METHODS OF MOBILIZING MARROW INFILTRATING LYMPHOCYTES AND USES THEREOF
Methods are disclosed for the mobilization of marrow infiltrating cells (MILs) using E-selectin antagonists for the treatment of disorders such as cancer. Methods for treating or preventing cancers using MILs mobilized by E-selectin antagonists are further disclosed.
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This application claims the benefit under 35 U.S.C. § 119(e) to U.S. Provisional Application No. 62/592,686, filed Nov. 30, 2017, which is incorporated by reference herein in its entirety.
The present disclosure relates to methods for mobilizing tumor-specific, primed, marrow infiltrating lymphocytes (MILs) from the bone marrow using at least one E-selectin antagonist or compositions comprising the same as well as methods of treatment or prevention of cancers using the mobilized MILs.
Immunotherapy has become a major focus of research in oncology. For example, for many years, Adoptive T-cell Therapy (ACT) has been used as a treatment for various cancers. ACT involves the isolation and ex vivo expansion of tumor specific T-cells to achieve greater number of T-cells than what could be obtained by vaccination alone. The tumor specific T-cells are then infused into patients with cancer in an attempt to give their immune system the ability to overwhelm remaining tumor via T-cells which can attack and kill cancer. Therefore, efficacious ACT requires the ability to activate tumor-specific T-cells that have the ability to travel to the tumor site and effectively kill their target. See, e.g., Noonan et al., Adoptive Transfer of Activated Marrow-Infiltrating Lymphocytes Induces Measureable Antitumor Immunity in the Bone Marrow in Multiple Myeloma, Cancer, Vol. 7, Issue 288 (May 15, 2015).
Prominent in oncology research is the tumor microenvironment and the interaction of T-cells. T-cells that are able to effectively identify and/or attack cancer cells are of particular interest because, for example, they can allow the body to quickly mount a response to cancer. T-cells that have long life spans are also of particular interest because, for example, they will be able to provide the body with longer-lasting defenses. One promising type of T-cell are MILs. MILs are T-cells that have been primed to tumor antigens. MILs have been found in patients suffering from hematological malignancies and in metastatic disease arising from solid tumors such as prostate, breast, and lung cancers. The presence of tumor-specific T-cells in the bone marrow of patients with hematologic malignancies and solid tumors opens up the prospect of utilizing MILs for many therapies including adoptive T-cell therapy (ACT).
A study by Noonan et al. has previously shown that anti-CD3/anti-CD28 ex vivo activated MILs have several fundamental properties, making them good candidates for cancer treatments. Noonan et al. at 2. Noonan found that, upon activation, MILs demonstrate significant tumor specificity compared to peripheral blood lymphocytes, target a broad range of antigens present on both the mature multiple myeloma plasma cells and their clonogenic precursors, and effectively kill multiple myeloma plasma cells. Id. Therefore, MILs exemplify a promising tumor-specific approach for treating cancers and cancerous malignancies.
Accordingly, there is an unmet need for methods of mobilizing MILs and inducing them to leave the marrow, where they can, for example, be used in ex vivo manipulations such as the development of CAR T-cells or used in autologous or allogenic donation.
Additionally, although ACT provides one option for cancer treatments, it requires ex vivo expansion of the cells, which can be time-consuming, inconvenient to patients, and labor intensive.
Accordingly, there is an unmet need for methods of mobilizing MILs for in vivo treatments.
The terms defined below are more fully defined by reference to the specification as a whole. While the terms used herein are believed to be well understood by one of ordinary skill in the art, the definitions included in this document are set forth to facilitate explanation of the presently-disclosed subject matter.
Following long-standing patent law convention, the terms “a,” “an,” and “the” refer to “one or more” when used in this application, including the claims. Thus, for example, reference to “a cell” includes one cell or a plurality of cells, and so forth.
Throughout this disclosure, various embodiments can be presented in a range format. Numeric ranges are inclusive of the numbers defining the range. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the disclosure. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range, such as from 1 to 6, should be considered to have specifically disclosed subranges, such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 2.7, 3.8, 4, 5.1, 5.3, and 6. This applies regardless of the breadth of the range.
E-selectin (CD62E) is a cell adhesion molecule that is expressed on activated endothelial cells and plays an important role in leukocyte recruitment to the site of injury. The terms “E-selectin antagonist” means an agent that inhibits an activity of E-selectin or inhibits the binding of E-selectin to one or more E-selectin ligands (which in turn may inhibit a biological activity of E-selectin). The term “E-selectin antagonist” includes antagonists of E-selectin only, as well as antagonists of E-selectin and either P-selectin or L-selectin, and antagonists of E-selectin, P-selectin, and L-selectin. E-selectin antagonists include the glycomimetic compounds described herein that inhibit interaction of E-selectin with sialyl Lea (sLea) or sialyl Lex (sLex). E-selectin antagonists also include antibodies, polypeptides, peptides, peptidomimetics, and aptamers which bind at or near the binding site on E-selectin to inhibit E-selectin interaction with sialyl Lea (sLea) or sialyl Lex (sLex)).
The term “non-glycomimetic moiety” includes moieties having a structure not intended to mimic a carbohydrate molecule. A non-glycomimetic moiety may not be (and is typically not) active as an E-selectin antagonist. Instead, non-glycomimetic moieties are generally moieties added to a glycomimetic moiety for purposes of altering at least one property, such as solubility, bio-availability, lipophilicity and/or other drug-like properties of the glycomimetic.
The terms “patient,” “subject,” “individual,” and the like are used interchangeably herein, and refer to any animal, or cells thereof whether in vitro or in situ, amenable to the methods described herein. In certain non-limiting embodiments, the patient, subject or individual is a human.
The term “therapy” refers to “treating” or “treatment” of a disease or condition including inhibiting the disease (slowing or arresting its development), providing relief from the symptoms or side-effects of the disease (including palliative treatment), and relieving the disease (causing regression of the disease). “Therapy” may also refer to prophylactic treatment, which includes preventing or delaying the onset of the disease or condition from occurring in a subject that may be predisposed to the disease but does not yet experience or exhibit symptoms of the disease.
The term “treatment” means the slowing down, interruption, arrest, reversal, or stoppage of the progression of the disease, which does not necessarily require the complete elimination of all the signs and symptoms of the disease. “Treatment” also includes prophylactic treatment to prevent or delay the onset of the disease or condition from occurring in a subject that may be predisposed to the disease but does not yet experience or exhibit symptoms of the disease. “Treatment” further means preventing or delaying the relapse or recurrence of the disease or condition in a subject that is considered in remission for the disease or condition. Furthermore, it is not necessary for the treatment to show effectiveness in 100% of the patients treated, rather, the term “treatment” is intended to mean that a statistically significant proportion of patients can be treated effectively, in such a way that the symptoms and clinical signs show at least an improvement. The person skilled in the art can easily establish whether the proportion is statistically significant using various statistical methods (e.g. confidence intervals, determination of them p value, Student's t-test, Mann-Whitney test etc.). Confidence intervals have a confidence of at least 90%, at least 95%, at least 97%, at least 98% or at least 99%. The p values are 0.1, 0.05, 0.01, 0.005 or 0.0001.
The term “prevention of relapse” refers to the reduction of the risk of the return of a disease or condition and/or extending the time until a relapse occurs.
As used herein, “together” is used to mean that the agents are administered concurrently. They can be administered in the same composition or in separate compositions. In contrast to “together,” “sequentially” is used herein to mean that the gap between administering one agent and the other is significant, i.e., the first administered agent may no longer be present in the bloodstream in a therapeutic amount when the second agent and/or third agent is administered. When administered sequentially, the compounds may be administered in any order.
Briefly, provided herein are agents that are E-selectin antagonists, compositions comprising the agents, and methods for using the agents for mobilizing marrow infiltrating lymphocytes from the bone marrow. Glycomimetic compounds that may be used in these methods are E-selectin antagonists as described herein. Additionally, compounds disclosed herein may be heterobifunctional, for example, an E-selectin antagonist linked to a CXCR4 chemokine receptor antagonist.
E-selectin is an adhesion molecule expressed on endothelial cells and binds to specific carbohydrate sequences (sialyl Lex and sialyl Lea) found on the surfaces of opposing bound cells. The endothelium in most of the normal vasculature does not express E-selectin until stimulation of protein synthesis by inflammatory mediators. After about three hours of de novo protein synthesis, E-selectin is then expressed as a result of an inflammatory response. In contrast, E-selectin is constitutively expressed in the bone marrow by the endothelial cells lining the blood vessels. Here, it is thought, without wishing to be bound by theory, that MILs reside in the vasculature niche of the bone marrow by binding to adhesion molecules, including E-selectin. In this disclosure, antagonists of E-selectin are provided that mobilize MILs from the bone marrow. Such antagonists may include but are not limited to small molecules, antibodies, aptamers, peptides, and glycoproteins. MILs derived from mobilized cells from the bone marrow have a wide range of therapeutic uses. For example, MILs can be induced to leave the marrow and distribute to the periphery where they may act in vivo or where they can be collected for ex vivo manipulation such as engineering CAR T-cells.
Furthermore, it is known that some individuals do not respond well to the use of Plerixafor (AMD-3100) and/or G-CSF due to age, disease, and certain genetic conditions. Thus, to the extent those prior art methods are found to be ineffective in mobilizing MILs, the disclosed methods provide an alternative.
In some embodiments, a method is provided for mobilizing MILs by inhibiting E-selectin, a major adhesion protein in the bone marrow vasculature. This method may comprise using the at least one E-selectin antagonist alone or in combination with other agents used to mobilize hematopoietic stem cells. Specific small molecule antagonists of E-selectin that mobilize hematopoietic cells and which are therefore useful for these methods and other methods are described herein.
In some embodiments, at least one E-selectin antagonist is administered to a patient. In some embodiments, at least one E-selectin antagonist is administered to a cancer patient in remission. In some embodiments, at least one E-selectin antagonist is administered as a cancer vaccine to stimulate MILs in a cancer patient or cancer survivor to prevent relapse.
In some embodiments, a method of treating cancer and/or preventing a cancer relapse is provided comprising administering to a patient at least one E-selectin antagonist in an amount sufficient to mobilize MILs of the patient into the peripheral blood.
In some embodiments, a method of treating cancer and/or preventing a cancer relapse is provided comprising administering to a donor patient at least one E-selectin antagonist in an amount of sufficient to mobilize MILs of the patient out of the marrow (e.g., into the peripheral blood), recovering MILS (e.g., recovering them from the peripheral blood), and transplanting at least a portion of the MIL cell population to the donor patient or another patient. In some embodiments, the MIL cell population is expanded ex vivo before transplantation.
In some embodiments, a method of preventing cancer is provided comprising administering to a donor patient at least one E-selectin antagonist in an amount sufficient to mobilize MILs of the patient out of the bone marrow (e.g., into the peripheral blood), recovering MILs (e.g., recovering them from the peripheral blood), and transplanting at least a portion of MIL cell population to a subject (e.g., a non-cancer patient, a patient suffering from a different form or type of cancer than the donor patient, etc.). In some embodiments, the MIL cell population is expanded ex vivo before transplantation.
In some embodiments, the at least one E-selectin antagonist is in the form of a pharmaceutical composition. In some embodiments the pharmaceutical composition further comprises at least one pharmaceutically acceptable ingredient.
At least one E-selectin antagonist may be chosen from glycomimetics. In some embodiments, at least one E-selectin antagonist is chosen from sialyl Lewisx (sLex) and sLex mimetics. In some embodiments, at least one E-selectin antagonist is chosen from glycomimetic antagonists of E-selectin, antibodies directed to E-selectin, aptamers to E-selectin, peptides or polypeptides directed to E-selectin, and peptidomimetics directed to E-selectin.
In some embodiments, a colony stimulating factor is administered with at least one E-selectin antagonist to the cancer patient.
In some embodiments, the cancer patient has received or will receive chemotherapy and/or radiotherapy. In some embodiments, the chemotherapy comprises administration of bortexomib and/or gemcitabine. In some embodiments, the cancer is a hematologic cancer. In some embodiments, the cancer is a solid cancer. In some embodiments, the cancer is a liquid cancer.
In some embodiments, the patient has been diagnosed with a first type of cancer and the cancer for which the method is performed to treat or prevent is a second type of cancer.
In some embodiments, a composition comprising MILs mobilized out of the bone marrow by at least one E-selectin antagonist is disclosed.
In some embodiments, treatment of cancer is provided by the mobilization of MILs following the administration of at least one E-selectin antagonist (i.e., in vivo mobilization of MILs). In some embodiments, relapse of cancer is prevented by the mobilization of MILs following the administration of at least one E-selectin antagonist.
In some embodiments, at least one E-selectin antagonist is chosen from compounds of Formula (I):
isomers of Formula (I), tautomers of Formula (I), and pharmaceutically acceptable salts of any of the foregoing, wherein:
-
- R1 is chosen from C1-C8alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups;
- R2 is chosen from H, -M, and -L-M;
- R3 is chosen from —OH, —NH2, —OC(═O)Y1, —NHC(═O)Y1, and —NHC(═O)NHY1 groups, wherein Y1 is chosen from C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, C2-C8 haloalkynyl, C6-C18 aryl, and C1-C13 heteroaryl groups;
- R4 is chosen from —OH and —NZ1Z2 groups, wherein Z1 and Z2, which may be identical or different, are each independently chosen from H, C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups, wherein Z1 and Z2 may together form a ring;
- R5 is chosen from C3-C8 cycloalkyl groups;
- R6 is chosen from —OH, C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups;
- R7 is chosen from —CH2OH, C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups;
- R8 is chosen from C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups;
- L is chosen from linker groups; and
- M is a non-glycomimetic moiety chosen from —C(═O)NH(CH2)1-4NH2, C1-C8 alkyl, —C(═O)OY2, and moieties comprising polyethylene glycol, thiazolyl, or chromenyl, wherein Y2 is chosen from C1-C4 alkyl, C2-C4 alkenyl, and C2-C4 alkynyl groups.
In some embodiments, at least one E-selectin antagonist is chosen from compounds of Formula (I), wherein M is a non-glycomimetic moiety comprising polyethylene glycol, thiazolyl, or chromenyl. In some embodiments, at least one E-selectin antagonist is chosen from compounds of Formula (I), wherein M is a non-glycomimetic moiety comprising polyethylene glycol.
As would be recognized by one of ordinary skill in the art, the phrase “isomers of Formula (I), tautomers of Formula (I), and pharmaceutically acceptable salts of any of the foregoing” includes hydrates and solvates.
In some embodiments, at least one E-selectin antagonist is chosen from compounds of Formula (I), wherein the non-glycomimetic moiety comprises polyethylene glycol.
In some embodiments, at least one E-selectin antagonist is chosen from compounds of Formula (II):
isomers of Formula (II), tautomers of Formula (II), and pharmaceutically acceptable salts of any of the foregoing, wherein:
-
- R1 is chosen from H, C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups;
- R2 is chosen from —OH, —NH2, —OC(═O)Y1, —NHC(═O)Y1, and —NHC(═O)NHY1 groups, wherein Y1 is chosen from C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, C2-C8 haloalkynyl, C6-C18 aryl, and C1-C13 heteroaryl groups;
- R3 is chosen from —CN, —CH2CN, and —C(═O)Y2 groups, wherein Y2 is chosen from C1-C8 alkyl, C2-C8 alkenyl, C2-C8 alkynyl, —OZ1, —NHOH, —NHOCH3, —NHCN, and —NZ1Z2 groups, wherein Z1 and Z2, which may be identical or different, are independently chosen from H, C1-C8alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups, wherein Z1 and Z2 may together form a ring;
- R4 is chosen from C3-C8 cycloalkyl groups;
- R5 is independently chosen from H, halo, Ci-Ce alkyl, C2-C8 alkenyl, C2-C8 alkynyl, C1-C8 haloalkyl, C2-C8 haloalkenyl, and C2-C8 haloalkynyl groups;
- n is chosen from integers ranging from 1 to 4; and
- L is chosen from linker groups.
As would be recognized by one of ordinary skill in the art, the phrase “isomers of Formula (II), tautomers of Formula (II), and pharmaceutically acceptable salts of any of the foregoing” includes hydrates and solvates.
In some embodiments, at least one E-selectin antagonist is chosen from compounds of Formula (IIa):
In some embodiments, the linker groups of Formula I and/or Formula II are independently chosen from groups comprising spacer groups, such spacer groups as, for example, —(CH2)p— and —O(CH2)p—, wherein p is chosen from integers ranging from 1 to 30. In some embodiments, p is chosen from integers ranging from 1 to 20. Other non-limiting examples of spacer groups include carbonyl groups and carbonyl-containing groups such as, for example, amide groups. A non-limiting example of a spacer group is
In some embodiments, the linker groups are independently chosen from
Other linker groups, such as, for example, polyethylene glycols (PEGs) and —C(═O)—NH—(CH2)p—C(═O)—NH—, wherein p is chosen from integers ranging from 1 to 30, or wherein p is chosen from integers ranging from 1 to 20, will be familiar to those of ordinary skill in the art and/or those in possession of the present disclosure.
In some embodiments, at least one linker group is
In some embodiments, at least one linker group is
In some embodiments, at least one linker group is chosen from —C(═O)NH(CH2)2NH—, —CH2NHCH2—, and —C(═O)NHCH2—. In some embodiments, at least one linker group is —C(═O)NH(CH2)2NH—.
In some embodiments, at least one E-selectin antagonist is chosen from compounds of Formula (Ia):
wherein n is chosen from integers ranging from 1 to 100. In some embodiments, n is chosen from 4, 8, 12, 16, 20, 24, and 28.
In some embodiments, at least one E-selectin antagonist is chosen from E-selectin antagonists disclosed in U.S. Pat. No. 9,109,002, which is hereby incorporated by reference. In some embodiments, at least one E-selectin antagonist is GMI-1271. See, e.g., Price et al., “Dormant breast cancer micrometastases reside in specific bone marrow niches that regulate their transit to and from bone,” Science Translational Medicine, Vol. 8(340), May 25, 2016, [DOI:10.1126/scitranslmed.aad4059]; Dutta et al., “E-Selectin Inhibition Mitigates Splenic HSC Activation and Myelopoiesis in Hypercholesterolemic Mice With Myocardial Infarction”, Arterioscler Thromb Vasc Biol [DOI: 10.1161/ATVBAHA.116.307519]
In some embodiments, at least one E-selectin antagonist is chosen from compounds of the following Formulae:
In some embodiments, at least one E-selectin antagonist is chosen from compounds of the following Formulae:
In some embodiments, at least one E-selectin antagonist is chosen from E-selectin antagonists disclosed in U.S. Pat. No. 8,410,066 and PCT/US2015/063191, which are hereby incorporated by reference. In some embodiments, at least one E-selectin antagonist is GMI-1359. See, e.g., Steele, Maria M. et al., “A small molecule glycomimetic antagonist of E-selectin and CXCR4 (GMI-1359) prevents pancreatic tumor metastasis and improves chemotherapy [abstract],” Proceedings of the 106th Annual Meeting of the American Association for Cancer Research, 2015 Apr. 18-22, Philadelphia, PA; Philadelphia (PA): AACR, Cancer Res 2015, 75(15 Suppl):Abstract nr 425. doi:10.1158/1538-7445.AM2015-425; Gravina, Giovanni L. et al., “Dual E-selectin and CXCR4 inhibition reduces tumor growth and increases the sensitivity to docetaxel in experimental bone metastases of prostate cancer [abstract],” Proceedings of the 106th Annual Meeting of the American Association for Cancer Research, 2015 Apr. 18-22, Philadelphia, PA; Philadelphia (PA): AACR, Cancer Res 2015, 75(15 Suppl):Abstract nr 428. doi:10.1158/1538-7445.AM2015-428, all of which are incorporated by reference.
Synthesis of the compounds of formula II (and substructures, and specific compounds) may be performed as described in U.S. Publication No. US 2017/0305951, which is incorporated herein by reference.
Also provided are pharmaceutical compositions comprising at least one compound of formula (I) and/or formula (II). Such pharmaceutical compositions are described in greater detail herein. These compounds and compositions may be used in the methods described herein.
In some embodiments, at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) and/or a pharmaceutical composition comprising at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) may be used in methods for releasing MILs out of bone marrow and into circulating blood and enhancing retention of MILs in the blood.
In some embodiments, at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) and/or a pharmaceutical composition comprising at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) may be used in methods described herein for treatment and/or prevention of a cancer. The cancer may be a cancer in which the cancer cells may leave the primary site. A primary site may be, for example, solid tissue (e.g., breast, prostate, or pancreatic) or the bloodstream.
One use of the method is, for example, for MILs harvesting. MILs may be needed, for example, after high-dose chemotherapy treatment. A compound described herein may be used, for example, to release MILs into circulating blood and enhance retention of MILs in the blood. The method may include a further step of collecting MILs that are released. A variety of techniques are known in the art for collecting MILs that have been released into the blood. For example, apheresis may be utilized.
The release of MILs from bone marrow into circulating blood and retention therein has a variety of uses. For example, the mobilized MILs may be collected from the blood. A use of such collected cells is to obtain healthy MILs from an individual prior to treatment of the individual in a manner such that MILs are suppressed. Following treatment, the individual can receive a transplantation utilizing MILs collected prior to treatment. This is useful, for example, where an individual needs to be subjected to a chemotherapy protocol that may damage MILs.
It can be desirable to additionally treat an individual with at least one (i.e., one or more) colony stimulating factor. Such a factor may be administered, for example, before or simultaneous with administration of at least one of the above-described compounds. Where administration is simultaneous, the combination may be administered from a single container or two (or more) separate containers. An example of a suitable colony stimulating factor is G-CSF. G-CSF induces the bone marrow to grow and produce more stem cells. A compound described herein aids in releasing MILs into circulating blood. MILs produced in bone marrow and released into circulating blood, as a result of the combination of the administration (separately or together) of a compound described herein and G-CSF, may be collected as described above. Such collected MILs may be, for example, administered to the individual after chemotherapy. Application of a compound described herein to mobilization and harvesting of healthy MILs from bone marrow treated with G-CSF provides cells useful, for example, for transplantation.
In some embodiments, at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) and/or a pharmaceutical composition comprising at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) may be used in methods described herein for treatment and/or prevention of tumor metastasis. In some embodiments, at least one additional chemotherapy agent such as gemcitabine is administered to the individual.
In some embodiments, at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) and/or a pharmaceutical composition comprising at least one compound of E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) may be used in methods for treatment and/or prevention of an inflammatory disease in which the adhesion or migration of cells occurs in the disease.
Examples of inflammatory diseases include inflammatory skin disorders such as atopic dermatitis and psoriasis. The treatment may reduce (partially or totally) the disease or a complication associated therewith, such as pain. The treatment may be used in conjunction with one or more other therapies for such an inflammatory disease or a complication associated therewith.
In some embodiments, at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) and/or a pharmaceutical composition comprising at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) may be used for treating at least one of the diseases, disorders, and conditions described herein or for the preparation or manufacture of a medicament for use in treating at least one of the diseases, disorders, and/or conditions described herein. Each of these methods and uses is described in greater detail.
In certain embodiments, the methods and E-selectin antagonists described herein are therefore useful for treating hematologic malignancies and metastatic disease, particularly in combination or as an adjunct therapy with chemotherapy and/or radiation therapy.
In some embodiments, at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) and/or a pharmaceutical composition comprising at least one E-selectin antagonist (e.g., a compound of formula (I) or formula (II)) may be used in combination with one or more other agents that mobilize hematopoietic cells. Such agents include, for example, G-CSF; AMD-3100 or other CXCR4 antagonists; GRO-β (CXCL2) and an N-terminal 4-amino truncated form (SB-251353); IL-8SDF-1a peptide analogs, CTCE-0021 and CTCE-0214; and the SDF1 analog, Met-SDF-1β (see, e.g., Pelus, supra and references cited therein). The appropriate therapeutic regimen for administering at least one E-selectin antagonist in combination with another mobilizing agent or agents can be readily determined by a person skilled in the clinical art.
In particular embodiments of the methods described herein, the subject is a human or non-human animal. A subject in need of the treatments described herein may exhibit symptoms or sequelae of cancer disease, disorder, or condition described herein or may be at risk of developing the disease, disorder, or condition. Non-human animals that may be treated include mammals, for example, non-human primates (e.g., monkey, chimpanzee, gorilla, and the like), rodents (e.g., rats, mice, gerbils, hamsters, ferrets, rabbits), lagomorphs, swine (e.g., pig, miniature pig), equine, canine, feline, bovine, and other domestic, farm, and zoo animals.
The effectiveness of a compound, agent, or composition described herein in treating or preventing a disease or disorder or condition, and determining and adjusting an appropriate dosing regimen (e.g., adjusting the amount of compound per dose and/or number of doses and frequency of dosing), can readily be determined by a person of ordinary skill in the medical and clinical arts. One or any combination of diagnostic methods, including physical examination, assessment and monitoring of clinical symptoms, and performance of analytical tests and methods described herein, may be used for monitoring the health status of the subject.
Mobilization of MILs can be monitored using methods and techniques routinely practiced in the art the skilled person. MILs may be identified by identifying the presence or absence of certain cell surface markers. For example, the presence and level of MILs can be determined by methods that detect the presence of CD8 or CD4 on the surface of cells (i.e., CD8+ or CD4+ cells).
The compounds described herein may be formulated in a pharmaceutical composition for use in medicaments and therapeutics for mobilizing MILs and for treatment or preventive (or prophylactic) treatment (e.g., reducing the likelihood of occurrence or of exacerbation of a disease, or of one or more symptoms of the disease) of a disease or disorder for which mobilizing MILs is beneficial or for which receiving a MILs transplant or replacement is beneficial. The methods and excipients described herein are exemplary and are in no way limiting.
The dose of an E-selectin antagonist described herein may depend upon the subject's condition, that is, stage of the disease, severity of symptoms caused by the disease, general health status, as well as age, gender, and weight, and other factors apparent to a person of ordinary skill in the medical art. Similarly, the dose of the therapeutic for treating a disease or disorder may be determined according to parameters understood by a person of ordinary skill in the medical art.
Pharmaceutical compositions may be administered in a manner appropriate to the disease or disorder to be treated as determined by persons of ordinary skill in the medical arts. An appropriate dose and a suitable duration and frequency of administration will be determined by such factors as discussed herein, including the condition of the patient, the type and severity of the patient's disease, the particular form of the active ingredient, and the method of administration. In general, an appropriate dose (or effective dose) and treatment regimen provides the pharmaceutical composition(s) as described herein in an amount sufficient to provide therapeutic and/or prophylactic benefit (for example, an improved clinical outcome, such as more frequent complete or partial remissions, or longer disease-free and/or overall survival, or a lessening of symptom severity or other benefit as described in detail above).
The pharmaceutical compositions described herein may be administered to a subject in need thereof by any one of several routes that effectively deliver an effective amount of the compound. Such administrative routes include, for example, topical, oral, nasal, intrathecal, enteral, buccal, sublingual, transdermal, rectal, vaginal, intraocular, subconjunctival, sublingual or parenteral administration, including subcutaneous, intravenous, intramuscular, intrasternal, intracavernous, intrameatal or intraurethral injection or infusion. Compositions administered by these routes of administration and others are described in greater detail herein.
A pharmaceutical composition may be a sterile aqueous or sterile non-aqueous solution, suspension or emulsion, which additionally comprises a physiologically acceptable excipient (pharmaceutically acceptable or suitable excipient or carrier) (i.e., a non-toxic material that does not interfere with the activity of the active ingredient). Such compositions may be in the form of a solid, liquid, or gas (aerosol). Alternatively, compositions described herein may be formulated as a lyophilizate, or compounds and polypeptides or peptides described herein may be encapsulated within liposomes using technology known in the art. Pharmaceutical compositions may also contain other components, which may be biologically active or inactive. Such components include, but are not limited to, buffers (e.g., neutral buffered saline or phosphate buffered saline), carbohydrates (e.g., glucose, mannose, sucrose or dextrans), mannitol, proteins, polypeptides or amino acids such as glycine, antioxidants, chelating agents such as EDTA or glutathione, stabilizers, dyes, flavoring agents, and suspending agents and/or preservatives.
Any suitable excipient or carrier known to those of ordinary skill in the art for use in pharmaceutical compositions may be employed in the compositions described herein. Excipients for therapeutic use are well known, and are described, for example, in Remington: The Science and Practice of Pharmacy (Gennaro, 21st Ed. Mack Pub. Co., Easton, PA (2005)). In general, the type of excipient is selected based on the mode of administration, as well as the chemical composition of the active ingredient(s). Pharmaceutical compositions may be formulated for any appropriate manner of administration, including, for example, topical, oral, nasal, intrathecal, enteral, buccal, sublingual, transdermal, rectal, vaginal, intraocular, subconjunctival, sublingual or parenteral administration, including subcutaneous, intravenous, intramuscular, intrasternal, intracavernous, intrameatal or intraurethral injection or infusion. For parenteral administration, the carrier preferably comprises water, saline, alcohol, a fat, a wax or a buffer. For oral administration, any of the above excipients or a solid excipient or carrier, such as mannitol, lactose, starch, magnesium stearate, sodium saccharine, talcum, cellulose, kaolin, glycerin, starch dextrins, sodium alginate, carboxymethylcellulose, ethyl cellulose, glucose, sucrose and/or magnesium carbonate, may be employed.
A pharmaceutical composition (e.g., for oral administration or delivery by injection) may be in the form of a liquid. A liquid pharmaceutical composition may include, for example, one or more of the following: a sterile diluent such as water for injection, saline solution, preferably physiological saline, Ringer's solution, isotonic sodium chloride, fixed oils that may serve as the solvent or suspending medium, polyethylene glycols, glycerin, propylene glycol or other solvents; antibacterial agents; antioxidants; chelating agents; buffers and agents for the adjustment of tonicity such as sodium chloride or dextrose. A parenteral preparation can be enclosed in ampoules, disposable syringes or multiple dose vials made of glass or plastic. The use of physiological saline is preferred, and an injectable pharmaceutical composition is preferably sterile.
For oral formulations, at least one E-selectin antagonist described herein can be used alone or in combination with appropriate additives to make tablets, powders, granules or capsules, for example, with any one or more conventional additives, disintegrators, lubricants, and if desired, diluents, buffering agents, moistening agents, preservatives, coloring agents, and flavoring agents. The compositions may be formulated to include a buffering agent to provide for protection of the active ingredient from low pH of the gastric environment and/or an enteric coating. A composition may be formulated for oral delivery with a flavoring agent, e.g., in a liquid, solid or semi-solid formulation and/or with an enteric coating.
Oral formulations may be provided as gelatin capsules, which may contain the active compound or biological along with powdered carriers. Similar carriers and diluents may be used to make compressed tablets. Tablets and capsules can be manufactured as sustained release products to provide for continuous release of active ingredients over a period of time. Compressed tablets can be sugar coated or film coated to mask any unpleasant taste and protect the tablet from the atmosphere, or enteric coated for selective disintegration in the gastrointestinal tract.
A pharmaceutical composition may be formulated for sustained or slow release. Such compositions may generally be prepared using well known technology and administered by, for example, oral, rectal or subcutaneous implantation, or by implantation at the desired target site. Sustained-release formulations may contain the active therapeutic dispersed in a carrier matrix and/or contained within a reservoir surrounded by a rate controlling membrane. Excipients for use within such formulations are biocompatible, and may also be biodegradable; preferably the formulation provides a relatively constant level of active component release. The amount of active therapeutic contained within a sustained release formulation depends upon the site of implantation, the rate and expected duration of release, and the nature of the condition to be treated or prevented.
The pharmaceutical compositions described herein can be formulated as suppositories by mixing with a variety of bases such as emulsifying bases or water-soluble bases. The pharmaceutical compositions may be prepared as aerosol formulations to be administered via inhalation. The compositions may be formulated into pressurized acceptable propellants such as dichlorodifluoromethane, propane, nitrogen and the like.
The at least one E-selectin antagonist may be administered topically (e.g., by transdermal administration). Topical formulations may be in the form of a transdermal patch, ointment, paste, lotion, cream, gel, and the like. Topical formulations may include one or more of a penetrating agent or enhancer (also call permeation enhancer), thickener, diluent, emulsifier, dispersing aid, or binder. Physical penetration enhancers include, for example, electrophoretic techniques such as iontophoresis, use of ultrasound (or “phonophoresis”), and the like. Chemical penetration enhancers are agents administered either prior to, with, or immediately following administration of the therapeutic, which increase the permeability of the skin, particularly the stratum corneum, to provide for enhanced penetration of the drug through the skin. Additional chemical and physical penetration enhancers are described in, for example, Transdermal Delivery of Drugs, A. F. Kydonieus (ED) 1987 CRL Press; Percutaneous Penetration Enhancers, eds. Smith et al. (CRC Press, 1995); Lenneras et al., J. Pharm. Pharmacol. 54:499-508 (2002); Karande et al., Pharm. Res. 19:655-60 (2002); Vaddi et al., Int. J. Pharm. 91:1639-51 (2002); Ventura et al., J. Drug Target 9:379-93 (2001); Shokri et al., Int. J. Pharm. 228(1-2):99-107 (2001); Suzuki et al., Biol. Pharm. Bull. 24:698-700 (2001); Alberti et al., J. Control Release 71:319-27 (2001); Goldstein et al., Urology 57:301-5 (2001); Kiijavainen et al., Eur. J. Pharm. Sci. 10:97-102 (2000); and Tenjarla et al., Int. J. Pharm. 192:147-58 (1999).
Routes of administration include, but are not limited to, intradermal, intramuscular, intraperitoneal, intravenous, intrathecal, and subcutaneous routes. In some embodiments, the compounds or compositions are administered locally (i.e., near a cancer tumor). In some embodiments, one or more of the compounds or compositions are administered using different routes of administration.
The compounds or pharmaceutical composition(s) can be administered in one or more doses and treatment regimens, which may be the same or different. In some embodiments, each of the compounds or pharmaceutical composition(s) is administered in an amount ranging from about 1 mg/kg to about 50 mg/kg once a day. In other embodiments, the dosage may be at any dosage including, but not limited to, about 1 μg/kg, 25 μg/kg, 50 μg/kg, 75 μg/kg, 100 μg/kg, 125 μg/kg, 150 μg/kg, 175 μg/kg, 200 μg/kg, 225 μg/kg, 250 μg/kg, 275 μg/kg, 300 μg/kg, 325 μg/kg, 350 μg/kg, 375 μg/kg, 400 μg/kg, 425 μg/kg, 450 μg/kg, 475 μg/kg, 500 μg/kg, 525 μg/kg, 550 μg/kg, 575 μg/kg, 600 μg/kg, 625 μg/kg, 650 μg/kg, 675 μg/kg, 700 μg/kg, 725 μg/kg, 750 μg/kg, 775 μg/kg, 800 μg/kg, 825 μg/kg, 850 μg/kg, 875 μg/kg, 900 μg/kg, 925 μg/kg, 950 μg/kg, 975 μg/kg, 1 mg/kg, 2 mg/kg, 3 mg/kg, 4 mg/kg, 5 mg/kg, 6 mg/kg, 7 mg/kg, 8 mg/kg, 9 mg/kg, or 10 mg/kg.
In some embodiments, the compounds or pharmaceutical composition(s) are administered in any of these amounts and ranges once a day, more than once a day, every other day, every two days, etc. One of more treatment cycles may be repeated, and any number of cycles is contemplated. The number of treatments per day and the amount per dose for each compound or pharmaceutical composition may vary during each cycle.
Kits with unit doses of one or more of the compounds, polypeptides, peptides, aptamers, antibodies and antigen binding fragments thereof described herein, usually in oral or injectable doses, are provided. Such kits may include a container containing the unit dose, an informational package insert describing the use and attendant benefits of the therapeutic in treating the pathological condition of interest, and optionally an appliance or device for delivery of the composition.
The following examples provide illustrative embodiments of the invention. One of ordinary skill in the art will recognize the numerous modifications and variations that may be performed without altering the spirit or scope of the present invention. Such modifications and variations are encompassed within the scope of the invention. The Examples do not in any way limit the invention.
EXAMPLESIn the disclosed examples, the following materials and methods were used.
Chemicals: GMI-1271 (100% parent, >97% purity) was obtained as a white, crystalline substance. It was stored protected from light at −20° C. The compound was formulated in sterile phosphate buffered saline (PBS), resulting in a clear, colorless solution with a pH value of 7.4 and a concentration of 4 mg/mL. The dosing solution was prepared 12 hours prior to the first dose and stored at 4° C. protected from light between treatments.
GMI-1359 (100% parent, >97% purity) was obtained as a white, granular powder. It was stored protected from light at −20° C. The compound was formulated in sterile (PBS), resulting in a clear, colorless solution with a pH value of 9.2 and a concentration of 4 mg/mL. The dosing solution was prepared 12 hours prior to the first dose and stored at 4° C. protected from light between treatments.
G-CSF (0.3 mg/mL) was obtained as a clear, colorless stock solution. It was stored protected from light and at 4° C. The dosing solution was prepared by diluting the stock solution with 5% dextrose. The result was a clear, colorless solution with a pH value of 4.8 and a concentration of 0.0128 mg/mL. The dosing formulation was prepared daily and was stored at room temperature and protected from light, between treatments.
Anti-CTLA-4 (7.36 mg/mL) was obtained as a clear, colorless stock solution. It was stored protected from light and at 4° C. The dosing solution was prepared by diluting the stock solution with PBS. The result was a clear, colorless solution with a pH value of 7 and a concentration of 1 mg/mL. The dosing formulation was prepared fresh weekly and stored at 4° C. and protected from light between treatments.
Animals and Husbandry: Female Envigo Balb/c mice (BALB/cAnNHsd) were used in this study. They were 6-7 weeks old on Day 1 of the experiment. The animals were fed irradiated Harlan 2918.15 Rodent Diet and water ad libitum. Animals were housed in Innovive disposable ventilated caging with corn cob bedding inside Biobubble® Clean Rooms that provide H.E.P.A filtered air into the bubble environment at 100 complete air changes per hour. All treatments, body weight determinations, and tumor measurements were carried out in the bubble environment. The environment was controlled to a temperature range of 70°±2° F. and a humidity range of 30-70%.
Cancer Cell Preparation: CT26WT cells were obtained. They were grown in RPMI 1640 medium which was modified with 1% 100 mM Na pyruvate, 1% 1 M HEPES buffer, 1% of a 45% glucose solution and supplemented with 10% non-heat-inactivated Fetal Bovine Serum (FBS) and 1% 100× Penicillin/Streptomycin/L-Glutamine (PSG). The growth environment was maintained in an incubator with a 5% CO2 atmosphere at 37° C. When expansion was complete, the cells (passage 3) were trypsinized using 0.25% trypsin-EDTA solution following cell detachment, the trypsin was inactivated by dilution with complete growth medium and any clumps of cells were separated by pipetting. The cells were centrifuged at 200 rcf for 8 minutes at 4° C., the supernatant was aspirated, and the pellet was re-suspended in cold Dulbecco's Phosphate Buffered Saline (DPBS) by pipetting. An aliquot of the homogeneous cell suspension was diluted in a trypan blue solution and counted using a Luna automated cell counter. The pre-implantation cell viability was 93%. The cell suspension was centrifuged at 200 rcf for 8 minutes at 4° C. The supernatant was aspirated and the cell pellet was re-suspended in cold serum-free medium to generate a final concentration of 2.50E+06 trypan-excluding cells/mL. The cell suspension was maintained on wet ice during implantation.
Following implantation, an aliquot of the remaining cells was diluted with a trypan blue solution and counted to determine the post-implantation cell viability (92%).
Test animals in were implanted subcutaneously, high in the axilla (just under the fore limb) on Day 0 with 5.0E+05 cells in 0.2 mL of serum-free medium using a 27-gauge needle and syringe.
Protocol for Detection and Mobilization of MILs in the CT-26 tumor model: GMI-1271 is a potent, small-molecule, glycomimetic antagonist of E-selectin. GMI-1359 is a potent, small-molecule glycomimetic dual antagonist, targeting E-selectin and CXCR4. The effects of inhibiting either E-selectin with GMI-1271 or E-selectin and CXCR4 with GMI-1359 on MIL mobilization was tested in BALB/c mice that had been induced to reject the syngeneic CT26 colon carcinoma via anti-CTLA-4 T cell checkpoint antibody. The experimental protocol is summarized in Table 1.
Treatment with anti-CTLA-4 for all mice implanted with CT26.WT began on Day 3. All mice were dosed intraperitoneally on Days 3, 6, 10, 13, and 17. All mice were dosed according to individual body weight on the day of treatment (0.2 mg/20 g).
On Day 25, mice without tumors following CTLA-4 treatment were distributed into the four “Tumor Immune” treatment groups indicated in Table 1 such that the mean body weight within each group was within 10% of the overall mean.
Treatment for “Tumor Immune” groups 1-4 began on Day 25. The Vehicle was dosed intraperitoneally every 12 hours for 3 days (Days 25-27). GMI-1271 and GMI-1359 were dosed intraperitoneally at 40 mg/kg every 12 hours for 3 days (Days 25-27). G-CSF was dosed at 0.125 mg/kg subcutaneously every 12 hours for 3 days (Days 25-27).
A “Nonimmune” group 5 was populated with age-matched, naive non-tumor bearing mice.
At 12 hours after the final dose of test agents, all mice in groups 1-5 (treatment “Tumor Immune” groups 1-4 and control “Nonimmune” group 5) were euthanized for blood and bone marrow collection.
Flow cytometric analysis was used to determine CD62L and CD44 expression on CD8+ T cells in whole blood and bone marrow samples. Secondary analysis included AH-1 Dextramer analysis on the three tissue types and IFNγ production in pooled blood and bone marrow samples. Samples were acquired using a 4 laser, 14 color Attune NxT Flow Cytometer with autosampler. CD62L and CD44 events were gated on CDS+ T cells.
ResultsThe distribution of CD8+ T cells in CT26 immune mice following administration of GMI-1271, GMI-1359, or G-CSF was analyzed. As shown in
The percent of CD8+ lymphocytes in bone marrow armed to produce IFNγ in the test subjects was also tested. As shown in
The percent of CD8+ lymphocytes in peripheral blood armed to produce IFNγ was tested as well.
Thus, the experimental results here highlight a unique use of E-selectin antagonists, such as GMI-1271 (a compound of formula (I)) and GMI-1359 (a compound of formula (II)). The administration of E-selectin antagonists results in mobilization or redistribution of tumor-primed MILs into peripheral blood.
The various embodiments described above can be combined to provide further embodiments. All U.S. patents, U.S. patent application publications, U.S. patent applications, non-U.S. patents, non-U.S. patent applications, and non-patent publications referred to in this specification and/or listed in the Application Data Sheet are incorporated herein by reference, in their entirety. Aspects of the embodiments can be modified, if necessary, to employ concepts of the various patents, applications, and publications to provide yet further embodiments.
These and other changes can be made to the embodiments in light of the above-detailed description. In general, in the following claims, the terms used should not be construed to limit the claims to the specific embodiments disclosed in the specification and the claims, but should be construed to include all possible embodiments along with the full scope of equivalents to which such claims are entitled. Accordingly, the claims are not limited by the disclosure.
Claims
1-19. (canceled)
20. A composition comprising MILs from a cancer patient that were mobilized out of the bone marrow by at least one E-selectin antagonist;
- wherein the at least one E-selectin antagonist is chosen from
21. The composition of claim 20, wherein the at least one E-selectin antagonist is not used in combination with other agents used to mobilize hematopoietic stem cells.
22. The composition of claim 20, wherein the MILs comprise CD8+ T cells.
23. The composition of claim 20, wherein the MILs comprise naïve CD8+ T cells.
24. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 5% of the CD8+ T cells are naïve CD8+ T cells.
25. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 10% of the CD8+ T cells are naïve CD8+ T cells.
26. The composition of claim 20, wherein the MILs comprise central memory CD8+ T cells.
27. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 35% of the CD8+ T cells are central memory CD8+ T cells.
28. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 40% of the CD8+ T cells are central memory CD8+ T cells.
29. The composition of claim 20, wherein the MILs comprise both naïve CD8+ T cells and central memory CD8+ T cells.
30. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 5% of the CD8+ T cells are naïve CD8+ T cells and at least 35% of the CD8+ T cells are central memory CD8+ T cells.
31. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 10% of the CD8+ T cells are naïve CD8+ T cells and at least 40% of the CD8+ T cells are central memory CD8+ T cells.
32. The composition of claim 20, wherein the MILs comprise CD8+ T cells armed to produce IFNγ following stimulation with a CT-26 tumor antigen.
33. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 15% of the CD8+ T cells are armed to produce IFNγ following stimulation with a CT-26 tumor antigen.
34. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 20% of the CD8+ T cells are armed to produce IFNγ following stimulation with a CT-26 tumor antigen.
35. The composition of claim 20, wherein the MILs comprise CD8+ T cells and wherein at least 5% of the CD8+ T cells are naïve CD8+ T cells, at least 35% of the CD8+ T cells are central memory CD8+ T cells, and at least 15% of the CD8+ T cells armed to produce IFNγ following stimulation with a CT-26 tumor antigen.
36. The composition of claim 20, wherein the at least one E-selectin antagonist is chosen from and pharmaceutically acceptable salts thereof.
37. The composition of claim 20, wherein the at least one E-selectin antagonist is
38. The composition of claim 20, wherein the at least one E-selectin antagonist is chosen from pharmaceutically acceptable salts thereof.
39. The composition of claim 20, wherein the at least one E-selectin antagonist is
Type: Application
Filed: Jun 1, 2023
Publication Date: Dec 28, 2023
Applicant: GlycoMimetics, Inc. (Rockville, MD)
Inventors: John L. Magnani (Gaithersburg, MD), William E. Fogler (Lutherville-Timonium, MD)
Application Number: 18/327,429
