WO2020236586A1 - N-hetaryl-squaramide compounds for treating conditions associated with sting activity - Google Patents

N-hetaryl-squaramide compounds for treating conditions associated with sting activity Download PDF

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Publication number
WO2020236586A1
WO2020236586A1 PCT/US2020/033127 US2020033127W WO2020236586A1 WO 2020236586 A1 WO2020236586 A1 WO 2020236586A1 US 2020033127 W US2020033127 W US 2020033127W WO 2020236586 A1 WO2020236586 A1 WO 2020236586A1
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independently selected
alkyl
optionally substituted
compound
group
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PCT/US2020/033127
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French (fr)
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Shankar Venkatraman
Jason Katz
William R. Roush
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Ifm Due, Inc.
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Publication of WO2020236586A1 publication Critical patent/WO2020236586A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D209/00Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom
    • C07D209/02Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom condensed with one carbocyclic ring
    • C07D209/04Indoles; Hydrogenated indoles
    • C07D209/30Indoles; Hydrogenated indoles with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, directly attached to carbon atoms of the hetero ring
    • C07D209/40Nitrogen atoms, not forming part of a nitro radical, e.g. isatin semicarbazone
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D231/00Heterocyclic compounds containing 1,2-diazole or hydrogenated 1,2-diazole rings
    • C07D231/54Heterocyclic compounds containing 1,2-diazole or hydrogenated 1,2-diazole rings condensed with carbocyclic rings or ring systems
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D231/00Heterocyclic compounds containing 1,2-diazole or hydrogenated 1,2-diazole rings
    • C07D231/54Heterocyclic compounds containing 1,2-diazole or hydrogenated 1,2-diazole rings condensed with carbocyclic rings or ring systems
    • C07D231/56Benzopyrazoles; Hydrogenated benzopyrazoles
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D401/00Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
    • C07D401/02Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
    • C07D401/12Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a chain containing hetero atoms as chain links
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D403/00Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00
    • C07D403/02Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00 containing two hetero rings
    • C07D403/12Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00 containing two hetero rings linked by a chain containing hetero atoms as chain links
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D417/00Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00
    • C07D417/02Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings
    • C07D417/04Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings directly linked by a ring-member-to-ring-member bond
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D417/00Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00
    • C07D417/02Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings
    • C07D417/12Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings linked by a chain containing hetero atoms as chain links
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D471/00Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00
    • C07D471/02Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00 in which the condensed system contains two hetero rings
    • C07D471/04Ortho-condensed systems

Definitions

  • This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING).
  • Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human).
  • This disclosure also features compositions containing the same as well as methods of using and making the same.
  • BACKGROUND STING also known as transmembrane protein 173 (TMEM173) and MPYS/MITA/ERIS, is a protein that in humans is encoded by the TMEM173 gene.
  • STING has been shown to play a role in innate immunity. STING induces type I interferon production when cells are infected with intracellular pathogens, such as viruses, mycobacteria and intracellular parasites. Type I interferon, mediated by STING, protects infected cells and nearby cells from local infection in an autocrine and paracrine manner.
  • STING a transmembrane protein localized to the endoplasmic reticulum (ER) acts as a second messenger receptor for 2', 3' cyclic GMP-AMP (hereafter cGAMP), which is produced by cGAS after dsDNA binding.
  • cGAMP 2', 3' cyclic GMP-AMP
  • STING can also function as a primary pattern recognition receptor for bacterial cyclic dinucleotides (CDNs) and small molecule agonists.
  • CDNs bacterial cyclic dinucleotides
  • Ligand-induced activation of STING triggers its re-localization to the Golgi, a process essential to promote the interaction of STING with TBK1.
  • This protein complex signals through the transcription factors IRF-3 to induce type I interferons (IFNs) and other co-regulated antiviral factors.
  • IFNs type I interferons
  • STING was shown to trigger NF-kB and MAP kinase activation. Following the initiation of signal transduction, STING is rapidly degraded, a step considered important in terminating the inflammatory response.
  • STING-associated vasculopathy with onset in infancy SAVI
  • STING STING-associated vasculopathy with onset in infancy
  • AGS Aicardi- Goutines Syndrome
  • This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING).
  • Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human).
  • This disclosure also features compositions containing the same as well as methods of using and making the same.
  • An "antagonist" of STING includes compounds that, at the protein level, directly bind or modify STING such that an activity of STING is decreased, e.g., by inhibition, blocking or dampening agonist-mediated responses, altered distribution, or otherwise.
  • STING antagonists include chemical entities, which interfere or inhibit STING signaling.
  • X 1 , X 2 , Y 1 , Y 2 , Y 3 , Y 4 , Z, Q, A, and R 6 can be as defined anywhere herein.
  • compositions are featured that include a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same) and one or more pharmaceutically acceptable excipients.
  • a chemical entity described herein e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same
  • one or more pharmaceutically acceptable excipients e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same.
  • methods for inhibiting (e.g., antagonizing) STING activity include contacting STING with a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
  • a chemical entity described herein e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same.
  • Methods include in vitro methods, e.g., contacting a sample that includes one or more cells comprising STING (e.g., innate immune cells, e.g., mast cells, macrophages, dendritic cells (DCs), and natural killer cells) with the chemical entity.
  • STING e.g., innate immune cells, e.g., mast cells, macrophages, dendritic cells (DCs), and natural killer cells
  • Methods can also include in vivo methods; e.g., administering the chemical entity to a subject (e.g., a human) having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and/or symptoms and/or progression of the disease.
  • methods of treating a condition, disease or disorder ameliorated by antagonizing STING are featured, e.g., treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human).
  • the methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
  • methods of treating cancer include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
  • a chemical entity described herein e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same.
  • STING-associated conditions are featured, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Gout Italian Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
  • SAVI STING-associated vasculopathywith onset in infancy
  • AVS Aicardi-Gout Italian Syndrome
  • genetic forms of lupus e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same.
  • methods of suppressing STING-dependent type I interferon production in a subject in need thereof include administering to the subject an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
  • a chemical entity described herein e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same.
  • methods of treating a disease in which increased (e.g., excessive) STING activation contributes to the pathology and/or symptoms and/or progression of the disease are featured.
  • the methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
  • methods of treatment include administering an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same) to a subject; wherein the subject has (or is predisposed to have) a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the disease.
  • a chemical entity described herein e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same
  • STING activation e.g., STING signaling
  • methods of treatment that include administering to a subject a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same), wherein the chemical entity is administered in an amount effective to treat a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the disease, thereby treating the disease.
  • a chemical entity described herein e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same
  • STING activation e.g., STING signaling
  • Embodiments can include one or more of the following features.
  • the chemical entity can be administered in combination with one or more additional therapeutic agents and/or regimens.
  • methods can further include administering one or more (e.g., two, three, four, five, six, or more) additional agents.
  • the chemical entity can be administered in combination with one or more additional therapeutic agents and/or regimens that are useful for treating other STING- associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Gout Italian Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
  • STING-associated conditions e.g., STING-associated vasculopathywith onset in infancy (SAVI)
  • Aicardi-Goutines Syndrome Aicardi-Goutines Syndrome
  • genetic forms of lupus e.g., and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
  • the chemical entity can be administered in combination with one or more additional cancer therapies (e.g., surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof; e.g., chemotherapy that includes administering one or more (e.g., two, three, four, five, six, or more) additional chemotherapeutic agents.
  • additional cancer therapies e.g., surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof; e.g., chemotherapy that includes administering one or more (e.g., two, three, four, five, six, or more) additional chemotherapeutic agents.
  • Non-limiting examples of additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin); an anti-metabolite (e.g.,azathioprine and/or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and/or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and/or Vindesine Taxol, Pacllitaxel and/or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and/or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and/or topotecan;.
  • an alkylating agent e.g.,
  • the subject can have cancer; e.g., the subject has undergone and/or is undergoing and/or will undergo one or more cancer therapies.
  • Non-limiting examples of cancer include melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
  • the cancer can be a refractory cancer.
  • the chemical entity can be administered intratumorally.
  • the methods can further include identifying the subject.
  • STING is meant to include, without limitation, nucleic acids, polynucleotides, oligonucleotides, sense and antisense polynucleotide strands, complementary sequences, peptides, polypeptides, proteins, homologous and/or orthologous STING molecules, isoforms, precursors, mutants, variants, derivatives, splice variants, alleles, different species, and active fragments thereof.
  • API refers to an active pharmaceutical ingredient.
  • an“effective amount” or“therapeutically effective amount,” as used herein, refer to a sufficient amount of a chemical entity being administered which will relieve to some extent one or more of the symptoms of the disease or condition being treated. The result includes reduction and/or alleviation of the signs, symptoms, or causes of a disease, or any other desired alteration of a biological system.
  • an“effective amount” for therapeutic uses is the amount of the composition comprising a compound as disclosed herein required to provide a clinically significant decrease in disease symptoms.
  • An appropriate“effective” amount in any individual case is determined using any suitable technique, such as a dose escalation study.
  • excipient or“pharmaceutically acceptable excipient” means a pharmaceutically-acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, carrier, solvent, or encapsulating material.
  • each component is“pharmaceutically acceptable” in the sense of being compatible with the other ingredients of a pharmaceutical formulation, and suitable for use in contact with the tissue or organ of humans and animals without excessive toxicity, irritation, allergic response, immunogenicity, or other problems or complications, commensurate with a reasonable benefit/risk ratio.
  • pharmaceutically acceptable salt refers to a formulation of a compound that does not cause significant irritation to an organism to which it is administered and does not abrogate the biological activity and properties of the compound.
  • pharmaceutically acceptable salts are obtained by reacting a compound described herein, with acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like.
  • pharmaceutically acceptable salts are obtained by reacting a compound having acidic group described herein with a base to form a salt such as an ammonium salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as dicyclohexylamine, N-methyl-D-glucamine, tris(hydroxymethyl)methylamine, and salts with amino acids such as arginine, lysine, and the like, or by other methods previously determined.
  • a salt such as an ammonium salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as dicyclohexylamine, N-methyl-D-glucamine, tris(hydroxymethyl)methylamine, and salts with amino acids such as arginine, lysine, and the like, or by other methods previously determined.
  • Examples of a salt that the compounds described hereinform with a base include the following: salts thereof with inorganic bases such as sodium, potassium, magnesium, calcium, and aluminum; salts thereof with organic bases such as methylamine, ethylamine and ethanolamine; salts thereof with basic amino acids such as lysine and ornithine; and ammonium salt.
  • the salts may be acid addition salts, which are specifically exemplified by acid addition salts with the following: mineral acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, and phosphoric acid:organic acids such as formic acid, acetic acid, propionic acid, oxalic acid, malonic acid, succinic acid, fumaric acid, maleic acid, lactic acid, malic acid, tartaric acid, citric acid, methanesulfonic acid, and ethanesulfonic acid; acidic amino acids such as aspartic acid and glutamic acid.
  • mineral acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, and phosphoric acid
  • organic acids such as formic acid, acetic acid, propionic acid, oxalic acid, malonic acid, succinic acid, fumaric acid, maleic acid, lactic acid, malic acid, tart
  • pharmaceutical composition refers to a mixture of a compound described herein with other chemical components (referred to collectively herein as “excipients”), such as carriers, stabilizers, diluents, dispersing agents, suspending agents, and/or thickening agents.
  • excipients such as carriers, stabilizers, diluents, dispersing agents, suspending agents, and/or thickening agents.
  • the pharmaceutical composition facilitates administration of the compound to an organism. Multiple techniques of administering a compound exist in the art including, but not limited to: rectal, oral, intravenous, aerosol, parenteral, ophthalmic, pulmonary, and topical administration.
  • subject refers to an animal, including, but not limited to, a primate (e.g., human), monkey, cow, pig, sheep, goat, horse, dog, cat, rabbit, rat, or mouse.
  • primate e.g., human
  • monkey cow, pig, sheep, goat
  • horse dog, cat, rabbit, rat
  • patient refers to a mammalian subject, such as a human.
  • treat in the context of treating a disease or disorder, are meant to include alleviating or abrogating a disorder, disease, or condition, or one or more of the symptoms associated with the disorder, disease, or condition; or to slowing the progression, spread or worsening of a disease, disorder or condition or of one or more symptoms thereof.
  • The“treatment of cancer” refers to one or more of the following effects: (1) inhibition, to some extent, of tumor growth, including, (i) slowing down and (ii) complete growth arrest; (2) reduction in the number of tumor cells; (3) maintaining tumor size; (4) reduction in tumor size; (5) inhibition, including (i) reduction, (ii) slowing down or (iii) complete prevention, of tumor cell infiltration into peripheral organs; (6) inhibition, including (i) reduction, (ii) slowing down or (iii) complete prevention, of metastasis; (7) enhancement of anti-tumor immune response, which may result in (i) maintaining tumor size, (ii) reducing tumor size, (iii) slowing the growth of a tumor, (iv) reducing, slowing or preventing invasion and/or (8) relief, to some extent, of the severity or number of one or more symptoms associated with the disorder.
  • halo refers to fluoro (F), chloro (Cl), bromo (Br), or iodo (I).
  • alkyl refers to a hydrocarbon chain that may be a straight chain or branched chain, containing the indicated number of carbon atoms.
  • C1-10 indicates that the group may have from 1 to 10 (inclusive) carbon atoms in it.
  • Non-limiting examples include methyl, ethyl, iso-propyl, tert-butyl, n-hexyl.
  • haloalkyl refers to an alkyl, in which one or more hydrogen atoms is/are replaced with an independently selected halo.
  • alkoxy refers to an -O-alkyl radical (e.g., -OCH3).
  • alkylene refers to a divalent alkyl (e.g., -CH 2 -).
  • alkenyl refers to a hydrocarbon chain that may be a straight chain or branched chain having one or more carbon-carbon double bonds.
  • the alkenyl moiety contains the indicated number of carbon atoms. For example, C2-6 indicates that the group may have from 2 to 6 (inclusive) carbon atoms in it.
  • alkynyl refers to a hydrocarbon chain that may be a straight chain or branched chain having one or more carbon-carbon triple bonds.
  • the alkynyl moiety contains the indicated number of carbon atoms. For example, C2-6 indicates that the group may have from 2 to 6 (inclusive) carbon atoms in it.
  • aryl refers to a 6-20 carbon mono-, bi-, tri- or polycyclic group wherein at least one ring in the system is aromatic (e.g., 6-carbon monocyclic, 10-carbon bicyclic, or 14-carbon tricyclic aromatic ring system); and wherein 0, 1, 2, 3, or 4 atoms of each ring may be substituted by a substituent.
  • aryl groups include phenyl, naphthyl, tetrahydronaphthyl, and the like.
  • cycloalkyl as used herein includes cyclic hydrocarbon groups having 3 to 20 ring carbons, preferably 3 to 16 ring carbons, and more preferably 3 to 12 ring carbons or 3-10 ring carbons or 3-6 ring carbons, wherein the cycloalkyl group may be optionally substituted.
  • cycloalkyl groups include, without limitation, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and cyclooctyl.
  • Cycloalkyl may include multiple fused and/or bridged rings.
  • Non-limiting examples of fused/bridged cycloalkyl includes: bicyclo[1.1.0]butane, bicyclo[2.1.0]pentane, bicyclo[1.1.1]pentane, bicyclo[3.1.0]hexane, bicyclo[2.1.1]hexane, bicyclo[3.2.0]heptane, bicyclo[4.1.0]heptane, bicyclo[2.2.1]heptane, bicyclo[3.1.1]heptane, bicyclo[4.2.0]octane, bicyclo[3.2.1]octane, bicyclo[2.2.2]octane, and the like.
  • Cycloalkyl also includes spirocyclic rings (e.g., spirocyclic bicycle wherein two rings are connected through just one atom).
  • spirocyclic cycloalkyls include spiro[2.2]pentane, spiro[2.5]octane, spiro[3.5]nonane, spiro[3.5]nonane, spiro[3.5]nonane, spiro[4.4]nonane, spiro[2.6]nonane, spiro[4.5]decane, spiro[3.6]decane, spiro[5.5]undecane, and the like.
  • cycloalkenyl as used herein includes partially unsaturated cyclic hydrocarbon groups having 3 to 20 ring carbons, preferably 3 to 16 ring carbons, and more preferably 3 to 12 ring carbons or 3-10 ring carbons or 3-6 ring carbons, wherein the cycloalkenyl group may be optionally substituted.
  • Examples of cycloalkenyl groups include, without limitation, cyclopentenyl, cyclohexenyl, cycloheptenyl, and cyclooctenyl.
  • Cycloalkenyl groups may have any degree of saturation provided that none of the rings in the ring system are aromatic; and the cycloalkenyl group is not fully saturated overall.
  • Cycloalkenyl may include multiple fused and/or bridged and/or spirocyclic rings.
  • heteroaryl as used herein, means a mono-, bi-, tri- or polycyclic group having 5 to 20 ring atoms, alternatively 5, 6, 9, 10, or 14 ring atoms; and having 6, 10, or 14 pi electrons shared in a cyclic array; wherein at least one ring in the system is aromatic (but does not have to be a ring which contains a heteroatom, e.g.
  • tetrahydroisoquinolinyl e.g., tetrahydroquinolinyl
  • at least one ring in the system contains one or more heteroatoms independently selected from the group consisting of N, O, and S.
  • Heteroaryl groups can either be unsubstituted or substituted with one or more substituents.
  • heteroaryl examples include thienyl, pyridinyl, furyl, oxazolyl, oxadiazolyl, pyrrolyl, imidazolyl, triazolyl, thiodiazolyl, pyrazolyl, isoxazolyl, thiadiazolyl, pyranyl, pyrazinyl, pyrimidinyl, pyridazinyl, triazinyl, thiazolyl benzothienyl, benzoxadiazolyl, benzofuranyl, benzimidazolyl, benzotriazolyl, cinnolinyl, indazolyl, indolyl, isoquinolinyl, isothiazolyl, naphthyridinyl, purinyl, thienopyridinyl, pyrido[2,3-d]pyrimidinyl, pyrrolo[2,3- b]pyridinyl, quinazoliny
  • the heteroaryl is selected from thienyl, pyridinyl, furyl, pyrazolyl, imidazolyl, isoindolinyl, pyranyl, pyrazinyl, and pyrimidinyl.
  • heterocyclyl refers to a mon-, bi-, tri-, or polycyclic nonaromatic ring system with 3-16 ring atoms (e.g., 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system) having 1-3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic or polycyclic, said heteroatoms selected from O, N, or S (e.g., carbon atoms and 1-3, 1-6, or 1-9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1, 2 or 3 atoms of each ring may be substituted by a substituent.
  • ring atoms e.g., 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system
  • heteroatoms selected from O, N, or S (e
  • heterocyclyl groups include piperazinyl, pyrrolidinyl, dioxanyl, morpholinyl, tetrahydrofuranyl, and the like.
  • Heterocyclyl may include multiple fused and bridged rings.
  • Non-limiting examples of fused/bridged heteorocyclyl includes: 2-azabicyclo[1.1.0]butane, 2-azabicyclo[2.1.0]pentane, 2- azabicyclo[1.1.1]pentane, 3-azabicyclo[3.1.0]hexane, 5-azabicyclo[2.1.1]hexane, 3- azabicyclo[3.2.0]heptane, octahydrocyclopenta[c]pyrrole, 3-azabicyclo[4.1.0]heptane, 7- azabicyclo[2.2.1]heptane, 6-azabicyclo[3.1.1]heptane, 7-azabicyclo[4.2.0]octane, 2- azabicyclo[2.2.2]octane, 3-azabicyclo[3.2.1]octane, 2-oxabicyclo[1.1.0]butane, 2- oxabicyclo[2.1.0]pentane, 2-oxabicyclo[1.1.1
  • Heterocyclyl also includes spirocyclic rings (e.g., spirocyclic bicycle wherein two rings are connected through just one atom).
  • spirocyclic heterocyclyls include 2- azaspiro[2.2]pentane, 4-azaspiro[2.5]octane, 1-azaspiro[3.5]nonane, 2- azaspiro[3.5]nonane, 7-azaspiro[3.5]nonane, 2-azaspiro[4.4]nonane, 6- azaspiro[2.6]nonane, 1,7-diazaspiro[4.5]decane, 7-azaspiro[4.5]decane 2,5- diazaspiro[3.6]decane, 3-azaspiro[5.5]undecane, 2-oxaspiro[2.2]pentane, 4- oxaspiro[2.5]octane, 1-oxaspiro[3.5]nonane
  • atoms making up the compounds of the present embodiments are intended to include all isotopic forms of such atoms.
  • Isotopes include those atoms having the same atomic number but different mass numbers.
  • isotopes of hydrogen include tritium and deuterium
  • isotopes of carbon include 13 C and 14 C.
  • This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING).
  • Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human).
  • This disclosure also features compositions containing the same as well as methods of using and making the same.
  • Z is selected from the group consisting of a bond, CR 1 , C(R 3 ) 2 , N, and NR 2 ;
  • each of Y 1 , Y 2 , and Y 3 is independently selected from the group consisting of O, S, CR 1 , C(R 3 )2, N, and NR 2 ;
  • Y 4 is C or N;
  • X 1 is selected from the group consisting of O, S, N, NR 2 , and CR 1 ;
  • X 2 is selected from the group consisting of O, S, N, NR 4 , and CR 5 ;
  • Q-A is defined according to (A) or (B) below: (A)
  • Q is selected from the group consisting of: NH; N(C1-6 alkyl) wherein the C1-6 alkyl is optionally substituted with 1-2 independently selected R a ; O; S; and C 1-3 alkylene which is optionally substituted with 1-2 independently selected R a and
  • A is:
  • ⁇ n is 0 or 1;
  • ⁇ Y A1 is C1-6 alkylene, which is optionally substituted with from 1-6 substituents each indepndently selected from the group consisting of R a ; C 6- 10 aryl optionally substituted with 1-4 independently selected C1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C1-4 alkyl; and
  • ⁇ Y A2 is:
  • heteroaryl including from 5-20 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c ; or (d) heterocyclyl including from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b , OR
  • ⁇ Z 1 is C 1-3 alkylene, which is optionally substituted with from 1-4 R a ;
  • ⁇ Z 2 is–N(H)-, -N(R d )-, -O-, or–S-;
  • ⁇ Z 3 is C2-7 alkyl, which is optionally substituted with from 1-4 R a ; OR
  • E is heterocyclyl including from 3-16 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ,
  • each occurrence of R 1 is independently selected from the group consisting of ⁇
  • R 1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NR e R f , C1-6 alkoxy, and C1-6 haloalkoxy, each occurrence of R 2 is independently selected from the group consisting of: (i) C1-6 alkyl, which is optionally substituted with from 1-2 independently selected R a ;
  • heteroaryl including from 5-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 ;
  • (xiii) H or a pair of R 1 and R 2 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R 2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 ; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NR e R f , C1-6 alkoxy, and C1-6 haloalkoxy,
  • a pair of R 3 taken together with the atom(s) connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NR e R f , C1-6 alkoxy, and C1-6 haloalkoxy; or
  • -L 2 is–O-, -N(H)-, -S(O)0-2-, or a bond;
  • R h is selected from:
  • heterocyclyl wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1- 4 haloalkyl;
  • heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ⁇ C 6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl; -L 3 is a bond or C1-3 alkylene;
  • -L 4 is–O-, -N(H)-, -S(O) 0-2 -, or a bond;
  • R i is selected from:
  • heterocyclyl wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1- 4 haloalkyl;
  • heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1-4 haloalkyl; and ⁇ C 6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1- 4 haloalkyl; and each occurrence of R’ and R’’ is independently selected from the group consisting of: H, C1-4 alkyl, and C6-10 aryl optionally substituted with from 1-2 substituents selected from halo, C 1-4 alkyl, and C 1-4 haloalkyl; or R’ and R’’ together with the nitrogen atom to which each is attached
  • the ring that includes Z, Y 1 , Y 2 , Y 3 , and Y 4 is aromatic. In some embodiments (e.g., when the ring that includes Z, Y 1 , Y 2 , Y 3 , and Y 4 is aromatic), Z is selected from the group consisting of CR 1 , N, and NR 2 .
  • Z is CR 1 .
  • each of Y 1 , Y 2 , and Y 3 is independently selected from the group consisting of CR 1 and N.
  • each of Y 1 , Y 2 , and Y 3 is independently selected from the group consisting of CR 1 and N. In some embodiments, each of Y 1 , Y 2 , and Y 3 is independently CR 1 .
  • Z is CR 1 ; and each of Y 1 , Y 2 , and Y 3 is
  • Y 1 , Y 2 , and Y 3 are independently N or NR 2 (e.g., from 1-2 of Y 1 , Y 2 , and Y 3 is independently N).
  • one of Y 1 , Y 2 , and Y 3 is N or NR 2 (e.g., one of Y 1 , Y 2 , and Y 3 is N).
  • each of the remaining Y 1 , Y 2 , and Y 3 is an independently selected CR 1 .
  • moiety is , wherein the asterisk denotes point of attachment to Y 4 .
  • moiety is or (e.g.,
  • moiety is , wherein the asterisk denotes point of attachment to Y 4 .
  • Z is N.
  • each of Y 1 , Y 2 , and Y 3 is N
  • each of Y 1 , Y 2 , and Y 3 is independently selected from the group consisting of CR 1 and N. In certain embodiments (when Z is N), each of Y 1 , Y 2 , and Y 3 is independently
  • CR 1 e.g., the moiety is wherein the asterisk denotes point of attachment to Y 4 ).
  • Z is a bond.
  • Y 2 is CR 1 .
  • from 1-2 of Y 1 and Y 3 is other than CR 1 .
  • Y 1 and Y 3 is independently selected from N, CR 1 , and S.
  • the ring that includes Z, Y 1 , Y 2 , Y 3 , and Y 4 is selected from:
  • the ring that includes Z, Y 1 , Y 2 , Y 3 , and Y 4 is partially saturated.
  • the ring that includes Z, Y 1 , Y 2 , Y 3 , and Y 4 is:
  • each denotes points of attachment to the ring comprising X 1 and X 2 , and wherein the bottom denotes point of attachment to X 1 .
  • Z is other than a single bond.
  • Y 4 is C.
  • each of Z, Y 1 , Y 2 , and Y 3 is C(R 3 ) 2 . In certain other embodiments, one of Z, Y 1 , Y 2 , and Y 3 is other than C(R 3 )2.
  • the ring comprising Z, Y 1 , Y 2 , Y 3 , and Y 4 is:
  • Z is C(R 3 )2 or a bond.
  • Z is a bond. In certain embodiments, Z is C(R 3 ) 2 .
  • each of Y 1 , Y 2 , and Y 3 is independently selected from the group consisting of C(R 3 )2, O, NR 2 , and S.
  • each of Y 1 , Y 2 , and Y 3 is independently C(R 3 ) 2 .
  • the moiety is
  • Y 4 is C.
  • X 1 is NR 2 (e.g., NH).
  • X 2 is CR 5 (e.g., CH).
  • X 2 is N. In certain embodiments, X 1 is NR 2 ; and X 2 is CR 5 . As a non-limiting example, X 1 is NH; and X 2 is CH. Non-Limiting Combinations of Z, Y 1 , Y 2 , Y 3 , Y 4 , X 1 , and X 2
  • the compound of formula (I) is selected from a compound of the following formulae:
  • the compound has formula (Ia):
  • the compound has formula (Ia-2):
  • the compound has formula (Ib):
  • the compound has
  • the compound has
  • the compound has formula (Id):
  • the compound has formula (Id-1):
  • the compound has formula (Ie-1):
  • the compound has formula (I)
  • the compound has formula
  • the compound has formula: (Ih), (Ii), (Ij), and
  • each occurrence of R 1 is independently selected from the group consisting of:
  • occurrences of R 1 is other than H; and each of the remaining occurrences of R 1 is H.
  • each occurrence of R 1 is H.
  • R 1 from 1-2 (e.g., 1 or 2) occurrences of R 1 is other than H.
  • one occurrence of R 1 is halo (e.g., F or Cl (e.g., F)).
  • one occurrence of R 1 is C1-6 alkyl (e.g., C1-3 alkyl) optionally substituted with 1-2 R a .
  • R 1 is C 2-6 alkynyl or C 2-6 alkenyl (e.g., C2-6 alkynyl).
  • one occurrence of R 1 is C 1-4 haloalkyl (e.g., CF 3 ).
  • R 1 is S(O)1-2(C1-4 alkyl) or
  • one occurrence of R 1 is SF 5 . In certain embodiments, one occurrence of R 1 is–L 3 -L 4 -R i .
  • R i is selected from the group consisting of:
  • heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ⁇ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1- 4 haloalkyl.
  • R i is C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R i is C6 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl (e.g., R i is unsubstituted phenyl).
  • R i is heteroaryl including from 5-10 (e.g., 5-6) ring atoms, wherein from 1-4 (e.g., from 1-2) ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R i is selected from pyridyl, thiazolyl, and pyrazolyl, each of which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R i is selected from: , and
  • R 1 when one occurrence of R 1 is–L 3 -L 4 -R i ),–L 3 is a bond. In certain other embodiments (when one occurrence of R 1 is–L 3 -L 4 -R i ),–L 3 is C1- 3 alkylene.
  • R 1 when one occurrence of R 1 is–L 3 -L 4 -R i ),–L 4 is a bond. In certain other embodiments (when one occurrence of R 1 is–L 3 -L 4 -R i ),–L 4 is– O- or–S-. In certain embodiments (when one occurrence of R 1 is–L 3 -L 4 -R i ),–L 3 is a bond; and–L 4 is a bond.
  • R 1 when one occurrence of R 1 is–L 3 -L 4 -R i ),–L 3 is C 1- 3 alkylene; and–L 4 is a bond.
  • R 1 is selected from the group consisting of:
  • R 1 is selected from the group consisting of:
  • each remaining R 1 is H.
  • one occurrence of R 1 is as defined in any one or more of the foregoing embodiments; one other occurrence of R 1 is halo (e.g., F) or C1-4 alkyl; and each remaining R 1 is H.
  • a pair of R 1 on adjacent atoms, taken together with the atoms connecting them form a ring including from 5-7 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C 1-6 alkyl, halo, C 1-6 haloalkyl, -OH, NR e R f , C1-6 alkoxy, and C1-6 haloalkoxy.
  • a pair of R 1 on adjacent atoms, taken together with the atoms connecting them form:
  • R 2 is H.
  • R 2 is C1-6 alkyl, which is optionally substituted with from 1-2 independently selected R a (e.g., unsubstituted C1-3 alkyl).
  • R 2 is -C(O)(C1-4 alkyl) (e.g., -C(O)Me).
  • R 2 is C6-10 aryl (e.g., phenyl). In certain embodiments, when X 1 is NR 2 , the R 2 group of X 1 is H.
  • each occurrence of R 3 is independently selected from: H; C1-6 alkyl optionally substituted with from 1-6 independently selected R a ; C1-4 haloalkyl; –OH; -F; -Cl;–NR e R f ; C1-4 alkoxy; and C1-4 haloalkoxy; or
  • each occurrence of R 3 is independently H, C1-6 alkyl, or C 1-4 haloalkyl. As a non-limiting example of the foregoing embodiments, each occurrence of R 3 is H.
  • R 5 is H.
  • R 5 is halo.
  • R 6 is H.
  • Q-A is defined according to (A).
  • Q is NH
  • Q is N(C 1-3 alkyl) (e.g., NMe or NEt).
  • A is -(Y A1 )n-Y A2 . In certain of these embodiments, n is 0. In certain other embodiments, n is 1.
  • Y A1 is C 1-6 alkylene, which is optionally substituted with from 1-4 R a .
  • Y A1 is -CH 2 -, -CH 2 CH 2 -, -CH 2 CH 2 CH 2 -, -CH(CF 3 )-, -CH 2 CH(OH)-, or (e.g.,
  • Y A1 is C 1-6 alkylene, which is substituted with C 6-10 aryl (e.g., C 6-10 aryl), wherein Y A1 is further optionally substituted with from 1-2 R a (e.g., Y A1 is -CH(Ph)CH 2 -).
  • Y A2 is C 6-10 aryl, which is optionally substituted with from 1-3 R c .
  • Y A2 is C6 aryl, which is optionally substituted with from 1-3 R c . In certain of the foregoing embodiments, Y A2 is C 6 aryl, which is substituted with from 1-3 R c .
  • Y A2 is phenyl substituted with from 1-3 R c , wherein one R c is at the ring carbon para to the point of attachment to Y A1 .
  • Y A2 is phenyl substituted with from 1-3 R c , wherein from 1-2 R c is at the ring carbons meta to the point of attachment to Y A1 .
  • Y A2 is phenyl substituted with from 1-3 R c , wherein from 1-2 R c is at the ring carbons ortho to the point of attachment to Y A1 .
  • Y A2 is C7-10 bicyclic aryl, which is optionally substituted with from 1-3 R c .
  • Y A2 is naphthyl (e.g.,
  • indacenyl e.g., or tetrahydronapthyl, each of which is optionally substituted with from 1- 3 R c ).
  • Y A2 is heteroaryl including from 5-14 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c .
  • Y A2 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected R c .
  • Y A2 is thiazolyl or triazolyl, each of which is optionally substituted with from 1-2 (e.g., 1) independently selected R c .
  • Y A2 is heteroaryl including 6 ring
  • Y A2 is substituted with from 1-3 independently selected R c ; and one occurrence of R c is at the ring carbon atom para to the point of attachment to Y A1 .
  • Y A2 is substituted with from 1-3 independently selected R c ; and one occurrence of R c is at the ring carbon atom meta to the point of attachment to Y A1 .
  • Y A2 is substituted with from 1-3 independently selected R c ; and one occurrence of R c is at the ring carbon atom ortho to the point of attachment to Y A1 .
  • Y A2 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted
  • R c e.g., Y A2 is or or each of which is optionally substituted with from 1-2 independently
  • R c selected R c ).
  • R c selected R c .
  • each occurrence of R c is independently selected from the group consisting of:
  • C 1-10 alkyl which is optionally substituted with from 1-6 independently selected R a ; C2-6 alkenyl;
  • R c is halo.
  • one occurrece of R c is C1-10 alkyl which is optionally substituted with from 1-6 independently selected R a .
  • one occurrence of R c is unsubstituted C1-10 alkyl (e.g., C2, C3, C4, C5, C6, or C7-10).
  • one occurrence of R c is ethyl, propyl (e.g., n-propyl), butyl (e.g., n-butyl, iso-butyl, sec- butyl, tert-butyl), or octyl (e.g., n-octyl).
  • each occurrence of R a is independently selected from halo, OH, C1-4 alkoxy, and C1-4 haloalkoxy.
  • one occurrence of R c is selected from: CF 3 , CHF 2 , CH 2 CH 2 CF 3 , CH 2 CH 2 CH 2 OH, CH 2 CH 2 OMe, and CH(OH)CH 2 CH 3 .
  • one occurrence of R c is -NR e R f (e.g., NMe2). In certain embodiments, one occurrence of R c is–L 1 -L 2 -R h . In certain of these embodiments, L 1 is a bond. In certain embodiments, L 2 is a bond. In certain other embodiments, L 2 is–O-.
  • R h is C 3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R h is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R h is selected from:
  • R h is heterocyclyl, wherein the heterocyclyl includes from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • the heterocyclyl includes from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R h is C 6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl.
  • R h is C6 aryl, which is optionally substituted with from 1-2 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl (e.g., R h is unsubstituted phenyl).
  • R h is heteroaryl including 5-6 ring atoms, wherein from 1-3 are ring heteroatoms each independently selected from N, O, and S, wherein the heteroaryl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, or C 1-4 haloalkyl.
  • R c is selected from the group
  • R c is selected from the group consisting of:
  • each of the remaining R c when present is independently halo or C 1-3 alkyl.
  • Y A2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 R b .
  • Y A2 is C3-6 (e.g., C3, C5, or C6) cycloalkyl, which is substituted with from 1-4 (e.g., from 1-2) R b (e.g., Y A2 is cyclopropyl, cyclopentyl, bicyclo[1.1.1]pentyl, cyclohexyl, each of which is optionally substituted with from 1-2 R b ).
  • Y A2 is C6 cycloalkyl, which is substituted with from 1-4 (e.g., from 1-2) R b . In certain of these embodiments, Y A2 is cyclohexyl which is optionally substituted with from 1-2 R b . In certain of the foregoing embodiments, one occurrence of R b is at the ring carbon atom para to the point of attachment to Y A1 . In certain embodiments, one occurrence of R b is at the ring carbon atom meta to the point of attachment to Y A1 . In certain embodiments, one occurrence of R b is at the ring carbon atom ortho to the point of attachment to Y A1 .
  • Y A2 is C7-10 cycloalkyl, which is optionally substituted with
  • R b e.g., Y A2 is bicyclooctyl ( adamantyl (e.g.,
  • bicycloheptyl e.g., ), or bicycloheptenyl (e.g., each of which is
  • Y A2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b .
  • Y A2 is heterocyclyl including from 5-12 (e.g., 5- 10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b (e.g., Y A2 is
  • pyrrolidinyl ( , piperidinyl ( r tetrahydropyranyl (e.g., each of which is further optionally substituted with from 1-3 independently
  • Y A2 is C 3-10 cycloalkyl, which is optionally substituted with from 1-4 R b ; or Y A2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ), one occurrece of R b substituent of Y A2 is C1-10 alkyl which is optionally substituted with from 1-6 independently selected R a .
  • one occurrence of R b substituent of Y A2 is unsubstituted C1-10 alkyl (e.g., C2, C3, C4, C5, C6, or C7-10).
  • one occurrence of R b substituent of Y A2 is ethyl, propyl (e.g., n- propyl), butyl (e.g., n-butyl; or sec-butyl; or tert-butyl; or iso-butyl), or octyl (e.g., n-octyl).
  • each occurrence of R a is independently selected from halo, OH, C1-4 alkoxy, and C1-4 haloalkoxy.
  • one occurrence of R b is selected from: CF3, CH 2 CH 2 CF 3 , CH 2 CH 2 CH 2 OH, CH 2 CH 2 OMe, and CH(OH)CH 2 CH 3 .
  • Y A2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 R b ; or Y A2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ), one occurrence of R b substituent of Y A2 is C 2-6 alkenyl or C 2-6 alkynyl.
  • Y A2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 R b ; or Y A2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ), one occurrence of R b substituent of Y A2 is–L 1 -L 2 -R h .
  • L 1 is a bond
  • L 2 is a bond.
  • R h is C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1-4 haloalkyl.
  • R h is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R h is selected from: , In certain embodiments (when one occurrence of R b substituent of Y A2 is–L 1 -L 2 - R h ), R h is heterocyclyl, wherein the heterocyclyl includes from 3-10 (e.g., 4, 5, 6, 7, 8, 9, or 10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1-4 haloalkyl.
  • R h is selected from: , In certain embodiments (when one occurrence of R b substituent of Y A2 is–L 1 -L 2 - R h ), R h is heterocyclyl, wherein the heterocyclyl includes from 3-10 (e.g., 4, 5,
  • R h is .
  • R h is C 6-10 aryl (e.g., C 6 ), which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl (e.g., R h is unsubstituted phenyl).
  • R b is C 6-10 aryl (e.g., C 6 ), which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl (e.g., R h is unsubstituted phenyl).
  • substituent of Y A2 is selected from the group consisting of:
  • Y A2 is C 3-10 cycloalkyl, which is optionally substituted with from 1-4 R b ; or Y A2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ), one occurrence of R b substituent of Y A2 is C1-4 haloalkoxy (e.g., OCH 2 CF3). In certain embodiments, one occurrence of R b substituent of Y A2 is–Cl or–F (e.g., -F).
  • one occurrence of R b substituent of Y A2 is cyano.
  • one occurrence of R b substituent of Y A2 is oxo.
  • each remaining occurrence of R b is independently selected from the group consisting of–Cl, -F, -Br, cyano, C 1-3 alkyl, and C 1- 3 haloalkyl.
  • Y A2 is n1 is 0, 1, or 2; and each of R cA and R cB is an independently selected R c .
  • each of R cA and R cA is independently selected from the group consisting of R cA and R cA.
  • R cB is an independently selected R c .
  • each of R cA and R cB is an independently selected R c .
  • one of Q 1 and Q 2 is N; the other one of Q 1 and Q 2 is CH; n1 is 0, 1, or 2; and each of R cA and R cB is an independently selected R c .
  • Y A2 is one of Q 1 , Q 2 , Q 3 , and Q 4 is N; each of the remaining of Q 1 , Q 2 , Q 3 , and Q 4 is CH; n1 is 0, 1, or 2; and each of R cA and R cB is an independently selected R c .
  • Y A2 is ; one of Q 1 , Q 2 , Q 3 , and Q 4 is N; each of the remaining of Q 1 , Q 2 , Q 3 , and Q 4 is CH; n1 is 0, 1, or 2; and each of R cA and R cB is an independently selected R c .
  • R cA is as defined for R c in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114).
  • R cA is as defined for R c in any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118).
  • R cA is as defined for R c in any one of clauses 119-132 (e.g., 119; e.g., R cA is L 1 -L 2 -R h , wherein R h is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., R cA is as defined in clause 131 or clause 132).
  • n1 is 0. In certain embodiments (when Y A2 is ; or when Y A2 is ), n1 is 0. In certain embodiments (when Y A2 is ; or when Y A2 is ), n1 is 0. In certain embodiments (when Y A2 is ; or when Y A2 is ), n1 is 0. In certain embodiments (when Y A2 is ; or when Y A2 is ), n1 is 0. In certain embodiments (when Y A2 is ; or when Y A2 is
  • each R cB is independently halo or C 1-3 alkyl (e.g., halo).
  • Y A2 is ; n2 is 0, 1, or 2; and each of R bA and R bB is an independently selected R b .
  • Y A2 is ; n2 is 0, 1, or 2; and each of R bA and R bB is an independently selected R b .
  • Y A2 is ; n2 is 0, 1, or 2; and each of R bA and R bB is an independently selected R b . In certain embodiments (when Y A2 is ; or when Y A2 is
  • R bA is as defined for R b in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148).
  • R bA is as defined for R b in any one of clauses 149-158 (e.g., 149; e.g., R bA is–L 1 -L 2 -R h , and R h is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or R bA is as defined in clause 158).
  • R bA is as defined for R b in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
  • n2 is 0. In certain of embodiments, n2 is 1 or 2. In certain of these embodiments, each R bB is independently selected from the group consisting of–Cl, -F, C1-3 alkyl, and C1-3 haloalkyl.
  • Non-limiting examples of Y A2 also include:
  • A is C1-10 alkyl, which is optionally substituted with from 1-6 independently selected R a . In certain embodiments, A is C 2-10 alkyl, which is optionally substituted with from 1-6 independently selected R a . In certain embodiments, A is unsubstituted C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8,
  • each R a is an independently selected halo (e.g., A is or ).
  • Non-limiting examples of A include:
  • Non-limiting examples of A include:
  • Non-limiting examples of A include: , , , , , , and .
  • Non-limiting examples of A include: and .
  • Non-limiting examples of A also include: , , , , , , and . Further non-limiting examples of A include: and . Further non-limiting examples of A include:
  • A includes:
  • E is heterocyclyl including from 3-10 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected R b .
  • E is heterocyclyl including from 5-8 ring atoms, wherein aside from the nitrogen atom present, from 0-2 (e.g., 0-1) additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected R b .
  • E is piperidinyl, pyrrolidinyl, piperazinyl, oxazepanyl, each of which is optionally substituted with from 1-4 (e.g., 1-3) independently selected R b .
  • E is selected from
  • one occurrence of R b substituent of E is C1-10 alkyl optionally substituted with from 1-6 independently selected R a .
  • each R a is selected from the group consisting of–OH, -NR e R f , halo, C 1-4 aloxy, C 1-4 haloalkoxy, and C 3-6 cycloalkyl (e.g., cyclopropyl).
  • one occurrence of R b substituent of E is F or Cl (e.g., F).
  • E is: , , , or .
  • the compound has the following formula:
  • n1 is 0, 1, or 2; each of R cA and R cB is an independently selected R c ; and R 7 is H or C1-4 alkyl.
  • the compound has the following formula:
  • n1 is 0, 1, or 2; each of R cA and R cB is an independently selected R c ; and R 7 is H or C1-4 alkyl.
  • the compound has the following formula:
  • n1 is 0, 1, or 2; each of R cA and R cB is an independently selected R c ; and and R 7 is H or C1-4 alkyl.
  • the compound has the following formula:
  • the compound has the following formula:
  • each of Q 1 , Q 2 , Q 3 , and Q 4 is N; each of the remaining of Q 1 , Q 2 , Q 3 , Q 4 is CH; n1 is 0, 1, or 2; and each of R cA and R cB is an independently selected R c ; and R 7 is H or C 1-4 alkyl.
  • the compound has the following formula: or (I-6), wherein one of Q 1 , Q 2 , Q 3 , and Q 4 is N; each of the remaining of Q 1 , Q 2 , Q 3 , and Q 4 is CH; n1 is 0, 1, or 2; each of R cA and R cB is an independently selected R c ; and R 7 is H or C 1-4 alkyl.
  • the compound has the following formula:
  • B 1 is selected from the group consisting of: (a) heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected R c ; (b) bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c ; and (c) C7-10 bicyclic aryl, which is optionally substituted with from 1-3 R c ; and R 7 is H
  • B 1 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected R c .
  • B 1 is thiazolyl or triazolyl, each of which is optionally substituted with from 1-2 (e.g., 1) independently selected R c .
  • B 1 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c .
  • B 1 is , ,
  • B 1 is C 7-10 bicyclic aryl, which is optionally substituted with from 1-3 R c .
  • B 1 is naphthyl (e.g.,
  • R cA is as defined for R c in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114).
  • R cA is as defined for R c in any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118).
  • R cA is as defined for R c in any one of clauses 119-132 (e.g., 131 or 132) (e.g., 119; e.g., R cA is L 1 -L 2 -R h , wherein R h is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., R cA is as defined in clause 131 or clause 132).
  • one occurrence of R c is as defined for R c in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114).
  • one occurrence of R c is as defined any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118).
  • one occurrence of R c is as defined in any one of clauses 119-132 (e.g., 131 or 132) (e.g., 119; e.g., R c is L 1 -L 2 -R h , wherein R h is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., R c is as defined in clause 131 or clause 132).
  • each R c is as defined in clause 7.
  • each of the remaining occurrences of R c is independently halo or C 1-3 alkyl.
  • n1 is 0. In certain other embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), and/or (I-6), n1 is 1 or 2. In certain of these embodiments, each occurrence of R cB is independently halo or C1-3 alkyl.
  • the compound has the following formula:
  • n2 is 0, 1, or 2; each of R bA and R bB is an independently selected R b ; and R 7 is H or C 1-4 alkyl.
  • the compound has the following formula: or (I-9), wherein n2 is 0, 1, or 2; each of R bA and R bB is an independently selected R b ; and R 7 is H or C 1-4 alkyl.
  • the compound has the following formula:
  • n2 is 0, 1, or 2; each of R bA and R bB is an independently selected R b ; and R 7 is H or C 1-4 alkyl.
  • the compound has the following formula:
  • B 2 is selected from the group consisting of: (a) C 3 - 5 monocyclic cycloalkyl which is optionally substituted with from 1-4 R b ; (b) C5-6 (e.g., C5 or C6) bicyclic cycloalkyl which is optionally substituted with from 1-4 R b ;
  • heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ; and R 7 is H or C1-4 alkyl.
  • B 2 is C3-5 (e.g., C3 or C5) monocyclic cycloalkyl which is optionally substituted with from 1-4 R b .
  • B 2 is C 5 - 6 (e.g., C 5 or C 6 ) bicyclic
  • B 2 is C 7-10 (e.g., bicyclic or tricyclic) cycloalkyl, which is optionally substituted with from 1-4 R b .
  • B 2 is is bicyclooctyl (e.g., ),
  • adamantyl e.g., ), bicycloheptyl (e.g., ), or bicycloheptenyl (e.g.,
  • B 2 is heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each
  • B 2 is selected from the group consisting of:
  • pyrrolidinyl e.g., ), piperidinyl (e.g., ), or tetrahydropyranyl (e.g.,
  • R bA is as defined for R b in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148).
  • R bA is as defined for R b in any one of clauses 149-158 (e.g., 149; e.g., R bA is–L 1 -L 2 -R h , and R h is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or R bA is as defined in clause 158).
  • R bA is as defined for R b in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
  • one occurrence of R b is as defined in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148).
  • one occurrence of R b is as defined in any one of clauses 149-158 (e.g., 149; e.g., R b is–L 1 -L 2 -R h , and R h is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or R b is as defined in clause 158).
  • one occurrence of R b is as defined in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
  • each remaining R b is independently–F, -Cl, or C 1-3 alkyl.
  • n2 is 0.
  • n2 is 1 or 2.
  • each R bB is independently–F, -Cl, or C1-3 alkyl.
  • Y A1 is a bond (i.e., Y A1 is absent (e.g., Formula (I-11): ( or
  • Y A1 is C 1-6 alkylene, which is optionally substituted with from 1-2 R a (e.g., Y A1 is -CH 2 -, -CH 2 CH 2 -, -CH 2 CH 2 CH 2 -, -CH(CF 3 )-, -CH 2 CH(OH)-, or (e.g., CH 2 )).
  • the compound has the following formula:
  • R a independently selected independently selected R a ; and R 7 is H or C1-4 alkyl.
  • B 3 is unsubstituted C2-10 (e.g., C2, C3,
  • alkyl e.g., , , or ).
  • B 3 is C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8, C9, C10) alkyl, which is substituted with from 1-6 independently selected R a .
  • each R a is an independently selected halo (e.g., B 3 is or ).
  • the compound has the following formula:
  • E is heterocyclyl including from 3-10 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected R b .
  • E is heterocyclyl including from 5-8 ring atoms, wherein aside from the nitrogen atom present, from 0-2 (e.g., 0-1) additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected R b .
  • E is piperidinyl, pyrrolidinyl, piperazinyl, oxazepanyl, each of which is optionally substituted with from 1-4 (e.g., 1-3) independently selected R b .
  • E is selected from the
  • each R b substituent of E is as defined in any one of clauses 196-199 (e.g., 196; e.g., 197; e.g., 198; or e.g., 199).
  • each R 1 is as defined in any one of clauses 41-71 (e.g., 41; e.g., 42; e.g., 43; e.g., 44; or e.g., 54 (e.g., wherein R i is as defined in clauses 58 or 59)).
  • each R 1 is as defined in any one of clauses 72-74 (e.g., 72; e.g., 73; or e.g., 74).
  • 72-74 e.g., 72; e.g., 73; or e.g., 74.
  • each R 3 is as defined in any one of clauses 75-76 (e.g., each R 3 is H) (e.g., 75; or e.g., 76).
  • R 5 is H.
  • R 5 is halo.
  • R 2 is H.
  • R 6 is H.
  • R 7 is H.
  • each occurrence of R 3 is independently selected from: H; C 1-6 alkyl optionally substituted with from 1-6 independently selected R a ; C1-4 haloalkyl;–OH; -F; -Cl;–NR e R f ; C 1-4 alkoxy; and C 1-4 haloalkoxy; or two R 3 on the same carbon combine to form an oxo; OR
  • each occurrence of R 3 is independently H, C1-6 alkyl, or C1-4 haloalkyl.
  • the compound is selected from the group consisting of the compounds delineated in Table C1 (infra) or a pharmaceutically acceptable salt thereof: Table C1
  • a chemical entity e.g., a compound that inhibits (e.g., antagonizes) STING, or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination thereof
  • a pharmaceutical composition that includes the chemical entity and one or more pharmaceutically acceptable excipients, and optionally one or more additional therapeutic agents as described herein.
  • the chemical entities can be administered in combination with one or more conventional pharmaceutical excipients.
  • Pharmaceutically acceptable excipients include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, self-emulsifying drug delivery systems (SEDDS) such as d-a-tocopherol polyethylene glycol 1000 succinate, surfactants used in pharmaceutical dosage forms such as Tweens, poloxamers or other similar polymeric delivery matrices, serum proteins, such as human serum albumin, buffer substances such as phosphates, tris, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium-chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium, sodium
  • Cyclodextrins such as a-, ⁇ , and g-cyclodextrin, or chemically modified derivatives such as hydroxyalkylcyclodextrins, including 2- and 3- hydroxypropyl-b-cyclodextrins, or other solubilized derivatives can also be used to enhance delivery of compounds described herein.
  • Dosage forms or compositions containing a chemical entity as described herein in the range of 0.005% to 100% with the balance made up from non-toxic excipient may be prepared.
  • the contemplated compositions may contain 0.001%-100% of a chemical entity provided herein, in one embodiment 0.1-95%, in another embodiment 75-85%, in a further embodiment 20-80%.
  • the chemical entities described herein or a pharmaceutical composition thereof can be administered to subject in need thereof by any accepted route of administration.
  • Acceptable routes of administration include, but are not limited to, buccal, cutaneous, endocervical, endosinusial, endotracheal, enteral, epidural, interstitial, intra-abdominal, intra-arterial, intrabronchial, intrabursal, intracerebral, intracisternal, intracoronary, intradermal, intraductal, intraduodenal, intradural, intraepidermal, intraesophageal, intragastric, intragingival, intraileal, intralymphatic, intramedullary, intrameningeal, intramuscular, intraovarian, intraperitoneal, intraprostatic, intrapulmonary, intrasinal, intraspinal, intrasynovial, intratesticular, intrathecal, intratubular, intratumoral, intrauterine, intravascular, intravenous, nasal, nasogastric
  • compositions can be formulated for parenteral administration, e.g., formulated for injection via the intravenous, intramuscular, sub-cutaneous, or even intraperitoneal routes.
  • parenteral administration e.g., formulated for injection via the intravenous, intramuscular, sub-cutaneous, or even intraperitoneal routes.
  • such compositions can be prepared as injectables, either as liquid solutions or suspensions; solid forms suitable for use to prepare solutions or suspensions upon the addition of a liquid prior to injection can also be prepared; and the preparations can also be emulsified.
  • injectables either as liquid solutions or suspensions
  • solid forms suitable for use to prepare solutions or suspensions upon the addition of a liquid prior to injection can also be prepared; and the preparations can also be emulsified.
  • the preparation of such formulations will be known to those of skill in the art in light of the present disclosure.
  • the pharmaceutical forms suitable for injectable use include sterile aqueous solutions or dispersions; formulations including sesame oil, peanut oil, or aqueous propylene glycol; and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions.
  • the form must be sterile and must be fluid to the extent that it may be easily injected. It also should be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms, such as bacteria and fungi.
  • the carrier also can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils.
  • the proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of dispersion, and by the use of surfactants.
  • the prevention of the action of microorganisms can be brought about by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like.
  • isotonic agents for example, sugars or sodium chloride.
  • Prolonged absorption of the injectable compositions can be brought about by the use in the compositions of agents delaying absorption, for example, aluminum monostearate and gelatin.
  • Sterile injectable solutions are prepared by incorporating the active compounds in the required amount in the appropriate solvent with various of the other ingredients enumerated above, as required, followed by filtered sterilization.
  • dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above.
  • the preferred methods of preparation are vacuum-drying and freeze-drying techniques, which yield a powder of the active ingredient, plus any additional desired ingredient from a previously sterile-filtered solution thereof.
  • Intratumoral injections are discussed, e.g., in Lammers, et al.,“Effect of Intratumoral Injection on the Biodistribution and the Therapeutic Potential of HPMA Copolymer-Based Drug Delivery Systems” Neoplasia.2006, 10, 788–795.
  • Pharmacologically acceptable excipients usable in the rectal composition as a gel, cream, enema, or rectal suppository include, without limitation, any one or more of cocoa butter glycerides, synthetic polymers such as polyvinylpyrrolidone, PEG (like PEG ointments), glycerine, glycerinated gelatin, hydrogenated vegetable oils, poloxamers, mixtures of polyethylene glycols of various molecular weights and fatty acid esters of polyethylene glycol Vaseline, anhydrous lanolin, shark liver oil, sodium saccharinate, menthol, sweet almond oil, sorbitol, sodium benzoate, anoxid SBN, vanilla essential oil, aerosol, parabens in phenoxyethanol, sodium methyl p-oxybenzoate, sodium propyl p- oxybenzoate, diethylamine, carbomers, carbopol, methyloxybenzoate, macrogol cetostearyl ether, cocoyl caprylo
  • suppositories can be prepared by mixing the chemical entities described herein with suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum and release the active compound.
  • suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum and release the active compound.
  • compositions for rectal administration are in the form of an enema.
  • the compounds described herein or a pharmaceutical composition thereof are suitable for local delivery to the digestive or GI tract by way of oral administration (e.g., solid or liquid dosage forms.).
  • Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules.
  • the chemical entity is mixed with one or more pharmaceutically acceptable excipients, such as sodium citrate or dicalcium phosphate and/or: a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol mono
  • the dosage form may also comprise buffering agents.
  • Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.
  • the compositions will take the form of a unit dosage form such as a pill or tablet and thus the composition may contain, along with a chemical entity provided herein, a diluent such as lactose, sucrose, dicalcium phosphate, or the like; a lubricant such as magnesium stearate or the like; and a binder such as starch, gum acacia, polyvinylpyrrolidine, gelatin, cellulose, cellulose derivatives or the like.
  • a diluent such as lactose, sucrose, dicalcium phosphate, or the like
  • a lubricant such as magnesium stearate or the like
  • a binder such as starch, gum acacia, polyvinylpyrrolidine, gelatin, cellulose, cellulose derivatives or the like.
  • a powder, marume, solution or suspension (e.g., in propylene carbonate, vegetable oils, PEG’s, poloxamer 124 or triglycerides) is encapsulated in a capsule (gelatin or cellulose base capsule).
  • Unit dosage forms in which one or more chemical entities provided herein or additional active agents are physically separated are also contemplated; e.g., capsules with granules (or tablets in a capsule) of each drug; two-layer tablets; two- compartment gel caps, etc. Enteric coated or delayed release oral dosage forms are also contemplated.
  • physiologically acceptable compounds include wetting agents, emulsifying agents, dispersing agents or preservatives that are particularly useful for preventing the growth or action of microorganisms.
  • Various preservatives are well known and include, for example, phenol and ascorbic acid.
  • the excipients are sterile and generally free of undesirable matter. These compositions can be sterilized by conventional, well-known sterilization techniques. For various oral dosage form excipients such as tablets and capsules sterility is not required. The USP/NF standard is usually sufficient.
  • solid oral dosage forms can further include one or more components that chemically and/or structurally predispose the composition for delivery of the chemical entity to the stomach or the lower GI; e.g., the ascending colon and/or transverse colon and/or distal colon and/or small bowel.
  • Exemplary formulation techniques are described in, e.g., Filipski, K.J., et al., Current Topics in Medicinal Chemistry, 2013, 13, 776-802, which is incorporated herein by reference in its entirety.
  • Examples include upper-GI targeting techniques, e.g., Accordion Pill (Intec Pharma), floating capsules, and materials capable of adhering to mucosal walls.
  • Upper-GI targeting techniques e.g., Accordion Pill (Intec Pharma)
  • floating capsules e.g., floating capsules, and materials capable of adhering to mucosal walls.
  • enteric/pH-responsive coatings and excipients are available. These materials are typically polymers that are designed to dissolve or erode at specific pH ranges, selected based upon the GI region of desired drug release. These materials also function to protect acid labile drugs from gastric fluid or limit exposure in cases where the active ingredient may be irritating to the upper GI (e.g., hydroxypropyl methylcellulose phthalate series, Coateric (polyvinyl acetate phthalate), cellulose acetate phthalate, hydroxypropyl methylcellulose acetate succinate, Eudragit series (methacrylic acid–methyl methacrylate copolymers), and Marcoat).
  • Other techniques include dosage forms that respond to local flora in the GI tract, Pressure-controlled colon delivery capsule, and Pulsincap.
  • Ocular compositions can include, without limitation, one or more of any of the following: viscogens (e.g., Carboxymethylcellulose, Glycerin, Polyvinylpyrrolidone, Polyethylene glycol); Stabilizers (e.g., Pluronic (triblock copolymers), Cyclodextrins); Preservatives (e.g., Benzalkonium chloride, ETDA, SofZia (boric acid, propylene glycol, sorbitol, and zinc chloride; Alcon Laboratories, Inc.), Purite (stabilized oxychloro complex; Allergan, Inc.)).
  • viscogens e.g., Carboxymethylcellulose, Glycerin, Polyvinylpyrrolidone, Polyethylene glycol
  • Stabilizers e.g., Pluronic (triblock copolymers), Cyclodextrins
  • Preservatives e.g., Benzalkonium chloride, ETDA, SofZ
  • Topical compositions can include ointments and creams.
  • Ointments are semisolid preparations that are typically based on petrolatum or other petroleum derivatives.
  • Creams containing the selected active agent are typically viscous liquid or semisolid emulsions, often either oil-in-water or water-in-oil.
  • Cream bases are typically water-washable, and contain an oil phase, an emulsifier and an aqueous phase.
  • the oil phase also sometimes called the“internal” phase, is generally comprised of petrolatum and a fatty alcohol such as cetyl or stearyl alcohol; the aqueous phase usually, although not necessarily, exceeds the oil phase in volume, and generally contains a humectant.
  • the emulsifier in a cream formulation is generally a nonionic, anionic, cationic or amphoteric surfactant.
  • an ointment base should be inert, stable, nonirritating and non- sensitizing.
  • compositions described herein can include one or more one or more of the following: lipids, interbilayer crosslinked multilamellar vesicles, biodegradeable poly(D,L-lactic-co-glycolic acid) [PLGA]-based or poly anhydride-based nanoparticles or microparticles, and nanoporous particle-supported lipid bilayers.
  • lipids interbilayer crosslinked multilamellar vesicles
  • biodegradeable poly(D,L-lactic-co-glycolic acid) [PLGA]-based or poly anhydride-based nanoparticles or microparticles and nanoporous particle-supported lipid bilayers.
  • the dosages may be varied depending on the requirement of the patient, the severity of the condition being treating and the particular compound being employed. Determination of the proper dosage for a particular situation can be determined by one skilled in the medical arts.
  • the total daily dosage may be divided and administered in portions throughout the day or by means providing continuous delivery.
  • the compounds described herein are administered at a dosage of from about 0.001 mg/Kg to about 500 mg/Kg (e.g., from about 0.001 mg/Kg to about 200 mg/Kg; from about 0.01 mg/Kg to about 200 mg/Kg; from about 0.01 mg/Kg to about 150 mg/Kg; from about 0.01 mg/Kg to about 100 mg/Kg; from about 0.01 mg/Kg to about 50 mg/Kg; from about 0.01 mg/Kg to about 10 mg/Kg; from about 0.01 mg/Kg to about 5 mg/Kg; from about 0.01 mg/Kg to about 1 mg/Kg; from about 0.01 mg/Kg to about 0.5 mg/Kg; from about 0.01 mg/Kg to about 0.1 mg/Kg; from about 0.1 mg/Kg to about 200 mg/Kg; from about 0.1 mg/Kg to about 150 mg/Kg; from about 0.1 mg/Kg to about 100 mg/Kg; from about 0.1 mg
  • the foregoing dosages can be administered on a daily basis (e.g., as a single dose or as two or more divided doses) or non-daily basis (e.g., every other day, every two days, every three days, once weekly, twice weeks, once every two weeks, once a month).
  • a daily basis e.g., as a single dose or as two or more divided doses
  • non-daily basis e.g., every other day, every two days, every three days, once weekly, twice weeks, once every two weeks, once a month.
  • the period of administration of a compound described herein is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 1 1 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more.
  • a period of during which administration is stopped is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more.
  • a therapeutic compound is administered to an individual for a period of time followed by a separate period of time.
  • a therapeutic compound is administered for a first period and a second period following the first period, with administration stopped during the second period, followed by a third period where administration of the therapeutic compound is started and then a fourth period following the third period where administration is stopped.
  • the period of administration of a therapeutic compound followed by a period where administration is stopped is repeated for a determined or undetermined period of time.
  • a period of administration is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more.
  • a period of during which administration is stopped is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more.
  • methods for treating a subject having condition, disease or disorder in which increased (e.g., excessive)STING activity e.g., , e.g., STING signaling
  • increases e.g., excessive
  • STING activity e.g., , e.g., STING signaling
  • pathology and/or symptoms and/or progression of the condition, disease or disorder e.g., immune disorders, cancer
  • the condition, disease or disorder is cancer.
  • cancer include melanoma, carcinoma, lymphoma, blastoma, sarcoma, and leukemia or lymphoid malignancies. More particular examples of such cancers include breast cancer, colon cancer, rectal cancer, colorectal cancer, kidney or renal cancer, clear cell cancer lung cancer including small-cell lung cancer, non- small cell lung cancer, adenocarcinoma of the lung and squamous carcinoma of the lung, squamous cell cancer (e.g.
  • epithelial squamous cell cancer cervical cancer, ovarian cancer, prostate cancer, prostatic neoplasms, liver cancer, bladder cancer, cancer of the peritoneum, hepatocellular cancer, gastric or stomach cancer including gastrointestinal cancer, gastrointestinal stromal tumor, pancreatic cancer, head and neck cancer, glioblastoma, retinoblastoma, astrocytoma, thecomas, arrhenoblastomas, hepatoma, hematologic malignancies including non-Hodgkins lymphoma (NHL), multiple myeloma, myelodysplasia disorders, myeloproliferative disorders, chronic myelogenous leukemia, and acute hematologic malignancies, endometrial or uterine carcinoma, endometriosis, endometrial stromal sarcoma, fibrosarcomas, choriocarcinoma, salivary gland carcinoma, vulval cancer, thyroid cancer, es
  • the condition, disease or disorder is a neurological disorder, which includes disorders that involve the central nervous system (brain, brainstem and cerebellum), the peripheral nervous system (including cranial nerves), and the autonomic nervous system (parts of which are located in both central and peripheral nervous system).
  • a neurological disorder which includes disorders that involve the central nervous system (brain, brainstem and cerebellum), the peripheral nervous system (including cranial nerves), and the autonomic nervous system (parts of which are located in both central and peripheral nervous system).
  • Non-limiting examples of cancer include acquired epileptiform aphasia; acute disseminated encephalomyelitis; adrenoleukodystrophy; age-related macular degeneration; agenesis of the corpus callosum; agnosia; Aicardi syndrome; Alexander disease; Alpers' disease; alternating hemiplegia; Alzheimer's disease; Vascular dementia; amyotrophic lateral sclerosis; anencephaly; Angelman syndrome; angiomatosis; anoxia; aphasia; apraxia; arachnoid cysts; arachnoiditis; Anronl-Chiari malformation; arteriovenous malformation; Asperger syndrome; ataxia telegiectasia; attention deficit hyperactivity disorder; autism; autonomic dysfunction; back pain; Batten disease; Behcet's disease; Bell's palsy; benign essential blepharospasm; benign focal; amyotrophy; benign intracranial hypertension; Bin
  • the condition, disease or disorder is STING-associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutines Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
  • STING-associated conditions e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutines Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
  • SAVI STING-associated vasculopathywith onset in infancy
  • AVS Aicardi-Gout Italian Syndrome
  • genetic forms of lupus e.g., systemic lupus
  • Non-limiting examples include rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, inflammatory bowel diseases (IBDs) comprising Crohn disease (CD) and ulcerative colitis (UC), which are chronic inflammatory conditions with polygenic susceptibility.
  • the condition is an inflammatory bowel disease.
  • the condition is Crohn’s disease, autoimmune colitis, iatrogenic autoimmune colitis, ulcerative colitis, colitis induced by one or more chemotherapeutic agents, colitis induced by treatment with adoptive cell therapy, colitis associated by one or more alloimmune diseases (such as graft-vs-host disease, e.g., acute graft vs.
  • the condition is alloimmune disease (such as graft-vs-host disease, e.g., acute graft vs. host disease and chronic graft vs.
  • celiac disease irritable bowel syndrome
  • rheumatoid arthritis lupus
  • scleroderma e.g., cutaneous T-cell lymphoma
  • uveitis e.g., uveitis
  • mucositis e.g., oral mucositis, esophageal mucositis or intestinal mucositis.
  • modulation of the immune system by STING provides for the treatment of diseases, including diseases caused by foreign agents.
  • exemplary infections by foreign agents which may be treated and/or prevented by the method of the present invention include an infection by a bacterium (e.g., a Gram-positive or Gram- negative bacterium), an infection by a fungus, an infection by a parasite, and an infection by a virus.
  • the infection is a bacterial infection (e.g., infection by E.
  • the infection is a fungal infection (e.g. infection by a mould, a yeast, or a higher fungus).
  • the infection is a parasitic infection (e.g., infection by a single-celled or multicellular parasite, including Giardia duodenalis, Cryptosporidium parvum, Cyclospora cayetanensis, and Toxoplasma gondiz).
  • the infection is a viral infection (e.g., infection by a virus associated with AIDS, avian flu, chickenpox, cold sores, common cold, gastroenteritis, glandular fever, influenza, measles, mumps, pharyngitis, pneumonia, rubella, SARS, and lower or upper respiratory tract infection (e.g., respiratory syncytial virus)).
  • a viral infection e.g., infection by a virus associated with AIDS, avian flu, chickenpox, cold sores, common cold, gastroenteritis, glandular fever, influenza, measles, mumps, pharyngitis, pneumonia, rubella, SARS, and lower or upper respiratory tract infection (e.g., respiratory syncytial virus)).
  • condition, disease or disorder is hepatits B (see, e.g., WO 2015/061294).
  • the condition, disease or disorder is selected from cardiovascular diseases (including e.g., myocardial infarction).
  • the condition, disease or disorder is age-related macular degeneration.
  • condition, disease or disorder is mucositis, also known as stomatitits, which can occur as a result of chemotherapy or radiation therapy, either alone or in combination as well as damage caused by exposure to radiation outside of the context of radiation therapy.
  • the condition, disease or disorder is uveitis, which is inflammation of the uvea (e.g., anterior uveitis, e.g., iridocyclitis or LTDis; intermediate uveitis (also known as pars planitis); posterior uveitis; or chorioretinitis, e.g., pan-uveitis).
  • uveitis inflammation of the uvea
  • anterior uveitis e.g., iridocyclitis or ulceris
  • intermediate uveitis also known as pars planitis
  • posterior uveitis e.g., pan-uveitis
  • chorioretinitis e.g., pan-uveitis
  • the condition, disease or disorder is selected from the group consisting of a cancer, a neurological disorder, an autoimmune disease, hepatitis B, uvetitis, a cardiovascular disease, age-related macular degeneration, and mucositis.
  • Combination therapy can include those indications discussed herein and below in contemplated combination therapy regimens.
  • This disclosure contemplates both monotherapy regimens as well as combination therapy regimens.
  • the methods described herein can further include administering one or more additional therapies (e.g., one or more additional therapeutic agents and/or one or more therapeutic regimens) in combination with administration of the compounds described herein.
  • additional therapies e.g., one or more additional therapeutic agents and/or one or more therapeutic regimens
  • the methods described herein can further include administering one or more additional cancer therapies.
  • the one or more additional cancer therapies can include, without limitation, surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy, cancer vaccines (e.g., HPV vaccine, hepatitis B vaccine, Oncophage, Provenge) and gene therapy, as well as combinations thereof.
  • Immunotherapy including, without limitation, adoptive cell therapy, the derivation of stem cells and/or dendritic cells, blood transfusions, lavages, and/or other treatments, including, without limitation, freezing a tumor.
  • the one or more additional cancer therapies is chemotherapy, which can include administering one or more additional chemotherapeutic agents.
  • the additional chemotherapeutic agent is an immunomodulatory moiety, e.g., an immune checkpoint inhibitor.
  • the immune checkpoint inhibitor targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1– PD-L1, PD-1– PD- L2, interleukin ⁇ 2 (IL ⁇ 2), indoleamine 2,3-dioxygenase (IDO), IL ⁇ 10, transforming growth factor-b (TGFb), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9– TIM3, Phosphatidylserine– TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II– LAG3, 4 ⁇ 1BB–4 ⁇ 1BB ligand, OX40–OX40 ligand, GITR, GITR ligand– GITR, CD27, CD70-CD27, TNFRSF25, TNFR
  • the immune checkpoint inhibitor is selected from the group consisting of: Urelumab, PF ⁇ 05082566, MEDI6469, TRX518, Varlilumab, CP ⁇ 870893, Pembrolizumab (PD1), Nivolumab (PD1), Atezolizumab (formerly MPDL3280A) (PDL1), MEDI4736 (PD-L1), Avelumab (PD-L1), PDR001 (PD1), BMS ⁇ 986016, MGA271, Lirilumab, IPH2201, Emactuzumab, INCB024360, Galunisertib, Ulocuplumab, BKT140, Bavituximab, CC ⁇ 90002, Bevacizumab, and MNRP1685A, and MGA271.
  • the additional chemotherapeutic agent is an alkylating agent.
  • Alkylating agents are so named because of their ability to alkylate many nucleophilic functional groups under conditions present in cells, including, but not limited to cancer cells.
  • an alkylating agent includes, but is not limited to, Cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin.
  • alkylating agents can function by impairing cell function by forming covalent bonds with the amino, carboxyl, sulfhydryl, and phosphate groups in biologically important molecules or they can work by modifying a cell's DNA.
  • an alkylating agent is a synthetic, semisynthetic or derivative.
  • the additional chemotherapeutic agent is an anti- metabolite.
  • Anti-metabolites masquerade as purines or pyrimidines, the building-blocks of DNA and in general, prevent these substances from becoming incorporated in to DNA during the "S" phase (of the cell cycle), stopping normal development and division.
  • Anti- metabolites can also affect RNA synthesis.
  • an antimetabolite includes, but is not limited to azathioprine and/or mercaptopurine.
  • an anti- metabolite is a synthetic, semisynthetic or derivative.
  • the additional chemotherapeutic agent is a plant alkaloid and/or terpenoid.
  • These alkaloids are derived from plants and block cell division by, in general, preventing microtubule function.
  • a plant alkaloid and/or terpenoid is a vinca alkaloid, a podophyllotoxin and/or a taxane.
  • Vinca alkaloids in general, bind to specific sites on tubulin, inhibiting the assembly of tubulin into microtubules, generally during the M phase of the cell cycle.
  • a vinca alkaloid is derived, without limitation, from the Madagascar periwinkle, Catharanthus roseus (formerly known as Vinca rosea).
  • a vinca alkaloid includes, without limitation, Vincristine, Vinblastine, Vinorelbine and/or Vindesine.
  • a taxane includes, but is not limited, to Taxol, Paclitaxel and/or Docetaxel.
  • a plant alkaloid or terpernoid is a synthetic, semisynthetic or derivative.
  • a podophyllotoxin is, without limitation, an etoposide and/or teniposide.
  • a taxane is, without limitation, docetaxel and/or ortataxel. [021]
  • a cancer therapeutic is a topoisomerase.
  • Topoisomerases are essential enzymes that maintain the topology of DNA. Inhibition of type I or type II topoisomerases interferes with both transcription and replication of DNA by upsetting proper DNA supercoiling.
  • a topoisomerase is, without limitation, a type I topoisomerase inhibitor or a type II topoisomerase inhibitor.
  • a type I topoisomerase inhibitor is, without limitation, a camptothecin.
  • a camptothecin is, without limitation, exatecan, irinotecan, lurtotecan, topotecan, BNP 1350, CKD 602, DB 67 (AR67) and/or ST 1481.
  • a type II topoisomerase inhibitor is, without limitation, epipodophyllotoxin.
  • an epipodophyllotoxin is, without limitation, an amsacrine, etoposid, etoposide phosphate and/or teniposide.
  • a topoisomerase is a synthetic, semisynthetic or derivative, including those found in nature such as, without limitation, epipodophyllotoxins, substances naturally occurring in the root of American Mayapple (Podophyllum peltatum).
  • the additional chemotherapeutic agent is a stilbenoid.
  • a stilbenoid includes, but is not limited to, Resveratrol, Piceatannol, Pinosylvin, Pterostilbene, Alpha-Viniferin, Ampelopsin A, Ampelopsin E, Diptoindonesin C, Diptoindonesin F, Epsilon- Vinferin, Flexuosol A, Gnetin H, Hemsleyanol D, Hopeaphenol, Trans-Diptoindonesin B, Astringin, Piceid and Diptoindonesin A.
  • a stilbenoid is a synthetic, semisynthetic or derivative.
  • the additional chemotherapeutic agent is a cytotoxic antibiotic.
  • a cytotoxic antibiotic is, without limitation, an actinomycin, an anthracenedione, an anthracycline, thalidomide, dichloroacetic acid, nicotinic acid, 2- deoxyglucose and/or chlofazimine.
  • an actinomycin is, without limitation, actinomycin D, bacitracin, colistin (polymyxin E) and/or polymyxin B.
  • an antracenedione is, without limitation, mitoxantrone and/or pixantrone.
  • an anthracycline is, without limitation, bleomycin, doxorubicin (Adriamycin), daunorubicin (daunomycin), epirubicin, idarubicin, mitomycin, plicamycin and/or valrubicin.
  • a cytotoxic antibiotic is a synthetic, semisynthetic or derivative.
  • the additional chemotherapeutic agent is selected from endostatin, angiogenin, angiostatin, chemokines, angioarrestin, angiostatin (plasminogen fragment), basement-membrane collagen-derived anti-angiogenic factors (tumstatin, canstatin, or arrestin), anti-angiogenic antithrombin III, signal transduction inhibitors, cartilage-derived inhibitor (CDI), CD59 complement fragment, fibronectin fragment, gro- beta, heparinases, heparin hexasaccharide fragment, human chorionic gonadotropin (hCG), interferon alpha/beta/gamma, interferon inducible protein (IP-10), interleukin-12, kringle 5 (plasminogen fragment), metalloproteinase inhibitors (TIMPs), 2-methoxyestradiol, placental ribonuclease inhibitor, plasminogen activator inhibitor, platelet factor-4 (PF4), prolactin
  • the additional chemotherapeutic agent is selected from abiraterone acetate, altretamine, anhydrovinblastine, auristatin, bexarotene, bicalutamide, BMS 184476, 2,3,4,5,6-pentafluoro-N-(3-fluoro-4-methoxyphenyl)benzene sulfonamide, bleomycin, N,N-dimethyl-L-valyl-L-valyl-N-methyl-L-valyl-L-proly-1-Lproline-t- butylamide, cachectin, cemadotin, chlorambucil, cyclophosphamide, 3 ,4 -didehydro-4 - deoxy-8 -norvin-caleukoblastine, docetaxol, doxetaxel, cyclophosphamide, carboplatin, carmustine, cisplatin, cryptophycin, cycl
  • the additional chemotherapeutic agent is platinum, cisplatin, carboplatin, oxaliplatin, mechlorethamine, cyclophosphamide, chlorambucil, azathioprine, mercaptopurine, vincristine, vinblastine, vinorelbine, vindesine, etoposide and teniposide, paclitaxel, docetaxel, irinotecan, topotecan, amsacrine, etoposide, etoposide phosphate, teniposide, 5-fluorouracil, leucovorin, methotrexate, gemcitabine, taxane, leucovorin, mitomycin C, tegafur-uracil, idarubicin, fludarabine, mitoxantrone, ifosfamide and doxorubicin.
  • Additional agents include inhibitors of mTOR (mammalian target of rapamycin), including but
  • the additional chemotherapeutic agent can be selected from those delineated in U.S. Patent 7,927,613, which is incorporated herein by reference in its entirety.
  • the additional therapeutic agent and/or regimen are those that can be used for treating other STING-associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Gout Italian Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis and the like.
  • STING-associated conditions e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutines Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis and the like.
  • STING-associated conditions e.g., type I interferonopathies (e.g., STING-associated vasculopathywith
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating rheumatoid arthritis include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), disease-modifying antirheumatic drugs (DMARDs; e.g., methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), leflunomide (Arava®), hydroxychloroquine (Plaquenil), PF-06650833, iguratimod, tofacitinib (Xeljanz®), ABBV-599, evobrutinib, and sulfasalazine (Azulfidine®)), and biologics (e.g., abatacept (Orencia®), adalimumab (Humira®), anakinra (Kineret®),
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating lupus include steroids, topical immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), thalidomide (Thalomid®), non-steroidal anti- inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., evobrutinib, iberdomide, voclosporin, cenerimod, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and mycophenolate mofetil) baricitin
  • non-limiting treatments for systemic lupus erythematosus include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., iberdomide, voclosporin, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and mycophenolate mofetil, baricitinb, filogotinib, and PF-06650833), and biologics (e.g., belimumab (Benlysta®), anifrolumab, prezalumab, MEDI0700, vobarilizumab,
  • non-limiting examples of treatments for cutaneous lupus include steroids, immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), GS-9876, filogotinib, and thalidomide (Thalomid®).
  • agents and regimens for treating drug-induced and/or neonatal lupus can also be administered.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating STING-associated vasculopathy with onset in infancy include JAK inhibitors (e.g., tofacitinib, ruxolitinib, filgotinib, and baricitinib).
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating Aicardi-Goutines Syndrome include physiotherapy, treatment for respiratory complications, anticonvulsant therapies for seizures, tube-feeding, nucleoside reverse transcriptase inhibitors (e.g., emtricitabine (e.g., Emtriva®), tenofovir (e.g., Viread®), emtricitabine/tenofovir (e.g., Truvada®), zidovudine, lamivudine, and abacavir), and JAK inhibitors (e.g., tofacitinib, ruxolitinib, filgotinib, and baricitinib).
  • nucleoside reverse transcriptase inhibitors e.g., emtricitabine (e.g., Emtriva®), tenofovir (e.g., Viread®), emtricitabine/tenofovir (e.g., Truvada
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating IBDs include 6-mercaptopurine, AbGn-168H, ABX464, ABT-494, adalimumab, AJM300, alicaforsen, AMG139, anrukinzumab, apremilast, ATR-107 (PF0530900), autologous CD34-selected peripheral blood stem cells transplant, azathioprine, bertilimumab, BI 655066, BMS-936557, certolizumab pegol (Cimzia®), cobitolimod, corticosteroids (e.g., prednisone, Methylprednisolone, prednisone), CP-690,550, CT-P13, cyclosporine, DIMS0150, E6007, E6011, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, fingolimod, fi
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating irritable bowel syndrome include alosetron, bile acid sequesterants (e.g., cholestyramine, colestipol, colesevelam), chloride channel activators (e.g., lubiprostone), coated peppermint oil capsules, desipramine, dicyclomine, ebastine, eluxadoline, farnesoid X receptor agonist (e.g., obeticholic acid), fecal microbiota transplantation, fluoxetine, gabapentin, guanylate cyclase-C agonists (e.g., linaclotide, plecanatide), ibodutant, imipramine, JCM-16021, loperamide, lubiprostone, nortriptyline, ondansetron, opioids, paroxetine, pinaverium, polyethylene glycol, pregabalin, probiotics, ramosetron,
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating scleroderma include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), immunomodulators (e.g., azathioprine, methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), antithymocyte globulin, mycophenolate mofetil, intravenous immunoglobulin, rituximab, sirolimus, and alefacept), calcium channel blockers (e.g., nifedipine), alpha blockers, serotonin receptor antagonists, angiotensin II receptor inhibitors, statins, local
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating Crohn’s Disease include adalimumab, autologous CD34-selected peripheral blood stem cells transplant, 6-mercaptopurine, azathioprine, certolizumab pegol (Cimzia®), corticosteroids (e.g., prednisone), etrolizumab, E6011, fecal microbial transplantation, figlotinib, guselkumab, infliximab, IL-2, JAK inhibitors, matrix metalloproteinase 9 (MMP 9) inhibitors (e.g., GS-5745), MEDI2070, mesalamine, methotrexate, natalizumab, ozanimod, RHB-104, rifaximin, risankizumab, SHP647, sulfasalazine, thalidomide, upadacitinib, V
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating UC include AbGn-168H, ABT-494, ABX464, apremilast, PF-00547659, PF-06687234, 6- mercaptopurine, adalimumab, azathioprine, bertilimumab, brazikumab (MEDI2070), cobitolimod, certolizumab pegol (Cimzia®), CP-690,550, corticosteroids (e.g., multimax budesonide, Methylprednisolone), cyclosporine, E6007, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, guselkumab, golimumab, IL-2, IMU-838, infliximab, matrix metalloproteinase 9 (MMP9) inhibitors (e.g., GS-57
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating autoimmune colitis include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating iatrogenic autoimmune colitis include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating colitis induced by one or more chemotherapeutics agents include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No.2012/0202848), and vedolizumab.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating colitis induced by treatment with adoptive cell therapy include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No.2012/0202848), and vedolizumab.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating colitis associated with one or more alloimmune diseases include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), sulfasalazine, and eicopentaenoic acid.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • sulfasalazine eicopentaenoic acid.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating radaiation enteritis include teduglutide, amifostine, angiotensin-converting enzyme (ACE) inhibitors (e.g., benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril), probiotics, selenium supplementation, statins (e.g., atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin), sucralfate, and vitamin E.
  • ACE angiotensin-converting enzyme
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating collagenous colitis include 6-mercaptopurine, azathaioprine, bismuth subsalicate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • loperamide mesalamine, methotrexate, probiotics, and sulfasalazine.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating lyphocytic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, and sulfasalazine.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating microscopic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), fecal microbial transplantation, loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • fecal microbial transplantation loperamide, mesalamine, methot
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating alloimmune disease include intrauterine platelet transfusions, intravenous immunoglobin, maternal steroids, abatacept, alemtuzumab, alpha1-antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, pevonedistat, photobiomodulation,
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating multiple sclerosis include alemtuzumab (Lemtrada®), ALKS 8700, amiloride, ATX- MS-1467, azathioprine, baclofen (Lioresal®), beta interferons (e.g., IFN-b-1a, IFN-b-1b), cladribine, corticosteroids (e.g., methylprednisolone), daclizumab, dimethyl fumarate (Tecfidera®), fingolimod (Gilenya®), fluoxetine, glatiramer acetate (Copaxone®), hydroxychloroquine, ibudilast, idebenone, laquinimod, lipoic acid, losartan, masitinib, MD1003 (biotin), mitoxantrone, montelukast, natalizumab (Tysabri®), NeuroVax
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating graft-vs-host disease include abatacept, alemtuzumab, alpha1-antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, pevonedistat, photobiomodulation, photopheresis, rux
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating acute graft-vs-host disease include alemtuzumab, alpha-1 antitrypsin, antithymocyte globulin, basiliximab, brentuximab, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, ibrutinib, infliximab, itacitinib, LBH589, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, photopheresis, ruxolitinib, sirolimus, tacrolimus, and tocilizumab.
  • corticosteroids e.g., methylprednisone, prednisone
  • cyclosporine e.g., methyl
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating chronic graft vs. host disease include abatacept, alemtuzumab, AMG592, antithymocyte globulin, basiliximab, bortezomib, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, mycophenolate mofetil, pentostatin, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib.
  • corticosteroids e.g., methylprednisone, prednisone
  • corticosteroids e.g., methylpred
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating celiac disease include AMG 714, AMY01, Aspergillus niger prolyl endoprotease, BL- 7010, CALY-002, GBR 830, Hu-Mik-Beta-1, IMGX003, KumaMax, Larazotide Acetate, Nexvan2®, pancrelipase, TIMP-GLIA, vedolizumab, and ZED1227.
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating psoriasis include topical corticosteroids, topical crisaborole/AN2728, topical SNA-120, topical SAN021, topical tapinarof, topical tocafinib, topical IDP-118, topical M518101, topical calcipotriene and betamethasone dipropionate (e.g., MC2-01 cream and Taclonex®), topical P-3073, topical LEO 90100 (Enstilar®), topical betamethasone dipropriate (Sernivo®), halobetasol propionate (Ultravate®), vitamin D analogues (e.g., calcipotriene (Dovonex®) and calcitriol (Vectical®)), anthralin (e.g., Dritho-scalp® and Dritho-crème®), topical retinoids (e.g., t
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating cutaneous T-cell lymphoma include phototherapy (e.g., exposure to sunlight, UVB phototherapy, narrow band UVB phototherapy, Goeckerman therapy, psoralen plus ultraviolet A (PUVA) therapy, and excimer laser), extracorporeal photopheresis, radiation therapy (e.g., spot radiation and total skin body electron beam therapy), stem cell transplant, corticosteroids, imiquimod, bexarotene gel, topical bis-chloroethyl-nitrourea, mechlorethamine gel, vorinostat (Zolinza®), romidepsin (Istodax®), pralatrexate (Folotyn®) biologics (e.g., alemtuzumab (Campath®), brentuximab vedotin (SGN-35), mogamulizumab, and IPH4102).
  • phototherapy e.g., exposure to sunlight
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating uveitis include corticosteroids (e.g., intravitreal triamcinolone acetonide injectable suspensions), antibiotics, antivirals (e.g., acyclovir), dexamethasone, immunomodulators (e.g., tacrolimus, leflunomide, cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), chlorambucil, azathioprine, methotrexate, and mycophenolate mofetil), biologics (e.g., infliximab (Remicade®), adalimumab (Humira®), etanercept (Enbrel®), golimumab (Simponi®), certolizumab (Cimzia®), rituximab (Rituxan®
  • Non-limiting examples of additional therapeutic agents and/or regimens for treating mucositis include AG013, SGX942 (dusquetide), amifostine (Ethyol®), cryotherapy, cepacol lonzenges, capsaicin lozenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e.g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone- sodium hyaluronate gel (Gelclair®)), oral lubricants (e.g., Oral Balance®), caphosol, chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g., lidocaine, benzocaine, dyclonine hydroch
  • non-limiting examples of treatments for oral mucositis include AG013, amifostine (Ethyol®), cryotherapy, cepacol lonzenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e.g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair®)), oral lubricants (e.g., Oral Balance®), caphosol, chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g., lidocaine, benzocaine, dyclonine hydrochloride, xylocaine (e.g., viscous xyloc
  • non-limiting examples of treatments for esophageal mucositis include xylocaine (e.g., gel viscous Xylocaine 2%).
  • treatments for intestinal mucositis, treatments to modify intestinal mucositis, and treatments for intestinal mucositis signs and symptoms include gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)).
  • an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox)
  • an antifungal e.g., nystatin
  • an analgesic e.g., hurricane liquid
  • the second therapeutic agent or regimen is administered to the subject prior to contacting with or administering the chemical entity (e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior).
  • the chemical entity e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior.
  • the second therapeutic agent or regimen is administered to the subject at about the same time as contacting with or administering the chemical entity.
  • the second therapeutic agent or regimen and the chemical entity are provided to the subject simultaneously in the same dosage form.
  • the second therapeutic agent or regimen and the chemical entity are provided to the subject concurrently in separate dosage forms.
  • the second therapeutic agent or regimen is administered to the subject after contacting with or administering the chemical entity (e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after).
  • the chemical entity e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after.
  • the methods described herein further include the step of identifying a subject (e.g., a patient) in need of such treatment (e.g., by way of biopsy, endoscopy, or other conventional method known in the art).
  • the STING protein can serve as a biomarker for certain types of cancer, e.g., colon cancer and prostate cancer.
  • identifying a subject can include assaying the patient’s tumor microenvironment for the absence of T-cells and/or presence of exhausted T-cells, e.g., patients having one or more cold tumors. Such patients can include those that are resistant to treatment with checkpoint inhibitors.
  • such patients can be treated with a chemical entity herein, e.g., to recruit T-cells into the tumor, and in some cases, further treated with one or more checkpoint inhibitors, e.g., once the T-cells become exhausted.
  • a chemical entity herein e.g., to recruit T-cells into the tumor
  • one or more checkpoint inhibitors e.g., once the T-cells become exhausted.
  • the chemical entities, methods, and compositions described herein can be administered to certain treatment-resistant patient populations (e.g., patients resistant to checkpoint inhibitors; e.g., patients having one or more cold tumors, e.g., tumors lacking T-cells or exhausted T-cells).
  • certain treatment-resistant patient populations e.g., patients resistant to checkpoint inhibitors; e.g., patients having one or more cold tumors, e.g., tumors lacking T-cells or exhausted T-cells.
  • Step 1 Synthesis of 3-((1H-indol-3-yl)amino)-4-methoxycyclobut-3-ene-1,2-dione
  • THP1-DualTM KO-IFNAR2 Cells (obtained from invivogen) are maintained in RPMI, 10% FCS, 5 ml P/S, 2mM L-glut, 10mM Hepes, and 1 mM sodium pyruvate. Compounds are spotted in empty 384 well tissue culture plates (Greiner 781182) by Echo for a final concentration of 0.0017 - 100 ⁇ M. Cells are plated into the TC plates at 40 mL per well, 2 ⁇ 10E6 cells/mL. For activation with STING ligand, 2'3'cGAMP (MW 718.38, obtained from Invivogen), is prepared in Optimem media.
  • o Solution B 2 mL Optimem with 60 mL Lipofectamine 2000 -> Incubate 5 min at RT 2 mL of solution A and 2 ml Solution B is mixed and incubated for 20 min at room temperature (RT).20 uL of transfection solution (A+B) is added on top of the plated cells, with a final 2’3’cGAMP concentration of 15 mM. The plates are then centrifuged immediately at 340 g for 1 minute, after which they are incubated at 37 o C, 5% CO2, >98% humidity for 24h. Luciferase reporter activity is then measured. EC50 values were calculated by using standard methods known in the art.
  • Luciferase reporter assay 10 ⁇ L of supernatant from the assay is transferred to white 384-plate with flat bottom and squared wells.
  • one pouch of QUANTI-LucTM Plus is dissolved in 25 mL of water.100 ⁇ L of QLC Stabilizer per 25 mL of QUANTI-LucTM Plus solution was added.50 ⁇ L of QUANTI-LucTM Plus/QLC solution per well is then added.
  • Luminescence is measured on a Platereader (e.g., Spectramax I3X (Molecular Devices GF3637001)).
  • Luciferase reporter activity is then measured. EC 50 values are calculated by using standard methods known in the art.
  • Z is selected from the group consisting of a bond, CR 1 , C(R 3 )2, N, and NR 2 ;
  • each of Y 1 , Y 2 , and Y 3 is independently selected from the group consisting of O, S, CR 1 , C(R 3 ) 2 , N, and NR 2 ;
  • Y 4 is C or N
  • X 1 is selected from the group consisting of O, S, N, NR 2 , and CR 1 ;
  • X 2 is selected from the group consisting of O, S, N, NR 4 , and CR 5 ;
  • each is independently a single bond or a double bond, provided that the five- membered ring comprising Y 4 , X 1 , and X 2 is heteroaryl;
  • Q-A is defined according to (A) or (B) below:
  • Q is selected from the group consisting of: NH; N(C1-6 alkyl) wherein the C1-6 alkyl is optionally substituted with 1-2 independently selected R a ; O; S; and C1-3 alkylene which is optionally substituted with 1-2 independently selected R a and
  • A is:
  • ⁇ n is 0 or 1;
  • ⁇ Y A1 is C1-6 alkylene, which is optionally substituted with from 1-6 substituents each indepndently selected from the group consisting of R a ; C6- 1 0 aryl optionally substituted with 1-4 independently selected C 1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C 1-4 alkyl; and
  • ⁇ Y A2 is:
  • heteroaryl including from 5-20 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c ; or (d) heterocyclyl including from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ,
  • ⁇ Z 1 is C1-3 alkylene, which is optionally substituted with from 1-4 R a ;
  • ⁇ Z 2 is–N(H)-, -N(R d )-, -O-, or–S-;
  • ⁇ Z 3 is C2-7 alkyl, which is optionally substituted with from 1-4 R a ;
  • E is heterocyclyl including from 3-16 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b , each occurrence of R 1 is independently selected from the group consisting of ⁇ H;
  • R 1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 ; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NR e R f , C1-6 alkoxy, and C 1-6 haloalkoxy, each occurrence of R 2 is independently selected from the group consisting of: (i) C 1-6 alkyl, which is optionally substituted with from 1-2 independently selected R a ;
  • heterocyclyl including from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 ; (iv) C6-10 aryl;
  • heteroaryl including from 5-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2;
  • R 1 and R 2 on adjacent atoms taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R 2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 ; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C 1-6 alkyl, halo, C1-6 haloalkyl, -OH, NR e R f , C1-6 alkoxy, and C1-6 haloalkoxy; each occurrence of R 3 is independently selected from H; C 1-6 alkyl optionally substituted with from 1-6 independently selected R a ; C1-4 haloalkyl;–OH; -F; -Cl; -Br;– NR e R f ; C1-4 alkoxy; C1-4
  • a pair of R 3 taken together with the atom(s) connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C 1-6 haloalkyl, -OH, NR e R f , C 1-6 alkoxy, and C 1-6 haloalkoxy; or a pair of R 1 and R 3 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2; and wherein the ring is optionally substituted with
  • R 2 and R 3 on adjacent atoms taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R 2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 ; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NR e R f , C1-6 alkoxy, and C1-6 haloalkoxy; R 4 is selected from H and C1-6 alkyl;
  • R 5 is selected from H and halo
  • R d is selected from the group consisting of: C1-6 alkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); -CON(R’)(R’’); -S(O)1-2(NR’R’’); - S(O)1-2(C1-4 alkyl); -OH; and C 1-4 alkoxy;
  • each occurrence of R e and R f is independently selected from the group consisting of: H; C1-6 alkyl; C1-6 haloalkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); - CON(R’)(R’’); -S(O) 1-2 (NR’R’’); - S(O) 1-2 (C 1-4 alkyl); -OH; and C 1-4 alkoxy; or R e and R f together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from H and C1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to R e and R f ), which are each independently selected from the group consisting of N(R
  • -L 2 is–O-, -N(H)-, -S(O) 0-2 -, or a bond;
  • R h is selected from:
  • heterocyclyl wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
  • heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and
  • ⁇ C 6-10 aryl which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1- 4 haloalkyl;
  • -L 3 is a bond or C 1-3 alkylene;
  • -L 4 is–O-, -N(H)-, -S(O)0-2-, or a bond;
  • R i is selected from:
  • heterocyclyl wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
  • heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1-4 haloalkyl; and ⁇ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, or C 1- 4 haloalkyl; and
  • each occurrence of R’ and R’’ is independently selected from the group consisting of: H, C 1-4 alkyl, and C 6-10 aryl optionally substituted with from 1-2 substituents selected from halo, C 1-4 alkyl, and C 1-4 haloalkyl; or R’ and R’’ together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from the group consisting of H and C 1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to R’ and R’’), which are each independently selected from the group consisting of N(H), N(C1-6 alkyl), O, and S.
  • each of the remaining Y 1 , Y 2 , and Y 3 is an independently selected CR 1 .
  • Y 2 , and Y 3 is independently CR 1 (e.g., the moi wherein the asterisk denotes point of attachment to Y 4 ).
  • R 1 is C1-6 alkyl (e.g., C 1-3 alkyl) optionally substituted with 1-2 R a .
  • heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and
  • C 6-10 aryl which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • R i is C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1-4 haloalkyl.
  • R i is heteroaryl including from 5-10 (e.g., 5-6) ring atoms, wherein from 1-4 (e.g., from 1-2) ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • each occurrence of R 3 is independently selected from: H; C 1-6 alkyl optionally substituted with from 1-6 independently selected R a ; C 1-4 haloalkyl;–OH; -F; -Cl;–NR e R f ; C 1-4 alkoxy; and C1-4 haloalkoxy; or two R 3 on the same carbon combine to form an oxo.
  • Y A2 is heteroaryl including from 5-14 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c .
  • Y A2 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected R c .
  • ring atoms e.g., pyridyl or pyrimidinyl (e.g., pyridyl (e.g., )
  • heteroaryl ring is optionally substituted with from 1-3 independently selected R c .
  • Y A2 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally
  • R c substituted with from 1-4 independently selected R c (e.g., Y A2 is , ,
  • R c is ethyl, propyl (e.g., n-propyl), butyl (e.g., n-butyl, iso-butyl, sec-butyl, tert-butyl), or octyl (e.g., n-octyl).
  • each occurrence of R a is independently selected from–F, -Cl, -Br, OH, C 1-4 alkoxy, and C 1-4 haloalkoxy.
  • R h is heterocyclyl, wherein the heterocyclyl includes from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
  • Y A2 is C3-6 (e.g., C3, C5, or C6) cycloalkyl, which is substituted with from 1-4 (e.g., from 1-2) R b (e.g., Y A2 is cyclopropyl, cyclopentyl, bicyclo[1.1.1]pentyl, cyclohexyl, each of which is optionally substituted with from 1-2 R b ).
  • Y A2 is bicyclooctyl (e.g., ), adamantyl (e.g., ), bicycloheptyl (e.g., ), or bicycloheptenyl (e.g.,
  • Y A2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b .
  • Y A2 is heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently
  • R b e.g., Y A2 is pyrrolidinyl (e.g., ), piperidinyl (e.g., ), or
  • tetrahydropyranyl e.g., ), or , each of which is further optionally substituted with from 1-3 independently selected R b ).
  • R b substituent of Y A2 is ethyl, propyl (e.g., n-propyl), butyl (e.g., n-butyl; or sec-butyl; or tert-butyl; or iso- butyl), or octyl (e.g., n-octyl).
  • each occurrence of R a is independently selected from–F, -Cl, -Br, OH, C1-4 alkoxy, and C1-4 haloalkoxy.
  • R h is heterocyclyl
  • the heterocyclyl includes from 3-10 (e.g., 4, 5, 6, 7, 8, 9, or 10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C 1-4 alkyl, and C 1-4 haloalkyl.
  • n1 is 0, 1, or 2; and each of R cA and R cB is an independently selected R c .
  • R cA and R cB are independently selected R c .
  • one of Q 1 and Q 2 is N; the other one of Q 1 and Q 2 is CH; n1 is 0, 1, or 2; and each of R cA and R cB is an independently selected R c .
  • one of Q 1 , Q 2 , Q 3 , and Q 4 is N; each of the remaining of Q 1 , Q 2 , Q 3 ,
  • R cA and R cB is an independently selected R c .
  • R bA and R bB is an independently selected R b .
  • R bA is as defined for R b in any one of clauses 149-158 (e.g., 149; e.g., R bA is–L 1 -L 2 -R h , and R h is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or R bA is as defined in clause 158).
  • R bA is as defined for R b in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
  • each R bB is independently selected from the group consisting of–Cl, -F, C1-3 alkyl, and C1-3 haloalkyl.
  • each R a is an independently selected halo (e.g., A is or ).
  • E is heterocyclyl including from 5-8 ring atoms, wherein aside from the nitrogen atom present, from 0-2 (e.g., 0-1) additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected R b .
  • R a is selected from the group consisting of–OH, -NR e R f , -F, -Cl, -Br, C 1-4 aloxy, C 1-4 haloalkoxy, and C 3-6 cycloalkyl (e.g., cyclopropyl).
  • n1 is 0, 1, or 2; each of R cA and R cB is an independently selected R c ; and R 7 is H or C 1-4 alkyl.
  • n1 is 0, 1, or 2; each of R cA and R cB is an independently selected R c ; and and R 7 is H or C1-4 alkyl.
  • B 1 is selected from the group consisting of:
  • heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected R c ;
  • bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c ; and (c) C 7-10 bicyclic aryl, which is optionally substituted with from 1-3 R c ;
  • R 7 is H or C1-4 alkyl.
  • B 1 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected R c .
  • B 1 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected R c .
  • B 2 is selected from the group consisting of:
  • heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1- 3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b ;
  • R 7 is H or C1-4 alkyl. 228.
  • B 2 is C3-5 (e.g., C3 or C5) monocyclic cycloalkyl which is optionally substituted with from 1-4 R b . 229.
  • B 2 is C 5 - 6 (e.g., C 5 or C 6 ) bicyclic
  • adamantyl e.g., bicycloheptyl or bicycloheptenyl (e.g., each of which is further optionally substituted with from 1-3 R b .
  • B 2 is heterocyclyl including from 5- 12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(R d ), O, and S(O) 0-2 , and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected R b .
  • B 2 is selected from the group
  • Y A1 is C1-6 alkylene, which is optionally substituted with from 1-2 R a (e.g., Y A1 is -CH 2 -, -CH 2 CH 2 -, -CH 2 CH 2 CH 2 -, -CH(CF 3 )-, -CH 2 CH(OH)-, or (e.g., CH 2 )).
  • B 3 is C1-10 alkyl, which is optionally substituted with from 1-6 independently selected R a ; and R 7 is H or C 1-4 alkyl.
  • alkyl e.g., , , or ).

Abstract

This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING). Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). This disclosure also features compositions containing the same as well as methods of using and making the same.

Description

Compounds and Compositions for Treating Conditions Associated with STING Activity CROSS REFERENCE TO RELATED APPLICATIONS
This application claims the benefit of U.S. Provisional Application Serial No. 62/849,811, filed on May 17, 2019; and U.S. Provisional Application Serial No. 62/861,880, filed on June 14, 2019; each of which is incorporated herein by reference in its entirety. TECHNICAL FIELD
This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING). Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). This disclosure also features compositions containing the same as well as methods of using and making the same.
BACKGROUND STING, also known as transmembrane protein 173 (TMEM173) and MPYS/MITA/ERIS, is a protein that in humans is encoded by the TMEM173 gene. STING has been shown to play a role in innate immunity. STING induces type I interferon production when cells are infected with intracellular pathogens, such as viruses, mycobacteria and intracellular parasites. Type I interferon, mediated by STING, protects infected cells and nearby cells from local infection in an autocrine and paracrine manner.
The STING pathway is pivotal in mediating the recognition of cytosolic DNA. In this context, STING, a transmembrane protein localized to the endoplasmic reticulum (ER), acts as a second messenger receptor for 2', 3' cyclic GMP-AMP (hereafter cGAMP), which is produced by cGAS after dsDNA binding. In addition, STING can also function as a primary pattern recognition receptor for bacterial cyclic dinucleotides (CDNs) and small molecule agonists. The recognition of endogenous or prokaryotic CDNs proceeds through the carboxy-terminal domain of STING, which faces into the cytosol and creates a V-shaped binding pocket formed by a STING homodimer. Ligand-induced activation of STING triggers its re-localization to the Golgi, a process essential to promote the interaction of STING with TBK1. This protein complex, in turn, signals through the transcription factors IRF-3 to induce type I interferons (IFNs) and other co-regulated antiviral factors. In addition, STING was shown to trigger NF-kB and MAP kinase activation. Following the initiation of signal transduction, STING is rapidly degraded, a step considered important in terminating the inflammatory response.
Excessive activation of STING is associated with a subset of monogenic autoinflammatory conditions, the so-called type I interferonopathies. Examples of these diseases include a clinical syndrome referred to as STING-associated vasculopathy with onset in infancy (SAVI), which is caused by gain-of-function mutations in TMEM173 (the gene name of STING). Moreover, STING is implicated in the pathogenesis of Aicardi- Goutières Syndrome (AGS) and genetic forms of lupus. As opposed to SAVI, it is the dysregulation of nucleic acid metabolism that underlies continuous innate immune activation in AGS. Apart from these genetic disorders, emerging evidence points to a more general pathogenic role for STING in a range of inflammation-associated disorders such as systemic lupus erythematosus, rheumatoid arthritis and cancer. Thus, small molecule- based pharmacological interventions into the STING signaling pathway hold significant potential for the treatment of a wide spectrum of diseases SUMMARY
This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING). Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). This disclosure also features compositions containing the same as well as methods of using and making the same. An "antagonist" of STING includes compounds that, at the protein level, directly bind or modify STING such that an activity of STING is decreased, e.g., by inhibition, blocking or dampening agonist-mediated responses, altered distribution, or otherwise. STING antagonists include chemical entities, which interfere or inhibit STING signaling.
In one aspect, compounds of Formula (I), or a pharmaceutically acceptable salt thereof, are featured:
Figure imgf000004_0001
In which X1, X2, Y1, Y2, Y3, Y4, Z, Q, A, and R6 can be as defined anywhere herein.
In one aspect, pharmaceutical compositions are featured that include a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same) and one or more pharmaceutically acceptable excipients.
In one aspect, methods for inhibiting (e.g., antagonizing) STING activity are featured that include contacting STING with a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same). Methods include in vitro methods, e.g., contacting a sample that includes one or more cells comprising STING (e.g., innate immune cells, e.g., mast cells, macrophages, dendritic cells (DCs), and natural killer cells) with the chemical entity. Methods can also include in vivo methods; e.g., administering the chemical entity to a subject (e.g., a human) having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and/or symptoms and/or progression of the disease. In one aspect, methods of treating a condition, disease or disorder ameliorated by antagonizing STING are featured, e.g., treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). The methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
In another aspect, methods of treating cancer are featured that include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
In a further aspect, methods of treating other STING-associated conditions are featured, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutières Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis. The methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
In another aspect, methods of suppressing STING-dependent type I interferon production in a subject in need thereof are featured that include administering to the subject an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
In a further aspect, methods of treating a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the disease are featured. The methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same). In another aspect, methods of treatment are featured that include administering an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same) to a subject; wherein the subject has (or is predisposed to have) a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the disease.
In a further aspect, methods of treatment that include administering to a subject a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same), wherein the chemical entity is administered in an amount effective to treat a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the disease, thereby treating the disease.
Embodiments can include one or more of the following features.
The chemical entity can be administered in combination with one or more additional therapeutic agents and/or regimens. For examples, methods can further include administering one or more (e.g., two, three, four, five, six, or more) additional agents.
The chemical entity can be administered in combination with one or more additional therapeutic agents and/or regimens that are useful for treating other STING- associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutières Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
The chemical entity can be administered in combination with one or more additional cancer therapies (e.g., surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof; e.g., chemotherapy that includes administering one or more (e.g., two, three, four, five, six, or more) additional chemotherapeutic agents. Non-limiting examples of additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin); an anti-metabolite (e.g.,azathioprine and/or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and/or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and/or Vindesine Taxol, Pacllitaxel and/or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and/or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and/or topotecan;. amsacrine, etoposide, etoposide phosphate and/or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and/or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and/or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Muromonab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and/or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an anti- helminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1– PD-L1, PD- 1– PD-L2, interleukin‑2 (IL‑2), indoleamine 2,3-dioxygenase (IDO), IL‑10, transforming growth factor-b (TGFb), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9– TIM3, Phosphatidylserine– TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II– LAG3, 4‑1BB–4‑1BB ligand, OX40–OX40 ligand, GITR, GITR ligand– GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25–TL1A, CD40L, CD40– CD40 ligand, HVEM–LIGHT–LTA, HVEM, HVEM– BTLA, HVEM– CD160, HVEM – LIGHT, HVEM–BTLA–CD160, CD80, CD80– PDL-1, PDL2– CD80, CD244, CD48 – CD244, CD244, ICOS, ICOS–ICOS ligand, B7‑H3, B7‑H4, VISTA, TMIGD2, HHLA2–TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86– CD28, CD86– CTLA, CD80– CD28, CD39, CD73 Adenosine–CD39– CD73, CXCR4–CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine – TIM3, SIRPA–CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
The subject can have cancer; e.g., the subject has undergone and/or is undergoing and/or will undergo one or more cancer therapies.
Non-limiting examples of cancer include melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma. In certain embodiments, the cancer can be a refractory cancer.
The chemical entity can be administered intratumorally.
The methods can further include identifying the subject.
Other embodiments include those described in the Detailed Description and/or in the claims. Additional Definitions
To facilitate understanding of the disclosure set forth herein, a number of additional terms are defined below. Generally, the nomenclature used herein and the laboratory procedures in organic chemistry, medicinal chemistry, and pharmacology described herein are those well-known and commonly employed in the art. Unless defined otherwise, all technical and scientific terms used herein generally have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. Each of the patents, applications, published applications, and other publications that are mentioned throughout the specification and the attached appendices are incorporated herein by reference in their entireties.
As used herein, the term“STING” is meant to include, without limitation, nucleic acids, polynucleotides, oligonucleotides, sense and antisense polynucleotide strands, complementary sequences, peptides, polypeptides, proteins, homologous and/or orthologous STING molecules, isoforms, precursors, mutants, variants, derivatives, splice variants, alleles, different species, and active fragments thereof.
The term“acceptable” with respect to a formulation, composition or ingredient, as used herein, means having no persistent detrimental effect on the general health of the subject being treated.
“API” refers to an active pharmaceutical ingredient.
The terms“effective amount” or“therapeutically effective amount,” as used herein, refer to a sufficient amount of a chemical entity being administered which will relieve to some extent one or more of the symptoms of the disease or condition being treated. The result includes reduction and/or alleviation of the signs, symptoms, or causes of a disease, or any other desired alteration of a biological system. For example, an“effective amount” for therapeutic uses is the amount of the composition comprising a compound as disclosed herein required to provide a clinically significant decrease in disease symptoms. An appropriate“effective” amount in any individual case is determined using any suitable technique, such as a dose escalation study.
The term “excipient” or“pharmaceutically acceptable excipient” means a pharmaceutically-acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, carrier, solvent, or encapsulating material. In one embodiment, each component is“pharmaceutically acceptable” in the sense of being compatible with the other ingredients of a pharmaceutical formulation, and suitable for use in contact with the tissue or organ of humans and animals without excessive toxicity, irritation, allergic response, immunogenicity, or other problems or complications, commensurate with a reasonable benefit/risk ratio. See, e.g., Remington: The Science and Practice of Pharmacy, 21st ed.; Lippincott Williams & Wilkins: Philadelphia, PA, 2005; Handbook of Pharmaceutical Excipients, 6th ed.; Rowe et al., Eds.; The Pharmaceutical Press and the American Pharmaceutical Association: 2009; Handbook of Pharmaceutical Additives, 3rd ed.; Ash and Ash Eds.; Gower Publishing Company: 2007; Pharmaceutical Preformulation and Formulation, 2nd ed.; Gibson Ed.; CRC Press LLC: Boca Raton, FL, 2009.
The term“pharmaceutically acceptable salt” refers to a formulation of a compound that does not cause significant irritation to an organism to which it is administered and does not abrogate the biological activity and properties of the compound. In certain instances, pharmaceutically acceptable salts are obtained by reacting a compound described herein, with acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like. In some instances, pharmaceutically acceptable salts are obtained by reacting a compound having acidic group described herein with a base to form a salt such as an ammonium salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as dicyclohexylamine, N-methyl-D-glucamine, tris(hydroxymethyl)methylamine, and salts with amino acids such as arginine, lysine, and the like, or by other methods previously determined. The pharmacologically acceptable salt s not specifically limited as far as it can be used in medicaments. Examples of a salt that the compounds described hereinform with a base include the following: salts thereof with inorganic bases such as sodium, potassium, magnesium, calcium, and aluminum; salts thereof with organic bases such as methylamine, ethylamine and ethanolamine; salts thereof with basic amino acids such as lysine and ornithine; and ammonium salt. The salts may be acid addition salts, which are specifically exemplified by acid addition salts with the following: mineral acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, and phosphoric acid:organic acids such as formic acid, acetic acid, propionic acid, oxalic acid, malonic acid, succinic acid, fumaric acid, maleic acid, lactic acid, malic acid, tartaric acid, citric acid, methanesulfonic acid, and ethanesulfonic acid; acidic amino acids such as aspartic acid and glutamic acid.
The term“pharmaceutical composition” refers to a mixture of a compound described herein with other chemical components (referred to collectively herein as “excipients”), such as carriers, stabilizers, diluents, dispersing agents, suspending agents, and/or thickening agents. The pharmaceutical composition facilitates administration of the compound to an organism. Multiple techniques of administering a compound exist in the art including, but not limited to: rectal, oral, intravenous, aerosol, parenteral, ophthalmic, pulmonary, and topical administration.
The term“subject” refers to an animal, including, but not limited to, a primate (e.g., human), monkey, cow, pig, sheep, goat, horse, dog, cat, rabbit, rat, or mouse. The terms “subject and“patient are used interchangeably herein in reference, for example, to a mammalian subject, such as a human.
The terms“treat,”“treating,” and“treatment,” in the context of treating a disease or disorder, are meant to include alleviating or abrogating a disorder, disease, or condition, or one or more of the symptoms associated with the disorder, disease, or condition; or to slowing the progression, spread or worsening of a disease, disorder or condition or of one or more symptoms thereof. The“treatment of cancer”, refers to one or more of the following effects: (1) inhibition, to some extent, of tumor growth, including, (i) slowing down and (ii) complete growth arrest; (2) reduction in the number of tumor cells; (3) maintaining tumor size; (4) reduction in tumor size; (5) inhibition, including (i) reduction, (ii) slowing down or (iii) complete prevention, of tumor cell infiltration into peripheral organs; (6) inhibition, including (i) reduction, (ii) slowing down or (iii) complete prevention, of metastasis; (7) enhancement of anti-tumor immune response, which may result in (i) maintaining tumor size, (ii) reducing tumor size, (iii) slowing the growth of a tumor, (iv) reducing, slowing or preventing invasion and/or (8) relief, to some extent, of the severity or number of one or more symptoms associated with the disorder.
The term "halo" refers to fluoro (F), chloro (Cl), bromo (Br), or iodo (I).
The term "alkyl" refers to a hydrocarbon chain that may be a straight chain or branched chain, containing the indicated number of carbon atoms. For example, C1-10 indicates that the group may have from 1 to 10 (inclusive) carbon atoms in it. Non-limiting examples include methyl, ethyl, iso-propyl, tert-butyl, n-hexyl.
The term "haloalkyl" refers to an alkyl, in which one or more hydrogen atoms is/are replaced with an independently selected halo.
The term "alkoxy" refers to an -O-alkyl radical (e.g., -OCH3).
The term "alkylene" refers to a divalent alkyl (e.g., -CH2-).
The term "alkenyl" refers to a hydrocarbon chain that may be a straight chain or branched chain having one or more carbon-carbon double bonds. The alkenyl moiety contains the indicated number of carbon atoms. For example, C2-6 indicates that the group may have from 2 to 6 (inclusive) carbon atoms in it.
The term "alkynyl" refers to a hydrocarbon chain that may be a straight chain or branched chain having one or more carbon-carbon triple bonds. The alkynyl moiety contains the indicated number of carbon atoms. For example, C2-6 indicates that the group may have from 2 to 6 (inclusive) carbon atoms in it.
The term "aryl" refers to a 6-20 carbon mono-, bi-, tri- or polycyclic group wherein at least one ring in the system is aromatic (e.g., 6-carbon monocyclic, 10-carbon bicyclic, or 14-carbon tricyclic aromatic ring system); and wherein 0, 1, 2, 3, or 4 atoms of each ring may be substituted by a substituent. Examples of aryl groups include phenyl, naphthyl, tetrahydronaphthyl, and the like.
The term "cycloalkyl" as used herein includes cyclic hydrocarbon groups having 3 to 20 ring carbons, preferably 3 to 16 ring carbons, and more preferably 3 to 12 ring carbons or 3-10 ring carbons or 3-6 ring carbons, wherein the cycloalkyl group may be optionally substituted. Examples of cycloalkyl groups include, without limitation, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and cyclooctyl. Cycloalkyl may include multiple fused and/or bridged rings. Non-limiting examples of fused/bridged cycloalkyl includes: bicyclo[1.1.0]butane, bicyclo[2.1.0]pentane, bicyclo[1.1.1]pentane, bicyclo[3.1.0]hexane, bicyclo[2.1.1]hexane, bicyclo[3.2.0]heptane, bicyclo[4.1.0]heptane, bicyclo[2.2.1]heptane, bicyclo[3.1.1]heptane, bicyclo[4.2.0]octane, bicyclo[3.2.1]octane, bicyclo[2.2.2]octane, and the like. Cycloalkyl also includes spirocyclic rings (e.g., spirocyclic bicycle wherein two rings are connected through just one atom). Non-limiting examples of spirocyclic cycloalkyls include spiro[2.2]pentane, spiro[2.5]octane, spiro[3.5]nonane, spiro[3.5]nonane, spiro[3.5]nonane, spiro[4.4]nonane, spiro[2.6]nonane, spiro[4.5]decane, spiro[3.6]decane, spiro[5.5]undecane, and the like.
The term "cycloalkenyl" as used herein includes partially unsaturated cyclic hydrocarbon groups having 3 to 20 ring carbons, preferably 3 to 16 ring carbons, and more preferably 3 to 12 ring carbons or 3-10 ring carbons or 3-6 ring carbons, wherein the cycloalkenyl group may be optionally substituted. Examples of cycloalkenyl groups include, without limitation, cyclopentenyl, cyclohexenyl, cycloheptenyl, and cyclooctenyl. Cycloalkenyl groups may have any degree of saturation provided that none of the rings in the ring system are aromatic; and the cycloalkenyl group is not fully saturated overall. Cycloalkenyl may include multiple fused and/or bridged and/or spirocyclic rings. The term“heteroaryl , as used herein, means a mono-, bi-, tri- or polycyclic group having 5 to 20 ring atoms, alternatively 5, 6, 9, 10, or 14 ring atoms; and having 6, 10, or 14 pi electrons shared in a cyclic array; wherein at least one ring in the system is aromatic (but does not have to be a ring which contains a heteroatom, e.g. tetrahydroisoquinolinyl, e.g., tetrahydroquinolinyl), and at least one ring in the system contains one or more heteroatoms independently selected from the group consisting of N, O, and S. Heteroaryl groups can either be unsubstituted or substituted with one or more substituents. Examples of heteroaryl include thienyl, pyridinyl, furyl, oxazolyl, oxadiazolyl, pyrrolyl, imidazolyl, triazolyl, thiodiazolyl, pyrazolyl, isoxazolyl, thiadiazolyl, pyranyl, pyrazinyl, pyrimidinyl, pyridazinyl, triazinyl, thiazolyl benzothienyl, benzoxadiazolyl, benzofuranyl, benzimidazolyl, benzotriazolyl, cinnolinyl, indazolyl, indolyl, isoquinolinyl, isothiazolyl, naphthyridinyl, purinyl, thienopyridinyl, pyrido[2,3-d]pyrimidinyl, pyrrolo[2,3- b]pyridinyl, quinazolinyl, quinolinyl, thieno[2,3-c]pyridinyl, pyrazolo[3,4-b]pyridinyl, pyrazolo[3,4-c]pyridinyl, pyrazolo[4,3-c]pyridine, pyrazolo[4,3-b]pyridinyl, tetrazolyl, chromane, 2,3-dihydrobenzo[b][1,4]dioxine, benzo[d][1,3]dioxole, 2,3- dihydrobenzofuran, tetrahydroquinoline, 2,3-dihydrobenzo[b][1,4]oxathiine, isoindoline, and others. In some embodiments, the heteroaryl is selected from thienyl, pyridinyl, furyl, pyrazolyl, imidazolyl, isoindolinyl, pyranyl, pyrazinyl, and pyrimidinyl.
The term "heterocyclyl" refers to a mon-, bi-, tri-, or polycyclic nonaromatic ring system with 3-16 ring atoms (e.g., 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system) having 1-3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic or polycyclic, said heteroatoms selected from O, N, or S (e.g., carbon atoms and 1-3, 1-6, or 1-9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1, 2 or 3 atoms of each ring may be substituted by a substituent. Examples of heterocyclyl groups include piperazinyl, pyrrolidinyl, dioxanyl, morpholinyl, tetrahydrofuranyl, and the like. Heterocyclyl may include multiple fused and bridged rings. Non-limiting examples of fused/bridged heteorocyclyl includes: 2-azabicyclo[1.1.0]butane, 2-azabicyclo[2.1.0]pentane, 2- azabicyclo[1.1.1]pentane, 3-azabicyclo[3.1.0]hexane, 5-azabicyclo[2.1.1]hexane, 3- azabicyclo[3.2.0]heptane, octahydrocyclopenta[c]pyrrole, 3-azabicyclo[4.1.0]heptane, 7- azabicyclo[2.2.1]heptane, 6-azabicyclo[3.1.1]heptane, 7-azabicyclo[4.2.0]octane, 2- azabicyclo[2.2.2]octane, 3-azabicyclo[3.2.1]octane, 2-oxabicyclo[1.1.0]butane, 2- oxabicyclo[2.1.0]pentane, 2-oxabicyclo[1.1.1]pentane, 3-oxabicyclo[3.1.0]hexane, 5- oxabicyclo[2.1.1]hexane, 3-oxabicyclo[3.2.0]heptane, 3-oxabicyclo[4.1.0]heptane, 7- oxabicyclo[2.2.1]heptane, 6-oxabicyclo[3.1.1]heptane, 7-oxabicyclo[4.2.0]octane, 2- oxabicyclo[2.2.2]octane, 3-oxabicyclo[3.2.1]octane, and the like. Heterocyclyl also includes spirocyclic rings (e.g., spirocyclic bicycle wherein two rings are connected through just one atom). Non-limiting examples of spirocyclic heterocyclyls include 2- azaspiro[2.2]pentane, 4-azaspiro[2.5]octane, 1-azaspiro[3.5]nonane, 2- azaspiro[3.5]nonane, 7-azaspiro[3.5]nonane, 2-azaspiro[4.4]nonane, 6- azaspiro[2.6]nonane, 1,7-diazaspiro[4.5]decane, 7-azaspiro[4.5]decane 2,5- diazaspiro[3.6]decane, 3-azaspiro[5.5]undecane, 2-oxaspiro[2.2]pentane, 4- oxaspiro[2.5]octane, 1-oxaspiro[3.5]nonane, 2-oxaspiro[3.5]nonane, 7- oxaspiro[3.5]nonane, 2-oxaspiro[4.4]nonane, 6-oxaspiro[2.6]nonane, 1,7- dioxaspiro[4.5]decane, 2,5-dioxaspiro[3.6]decane, 1-oxaspiro[5.5]undecane, 3- oxaspiro[5.5]undecane, 3-oxa-9-azaspiro[5.5]undecane and the like.
In addition, atoms making up the compounds of the present embodiments are intended to include all isotopic forms of such atoms. Isotopes, as used herein, include those atoms having the same atomic number but different mass numbers. By way of general example and without limitation, isotopes of hydrogen include tritium and deuterium, and isotopes of carbon include 13C and 14C.
In addition, the compounds generically or specifically disclosed herein are intended to include all tautomeric forms. Thus, by way of example, a compound containing the
encompasses the tautomeric form containing the moiety:
Figure imgf000014_0001
, a pyridinyl or pyrimidinyl moiety that is described to be optionally substituted with hydroxyl encompasses pyridone or pyrimidone tautomeric forms. The details of one or more embodiments of the invention are set forth in the accompanying drawings and the description below. Other features and advantages of the invention will be apparent from the description and drawings, and from the claims. DETAILED DESCRIPTION
This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING). Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). This disclosure also features compositions containing the same as well as methods of using and making the same.
Formula I Compounds
In one aspect, compounds of Formula (I), or a pharmaceutically acceptable salt thereof, are featured:
Figure imgf000015_0001
or a pharmaceutically acceptable salt thereof or a tautomer thereof, wherein: Z is selected from the group consisting of a bond, CR1, C(R3)2, N, and NR2;
each of Y1, Y2, and Y3 is independently selected from the group consisting of O, S, CR1, C(R3)2, N, and NR2;
Y4 is C or N; X1 is selected from the group consisting of O, S, N, NR2, and CR1;
X2 is selected from the group consisting of O, S, N, NR4, and CR5;
each is independently a single bond or a double bond, provided that the five- membered ring comprising Y4, X1, and X2 is heteroaryl; Q-A is defined according to (A) or (B) below: (A)
Q is selected from the group consisting of: NH; N(C1-6 alkyl) wherein the C1-6 alkyl is optionally substituted with 1-2 independently selected Ra; O; S; and C1-3 alkylene which is optionally substituted with 1-2 independently selected Ra and
A is:
(i) -(YA1)n-YA2, wherein:
^ n is 0 or 1;
^ YA1 is C1-6 alkylene, which is optionally substituted with from 1-6 substituents each indepndently selected from the group consisting of Ra; C6- 10 aryl optionally substituted with 1-4 independently selected C1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C1-4 alkyl; and
^ YA2 is:
(a) C3-20 cycloalkyl, which is optionally substituted with from 1-4 Rb, (b) C6-20 aryl, which is optionally substituted with from 1-4 Rc;
(c) heteroaryl including from 5-20 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc; or (d) heterocyclyl including from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb, OR
(ii) -Z1 -Z2-Z3, wherein:
^ Z1 is C1-3 alkylene, which is optionally substituted with from 1-4 Ra;
^ Z2 is–N(H)-, -N(Rd)-, -O-, or–S-; and
^ Z3 is C2-7 alkyl, which is optionally substituted with from 1-4 Ra; OR
(iii) C1-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra, OR
Q and A, taken together, form:
Figure imgf000017_0001
E is heterocyclyl including from 3-16 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb,
each occurrence of R1 is independently selected from the group consisting of ^
^ halo;
^ cyano;
^ C1-6 alkyl optionally substituted with 1-2 Ra;
^ C2-6 alkenyl;
^ C2-6 alkynyl; ^ C1-4 haloalkyl;
^ C1-4 alkoxy;
^ C1-4 haloalkoxy;
^ –L3-L4-Ri;
^ -S(O)1-2(C1-4 alkyl),
^ -S(O)(=NH)(C1-4 alkyl),
^ SF5,
^ -NReRf,
^ –OH,
^ oxo,
^ -S(O)1-2(NR’R’’),
^ -C1-4 thioalkoxy,
^ -NO2,
^ -C(=O)(C1-4 alkyl),
^ -C(=O)O(C1-4 alkyl),
^ -C(=O)OH, and
^ -C(=O)N(R’)(R’’); or a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy, each occurrence of R2 is independently selected from the group consisting of: (i) C1-6 alkyl, which is optionally substituted with from 1-2 independently selected Ra;
(ii) C3-6 cycloalkyl; (iii) heterocyclyl including from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2;
(iv) C6-10 aryl;
(v) heteroaryl including from 5-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2;
(vi) -C(O)(C1-4 alkyl);
(vii) -C(O)O(C1-4 alkyl);
(viii) -CON(R’)(R’’);
(ix) -S(O)1-2(NR’R’’);
(x) - S(O)1-2(C1-4 alkyl);
(xi) -OH;
(xii) C1-4 alkoxy; and
(xiii) H; or a pair of R1 and R2 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy,
each occurrence of R3 is independently selected from H; C1-6 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;–OH; -F; -Cl; -Br;– NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-4 alkyl); -C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)N(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano; and C3-6 cycloalkyl optionally substituted with from 1-4 independently selected C1-4 alkyl; or
two R3 on the same carbon combine to form an oxo; or
a pair of R3, taken together with the atom(s) connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; or
a pair of R1 and R3 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; or
or a pair of R2 and R3 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; R4 is selected from H and C1-6 alkyl; R5 is selected from H and halo; R6 is selected from H; C1-6 alkyl; -OH; C1-4 alkoxy; C(=O)H; C(=O)(C1-4 alkyl); CN; C6-10 aryl optionally substituted with from 1-4 independently selected C1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C1-4 alkyl; each occurrence of Ra is independently selected from the group consisting of:– OH; -F; -Cl; -Br;–NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1- 4 alkyl); -C(=O)OH; -CON(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano, and C3- 6 cycloalkyl optionally substituted with from 1-4 independently selected C1-4 alkyl; each occurrence of Rb is independently selected from the group consisting of: C1- 10 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;– OH; oxo; -F; -Cl; -Br;–NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)N(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano; and–L1-L2-Rh; each occurrence of Rc is independently selected from the group consisting of: (a) halo;
(b) cyano;
(c) C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra;
(d) C2-6 alkenyl;
(e) C2-6 alkynyl;
(g) C1-4 alkoxy;
(h) C1-4 haloalkoxy;
(i) -S(O)1-2(C1-4 alkyl);
(j) -NReRf;
(k)–OH;
(l) -S(O)1-2(NR’R’’);
(m) -C1-4 thioalkoxy;
(n) -NO2;
(o) -C(=O)(C1-10 alkyl);
(p) -C(=O)O(C1-4 alkyl);
(q) -C(=O)OH;
(r) -C(=O)N(R’)(R’’); and
(s)–L1-L2-Rh; Rd is selected from the group consisting of: C1-6 alkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); -CON(R’)(R’’); -S(O)1-2(NR’R’’); - S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; each occurrence of Re and Rf is independently selected from the group consisting of: H; C1-6 alkyl; C1-6 haloalkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); - CON(R’)(R’’); -S(O)1-2(NR’R’’); - S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; or Re and Rf together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from H and C1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to Re and Rf), which are each independently selected from the group consisting of N(Rd), NH, O, and S; -L1 is a bond or C1-3 alkylene;
-L2 is–O-, -N(H)-, -S(O)0-2-, or a bond;
Rh is selected from:
^ C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl (in certain embodiments, it is provided that when Rh is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected C1-4 alkyl, -L1 is a bond, or–L2 is–O-, -N(H)-, or -S-);
^ heterocyclyl, wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
^ heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ^ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl; -L3 is a bond or C1-3 alkylene;
-L4 is–O-, -N(H)-, -S(O)0-2-, or a bond;
Ri is selected from:
^ C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
^ heterocyclyl, wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
^ heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ^ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1- 4 haloalkyl; and each occurrence of R’ and R’’ is independently selected from the group consisting of: H, C1-4 alkyl, and C6-10 aryl optionally substituted with from 1-2 substituents selected from halo, C1-4 alkyl, and C1-4 haloalkyl; or R’ and R’’ together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from the group consisting of H and C1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to R’ and R’’), which are each independently selected from the group consisting of N(H), N(C1-6 alkyl), O, and S. The Variables Z, Y1, Y2, Y3, and Y4
In some embodiments, the ring that includes Z, Y1, Y2, Y3, and Y4 is aromatic. In some embodiments (e.g., when the ring that includes Z, Y1, Y2, Y3, and Y4 is aromatic), Z is selected from the group consisting of CR1, N, and NR2.
In certain of these embodiments, Z is CR1.
In some embodiments, each of Y1, Y2, and Y3 is independently selected from the group consisting of CR1 and N.
In certain of these embodiments (when Z is CR1), each of Y1, Y2, and Y3 is independently selected from the group consisting of CR1 and N. In some embodiments, each of Y1, Y2, and Y3 is independently CR1.
In certain of these embodiments, Z is CR1; and each of Y1, Y2, and Y3 is
Figure imgf000024_0001
In some other embodiments (e.g., when Z is selected from the group consisting of CR1, N, and NR2 (e.g., when Z is CR1)), from 1-2 of Y1, Y2, and Y3 is independently N or NR2 (e.g., from 1-2 of Y1, Y2, and Y3 is independently N).
In some embodiments (e.g., when Z is selected from the group consisting of CR1, N, and NR2 (e.g., when Z is CR1)), one of Y1, Y2, and Y3 is N or NR2 (e.g., one of Y1, Y2, and Y3 is N).
In certain of these embodiments, each of the remaining Y1, Y2, and Y3 is an independently selected CR1. In some embodiments, moiety is , wherein the asterisk denotes point of attachment to Y4.
In some embodiments, moiety is or (e.g.,
), wherein the asterisk denotes point of attachment to Y4.
In some embodiments, moiety is , wherein the asterisk denotes point of attachment to Y4. In certain embodiments (when the ring that includes Z, Y1, Y2, Y3, and Y4 is aromatic), Z is N.
In some embodiments (e.g., when Z is N), each of Y1, Y2, and Y3 is
independently selected from the group consisting of CR1 and N. In certain embodiments (when Z is N), each of Y1, Y2, and Y3 is independently
CR1 (e.g., the moiety is wherein the asterisk denotes point of attachment to Y4). In some embodiments (e.g., when the ring that includes Z, Y1, Y2, Y3, and Y4 is aromatic), Z is a bond.
In certain of these embodiments, Y2 is CR1.
In certain of these embodiments, from 1-2 of Y1 and Y3 is other than CR1.
In certain of these embodiments, from 1-2 of Y1 and Y3 is independently selected from N, CR1 , and S.
For example, the ring that includes Z, Y1, Y2, Y3, and Y4 is selected from:
wherein each denotes points of attachment to the ring comprising X1 and X2, and wherein the bottom denotes point of attachment to X1. In some embodiments, the ring that includes Z, Y1, Y2, Y3, and Y4 is partially saturated.
In certain of these embodiments, the ring that includes Z, Y1, Y2, Y3, and Y4 is:
wherein each denotes points of attachment to the ring comprising X1 and X2, and wherein the bottom denotes point of attachment to X1.
In some of these embodiments, Z is other than a single bond.
In certain embodiments, Y4 is C.
In certain embodiments, each of Z, Y1, Y2, and Y3 is C(R3)2. In certain other embodiments, one of Z, Y1, Y2, and Y3 is other than C(R3)2. For example, the ring comprising Z, Y1, Y2, Y3, and Y4 is:
or , wherein each denotes points of attachment to the ring comprising X1 and X2, and wherein the bottom denotes point of attachment to X1. In certain embodiments (when the ring that includes Z, Y1, Y2, Y3, and Y4 is partially saturated), Z is C(R3)2 or a bond.
In certain embodiments, Z is a bond. In certain embodiments, Z is C(R3)2.
In certain embodiments (e.g., when Z is a bond), each of Y1, Y2, and Y3 is independently selected from the group consisting of C(R3)2, O, NR2, and S.
In certain of these embodiments, each of Y1, Y2, and Y3 is independently C(R3)2.
As a non-limiting example of the foregoing embodiments, the moiety is
, wherein the asterisk denotes point of attachment to Y4. In some embodiments, Y4 is C.
The Variables X1 and X2
In some embodiments, X1 is NR2 (e.g., NH).
In some embodiments, X2 is CR5 (e.g., CH).
In some other embodiments, X2 is N. In certain embodiments, X1 is NR2; and X2 is CR5. As a non-limiting example, X1 is NH; and X2 is CH. Non-Limiting Combinations of Z, Y1, Y2, Y3, Y4, X1, and X2
In certain embodiments, the compound of formula (I) is selected from a compound of the following formulae:
(Ig) (e.g., R6 is H in one or more of the foregoing formulae).
In certain embodiments, the compound has formula (Ia):
(Ia) (e.g., R6 is H). As a non-limiting example of the foregoing embodiments, the compound has formula (Ia-1):
(Ia-1) (e.g., R6 is H).
As another non-limting example, the compound has formula (Ia-2):
(Ia-2) (e.g., R6 is H).
In certain embodiments, the compound has formula (Ib):
(Ib) (e.g., R6 is H).
As a non-limiting example of the foregoing embodiments, the compound has
formula (Ib-1): (Ib-1) (e.g., R6 is H). In certain embodiments, the compound has formula (Ic):
(Ic) (e.g., R6 is H).
As a non-limiting example of the foregoing embodiments, the compound has
formula (Ic-1): (Ic-1) (e.g., R6 is H).
In certain embodiments, the compound has formula (Id):
(Id) (e.g., R6 is H).
As a non-limiting example of the foregoing, the compound has formula (Id-1):
(Id-1) (e.g., R6 is H). In certain embodiments, the compound has formula (I
Figure imgf000031_0003
(Ie) (e.g., R6 is H).
As a non-limiting example of the foregoing, the compound has formula (Ie-1):
Figure imgf000031_0001
In certain embodiments, the compound has formula (
Figure imgf000031_0002
(If) (e.g., R6 is H).
In certain embodiments, the compound has formula
Figure imgf000031_0004
(Ig) (e.g., R6 is H). In certain embodiments, the compound has formula: (Ih), (Ii), (Ij), and
(Ik) (e.g., R6 is H in one or more of the foregoing formulae). In certain embodiments, the compound has Formula:
(Il) (e.g., (Im) or
(In)) (e.g., R6 is H in one or more of the foregoing formulae). In certain embodiments, the compound has formula (Io):
(Io) (e.g., (Io-1)) (e.g., R6 is H). The Variable R1
In some embodiments, each occurrence of R1 is independently selected from the group consisting of:
^ H;
^ halo;
^ cyano;
^ C1-6 alkyl optionally substituted with 1-2 Ra;
^ C2-6 alkenyl;
^ C2-6 alkynyl;
^ C1-4 haloalkyl;
^ C1-4 alkoxy;
^ C1-4 haloalkoxy;
^ –L3-L4-Ri;
^ -S(O)1-2(C1-4 alkyl),
^ -S(O)(=NH)(C1-4 alkyl),
^ SF5,
^ -S(O)1-2(NR’R’’),
^ -C1-4 thioalkoxy,
^ -NO2,
^ -C(=O)(C1-4 alkyl),
^ -C(=O)O(C1-4 alkyl),
^ -C(=O)OH, and
^ -C(=O)N(R’)(R’’). In some embodiments, from 0-3 (e.g., 0, 1, 2, or 3) occurrences of R1 is other than H; and each of the remaining occurrences of R1 is H.
In certain embodiments, each occurrence of R1 is H.
In certain other embodiments, from 1-2 (e.g., 1 or 2) occurrences of R1 is other than H. In certain embodiments, one occurrence of R1 is halo (e.g., F or Cl (e.g., F)). In certain embodiments, one occurrence of R1 is C1-6 alkyl (e.g., C1-3 alkyl) optionally substituted with 1-2 Ra. In certain of these embodiments, Ra is selected from OH, NReRf, C(=O)OH, C1-4 alkoxy, and C1-4 haloalkoxy. As non-limiting examples of the foregoing embodiments, R1 is selected from the group consisting of methyl, propyl, CH2NMe2, CH2CH2OH, and CH2C(=O)OH.
In certain embodiments, one occurrence of R1 is C2-6 alkynyl or C2-6 alkenyl (e.g., C2-6 alkynyl).
In certain embodiments, one occurrence of R1 is -C(=O)(C1-4 alkyl) (e.g., - C(=O)Me).
In certain embodiments, one occurrence of R1 is C(=O)N(R’)(R’’) (e.g.,
C(=O)NHMe or C(=O)NMe2).
In certain embodiments, one occurrence of R1 is C1-4 haloalkyl (e.g., CF3).
In certain embodiments, one occurrence of R1 is S(O)1-2(C1-4 alkyl) or
S(O)(=NH)(C1-4 alkyl) (e.g., S(O)2Me or S(O)(=NH)(Me)).
In certain embodiments, one occurrence of R1 is SF5. In certain embodiments, one occurrence of R1 is–L3-L4-Ri.
In certain of these embodiments, Ri is selected from the group consisting of:
^ heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ^ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl.
In certain embodiments (when one occurrence of R1 is–L3-L4-Ri), Ri is C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. As a non-limiting example of the foregoing embodiments, Ri is C6 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl (e.g., Ri is unsubstituted phenyl). In certain embodiments (when one occurrence of R1 is–L3-L4-Ri), Ri is heteroaryl including from 5-10 (e.g., 5-6) ring atoms, wherein from 1-4 (e.g., from 1-2) ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. In certain of these embodiments, Ri is selected from pyridyl, thiazolyl, and pyrazolyl, each of which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. As non-limiting examples of the foregoing embodiments, Ri is selected from:
Figure imgf000035_0001
, and
Figure imgf000035_0002
.
In certain embodiments (when one occurrence of R1 is–L3-L4-Ri),–L3 is a bond. In certain other embodiments (when one occurrence of R1 is–L3-L4-Ri),–L3 is C1- 3 alkylene.
In certain embodiments (when one occurrence of R1 is–L3-L4-Ri),–L4 is a bond. In certain other embodiments (when one occurrence of R1 is–L3-L4-Ri),–L4 is– O- or–S-. In certain embodiments (when one occurrence of R1 is–L3-L4-Ri),–L3 is a bond; and–L4 is a bond.
In certain other embodiments (when one occurrence of R1 is–L3-L4-Ri),–L3 is C1- 3 alkylene; and–L4 is a bond.
In certain other embodiments (when one occurrence of R1 is–L3-L4-Ri),–L3 is a bond; and–L4 is–O- or–S-. As non-limiting examples when one occurrence of R1 is–L3-L4-Ri, R1 is selected from the group consisting of:
Figure imgf000036_0002
As further non-limiting examples when one occurrence of R1 is–L3-L4-Ri, R1 is selected from the group consisting of:
Figure imgf000036_0001
In certain embodiments (when from 1-2 (e.g., 1 or 2) occurrences of R1 is other than H), each remaining R1 is H. In certain embodiments (when 2 occurrences of R1 are other than H), one occurrence of R1 is as defined in any one or more of the foregoing embodiments; one other occurrence of R1 is halo (e.g., F) or C1-4 alkyl; and each remaining R1 is H. In some embodiments, a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy.
In certain of these embodiments, a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 5-7 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy. As a non-limiting example of the foregoing embodiments, a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form:
.
Figure imgf000037_0001
The Variable R2
In some embodiments, R2 is H.
In some embodiments, R2 is C1-6 alkyl, which is optionally substituted with from 1-2 independently selected Ra (e.g., unsubstituted C1-3 alkyl). In some embodiments, R2 is -C(O)(C1-4 alkyl) (e.g., -C(O)Me).
In some embodiments, R2 is C6-10 aryl (e.g., phenyl). In certain embodiments, when X1 is NR2, the R2 group of X1 is H.
The Variable R3
In some embodiments, each occurrence of R3 is independently selected from: H; C1-6 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl; –OH; -F; -Cl;–NReRf; C1-4 alkoxy; and C1-4 haloalkoxy; or
two R3 on the same carbon combine to form an oxo. In certain embodiments, each occurrence of R3 is independently H, C1-6 alkyl, or C1-4 haloalkyl. As a non-limiting example of the foregoing embodiments, each occurrence of R3 is H.
The Variable R5
In some embodiments, R5 is H.
In some other embodiments, R5 is halo. The Variable R6
In some embodiments, R6 is H. The Variable Q-A Embodiments when Q-A is defined according to (A)
In some embodiments, Q-A is defined according to (A).
In certain embodiments, Q is NH.
In certain embodiments, Q is N(C1-3 alkyl) (e.g., NMe or NEt).
In certain embodiments, A is -(YA1)n-YA2. In certain of these embodiments, n is 0. In certain other embodiments, n is 1.
In certain embodiments (when A is -(YA1)n-YA2; and n is 1), YA1 is C1-6 alkylene, which is optionally substituted with from 1-4 Ra. In certain of the foregoing embodiments, YA1 is -CH2-, -CH2CH2-, -CH2CH2CH2-, -CH(CF3)-, -CH2CH(OH)-, or (e.g.,
Figure imgf000038_0001
CH2).
In certain embodiments (when A is -(YA1)n-YA2; and n is 1), YA1 is C1-6 alkylene, which is substituted with C6-10 aryl (e.g., C6-10 aryl), wherein YA1 is further optionally substituted with from 1-2 Ra (e.g., YA1 is -CH(Ph)CH2-). In certain embodiments (when A is -(YA1)n-YA2), YA2 is C6-10 aryl, which is optionally substituted with from 1-3 Rc.
In certain of these embodiments, YA2 is C6 aryl, which is optionally substituted with from 1-3 Rc. In certain of the foregoing embodiments, YA2 is C6 aryl, which is substituted with from 1-3 Rc.
As a non-limiting example, YA2 is phenyl substituted with from 1-3 Rc, wherein one Rc is at the ring carbon para to the point of attachment to YA1. As another non-limiting example, YA2 is phenyl substituted with from 1-3 Rc, wherein from 1-2 Rc is at the ring carbons meta to the point of attachment to YA1. As yet another non-limiting example, YA2 is phenyl substituted with from 1-3 Rc, wherein from 1-2 Rc is at the ring carbons ortho to the point of attachment to YA1. In certain embodiments (when A is -(YA1)n-YA2; and YA2 is C6-10 aryl, which is optionally substituted with from 1-3 Rc), YA2 is C7-10 bicyclic aryl, which is optionally substituted with from 1-3 Rc. As a non-limiting example, YA2 is naphthyl (e.g.,
indacenyl (e.g., or tetrahydronapthyl, each of which is optionally
Figure imgf000039_0001
substituted with from 1- 3 Rc).
Figure imgf000039_0002
In certain embodiments (when A is -(YA1)n-YA2), YA2 is heteroaryl including from 5-14 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc.
In certain of these embodiments, YA2 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc.
As a non-limiting example of the foregoing embodiments, YA2 is thiazolyl or triazolyl, each of which is optionally substituted with from 1-2 (e.g., 1) independently selected Rc. In certain embodiments (when A is -(YA1)n-YA2), YA2 is heteroaryl including 6 ring
atoms (e.g., pyridyl or pyrimidinyl (e.g., pyridyl (e.g.,
Figure imgf000039_0003
wherein from 1-2 ring nitrogen atoms, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc. In certain of these embodiments, YA2 is substituted with from 1-3 independently selected Rc; and one occurrence of Rc is at the ring carbon atom para to the point of attachment to YA1.
In certain embodiments, YA2 is substituted with from 1-3 independently selected Rc; and one occurrence of Rc is at the ring carbon atom meta to the point of attachment to YA1.
In certain embodiments, YA2 is substituted with from 1-3 independently selected Rc; and one occurrence of Rc is at the ring carbon atom ortho to the point of attachment to YA1. In certain embodiments (when A is -(YA1)n-YA2), YA2 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted
with from 1-4 independently selected Rc (e.g., YA2 is or
Figure imgf000040_0002
or each of which is optionally substituted with from 1-2 independently
Figure imgf000040_0001
selected Rc). In certain embodiments (e.g., when A is -(YA1)n-YA2; and YA2 is C6-10 aryl, which is optionally substituted with from 1-3 Rc; or YA2 is heteroaryl including from 5-14 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc), each occurrence of Rc is independently selected from the group consisting of:
halo;
cyano;
C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra; C2-6 alkenyl;
C2-6 alkynyl;
C1-4 alkoxy;
C1-4 haloalkoxy;
-S(O)1-2(C1-4 alkyl);
-NReRf;
-C1-4 thioalkoxy;
-C(=O)(C1-10 alkyl);
-C(=O)(OH);
–C(=O)O(C1-4 alkyl); and
–L1-L2-Rh. In certain embodiments, one occurrence of Rc is halo. In certain embodiments, one occurrece of Rc is C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra.
In certain of these embodiments, one occurrence of Rc is unsubstituted C1-10 alkyl (e.g., C2, C3, C4, C5, C6, or C7-10). As non-limiting examples of the foregoing embodiments, one occurrence of Rc is ethyl, propyl (e.g., n-propyl), butyl (e.g., n-butyl, iso-butyl, sec- butyl, tert-butyl), or octyl (e.g., n-octyl).
In certain embodiments (when one occurrece of Rc is C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra), the occurrece of Rc is C1-10 alkyl which is substituted with from 1-6 independently selected Ra. In certain of these embodiments, each occurrence of Ra is independently selected from halo, OH, C1-4 alkoxy, and C1-4 haloalkoxy. As non-limiting examples of the foregoing embodiments, one occurrence of Rc is selected from: CF3, CHF2, CH2CH2CF3, CH2CH2CH2OH, CH2CH2OMe, and CH(OH)CH2CH3. In certain embodiments, one occurrence of Rc is C2-6 alkenyl or C2-6 alkynyl. In certain embodiments, one occurrence of Rc is -C(=O)OH or–C(=O)O(C1-4 alkyl).
In certain embodiments, one occurrence of Rc is–C(=O)(C1-10 alkyl) (e.g., - C(=O)(C3-10 alkyl) (e.g., -C(=O)CH2CH2CH2CH2CH2CH2CH2)).
In certain embodiments, one occurrence of Rc is -NReRf (e.g., NMe2). In certain embodiments, one occurrence of Rc is–L1-L2-Rh. In certain of these embodiments, L1 is a bond. In certain embodiments, L2 is a bond. In certain other embodiments, L2 is–O-.
In certain embodiments (when Rc is–L1-L2-Rh), Rh is C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. In certain of these embodiments, Rh is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. As a non-limiting example of the
foregoing embodiments, Rh is selected from:
Figure imgf000042_0001
In certain embodiments (when Rc is–L1-L2-Rh), Rh is heterocyclyl, wherein the heterocyclyl includes from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. As a non-limiting
example of the foregoing embodiments,
Figure imgf000042_0002
In certain embodiments (when Rc is–L1-L2-Rh), Rh is C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl. In certain of thes embodiments, Rh is C6 aryl, which is optionally substituted with from 1-2 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl (e.g., Rh is unsubstituted phenyl). In certain embodiments (when Rc is–L1-L2-Rh), Rh is heteroaryl including 5-6 ring atoms, wherein from 1-3 are ring heteroatoms each independently selected from N, O, and S, wherein the heteroaryl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl.
As non-limiting examples (when Rc is–L1-L2-Rh), Rc is selected from the group
Figure imgf000043_0001
As further non-limiting examples, Rc is selected from the group consisting of:
Figure imgf000043_0002
In one or more of the foregoing embodiments, each of the remaining Rc when present is independently halo or C1-3 alkyl. In certain embodiments, YA2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb. In certain of the foregoing embodiments, YA2 is C3-6 (e.g., C3, C5, or C6) cycloalkyl, which is substituted with from 1-4 (e.g., from 1-2) Rb (e.g., YA2 is cyclopropyl, cyclopentyl, bicyclo[1.1.1]pentyl, cyclohexyl, each of which is optionally substituted with from 1-2 Rb). In certain of these embodiments. YA2 is C6 cycloalkyl, which is substituted with from 1-4 (e.g., from 1-2) Rb. In certain of these embodiments, YA2 is cyclohexyl which is optionally substituted with from 1-2 Rb. In certain of the foregoing embodiments, one occurrence of Rb is at the ring carbon atom para to the point of attachment to YA1. In certain embodiments, one occurrence of Rb is at the ring carbon atom meta to the point of attachment to YA1. In certain embodiments, one occurrence of Rb is at the ring carbon atom ortho to the point of attachment to YA1.
In certain embodiments, YA2 is C7-10 cycloalkyl, which is optionally substituted with
from 1-4 Rb (e.g., YA2 is bicyclooctyl ( adamantyl (e.g.,
Figure imgf000044_0001
Figure imgf000044_0002
bicycloheptyl (e.g.,
Figure imgf000044_0003
), or bicycloheptenyl (e.g., each of which is
Figure imgf000044_0004
further optionally substituted with from 1-3 Rb). In certain embodiments, YA2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb.
In certain of these embodiments, YA2 is heterocyclyl including from 5-12 (e.g., 5- 10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb (e.g., YA2 is
pyrrolidinyl (
Figure imgf000044_0006
, piperidinyl (
Figure imgf000044_0007
r tetrahydropyranyl (e.g.,
Figure imgf000044_0005
each of which is further optionally substituted with from 1-3 independently
Figure imgf000045_0001
selected Rb). In certain embodiments (e.g., when YA2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb; or YA2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb), each occurrence of Rb substituent of YA2 is independently selected from the group consisting of: C1-10 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl; -F; -Cl; - Br; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-10 alkyl); -C(=O)O(C1-4 alkyl); -S(O)1-2(C1-4 alkyl); cyano; and–L1-L2-Rh.
In certain embodiments (e.g., when YA2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb; or YA2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb), one occurrece of Rb substituent of YA2 is C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra.
In certain of these embodiments, one occurrence of Rb substituent of YA2 is unsubstituted C1-10 alkyl (e.g., C2, C3, C4, C5, C6, or C7-10). As non-limiting examples of the foregoing embodiments, one occurrence of Rb substituent of YA2 is ethyl, propyl (e.g., n- propyl), butyl (e.g., n-butyl; or sec-butyl; or tert-butyl; or iso-butyl), or octyl (e.g., n-octyl).
In certain embodiments (e.g., when one occurrece of Rb substituent of YA2 is C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra), the occurrece of Rb substituent of YA2 is C1-10 alkyl which is substituted with from 1-6 independently selected Ra. In certain of these embodiments, each occurrence of Ra is independently selected from halo, OH, C1-4 alkoxy, and C1-4 haloalkoxy. As non-limiting examples of the foregoing embodiments, one occurrence of Rb is selected from: CF3, CH2CH2CF3, CH2CH2CH2OH, CH2CH2OMe, and CH(OH)CH2CH3. In certain embodiments (e.g., when YA2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb; or YA2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb), one occurrence of Rb substituent of YA2 is C2-6 alkenyl or C2-6 alkynyl. In certain embodiments (e.g., when YA2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb; or YA2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb), one occurrence of Rb substituent of YA2 is–L1-L2-Rh.
In certain of these embodiments, L1 is a bond.
In certain embodiments (when one occurrence of Rb substituent of YA2 is–L1-L2- Rh), L2 is a bond.
In certain embodiments (when one occurrence of Rb substituent of YA2 is–L1-L2- Rh), Rh is C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. In certain of these embodiments, Rh is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. As
non-limiting examples of the foregoing embodiments, Rh is selected from:
Figure imgf000046_0001
,
Figure imgf000046_0002
In certain embodiments (when one occurrence of Rb substituent of YA2 is–L1-L2- Rh), Rh is heterocyclyl, wherein the heterocyclyl includes from 3-10 (e.g., 4, 5, 6, 7, 8, 9, or 10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. As a non-limiting example
of the foregoing embodiments, Rh is
Figure imgf000047_0001
.
In certain embodiments (when one occurrence of Rb substituent of YA2 is–L1-L2- Rh), Rh is C6-10 aryl (e.g., C6), which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl (e.g., Rh is unsubstituted phenyl). As non-limiting examples of one or more of the foregoing embodiments, Rb
substituent of YA2 is selected from the group consisting of:
Figure imgf000047_0002
Figure imgf000047_0003
. In certain embodiments (e.g., when YA2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb; or YA2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb), one occurrence of Rb substituent of YA2 is C1-4 haloalkoxy (e.g., OCH2CF3). In certain embodiments, one occurrence of Rb substituent of YA2 is–Cl or–F (e.g., -F).
In certain embodiments, one occurrence of Rb substituent of YA2 is cyano.
In certain embodiments, one occurrence of Rb substituent of YA2 is oxo. In one or more of the foregoing embodiments, each remaining occurrence of Rb is independently selected from the group consisting of–Cl, -F, -Br, cyano, C1-3 alkyl, and C1- 3 haloalkyl.
In certain embodiments, YA2 is
Figure imgf000048_0001
n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
In certain embodiments, each of RcA and
Figure imgf000048_0002
RcB is an independently selected Rc.
In certain embodiments,
Figure imgf000048_0003
each of RcA and RcB is an independently selected Rc.
In certain embodiments,
Figure imgf000048_0004
one of Q1 and Q2 is N; the other one of Q1 and Q2 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc. In certain embodiments, YA2 is one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3, and Q4 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
In certain embodiments, YA2 is ; one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3, and Q4 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
In certain embodiments (when YA2 is or when YA2 is
; or when YA2 is ;or when YA2 is or when YA2
is ; or when YA2 is ), RcA is as defined for Rc in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114)..
In certain embodiments (when YA2 is or when YA2 is
or when YA2 is ;or when YA2 is ; or when YA2 is ; or when YA2 is ), RcA is as defined for Rc in any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118).
In certain embodiments (when YA2 is ; or when YA2 is
; or when YA2 is ;or when YA2 is ; or when
YA2 is ; or when YA2 is ), RcA is as defined for Rc in any one of clauses 119-132 (e.g., 119; e.g., RcA is L1-L2-Rh, wherein Rh is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., RcA is as defined in clause 131 or clause 132).
In certain embodiments (when YA2 is ; or when YA2 is
; or when YA2 is ;or when YA2 is ; or when YA2
is ; or when YA2 is ), n1 is 0. In certain embodiments (when YA2 is ; or when YA2 is
; or when YA2 is ;or when YA2 is ; or when
YA2 is ; or when YA2 is ), n1 is 1 or 2. In certain of these embodiments (when n1 is 1 or 2), each RcB is independently halo or C1-3 alkyl (e.g., halo).
In certain embodiments, YA2 is ; n2 is 0, 1, or 2; and each of RbA and RbB is an independently selected Rb.
In certain embodiments, YA2 is ; n2 is 0, 1, or 2; and each of RbA and RbB is an independently selected Rb.
In certain embodiments, YA2 is ; n2 is 0, 1, or 2; and each of RbA and RbB is an independently selected Rb. In certain embodiments (when YA2 is ; or when YA2 is
; or when YA2 is ), RbA is as defined for Rb in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148).
In certain embodiments (when YA2 is ; or when YA2 is
; or when YA2 is ), RbA is as defined for Rb in any one of clauses 149-158 (e.g., 149; e.g., RbA is–L1-L2-Rh, and Rh is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or RbA is as defined in clause 158).
In certain embodiments (when YA2 is ; or when YA2 is
; or when YA2 is ), RbA is as defined for Rb in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
In certain embodiments (when YA2 is ; or when YA2 is
; or when YA2 is ), n2 is 0. In certain of embodiments, n2 is 1 or 2. In certain of these embodiments, each RbB is independently selected from the group consisting of–Cl, -F, C1-3 alkyl, and C1-3 haloalkyl.
Non-limiting examples of YA2 when YA2 is include: , , , , , , , , , , , , , , and . Non-limiting examples of YA2 when YA2 is include: , , , , , , , , , and . Non-limiting examples of YA2 when YA2 is include: , , , and . Non-limiting examples of YA2 when YA2 is include: , , , , , , , and . Non-limiting examples of YA2 when YA2 is include:
. Non-limiting examples of YA2 when YA2 is include: , and Non-limiting examples of YA2 when YA2 is include: , , , , and .
Non-limiting examples of YA2 also include:
, , , , , , ,
, , , , , , , ,
, , , , , and .
In some embodiments, A is C1-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra. In certain embodiments, A is C2-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra. In certain embodiments, A is unsubstituted C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8,
C9, C10) alkyl (e.g., , , or ). In certain embodiments, A is C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8, C9, C10) alkyl, which is substituted with from 1-6 independently selected Ra. In certain of these embodiments, each Ra is independently selected from the group consisting of halo, -OH, C(=O)OH, C(=O)(C1-3 alkyl), and NReRf. In certain of the foregoing embodiments, each Ra is an independently selected halo (e.g., A is or ). In certain other of the foregoing embodiments, each Ra is independently selected from the group consisting of -OH, C(=O)OH, C(=O)(C1-3 alkyl), and NReRf (e.g., A is
or ).
Non-limiting examples of A include:
, , , , , , , , and . Non-limiting examples of A include:
, , , ,
and , .
Non-limiting examples of A include: , , , , , , and . Non-limiting examples of A include: and .
Non-limiting examples of A also include: , , , , , , and . Further non-limiting examples of A include: and . Further non-limiting examples of A include:
. Further non-limiting examples of A include:
. Embodiments when Q-A is defined according to (B) In some embodiments, Q and A, taken together, form: ; and
E is heterocyclyl including from 3-10 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb. In certain of these embodiments, E is heterocyclyl including from 5-8 ring atoms, wherein aside from the nitrogen atom present, from 0-2 (e.g., 0-1) additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
In certain of these embodiments, E is piperidinyl, pyrrolidinyl, piperazinyl, oxazepanyl, each of which is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb. As non-limiting examples of the foregoing embodiments, E is selected from
the group consisting of: , , , and , each of which is optionally further substituted with one Rb.
In certain embodiments, each Rb substituent of E is independently selected from the group consisting of: C1-10 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl; -F; -Cl; -Br; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-10 alkyl); -C(=O)O(C1-4 alkyl); -S(O)1-2(C1-4 alkyl); cyano; and–L1-L2-Rh.
In certain of these embodiments, one occurrence of Rb substituent of E is C1-10 alkyl optionally substituted with from 1-6 independently selected Ra. In certain of these embodiments, each Ra is selected from the group consisting of–OH, -NReRf, halo, C1-4 aloxy, C1-4 haloalkoxy, and C3-6 cycloalkyl (e.g., cyclopropyl). In certain embodiments, one occurrence of Rb substituent of E is F or Cl (e.g., F).
As a non-limiting example, E is: , , , or . Non-Limiting Combinations
In some embodiments, the compound has the following formula:
or (I-1),
wherein n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl. In some embodiments, the compound has the following formula:
or (I-2),
wherein n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl. In some embodiments, the compound has the following formula:
or (I-3),
wherein n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and and R7 is H or C1-4 alkyl. In some embodiments, the compound has the following formula:
or (I-4), wherein one of Q1 and Q2 is N; the other one of Q1 and Q2 is CH; n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl. In some embodiments, the compound has the following formula:
or (I-5), wherein one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3, Q4 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl.
In some embodiments, the compound has the following formula: or (I-6), wherein one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3, and Q4 is CH; n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl.
In some embodiments, the compound has the following formula:
or (I-7), wherein B1 is selected from the group consisting of: (a) heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc; (b) bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc; and (c) C7-10 bicyclic aryl, which is optionally substituted with from 1-3 Rc; and R7 is H or C1-4 alkyl. In certain embodiments of formula (I-7), B1 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc. In certain embodiments of formula (I-7), B1 is thiazolyl or triazolyl, each of which is optionally substituted with from 1-2 (e.g., 1) independently selected Rc. In certain embodiments of formula (I-7), B1 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc.
As non-limiting examples of the foregoing embodiments, B1 is , ,
, or , each of which is optionally substituted with from 1-2 independently selected Rc.
In certain embodiments of formula (I-7), B1 is C7-10 bicyclic aryl, which is optionally substituted with from 1-3 Rc. As non-limiting examples of the foregoing embodiments, B1 is naphthyl (e.g.,
), indacenyl (e.g., ), or tetrahydronapthyl, each of which is optionally substituted with from 1- 3 Rc)
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), and/or (I-6), RcA is as defined for Rc in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114). In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), and/or (I-6), RcA is as defined for Rc in any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118).
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), and/or (I-6), one occurrence of RcA is as defined for Rc in any one of clauses 119-132 (e.g., 131 or 132) (e.g., 119; e.g., RcA is L1-L2-Rh, wherein Rh is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., RcA is as defined in clause 131 or clause 132). In certain embodiments of formula (I-7), one occurrence of Rc is as defined for Rc in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114). In certain embodiments of formula (I-7), one occurrence of Rc is as defined any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118). In certain embodiments of formula (I-7), one occurrence of Rc is as defined in any one of clauses 119-132 (e.g., 131 or 132) (e.g., 119; e.g., Rc is L1-L2-Rh, wherein Rh is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., Rc is as defined in clause 131 or clause 132). In certain embodiments of formula (I-7), each Rc is as defined in clause 7. In one or more of the foregoing embodiments of formula (I-7), each of the remaining occurrences of Rc is independently halo or C1-3 alkyl.
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), and/or (I-6), n1 is 0. In certain other embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), and/or (I- 6), n1 is 1 or 2. In certain of these embodiments, each occurrence of RcB is independently halo or C1-3 alkyl.
In some embodiments, the compound has the following formula:
or (I-8), wherein n2 is 0, 1, or 2; each of RbA and RbB is an independently selected Rb; and R7 is H or C1-4 alkyl.
In some embodiments, the compound has the following formula: or (I-9), wherein n2 is 0, 1, or 2; each of RbA and RbB is an independently selected Rb; and R7 is H or C1-4 alkyl.
In some embodiments, the compound has the following formula:
or (I-10), wherein n2 is 0, 1, or 2; each of RbA and RbB is an independently selected Rb; and R7 is H or C1-4 alkyl.
In some embodiments, the compound has the following formula:
or (I-11),
67 wherein B2 is selected from the group consisting of: (a) C3-5 monocyclic cycloalkyl which is optionally substituted with from 1-4 Rb; (b) C5-6 (e.g., C5 or C6) bicyclic cycloalkyl which is optionally substituted with from 1-4 Rb;
(c) C7-10 (e.g., bicyclic or tricyclic) cycloalkyl, which is optionally substituted with from 1-4 Rb; and
(d) heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb; and R7 is H or C1-4 alkyl.
In certain embodiments of Formula (I-11), B2 is C3-5 (e.g., C3 or C5) monocyclic cycloalkyl which is optionally substituted with from 1-4 Rb.
In certain embodiments of Formula (I-11), B2 is C5-6 (e.g., C5 or C6) bicyclic
cycloalkyl which is optionally substituted with from 1-4 Rb (e.g., B2 is ). In certain embodiments of Formula (I-11), B2 is C7-10 (e.g., bicyclic or tricyclic) cycloalkyl, which is optionally substituted with from 1-4 Rb. In certain of these embodiments, B2 is is bicyclooctyl (e.g., ),
adamantyl (e.g., ), bicycloheptyl (e.g., ), or bicycloheptenyl (e.g.,
), each of which is further optionally substituted with from 1-3 Rb.
In certain embodiments of Formula (I-11), B2 is heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each
independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb. In certain of these embodiments, B2 is selected from the group consisting of:
pyrrolidinyl (e.g., ), piperidinyl (e.g., ), or tetrahydropyranyl (e.g.,
), or , each of which is further optionally substituted with from 1-3 independently selected Rb. In certain embodiments of formulae (I-8), (I-9), and/or (I-10), RbA is as defined for Rb in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148). In certain embodiments of formulae (I-8), (I-9), and/or (I-10), RbA is as defined for Rb in any one of clauses 149-158 (e.g., 149; e.g., RbA is–L1-L2-Rh, and Rh is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or RbA is as defined in clause 158). In certain embodiments of formulae (I-8), (I-9), and/or (I-10), RbA is as defined for Rb in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161). In certain embodiments of formula (I-11), one occurrence of Rb is as defined in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148). In certain embodiments of formula (I-11), one occurrence of Rb is as defined in any one of clauses 149-158 (e.g., 149; e.g., Rb is–L1-L2-Rh, and Rh is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or Rb is as defined in clause 158). In certain embodiments of formula (I-11), one occurrence of Rb is as defined in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161). In one or more of the foregoing embodiments of formula (I-11), each remaining Rb is independently–F, -Cl, or C1-3 alkyl. In certain embodiments of formulae (I-8), (I-9), and/or (I-10), n2 is 0. In certain other embodiments of formulae (I-8), (I-9), and/or (I-10), n2 is 1 or 2. In certain of these embodiments, each RbB is independently–F, -Cl, or C1-3 alkyl. In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), and/or (I-11), YA1 is a bond (i.e., YA1 is absent (e.g., Formula (I-11): ( or
) is )).
. In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), and/or (I-11), YA1 is C1-6 alkylene, which is optionally substituted with from 1-2 Ra (e.g., YA1 is -CH2-, -CH2CH2-, -CH2CH2CH2-, -CH(CF3)-, -CH2CH(OH)-, or (e.g., CH2)).
In some embodiments, the compound has the following formula:
(I-12), wherein B3 is C1-10 alkyl, which is optionally substituted with from 1-6
independently selected Ra; and R7 is H or C1-4 alkyl.
In certain embodiments of formula (I-12), B3 is unsubstituted C2-10 (e.g., C2, C3,
C4, C5, C6, C7, C8, C9, C10) alkyl (e.g., , , or ).
In certain embodiments of formula (I-12), B3 is C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8, C9, C10) alkyl, which is substituted with from 1-6 independently selected Ra. In certain of these embodiments, each Ra is independently selected from the group consisting of halo, -OH, C(=O)OH, C(=O)(C1-3 alkyl), and NReRf. In certain embodiments of formula (I-12) (when B3 is C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8, C9, C10) alkyl, which is substituted with from 1-6 independently selected Ra ), each Ra is an independently selected halo (e.g., B3 is or ).
In certain embodiments of formula (I-12) (when B3 is C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8, C9, C10) alkyl, which is substituted with from 1-6 independently selected Ra ), each Ra is independently selected from the group consisting of -OH, C(=O)OH,
C(=O)(C1-3 alkyl), and NReRf (e.g., B3 is or ).
In some embodiments, the compound has the following formula:
(I-13),
wherein E is heterocyclyl including from 3-10 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
In certain embodiments of formula (I-13), E is heterocyclyl including from 5-8 ring atoms, wherein aside from the nitrogen atom present, from 0-2 (e.g., 0-1) additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
In certain of these embodiments, E is piperidinyl, pyrrolidinyl, piperazinyl, oxazepanyl, each of which is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
As non-limiting examples of the foregoing embodiments, E is selected from the
group consisting of: , , , and , each of which is optionally further substituted with one Rb.
In certain embodiments of formula (I-13), each Rb substituent of E is as defined in any one of clauses 196-199 (e.g., 196; e.g., 197; e.g., 198; or e.g., 199). In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I-
8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), the moiety is
(e.g., or ).
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I-
8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), the moiety is
(e.g., ).
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I-
8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), the moiety is
(e.g., ). In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I-
8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), the moiety is
(e.g., ). In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I-
8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), the moiety is
(e.g., ). In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), each R1 is as defined in any one of clauses 41-71 (e.g., 41; e.g., 42; e.g., 43; e.g., 44; or e.g., 54 (e.g., wherein Ri is as defined in clauses 58 or 59)).
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), each R1 is as defined in any one of clauses 72-74 (e.g., 72; e.g., 73; or e.g., 74). In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I-
8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), the moiety is
.
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), each R3 is as defined in any one of clauses 75-76 (e.g., each R3 is H) (e.g., 75; or e.g., 76).
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), R5 is H.
In certain other embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I- 7), (I-8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), R5 is halo.
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), R2 is H.
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), R6 is H.
In certain embodiments of formulae (I-1), (I-2), (I-3), (I-4), (I-5), (I-6), (I-7), (I- 8), (I-9), (I-10), (I-11), (I-12), and/or (I-13), R7 is H. The detailed description concludes with a list of 326 numbered clauses, which further describe the compounds, compositions, methods, and other subject matter described herein. For ease of exposition, certain variable definitions refer to one or more specifically numbered clauses. For the avoidance of doubt, use of a phrase, such as“each R3 is as defined in any one of clauses 75-76” is intended to individually, or in combination, the following definitions:
each occurrence of R3 is independently selected from: H; C1-6 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;–OH; -F; -Cl;–NReRf; C1-4 alkoxy; and C1-4 haloalkoxy; or two R3 on the same carbon combine to form an oxo; OR
each occurrence of R3 is independently H, C1-6 alkyl, or C1-4 haloalkyl. In certain embodiments, the compound is selected from the group consisting of the compounds delineated in Table C1 (infra) or a pharmaceutically acceptable salt thereof: Table C1
mpound Structure Compound Structure
Figure imgf000078_0001
Figure imgf000079_0001
Figure imgf000080_0001
Figure imgf000081_0001
Figure imgf000082_0001
Figure imgf000083_0001
Figure imgf000084_0001
Figure imgf000085_0001
Figure imgf000086_0001
Figure imgf000087_0001
Figure imgf000088_0001
Figure imgf000089_0001
Figure imgf000090_0001
Figure imgf000091_0001
Figure imgf000092_0001
Figure imgf000093_0001
Pharmaceutical Compositions and Administration
General
In some embodiments, a chemical entity (e.g., a compound that inhibits (e.g., antagonizes) STING, or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination thereof) is administered as a pharmaceutical composition that includes the chemical entity and one or more pharmaceutically acceptable excipients, and optionally one or more additional therapeutic agents as described herein.
In some embodiments, the chemical entities can be administered in combination with one or more conventional pharmaceutical excipients. Pharmaceutically acceptable excipients include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, self-emulsifying drug delivery systems (SEDDS) such as d-a-tocopherol polyethylene glycol 1000 succinate, surfactants used in pharmaceutical dosage forms such as Tweens, poloxamers or other similar polymeric delivery matrices, serum proteins, such as human serum albumin, buffer substances such as phosphates, tris, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium-chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethyl cellulose, polyacrylates, waxes, polyethylene-polyoxypropylene-block polymers, and wool fat. Cyclodextrins such as a-, ^, and g-cyclodextrin, or chemically modified derivatives such as hydroxyalkylcyclodextrins, including 2- and 3- hydroxypropyl-b-cyclodextrins, or other solubilized derivatives can also be used to enhance delivery of compounds described herein. Dosage forms or compositions containing a chemical entity as described herein in the range of 0.005% to 100% with the balance made up from non-toxic excipient may be prepared. The contemplated compositions may contain 0.001%-100% of a chemical entity provided herein, in one embodiment 0.1-95%, in another embodiment 75-85%, in a further embodiment 20-80%. Actual methods of preparing such dosage forms are known, or will be apparent, to those skilled in this art; for example, see Remington: The Science and Practice of Pharmacy, 22nd Edition (Pharmaceutical Press, London, UK.2012). Routes of Administration and Composition Components
In some embodiments, the chemical entities described herein or a pharmaceutical composition thereof can be administered to subject in need thereof by any accepted route of administration. Acceptable routes of administration include, but are not limited to, buccal, cutaneous, endocervical, endosinusial, endotracheal, enteral, epidural, interstitial, intra-abdominal, intra-arterial, intrabronchial, intrabursal, intracerebral, intracisternal, intracoronary, intradermal, intraductal, intraduodenal, intradural, intraepidermal, intraesophageal, intragastric, intragingival, intraileal, intralymphatic, intramedullary, intrameningeal, intramuscular, intraovarian, intraperitoneal, intraprostatic, intrapulmonary, intrasinal, intraspinal, intrasynovial, intratesticular, intrathecal, intratubular, intratumoral, intrauterine, intravascular, intravenous, nasal, nasogastric, oral, parenteral, percutaneous, peridural, rectal, respiratory (inhalation), subcutaneous, sublingual, submucosal, topical, transdermal, transmucosal, transtracheal, ureteral, urethral and vaginal. In certain embodiments, a preferred route of administration is parenteral (e.g., intratumoral).
Compositions can be formulated for parenteral administration, e.g., formulated for injection via the intravenous, intramuscular, sub-cutaneous, or even intraperitoneal routes. Typically, such compositions can be prepared as injectables, either as liquid solutions or suspensions; solid forms suitable for use to prepare solutions or suspensions upon the addition of a liquid prior to injection can also be prepared; and the preparations can also be emulsified. The preparation of such formulations will be known to those of skill in the art in light of the present disclosure.
The pharmaceutical forms suitable for injectable use include sterile aqueous solutions or dispersions; formulations including sesame oil, peanut oil, or aqueous propylene glycol; and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. In all cases the form must be sterile and must be fluid to the extent that it may be easily injected. It also should be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms, such as bacteria and fungi.
The carrier also can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils. The proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of dispersion, and by the use of surfactants. The prevention of the action of microorganisms can be brought about by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars or sodium chloride. Prolonged absorption of the injectable compositions can be brought about by the use in the compositions of agents delaying absorption, for example, aluminum monostearate and gelatin.
Sterile injectable solutions are prepared by incorporating the active compounds in the required amount in the appropriate solvent with various of the other ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation are vacuum-drying and freeze-drying techniques, which yield a powder of the active ingredient, plus any additional desired ingredient from a previously sterile-filtered solution thereof.
Intratumoral injections are discussed, e.g., in Lammers, et al.,“Effect of Intratumoral Injection on the Biodistribution and the Therapeutic Potential of HPMA Copolymer-Based Drug Delivery Systems” Neoplasia.2006, 10, 788–795. Pharmacologically acceptable excipients usable in the rectal composition as a gel, cream, enema, or rectal suppository, include, without limitation, any one or more of cocoa butter glycerides, synthetic polymers such as polyvinylpyrrolidone, PEG (like PEG ointments), glycerine, glycerinated gelatin, hydrogenated vegetable oils, poloxamers, mixtures of polyethylene glycols of various molecular weights and fatty acid esters of polyethylene glycol Vaseline, anhydrous lanolin, shark liver oil, sodium saccharinate, menthol, sweet almond oil, sorbitol, sodium benzoate, anoxid SBN, vanilla essential oil, aerosol, parabens in phenoxyethanol, sodium methyl p-oxybenzoate, sodium propyl p- oxybenzoate, diethylamine, carbomers, carbopol, methyloxybenzoate, macrogol cetostearyl ether, cocoyl caprylocaprate, isopropyl alcohol, propylene glycol, liquid paraffin, xanthan gum, carboxy-metabisulfite, sodium edetate, sodium benzoate, potassium metabisulfite, grapefruit seed extract, methyl sulfonyl methane (MSM) , lactic acid, glycine, vitamins, such as vitamin A and E and potassium acetate. In certain embodiments, suppositories can be prepared by mixing the chemical entities described herein with suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum and release the active compound. In other embodiments, compositions for rectal administration are in the form of an enema. In other embodiments, the compounds described herein or a pharmaceutical composition thereof are suitable for local delivery to the digestive or GI tract by way of oral administration (e.g., solid or liquid dosage forms.).
Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules. In such solid dosage forms, the chemical entity is mixed with one or more pharmaceutically acceptable excipients, such as sodium citrate or dicalcium phosphate and/or: a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol monostearate, h) absorbents such as kaolin and bentonite clay, and i) lubricants such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof. In the case of capsules, tablets and pills, the dosage form may also comprise buffering agents. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.
In one embodiment, the compositions will take the form of a unit dosage form such as a pill or tablet and thus the composition may contain, along with a chemical entity provided herein, a diluent such as lactose, sucrose, dicalcium phosphate, or the like; a lubricant such as magnesium stearate or the like; and a binder such as starch, gum acacia, polyvinylpyrrolidine, gelatin, cellulose, cellulose derivatives or the like. In another solid dosage form, a powder, marume, solution or suspension (e.g., in propylene carbonate, vegetable oils, PEG’s, poloxamer 124 or triglycerides) is encapsulated in a capsule (gelatin or cellulose base capsule). Unit dosage forms in which one or more chemical entities provided herein or additional active agents are physically separated are also contemplated; e.g., capsules with granules (or tablets in a capsule) of each drug; two-layer tablets; two- compartment gel caps, etc. Enteric coated or delayed release oral dosage forms are also contemplated.
Other physiologically acceptable compounds include wetting agents, emulsifying agents, dispersing agents or preservatives that are particularly useful for preventing the growth or action of microorganisms. Various preservatives are well known and include, for example, phenol and ascorbic acid.
In certain embodiments the excipients are sterile and generally free of undesirable matter. These compositions can be sterilized by conventional, well-known sterilization techniques. For various oral dosage form excipients such as tablets and capsules sterility is not required. The USP/NF standard is usually sufficient.
In certain embodiments, solid oral dosage forms can further include one or more components that chemically and/or structurally predispose the composition for delivery of the chemical entity to the stomach or the lower GI; e.g., the ascending colon and/or transverse colon and/or distal colon and/or small bowel. Exemplary formulation techniques are described in, e.g., Filipski, K.J., et al., Current Topics in Medicinal Chemistry, 2013, 13, 776-802, which is incorporated herein by reference in its entirety.
Examples include upper-GI targeting techniques, e.g., Accordion Pill (Intec Pharma), floating capsules, and materials capable of adhering to mucosal walls.
Other examples include lower-GI targeting techniques. For targeting various regions in the intestinal tract, several enteric/pH-responsive coatings and excipients are available. These materials are typically polymers that are designed to dissolve or erode at specific pH ranges, selected based upon the GI region of desired drug release. These materials also function to protect acid labile drugs from gastric fluid or limit exposure in cases where the active ingredient may be irritating to the upper GI (e.g., hydroxypropyl methylcellulose phthalate series, Coateric (polyvinyl acetate phthalate), cellulose acetate phthalate, hydroxypropyl methylcellulose acetate succinate, Eudragit series (methacrylic acid–methyl methacrylate copolymers), and Marcoat). Other techniques include dosage forms that respond to local flora in the GI tract, Pressure-controlled colon delivery capsule, and Pulsincap.
Ocular compositions can include, without limitation, one or more of any of the following: viscogens (e.g., Carboxymethylcellulose, Glycerin, Polyvinylpyrrolidone, Polyethylene glycol); Stabilizers (e.g., Pluronic (triblock copolymers), Cyclodextrins); Preservatives (e.g., Benzalkonium chloride, ETDA, SofZia (boric acid, propylene glycol, sorbitol, and zinc chloride; Alcon Laboratories, Inc.), Purite (stabilized oxychloro complex; Allergan, Inc.)).
Topical compositions can include ointments and creams. Ointments are semisolid preparations that are typically based on petrolatum or other petroleum derivatives. Creams containing the selected active agent are typically viscous liquid or semisolid emulsions, often either oil-in-water or water-in-oil. Cream bases are typically water-washable, and contain an oil phase, an emulsifier and an aqueous phase. The oil phase, also sometimes called the“internal” phase, is generally comprised of petrolatum and a fatty alcohol such as cetyl or stearyl alcohol; the aqueous phase usually, although not necessarily, exceeds the oil phase in volume, and generally contains a humectant. The emulsifier in a cream formulation is generally a nonionic, anionic, cationic or amphoteric surfactant. As with other carriers or vehicles, an ointment base should be inert, stable, nonirritating and non- sensitizing.
In any of the foregoing embodiments, pharmaceutical compositions described herein can include one or more one or more of the following: lipids, interbilayer crosslinked multilamellar vesicles, biodegradeable poly(D,L-lactic-co-glycolic acid) [PLGA]-based or poly anhydride-based nanoparticles or microparticles, and nanoporous particle-supported lipid bilayers. Dosages
The dosages may be varied depending on the requirement of the patient, the severity of the condition being treating and the particular compound being employed. Determination of the proper dosage for a particular situation can be determined by one skilled in the medical arts. The total daily dosage may be divided and administered in portions throughout the day or by means providing continuous delivery.
In some embodiments, the compounds described herein are administered at a dosage of from about 0.001 mg/Kg to about 500 mg/Kg (e.g., from about 0.001 mg/Kg to about 200 mg/Kg; from about 0.01 mg/Kg to about 200 mg/Kg; from about 0.01 mg/Kg to about 150 mg/Kg; from about 0.01 mg/Kg to about 100 mg/Kg; from about 0.01 mg/Kg to about 50 mg/Kg; from about 0.01 mg/Kg to about 10 mg/Kg; from about 0.01 mg/Kg to about 5 mg/Kg; from about 0.01 mg/Kg to about 1 mg/Kg; from about 0.01 mg/Kg to about 0.5 mg/Kg; from about 0.01 mg/Kg to about 0.1 mg/Kg; from about 0.1 mg/Kg to about 200 mg/Kg; from about 0.1 mg/Kg to about 150 mg/Kg; from about 0.1 mg/Kg to about 100 mg/Kg; from about 0.1 mg/Kg to about 50 mg/Kg; from about 0.1 mg/Kg to about 10 mg/Kg; from about 0.1 mg/Kg to about 5 mg/Kg; from about 0.1 mg/Kg to about 1 mg/Kg; from about 0.1 mg/Kg to about 0.5 mg/Kg). Regimens
The foregoing dosages can be administered on a daily basis (e.g., as a single dose or as two or more divided doses) or non-daily basis (e.g., every other day, every two days, every three days, once weekly, twice weeks, once every two weeks, once a month).
In some embodiments, the period of administration of a compound described herein is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 1 1 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more. In a further embodiment, a period of during which administration is stopped is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more. In an embodiment, a therapeutic compound is administered to an individual for a period of time followed by a separate period of time. In another embodiment, a therapeutic compound is administered for a first period and a second period following the first period, with administration stopped during the second period, followed by a third period where administration of the therapeutic compound is started and then a fourth period following the third period where administration is stopped. In an aspect of this embodiment, the period of administration of a therapeutic compound followed by a period where administration is stopped is repeated for a determined or undetermined period of time. In a further embodiment, a period of administration is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more. In a further embodiment, a period of during which administration is stopped is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more. Methods of Treatment
In some embodiments, methods for treating a subject having condition, disease or disorder in which increased (e.g., excessive)STING activity (e.g., , e.g., STING signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder (e.g., immune disorders, cancer) are provided. Indications
In some embodiments, the condition, disease or disorder is cancer. Non-limiting examples of cancer include melanoma, carcinoma, lymphoma, blastoma, sarcoma, and leukemia or lymphoid malignancies. More particular examples of such cancers include breast cancer, colon cancer, rectal cancer, colorectal cancer, kidney or renal cancer, clear cell cancer lung cancer including small-cell lung cancer, non- small cell lung cancer, adenocarcinoma of the lung and squamous carcinoma of the lung, squamous cell cancer (e.g. epithelial squamous cell cancer), cervical cancer, ovarian cancer, prostate cancer, prostatic neoplasms, liver cancer, bladder cancer, cancer of the peritoneum, hepatocellular cancer, gastric or stomach cancer including gastrointestinal cancer, gastrointestinal stromal tumor, pancreatic cancer, head and neck cancer, glioblastoma, retinoblastoma, astrocytoma, thecomas, arrhenoblastomas, hepatoma, hematologic malignancies including non-Hodgkins lymphoma (NHL), multiple myeloma, myelodysplasia disorders, myeloproliferative disorders, chronic myelogenous leukemia, and acute hematologic malignancies, endometrial or uterine carcinoma, endometriosis, endometrial stromal sarcoma, fibrosarcomas, choriocarcinoma, salivary gland carcinoma, vulval cancer, thyroid cancer, esophageal carcinomas, hepatic carcinoma, anal carcinoma, penile carcinoma, nasopharyngeal carcinoma, laryngeal carcinomas, Kaposi's sarcoma, mast cell sarcoma, ovarian sarcoma, uterine sarcoma, melanoma, malignant mesothelioma, skin carcinomas, Schwannoma, oligodendroglioma, neuroblastomas, neuroectodermal tumor, rhabdomyosarcoma, osteogenic sarcoma, leiomyosarcomas, Ewing Sarcoma, peripheral primitive neuroectodermal tumor, urinary tract carcinomas, thyroid carcinomas, Wilm's tumor, as well as abnormal vascular proliferation associated with phakomatoses, edema (such as that associated with brain tumors), and Meigs' syndrome. In some cases, the cancer is melanoma.
In some embodiments, the condition, disease or disorder is a neurological disorder, which includes disorders that involve the central nervous system (brain, brainstem and cerebellum), the peripheral nervous system (including cranial nerves), and the autonomic nervous system (parts of which are located in both central and peripheral nervous system). Non-limiting examples of cancer include acquired epileptiform aphasia; acute disseminated encephalomyelitis; adrenoleukodystrophy; age-related macular degeneration; agenesis of the corpus callosum; agnosia; Aicardi syndrome; Alexander disease; Alpers' disease; alternating hemiplegia; Alzheimer's disease; Vascular dementia; amyotrophic lateral sclerosis; anencephaly; Angelman syndrome; angiomatosis; anoxia; aphasia; apraxia; arachnoid cysts; arachnoiditis; Anronl-Chiari malformation; arteriovenous malformation; Asperger syndrome; ataxia telegiectasia; attention deficit hyperactivity disorder; autism; autonomic dysfunction; back pain; Batten disease; Behcet's disease; Bell's palsy; benign essential blepharospasm; benign focal; amyotrophy; benign intracranial hypertension; Binswanger's disease; blepharospasm; Bloch Sulzberger syndrome; brachial plexus injury; brain abscess; brain injury; brain tumors (including glioblastoma multiforme); spinal tumor; Brown-Sequard syndrome; Canavan disease; carpal tunnel syndrome; causalgia; central pain syndrome; central pontine myelinolysis; cephalic disorder; cerebral aneurysm; cerebral arteriosclerosis; cerebral atrophy; cerebral gigantism; cerebral palsy; Charcot-Marie-Tooth disease; chemotherapy-induced neuropathy and neuropathic pain; Chiari malformation; chorea; chronic inflammatory demyelinating polyneuropathy; chronic pain; chronic regional pain syndrome; Coffin Lowry syndrome; coma, including persistent vegetative state; congenital facial diplegia; corticobasal degeneration; cranial arteritis; craniosynostosis; Creutzfeldt-Jakob disease; cumulative trauma disorders; Cushing's syndrome; cytomegalic inclusion body disease; cytomegalovirus infection; dancing eyes-dancing feet syndrome; Dandy-Walker syndrome; Dawson disease; De Morsier's syndrome; Dejerine-Klumke palsy; dementia; dermatomyositis; diabetic neuropathy; diffuse sclerosis; dysautonomia; dysgraphia; dyslexia; dystonias; early infantile epileptic encephalopathy; empty sella syndrome; encephalitis; encephaloceles; encephalotrigeminal angiomatosis; epilepsy; Erb's palsy; essential tremor; Fabry's disease; Fahr's syndrome; fainting; familial spastic paralysis; febrile seizures; Fisher syndrome; Friedreich's ataxia; fronto-temporal dementia and other “tauopathies”; Gaucher's disease; Gerstmann's syndrome; giant cell arteritis; giant cell inclusion disease; globoid cell leukodystrophy; Guillain-Barre syndrome; HTLV-1- associated myelopathy; Hallervorden-Spatz disease; head injury; headache; hemifacial spasm; hereditary spastic paraplegia; heredopathia atactica polyneuritiformis; herpes zoster oticus; herpes zoster; Hirayama syndrome; HIV-associated dementia and neuropathy (also neurological manifestations of AIDS); holoprosencephaly; Huntington's disease and other polyglutamine repeat diseases; hydranencephaly; hydrocephalus; hypercortisolism; hypoxia; immune-mediated encephalomyelitis; inclusion body myositis; incontinentia pigmenti; infantile phytanic acid storage disease; infantile refsum disease; infantile spasms; inflammatory myopathy; intracranial cyst; intracranial hypertension; Joubert syndrome; Kearns-Sayre syndrome; Kennedy disease Kinsbourne syndrome; Klippel Feil syndrome; Krabbe disease; Kugelberg-Welander disease; kuru; Lafora disease; Lambert-Eaton myasthenic syndrome; Landau-Kleffner syndrome; lateral medullary (Wallenberg) syndrome; learning disabilities; Leigh's disease; Lennox-Gustaut syndrome; Lesch-Nyhan syndrome; leukodystrophy; Lewy body dementia; Lissencephaly; locked-in syndrome; Lou Gehrig's disease (i.e., motor neuron disease or amyotrophic lateral sclerosis); lumbar disc disease; Lyme disease—neurological sequelae; Machado-Joseph disease; macrencephaly; megalencephaly; Melkersson-Rosenthal syndrome; Menieres disease; meningitis; Menkes disease; metachromatic leukodystrophy; microcephaly; migraine; Miller Fisher syndrome; mini-strokes; mitochondrial myopathies; Mobius syndrome; monomelic amyotrophy; motor neuron disease; Moyamoya disease; mucopolysaccharidoses; milti-infarct dementia; multifocal motor neuropathy; multiple sclerosis and other demyelinating disorders; multiple system atrophy with postural hypotension; p muscular dystrophy; myasthenia gravis; myelinoclastic diffuse sclerosis; myoclonic encephalopathy of infants; myoclonus; myopathy; myotonia congenital; narcolepsy; neurofibromatosis; neuroleptic malignant syndrome; neurological manifestations of AIDS; neurological sequelae of lupus; neuromyotonia; neuronal ceroid lipofuscinosis; neuronal migration disorders; Niemann-Pick disease; O'Sullivan-McLeod syndrome; occipital neuralgia; occult spinal dysraphism sequence; Ohtahara syndrome; olivopontocerebellar atrophy; opsoclonus myoclonus; optic neuritis; orthostatic hypotension; overuse syndrome; paresthesia; Parkinson's disease; paramyotonia congenital; paraneoplastic diseases; paroxysmal attacks; Parry Romberg syndrome; Pelizaeus-Merzbacher disease; periodic paralyses; peripheral neuropathy; painful neuropathy and neuropathic pain; persistent vegetative state; pervasive developmental disorders; photic sneeze reflex; phytanic acid storage disease; Pick's disease; pinched nerve; pituitary tumors; polymyositis; porencephaly; post-polio syndrome; postherpetic neuralgia; postinfectious encephalomyelitis; postural hypotension; Prader-Willi syndrome; primary lateral sclerosis; prion diseases; progressive hemifacial atrophy; progressive multifocal leukoencephalopathy; progressive sclerosing poliodystrophy; progressive supranuclear palsy; pseudotumor cerebri; Ramsay-Hunt syndrome (types I and II); Rasmussen's encephalitis; reflex sympathetic dystrophy syndrome; Refsum disease; repetitive motion disorders; repetitive stress injuries; restless legs syndrome; retrovirus- associated myelopathy; Rett syndrome; Reye's syndrome; Saint Vitus dance; Sandhoff disease; Schilder's disease; schizencephaly; septo-optic dysplasia; shaken baby syndrome; shingles; Shy-Drager syndrome; Sjögren's syndrome; sleep apnea; Soto's syndrome; spasticity; spina bifida; spinal cord injury; spinal cord tumors; spinal muscular atrophy; Stiff-Person syndrome; stroke; Sturge-Weber syndrome; subacute sclerosing panencephalitis; subcortical arteriosclerotic encephalopathy; Sydenham chorea; syncope; syringomyelia; tardive dyskinesia; Tay-Sachs disease; temporal arteritis; tethered spinal cord syndrome; Thomsen disease; thoracic outlet syndrome; Tic Douloureux; Todd's paralysis; Tourette syndrome; transient ischemic attack; transmissible spongiform encephalopathies; transverse myelitis; traumatic brain injury; tremor; trigeminal neuralgia; tropical spastic paraparesis; tuberous sclerosis; vascular dementia (multi-infarct dementia); vasculitis including temporal arteritis; Von Hippel-Lindau disease; Wallenberg's syndrome; Werdnig-Hoffman disease; West syndrome; whiplash; Williams syndrome; Wildon's disease; amyotrophe lateral sclerosis and Zellweger syndrome.
In some embodiments, the condition, disease or disorder is STING-associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutières Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis. In certain embodiments, the condition, disease or disorder is an autoimmune disease (e.g., a cytosolic DNA-triggered autoinflammatory disease). Non-limiting examples include rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, inflammatory bowel diseases (IBDs) comprising Crohn disease (CD) and ulcerative colitis (UC), which are chronic inflammatory conditions with polygenic susceptibility. In certain embodiments, the condition is an inflammatory bowel disease. In certain embodiments, the condition is Crohn’s disease, autoimmune colitis, iatrogenic autoimmune colitis, ulcerative colitis, colitis induced by one or more chemotherapeutic agents, colitis induced by treatment with adoptive cell therapy, colitis associated by one or more alloimmune diseases (such as graft-vs-host disease, e.g., acute graft vs. host disease and chronic graft vs. host disease), radiation enteritis, collagenous colitis, lymphocytic colitis, microscopic colitis, and radiation enteritis. In certain of these embodiments, the condition is alloimmune disease (such as graft-vs-host disease, e.g., acute graft vs. host disease and chronic graft vs. host disease), celiac disease, irritable bowel syndrome, rheumatoid arthritis, lupus, scleroderma, psoriasis, cutaneous T-cell lymphoma, uveitis, and mucositis (e.g., oral mucositis, esophageal mucositis or intestinal mucositis).
In some embodiments, modulation of the immune system by STING provides for the treatment of diseases, including diseases caused by foreign agents. Exemplary infections by foreign agents which may be treated and/or prevented by the method of the present invention include an infection by a bacterium (e.g., a Gram-positive or Gram- negative bacterium), an infection by a fungus, an infection by a parasite, and an infection by a virus. In one embodiment of the present invention, the infection is a bacterial infection (e.g., infection by E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella spp., Staphylococcus aureus, Streptococcus spp., or vancomycin-resistant enterococcus), or sepsis. In another embodiment, the infection is a fungal infection (e.g. infection by a mould, a yeast, or a higher fungus). In still another embodiment, the infection is a parasitic infection (e.g., infection by a single-celled or multicellular parasite, including Giardia duodenalis, Cryptosporidium parvum, Cyclospora cayetanensis, and Toxoplasma gondiz). In yet another embodiment, the infection is a viral infection (e.g., infection by a virus associated with AIDS, avian flu, chickenpox, cold sores, common cold, gastroenteritis, glandular fever, influenza, measles, mumps, pharyngitis, pneumonia, rubella, SARS, and lower or upper respiratory tract infection (e.g., respiratory syncytial virus)).
In some embodiments, the condition, disease or disorder is hepatits B (see, e.g., WO 2015/061294).
In some embodiments, the condition, disease or disorder is selected from cardiovascular diseases (including e.g., myocardial infarction).
In some embodiemnts, the condition, disease or disorder is age-related macular degeneration.
In some embodiments, the condition, disease or disorder is mucositis, also known as stomatitits, which can occur as a result of chemotherapy or radiation therapy, either alone or in combination as well as damage caused by exposure to radiation outside of the context of radiation therapy.
In some embodiments, the condition, disease or disorder is uveitis, which is inflammation of the uvea (e.g., anterior uveitis, e.g., iridocyclitis or iritis; intermediate uveitis (also known as pars planitis); posterior uveitis; or chorioretinitis, e.g., pan-uveitis).
In some embodiments, the condition, disease or disorder is selected from the group consisting of a cancer, a neurological disorder, an autoimmune disease, hepatitis B, uvetitis, a cardiovascular disease, age-related macular degeneration, and mucositis.
Still other examples can include those indications discussed herein and below in contemplated combination therapy regimens. Combination therapy
This disclosure contemplates both monotherapy regimens as well as combination therapy regimens.
In some embodiments, the methods described herein can further include administering one or more additional therapies (e.g., one or more additional therapeutic agents and/or one or more therapeutic regimens) in combination with administration of the compounds described herein.
In certain embodiments, the methods described herein can further include administering one or more additional cancer therapies.
The one or more additional cancer therapies can include, without limitation, surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy, cancer vaccines (e.g., HPV vaccine, hepatitis B vaccine, Oncophage, Provenge) and gene therapy, as well as combinations thereof. Immunotherapy, including, without limitation, adoptive cell therapy, the derivation of stem cells and/or dendritic cells, blood transfusions, lavages, and/or other treatments, including, without limitation, freezing a tumor. In some embodiments, the one or more additional cancer therapies is chemotherapy, which can include administering one or more additional chemotherapeutic agents.
In certain embodiments, the additional chemotherapeutic agent is an immunomodulatory moiety, e.g., an immune checkpoint inhibitor. In certain of these embodiments, the immune checkpoint inhibitor targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1– PD-L1, PD-1– PD- L2, interleukin‑2 (IL‑2), indoleamine 2,3-dioxygenase (IDO), IL‑10, transforming growth factor-b (TGFb), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9– TIM3, Phosphatidylserine– TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II– LAG3, 4‑1BB–4‑1BB ligand, OX40–OX40 ligand, GITR, GITR ligand– GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25–TL1A, CD40L, CD40–CD40 ligand, HVEM–LIGHT–LTA, HVEM, HVEM– BTLA, HVEM– CD160, HVEM– LIGHT, HVEM–BTLA–CD160, CD80, CD80– PDL-1, PDL2– CD80, CD244, CD48– CD244, CD244, ICOS, ICOS–ICOS ligand, B7‑H3, B7‑H4, VISTA, TMIGD2, HHLA2– TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86– CD28, CD86– CTLA, CD80– CD28, CD39, CD73 Adenosine–CD39–CD73, CXCR4–CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine– TIM3, SIRPA–CD47, VEGF, Neuropilin, CD160, CD30, and CD155; e.g., CTLA-4 or PD1 or PD-L1). See, e.g., Postow, M. J. Clin. Oncol.2015, 33, 1.
In certain of these embodiments, the immune checkpoint inhibitor is selected from the group consisting of: Urelumab, PF‑05082566, MEDI6469, TRX518, Varlilumab, CP‑870893, Pembrolizumab (PD1), Nivolumab (PD1), Atezolizumab (formerly MPDL3280A) (PDL1), MEDI4736 (PD-L1), Avelumab (PD-L1), PDR001 (PD1), BMS‑986016, MGA271, Lirilumab, IPH2201, Emactuzumab, INCB024360, Galunisertib, Ulocuplumab, BKT140, Bavituximab, CC‑90002, Bevacizumab, and MNRP1685A, and MGA271. In certain embodiments, the additional chemotherapeutic agent is an alkylating agent. Alkylating agents are so named because of their ability to alkylate many nucleophilic functional groups under conditions present in cells, including, but not limited to cancer cells. In a further embodiment, an alkylating agent includes, but is not limited to, Cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin. In an embodiment, alkylating agents can function by impairing cell function by forming covalent bonds with the amino, carboxyl, sulfhydryl, and phosphate groups in biologically important molecules or they can work by modifying a cell's DNA. In a further embodiment an alkylating agent is a synthetic, semisynthetic or derivative.
In certain embodiments, the additional chemotherapeutic agent is an anti- metabolite. Anti-metabolites masquerade as purines or pyrimidines, the building-blocks of DNA and in general, prevent these substances from becoming incorporated in to DNA during the "S" phase (of the cell cycle), stopping normal development and division. Anti- metabolites can also affect RNA synthesis. In an embodiment, an antimetabolite includes, but is not limited to azathioprine and/or mercaptopurine. In a further embodiment an anti- metabolite is a synthetic, semisynthetic or derivative.
In certain embodiments, the additional chemotherapeutic agent is a plant alkaloid and/or terpenoid. These alkaloids are derived from plants and block cell division by, in general, preventing microtubule function. In an embodiment, a plant alkaloid and/or terpenoid is a vinca alkaloid, a podophyllotoxin and/or a taxane. Vinca alkaloids, in general, bind to specific sites on tubulin, inhibiting the assembly of tubulin into microtubules, generally during the M phase of the cell cycle. In an embodiment, a vinca alkaloid is derived, without limitation, from the Madagascar periwinkle, Catharanthus roseus (formerly known as Vinca rosea). In an embodiment, a vinca alkaloid includes, without limitation, Vincristine, Vinblastine, Vinorelbine and/or Vindesine. In an embodiment, a taxane includes, but is not limited, to Taxol, Paclitaxel and/or Docetaxel. In a further embodiment a plant alkaloid or terpernoid is a synthetic, semisynthetic or derivative. In a further embodiment, a podophyllotoxin is, without limitation, an etoposide and/or teniposide. In an embodiment, a taxane is, without limitation, docetaxel and/or ortataxel. [021] In an embodiment, a cancer therapeutic is a topoisomerase. Topoisomerases are essential enzymes that maintain the topology of DNA. Inhibition of type I or type II topoisomerases interferes with both transcription and replication of DNA by upsetting proper DNA supercoiling. In a further embodiment, a topoisomerase is, without limitation, a type I topoisomerase inhibitor or a type II topoisomerase inhibitor. In an embodiment a type I topoisomerase inhibitor is, without limitation, a camptothecin. In another embodiment, a camptothecin is, without limitation, exatecan, irinotecan, lurtotecan, topotecan, BNP 1350, CKD 602, DB 67 (AR67) and/or ST 1481. In an embodiment, a type II topoisomerase inhibitor is, without limitation, epipodophyllotoxin. In a further embodiment an epipodophyllotoxin is, without limitation, an amsacrine, etoposid, etoposide phosphate and/or teniposide. In a further embodiment a topoisomerase is a synthetic, semisynthetic or derivative, including those found in nature such as, without limitation, epipodophyllotoxins, substances naturally occurring in the root of American Mayapple (Podophyllum peltatum). In certain embodiments, the additional chemotherapeutic agent is a stilbenoid. In a further embodiment, a stilbenoid includes, but is not limited to, Resveratrol, Piceatannol, Pinosylvin, Pterostilbene, Alpha-Viniferin, Ampelopsin A, Ampelopsin E, Diptoindonesin C, Diptoindonesin F, Epsilon- Vinferin, Flexuosol A, Gnetin H, Hemsleyanol D, Hopeaphenol, Trans-Diptoindonesin B, Astringin, Piceid and Diptoindonesin A. In a further embodiment a stilbenoid is a synthetic, semisynthetic or derivative.
In certain embodiments, the additional chemotherapeutic agent is a cytotoxic antibiotic. In an embodiment, a cytotoxic antibiotic is, without limitation, an actinomycin, an anthracenedione, an anthracycline, thalidomide, dichloroacetic acid, nicotinic acid, 2- deoxyglucose and/or chlofazimine. In an embodiment, an actinomycin is, without limitation, actinomycin D, bacitracin, colistin (polymyxin E) and/or polymyxin B. In another embodiment, an antracenedione is, without limitation, mitoxantrone and/or pixantrone. In a further embodiment, an anthracycline is, without limitation, bleomycin, doxorubicin (Adriamycin), daunorubicin (daunomycin), epirubicin, idarubicin, mitomycin, plicamycin and/or valrubicin. In a further embodiment a cytotoxic antibiotic is a synthetic, semisynthetic or derivative. In certain embodiments, the additional chemotherapeutic agent is selected from endostatin, angiogenin, angiostatin, chemokines, angioarrestin, angiostatin (plasminogen fragment), basement-membrane collagen-derived anti-angiogenic factors (tumstatin, canstatin, or arrestin), anti-angiogenic antithrombin III, signal transduction inhibitors, cartilage-derived inhibitor (CDI), CD59 complement fragment, fibronectin fragment, gro- beta, heparinases, heparin hexasaccharide fragment, human chorionic gonadotropin (hCG), interferon alpha/beta/gamma, interferon inducible protein (IP-10), interleukin-12, kringle 5 (plasminogen fragment), metalloproteinase inhibitors (TIMPs), 2-methoxyestradiol, placental ribonuclease inhibitor, plasminogen activator inhibitor, platelet factor-4 (PF4), prolactin 16 kD fragment, proliferin-related protein (PRP), various retinoids, tetrahydrocortisol-S, thrombospondin-1 (TSP-1), transforming growth factor-beta (TGF- b), vasculostatin, vasostatin (calreticulin fragment) and the like.
In certain embodiments, the additional chemotherapeutic agent is selected from abiraterone acetate, altretamine, anhydrovinblastine, auristatin, bexarotene, bicalutamide, BMS 184476, 2,3,4,5,6-pentafluoro-N-(3-fluoro-4-methoxyphenyl)benzene sulfonamide, bleomycin, N,N-dimethyl-L-valyl-L-valyl-N-methyl-L-valyl-L-proly-1-Lproline-t- butylamide, cachectin, cemadotin, chlorambucil, cyclophosphamide, 3 ,4 -didehydro-4 - deoxy-8 -norvin-caleukoblastine, docetaxol, doxetaxel, cyclophosphamide, carboplatin, carmustine, cisplatin, cryptophycin, cyclophosphamide, cytarabine, dacarbazine (DTIC), dactinomycin, daunorubicin, decitabine dolastatin, doxorubicin (adriamycin), etoposide, 5- fluorouracil, finasteride, flutamide, hydroxyurea and hydroxyureataxanes, ifosfamide, liarozole, lonidamine, lomustine (CCNU), MDV3100, mechlorethamine (nitrogen mustard), melphalan, mivobulin isethionate, rhizoxin, sertenef, streptozocin, mitomycin, methotrexate, taxanes, nilutamide, onapristone, paclitaxel, prednimustine, procarbazine, RPR109881, stramustine phosphate, tamoxifen, tasonermin, taxol, tretinoin, vinblastine, vincristine, vindesine sulfate, and vinflunine.
In certain embodiments, the additional chemotherapeutic agent is platinum, cisplatin, carboplatin, oxaliplatin, mechlorethamine, cyclophosphamide, chlorambucil, azathioprine, mercaptopurine, vincristine, vinblastine, vinorelbine, vindesine, etoposide and teniposide, paclitaxel, docetaxel, irinotecan, topotecan, amsacrine, etoposide, etoposide phosphate, teniposide, 5-fluorouracil, leucovorin, methotrexate, gemcitabine, taxane, leucovorin, mitomycin C, tegafur-uracil, idarubicin, fludarabine, mitoxantrone, ifosfamide and doxorubicin. Additional agents include inhibitors of mTOR (mammalian target of rapamycin), including but not limited to rapamycin, everolimus, temsirolimus and deforolimus.
In still other embodiments, the additional chemotherapeutic agent can be selected from those delineated in U.S. Patent 7,927,613, which is incorporated herein by reference in its entirety.
In some embodiments, the additional therapeutic agent and/or regimen are those that can be used for treating other STING-associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutières Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis and the like.
Non-limiting examples of additional therapeutic agents and/or regimens for treating rheumatoid arthritis include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), disease-modifying antirheumatic drugs (DMARDs; e.g., methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), leflunomide (Arava®), hydroxychloroquine (Plaquenil), PF-06650833, iguratimod, tofacitinib (Xeljanz®), ABBV-599, evobrutinib, and sulfasalazine (Azulfidine®)), and biologics (e.g., abatacept (Orencia®), adalimumab (Humira®), anakinra (Kineret®), certolizumab (Cimzia®), etanercept (Enbrel®), golimumab (Simponi®), infliximab (Remicade®), rituximab (Rituxan®), tocilizumab (Actemra®), vobarilizumab, sarilumab (Kevzara®), secukinumab, ABP 501, CHS-0214, ABC-3373, and tocilizumab (ACTEMRA®)).
Non-limiting examples of additional therapeutic agents and/or regimens for treating lupus include steroids, topical immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), thalidomide (Thalomid®), non-steroidal anti- inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., evobrutinib, iberdomide, voclosporin, cenerimod, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and mycophenolate mofetil) baricitinb, iguratimod, filogotinib, GS-9876, rapamycin, and PF-06650833), and biologics (e.g., belimumab (Benlysta®), anifrolumab, prezalumab, MEDI0700, obinutuzumab, vobarilizumab, lulizumab, atacicept, PF-06823859, and lupizor, rituximab, BT063, BI655064, BIIB059, aldesleukin (Proleukin®), dapirolizumab, edratide, IFN-a-kinoid, OMS721, RC18, RSLV- 132, theralizumab, XmAb5871, and ustekinumab (Stelara®)). For example, non-limiting treatments for systemic lupus erythematosus include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., iberdomide, voclosporin, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and mycophenolate mofetil, baricitinb, filogotinib, and PF-06650833), and biologics (e.g., belimumab (Benlysta®), anifrolumab, prezalumab, MEDI0700, vobarilizumab, lulizumab, atacicept, PF-06823859, lupizor, rituximab, BT063, BI655064, BIIB059, aldesleukin (Proleukin®), dapirolizumab, edratide, IFN-a-kinoid, RC18, RSLV-132, theralizumab, XmAb5871, and ustekinumab (Stelara®)). As another example, non-limiting examples of treatments for cutaneous lupus include steroids, immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), GS-9876, filogotinib, and thalidomide (Thalomid®). Agents and regimens for treating drug-induced and/or neonatal lupus can also be administered.
Non-limiting examples of additional therapeutic agents and/or regimens for treating STING-associated vasculopathy with onset in infancy (SAVI) include JAK inhibitors (e.g., tofacitinib, ruxolitinib, filgotinib, and baricitinib).
Non-limiting examples of additional therapeutic agents and/or regimens for treating Aicardi-Goutières Syndrome (AGS) include physiotherapy, treatment for respiratory complications, anticonvulsant therapies for seizures, tube-feeding, nucleoside reverse transcriptase inhibitors (e.g., emtricitabine (e.g., Emtriva®), tenofovir (e.g., Viread®), emtricitabine/tenofovir (e.g., Truvada®), zidovudine, lamivudine, and abacavir), and JAK inhibitors (e.g., tofacitinib, ruxolitinib, filgotinib, and baricitinib).
Non-limiting examples of additional therapeutic agents and/or regimens for treating IBDs include 6-mercaptopurine, AbGn-168H, ABX464, ABT-494, adalimumab, AJM300, alicaforsen, AMG139, anrukinzumab, apremilast, ATR-107 (PF0530900), autologous CD34-selected peripheral blood stem cells transplant, azathioprine, bertilimumab, BI 655066, BMS-936557, certolizumab pegol (Cimzia®), cobitolimod, corticosteroids (e.g., prednisone, Methylprednisolone, prednisone), CP-690,550, CT-P13, cyclosporine, DIMS0150, E6007, E6011, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, fingolimod, firategrast (SB-683699) (formerly T-0047), GED0301, GLPG0634, GLPG0974, guselkumab, golimumab, GSK1399686, HMPL-004 (Andrographis paniculata extract), IMU-838, infliximab, Interleukin 2 (IL-2), Janus kinase (JAK) inhibitors, laquinimod, masitinib (AB1010), matrix metalloproteinase 9 (MMP 9) inhibitors (e.g., GS-5745), MEDI2070, mesalamine, methotrexate, mirikizumab (LY3074828), natalizumab, NNC 0142-0000-0002, NNC0114-0006, ozanimod, peficitinib (JNJ-54781532), PF-00547659, PF-04236921, PF-06687234, QAX576, RHB- 104, rifaximin, risankizumab, RPC1063, SB012, SHP647, sulfasalazine, TD-1473, thalidomide, tildrakizumab (MK 3222), TJ301, TNF-Kinoid®, tofacitinib, tralokinumab, TRK-170, upadacitinib, ustekinumab, UTTR1147A, V565, vatelizumab, VB-201, vedolizumab, and vidofludimus.
Non-limiting examples of additional therapeutic agents and/or regimens for treating irritable bowel syndrome include alosetron, bile acid sequesterants (e.g., cholestyramine, colestipol, colesevelam), chloride channel activators (e.g., lubiprostone), coated peppermint oil capsules, desipramine, dicyclomine, ebastine, eluxadoline, farnesoid X receptor agonist (e.g., obeticholic acid), fecal microbiota transplantation, fluoxetine, gabapentin, guanylate cyclase-C agonists (e.g., linaclotide, plecanatide), ibodutant, imipramine, JCM-16021, loperamide, lubiprostone, nortriptyline, ondansetron, opioids, paroxetine, pinaverium, polyethylene glycol, pregabalin, probiotics, ramosetron, rifaximin, and tanpanor.
Non-limiting examples of additional therapeutic agents and/or regimens for treating scleroderma include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), immunomodulators (e.g., azathioprine, methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), antithymocyte globulin, mycophenolate mofetil, intravenous immunoglobulin, rituximab, sirolimus, and alefacept), calcium channel blockers (e.g., nifedipine), alpha blockers, serotonin receptor antagonists, angiotensin II receptor inhibitors, statins, local nitrates, iloprost, phosphodiesterase 5 inhibitors (e.g., sildenafil), bosentan, tetracycline antibiotics, endothelin receptor antagonists, prostanoids, and tyrosine kinase inhibitors (e.g., imatinib, nilotinib and dasatinib).
Non-limiting examples of additional therapeutic agents and/or regimens for treating Crohn’s Disease (CD) include adalimumab, autologous CD34-selected peripheral blood stem cells transplant, 6-mercaptopurine, azathioprine, certolizumab pegol (Cimzia®), corticosteroids (e.g., prednisone), etrolizumab, E6011, fecal microbial transplantation, figlotinib, guselkumab, infliximab, IL-2, JAK inhibitors, matrix metalloproteinase 9 (MMP 9) inhibitors (e.g., GS-5745), MEDI2070, mesalamine, methotrexate, natalizumab, ozanimod, RHB-104, rifaximin, risankizumab, SHP647, sulfasalazine, thalidomide, upadacitinib, V565, and vedolizumab. Non-limiting examples of additional therapeutic agents and/or regimens for treating UC include AbGn-168H, ABT-494, ABX464, apremilast, PF-00547659, PF-06687234, 6- mercaptopurine, adalimumab, azathioprine, bertilimumab, brazikumab (MEDI2070), cobitolimod, certolizumab pegol (Cimzia®), CP-690,550, corticosteroids (e.g., multimax budesonide, Methylprednisolone), cyclosporine, E6007, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, guselkumab, golimumab, IL-2, IMU-838, infliximab, matrix metalloproteinase 9 (MMP9) inhibitors (e.g., GS-5745), mesalamine, mesalamine, mirikizumab (LY3074828), RPC1063, risankizumab (BI 6555066), SHP647, sulfasalazine, TD-1473, TJ301, tildrakizumab (MK 3222), tofacitinib, tofacitinib, ustekinumab, UTTR1147A, and vedolizumab.
Non-limiting examples of additional therapeutic agents and/or regimens for treating autoimmune colitis include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
Non-limiting examples of additional therapeutic agents and/or regimens for treating iatrogenic autoimmune colitis include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
Non-limiting examples of additional therapeutic agents and/or regimens for treating colitis induced by one or more chemotherapeutics agents include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No.2012/0202848), and vedolizumab.
Non-limiting examples of additional therapeutic agents and/or regimens for treating colitis induced by treatment with adoptive cell therapy include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No.2012/0202848), and vedolizumab. Non-limiting examples of additional therapeutic agents and/or regimens for treating colitis associated with one or more alloimmune diseases include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), sulfasalazine, and eicopentaenoic acid.
Non-limiting examples of additional therapeutic agents and/or regimens for treating radaiation enteritis include teduglutide, amifostine, angiotensin-converting enzyme (ACE) inhibitors (e.g., benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril), probiotics, selenium supplementation, statins (e.g., atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin), sucralfate, and vitamin E.
Non-limiting examples of additional therapeutic agents and/or regimens for treating collagenous colitis include 6-mercaptopurine, azathaioprine, bismuth subsalicate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
Non-limiting examples of additional therapeutic agents and/or regimens for treating lyphocytic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, and sulfasalazine.
Non-limiting examples of additional therapeutic agents and/or regimens for treating microscopic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), fecal microbial transplantation, loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
Non-limiting examples of additional therapeutic agents and/or regimens for treating alloimmune disease include intrauterine platelet transfusions, intravenous immunoglobin, maternal steroids, abatacept, alemtuzumab, alpha1-antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, pevonedistat, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib.
Non-limiting examples of additional therapeutic agents and/or regimens for treating multiple sclerosis (MS) include alemtuzumab (Lemtrada®), ALKS 8700, amiloride, ATX- MS-1467, azathioprine, baclofen (Lioresal®), beta interferons (e.g., IFN-b-1a, IFN-b-1b), cladribine, corticosteroids (e.g., methylprednisolone), daclizumab, dimethyl fumarate (Tecfidera®), fingolimod (Gilenya®), fluoxetine, glatiramer acetate (Copaxone®), hydroxychloroquine, ibudilast, idebenone, laquinimod, lipoic acid, losartan, masitinib, MD1003 (biotin), mitoxantrone, montelukast, natalizumab (Tysabri®), NeuroVaxTM, ocrelizumab, ofatumumab, pioglitazone, and RPC1063.
Non-limiting examples of additional therapeutic agents and/or regimens for treating graft-vs-host disease include abatacept, alemtuzumab, alpha1-antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, pevonedistat, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib.
Non-limiting examples of additional therapeutic agents and/or regimens for treating acute graft-vs-host disease include alemtuzumab, alpha-1 antitrypsin, antithymocyte globulin, basiliximab, brentuximab, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, ibrutinib, infliximab, itacitinib, LBH589, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, photopheresis, ruxolitinib, sirolimus, tacrolimus, and tocilizumab.
Non-limiting examples of additional therapeutic agents and/or regimens for treating chronic graft vs. host disease include abatacept, alemtuzumab, AMG592, antithymocyte globulin, basiliximab, bortezomib, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, mycophenolate mofetil, pentostatin, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib. Non-limiting examples of additional therapeutic agents and/or regimens for treating celiac disease include AMG 714, AMY01, Aspergillus niger prolyl endoprotease, BL- 7010, CALY-002, GBR 830, Hu-Mik-Beta-1, IMGX003, KumaMax, Larazotide Acetate, Nexvan2®, pancrelipase, TIMP-GLIA, vedolizumab, and ZED1227.
Non-limiting examples of additional therapeutic agents and/or regimens for treating psoriasis include topical corticosteroids, topical crisaborole/AN2728, topical SNA-120, topical SAN021, topical tapinarof, topical tocafinib, topical IDP-118, topical M518101, topical calcipotriene and betamethasone dipropionate (e.g., MC2-01 cream and Taclonex®), topical P-3073, topical LEO 90100 (Enstilar®), topical betamethasone dipropriate (Sernivo®), halobetasol propionate (Ultravate®), vitamin D analogues (e.g., calcipotriene (Dovonex®) and calcitriol (Vectical®)), anthralin (e.g., Dritho-scalp® and Dritho-crème®), topical retinoids (e.g., tazarotene (e.g., Tazorac® and Avage®)), calcineurin inhibitors (e.g., tacrolimus (Prograf®) and pimecrolimus (Elidel®)), salicylic acid, coal tar, moisturizers, phototherapy (e.g., exposure to sunlight, UVB phototherapy, narrow band UVB phototherapy, Goeckerman therapy, psoralen plus ultraviolet A (PUVA) therapy, and excimer laser), retinoids (e.g., acitretin (Soriatane®)), methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), Apo805K1, baricitinib, FP187, KD025, prurisol, VTP-43742, XP23829, ZPL-389, CF101 (piclidenoson), LAS41008, VPD-737 (serlopitant), upadacitinib (ABT-494), aprmilast, tofacitibin, cyclosporine (Neoral®, Sandimmune®, Gengraf®), biologics (e.g., etanercept (Enbrel®), entanercept-szzs (Elrezi®), infliximab (Remicade®), adalimumab (Humira®), adalimumab-adbm (Cyltezo®), ustekinumab (Stelara®), golimumab (Simponi®), apremilast (Otezla®), secukinumab (Cosentyx®), certolixumab pegol, secukinumab, tildrakizumab-asmn, infliximab-dyyb, abatacept, ixekizumab (Taltz®), ABP 710, BCD-057, BI695501, bimekizumab (UCB4940), CHS-1420, GP2017, guselkumab (CNTO 1959), HD203, M923, MSB11022, Mirikizumab (LY3074828), PF-06410293, PF-06438179, risankizumab (BI655066), SB2, SB4, SB5, siliq (brodalumab), namilumab (MT203, tildrakizumab (MK-3222), and ixekizumab (Taltz®)), thioguanine, and hydroxyurea (e.g., Droxia® and Hydrea®).
Non-limiting examples of additional therapeutic agents and/or regimens for treating cutaneous T-cell lymphoma include phototherapy (e.g., exposure to sunlight, UVB phototherapy, narrow band UVB phototherapy, Goeckerman therapy, psoralen plus ultraviolet A (PUVA) therapy, and excimer laser), extracorporeal photopheresis, radiation therapy (e.g., spot radiation and total skin body electron beam therapy), stem cell transplant, corticosteroids, imiquimod, bexarotene gel, topical bis-chloroethyl-nitrourea, mechlorethamine gel, vorinostat (Zolinza®), romidepsin (Istodax®), pralatrexate (Folotyn®) biologics (e.g., alemtuzumab (Campath®), brentuximab vedotin (SGN-35), mogamulizumab, and IPH4102).
Non-limiting examples of additional therapeutic agents and/or regimens for treating uveitis include corticosteroids (e.g., intravitreal triamcinolone acetonide injectable suspensions), antibiotics, antivirals (e.g., acyclovir), dexamethasone, immunomodulators (e.g., tacrolimus, leflunomide, cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), chlorambucil, azathioprine, methotrexate, and mycophenolate mofetil), biologics (e.g., infliximab (Remicade®), adalimumab (Humira®), etanercept (Enbrel®), golimumab (Simponi®), certolizumab (Cimzia®), rituximab (Rituxan®), abatacept (Orencia®), basiliximab (Simulect®), anakinra (Kineret®), canakinumab (Ilaris®), gevokixumab (XOMA052), tocilizumab (Actemra®), alemtuzumab (Campath®), efalizumab (Raptiva®), LFG316, sirolimus (Santen®), abatacept, sarilumab (Kevzara®), and daclizumab (Zenapax®)), cytotoxic drugs, surgical implant (e.g., fluocinolone insert), and vitrectomy. Non-limiting examples of additional therapeutic agents and/or regimens for treating mucositis include AG013, SGX942 (dusquetide), amifostine (Ethyol®), cryotherapy, cepacol lonzenges, capsaicin lozenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e.g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone- sodium hyaluronate gel (Gelclair®)), oral lubricants (e.g., Oral Balance®), caphosol, chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g., lidocaine, benzocaine, dyclonine hydrochloride, xylocaine (e.g., viscous xylocaine 2%), and Ulcerease® (0.6% phenol)), corticosteroids (e.g., prednisone), pain killers (e.g., ibuprofen, naproxen, acetaminophen, and opioids), GC4419, palifermin (keratinocyte growth factor; Kepivance®), ATL-104, clonidine lauriad, IZN-6N4, SGX942, rebamipide, nepidermin, soluble b-1,3/1,6 glucan, P276, LP-0004-09, CR-3294, ALD-518, IZN-6N4, quercetin, granules comprising vaccinium myrtillus extract, macleaya cordata alkaloids and echinacea angustifolia extract (e.g., SAMITAL®), and gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)). For example, non- limiting examples of treatments for oral mucositis include AG013, amifostine (Ethyol®), cryotherapy, cepacol lonzenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e.g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair®)), oral lubricants (e.g., Oral Balance®), caphosol, chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g., lidocaine, benzocaine, dyclonine hydrochloride, xylocaine (e.g., viscous xylocaine 2%), and Ulcerease® (0.6% phenol)), corticosteroids (e.g., prednisone), pain killers (e.g., ibuprofen, naproxen, acetaminophen, and opioids), GC4419, palifermin (keratinocyte growth factor; Kepivance®), ATL-104, clonidine lauriad, IZN-6N4, SGX942, rebamipide, nepidermin, soluble b-1,3/1,6 glucan, P276, LP-0004-09, CR-3294, ALD-518, IZN-6N4, quercetin, and gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)). As another example, non-limiting examples of treatments for esophageal mucositis include xylocaine (e.g., gel viscous Xylocaine 2%). As another example, treatments for intestinal mucositis, treatments to modify intestinal mucositis, and treatments for intestinal mucositis signs and symptoms include gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)).
In certain embodiments, the second therapeutic agent or regimen is administered to the subject prior to contacting with or administering the chemical entity (e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior).
In other embodiments, the second therapeutic agent or regimen is administered to the subject at about the same time as contacting with or administering the chemical entity. By way of example, the second therapeutic agent or regimen and the chemical entity are provided to the subject simultaneously in the same dosage form. As another example, the second therapeutic agent or regimen and the chemical entity are provided to the subject concurrently in separate dosage forms.
In still other embodiments, the second therapeutic agent or regimen is administered to the subject after contacting with or administering the chemical entity (e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after). Patient Selection
In some embodiments, the methods described herein further include the step of identifying a subject (e.g., a patient) in need of such treatment (e.g., by way of biopsy, endoscopy, or other conventional method known in the art). In certain embodiments, the STING protein can serve as a biomarker for certain types of cancer, e.g., colon cancer and prostate cancer. In other embodiments, identifying a subject can include assaying the patient’s tumor microenvironment for the absence of T-cells and/or presence of exhausted T-cells, e.g., patients having one or more cold tumors. Such patients can include those that are resistant to treatment with checkpoint inhibitors. In certain embodiments, such patients can be treated with a chemical entity herein, e.g., to recruit T-cells into the tumor, and in some cases, further treated with one or more checkpoint inhibitors, e.g., once the T-cells become exhausted.
In some embodiments, the chemical entities, methods, and compositions described herein can be administered to certain treatment-resistant patient populations (e.g., patients resistant to checkpoint inhibitors; e.g., patients having one or more cold tumors, e.g., tumors lacking T-cells or exhausted T-cells). Compound Preparation
As can be appreciated by the skilled artisan, methods of synthesizing the compounds of the formulae herein will be evident to those of ordinary skill in the art. Synthetic chemistry transformations and protecting group methodologies (protection and deprotection) useful in synthesizing the compounds described herein are known in the art and include, for example, those such as described in R. Larock, Comprehensive Organic Transformations, VCH Publishers (1989); T. W. Greene and RGM. Wuts, Protective Groups in Organic Synthesis, 2d. Ed., John Wiley and Sons (1991); L. Fieser and M. Fieser, Fieser and Fieser's Reagents for Organic Synthesis, John Wiley and Sons (1994); and L. Paquette, ed., Encyclopedia of Reagents for Organic Synthesis, John Wiley and Sons (1995), and subsequent editions thereof. The starting materials used in preparing the compounds of the invention are known, made by known methods, or are commercially available. The skilled artisan will also recognize that conditions and reagents described herein that can be interchanged with alternative art-recognized equivalents. For example, in many reactions, triethylamine can be interchanged with other bases, such as non- nucleophilic bases (e.g. diisopropylamine, 1,8-diazabicycloundec-7-ene, 2,6-di-tert- butylpyridine, or tetrabutylphosphazene).
The skilled artisan will recognize a variety of analytical methods that can be used to characterize the compounds described herein, including, for example, 1H NMR, heteronuclear NMR, mass spectrometry, liquid chromatography, and infrared spectroscopy. The foregoing list is a subset of characterization methods available to a skilled artisan and is not intended to be limiting.
To further illustrate the foregoing, the following non-limiting, exemplary synthetic schemes are included. Variations of these examples within the scope of the claims are within the purview of one skilled in the art and are considered to fall within the scope of the invention as described, and claimed herein. The reader will recognize that the skilled artisan, provided with the present disclosure, and skill in the art is able to prepare and use the invention without exhaustive examples. Examples
Example 1. Synthesis of Compound 101
Figure imgf000122_0001
Compound 101
Step 1: Synthesis of 3-((1H-indol-3-yl)amino)-4-methoxycyclobut-3-ene-1,2-dione
Figure imgf000123_0001
Indoleamine (100.00 mg, 0.757 mmol, 1.00 equiv) was dissolved in MeOH (30.00 mL). TEA (229 mg, 2.3 mmol, 3.0 equiv) and dimethoxycyclobut-3-ene-1,2-dione (108 mg, 0.8 mmol, 1.0 equiv) were added. Upon stirring for 30 min, the resulting solution was directly used for next step. Step 2: Synthesis of 3-((1H-indol-3-yl)amino)-4-((4- butylcyclohexyl) amino)cyclobut- 3-ene-1,2-dione
Figure imgf000123_0002
To the solution obtained from Step 1 was added 4-butylcyclohexan-1-amine (129 mg, 0.8 mmol, 1.1 equiv). Upon stirring for 30 min, the resulting solid was collected by filtration and dissolved in DMF (2.0 mL). Then the crude product was purified by Prep- HPLC under the following conditions (2#SHIMADZU (HPLC-01)): Column, YMC-Actus Triart C18, 20*250MM, 5um, 12nm; mobile phase A: Water (10MMOL/L NH4HCO3), mobile phase B: ACN; Flow rate:50 mL/min; Gradient: 59 B to 89 B in 7 min; 254 nm; RT1:6.93; Detector, 254nm. 3-((1H-indol-3-yl)amino)-4-((4-butylcyclohexyl)amino) cyclobut-3-ene-1,2-dione (25 mg, 9%) was isolated as a white solid. m/z = 366.2 (M+ H+) (LC/MS) LCMS Method: XBridge Shield RP18, 50 *4.6mm, 3.0 µL injection, 1.5 mL/min flowrate, 90-900 amu scan range, 254 nm UV detection. Mobile Phase A (MPA): Water/0.04% NH3.H2O and Mobile Phase B (MPB): Acetonitrile. Elution 40% MPB to 70% in 2.80 min, upto 95% in 0.20min, hold at 95% MPB for 0.5 min, 95% MPB to 10% in 0.05 min, then equilibration to 10% MPB for 0.25 min. Compounds 205, 204, 203b, 203a, 203, 202, 201, 200, 199, 198, 197, 196, 195, 194b, 194a, 194, 193, 192, 191, 190b, 190a, 190, 189, 188, 187, 186, 185, 184, 183, 182, 181, 180, 179b, 179a, 179, 178b, 178a, 178, 177b, 177a, 177, 176, 175, 174, 173b, 173a, 173, 172b, 172a, 172, 171, 170, 169, 168, 167, 166, 165, 164, 163, 162, 161, 160b, 160a, 160, 159, 158b, 158a, 158, 157b, 157a, 157, 156, 155, 154, 153, 152, 151, 150, 149, 148, 147, 146, 145, 144, 143, 142, 141, 140, 139, 138, 137, 136, 135, 134, 133, 132, 131, 130, 129, 128, 127, 126, 125, 124, 123, 122, 121, 120, 119, 118, 117, 116, 115, 114, 113, 112, 111, 110, 109, 108, 107, 106, 105, 104, 103, 102 are synthesized using methods described in Example 1. Biological Assays
STING pathway activation by the compounds described herein is measured using THP1-Dual™ cells (KO-IFNAR2).
THP1-Dual™ KO-IFNAR2 Cells (obtained from invivogen) are maintained in RPMI, 10% FCS, 5 ml P/S, 2mM L-glut, 10mM Hepes, and 1 mM sodium pyruvate. Compounds are spotted in empty 384 well tissue culture plates (Greiner 781182) by Echo for a final concentration of 0.0017 - 100 µM. Cells are plated into the TC plates at 40 mL per well, 2×10E6 cells/mL. For activation with STING ligand, 2'3'cGAMP (MW 718.38, obtained from Invivogen), is prepared in Optimem media.
The following solutions are prepared for each 1×384 plate:
o Solution A: 2 mL Optimem with one of the following stimuli:
^ 60 uL of 10 mM 2'3'cGAMP -> 150 mM stock
o Solution B: 2 mL Optimem with 60 mL Lipofectamine 2000 -> Incubate 5 min at RT 2 mL of solution A and 2 ml Solution B is mixed and incubated for 20 min at room temperature (RT).20 uL of transfection solution (A+B) is added on top of the plated cells, with a final 2’3’cGAMP concentration of 15 mM. The plates are then centrifuged immediately at 340 g for 1 minute, after which they are incubated at 37 oC, 5% CO2, >98% humidity for 24h. Luciferase reporter activity is then measured. EC50 values were calculated by using standard methods known in the art.
Luciferase reporter assay: 10 µL of supernatant from the assay is transferred to white 384-plate with flat bottom and squared wells. one pouch of QUANTI-Luc™ Plus is dissolved in 25 mL of water.100 µL of QLC Stabilizer per 25 mL of QUANTI-Luc™ Plus solution was added.50 µL of QUANTI-Luc™ Plus/QLC solution per well is then added. Luminescence is measured on a Platereader (e.g., Spectramax I3X (Molecular Devices GF3637001)).
Luciferase reporter activity is then measured. EC50 values are calculated by using standard methods known in the art.
Table BA shows the activity of compounds in STING reporter assay: <0.008 µM = “++++++”; ³0.008 and <0.04 µM =“+++++”; ³0.04 and <0.2 µM =“++++”; ³0.2 and <1 µM =“+++”; ³1 and <5 µM =“++”; ³5 and <100 µM =“+”.
Figure imgf000125_0001
Figure imgf000126_0002
Numbered Clauses
The compounds, compositions, methods, and other subject matter described herein are futther described in the following numbered clauses:
1. A compound of Formula I as claimed in claim 1 of U.S. Provisional Application Serial No.62/849,811, filed on May 17, 2019; or U.S. Provisional Application Serial No.62/861,880, filed on June 14, 2019; e.g., a compound of Formula I, wherein:
Figure imgf000126_0001
Formula (I)
or a pharmaceutically acceptable salt thereof or a tautomer thereof, wherein: Z is selected from the group consisting of a bond, CR1, C(R3)2, N, and NR2;
each of Y1, Y2, and Y3 is independently selected from the group consisting of O, S, CR1, C(R3)2, N, and NR2;
Y4 is C or N;
X1 is selected from the group consisting of O, S, N, NR2, and CR1;
X2 is selected from the group consisting of O, S, N, NR4, and CR5;
each is independently a single bond or a double bond, provided that the five- membered ring comprising Y4, X1, and X2 is heteroaryl;
Q-A is defined according to (A) or (B) below:
(A)
Q is selected from the group consisting of: NH; N(C1-6 alkyl) wherein the C1-6 alkyl is optionally substituted with 1-2 independently selected Ra; O; S; and C1-3 alkylene which is optionally substituted with 1-2 independently selected Ra and
A is:
(i) -(YA1)n-YA2, wherein:
^ n is 0 or 1;
^ YA1 is C1-6 alkylene, which is optionally substituted with from 1-6 substituents each indepndently selected from the group consisting of Ra; C6- 10 aryl optionally substituted with 1-4 independently selected C1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C1-4 alkyl; and
^ YA2 is:
(a) C3-20 cycloalkyl, which is optionally substituted with from 1-4 Rb, (b) C6-20 aryl, which is optionally substituted with from 1-4 Rc;
(c) heteroaryl including from 5-20 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc; or (d) heterocyclyl including from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb,
OR
(ii) -Z1 -Z2-Z3, wherein:
^ Z1 is C1-3 alkylene, which is optionally substituted with from 1-4 Ra;
^ Z2 is–N(H)-, -N(Rd)-, -O-, or–S-; and
^ Z3 is C2-7 alkyl, which is optionally substituted with from 1-4 Ra;
OR
(iii) C1-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra,
OR
(B) Q and A, taken together, form:
Figure imgf000128_0001
E is heterocyclyl including from 3-16 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb, each occurrence of R1 is independently selected from the group consisting of ^ H;
^ halo;
^ cyano;
^ C1-6 alkyl optionally substituted with 1-2 Ra;
^ C2-6 alkenyl;
^ C2-6 alkynyl;
^ C1-4 haloalkyl; ^ C1-4 alkoxy;
^ C1-4 haloalkoxy;
^ –L3-L4-Ri;
^ -S(O)1-2(C1-4 alkyl),
^ -S(O)(=NH)(C1-4 alkyl),
^ SF5,
^ -NReRf,
^ –OH,
^ oxo,
^ -S(O)1-2(NR’R’’),
^ -C1-4 thioalkoxy,
^ -NO2,
^ -C(=O)(C1-4 alkyl),
^ -C(=O)O(C1-4 alkyl),
^ -C(=O)OH, and
^ -C(=O)N(R’)(R’’);
or a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy, each occurrence of R2 is independently selected from the group consisting of: (i) C1-6 alkyl, which is optionally substituted with from 1-2 independently selected Ra;
(ii) C3-6 cycloalkyl;
(iii) heterocyclyl including from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; (iv) C6-10 aryl;
(v) heteroaryl including from 5-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2;
(vi) -C(O)(C1-4 alkyl);
(vii) -C(O)O(C1-4 alkyl);
(viii) -CON(R’)(R’’);
(ix) -S(O)1-2(NR’R’’);
(x) - S(O)1-2(C1-4 alkyl);
(xi) -OH;
(xii) C1-4 alkoxy; and
(xiii) H;
or a pair of R1 and R2 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; each occurrence of R3 is independently selected from H; C1-6 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;–OH; -F; -Cl; -Br;– NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-4 alkyl); -C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)N(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano; and C3-6 cycloalkyl optionally substituted with from 1-4 independently selected C1-4 alkyl; or
two R3 on the same carbon combine to form an oxo; or
a pair of R3, taken together with the atom(s) connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; or a pair of R1 and R3 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; or
or a pair of R2 and R3 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; R4 is selected from H and C1-6 alkyl;
R5 is selected from H and halo;
R6 is selected from H; C1-6 alkyl; -OH; C1-4 alkoxy; C(=O)H; C(=O)(C1-4 alkyl); CN; C6-10 aryl optionally substituted with from 1-4 independently selected C1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C1-4 alkyl; each occurrence of Ra is independently selected from the group consisting of:– OH; -F; -Cl; -Br;–NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1- 4 alkyl); -C(=O)OH; -CON(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano, and C3- 6 cycloalkyl optionally substituted with from 1-4 independently selected C1-4 alkyl;
each occurrence of Rb is independently selected from the group consisting of: C1- 10 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;– OH; oxo; -F; -Cl; -Br;–NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)N(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano; and–L1-L2-Rh; each occurrence of Rc is independently selected from the group consisting of: (a) halo;
(b) cyano;
(c) C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra;
(d) C2-6 alkenyl;
(e) C2-6 alkynyl;
(g) C1-4 alkoxy;
(h) C1-4 haloalkoxy;
(i) -S(O)1-2(C1-4 alkyl);
(j) -NReRf;
(k)–OH;
(l) -S(O)1-2(NR’R’’);
(m) -C1-4 thioalkoxy;
(n) -NO2;
(o) -C(=O)(C1-10 alkyl);
(p) -C(=O)O(C1-4 alkyl);
(q) -C(=O)OH;
(r) -C(=O)N(R’)(R’’); and
(s)–L1-L2-Rh;
Rd is selected from the group consisting of: C1-6 alkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); -CON(R’)(R’’); -S(O)1-2(NR’R’’); - S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy;
each occurrence of Re and Rf is independently selected from the group consisting of: H; C1-6 alkyl; C1-6 haloalkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); - CON(R’)(R’’); -S(O)1-2(NR’R’’); - S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; or Re and Rf together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from H and C1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to Re and Rf), which are each independently selected from the group consisting of N(Rd), NH, O, and S; -L1 is a bond or C1-3 alkylene;
-L2 is–O-, -N(H)-, -S(O)0-2-, or a bond;
Rh is selected from:
^ C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl (in certain embodiments, it is provided that when Rh is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected C1-4 alkyl, -L1 is a bond, or–L2 is–O-, -N(H)-, or -S-);
^ heterocyclyl, wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
^ heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and
^ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl; -L3 is a bond or C1-3 alkylene;
-L4 is–O-, -N(H)-, -S(O)0-2-, or a bond;
Ri is selected from:
^ C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl (in certain embodiments, it is provided that when Ri is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected C1-4 alkyl, -L1 is a bond, or–L2 is–O-, -N(H)-, or -S-);
^ heterocyclyl, wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
^ heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ^ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1- 4 haloalkyl; and
each occurrence of R’ and R’’ is independently selected from the group consisting of: H, C1-4 alkyl, and C6-10 aryl optionally substituted with from 1-2 substituents selected from halo, C1-4 alkyl, and C1-4 haloalkyl; or R’ and R’’ together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from the group consisting of H and C1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to R’ and R’’), which are each independently selected from the group consisting of N(H), N(C1-6 alkyl), O, and S.
2. The compound of clause 1, wherein the ring that includes Z, Y1, Y2, Y3, and Y4 is aromatic.
3. The compound of any one of clauses 1-2, wherein Z is selected from the group consisting of CR1, N, and NR2.
4. The compound of any one of clauses 1-3, wherein Z is CR1. 5. The compound of any one of clauses 1-4, wherein each of Y1, Y2, and Y3 is independently selected from the group consisting of CR1 and N.
6. The compound of any one of clauses 1-5, wherein each of Y1, Y2, and Y3 is independently CR1.
7. The compound of any one of clauses 1-6, wherein the
Figure imgf000135_0001
moiety is
Figure imgf000135_0002
.
8. The compound of any one of clauses 1-5, wherein from 1-2 of Y1, Y2, and Y3 is independently N or NR2 (e.g., N).
9. The compound of any one of clauses 1-5 and 8, wherein one of Y1, Y2, and Y3 is N or NR2 (e.g., N).
10. The compound of clause 9, wherein each of the remaining Y1, Y2, and Y3 is an independently selected CR1.
11. The compound of any one of clauses 1-4 and 8-10, wherein
Figure imgf000135_0003
moiety i
Figure imgf000135_0004
wherein the asterisk denotes point of attachment to Y4.
12. The compound of any one of clauses 1-4 and 8-10, wherein
Figure imgf000136_0001
moiety wherein the asterisk denotes
Figure imgf000136_0002
point of attachment to Y4.
13. The compound of any one of clauses 1-4 and 8-10, wherein
Figure imgf000136_0003
moiety i wherein the asterisk denotes point of attachment to Y4.
Figure imgf000136_0004
14. The compound of any one of clauses 1-3, wherein Z is N.
15. The compound of any one of clauses 1-2 and 14, wherein each of Y1, Y2, and Y3 is independently selected from the group consisting of CR1 and N.
16. The compound of any one of clauses 1-2 and 14-15, wherein each of Y1,
Y2, and Y3 is independently CR1 (e.g., the
Figure imgf000136_0006
moi
Figure imgf000136_0005
wherein the asterisk denotes point of attachment to Y4).
17. The compound of clause 1, wherein the ring that includes Z, Y1, Y2, Y3, and Y4 is partially saturated.
18. The compound of any one of clauses 1 and 17, wherein Z is C(R3)2 or a bond.
19. The compound of any one of clauses 1 and 17-18, wherein Z is a bond. 20. The compound of any one of clauses 1 and 17-19, wherein each of Y1, Y2, and Y3 is independently selected from the group consisting of C(R3)2, O, NR2, and S.
21. The compound of any one of clauses 1 and 17-20, wherein each of Y1, Y2, and Y3 is independently C(R3)2.
Figure imgf000137_0001
22. The compound of clause 21, wherein the
Figure imgf000137_0002
moiety is , wherein the asterisk denotes point of attachment to Y4.
23. The compound of any one of clauses 1-22, wherein Y4 is C.
24. The compound of any one of clauses 1-23, wherein X1 is NR2 (e.g., NH). 25. The compound of any one of clauses 1-24, wherein X2 is CR5 (e.g., CH). 26. The compound of any one of clauses 1-24, wherein X2 is N.
27. The compound of any one of clauses 1-3, wherein the compound is selected from a compound of the following formulae:
Figure imgf000137_0003
28. The compound of any one of clauses 1-3 and 27, wherein the compound
has formula (Ia): (Ia).
29. The compound of clause 28, wherein the compound has formula (Ia-1):
(Ia-1).
30. The compound of clause 28, wherein the compound has formula (Ia-2):
(Ia-2).
31. The compound of any one of clauses 1-3 and 27, wherein the compound
has formula (Ib): (Ib).
32. The compound of clause 31, wherein the compound has formula (Ib-1):
(Ib-1). 33. The compound of any one of clauses 1-3 and 27, wherein the compound
has formula (Ic): (Ic).
34. The compound of clause 33, wherein the compound has formula (Ic-1):
(Ic-1).
35. The compound of any one of clauses 1-3 and 27, wherein the compound
has formula (Id): (Id).
36. The compound of clause 35, wherein the compound has formula (Id-1):
(Id-1).
37. The compound of any one of clauses 1-3 and 27, wherein the compound
has formula (Ie): (Ie).
38. The compound of clause 27, wherein the compound has formula (Ie-1): (Ie-1).
39. The compound of any one of clauses 1 and 17-21, wherein the compound has formula (Io):
(Io) (e.g., (Io-1)).
40. The compound of any one of clauses 1-16 and 23-38, wherein each occurrence of R1 is independently selected from the group consisting of: H; halo; cyano; C1-6 alkyl optionally substituted with 1-2 Ra; C2-6 alkenyl; C2-6 alkynyl; C1-4 haloalkyl; C1- 4 alkoxy; C1-4 haloalkoxy;–L3-L4-Ri; -S(O)1-2(C1-4 alkyl); -S(O)(=NH)(C1-4 alkyl); SF5; - S(O)1-2(NR’R’’); -C1-4 thioalkoxy; -NO2; -C(=O)(C1-4 alkyl); -C(=O)O(C1-4 alkyl); - C(=O)OH, and- C(=O)N(R’)(R’’).
41. The compound of any one of clauses 1-16, 23-38, and 40, wherein from 0- 3 (e.g., 0, 1, 2, or 3) occurrences of R1 is other than H; and each of the remaining occurrences of R1 is H.
42. The compound of any one of clauses 1-16, 23-38, and 40-41, wherein each occurrence of R1 is H.
43. The compound of any one of clauses 1-16, 23-38, and 40-41, wherein from 1-2 (e.g., 1 or 2) occurrences of R1 is other than H.
44. The compound of clauses 41 or 43, wherein one occurrence of R1 is halo (e.g., F or Cl (e.g., F)).
45. The compound of clauses 41 or 43, wherein one occurrence of R1 is C1-6 alkyl (e.g., C1-3 alkyl) optionally substituted with 1-2 Ra.
46. The compound of clause 45, wherein Ra is selected from OH, NReRf, C(=O)OH, C1-4 alkoxy, and C1-4 haloalkoxy. 47. The compound of clause 46, wherein R1 is selected from the group consisting of methyl, propyl, CH2NMe2, CH2CH2OH, and CH2C(=O)OH.
48. The compound of clauses 41 or 43, wherein one occurrence of R1 is C2-6 alkynyl or C2-6 alkenyl (e.g., C2-6 alkynyl).
49. The compound of clauses 41 or 43, wherein one occurrence of R1 is - C(=O)(C1-4 alkyl) (e.g., -C(=O)Me).
50. The compound of clauses 41 or 43, wherein one occurrence of R1 is C(=O)N(R’)(R’’) (e.g., C(=O)NHMe or C(=O)NMe2).
51. The compound of clauses 41 or 43, wherein one occurrence of R1 is C1-4 haloalkyl (e.g., CF3).
52. The compound of clauses 41 or 43, wherein one occurrence of R1 is S(O)1- 2(C1-4 alkyl) or S(O)(=NH)(C1-4 alkyl) (e.g., S(O)2Me or S(O)(=NH)(Me)).
53. The compound of clauses 41 or 43, wherein one occurrence of R1 is SF5. 54. The compound of clauses 41 or 43, wherein one occurrence of R1 is–L3- L4-Ri.
55. The compound of clause 54, wherein Ri is selected from the group consisting of:
heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and
C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
56. The compound of clause 55, wherein Ri is C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
57. The compound of clause 56, wherein Ri is C6 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl (e.g., Ri is unsubstituted phenyl). 58. The compound of clause 55, wherein Ri is heteroaryl including from 5-10 (e.g., 5-6) ring atoms, wherein from 1-4 (e.g., from 1-2) ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
59. The compound of clause 58, wherein Ri is selected from pyridyl, thiazolyl, and pyrazolyl, each of which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. 60. The compound of clause 59, wherein Ri is selected from:
Figure imgf000142_0001
,
Figure imgf000142_0002
61. The compound of any one of clauses 54-60, wherein–L3 is a bond.
62. The compound of any one of clauses 54-60, wherein–L3 is C1-3 alkylene. 63. The compound of any one of clauses 54-62, wherein–L4 is a bond.
64. The compound of any one of clauses 54-62, wherein–L4 is–O- or–S-. 65. The compound of any one of clauses 54-60, wherein–L3 is a bond; and– L4 is a bond.
66. The compound of any one of clauses 54-60, wherein–L3 is C1-3 alkylene; and–L4 is a bond.
67. The compound of any one of clauses 54-60, wherein–L3 is a bond; and– L4 is–O- or–S-.
68. The compound of clause 54, wherein R1 is selected from the group
consisting of: , , , and .
69. The compound of clause 54, wherein R1 is selected from the group
consisting of:
Figure imgf000142_0003
70. The compound of any one of clauses 44-69, wherein each remaining R1 is H.
71. The compound of any one of clauses 44-69, wherein one other occurrence of R1 is halo (e.g., F) or C1-4 alkyl; and each remaining R1 is H.
72. The compound of any one of clauses 1-16, 23-29, 31-33, 35, and 37-38, wherein a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy.
73. The compound of clause 72, wherein a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 5-7 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy.
74. The compound of clause 73, wherein a pair of R1 on adjacent atoms, taken
together with the atoms connecting them, form:
Figure imgf000143_0001
.
75. The compound of any one of clauses 1, 17-22, and 39, wherein each occurrence of R3 is independently selected from: H; C1-6 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;–OH; -F; -Cl;–NReRf; C1-4 alkoxy; and C1-4 haloalkoxy; or two R3 on the same carbon combine to form an oxo.
76. The compound of any one of clauses 1, 17-22, 39, and 75, wherein each occurrence of R3 is independently H, C1-6 alkyl, or C1-4 haloalkyl.
77. The compound of any one of clauses 1-76, wherein R2 is H.
78. The compound of any one of clauses 1-76, wherein R2 is C1-6 alkyl, which is optionally substituted with from 1-2 independently selected Ra (e.g., unsubstituted C1-3 alkyl). 79. The compound of any one of clauses 1-76, wherein R2 is -C(O)(C1-4 alkyl) (e.g., C(O)Me).
80. The compound of any one of clauses 1-76, wherein R2 is C6-10 aryl (e.g., phenyl).
81. The compound of any one of clauses 1-76, wherein when X1 is NR2, the R2 group of X1 is H.
82. The compound of any one of clauses 1-81, wherein R5 is H.
83. The compound of any one of clauses 1-81, wherein R5 is halo.
84. The compound of any one of clauses 1-83, wherein Q-A is defined according to (A). 85. The compound of any one of clauses 1-84, wherein Q is NH.
86. The compound of any one of clauses 1-85, wherein A is -(YA1)n-YA2. 87. The compound of any one of clauses 1-86, wherein n is 0.
88. The compound of any one of clauses 1-86, wherein n is 1.
89. The compound of clause 88, wherein YA1 is C1-6 alkylene, which is optionally substituted with from 1-4 Ra.
90. The compound of clause 89, wherein YA1 is -CH2-, -CH2CH2-, - CH2CH2CH2-, -CH(CF3)-, -CH2CH(OH)-, or (e.g., CH2).
91. The compound of clause 88, wherein YA1 is C1-6 alkylene, which is substituted with C6-10 aryl (e.g., C6-10 aryl), wherein YA1 is further optionally substituted with from 1-2 Ra (e.g., YA1 is -CH(Ph)CH2-).
92. The compound of any one of clauses 1-91, wherein YA2 is C6-10 aryl, which is optionally substituted with from 1-3 Rc.
93. The compound of any one of clauses 1-92, wherein YA2 is C6 aryl, which is optionally substituted with from 1-3 Rc.
94. The compound of any one of clauses 1-93, wherein YA2 is C6 aryl, which is substituted with from 1-3 Rc. 95. The compound of any one of clauses 1-94, wherein YA2 is phenyl substituted with from 1-3 Rc, wherein one Rc is at the ring carbon para to the point of attachment to YA1.
96. The compound of any one of clauses 1-94, wherein YA2 is phenyl substituted with from 1-3 Rc, wherein from 1-2 Rc is at the ring carbons meta to the point of attachment to YA1.
97. The compound of any one of clauses 1-94, wherein YA2 is phenyl substituted with from 1-3 Rc, wherein from 1-2 Rc is at the ring carbons ortho to the point of attachment to YA1.
98. The compound of any one of clauses 1-92, wherein YA2 is C7-10 bicyclic aryl, which is optionally substituted with from 1-3 Rc (e.g., YA2 is naphthyl (e.g.,
), indacenyl (e.g., ), or tetrahydronapthyl, each of which is optionally substituted with from 1- 3 Rc).
99. The compound of any one of clauses 1-91, wherein YA2 is heteroaryl including from 5-14 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc.
100. The compound of any one of clauses 1-91 and 99, wherein YA2 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc.
101. The compound of clause 89, wherein YA2 is thiazolyl or triazolyl, each of which is optionally substituted with from 1-2 (e.g., 1) independently selected Rc.
102. The compound of any one of clauses 1-91 and 99, wherein YA2 is heteroaryl
including 6 ring atoms (e.g., pyridyl or pyrimidinyl (e.g., pyridyl (e.g., )), wherein from 1-2 ring nitrogen atoms, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc.
103. The compound of clause 102, wherein YA2 is substituted with from 1-3 independently selected Rc; and one occurrence of Rc is at the ring carbon atom para to the point of attachment to YA1.
104. The compound of clause 102, wherein YA2 is substituted with from 1-3 independently selected Rc; and one occurrence of Rc is at the ring carbon atom meta to the point of attachment to YA1.
105. The compound of clause 102, wherein YA2 is substituted with from 1-3 independently selected Rc; and one occurrence of Rc is at the ring carbon atom ortho to the point of attachment to YA1.
106. The compound of any one of clauses 1-91 and 99, wherein YA2 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally
substituted with from 1-4 independently selected Rc (e.g., YA2 is , ,
, or , each of which is optionally substituted with from 1-2 independently selected Rc).
107. The compound of any one of clauses 92-106, wherein each occurrence of Rc is independently selected from the group consisting of: halo; cyano; C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra; C2-6 alkenyl; C2-6 alkynyl; C1-4 alkoxy; C1-4 haloalkoxy; -S(O)1-2(C1-4 alkyl); -NReRf; -C1-4 thioalkoxy; - C(=O)(C1-10 alkyl); -C(=O)(OH);–C(=O)O(C1-4 alkyl); and–L1-L2-Rh.
108. The compound of any one of clauses 92-107, wherein one occurrence of Rc is halo. 109. The compound of any one of clauses 92-107, wherein one occurrece of Rc is C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra.
110. The compound of clause 109, wherein one occurrence of Rc is unsubstituted C1-10 alkyl (e.g., C2, C3, C4, C5, C6, or C7-10).
111. The compound of clause 109, wherein one occurrence of Rc is ethyl, propyl (e.g., n-propyl), butyl (e.g., n-butyl, iso-butyl, sec-butyl, tert-butyl), or octyl (e.g., n-octyl).
112. The compound of clause 109, wherein one occurrece of Rc is C1-10 alkyl which is substituted with from 1-6 independently selected Ra.
113. The compound of clause 112, wherein each occurrence of Ra is independently selected from–F, -Cl, -Br, OH, C1-4 alkoxy, and C1-4 haloalkoxy.
114. The compound of any one of clauses 112-113, wherein one occurrence of Rc is selected from: CF3, CHF2, CH2CH2CF3, CH2CH2CH2OH, CH2CH2OMe, and CH(OH)CH2CH3.
115. The compound of any one of clauses 92-107, wherein one occurrence of Rc is C2-6 alkenyl or C2-6 alkynyl.
116. The compound of any one of clauses 92-107, wherein one occurrence of Rc is -C(=O)OH or–C(=O)O(C1-4 alkyl).
117. The compound of any one of clauses 92-107, wherein one occurrence of Rc is –C(=O)(C1-10 alkyl) (e.g., -C(=O)(C3-10 alkyl) (e.g., - C(=O)CH2CH2CH2CH2CH2CH2CH2)).
118. The compound of any one of clauses 92-107, wherein one occurrence of Rc is -NReRf (e.g., NMe2).
119. The compound of any one of clauses 92-107, wherein one occurrence of Rc is–L1-L2-Rh.
120. The compound of clause 119, wherein L1 is a bond.
121. The compound of any one of clauses 119-120, wherein L2 is a bond.
122. The compound of any one of clauses 119-120, wherein L2 is–O-.
123. The compound of any one of clauses 119-122, wherein Rh is C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl. 124. The compound of clause 123, wherein Rh is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
125. The compound of clause 124, wherein Rh is selected from: , ,
and .
126. The compound of any one of clauses 119-125, wherein Rh is heterocyclyl, wherein the heterocyclyl includes from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
127. The compound of clause 126, wherein Rh is .
128. The compound of any one of clauses 119-122, wherein Rh is C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl.
129. The compound of clause 128, wherein Rh is C6 aryl, which is optionally substituted with from 1-2 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl (e.g., Rh is unsubstituted phenyl).
130. The compound of any one of clauses 119-122, wherein Rh is heteroaryl including 5-6 ring atoms, wherein from 1-3 are ring heteroatoms each independently selected from N, O, and S, wherein the heteroaryl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl. 131. The compound of any one of clauses 1-107 and 119, wherein Rc is selected
from the group consisting of: , , , , , , and
.
132. The compound of any one of clauses 1-107 and 119, wherein Rc is selected
from the group consisting of: , , and .
133. The compound of any one of clauses 108-132, wherein each of the remaining Rc when present is independently halo or C1-3 alkyl.
134. The compound of any one of clauses 1-91, wherein YA2 is C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb.
135. The compound of clause 134, wherein YA2 is C3-6 (e.g., C3, C5, or C6) cycloalkyl, which is substituted with from 1-4 (e.g., from 1-2) Rb (e.g., YA2 is cyclopropyl, cyclopentyl, bicyclo[1.1.1]pentyl, cyclohexyl, each of which is optionally substituted with from 1-2 Rb).
136. The compound of clause 135, wherein YA2 is cyclohexyl which is optionally substituted with from 1-2 Rb.
137. The compound of clause 136, wherein one occurrence of Rb is at the ring carbon atom para to the point of attachment to YA1; or one occurrence of Rb is at the ring carbon atom meta to the point of attachment to YA1; or one occurrence of Rb is at the ring carbon atom ortho to the point of attachment to YA1.
138. The compound of clause 134, wherein YA2 is C7-10 cycloalkyl, which is
optionally substituted with from 1-4 Rb (e.g., YA2 is bicyclooctyl (e.g., ), adamantyl (e.g., ), bicycloheptyl (e.g., ), or bicycloheptenyl (e.g.,
), each of which is further optionally substituted with from 1-3 Rb).
139. The compound of any one of clauses 1-91, wherein YA2 is heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb.
140. The compound of clause 139, wherein YA2 is heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently
selected Rb (e.g., YA2 is pyrrolidinyl (e.g., ), piperidinyl (e.g., ), or
tetrahydropyranyl (e.g., ), or , each of which is further optionally substituted with from 1-3 independently selected Rb).
141. The compound of any one of clauses 134-140, wherein each occurrence of Rb substituent of YA2 is independently selected from the group consisting of: C1-10 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl; -F; -Cl; - Br; cyano; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-10 alkyl); -C(=O)O(C1-4 alkyl); -S(O)1- 2(C1-4 alkyl); oxo; cyano; and–L1-L2-Rh.
142. The compound of any one of clauses 134-141, wherein one occurrece of Rb substituent of YA2 is C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra. 143. The compound of clause 142, wherein one occurrence of Rb substituent of YA2 is unsubstituted C1-10 alkyl (e.g., C2, C3, C4, C5, C6, or C7-10).
144. The compound of clause 143, wherein one occurrence of Rb substituent of YA2 is ethyl, propyl (e.g., n-propyl), butyl (e.g., n-butyl; or sec-butyl; or tert-butyl; or iso- butyl), or octyl (e.g., n-octyl).
145. The compound of clause 142, wherein one occurrece of Rb substituent of YA2 is C1-10 alkyl which is substituted with from 1-6 independently selected Ra.
146. The compound of clause 145, wherein each occurrence of Ra is independently selected from–F, -Cl, -Br, OH, C1-4 alkoxy, and C1-4 haloalkoxy.
147. The compound of any one of clauses 145-146, wherein one occurrence of Rb substituent of YA2 is selected from: CF3, CH2CH2CF3, CH2CH2CH2OH, CH2CH2OMe, and CH(OH)CH2CH3.
148. The compound of any one of clauses 134-141, wherein one occurrence of Rb substituent of YA2 is C2-6 alkenyl or C2-6 alkynyl.
149. The compound of any one of clauses 134-141, wherein one occurrence of Rb substituent of YA2 is–L1-L2-Rh.
150. The compound of clause 149, wherein L1 is a bond.
151. The compound of any one of clauses 149-150, wherein L2 is a bond.
152. The compound of any one of clauses 149-151, wherein Rh is C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
153. The compound of clause 152, wherein Rh is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
154. The compound of clause 153, wherein Rh is selected from: , ,
and . 155. The compound of any one of clauses 149-151, wherein Rh is heterocyclyl, wherein the heterocyclyl includes from 3-10 (e.g., 4, 5, 6, 7, 8, 9, or 10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl.
156. The compound of clause 155, wherein Rh is .
157. The compound of any one of clauses 149-151, wherein Rh is C6-10 aryl (e.g., C6), which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1-4 haloalkyl (e.g., Rh is unsubstituted phenyl).
158. The compound of any one of clauses 134-141, wherein Rb is selected from
the group consisting of: , , , , and .
159. The compound of any one of clauses 134-141, wherein one occurrence of Rb is C1-4 haloalkoxy (e.g., OCH2CF3).
160. The compound of any one of clauses 134-141, wherein one occurrence of Rb is–Cl or–F (e.g., -F).
161. The compound of any one of clauses 134-141, wherein one occurrence of Rb is oxo; or wherein one occurrence of Rb is cyano.
162. The compound of any one of clauses 142-161, wherein each remaining occurrence of Rb is independently selected from the group consisting of–Cl, -F, -Br, cyano, C1-3 alkyl, and C1-3 haloalkyl.
163. The compound of any one of clauses 1-91, wherein YA2 is ; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc. 164. The compound of any one of clauses 1-91, wherein
Figure imgf000153_0001
n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
165. The compound of any one of clauses 1-91, wherein
Figure imgf000153_0002
is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
166. The compound of any one of clauses 1-91, wherein YA2 is
Figure imgf000153_0003
; one of Q1 and Q2 is N; the other one of Q1 and Q2 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
167. The compound of any one of clauses 1-91, wherein YA2 is
one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3,
Figure imgf000153_0004
and Q4 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
168. The compound of any one of clauses 1-91, wherein YA2 is
Figure imgf000153_0005
one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3, and Q4 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc.
169. The compound of any one of clauses 163-168, wherein RcA is as defined for Rc in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114). 170. The compound of any one of clauses 140-142, wherein RcA is as defined for Rc in any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118). 171. The compound of any one of clauses 140-142, wherein RcA is as defined for Rc in any one of clauses 119-132 (e.g., 119; e.g., RcA is L1-L2-Rh, wherein Rh is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., RcA is as defined in clause 131 or clause 132). 172. The compound of any one of clauses 163-168, wherein n1 is 0. 173. The compound of any one of clauses 163-168, wherein n1 is 1 or 2. 174. The compound of clause 173, wherein each RcB is independently halo or C1-3 alkyl (e.g., halo).
175. The compound of any one of clauses 1-91, wherein YA2 is
Figure imgf000154_0001
; n2 is 0, 1, or 2; and each of RbA and RbB is an independently selected Rb.
176. The compound of any one of clauses 1-91, wherein YA2 is ; n2 is 0, 1, or 2; and each of RbA and RbB is an independently selected Rb.
177. The compound of any one of clauses 1-91, wherein
Figure imgf000154_0002
is 0, 1, or 2; and each of RbA and RbB is an independently selected Rb. 178. The compound of any one of clauses 175-177 wherein RbA is as defined for Rb in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148). 179. The compound of any one of clauses 175-177, wherein RbA is as defined for Rb in any one of clauses 149-158 (e.g., 149; e.g., RbA is–L1-L2-Rh, and Rh is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or RbA is as defined in clause 158). 180. The compound of any one of clauses 175-177, wherein RbA is as defined for Rb in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
181. The compound of any one of clauses 175-180, wherein n2 is 0.
182. The compound of any one of clauses 175-180, wherein n2 is 1 or 2.
183. The compound of any one of clauses 175-180 and 182, wherein each RbB is independently selected from the group consisting of–Cl, -F, C1-3 alkyl, and C1-3 haloalkyl.
184. The compound of any one of clauses 1-85, wherein A is C1-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra.
185. The compound of any one of clauses 1-85 and 184, wherein A is C2-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra.
186. The compound of clause 185, wherein A is unsubstituted C2-10 (e.g., C2,
C3, C4, C5, C6, C7, C8, C9, C10) alkyl (e.g., , , or ). 187. The compound of any one of clauses 1-85, wherein A is C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8, C9, C10) alkyl, which is substituted with from 1-6 independently selected Ra. 188. The compound of clause 187, wherein each Ra is independently selected from the group consisting of halo, -OH, C(=O)OH, C(=O)(C1-3 alkyl), and NReRf. 189. The compound of any one of clauses 187-188, wherein each Ra is an independently selected halo (e.g., A is or ). 190. The compound of any one of clauses 187-188, wherein each Ra is independently selected from the group consisting of -OH, C(=O)OH, C(=O)(C1-3 alkyl),
and NReRf (e.g., A is or ). 191. The compound of any one of clauses 1-83, wherein Q-A is defined according to (B). 192. The compound of any one of clauses 1-83 and 191, wherein Q and A, taken together, form: ; and E is heterocyclyl including from 3-10 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
193. The compound of clause 192, wherein E is heterocyclyl including from 5-8 ring atoms, wherein aside from the nitrogen atom present, from 0-2 (e.g., 0-1) additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
194. The compound of clause 193, wherein E is piperidinyl, pyrrolidinyl, piperazinyl, oxazepanyl, each of which is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
195. The compound of clause 194, wherein E is selected from the group
consisting of: , , , and , each of which is optionally further substituted with one Rb.
196. The compound of any one of clauses 192-195, wherein each Rb substituent of E is independently selected from the group consisting of: C1-10 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl; -F; -Cl; -Br; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-10 alkyl); -C(=O)O(C1-4 alkyl); -S(O)1-2(C1-4 alkyl); oxo; cyano; and–L1-L2-Rh.
197. The compound of clause 196, wherein one occurrence of Rb substituent of E is C1-10 alkyl optionally substituted with from 1-6 independently selected Ra.
198. The compound of clause 197, wherein Ra is selected from the group consisting of–OH, -NReRf, -F, -Cl, -Br, C1-4 aloxy, C1-4 haloalkoxy, and C3-6 cycloalkyl (e.g., cyclopropyl).
199. The compound of clause 196, wherein one occurrence of Rb substituent of E is F or Cl (e.g., F).
200. The compound of clause 1, wherein the compound has the following formula:
or (I-1),
wherein n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl.
201. The compound of clause 1, wherein the compound has the following formula:
or (I-2),
wherein n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl. 202. The compound of clause 1, wherein the compound has the following formula:
or (I-3), wherein n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and and R7 is H or C1-4 alkyl.
203. The compound of clause 1, wherein the compound has the following formula:
or (I-4),
wherein one of Q1 and Q2 is N; the other one of Q1 and Q2 is CH; n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl. 204. The compound of clause 1, wherein the compound has the following formula:
or (I-5), wherein one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3, Q4 is CH; n1 is 0, 1, or 2; and each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl. 205. The compound of clause 1, wherein the compound has the following formula:
or (I- 6), wherein one of Q1, Q2, Q3, and Q4 is N; each of the remaining of Q1, Q2, Q3, and Q4 is CH; n1 is 0, 1, or 2; each of RcA and RcB is an independently selected Rc; and R7 is H or C1-4 alkyl. 206. The compound of clause 1, wherein the compound has the following formula:
or (I-7), wherein B1 is selected from the group consisting of:
(a) heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc;
(b) bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc; and (c) C7-10 bicyclic aryl, which is optionally substituted with from 1-3 Rc;
and R7 is H or C1-4 alkyl. 207. The compound of clause 206, wherein B1 is heteroaryl including 5 ring atoms, wherein from 1-2 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-3 independently selected Rc.
208. The compound of clause 207, wherein B1 is thiazolyl or triazolyl, each of which is optionally substituted with from 1-2 (e.g., 1) independently selected Rc.
209. The compound of clause 206, wherein B1 is bicyclic or tricyclic heteroaryl including from 7-14 (e.g., 9-12 (e.g., 9, 10, 11, or 12)) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc.
210. The compound of clause 209, wherein B1 is
Figure imgf000160_0001
,
Figure imgf000160_0002
each of which is optionally substituted with from 1-2 independently selected Rc. 211. The compound of clause 206, wherein B1 is C7-10 bicyclic aryl, which is optionally substituted with from 1-3 Rc.
212. The compound of clause 211, wherein B1 is naphthyl (
Figure imgf000161_0001
indacenyl tetrahydronapthyl, each of which is optionally substituted
Figure imgf000161_0002
with from 1- 3 Rc).
213. The compound of any one of clauses 200-205, wherein RcA is as defined for Rc in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114).
214. The compound of any one of clauses 200-205, wherein RcA is as defined for Rc in any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118).
215. The compound of any one of clauses 200-205, wherein one occurrence of RcA is as defined for Rc in any one of clauses 119-132 (e.g., 119; e.g., RcA is L1-L2-Rh, wherein Rh is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., RcA is as defined in clause 131 or clause 132).
216. The compound of any one of clauses 206-212, wherein one occurrence of Rc is as defined for Rc in any one of clauses 108-114 (e.g., 108; e.g., 109; e.g., 110; e.g., 112, 113, or 114).
217. The compound of any one of clauses 206-212, wherein one occurrence of Rc is as defined any one of clauses 115-118 (e.g., 115; e.g., 116; e.g., 117; e.g., 118).
218. The compound of any one of clauses 206-212, wherein one occurrence of Rc is as defined in any one of clauses 119-132 (e.g., 119; e.g., Rc is L1-L2-Rh, wherein Rh is as defined in clauses 124, clause 125, clause 126, or clause 129; e.g., Rc is as defined in clause 131 or clause 132). 219. The compound of any one of clauses 206-212, wherein each Rc is as defined in clause 107.
220. The compound of any one of clauses 200-205, wherein n1 is 0.
221. The compound of any one of clauses 200-205, wherein n1 is 1 or 2.
222. The compound of clause 221, wherein each occurrence of RcB is independently halo or C1-3 alkyl.
223. The compound of any one of clauses 215-219, wherein each of the remaining occurrences of Rc is independently halo or C1-3 alkyl.
224. The compound of clause 1, wherein the compound has the following formula:
Figure imgf000162_0001
wherein n2 is 0, 1, or 2; each of RbA and RbB is an independently selected Rb; and R7 is H or C1-4 alkyl. 225. The compound of clause 1, wherein the compound has the following formula:
Figure imgf000162_0002
wherein n2 is 0, 1, or 2; each of RbA and RbB is an independently selected Rb; and R7 is H or C1-4 alkyl. 226. The compound of clause 1, wherein the compound has the following formula:
Figure imgf000163_0001
wherein n2 is 0, 1, or 2; each of RbA and RbB is an independently selected Rb; and R7 is H or C1-4 alkyl. 227. The compound of clause 1, wherein the compound has the following formula:
Figure imgf000163_0002
wherein B2 is selected from the group consisting of:
(a) C3-5 monocyclic cycloalkyl which is optionally substituted with from 1-4 Rb;
(b) C5-6 (e.g., C5 or C6) bicyclic cycloalkyl which is optionally substituted with from 1-4 Rb;
(c) C7-10 (e.g., bicyclic or tricyclic) cycloalkyl, which is optionally substituted with from 1-4 Rb; and
(d) heterocyclyl including from 5-12 (e.g., 5-10) ring atoms, wherein from 1- 3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb;
and R7 is H or C1-4 alkyl. 228. The compound of clause 227, wherein B2 is C3-5 (e.g., C3 or C5) monocyclic cycloalkyl which is optionally substituted with from 1-4 Rb. 229. The compound of clause 228, wherein B2 is C5-6 (e.g., C5 or C6) bicyclic
cycloalkyl which is optionally substituted with from 1
Figure imgf000164_0001
230. The compound of clause 227, wherein B2 is C7-10 (e.g., bicyclic) cycloalkyl, which is optionally substituted with from 1-4 Rb.
231. The compound of clause 230, wherein B2 is is bicyclooctyl (e
Figure imgf000164_0002
), adamantyl (e.g., bicycloheptyl or bicycloheptenyl (e.g.,
Figure imgf000164_0003
Figure imgf000164_0004
each of which is further optionally substituted with from 1-3 Rb.
Figure imgf000164_0005
232. The compound of clause 227, wherein B2 is heterocyclyl including from 5- 12 (e.g., 5-10) ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb. 233. The compound of clause 232, wherein B2 is selected from the group
consisting of: pyrrolidinyl
Figure imgf000164_0006
piperidinyl (
Figure imgf000164_0007
tetrahydropyranyl ( each of which is further optionally
Figure imgf000165_0001
substituted with from 1-3 independently selected Rb. 234. The compound of any one of clauses 224-226, wherein RbA is as defined for Rb in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148).
235. The compound of any one of clauses 224-226, wherein RbA is as defined for Rb in any one of clauses 149-158 (e.g., 149; e.g., RbA is–L1-L2-Rh, and Rh is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or RbA is as defined in clause 158).
236. The compound of any one of clauses 224-226, wherein RbA is as defined for Rb in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
237. The compound of any one of clauses 227-233, wherein one occurrence of Rb is as defined in any one of clauses 142-148 (e.g., 142; e.g., 143 or 144; e.g., 145 or 146; or 148).
238. The compound of any one of clauses 227-233, wherein one occurrence of Rb is as defined in any one of clauses 149-158 (e.g., 149; e.g., Rb is–L1-L2-Rh, and Rh is as defined in clause 153, clause 154, clause 155, clause 156, or clause 157; or Rb is as defined in clause 158).
239. The compound of any one of clauses 227-233, wherein one occurrence of Rb is as defined in any one of clauses 159-161 (e.g., clause 159, clause 160, or clause 161).
240. The compound of any one of clauses 224-226, wherein n2 is 0.
241. The compound of any one of clauses 224-226, wherein n2 is 1 or 2. 242. The compound of clause 241, wherein each RbB is independently–F, -Cl, or C1-3 alkyl. 243. The compound of any one of clauses 227-233 and 237-239, wherein each remaining Rb is independently–F, -Cl, or C1-3 alkyl. 244. The compound of any one of clauses 200-243, wherein YA1 is a bond (i.e., YA1 is absent).
245. The compound of any one of clauses 200-243, wherein YA1 is C1-6 alkylene, which is optionally substituted with from 1-2 Ra (e.g., YA1 is -CH2-, -CH2CH2-, -CH2CH2CH2-, -CH(CF3)-, -CH2CH(OH)-, or (e.g., CH2)).
246. The compound of clause 1, wherein the compound has the following
formula: (I-12),
wherein B3 is C1-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra; and R7 is H or C1-4 alkyl.
247. The compound of clause 246, wherein B3 is unsubstituted C2-10 (e.g., C2,
C3, C4, C5, C6, C7, C8, C9, C10) alkyl (e.g., , , or ).
248. The compound of clause 246, wherein B3 is C2-10 (e.g., C2, C3, C4, C5, C6, C7, C8, C9, C10) alkyl, which is substituted with from 1-6 independently selected Ra.
249. The compound of clause 248, wherein each Ra is independently selected from the group consisting of halo, -OH, C(=O)OH, C(=O)(C1-3 alkyl), and NReRf.
250. The compound of clause 249, wherein each Ra is an independently selected halo (e.g., B3 is or ). 251. The compound of clause 249, wherein each Ra is independently selected from the group consisting of -OH, C(=O)OH, C(=O)(C1-3 alkyl), and NReRf (e.g., B3 is
Figure imgf000167_0001
252. The compound of clause 1, wherein the compound has the following formula:
Figure imgf000167_0002
wherein E is heterocyclyl including from 3-10 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
253. The compound of clause 252, wherein E is heterocyclyl including from 5-8 ring atoms, wherein aside from the nitrogen atom present, from 0-2 (e.g., 0-1) additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb.
254. The compound of clause 253, wherein E is piperidinyl, pyrrolidinyl, piperazinyl, oxazepanyl, each of which is optionally substituted with from 1-4 (e.g., 1-3) independently selected Rb. 255. The compound of clause 254, wherein E is selected from the group
consisting of: each of which is optionally further
Figure imgf000168_0001
substituted with one Rb.
256. The compound of any one of clauses 252-255, wherein each Rb substituent of E is as defined in any one of clauses (e.g., 196; e.g., 197; e.g., 198; or e.g., 199).
257. The compound of any one of clauses 200-256, wherein the
Figure imgf000168_0002
moiety
Figure imgf000168_0003
258. The compound of any one of clauses 200-256, wherein the
Figure imgf000168_0004
moiety
Figure imgf000168_0005
259. The compound of any one of clauses 200-256, wherein the
Figure imgf000168_0006
moiety
Figure imgf000168_0007
260. The compound of any one of clauses 200-256, wherein the
moiety is (e.g., ).
261. The compound of any one of clauses 200-256, wherein the
moiety is (e.g., ).
262. The compound of any one of clauses 200-261, wherein each R1 is as defined in any one of clauses 41-71 (e.g., 41; e.g., 42; e.g., 43; e.g., 44; or e.g., 54 (e.g., wherein Ri is as defined in clauses 58 or 59)).
263. The compound of any one of clauses 200-261, wherein each R1 is as defined in any one of clauses 72-74 (e.g., 72; e.g., 73; or e.g., 74).
264. The compound of any one of clauses 200-256, wherein the
moiety is .
265. The compound of any one of clauses 200-256 and 264, wherein each R3 is as defined in any one of clauses 75-76 (e.g., each R3 is H).
266. The compound of any one of clauses 200-265, wherein R5 is H.
267. The compound of any one of clauses 200-265, wherein R5 is halo.
268. The compound of any one of clauses 200-267, wherein R2 is H.
269. The compound of any one of clauses 1-268, wherein R6 is H.
270 The compound of any one of clauses 1-269, wherein R7 is H. 271. The compound of any one of clauses 1-270, wherein the compound is selected from the group consisting of the compounds delineated in Table C1 or a pharmaceutically acceptable salt thereof.
272. A pharmaceutical composition comprising a compound of clauses 1-271 or a pharmaceutically acceptable salt thereof, and one or more pharmaceutically acceptable excipients.
273. A method for inhibiting STING activity, the method comprising contacting STING with a compound as described in any one of clauses 1-271, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as described in clause 272.
274. The method of clause 273, wherein the inhibiting comprises antagonizing STING.
275. The method of any one of clauses 273-274, which is carried out in vitro. 276. The method of clause 275, wherein the method comprises contacting a sample comprising one or more cells comprising STING with the compound.
277. The method of clause 275 or 276, wherein the one or more cells are one or more cancer cells.
278. The method of clause 276 or 277 wherein the sample further comprises one or more cancer cells (e.g., wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma).
279. The method of clause 273, which is carried out in vivo.
280. The method of clause 279, wherein the method comprises administering the compound to a subject having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and/or symptoms and/or progression of the disease.
281. The method of clause 280, wherein the subject is a human.
282. The method of clause 280, wherein the disease is cancer. 283. The method of clause 282, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
284. The method of clause 282 or 283, wherein the cancer is a refractory cancer. 285. The method of clause 280, wherein the compound is administered in combination with one or more additional cancer therapies.
286. The method of clause 285, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
287. The method of clause 286, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
288. The method of clause 287, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin); an anti-metabolite (e.g.,azathioprine and/or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and/or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and/or Vindesine Taxol, Pacllitaxel and/or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and/or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and/or topotecan;. amsacrine, etoposide, etoposide phosphate and/or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and/or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and/or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Muromonab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and/or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an anti- helminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1– PD-L1, PD- 1– PD-L2, interleukin‑2 (IL‑2), indoleamine 2,3-dioxygenase (IDO), IL‑10, transforming growth factor-b (TGFb), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9– TIM3, Phosphatidylserine– TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II– LAG3, 4‑1BB–4‑1BB ligand, OX40–OX40 ligand, GITR, GITR ligand– GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25–TL1A, CD40L, CD40– CD40 ligand, HVEM–LIGHT–LTA, HVEM, HVEM– BTLA, HVEM– CD160, HVEM – LIGHT, HVEM–BTLA–CD160, CD80, CD80– PDL-1, PDL2– CD80, CD244, CD48 – CD244, CD244, ICOS, ICOS–ICOS ligand, B7‑H3, B7‑H4, VISTA, TMIGD2, HHLA2–TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86– CD28, CD86– CTLA, CD80– CD28, CD39, CD73 Adenosine–CD39– CD73, CXCR4–CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine – TIM3, SIRPA–CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
289. The method of any one of clauses 280-288, wherein the compound is administered intratumorally.
290. A method of treating cancer, comprising administering to a subject in need of such treatment an effective amount of a compound as described in any one of clauses 1- 271, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as described in clause 272.
291. The method of clause 290, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
292. The method of clause 290 or 291, wherein the cancer is a refractory cancer. 293. The method of clause 290, wherein the compound is administered in combination with one or more additional cancer therapies.
294. The method of clause 293, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
295. The method of clause 294, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
296. The method of clause 295, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin); an anti-metabolite (e.g.,azathioprine and/or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and/or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and/or Vindesine Taxol, Pacllitaxel and/or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and/or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and/or topotecan;. amsacrine, etoposide, etoposide phosphate and/or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and/or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and/or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Muromonab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and/or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an anti- helminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1– PD-L1, PD- 1– PD-L2, interleukin‑2 (IL‑2), indoleamine 2,3-dioxygenase (IDO), IL‑10, transforming growth factor-b (TGFb), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9– TIM3, Phosphatidylserine– TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II– LAG3, 4‑1BB–4‑1BB ligand, OX40–OX40 ligand, GITR, GITR ligand– GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25–TL1A, CD40L, CD40– CD40 ligand, HVEM–LIGHT–LTA, HVEM, HVEM– BTLA, HVEM– CD160, HVEM – LIGHT, HVEM–BTLA–CD160, CD80, CD80– PDL-1, PDL2– CD80, CD244, CD48 – CD244, CD244, ICOS, ICOS–ICOS ligand, B7‑H3, B7‑H4, VISTA, TMIGD2, HHLA2–TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86– CD28, CD86– CTLA, CD80– CD28, CD39, CD73 Adenosine–CD39– CD73, CXCR4–CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine – TIM3, SIRPA–CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
297. The method of any one of clauses 290-296, wherein the compound is administered intratumorally.
298. A method of inducing an immune response in a subject in need thereof, the method comprising administering to the subject an effective amount of a compound as described in any one of clauses 1-271, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as described in clause 272.
299. The method of clause 298, wherein the subject has cancer.
300. The method of clause 299, wherein the subject has undergone and/or is undergoing and/or will undergo one or more cancer therapies.
301. The method of clause 299, wherein the cancer selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
302. The method of clause 301, wherein the cancer is a refractory cancer.
303. The method of clause 298, wherein the immune response is an innate immune response.
304. The method of clause 303, wherein the at least one or more cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
305. The method of clause 304, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
306. The method of clause 305, wherein the one or more additional chemotherapeutic agents is selected from alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin); an anti-metabolite (e.g.,azathioprine and/or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and/or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and/or Vindesine Taxol, Pacllitaxel and/or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and/or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and/or topotecan;. amsacrine, etoposide, etoposide phosphate and/or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and/or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and/or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Muromonab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and/or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an anti- helminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1– PD-L1, PD- 1– PD-L2, interleukin‑2 (IL‑2), indoleamine 2,3-dioxygenase (IDO), IL‑10, transforming growth factor-b (TGFb), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9– TIM3, Phosphatidylserine– TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II– LAG3, 4‑1BB–4‑1BB ligand, OX40–OX40 ligand, GITR, GITR ligand– GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25–TL1A, CD40L, CD40– CD40 ligand, HVEM–LIGHT–LTA, HVEM, HVEM– BTLA, HVEM– CD160, HVEM – LIGHT, HVEM–BTLA–CD160, CD80, CD80– PDL-1, PDL2– CD80, CD244, CD48 – CD244, CD244, ICOS, ICOS–ICOS ligand, B7‑H3, B7‑H4, VISTA, TMIGD2, HHLA2–TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86– CD28, CD86– CTLA, CD80– CD28, CD39, CD73 Adenosine–CD39– CD73, CXCR4–CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine – TIM3, SIRPA–CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
307. A method of treatment of a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and/or symptoms and/or progression of the disease, comprising administering to a subject in need of such treatment an effective amount of a compound as described in any one of clauses 1-271, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as described in clause 272.
308. A method of treatment comprising administering to a subject having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and/or symptoms and/or progression of the disease an effective amount of a compound as described in any one of clauses 1-271, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as described in clause 272.
309. A method of treatment comprising administering to a subject a compound as described in any one of clauses 1-271, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as described in clause 272, wherein the compound or composition is administered in an amount effective to treat a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and/or symptoms and/or progression of the disease, thereby treating the disease.
310. The method of any one of clauses 307-309, wherein the disease is cancer. 311. The method of clause 310, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
312. The method of clause 310 or 311, wherein the cancer is a refractory cancer. 313. The method of any one of clauses 310-312, wherein the compound is administered in combination with one or more additional cancer therapies.
314. The method of clause 313, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
315. The method of clause 314, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
316. The method of clause 315, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and/or oxaliplatin); an anti-metabolite (e.g.,azathioprine and/or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and/or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and/or Vindesine Taxol, Pacllitaxel and/or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and/or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and/or topotecan;. amsacrine, etoposide, etoposide phosphate and/or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and/or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and/or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Muromonab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and/or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an anti- helminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1– PD-L1, PD- 1– PD-L2, interleukin‑2 (IL‑2), indoleamine 2,3-dioxygenase (IDO), IL‑10, transforming growth factor-b (TGFb), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9– TIM3, Phosphatidylserine– TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II– LAG3, 4‑1BB–4‑1BB ligand, OX40–OX40 ligand, GITR, GITR ligand– GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25–TL1A, CD40L, CD40– CD40 ligand, HVEM–LIGHT–LTA, HVEM, HVEM– BTLA, HVEM– CD160, HVEM – LIGHT, HVEM–BTLA–CD160, CD80, CD80– PDL-1, PDL2– CD80, CD244, CD48 – CD244, CD244, ICOS, ICOS–ICOS ligand, B7‑H3, B7‑H4, VISTA, TMIGD2, HHLA2–TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86– CD28, CD86– CTLA, CD80– CD28, CD39, CD73 Adenosine–CD39– CD73, CXCR4–CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine – TIM3, SIRPA–CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
317. The method of any one of clauses 307-316, wherein the compound is administered intratumorally.
318. A method of treatment of a disease, disorder, or condition associated with STING, comprising administering to a subject in need of such treatment an effective amount of a compound as described in any one of clauses 1-271, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as described in clause 272. 319. The method of clause 318, wherein the disease, disorder, or condition is selected from type I interferonopathies, Aicardi-Goutières Syndrome (AGS), genetic forms of lupus, inflammation-associated disorders, and rheumatoid arthritis.
320. The method of clause 319, wherein the disease, disorder, or condition is a type I interferonopathy (e.g., STING-associated vasculopathywith onset in infancy (SAVI)).
321. The method of clause 320, wherein the type I interferonopathy is STING- associated vasculopathy with onset in infancy (SAVI)).
322. The method of clause 320, wherein the disease, disorder, or condition is Aicardi-Goutières Syndrome (AGS).
323. The method of clause 319, wherein the disease, disorder, or condition is a genetic form of lupus.
324. The method of clause 319, wherein the disease, disorder, or condition is inflammation-associated disorder.
325. The method of clause 324, wherein the inflammation-associated disorder is systemic lupus erythematosus.
326. The method of any one of clauses 273-325, wherein the method further comprises identifying the subject.

Claims

WHAT IS CLAIMED IS: 1. A compound of Formula I:
Figure imgf000180_0001
Formula (I)
or a pharmaceutically acceptable salt thereof or a tautomer thereof,
wherein:
Z is selected from the group consisting of a bond, CR1, C(R3)2, N, and NR2;
each of Y1, Y2, and Y3 is independently selected from the group consisting of O, S, CR1, C(R3)2, N, and NR2;
Y4 is C or N;
X1 is selected from the group consisting of O, S, N, NR2, and CR1;
X2 is selected from the group consisting of O, S, N, NR4, and CR5;
each is independently a single bond or a double bond, provided that the five- membered ring comprising Y4, X1, and X2 is heteroaryl; Q-A is defined according to (A) or (B) below:
(A)
Q is selected from the group consisting of: NH; N(C1-6 alkyl) wherein the C1-6 alkyl is optionally substituted with 1-2 independently selected Ra; O; S; and C1-3 alkylene which is optionally substituted with 1-2 independently selected Ra and
A is:
(i) -(YA1)n-YA2, wherein:
^ n is 0 or 1;
^ YA1 is C1-6 alkylene, which is optionally substituted with from 1-6 substituents each indepndently selected from the group consisting of Ra; C6- 10 aryl optionally substituted with 1-4 independently selected C1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C1-4 alkyl; and
^ YA2 is:
(a) C3-20 cycloalkyl, which is optionally substituted with from 1-4 Rb, (b) C6-20 aryl, which is optionally substituted with from 1-4 Rc;
(c) heteroaryl including from 5-20 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc; or (d) heterocyclyl including from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb,
OR
(ii) -Z1 -Z2-Z3, wherein:
^ Z1 is C1-3 alkylene, which is optionally substituted with from 1-4 Ra;
^ Z2 is–N(H)-, -N(Rd)-, -O-, or–S-; and
^ Z3 is C2-7 alkyl, which is optionally substituted with from 1-4 Ra;
OR
(iii) C1-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra,
OR
(B) Q and A, taken together, form:
Figure imgf000181_0001
E is heterocyclyl including from 3-16 ring atoms, wherein aside from the nitrogen atom present, from 0-3 additional ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb, each occurrence of R1 is independently selected from the group consisting of ^ H;
^ halo;
^ cyano;
^ C1-6 alkyl optionally substituted with 1-2 Ra;
^ C2-6 alkenyl;
^ C2-6 alkynyl;
^ C1-4 haloalkyl;
^ C1-4 alkoxy;
^ C1-4 haloalkoxy;
^ –L3-L4-Ri;
^ -S(O)1-2(C1-4 alkyl),
^ -S(O)(=NH)(C1-4 alkyl),
^ SF5,
^ -NReRf,
^ –OH,
^ oxo,
^ -S(O)1-2(NR’R’’),
^ -C1-4 thioalkoxy,
^ -NO2,
^ -C(=O)(C1-4 alkyl),
^ -C(=O)O(C1-4 alkyl),
^ -C(=O)OH, and
^ -C(=O)N(R’)(R’’);
or a pair of R1 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy, each occurrence of R2 is independently selected from the group consisting of: (i) C1-6 alkyl, which is optionally substituted with from 1-2 independently selected Ra;
(ii) C3-6 cycloalkyl;
(iii) heterocyclyl including from 3-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2;
(iv) C6-10 aryl;
(v) heteroaryl including from 5-10 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2;
(vi) -C(O)(C1-4 alkyl);
(vii) -C(O)O(C1-4 alkyl);
(viii) -CON(R’R’’);
(ix) -S(O)1-2(NR’R’’);
(x) - S(O)1-2(C1-4 alkyl);
(xi) -OH;
(xii) C1-4 alkoxy; and
(xiii) H; or a pair of R1 and R2 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy, each occurrence of R3 is independently selected from H; C1-6 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;–OH; -F; -Cl; -Br;– NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-4 alkyl); -C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)N(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano; and C3-6 cycloalkyl optionally substituted with from 1-4 independently selected C1-4 alkyl; or
two R3 on the same carbon combine to form an oxo; or
a pair of R3, taken together with the atom(s) connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; or
a pair of R1 and R3 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; or
or a pair of R2 and R3 on adjacent atoms, taken together with the atoms connecting them, form a ring including from 3-10 ring atoms, wherein from 0-2 ring atoms (in addition to the nitrogen atom to which the R2 is attached) are heteroatoms each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2; and wherein the ring is optionally substituted with from 1-4 substituents each independently selected from C1-6 alkyl, halo, C1-6 haloalkyl, -OH, NReRf, C1-6 alkoxy, and C1-6 haloalkoxy; R4 is selected from H and C1-6 alkyl;
R5 is selected from H and halo;
R6 is selected from H; C1-6 alkyl; -OH; C1-4 alkoxy; C(=O)H; C(=O)(C1-4 alkyl); CN; C6-10 aryl optionally substituted with from 1-4 independently selected C1-4 alkyl; and heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected C1-4 alkyl; each occurrence of Ra is independently selected from the group consisting of:– OH; -F; -Cl; -Br;–NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1- 4 alkyl); -C(=O)OH; -CON(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano, and C3- 6 cycloalkyl optionally substituted with from 1-4 independently selected C1-4 alkyl;
each occurrence of Rb is independently selected from the group consisting of: C1- 10 alkyl optionally substituted with from 1-6 independently selected Ra; C1-4 haloalkyl;– OH; oxo; -F; -Cl; -Br;–NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)N(R’)(R’’); -S(O)1-2(NR’R’’); -S(O)1-2(C1-4 alkyl); cyano; and–L1-L2-Rh;
each occurrence of Rc is independently selected from the group consisting of: (a) halo;
(b) cyano;
(c) C1-10 alkyl which is optionally substituted with from 1-6 independently selected Ra;
(d) C2-6 alkenyl;
(e) C2-6 alkynyl;
(g) C1-4 alkoxy;
(h) C1-4 haloalkoxy;
(i) -S(O)1-2(C1-4 alkyl);
(j) -NReRf;
(k)–OH;
(l) -S(O)1-2(NR’R’’);
(m) -C1-4 thioalkoxy;
(n) -NO2;
(o) -C(=O)(C1-10 alkyl);
(p) -C(=O)O(C1-4 alkyl);
(q) -C(=O)OH;
(r) -C(=O)N(R’)(R’’); and (s)–L1-L2-Rh;
Rd is selected from the group consisting of: C1-6 alkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); -CON(R’)(R’’); -S(O)1-2(NR’R’’); - S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy;
each occurrence of Re and Rf is independently selected from the group consisting of: H; C1-6 alkyl; C1-6 haloalkyl; C3-6 cycloalkyl; -C(O)(C1-4 alkyl); -C(O)O(C1-4 alkyl); - CON(R’)(R’’); -S(O)1-2(NR’R’’); - S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; or Re and Rf together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from H and C1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to Re and Rf), which are each independently selected from the group consisting of N(Rd), NH, O, and S; -L1 is a bond or C1-3 alkylene;
-L2 is–O-, -N(H)-, -S(O)0-2-, or a bond;
Rh is selected from:
^ C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl (in certain embodiments, it is provided that when Rh is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected C1-4 alkyl, -L1 is a bond, or–L2 is–O-, -N(H)-, or -S-);
^ heterocyclyl, wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
^ heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ^ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl; -L3 is a bond or C1-3 alkylene;
-L4 is–O-, -N(H)-, -S(O)0-2-, or a bond;
Ri is selected from:
^ C3-8 cycloalkyl optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl (in certain embodiments, it is provided that when Ri is C3-6 cycloalkyl optionally substituted with from 1-4 substituents independently selected C1-4 alkyl, -L1 is a bond, or–L2 is–O-, -N(H)-, or -S-);
^ heterocyclyl, wherein the heterocyclyl includes from 3-16 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, wherein the heterocyclyl is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1- 4 haloalkyl;
^ heteroaryl including from 5-10 ring atoms, wherein from 1-4 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2 and wherein the heteroaryl ring is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, and C1-4 haloalkyl; and ^ C6-10 aryl, which is optionally substituted with from 1-4 substituents independently selected from the group consisting of halo, C1-4 alkyl, or C1- 4 haloalkyl; and each occurrence of R’ and R’’ is independently selected from the group consisting of: H, C1-4 alkyl, and C6-10 aryl optionally substituted with from 1-2 substituents selected from halo, C1-4 alkyl, and C1-4 haloalkyl; or R’ and R’’ together with the nitrogen atom to which each is attached forms a ring including from 3-8 ring atoms, wherein the ring includes: (a) from 1-7 ring carbon atoms, each of which is substituted with from 1-2 substituents independently selected from the group consisting of H and C1-3 alkyl; and (b) from 0-3 ring heteroatoms (in addition to the nitrogen atom attached to R’ and R’’), which are each independently selected from the group consisting of N(H), N(C1-6 alkyl), O, and S.
2. The compound of claim 1, wherein the ring that includes Z, Y1, Y2, Y3, and Y4 is aromatic.
3. The compound of claim 1 or 2, wherein the
Figure imgf000188_0001
moiety is
Figure imgf000188_0002
.
4. The compound of claim 1 or 2, wherein from 1-2 of Y1, Y2, and Y3 is independently N or NR2, such as N; or wherein Z is N.
5. The compound of claims 1-2 or 4, wherein the
Figure imgf000188_0003
Figure imgf000188_0004
, , , , , wherein the asterisk denotes point of attachment to Y4.
6. The compound of claim 1, wherein the ring that includes Z, Y1, Y2, Y3, and Y4 is partially saturated.
7. The compound of any one of claims 1-6, wherein X1 is NR2 such as NH; and/or X2 is CR5 such as CH.
8. The compound of claim 1 or 2, wherein the compound is selected from a compound of the following formulae:
Figure imgf000189_0001
9. The compound of claims 1 or 6, wherein the compound has formula (Io):
Figure imgf000190_0001
10. The compound of any one of claims 1-9, wherein Q-A is defined according to (A).
11. The compound of any one of claims 1-10, wherein A is -(YA1)n-YA2.
12. The compound of any one of claims 1-11, wherein n is 0; or wherein n is 1.
13. The compound of any one of claims 1-12, wherein YA1 is C1-6 alkylene, which is optionally substituted with from 1-4 Ra.
14. The compound of any one of claims 1-13, wherein YA2 is C6-10 aryl, which is optionally substituted with from 1-3 Rc.
15. The compound of any one of claims 1-13, wherein YA2 is:
(a) heteroaryl including from 5-14 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl ring is optionally substituted with from 1-4 independently selected Rc;
(b) C3-10 cycloalkyl, which is optionally substituted with from 1-4 Rb; or
(c) heterocyclyl including from 3-12 ring atoms, wherein from 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl ring is optionally substituted with from 1-4 independently selected Rb.
16. The compound of any one of claims 1-10, wherein A is C1-10 alkyl, which is optionally substituted with from 1-6 independently selected Ra.
17. The compound of any one of claims 1-9, wherein Q-A is defined according to (B).
18. The compound of claim 1, wherein the compound is selected from the group consisting of the compounds delineated in Table C1 or a pharmaceutically acceptable salt thereof.
19. A pharmaceutical composition comprising a compound of any one of claims 1-18, or a pharmaceutically acceptable salt thereof, and one or more pharmaceutically acceptable excipients.
20. A method for inhibiting STING activity, the method comprising contacting STING with a compound as claimed in any one of claims 1-18, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as claimed in claim 19.
21. A method of inducing an immune response in a subject in need thereof, the method comprising administering to the subject an effective amount of a compound as claimed in any one of claims 1-18, or a pharmaceutically acceptable salt thereof; or a pharmaceutical composition as claimed in claim 19.
22. A method of treatment of disease, disorder, or condition associated with STING, such as a disease, disorder, or condition, in which increased STING signaling, such as excessive STING signaling, contributes to the pathology and/or symptoms and/or progression of the disease, such as cancer, comprising administering to a subject in need of such treatment an effective amount of a compound as claimed in any one of claims 1- 18, or a pharmaceutically acceptable salt thereof, or a pharmaceutical composition as claimed in claim 19.
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