描出することにより算出した(GraphPad-PRISM 6.2, MDF社)。有意差は、Logrank(Mantel-COX)およびGehan-Breslow-Wilcoxon検定で評価した。算出した結果を図5の上のグラフに示した。
癌細胞に対して様々な機序で傷害作用を持つ種々の薬剤について、ゴボウシ由来のアルクチゲニンと併用投与したときの、薬剤の殺傷効果の増強作用を検討した。
膵臓癌移植モデルを用いて、既存の各種抗癌剤、アルクチゲニン高含有ゴボウシエキスおよびこれらの組み合わせによる治療を行い、腫瘍サイズの変動を評価した。
5×106 Cells/200μlのMiapaca-2細胞をBALB/cAJcl-nu/nuマウス(日本クレア)の脇下皮下に移植し、約2週間飼育後、約100mm3または約600mm3程度のサイズになったものを、治療対象マウスとした。
作製した移植マウスを、未治療群、各種の抗癌作用を有する成分である既存抗癌剤投与群、ゴボウシエキス投与群およびこれらの併用投与群の各群に分け、各群の5~6腫瘍に対して、約4週間程度にわたって治療を継続した。既存抗癌剤としては、カルボプラチン(CBDCA、Bristol-Myers、60mg/kgを週1回腹腔投与)、ドキソルビシン(Doxorubicin、協和発酵、10mg/kgを週2回腹腔投与)、オキサリプラチン(Oxaliplatin、ヤクルト、8mg/kgを週1回腹腔投与)、エベロリムス(Everolimus、ノバルティス、5mg/kgを週5回経口投与)、ボルテゾミブ(Bortezomib、ヤンセンファーマ、1mg/kgを週2回腹腔投与)、イリノテカン(Irinotecan、ヤクルト、25mg/kgを週2回腹腔投与)およびヒドロキシクロロキン(Hydroxychloroquine、サノフィー、100mg/kgを週5回腹腔投与)を用いた。ゴボウシエキスは、10%アルクチゲニンを含むゴボウシエキス(クラシエ製薬、GBS-01)を用い、750mg/kgを週5日経口投与した。
治療開始後、3-4日毎に、マウスを保定して精密デジタルノギスで腫瘍の長径(L)、短径(W)および高さ(H)を測定し、腫瘍サイズ= 4/3 * pi * L/2 * H/2 * W/2 (pi=3.14)の式を用いてサイズを求めた。また、高さが測定できない場合は、簡易的に、腫瘍サイズ = 4/3 * pi * L/2 * (W/2)2を使用した。測定結果を図6に示した。
アルクチゲニン高含有ゴボウシエキスおよびベバシズマブの併用治療による大腸癌に対する効果を調べた。ベバシズマブとして、アバスチンを用いた。
ヒト大腸癌細胞LS174T(ATCC. CL-188)の5×105細胞をBALB/cAJc1-nu/nuマウス(日本クレア)の皮下に移植した。移植14日目に、移植マウスを、(a)未治療群、(b)ベバシズマブ投与群、(c)ゴボウシエキス投与群、並びに(d)ゴボウシエキスおよびベバシズマブを併用して投与する群(併用投与群)、の4つの群に分け、4週間治療を継続した。ゴボウシエキスを投与する場合は、実施例1のゴボウシエキスの250mg/kg(アルクチゲニンとして25mg/kg)を週6回、経口投与した。ベバシズマブは、アバスチン点滴静注用100mg/4ml(中外製薬)を使用して、5mg/kgを週1回、腹腔内投与した。
治療試験後、各投与群について腫瘍重量を測定した。その結果、治療試験後の腫瘍重量は、未治療群では2.51g、ベバシズマブ投与群では1.33g、ゴボウシエキス投与群では1.25g、および併用投与群では0.68gであった。したがって、ベバシズマブ投与群、ゴボウシエキス投与群および併用投与群のいずれにおいても、未治療群と比較して、腫瘍重量増大の抑制が認められた。また、併用投与群では、単独で投与した場合と比較して、腫瘍重量増大がより強く抑制された。
次いで、腫瘍組織から癌細胞を回収し、CD133およびCD44の2重陽性マーカーを使用して、治療試験後の腫瘍内のCD133+, CD44+細胞の比率をFACS ARIA IIフローサイトメーター(BD bioscience)を使用して評価した。また、比率は、腫瘍内に存在する細胞をTruStain fcX(mouse, biolegend)で処理後、死細胞をSytox-Red(Invitrogen)で除き、また、マウス由来の細胞をmouse lineage cocktail(biolegend), anti-H2-Kd(biolegend)で除き、残った2.5X104の膵臓癌細胞における比率とした。
ゴボウシエキスおよびゲムシタビンの併用反復投与による毒性試験を行った。
Claims (8)
- アルクチゲニンと、アルクチゲニン以外の抗癌作用を有する成分とを組み合わせた、抗癌剤。
- 配合剤である、請求項1に記載の抗癌剤。
- 前記アルクチゲニンを含む製剤と前記抗癌作用を有する成分を含む製剤とにより構成されるキットである、請求項1に記載の抗癌剤。
- 前記アルクチゲニンがゴボウシ抽出物である、請求項1~3のいずれか1項に記載の抗癌剤。
- アルクチゲニンを有効成分として含有する、アルクチゲニン以外の抗癌作用を有する成分と組み合わせて併用投与するための製剤。
- アルクチゲニンを有効成分として含有する、アルクチゲニン以外の抗癌作用を有する成分による副作用を軽減するための副作用軽減剤。
- アルクチゲニンを有効成分として含有する、腫瘍内血管正常化剤。
- アルクチゲニンを有効成分として含有する、抗癌作用を有する成分の腫瘍組織への薬剤送達の増強剤。
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| JP2018008898A (ja) * | 2016-07-14 | 2018-01-18 | クラシエ製薬株式会社 | 抗癌剤、放射線増感剤および食品組成物 |
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| CN102370983A (zh) * | 2010-08-10 | 2012-03-14 | 山东新时代药业有限公司 | 一种抗肿瘤药物组合物及其用途 |
| CN102397548A (zh) * | 2010-09-19 | 2012-04-04 | 山东新时代药业有限公司 | 含有牛蒡苷元的药物组合物及其医药用途 |
| CN102805743A (zh) * | 2011-06-03 | 2012-12-05 | 鲁南制药集团股份有限公司 | 牛蒡苷元在治疗血管生成性疾病中的应用 |
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| CN102335166B (zh) * | 2010-07-15 | 2014-12-31 | 山东新时代药业有限公司 | 含有牛蒡苷元的药物组合物及其用途 |
| CN102370645B (zh) * | 2010-08-04 | 2014-07-23 | 山东新时代药业有限公司 | 一种抗癌药物组合物 |
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- 2015-04-10 JP JP2016512802A patent/JP6234553B2/ja active Active
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- 2015-04-10 US US15/302,863 patent/US9907852B2/en active Active
- 2015-04-10 CN CN201580018769.9A patent/CN106163515A/zh active Pending
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| JP2018008898A (ja) * | 2016-07-14 | 2018-01-18 | クラシエ製薬株式会社 | 抗癌剤、放射線増感剤および食品組成物 |
| WO2018012441A1 (ja) * | 2016-07-14 | 2018-01-18 | クラシエ製薬株式会社 | 抗癌剤、放射線増感剤および食品組成物 |
Also Published As
| Publication number | Publication date |
|---|---|
| US20170028065A1 (en) | 2017-02-02 |
| JP6234553B2 (ja) | 2017-11-22 |
| JPWO2015156409A1 (ja) | 2017-04-13 |
| US9907852B2 (en) | 2018-03-06 |
| CN106163515A (zh) | 2016-11-23 |
| KR20160141748A (ko) | 2016-12-09 |
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