CN107801379B - 抗癌剂 - Google Patents
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Abstract
本发明的目的在于提供具有优异的治疗效果的癌症治疗药。通过联合应用CBP/连环蛋白抑制剂及免疫检查点抑制剂来对癌症进行治疗,不仅能够增强对于癌症的治疗效果,而且针对在仅有免疫检查点抑制剂时敏感性低的癌症患者也能够进行有效治疗。
Description
技术领域
本发明涉及联合应用CBP/连环蛋白(catenin)抑制剂和免疫检查点抑制剂(immune checkpoint inhibitor)来对癌症进行治疗的方法及癌症治疗药。
背景技术
最近,在癌症治疗中,对免疫检查点抑制剂的开发愈发活跃,其中,抗CTLA-4抗体、抗PD-1抗体正作为癌症治疗药而被销售。
PD-1(程序性死亡分子1,programmed death 1)与在抗原呈递细胞中表达的其配体PD-L1及PD-L2结合,向细胞毒性T细胞(CD8阳性T细胞)转导抑制性信号,对细胞毒性T细胞的活化状态进行负向调节。已知强制表达有PD-L1的癌细胞可使抗原特异性CD8阳性T细胞的细胞损伤活性减弱、或诱导凋亡。人们已知:PD-L1在多数癌细胞中表达,而表达水平越高则癌症预后越差。抗PD-1抗体纳武单抗(nivolumab)可阻断抑制性信号的转导,从而维持细胞毒性T细胞的活化状态,对癌细胞进行攻击。
另外,CTLA(细胞毒性T淋巴细胞相关抗原,cytotoxic T lymphocyte associatedantigen)-4与存在于抗原呈递细胞中的共刺激分子CD80(B7-1)或CD86(B7-2)结合后,细胞毒性T细胞的活化被抗原呈递细胞抑制。抗CTLA-4抗体伊匹单抗(ipilimumab)通过抑制该结合而使细胞毒性T细胞活化并增殖(参见图1)。
另外,对于PD-L1而言,在胆道癌的癌症干细胞的研究中,报道了PD-L1的表达水平降低的细胞具有各种癌症干细胞的特征(致瘤能力·静止期·ALDH活性等)(非专利文献1)。多数癌症干细胞的HLA I类的表达为阴性,不被细胞毒性T细胞识别。
另一方面,可以认为,多数癌细胞利用Wnt信号来激活β-连环蛋白,结果造成,细胞增殖的控制机构崩溃,细胞的癌化进展。虽然出于这样的考虑而将Wnt信号途径的抑制剂作为抗癌剂进行了研究,但未能实用化。
本申请的发明人已发现,较之以往的其他机制的Wnt抑制剂而言,作为抗癌剂正在进行临床开发的CBP/连环蛋白抑制剂PRI-724对于人具有明显更低的毒性(非专利文献2)。作为其机制,CBP与连环蛋白的结合被抑制,由此使得连环蛋白与同CBP相似性高的P300结合,而非与CBP结合。认为这样的变化可抑制癌的增殖以及诱导分化(非专利文献3)。
最近已发现,对于胆管癌而言,肿瘤经由Wnt-β-连环蛋白途径增殖是主要的途径,并公开了作为CBP/连环蛋白抑制剂的ICG-001在动物模型中具有强效的增殖抑制效果(非专利文献4)。
以往的Wnt抑制剂的机制为基于抑制Wnt配体的产生、阻碍受体的功能、促进连环蛋白的分解等机制来阻断信号,因此,几乎均在临床前试验、临床试验中发生毒性方面的问题而导致开发中止。这是因为,Wnt途径被认为对于生命维持而言是必需的。另一方面,CBP/连环蛋白抑制剂并不阻断信号,而是通过从CBP切换至P300来体现效果,因此,可以推测其安全性高。
此外,β-连环蛋白通过抑制T细胞分化来抑制T细胞的活化也是已知的(非专利文献5)。因此,认为CBP/β-连环蛋白抑制剂促进T细胞的分化、活化T细胞。
在临床中对抗PD-1抗体、抗CTLA-4抗体呈现显著效果的患者是有限的。其理由是,癌症患者中,CD-8阳性细胞数量与β-连环蛋白的表达呈完全逆相关,已发现在β-连环蛋白的表达水平高的组织中T细胞少,反之,β-连环蛋白的表达水平低的组织中T细胞多,并且,上述抗体在T细胞多的组织中呈现显著效果(非专利文献6)。
现有技术文献
非专利文献
非专利文献1:Cancer Sci(105)667-674,2014
非专利文献2:J Clin Oncol 31,2013(suppl;abstr 2501)
非专利文献3:The EMBO Journal 2013,1-13
非专利文献4:J Clin Invest.2015Mar 2;125(3):1269-85.doi:10.1172/JCI76452
非专利文献5:J Immunol 2011;186:784-790
非专利文献6:Nature.2015May 11.doi:10.1038/nature14404.
发明内容
发明所要解决的课题
在临床中对抗PD-1抗体、抗CTLA-4抗体呈现显著效果的患者是有限的,尽管已在尝试了将其与既往使用的各种癌症治疗药联合应用,但却不一定能得到令人满意的效果。
用于解决课题的手段
本发明中,发现通过联合应用PD-1-PD-L1抑制剂等免疫检查点抑制剂和CBP/连环蛋白抑制剂,能够得到优异的治疗效果,从而完成了本发明。
即,本发明的主要内容如下所述:
(1)癌症治疗药,其包含联合的CBP/连环蛋白抑制剂和免疫检查点抑制剂。
(2)如上述(1)所述的癌症治疗药,其中,免疫检查点抑制剂为选自PD-1拮抗剂、PD-L1拮抗剂、PD-L2拮抗剂、CTLA-4拮抗剂、KIR拮抗剂、CD137拮抗剂、LAG3拮抗剂及OX40拮抗剂中的一种以上的免疫检查点抑制剂。
(3)如上述(1)所述的癌症治疗药,其中,免疫检查点抑制剂为选自抗PD-1抗体、抗PD-L1抗体、抗PD-L2抗体、抗CTLA-4抗体、抗KIR抗体、抗LAG3抗体及抗OX40抗体中的一种以上的免疫检查点抑制剂。
(4)如上述(1)~(3)所述的癌症治疗药,其中,CBP/连环蛋白抑制剂为具有CBP/连环蛋白抑制活性的α-螺旋模拟化合物。
(5)如上述(4)所述的癌症治疗药,其中,上述α-螺旋模拟化合物为WO2003/031448、WO2004/093828、WO2005/116032、WO2009/148192、WO2010/044485、WO2010/128685、WO2012/115286及/或WO2015/098853中记载的α-螺旋模拟化合物中的任意一种以上的化合物。
(6)如上述(1)~(4)所述的癌症治疗药,其中,CBP/连环蛋白抑制剂为选自下述化合物中的一种以上的CBP/连环蛋白抑制剂,
(6S,9aS)-N-苄基-6-[(4-羟基苯基)甲基]-8-(萘-1-基甲基)-4,7-二氧代-3,6,9,9a-四氢-2H-吡嗪并[1,2-a]嘧啶-1-甲酰胺(ICG-001)、二氢磷酸4-(((6S,9S,9aS)-1-(苄基氨基甲酰基)-2,9-二甲基-4,7-二氧代-8-(喹啉-8-基甲基)八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-6-基)甲基)苯基酯、(6S,9S,9aS)-N-苄基-6-(4-羟基苄基)-2,9-二甲基-4,7-二氧代-8-(喹啉-8-基甲基)八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺、及(6S,9aS)-N-苄基-8-((6-(3-(4-乙基哌嗪-1-基)氮杂环丁烷-1-基)吡啶-2-基)甲基)-6-((2-氟-4-羟基苯基)甲基)-4,7-二氧代-2-(丙-2-烯-1-基)-八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺。
(7)癌症的治疗方法,所述方法包括下述步骤:将有效量的CBP/连环蛋白抑制剂和有效量的免疫检查点抑制剂施予至需要所述CBP/连环蛋白抑制剂和所述免疫检查点抑制剂的对象。
(8)如上述(7)所述的方法,其中,免疫检查点抑制剂为选自PD-1拮抗剂、PD-L1拮抗剂、PD-L2拮抗剂、CTLA-4拮抗剂、KIR拮抗剂、CD137拮抗剂、LAG3拮抗剂及OX40拮抗剂中的一种以上的免疫检查点抑制剂。
(9)如上述(7)所述的方法,其中,免疫检查点抑制剂为选自抗PD-1抗体、抗PD-L1抗体、抗PD-L2抗体、抗CTLA-4抗体、抗KIR抗体、抗LAG3抗体及抗OX40抗体中的一种以上的免疫检查点抑制剂。
(10)如上述(7)~(9)所述的方法,其中,CBP/连环蛋白抑制剂为具有CBP/连环蛋白抑制活性的α-螺旋模拟化合物。
(11)如上述(10)所述的方法,其中,上述α-螺旋模拟化合物为WO2003/031448、WO2004/093828、WO2005/116032、WO2009/148192、WO2010/044485、WO2010/128685、WO2012/115286及/或WO2015/098853中记载的α-螺旋模拟化合物中的任意一种以上的化合物。
(12)如上述(7)~(10)所述的方法,其中,CBP/连环蛋白抑制剂为选自下述化合物中的一种以上的CBP/连环蛋白抑制剂,
(6S,9aS)-N-苄基-6-[(4-羟基苯基)甲基]-8-(萘-1-基甲基)-4,7-二氧代-3,6,9,9a-四氢-2H-吡嗪并[1,2-a]嘧啶-1-甲酰胺(ICG-001)、二氢磷酸4-(((6S,9S,9aS)-1-(苄基氨基甲酰基)-2,9-二甲基-4,7-二氧代-8-(喹啉-8-基甲基)八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-6-基)甲基)苯基酯、(6S,9S,9aS)-N-苄基-6-(4-羟基苄基)-2,9-二甲基-4,7-二氧代-8-(喹啉-8-基甲基)八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺、及(6S,9aS)-N-苄基-8-((6-(3-(4-乙基哌嗪-1-基)氮杂环丁烷-1-基)吡啶-2-基)甲基)-6-((2-氟-4-羟基苯基)甲基)-4,7-二氧代-2-(丙-2-烯-1-基)-八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺。
发明效果
本发明的效果并非是免疫检查点抑制剂的癌症治疗效果与CBP/β-连环蛋白抑制剂的癌症治疗效果的单纯叠加效果,本发明中,CBP/β-连环蛋白抑制剂在促进细胞毒性T细胞的活化及其向癌症组织中的迁移从而增强癌症治疗效果的同时,还抑制CBP/β-连环蛋白的癌细胞增殖效果。CBP/β-连环蛋白抑制剂促进癌症干细胞的分化、增强抗原性,但另一方面,存在通过PD-L1的表达来抑制细胞毒性T细胞的功能的可能性,而免疫检查点抑制剂可通过抑制PD-1与PD-L1的结合来增强CBP/β-连环蛋白抑制剂的癌症治疗效果。
附图说明
[图1]图1为示出了免疫检查点抑制剂的作用机制的示意图。
[图2]图2为示出了CBP/β-连环蛋白抑制剂的作用机制的示意图。
[图3]图3为示出了实施例1中CBP/β-连环蛋白抑制剂使乳腺癌干细胞消失的图。
[图4]图4为示出了实施例3中CBP/β-连环蛋白抑制剂抑制了结肠直肠癌的增殖的图。
[图5]图5为示出了实施例4中CBP/β-连环蛋白抑制剂使IL-10减少的图。
具体实施方式
本发明提供联合应用CBP/连环蛋白抑制剂及免疫检查点抑制剂的癌症治疗药。以下,进行详细说明。
(CBP/连环蛋白抑制剂)
β-连环蛋白作为Wnt信号转导的介体而发挥作用,其与作为转录因子的Tcf/Lef(T细胞因子/淋巴细胞增强因子)结合,促进与Wnt信号转导有关的各种基因(cyclin D1、c-Myc等)的表达,控制细胞的增殖、分化(He等,1998Science 281 1509-1512:Kolligs等,1999Mol.Cell.Biol.19,5696-5706:Crawford等,1999,Oncogene 18,2883-2891:Shtutman等,1999,Proc.Natl.Acad.Sci.USA.,11,5522-5527:Tetsu and McCormick,1999Nature,398,422-426)(参见图2)。
CBP(环磷腺苷效应元件结合蛋白(cyclic AMP response element bindingprotein)(CREB)结合蛋白)在CREB结合域与β-连环蛋白直接相互作用,促进Tcf/Lef的转录激活(Ken-Ichi Takemaru and Randall T.Moon,2000J.Cell.Biol.,149,2,249-254)。
所谓CBP/连环蛋白抑制剂,只要是能抑制CBP与连环蛋白、尤其是与β-连环蛋白的相互作用的抑制剂即可,没有特别限定,优选如下的方式,即,抑制β-连环蛋白与CBP的结合,从而对介由β-连环蛋白复合体的基因表达进行抑制的方式。
对于CBP/β-连环蛋白抑制而言,可通过自身已知的结合分析(放射结合分析等)、报告基因分析法等进行测定,优选地,可以利用WO2009/148192中记载的报告基因分析法测定Wnt信号转导的基因表达,由此进行确认。
本发明的CBP/连环蛋白抑制剂只要为上文所定义的抑制剂即可,没有特别限定,优选为具有CBP/连环蛋白抑制活性的α-螺旋模拟化合物,可举出例如WO2003/031448、WO2004/093828、WO2005/116032、WO2009/148192、WO2010/044485、WO2010/128685、WO2012/115286等中记载的α-螺旋模拟化合物、其药物上允许的盐等。
可优选举出(6S,9aS)-N-苄基-6-[(4-羟基苯基)甲基]-8-(萘-1-基甲基)-4,7-二氧代-3,6,9,9a-四氢-2H-吡嗪并[1,2-a]嘧啶-1-甲酰胺(ICG-001)、二氢磷酸4-(((6S,9S,9aS)-1-(苄基氨基甲酰基)-2,9-二甲基-4,7-二氧代-8-(喹啉-8-基甲基)八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-6-基)甲基)苯基酯(化合物1)、及(6S,9S,9aS)-N-苄基-6-(4-羟基苄基)-2,9-二甲基-4,7-二氧代-8-(喹啉-8-基甲基)八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺(化合物2)等。
作为本发明的CBP/连环蛋白抑制剂,还可举出WO2015/098853中记载的具有Wnt途径调节作用的化合物、其药物上允许的盐等。
可优选举出(6S,9aS)-N-苄基-8-((6-(3-(4-乙基哌嗪-1-基)氮杂环丁烷-1-基)吡啶-2-基)甲基)-6-((2-氟-4-羟基苯基)甲基)-4,7-二氧代-2-(丙-2-烯-1-基)-八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺(化合物A)等。
CBP/连环蛋白抑制剂可作为利用常规方法制剂化而成的医药制剂(例如,注射剂、胶囊剂、片剂、散剂、颗粒剂等)进行施予。例如,可每天一次或分成数次,以换算为有效成分的量计为每天约0.01~1000mg/kg(体重)、优选每天约0.1~500mg/kg(体重)的施予量进行施予,其施予量、施予方法、施予次数可根据症状、年龄等而适宜变更。例如,制剂化为注射剂时,可使用蒸馏水、生理盐水等载体,制剂化为胶囊剂、片剂、散剂、颗粒剂时,可使用淀粉、乳糖、白糖、碳酸钙等赋形剂;淀粉糊液、***胶、明胶、海藻酸钠、羧甲基纤维素、羟丙基纤维素等粘合剂;硬脂酸镁、滑石等润滑剂等;淀粉、琼脂、结晶纤维素、碳酸钙、碳酸氢钠、海藻酸钠等崩解剂等。可使制剂中的有效成分的含有率在1~99重量%之间变动。例如,采用片剂、胶囊剂、颗粒剂、散剂等形态时,优选含有5~80重量%的有效成分,为注射剂时,优选含有1~10重量%的有效成分。
(免疫检查点抑制剂)
作为免疫检查点抑制剂,可举出例如针对T细胞抑制受体的阻断剂。针对T细胞抑制受体的阻断剂通常是特异性地与T细胞抑制受体的细胞外结构域或T细胞抑制受体配体的细胞外结构域相结合的分子,并通过阻断例如T细胞抑制受体与其配体(CD80、CD86、PD-L1、PD-L2等)的结合来阻止T细胞抑制受体的活化。具体而言,可举出PD-1拮抗剂(纳武单抗、派姆单抗(pembrolizumab)等抗PD-1抗体等)、PD-L1拮抗剂(皮地珠单抗(pidilizumab)、MPDL-3280A、MEDI4736、MSB0010718C、MEDI0680等抗PD-L1抗体等)、PD-L2拮抗剂(抗PD-L2抗体等)、CTLA-4拮抗剂(伊匹单抗、曲美木单抗(tremelimumab)等抗CTLA-4抗体等)、KIR拮抗剂(立鲁单抗(lirilumab)等抗杀伤细胞免疫球蛋白样受体抗体(抗KIR抗体)等)、CD137拮抗剂(乌瑞鲁单抗(urelumab)、PF-05082566等抗CD137抗体等)、LAG3拮抗剂(BMS-986016等抗淋巴细胞活化因子3抗体(抗LAG3抗体)等)及OX40拮抗剂(MEDI6469等抗OX40抗体)。优选抗PD-1抗体、抗PD-L1抗体、抗CTLA-4抗体。
免疫检查点抑制剂可利用常规方法制成医药组合物。对于该医药组合物而言,在多数情况下,根据需要而进一步含有一种以上的缓冲液(例如,已缓冲至中性的生理盐水或磷酸缓冲盐水)、糖类(例如,葡萄糖、甘露糖、蔗糖、或葡聚糖)、甘露糖醇、蛋白质、多肽、或甘氨酸等氨基酸、抗氧化剂(例如,抗坏血酸、二亚硫酸钠、丁基羟基甲苯、丁基羟基苯甲醚等)、抑菌剂、EDTA或谷胱甘肽等螯合剂、使组合物相对于受体的血液而言为等渗、低渗或略微高渗的溶质、悬浮剂、增稠剂、防腐剂、香料、甜味料及/或着色化合物。
(癌症治疗药、癌症的治疗方法)
本发明为对患有癌症的患者进行治疗的方法,所述方法包括向患者施予包含CBP/连环蛋白抑制剂和免疫检查点抑制剂的组合的癌症治疗药的步骤。本说明书中记载的方法以癌症治疗、例如白血病及实体肿瘤(例如黑色素瘤、癌症、肉瘤、淋巴瘤等)作为对象。具体而言,可举出肾癌、肾细胞癌、膀胱癌、尿路上皮癌、泌尿生殖器肿瘤、肺癌、肺鳞状细胞癌、小细胞性肺癌、非小细胞性肺癌、恶性黑色素瘤、葡萄膜黑色素瘤、眼黑色素瘤、胃癌、食道癌、胶质母细胞瘤(glioblastoma)、神经胶质肉瘤(gliosarcoma)、转移性脑肿瘤、肝癌、转移性肝癌、肝细胞癌、肝细胞上皮癌、大肠癌、结肠癌、胰腺癌、转移性胰腺癌、转移性头部鳞状细胞癌、乳腺癌、转移性乳腺癌、恶性胸膜间皮瘤、转移性颈部鳞状细胞癌、转移性鼻咽癌、HPV-16阳性实体癌、骨髓纤维化、原发性骨髓纤维化(Primary myelofibrosis,PMF)、转移自真性红细胞增多症(Polycythemia vera,PV)或特发性血小板增多症(Essentialthrombocythemia,ET)的骨髓纤维化和原发性骨髓纤维化、复发性上皮卵巢癌、输卵管癌、腹膜癌、转移性肉瘤、激素抵抗性***癌、肾上腺皮质癌、非霍奇金淋巴瘤、B细胞淋巴瘤、B细胞非霍奇金淋巴瘤、霍奇金淋巴瘤、急性髓细胞性白血病、慢性髓细胞性白血病、慢性淋巴细胞性淋巴瘤、小淋巴细胞性淋巴瘤、T-细胞白血病、T-细胞淋巴瘤、滤泡性淋巴瘤、骨髓增生异常综合征等。
另外,上述癌症患者中,尤其对于β-连环蛋白被激活的癌症是有效的。
对于本发明的包含CBP/连环蛋白抑制剂和免疫检查点抑制剂的组合的癌症治疗药而言,可以将CBP/连环蛋白抑制剂及免疫检查点抑制剂各自分别、或一同利用适合于例如经口、经鼻、粘膜、直肠、***内、局部、静脉内、腹膜内、皮内、皮下、及肌肉内施予等任意施予方式的方法进行配方。
本发明中,在本领域技术人员的知识范围内足以确定包含CBP/连环蛋白抑制剂和免疫检查点抑制剂的组合的癌症治疗药的各自的施予量及治疗上有效的量的施予时间。例如,最初的有效量可根据细胞培养或其他的体外(in vitro)分析进行推测。对于施予量而言,可以以在动物模型中实现由细胞培养分析求得的IC50的浓度等循环浓度或组织浓度的方式,来进行设定。
为实现本发明的目的,施予的方法可根据接受治疗的状态及治疗药来选择。CBP/连环蛋白抑制剂及免疫检查点抑制剂的施予可通过多种方法进行,例如,不受限定,可优选举出皮下、静脉内、腹膜内、肌肉内、及全身施予,根据情况而直接注入至特定的器官或肿瘤,等等。CBP/连环蛋白抑制剂及免疫检查点抑制剂的施予可通过单一的途径、或同时利用数种途径进行。
CBP/连环蛋白抑制剂及免疫检查点抑制剂尤其可根据治疗适应性及处方医师的判断而以每天1次、每天2次~数次、或每天多数次进行施予。
对于得到治疗效果而言必需的CBP/连环蛋白抑制剂及免疫检查点抑制剂的量,可基于特定的目的、按照以往的方法凭经验决定。一般而言,基于治疗目的向细胞施予时,细胞被施予药理学上有效的施予量。所谓“药理学上有效的量”或“药理学上有效的施予量”,是指为治疗特定的障碍或疾病状态而足以产生所期望的生理学效果(例如减轻或消除障碍或疾病的一种以上的症状或征兆等)的量、或能够达成所期望的结果的量。
本发明的包含CBP/连环蛋白抑制剂和免疫检查点抑制剂的组合的癌症治疗药还可与其他的癌症治疗(例如为外科切除、放射疗法、化学疗法、免疫疗法、以及支持疗法(例如镇痛剂、利尿药、抗利尿药、抗病毒药、抗生素、营养剂、贫血治疗、血液凝固治疗、骨治疗、以及精神病理学及心理学治疗))等联合。
以下,示出实施例更详细地说明本发明,但本发明的范围不限于这些实施例。
实施例
实施例1
使用Hoechst Blue和Hoechst Red对人乳腺癌细胞株(MDA-MB-231)进行二维分选,对于得到的侧群细胞(Side Population)组分(认为癌症干细胞已被浓缩),向培养液中添加0.3μM的CBP/连环蛋白抑制剂(化合物2),在4天后,侧群细胞组分基本消失(未使用药剂处理的情况下,检测到1.6%的SP细胞,化合物2处理组中为0%),认为癌症干细胞已经分化(图3)。
治疗例1
对于无法根治切除的恶性黑色素瘤患者,以每1次2mg/kg(体重)、3周间隔静脉滴注纳武单抗,同时,以30mg/m2/天静脉滴注CBP/β-连环蛋白抑制剂(化合物1)。
治疗例2
对于无法根治切除的恶性黑色素瘤患者,以每1次3mg/kg(体重)、3周间隔静脉滴注伊匹单抗,同时,以100mg/m2/天静脉滴注CBP/β-连环蛋白抑制剂(化合物1)。
实施例2
传代移植了转基因小鼠(MMTV-Wnt-1)的原发性乳腺癌的模型动物中的CBP/连环蛋白抑制剂(化合物A)与抗小鼠PD-1(CD279)抗体的联用效果
采集Wnt-1在乳腺上皮细胞中局部性表达的转基因小鼠(MMTV-Wnt-1)的原发性乳腺癌,使用套管针传代移植至成为背景品系的小鼠(C57BL/6J)。在移植传代后的肿瘤成为1.5g左右时将其摘出,切成30mg左右的片段,移植至各组为5例的小鼠(C57BL/6J)的体侧皮下。确认肿瘤的成活后,将化合物A(50mg/kg,每天2次,21天,经口施予)及抗小鼠PD-1抗体(克隆:RMP1-14,BioXCell)(10mg/kg,每周2次,3周,腹腔施予)以各自单独或者合用的方式施予。
将施予开始日作为第0天,之后,在第4、7、11、14、18及21天,用电子数显卡尺(Mitsutoyo)测定在各小鼠中长出的肿瘤的长径及短径。
根据下式,算出肿瘤体积。
肿瘤体积TV(mm3)=肿瘤长径(mm)×肿瘤短径2(mm2)/2
将TV的结果总结示于表1。通过将化合物A及抗小鼠PD-1抗体合用,呈现出较之分别单独施予的情况而言统计上显著(*p<0.05)优异的抗肿瘤效果(在重复测量方差分析(Repeated measures ANOVA)之后进行Dunnett多重比较(Dunnett’s type multiplecomparison))。
实施例3
向BALB/C小鼠移植结肠直肠癌细胞所得模型动物中的CBP/连环蛋白抑制剂(化合物1)与抗小鼠PD-L1抗体的合用效果
将作为结肠直肠癌细胞的CT26细胞皮下移植至雌性BALB/C小鼠的右腹部。饲养至平均肿瘤大小成为80mm3后,按照以下方式,以每组10例进行分组。
组1:背景介质(vehicle)组
组2:抗小鼠PD-L1抗体单独施予组
组3:化合物1单独施予组
组4:化合物1及抗小鼠PD-L1抗体的联合施予组
将化合物1(80mg/kg,每天1次,21天,腹腔内施予)及抗小鼠PD-L1抗体(目录编号:BE0101-100MG,BioXCell)(2mg/kg,每周2次,2周,腹腔施予)以各自单独或者联合的方式施予。
将施予开始日作为第0天,之后,在第3、6、9、12及15天,测定在各小鼠中长出的肿瘤的长径及短径。
根据下式,算出肿瘤体积。
肿瘤体积(mm3)=肿瘤长径(mm)×肿瘤短径2(mm2)/2
将肿瘤体积的结果总结示于图4。通过将化合物1及抗小鼠PD-L1抗体合用,呈现出较之分别单独施予的情况而言统计上显著(*p<0.01)优异的抗肿瘤效果(重复测量双因素方差分析(Repeated measurement Two-Way ANOVA))。
实施例4
CBP/连环蛋白抑制剂(化合物1)的抑制IL-10产生的作用
使用了由美国NIH基于人恶性黑色素瘤患者构建的细胞株(黑色素瘤)624mel细胞及928mel细胞。这些细胞已被活化,具有IL-10产生能力。
在培养液(含有10%FCS的RPMI 1640,添加有青霉素及链霉素)中,以1×105个细胞/2ml/孔的浓度将各黑色素瘤细胞接种于6孔培养板中。接种后,以成为规定的浓度的方式添加化合物1,培养24小时。在24小时后将培养上清液回收,测定上清液中的IL-10的浓度。IL-10浓度的测定使用了人IL10 OptEIA ELISA试剂盒(Human IL10 OptEIA ELISAset)(BD公司,#555157)。
将结果示于图5。
添加了1μM化合物1的情况下,在任一种细胞中均确认到化合物1对于增殖的影响,添加了0.2μM化合物1的情况下,在任一种细胞中均未确认到其对于增殖的影响。即使在对于增殖没有产生影响的条件下(0.2μM),IL-10的产生也受到了抑制,由此可知,化合物1具有抑制IL-10产生的作用。
作为免疫检查点抑制剂的抗PD-1抗体、抗CTLA-4抗体在临床中呈现显著效果的患者是有限的,已知该效果依赖于癌症患者中的CD-8阳性T细胞数量。尤其是CD-8阳性细胞数与β-连环蛋白的表达呈完全逆相关,在β-连环蛋白的表达水平高的组织中,T细胞少,反之,在β-连环蛋白的表达水平低的组织中,T细胞多。
CBP/连环蛋白抑制剂在β-连环蛋白的表达水平高的组织中呈现了更高的效果,另一方面,其抑制IL-10产生的作用能够使CD-8阳性T细胞数量增加。因此,可知通过将CBP/连环蛋白抑制剂与免疫检查点抑制剂联合应用,能够得到更高的抗癌效果。
本申请以在日本提出申请的日本特愿2015-121479(申请日为2015年6月16日)为基础,上述申请的内容全部包括在本说明书中。
Claims (2)
1.癌症治疗药,其包含联合的CBP/连环蛋白抑制剂和免疫检查点抑制剂,
所述CBP/连环蛋白抑制剂为(6S,9aS)-N-苄基-8-((6-(3-(4-乙基哌嗪-1-基)氮杂环丁烷-1-基)吡啶-2-基)甲基)-6-((2-氟-4-羟基苯基)甲基)-4,7-二氧代-2-(丙-2-烯-1-基)-八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺,
所述免疫检查点抑制剂为抗PD-1抗体,且
所述癌症是β-连环蛋白被激活的癌症。
2.CBP/连环蛋白抑制剂和免疫检查点抑制剂的组合用于制造癌症治疗药的用途,
所述CBP/连环蛋白抑制剂为(6S,9aS)-N-苄基-8-((6-(3-(4-乙基哌嗪-1-基)氮杂环丁烷-1-基)吡啶-2-基)甲基)-6-((2-氟-4-羟基苯基)甲基)-4,7-二氧代-2-(丙-2-烯-1-基)-八氢-1H-吡嗪并[2,1-c][1,2,4]三嗪-1-甲酰胺,
所述免疫检查点抑制剂为抗PD-1抗体,且
所述癌症是β-连环蛋白被激活的癌症。
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RU2729936C2 (ru) | 2020-08-13 |
CN107801379A (zh) | 2018-03-13 |
AU2016279474A1 (en) | 2018-02-01 |
JPWO2016204193A1 (ja) | 2018-04-05 |
CA2988707A1 (en) | 2016-12-22 |
RU2018100944A (ru) | 2019-07-16 |
EP3311841A4 (en) | 2019-02-13 |
KR20180018695A (ko) | 2018-02-21 |
US20180185395A1 (en) | 2018-07-05 |
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