PHARMACEUTICAL COMPOSITION OF POLYETHYLENE GLYCOL-MODIFIED CAMPTOTHECIN DERIVATIVE AND PREPARATION METHOD THEREOF

Abstract
A pharmaceutical composition of a polyethylene glycol-modified camptothecin derivative and a preparation method thereof. The pharmaceutical composition is prepared mainly from following components: a camptothecin derivative modified by polyethylene glycol, a pH value adjustment agent and water for injection. The pharmaceutical composition has high stability.
Description
FIELD OF THE INVENTION

The present invention belongs to the field of medicine, and in particular to a pharmaceutical composition of a polyethylene glycol-modified camptothecin derivative for injection and a preparation method and an application thereof.


BACKGROUND OF THE INVENTION

Camptothecin (CPT, Formula 1) is a natural product isolated from Nyssaceae plant Camptotheca acuminata, which was introduced into clinical practice in the early 1970s due to its excellent anticancer activity, later, due to diarrhea, hemorrhagic cystitis and other serious side effects, the clinical trials were terminated.




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Since the 1990s, a number of camptothecin derivatives have come into the market or entered into clinical studies successively, including 10-hydroxycamptothecin, 7-ethyl-10-hydroxycamptothecin, 9-nitrocamptothecin, 9-aminocamptothecin, irinotecan (CPT-11, Formula 2), topotecan and belotecan, exatecan, lurtotecan, diflomotecan, gimatecan, karenitecin, and so on. Among them, irinotecan has a very broad antitumor spectrum, and Phase I, II clinical study results show that the drug has a positive effect on chemotherapy-resistant tumors such as metastatic colorectal cancer, non-small cell lung cancer, ovarian cancer and cervical cancer, and also has a certain effect on gastric cancer, malignant lymphoma non-Hodgkin's lymphoma, breast cancer, small cell lung cancer, skin cancer, pancreatic cancer. It is now mainly used as an effective drug for the treatment of advanced colorectal cancer, and can still be effective for 5-FU resistant cases.




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However, camptothecin derivatives, including irinotecan, have a good anticancer activity, but still have some shortcomings, such as a poor solubility in water, great toxic side effects. The common adverse reactions are anorexia, nausea, vomit, diarrhea, leukopenia and neutropenia, anemia and thrombocytopenia, alopecia and acetylcholine syndrome. Especially diarrhea is the most common, nearly 90% of the subjects have diarrhea, of which nearly 30% have severe diarrhea.


Polyethylene glycol modification technology is a new technology developed rapidly in recent years, which is linking polyethylene glycol after activation to a drug molecule or surface to form a prodrug, and when the polyethylene glycol-drug complex enters the body, it can slowly release the drug molecule thus to produce curative effect. The polyethylene glycol-modified drug molecules have the following advantages: 1, increased water solubility of drugs; 2, reduced toxicity; 3, extended cycle half-life of drugs, reduced medication times, improved patient compliance, improved quality of life, reduced treatment cost; 4, reduced enzyme degradation effect, improved bioavailability.


Polyethylene glycol modification technology has been applied in camptothecin derivatives, WO2005028539 reports a series of compounds in which a multi-branched polyethylene glycol is linked to irinotecan, currently, in which one drug named etirinotecan pegol (Formula 3) is undergoing Phase III clinical trials for the treatment of metastatic breast cancer and colorectal cancer in a number of countries.


WO2007081596 reports a series of compounds in which a polyethylene glycol is linked to 7-ethyl-10-hydroxycamptothecin (an active metabolite of irinotecan in vivo), currently, in which one drug named firtecan pegol is undergoing Phase II clinical trials for the treatment of breast cancer and colorectal cancer in a number of countries.


CN103083680 discloses a polyethylene glycol-amino acid oligopeptide-irinotecan conjugate as shown in formula (4) having antitumor activity for the treatment of colorectal cancer, ovarian cancer and lung cancer, etc.


There have been no reports of pharmaceutical compositions of polyethylene glycol-modified camptothecin derivatives for injection in the prior art.




text missing or illegible when filed


In the prior art, the pharmaceutical composition of the camptothecin derivative is mostly a lyophilized preparation for injection, and CN103655491 reports a pharmaceutical composition of an irinotecan hydrochloride and a preparation method thereof, wherein the irinotecan hydrochloride is prepared into a lyophilized preparation, however, in the preparation process not only irinotecan hydrochloride and water for injection are used, lactose, ethanol and other additives are also used, which may not only increase the cost of product, more importantly, introduce substances that may affect the efficacy and produce side effects, resulting in uncertainty factors for the drug safety.


In addition, in the prior art, high molecular weight polyethylene glycol amino acid oligopeptides are linked to camptothecin derivative through ester bonds, the ester bonds have a poor stability, especially in a humid environment is easier to be hydrolyzed slowly and thus release the camptothecin derivative, which thereby affects the effect of polyethylene glycol modified drugs, and in the preparation, storage and use of injections, particularly lyophilized preparations for injection, contact with the humid environment is unavoidable, resulting in a slow degradation of the pharmaceutical composition of the polyethylene glycol-modified camptothecin derivative, which affects the drug stability.


SUMMARY OF THE INVENTION

It is one object of the present invention to provide a pharmaceutical composition of a polyethylene glycol-modified camptothecin derivative which has a high stability and can conform to the molding requirements and quality requirements of preparation and a preparation method thereof.


It is another object of the present invention to solve the problem that the polyethylene glycol-modified camptothecin derivative has a poor stability, and is easier to be slowly hydrolyzed in a humid environment and thus release the camptothecin derivative, which may thereby affect the effect of the polyethylene glycol-modified drug.


It is also one object of the present invention to provide an application of the pharmaceutical composition of polyethylene glycol-modified camptothecin derivative in the treatment of cancer.


Thus, one aspect of the present invention is to provide a pharmaceutical composition of a polyethylene glycol-modified camptothecin derivative which is mainly prepared by the following components: a polyethylene glycol-modified camptothecin derivative, pH adjuster and water for injection, wherein the pharmaceutical composition comprises 100 to 500 mg of the polyethylene glycol-modified camptothecin derivative.


The polyethylene glycol-modified camptothecin derivative of the present invention has the structure of the general formula (I):




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wherein:


PEG represents a polyethylene glycol residue, PEG has a molecular weight of 300 to 60,000 Daltons;


A1 and A2 represent the same or different amino acid residues;


m is an integer of 2 to 12, preferably, in is 2 to 6, more preferably, in is 2 or 3;


n is an integer of 0 to 6, preferably, n is 0 to 3, more preferably, n is 0, 1, 2 or 3;


and CPT is a camptothecin derivative residue, and the camptothecin derivative is selected from the group consisting of: 10-hydroxycamptothecin, 7-ethyl-10-hydroxycamptothecin, 9-nitrocamptothecin, 9-aminocamptothecin, irinotecan, topotecan and belotecan, exatecan, lurtotecan, diflutamide, diflomotecan, gimatecan or karenitecin. Preferably, the camptothecin derivative is 7-ethyl-10-hydroxycamptothecin (Formula 5) or irinotecan (Formula 2).




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Preferably, the PEG of the present invention has a molecular weight of 20,000 to 40,000 Daltons.


The PEG of the present invention may be a straight-chain, Y-type or multi-branched polyethylene glycol residue.


When PEG is a straight-chain polyethylene glycol residue, it has the structure of general formula (II):




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When PEG is a Y-type polyethylene glycol residue, it has the structure of general formula (III):




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wherein i is an integer of 10 to 1,500, preferably, i is an integer of 400 to 500.


When PEG is a multi-branched polyethylene glycol residue, it has the structure of general formula (IV):




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wherein:


k is an integer of 10 to 1,500, preferably, k is an integer of 160 to 180;


j is an integer of 3 to 8, preferably, j is 4;


and R is a core molecule of the multi-branched polyethylene glycol, and R is selected from the group consisting of residues of pentaerythritol, methylglucoside, sucrose, diethylene glycol, propylene glycol, glycerol or polyglycerol.


A1 and A2 in the present invention represent the same or different amino acid residues, and A1 and A2 are independently selected from the group consisting of aspartic acid, glutamic acid, glycine, alanine, leucine, isoleucine, valine, phenylalanine or methionine. Preferably, the A1 of the present invention is selected from aspartic acid or glutamic acid, the A2 is selected from the group consisting of glycine, alanine, leucine, isoleucine, valine, phenylalanine or methionine. More preferably, A1 is glutamic acid, A2 is glycine.


In a specific embodiment of the present invention, when in is preferably 2, n is preferably 1 in the structure of the general formula (I), the polyethylene glycol-modified camptothecin derivative has the structure of general formula (V):




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In a specific embodiment of the present invention, when in is preferably 3, n is preferably 1 in the structure of the general formula (I), the polyethylene glycol-modified camptothecin derivative has the structure of general formula (VI):




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In a more preferred embodiment of the present invention, the polyethylene glycol-modified camptothecin derivative having the structure of general formula (I) is:




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The content of the polyethylene glycol-modified camptothecin derivative in the pharmaceutical composition of the present invention can be determined according to the therapeutic dosage of the polyethylene glycol-modified camptothecin derivative in the art. The polyethylene glycol-modified camptothecin derivatives having different structures may be added to the pharmaceutical compositions in varying amounts. In a preferred embodiment of the present invention, the pharmaceutical composition comprises 100 to 500 mg of polyethylene glycol-modified camptothecin derivative, preferably 200 to 500 mg.


The pH adjuster of the present invention is one or a combination of more than two selected from the group consisting of hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, carbonic acid, toluenesulfonic acid, methanesulfonic acid, acetic acid, citric acid, malonic acid, tartaric acid, succinic acid, benzoic acid, ascorbic acid, α-ketoglutaric acid or α-glycerophosphoric acid. Preferably, the pH adjuster is one or a combination more than two selected from the group consisting of hydrochloric acid, acetic acid and phosphoric acid. More preferably, the pH adjuster is hydrochloric acid. The pH adjuster in the present invention is used to adjust the pH of the aqueous solution for injection comprising the polyethylene glycol-modified camptothecin derivative to 3.0 to 4.0. Since the polyethylene glycol-modified camptothecin derivatives are more stable in an acidic environment, especially acidic environment with a pH value lower than 4.0, and a faintly acidic environment with a pH value higher than 4.0, neutral or alkaline environments can cause a rapid degradation of polyethylene glycol-modified camptothecin derivatives. In the preparation process of the pharmaceutical composition of the polyethylene glycol-modified camptothecin derivative, the pH value of aqueous solution for injection comprising the polyethylene glycol-modified camptothecin derivative is adjusted to lower than 4.0 by the pH adjuster, and then a lyophilized preparation is prepared in accordance with a freeze-drying procedure. When the pH is lower than 3.0, both the appearance color of the lyophilized preparation product and the color after re-dissolution are darker, suggesting that the preparation product contains more colored impurities, so the pH is preferably in the range of 3.0 to 4.0. More preferably, the pH adjuster is used to adjust the pH of the aqueous solution for injection containing the polyethylene glycol-modified camptothecin derivative to 3.4 to 3.6.


In the present invention, the water for injection is used to provide an adjuvant material used for preparing the polyethylene glycol-modified camptothecin derivative into a preparation for injection. The water for injection is used to dissolve and dilute the polyethylene glycol-modified camptothecin derivative, which may be added in accordance with conventional additions in the art. In a specific embodiment of the present invention, the ratio of the amount of the water for injection and that of the polyethylene glycol-modified camptothecin derivative may be 10 to 80 ml/1 mg, preferably 20 to 60 ml/1 mg.


In a specific embodiment of the present invention, in addition to the polyethylene glycol-modified camptothecin derivative, the pH adjuster and the water for injection, the component further comprises a lyophilized excipient. The amount of the lyophilized excipient may be 0 to 10% (W/V), more preferably 0 to 5% (W/V) of the aqueous solution for injection comprising the polyethylene glycol-modified camptothecin derivative. The lyophilized excipient is one or more than two of mannitol, lactose, glucose, hydrolyzed gel, glycine or dextran. Preferably, the lyophilized excipient is mannitol and/or lactose. More preferably, the lyophilized excipient is mannitol.


The pharmaceutical composition of the polyethylene glycol-modified camptothecin derivative of the present invention is a solution injection, a suspension injection, an emulsion injection or sterile powder for injection. Preferably, the pharmaceutical composition is sterile powder for injection; more preferably, the pharmaceutical composition is a lyophilized preparation for injection.


Another aspect of the present invention is to provide a preparation method of the pharmaceutical composition of the polyethylene glycol-modified camptothecin derivative, the method comprises the following steps: (1) taking the polyethylene glycol-modified camptothecin derivative and lyophilized excipient, adding water for injection with a total volume of water for injection in the composition of 70% to 90%, stirring to make the solution completely dissolved; (2) adjusting the pH to 3.0 to 4.0 with the pH adjuster, adding water for injection to a full dose; (3) freeze-drying to obtain the product.


In a preferred embodiment of the present invention, the total volume of the water for injection added into components in the step (1) is 90%; stirring in the step (1) is stirring to make the solution completely dissolved, and the pH is adjusted to 3.0 to 4.0 with the pH adjuster in the step (2), the temperature in the process of adding water for injection to the full dose is lower than 30° C., preferably 15 to 30° C.; the preparation of the pharmaceutical composition of the polyethylene glycol-modified camptothecin derivative is completed within 10 hours, preferably within 8 hours.


In a specific embodiment of the present invention, the freeze-drying step in the step (3) is preferably pre-freezing at −20° C. to −40° C. for 4 to 8 hours and then completing sublimation drying within 40 to 60 hours, finally desorption drying at 25° C. for 4 to 8 hours. Preferably, the pre-freezing temperature is −40° C.


Yet another aspect of the present invention is to provide an application of the polyethylene glycol-modified camptothecin derivative pharmaceutical composition in the treatment of cancer. Preferably, the cancer is one of colorectal cancer, ovarian cancer, and lung cancer.


The pharmaceutical composition of the polyethylene glycol-modified camptothecin derivative of the present invention has a high stability and can conform to the molding requirements and quality requirements of preparation, and the stability of the preparation can be effectively improved by adjusting the pH of the medicated solution in the preparation method. But also by industrialized production, the pharmaceutical composition has been proved to may have very good process stability through an impact factor test, compatibility stability test, acceleration test, long-term test.







DETAILED DESCRIPTION OF THE INVENTION

The present invention will be further described in detail with reference to the following examples.


In the present invention, the straight-chain polyethylene glycol (with a molecular weight of 20,000 Daltons)-glutamate glycine pentapeptide-irinotecan is prepared according to patent CN103083680A, and other reagents are commercially available.


Example 1: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 1)

Each 15 ampoules of the lyophilized preparation has a composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 2.0 with 1.0% hydrochloric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 2: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 2)

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.0 with 1.0% hydrochloric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 3: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 3)

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 4.0 with 1.0% hydrochloric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 4: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 4)

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 5.0 with 1.0% hydrochloric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 5: Investigation of the pH Value Range of the Prepared Solution

The stability of the samples with the prepared solution pH value of 2, 3, 4 and 5, respectively, were investigated by taking the appearance character, related substances and solution clarity as the main indexes.


The prepared samples of different prescriptions were placed under the condition of high temperature (40° C.), respectively, and sampled at 5th, 10th day, the appearance character, clarity and small molecules related substances of the samples were investigated, and the results are shown in Table 1.









TABLE 1







Investigation results of the prescriptions with different pH values
















Color and

Maximum
Total


Pre-

Ap-
clarity after

individual
im-


scription
Time
pearance
re-
Irinotecan
impurity
purity


number
(day)
character
dissolution
(ppm)
(ppm)
(ppm)
















Pre-
Day
Yellow
Transparent
4.06
76.10
114.2


scription
0
green
yellow





1

block
green






Day
Yellow
Transparent
2.23
100.4
166.6



5
green
yellow







block
green






Day
Yellow
Transparent
30.28
189.3
276.2



10
green
yellow







block
green





Pre-
Day
Light
Transparent
6.09
78.97
118.3


scription
0
yellow
light





2

block
yellow






Day
Light
Transparent
23.57
94.53
158.0



5
yellow
light







block
yellow






Day
Light
Transparent
36.82
174.2
259.2



10
yellow
light







block
yellow





Pre-
Day
Light
Transparent
12.79
84.17
130.7


scription
0
yellow
light





3

block
yellow






Day
Light
Transparent
30.73
95.45
168.8



5
yellow
light







block
yellow






Day
Light
Transparent
45.10
174.4
268.0



10
yellow
light







block
yellow





Pre-
Day
Light
Transparent
26.16
83.80
144.2


scription
0
yellow
light





4

block
yellow






Day
Light
Transparent
70.17
131.8
248.7



5
yellow
light







block
yellow






Day
Light
Transparent
85.69
223.2
366.2



10
yellow
light







block
yellow









It can be seen from the above results that, when the pH value of the prepared solution is low, the samples are yellow green, and when the pH value of the prepared solution is greater than 3, the samples are light yellow. The samples with Prescription 1, 2, 3 have a relatively small change of small molecular impurities, and a relatively good prescription stability after being placed at a high temperature of 40° C. for 10 days, however, the color of the sample with the prescription 1 is yellow green, which is greatly different from the character of the samples with other prescriptions. Therefore, under the condition of a pH value range of 3.0 to 4.0, the stability of the prescription can be relatively good.


Example 6: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 5)

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 7: Detailed Investigation of the pH Value Range of the Prepared Solution

The pH value was investigated more detailed in the range of pH 3.0 to 4.0, the stability of the samples with the prepared solution pH value of 3.0, 3.4 to 3.6, 4.0, respectively, were investigated by taking the appearance character, related substances and solution clarity as the main indexes.


The prepared samples of different prescriptions were placed under the condition of high temperature (40° C.), respectively, and sampled at 5th, 10th day, the appearance character, clarity and small molecules related substances of the samples were investigated, and the results are shown in Table 2.









TABLE 2







Investigation results of the prescriptions with detailed pH values
















Color and

Maximum
Total


Pre-

Appear-
clarity after

individual
im-


scription
Time
ance
re-
Innotecan
impurity
purity


number
(day)
character
dissolution
(ppm)
(ppm)
(ppm)
















Pre-
Day
Light
Transparent
6.27
15.81
49.64


scription
0
yellow
light





2

block
yellow






Day
Light
Transparent
18.74
119.6
191.6



5
yellow
light







block
yellow






Day
Light
Transparent
33.01
117.7
192.5



10
yellow
light







block
yellow





Pre-
Day
Light
Transparent
8.24
16.00
53.30


scription
0
yellow
light





5

block
yellow






Day
Light
Transparent
19.55
122.4
190.0



5
yellow
light







block
yellow






Day
Light
Transparent
33.64
113.3
186.8



10
yellow
light







block
yellow





Pre-
Day
Light
Transparent
15.87
19.58
68.09


scription
0
yellow
light





3

block
yellow






Day
Light
Transparent
29.46
88.36
203.2



5
yellow
light







block
yellow






Day
Light
Transparent
54.20
100.3
211.6



10
yellow
light







block
yellow









It can be seen from the above results that, in the range of prepared solution pH value of 3.0 to 4.0, the samples have a good stability, and have a relatively small change of small molecular impurities after being placed at a high temperature of 40° C. for 10 days, a pH range of the prepared solution in the product according to the present invention of 3.0 to 4.0, and an internal control pH of 3.4 to 3.6 are determined.


Example 8: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 6)

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Acetic acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with acetic acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 9: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 7)

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Citric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with citric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 10: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 8)

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.275 g


glycine pentapeptide-irinotecan


Phosphoric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with phosphoric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 11: Investigation of the pH Adjuster

The stability of the samples with different pH adjusters were investigated by taking the appearance character, related substances and solution clarity as the main indexes, and using hydrochloric acid, acetic acid, citric acid and phosphoric acid as pH adjuster, respectively, to adjust the prepared solution pH value to 3.4 to 3.6.


The samples were placed under the condition of a high temperature (40° C.), respectively, and sampled at 5th, 10th day, the appearance character, clarity and small molecules related substances of the samples were investigated, and the results are shown in Table 3.









TABLE 3







Investigation results of the prescriptions with different pH adjusters
















Color and

Maximum
Total


Pre-

Appear-
clarity after

individual
im-


scription
Time
ance
re-
Irinotecan
impurity
purity


number
(day)
character
dissolution
(ppm)
(ppm)
(ppm)
















Pre-
Day 0
Light
Transparent
17.53
24.29
75.03


scription

yellow
light





5

block
yellow






Day 5
Light
Transparent
16.87
24.74
83.25




yellow
light







block
yellow






Day
Light
Transparent
29.67
46.12
125.0



10
yellow
light







block
yellow





Pre-
Day 0
Light
Transparent
21.20
28.69
75.74


scription

yellow
light





6

block
yellow






Day 5
Light
Transparent
32.26
38.40
135.1




yellow
light







block
yellow






Day
Light
Transparent
32.64
50.51
137.0



10
yellow
light







block
yellow





Pre-
Day 0
Light
Transparent
146.6
60.99
281.8


scription

yellow
light





7

block
yellow






Day 5
Light
Transparent
162.0
62.96
324.2




yellow
light







block
yellow






Day
Light
Transparent
176.1
63.01
364.2



10
yellow
light







block
yellow





Pre-
Day 0
Light
Transparent
32.95
25.23
81.61


scription

yellow
light





8

block
yellow






Day 5
Light
Transparent
47.00
46.18
146.4




yellow
light







block
yellow






Day
Light
Transparent
59.19
67.02
180.8



10
yellow
light







block
yellow









In the prescription samples with different pH adjusters, the sample with citric acid as the pH adjuster has a poor stability, and the other prescriptions are not very different, however, the sample with hydrochloric acid as the pH adjuster has the best stability relatively.


Example 12: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 9)

Each 10 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
2.85 g


glycine pentapeptide-irinotecan


mannitol
1.8 g (3%)


Hydrochloric acid
Appropriate amount


Water for injection
Added to 60 mL









Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan and mannitol were taken, and was added with 54 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 13: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof (Prescription 10)

Each 10 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
2.85 g


glycine pentapeptide-irinotecan


mannitol
3.0 g (5%)


Hydrochloric acid
Appropriate amount


Water for injection
Added to 60 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan and mannitol were taken, and was added with 54 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to the full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 14: Effect of Lyophilized Excipient on Formability of Lyophilized Samples

The effect of dosage of lyophilized excipient mannitol of 0%, 3%, 5%, respectively, on formability of the preparation was investigated by taking lyophilized formability, re-dissolvability as the main indicators, to optimize different prescription samples, and the results are shown in Table 4.









TABLE 4







Investigation results of the prescriptions


with different dosage of mannitol










Prescription
Ratio of
Lyophilized



number
mannitol
formability
Re-dissolvability





Prescription 5
0%
The content was
The preparation


Prescription 9
3%
loose block with
was dissolved when


Prescription 10
5%
a fine and smooth
water was added,




appearance, no
the solution had a




cracks, good
good clarity.




skeleton, without




shrinking or




collapse.









It can be seen from the above results that, the addition of mannitol has no effect on the formability and re-dissolvability of the product. Without the addition of mannitol, the lyophilized formability is good, and the content is loose block with a fine and smooth appearance, no cracks, good skeleton, without shrinking or collapse; and the re-dissolvability is good, the preparation is dissolved when water is added, and the solution has a good clarity.


As the product itself has a good lyophilized formability, it can be formed well without addition of any lyophilized excipients, and can conform to the quality requirements of lyophilized preparations.


Example 15: Investigation of Stability of the Prepared Solution

The preparation temperature and the preparation time of solution in the solution preparation process were mainly investigated in this experiment. The stability of the solution under the condition of preparation temperature of 30° C., 50° C. and 70° C., and preparation time of 0, 2, 4 and 8 hours were investigated by taking the related substances as the main index.


3.8 g of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-irinotecan (3 copies were prepared in parallel) were weighed, respectively, and was added with 72 mL of water for injection, and stirred to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and added to a constant volume which was the full dose (80 ml).


The solution was placed at constant temperature of 30° C. (Process 1), 50° C. (Process 2) and 70° C. (Process 3) (with shaking from time to time), respectively, and sampled at 0th, 2nd, 4th, 8th hour. The results are shown in Table 5.









TABLE 5







Investigation results of stability of the prepared solution (small


molecule related substances)
















Solution





Pro-

Solution
place-

Maximum



cess
Solution
color
ment

individual
Total


num-
preparation
and
time
Irinotecan
impurity
impurity


ber
temperature
clarity
(hours)
(ppm)
(ppm)
(ppm)
















Pro-
30° C.
Light
0
8.12
18.33
56.74


cess

yellow
2
9.39
19.97
62.12


1

trans-
4
10.22
20.89
61.99




parent
8
17.58
25.77
84.42




solution






Pro-
50° C.
Light
0
4.53
17.69
45.48


cess

yellow
2
52.74
52.78
182.7


2

trans-
4
41.04
47.14
149.9




parent
8
75.99
71.76
258.9




solution






Pro-
70° C.
Light
0
3.20
15.91
41.76


cess

yellow
2
75.12
59.15
233.6


3

trans-
4
138.85
112.3
399.1




parent
8
268.03
173.9
703.0




solution









It can be seen from the above results, with the solution preparation temperature raises, solution preparation time increases, the solution impurities are gradually increased. When Process 2 and Process 3 with solution preparation temperature of 50° C., 70° C., respectively are adopted, the small molecule impurities are significantly increased, therefore in the solution preparation process, the solution preparation temperature should be controlled not higher than 30° C., while the solution preparation, filtration, filling time should not exceed 8 hours.


Example 16: Lyophilized Preparation of Y-Type Polyethylene Glycol (with a Molecular Weight of 40,000 Daltons)-Glutamate Glycine Pentapeptide-Irinotecan and Preparation Thereof

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Y-type polyethylene glycol-glutamate glycine
7.395 g


pentapeptide-irinotecan


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the Y-type polyethylene glycol-glutamate glycine pentapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 17: Lyophilized Preparation of Four-Branched Polyethylene Glycol (with a Molecular Weight of 40,000 Daltons)-Glutamate Glycine Icosapeptide-Irinotecan and Preparation Thereof

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Four-branched polyethylene glycol-glutamate
2.355 g


glycine icosapeptide-irinotecan


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the four-branched polyethylene glycol-glutamate glycine icosapeptide-irinotecan was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 18: Lyophilized Preparation of Straight-Chain Polyethylene Glycol (with a Molecular Weight of 20,000 Daltons)-Glutamate Glycine Pentapeptide-7-Ethyl-10-Hydroxycamptothecin and Preparation Thereof

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Straight-chain polyethylene glycol-glutamate
4.155 g


glycine pentapeptide-7-ethyl-10-


hydroxycamptothecin


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the straight-chain polyethylene glycol-glutamate glycine pentapeptide-7-ethyl-10-hydroxycamptothecin was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 19: Lyophilized Preparation of Y-Type Polyethylene Glycol (with a Molecular Weight of 40,000 Daltons)-Glutamate Glycine Pentapeptide-7-Ethyl-10-Hydroxycamptothecin and Preparation Thereof

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Y-type polyethylene glycol-glutamate glycine
6.945 g


pentapeptide-7-ethyl-10-hydroxycamptothecin


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the Y-type polyethylene glycol-glutamate glycine pentapeptide-7-ethyl-10-hydroxycamptothecin was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 20: Lyophilized Preparation of Four-Branched Polyethylene Glycol (with a Molecular Weight of 40,000 Daltons)-Glutamate Glycine Icosapeptide-7-Ethyl-10-Hydroxycamptothecin and Preparation Thereof

Each 15 ampoules of the lyophilized preparation has a prescription composition of:















Four-branched polyethylene glycol-glutamate
1.935 g


glycine icosapeptide-7-ethyl-10-


hydroxycamptothecin


Hydrochloric acid
Appropriate amount


Water for injection
Added to 90 mL










Preparation process: a prescription amount of the four-branched polyethylene glycol-glutamate glycine icosapeptide-7-ethyl-10-hydroxycamptothecin was taken, and was added with 80 mL of water for injection, and stirred for 0.5 hour to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with 1.0% hydrochloric acid, and water for injection was added to full dose. The solution obtained was filtered through a 0.22 μm microporous filtering film, and subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


Example 21: Study on Scale-Up of Preparation Process

1. Sample Preparation


A pharmaceutical composition of straight-chain polyethylene glycol-glutamate glutamate pentapeptide-irinotecan for injection was prepared in the pilot production workshop according to the following process, with batch number of 120801, 120901, 121001 and 121201, respectively.


(1) Prescription:















Straight-chain polyethylene glycol-glutamate
285 g


glutamate pentapeptide-irinotecan


Hydrochloric acid
Appropriate amount



(the pH was



adjusted to 3.4



to 3.6)


Water for injection
Added to 6000 ml


Production
1000 ampoules









(2) Preparation Method:


285 g of the straight-chain polyethylene glycol-glutamate glycine icosapeptide-irinotecan was weighed, and was added with 90% of prescription amount of water for injection, and stirred to make the solution completely dissolved, and the pH was adjusted to 3.4 to 3.6 with hydrochloric acid, and water for injection was added to full dose. The solution obtained was subpackaged according to 6 ml/ampoule in the 100-class clean area, and pre-frozen at −40° C. for 4 to 8 hours, followed by being subjected to sublimation drying completed within 40 to 60 hours, and finally desorption drying at 25° C. for 4 to 8 hours, and plugged under vacuum and capped.


2. Impact Factor Test


The 120801 batch samples were taken for impact factor test, and test conditions were high temperature 60° C., high temperature 40° C., high humidity (RH92.5%) and strong light irradiation (4500Lx).


(1) Light Test


In a light cabinet at room temperature and with an intensity of illumination of 4500Lx, the samples with external packing and without external packing were placed at the same time for 10 days, and sampled at 5th and 10th day for various inspections, and the results are shown in Table 6.









TABLE 6







Investigation results of light test (1)


















Insoluble particles
Visible


Time
Placement

pH

(grain/ampoule)
foreign














(day)
condition
Character
value
Moisture
≧10 um
≧25 um
matter





0
Random
Light yellow loose
3.48
1.26%
965
7
1, 0, 0, 1, 1




block







5
Without
Dark yellow loose
3.11
1.34%


1, 0, 0, 0, 0



external
block








packing









With
Light yellow loose
3.62
1.37%
1243
28
0, 1, 0, 0, 0



external
block








packing








10
Without
Tan loose block
3.02
1.40%


0, 0, 0, 0, 0



external









packing









With
Light yellow loose
3.78
1.41%
778
22
0, 0, 0, 0, 1



external
block








packing










Investigation results of light test (2)













Osmotic pressure (mOsmol · kg−1)
















0.9% Sodium
Glucose for




Time
Placement
chloride
injection
Solution















(day)
condition
10 mg/ml
30 mg/ml
10 mg/ml
30 mg/ml
clarity
Solution color





0
Random
290
308
276
304
Equal to
Lighter than








No. 1
Yellow No. 1


5
Without
288
306
278
304
Lighter
Lighter than



external




than No. 1
Yellow No. 3



packing









With
288
304
279
305
Lighter
Lighter than



external




than No. 1
Yellow No. 1



packing








10
Without
290
308
276
305
Lighter
Lighter than



external




than No. 1
Yellow No. 5



packing









With
290
306
278
306
Lighter
Lighter than



external




than No. 1
Yellow No. 1



packing










Investigation results of light test (3)















Small molecule related

















substances (ppm)
Macromolecule related

















Maximum

substances (%)
















Time
Placement

individual
Total

Single
Free
Content


(day)
condition
Irinotecan
impurity
impurity
Disubstituted
substituted
PEG
(%)





0
Random
11.94
33.60
73.93
6.99
0.58
1.28
99.26


5
Without
34.78
1689.97
2612.60
16.33
2.55
3.17
67.76



external










packing










With
25.35
37.91
113.14
7.27
0.68
1.44
99.52



external










packing









10
Without
42.13
2289.93
3538.04
15.81
2.83
3.29
73.23



external










packing










With
10.57
24.37
97.96
7.21
0.73
1.60
100.24



external










packing









The results show that: (1) the product is very sensitive to light, and must be sealed and kept shading for preservation; (2) in the designed packaging conditions, after light test, the appearance character, pH, moisture, visible foreign matter, insoluble particles, solution clarity and color have no significant change compared with those at 0th day, and both the related substances and content detection have no significant change.


(2) High Temperature Test


The product was taken, removed the external packing, and placed under 40° C. condition for 10 days, and sampled at 5th and 10th day for various inspections, and the results are shown in Table 7.









TABLE 7







Investigation results of high temperature test (1)
















Insoluble particles
Visible


Time



(grain/ampoule)
foreign













(day)
Character
pH value
Moisture
≧10 um
≧25 um
matter





0
Light yellow loose
3.48
1.26%
965
7
1, 0, 0, 1, 1



block







5
Light yellow loose
3.42
1.35%
1072
110
0, 1, 0, 0, 0



block







10
Light yellow loose
3.33
1.34%
996
3
2, 0, 0, 0, 0



block















Investigation results of high temperature test (2)











Osmotic pressure (mOsmol · kg−1)














0.9% Sodium





Time
chloride
Glucose for injection















(day)
10 mg/ml
30 mg/ml
10 mg/ml
30 mg/ml
Solution clarity
Solution color





0
290
308
276
304
Equal to No. 1
Lighter than








Yellow No. 1


5
290
310
279
304
Lighter than No.
Lighter than







1
Yellow No. 1


10
291
308
278
308
Lighter than No.
Lighter than







1
Yellow No. 1










Investigation results of high temperature test (3)











Small molecule related















substances(ppm)


















Maximum

Macromolecule related substances(%)















Time

individual
Total

Single

Content


(day)
Irinotecan
impurity
impurity
Disubstituted
substituted
Free PEG
(%)





0
11.94
33.60
73.93
6.99
0.58
1.28
99.26


5
16.34
38.88
136.64
7.51
0.71
1.93
99.41


10
10.82
115.47
182.91
7.64
0.77
2.05
99.42









The results show that: after high temperature test, the appearance character, pH, moisture, visible foreign matter, osmotic pressure, insoluble particles, solution clarity and color, content of the product have no significant change compared with those at 0th day, and the small molecule, macromolecule related substances are slightly increased, indicating that the product is sensitive to heat, and should be kept cold for preservation.


(3) High Humidity Test


The product was taken, removed the external packing, and placed under the condition of a high humidity (RH92.5%, T=25° C.) for 10 days, and sampled at 5th and 10th day for various inspections, and the results are shown in Table 8.









TABLE 8







Investigation results of high humidity test (1)
















Insoluble particles
Visible


Time



(grain/ampoule)
foreign













(day)
Character
pH value
Moisture
≧10 um
≧25 um
matter





0
Light yellow loose
3.48
1.26%
965
7
1, 0, 0, 1, 1



block







5
Light yellow loose
3.87
1.58%
780
12
2, 0, 0, 0, 0



block







10
Light yellow loose
3.96
1.60%
1483
25
0, 3, 0, 0, 0



block










Investigation results of high humidity test (2)











Osmotic pressure (mOsmol · kg−1)













Time
0.9% Sodium chloride
Glucose for injection
Solution














(day)
10 mg/ml
30 mg/ml
10 mg/ml
30 mg/ml
clarity
Solution color





0
290
308
276
304
Equal to No. 1
Lighter than








Yellow No. 1


5
290
306
276
306
Lighter than
Lighter than







No. 1
Yellow No. 1


10
288
309
274
304
Lighter than
Lighter than







No. 2
Yellow No. 1










Investigation results of high humidity test (3)












Small molecule related














substances (ppm)
Macromolecule related substances















Maximum

(%)















Time

individual
Total

Single

Content


(day)
Irinotecan
impurity
impurity
Disubstituted
substituted
Free PEG
(%)





0
11.94
33.60
73.93
6.99
0.58
1.28
99.26


5
21.05
40.38
115.64
7.77
0.74
1.96
100.38


10
11.04
25.32
111.07
7.33
0.72
2.18
100.12









The results show that: after high humidity test, the appearance character, pH, moisture, visible foreign matter, osmotic pressure, insoluble particles, solution clarity and color, related substances, content of the product have no significant change compared with those at 0th day, indicating that the product is not sensitive to humidity.


3. Compatibility Stability Test


The 120801 batch samples were taken, and the compatibility of the sample and 0.9% sodium chloride injection and 5% glucose injection, respectively, were investigated, and sampled at 0th, 2nd, 4th, 8th hour for the detection of small molecule related substances, and the results shown in Table 9.









TABLE 9







Change of related substances in compatibility at different time










Compatibility of the
Compatibility of the



sample and sodium
sample and



chloride injection (ppm)
glucose injection (ppm)















Maximum


Maximum



Time

individual
Total

individual
Total


(h)
Irinotecan
impurity
impurity
Irinotecan
impurity
impurity
















0
3.60
19.32
73.76
4.11
27.00
101.63


1
5.97
26.63
83.51
5.90
47.04
115.17


2
8.04
26.19
88.83
8.08
46.67
123.49


4
10.07
20.76
97.18
11.56
38.59
134.94


8
16.43
20.04
107.56
16.31
48.57
134.79









In the compatibility test of the sample and 0.9% sodium chloride injection and 5% glucose injection, respectively, the product has a good stability within 8 hours.


4. Acceleration Test


The samples with packing were placed in a constant temperature and humidity chamber at a temperature of 25° C.±2° C. and a relative humidity of 60%±10% for 6 months, and sampled at 1st, 2nd, 3rd, 6th month, respectively, for various inspections; and the sample at 6th month was taken for bacterial endotoxin and sterile examination. The accelerated test results are shown in Table 10, 11, 12.









TABLE 10







Acceleration test results of the 120901 batch preparation sample (1)


















Insoluble








particles
Visible


Time
Placement



(grain/ampoule)
foreign














(month)
condition
Character
pH value
Moisture
≧10 um
≧25 um
matter





0
Random
Yellow loose
3.54
1.18%
2627
30
1, 0, 0, 0, 0




block







1
Random
Yellow loose
3.71
1.07%
3363
20
0, 0, 0, 0, 0




block







2
Random
Yellow loose
3.67
1.21%
2665
0
0, 1, 1, 0, 0




block







3
Placed
Yellow loose
3.71
1.15%
2208
22
2, 0, 0, 0, 0



forward
block








Placed upside
Yellow loose
3.63
1.16%
2053
30
0, 0, 1, 0, 1



down
block







6
Placed
Yellow loose
3.70
1.23%
2600
15
0, 0, 0, 0, 2



forward
block








Placed upside
Yellow loose
3.73
1.20%
2648
25
0, 1, 0, 0, 0



down
block















Acceleration test results of the 120901 batch preparation sample (2)















Osmotic pressure








(mOsmol · kg−1)




















0.9%









Sodium
Glucose for








chloride
injection



Bacterial
















Time
Placement
10
30
10
30
Solution
Solution

endotoxin


(month)
condition
mg/ml
mg/ml
mg/ml
mg/ml
clarity
color
Sterile
(EU/mg)





0
Random
294
308
272
302
Equal to
Lighter
The
0th


1
Random
293
306
272
304
No. 2
than
examination
month:


2
Random
296
308
274
301

Yellow
at 0th, 6th
 0.006;


3
Placed
295
310
274
300

No. 2
month
6th



forward






conformed
month:



Placed
296
306
275
306


to the
<0.004



upside






regulations.




down










6
Placed
296
306
276
301







forward











Placed
294
309
276
306







upside











down


















Acceleration test results of the 120901 batch preparation sample (3)
















Small molecule related


















substances (ppm)
Macromolecule related

















Maximum

substances (%)

















Placement

individual
Total

Single
Free
Content


Time
condition
Irinotecan
impurity
impurity
Disubstituted
substituted
PEG
(%)





Month
Random
6.64
17.99
52.30
7.76
0.70
1.35
101.9


0










Month
Random
11.17
19.51
70.48
7.41
0.84
1.27
100.8


1










Month
Random
7.26
22.37
104.9
7.52
0.63
1.13
101.8


2










Month
Placed
11.01
23.54
103.7
7.14
0.64
1.09
101.7


3
forward










Placed
13.48
32.88
124.6
7.08
0.55
1.13
102.1



upside










down









Month
Placed
14.74
21.17
119.8
7.24
0.69
1.29
102.0


6
forward










Placed
17.52
27.20
108.7
7.41
0.79
1.36
101.5



upside










down
















TABLE 11







Acceleration test results of the 121001 batch preparation sample (1)


















Insoluble particles
Visible


Time
Placement



(grain/ampoule)
foreign














(month)
condition
Character
pH value
Moisture
≧10 um
≧25 um
matter





0
Random
Yellow loose
3.50
1.22%
738
38
1, 2, 0, 0, 0




block







1
Random
Yellow loose
3.63
1.12%
728
7
1, 0, 0, 0, 0




block







2
Random
Yellow loose
3.66
1.18%
653
5
0, 0, 0, 1, 0




block







3
Placed
Yellow loose
3.61
1.24%
592
3
0, 0, 2, 0, 1



forward
block








Placed
Yellow loose








upside
block
3.58
1.23%
950
5
0, 0, 0, 0, 1



down








6
Placed
Yellow loose
3.65
1.25%
922
8
0, 0, 1, 1, 0



forward
block








Placed
Yellow loose
3.63
1.24%
773
13
1, 0, 0, 0, 0



upside
block








down










Acceleration test results of the 121001 batch preparation sample (2)















Osmotic pressure








(mOsmol · kg−1)





















0.9%






















Sodium
Glucose for








chloride
injection



Bacterial
















Time
Placement
10
30
10
30
Solution
Solution

endotoxin


(month)
condition
mg/ml
mg/ml
mg/ml
mg/ml
clarity
color
Sterile
(EU/mg)





0
Random
292
303
276
302
Lighter
Lighter
The
0th


1
Random
291
306
274
302
than No.
than
examination
month:


2
Random
294
302
277
306
1
Yellow
at 0th, 6th
0.015;


3
Placed
294
304
274
302

No. 2
month
6th



forward






conformed
month:



Placed
292
305
277
306


to the
<0.004



upside






regulations.




down










6
Placed
296
302
278
306







forward











Placed
293
306
276
305







upside











down










Acceleration test results of the 121001 batch preparation sample (3)













Small molecule related






substances (ppm)
Macromolecule related

















Maximum

substances (%)

















Placement

individual
Total

Single
Free
Content


Time
condition
Irinotecan
impurity
impurity
Disubstituted
substituted
PEG
(%)





Month
Random
4.21
19.34
47.49
7.51
0.81
1.17
102.4


0










Month
Random
11.95
19.66
66.96
7.66
0.80
1.35
101.3


1










Month
Random
4.90
25.60
99.55
7.38
0.67
1.53
101.4


2










Month
Placed
14.11
21.44
172.8
7.57
0.73
1.27
102.6


3
forward










Placed
11.37
73.78
128.0
7.70
0.71
1.47
102.0



upside










down









Month
Placed
16.60
17.80
110.2
7.55
0.79
1.49
102.4


6
forward










Placed
4.21
19.34
47.49
7.51
0.81
1.17
102.4



upside










down
















TABLE 12







Acceleration test results of the 121201 batch preparation sample (1)


















Insoluble particles



Time
Placement



(grain/ampoule)
Visible














(month)
condition
Character
pH value
Moisture
≧10 um
≧25 um
foreign matter





0
Random
Yellow loose
3.43
1.15%
1838
2
1, 1, 0, 0, 0




block







1
Random
Yellow loose
3.55
1.17%
1967
30
0, 1, 0, 1, 0




block







2
Random
Yellow loose
3.62
1.14%
1853
43
0, 0, 0, 1, 0




block







3
Placed
Yellow loose
3.71
1.20%
1108
8
1, 0, 0, 0, 0



forward
block








Placed
Yellow loose
3.62
1.21%
1213
15
0, 0, 0, 0, 2



upside
block








down








6
Placed
Yellow loose
3.59
1.19%
933
2
0, 0, 0, 0, 1



forward
block








Placed
Yellow loose
3.72
1.20%
975
8
0, 0, 1, 1, 0



upside
block








down
















Acceleration test results of the 121201 batch preparation sample (2)















Osmotic pressure








(mOsmol · kg−1)





















0.9%






















Sodium
Glucose for








chloride
injection



Bacterial
















Time
Placement
10
30
10
30
Solution
Solution

endotoxin


(month)
condition
mg/ml
mg/ml
mg/ml
mg/ml
clarity
color
Sterile
(EU/mg)





0
Random
295
308
275
305
Lighter
Lighter
The
0th


1
Random
296
310
277
302
than No.
than
examination
month:


2
Random
293
308
274
306
1
Yellow
at 0th, 6th
<0.004;


3
Placed
295
306
274
305

No. 2
month
6th



forward






conformed
month:



Placed
294
306
279
308


to the
<0.004



upside






regulations.




down










6
Placed
294
305
276
306







forward











Placed
294
308
278
307







upside











down


















Acceleration test results of the 121201 batch preparation sample (3)
















Small molecule related


















substances (ppm)
Macromolecule related

















Maximum

substances (%)

















Placement

individual
Total

Single
Free
Content


Time
condition
Irinotecan
impurity
impurity
Disubstituted
substituted
PEG
(%)





Month
Random
5.32
17.37
43.07
7.59
0.68
1.47
103.6


0










Month
Random
16.88
19.87
87.95
7.83
0.65
1.80
102.6


1










Month
Random
9.34
26.14
97.29
7.59
0.67
1.65
103.1


2










Month
Placed
13.83
23.41
130.1
7.57
0.74
1.85
103.5


3
forward










Placed
15.83
25.29
131.9
7.79
0.70
2.00
103.3



upside










down









Month
Placed
13.68
21.15
126.7
7.41
0.68
1.50
103.6


6
forward










Placed
18.04
22.11
139.9
7.50
0.69
1.45
103.6



upside










down









In the investigation of acceleration test for 6 months, the appearance character, pH, moisture, visible foreign matter, osmotic pressure, insoluble particles, solution clarity and color, macromolecule related substances, content of the product have no significant change, small molecule related substances, the total impurity are slightly increased, but are within the limits, the product is stable in the conditions.


5. Long-Term Test


The preparation samples were placed in a constant temperature and humidity chamber at a temperature of 4 to 8° C., forward and overturned, respectively, for 12 months, and sampled at 0st, 3rd, 6th, 9th, 12th month, respectively, for various inspections, and the sample at 12th month was taken for bacterial endotoxin and sterile examination. The long-term test results are shown in Table 13, 14, 15.









TABLE 13







Long-term test results of the 120901 batch preparation sample (1)


















Insoluble particles



Time
Placement



(grain/ampoule)
Visible














(month)
condition
Character
pH value
Moisture
≧10 um
≧25 um
foreign matter





0
Random
Yellow loose block
3.54
1.18%
2627
30
1, 0, 0, 0, 0


3
Placed
Yellow loose block
3.70
1.17%
3285
57
1, 0, 0, 0, 0



forward









Placed
Yellow loose block
3.68
1.15%
2498
7
0, 0, 0, 0, 0



upside









down








6
Placed
Yellow loose block
3.76
1.12%
2063
10
0, 0, 0, 0, 0



forward









Placed
Yellow loose block
3.71
1.13%
2638
35
0, 2, 0, 0, 0



upside









down








9
Random
Yellow loose block
3.63
1.19%
1835
0
0, 2, 0, 0, 0


12
Placed
Yellow loose block
3.66
1.16%
1923
42
0, 0, 0, 1, 1



forward









Placed
Yellow loose block
3.59
1.18%
1507
53
1, 0, 0, 0, 1



upside









down
















Long-term test results of the 120901 batch preparation sample (2)















Osmotic pressure








(mOsmol · kg−1)




















0.9%









Sodium
Glucose for








chloride
injection



Bacterial
















Time
Placement
10
30
10
30
Solution
Solution

endotoxin


(month)
condition
mg/ml
mg/ml
mg/ml
mg/ml
clarity
color
Sterile
(EU/mg)





0
Random
294
308
272
302
Equal to
Lighter
The
0th


3
Placed
291
308
274
304
No. 2
than
examination
month:



forward





Yellow
at 0th, 12th
0.006



Placed
295
306
276
304

No. 2
month
12th



upside






conformed
month:



down






to the
<0.004


6
Placed
296
304
274
300


regulations.




forward











Placed
294
310
276
304







upside











down










9
Random
294
307
274
304






12
Placed
296
305
276
300







forward











Placed
294
307
278
306







upside











down


















Long-term test results of the 120901 batch preparation sample (3)















Small molecule related

















substances (ppm)
Macromolecule related

















Maximum

substances (%)

















Placement

individual
Total

Single
Free
Content


Time
condition
Irinotecan
impurity
impurity
Disubstituted
substituted
PEG
(%)





Month
Random
6.64
17.99
52.30
7.76
0.70
1.35
101.9


0










Month
Placed
8.83
22.75
89.79
6.64
0.56
0.89
102.0


3
forward










Placed
9.67
22.88
89.93
7.15
0.55
0.98
102.4



upside










down









Month
Placed
12.82
22.20
95.05
7.26
0.81
1.18
101.2


6
forward










Placed
13.73
24.01
96.13
7.39
0.78
1.24
102.5



upside










down









Month
Random
10.17
58.54
114.6
7.19
0.84
1.05
100.8


9










Month
Placed
11.32
18.97
126.2
7.12
0.77
1.14
102.5


12
forward










Placed
12.03
17.09
109.5
7.08
0.76
1.17
102.1



upside










down
















TABLE 14







Long-term test results of the 121001 batch preparation sample (1)


















Insoluble particles



Time
Placement



(grain/ampoule)
Visible














(month)
condition
Character
pH value
Moisture
≧10 um
≧25 um
foreign matter





0
Random
Yellow loose block
3.50
1.22%
738
38
1, 2, 0, 0, 0


3
Placed
Yellow loose block
3.65
1.15%
1118
5
0, 1, 1, 1, 0



forward









Placed
Yellow loose block
3.59
1.14%
948
13
0, 0, 0, 0, 0



upside









down








6
Placed
Yellow loose block
3.58
1.21%
997
60
0, 1, 0, 0, 0



forward









Placed
Yellow loose block
3.60
1.20%
858
28
0, 0, 0, 0, 0



upside









down








9
Random
Yellow loose block
3.54
1.19%
998
7
1.0, 01, 1


12
Placed
Yellow loose block
3.53
1.23%
1360
30
1, 0, 0, 0, 1



forward








12
Placed
Yellow loose block
3.59
1.21%
847
7
0, 1, 0, 0, 0



upside









down
















Long-term test results of the 121001 batch preparation sample (2)















Osmotic pressure








(mOsmol · kg−1)





















0.9%






















Sodium
Glucose for








chloride
injection



Bacterial
















Time
Placement
10
30
10
30
Solution
Solution

endotoxin


(month)
condition
mg/ml
mg/ml
mg/ml
mg/ml
clarity
color
Sterile
(EU/mg)





0
Random
292
303
276
302
Lighter
Lighter
The
0th


3
Placed
291
306
275
300
than No.
than
examination
month:



forward




1
Yellow
at 0th, 12th
0.015



Placed
292
308
278
304

No. 2
month
12th



upside






conformed
month:



down






to the
<0.004


6
Placed
292
303
274
304


regulations.




forward











Placed
296
309
279
306







upside











down










9
Random
292
305
278
304






12
Placed
293
302
276
306







forward











Placed
296
306
276
302







upside











down










Long-term test results of the 121001 batch preparation sample (3)
















Small molecule related


















substances (ppm)
Macromolecule related

















Maximum

substances (%)

















Placement

individual
Total

Single
Free
Content


Time
condition
Irinotecan
impurity
impurity
Disubstituted
substituted
PEG
(%)





Month
Random
4.21
19.34
47.49
7.51
0.81
1.17
102.4


0










Month
Placed
12.52
63.66
116.8
7.39
0.65
1.15
102.3


3
forward










Placed
15.79
62.99
125.4
7.53
0.77
1.26
102.6



upside










down









Month
Placed
13.06
23.51
109.8
7.27
0.80
1.30
101.9


6
forward










Placed
17.15
23.02
109.3
7.17
0.77
1.28
101.8



upside










down









Month
Random
8.71
37.27
124.8
7.18
0.76
1.22
100.5


9










Month
Placed
10.59
89.78
167.8
7.04
0.76
1.01
101.5


12
forward










Placed
12.96
27.67
116.0
7.23
0.86
1.21
101.0



upside










down























TABLE 15







Long-term test results of the 121201 batch preparation sample (1)


















Insoluble particles
Visible


Time
Placement

pH

(grain/ampoule)
foreign














(month)
condition
Character
value
Moisture
≧10 um
≧25 um
matter





0
Random
Yellow loose block
3.43
1.15%
1838
2
1, 1, 0, 0, 0


3
Placed
Yellow loose block
3.46
1.19%
1430
88
0, 1, 1, 0, 0



forward









Placed
Yellow loose block
3.56
1.17%
1090
15
0, 0, 0, 0, 1



upside









down








6
Placed
Yellow loose block
3.48
1.16%
648
2
0, 0, 0, 0, 2



forward









Placed
Yellow loose block
3.39
1.14%
792
8
1, 0, 0, 0, 0



upside









down








9
Random
Yellow loose block
3.41
1.08%
827
0
1, 0, 0, 0, 0


12
Placed
Yellow loose block
3.55
1.17%
640
0
1, 2, 0, 0, 0



forward








12
Placed
Yellow loose block
3.59
1.18%
748
0
0, 0, 0, 0, 0



upside









down
















Long-term test results of the 121201 batch preparation sample (2)















Osmotic pressure








(mOsmol · kg−1)




















0.9% Sodium
Glucose for








chloride
injection



Bacterial
















Time
Placement
10
30
10
30
Solution
Solution

endotoxin


(month)
condition
mg/ml
mg/ml
mg/ml
mg/ml
clarity
color
Sterile
(EU/mg)





0
Random
295
308
275
305
Lighter
Lighter
The
0th


3
Placed
294
308
274
306
than
than
examination
month



forward




No. 1
Yellow
at 0th, 12th
<0.004



Placed
294
308
276
304

No. 2
month
12th



upside






conformed
month:



down






to the
<0.004


6
Placed
296
306
276
304


regulations.




forward











Placed
296
306
276
305







upside











down










9
Random
294
309
279
304






12
Placed
292
306
276
303







forward











Placed
292
306
275
304







upside











down










Long-term test results of the 121201 batch preparation sample (3)














Small molecule related
















substances (ppm)
Macromolecule related

















Maximum

substances (%)

















Placement

individual
Total

Single

Content


Time
condition
Irinotecan
impurity
impurity
Disubstituted
substituted
Free PEG
(%)





Month
Random
5.32
17.37
43.07
7.59
0.68
1.47
103.6


0










Month
Placed
11.56
21.67
96.98
7.74
0.67
1.94
102.8


3
forward










Placed
13.97
26.94
107.4
7.62
0.71
2.01
102.0



upside










down









Month
Placed
8.95
21.03
119.8
7.41
0.73
1.49
103.0


6
forward










Placed










upside
12.11
27.11
140.38
7.36
0.72
1.47
103.5



down









Month
Random
11.88
21.18
132.6
7.21
0.72
1.40
102.5


9










Month
Placed
12.54
19.37
130.4
7.25
0.81
1.29
102.8


12
forward










Placed
18.38
25.39
121.6
7.18
0.72
1.40
102.2



upside










down









In the investigation of accelerated long-term test for 12 months, the character, pH, moisture, visible foreign matter, osmotic pressure, insoluble particles, solution clarity and color, macromolecule related substances, content of the product have no significant change, small molecule related substances and the total impurity are slightly increased, indicating that the product has a good stability within 12 months.

Claims
  • 1. A pharmaceutical composition of a polyethylene glycol-modified camptothecin derivative, mainly prepared by the following components: a polyethylene glycol-modified camptothecin derivative, pH adjuster and water for injection, the pharmaceutical composition comprises 100 to 500 mg of the polyethylene glycol-modified camptothecin derivative, wherein:the polyethylene glycol-modified camptothecin derivative has the structure of general formula (I):
  • 2. The pharmaceutical composition of claim 1, wherein the A1 is aspartic acid or glutamic acid, the A2 is selected from the group consisting of glycine, alanine, leucine, isoleucine, valine, phenylalanine and methionine.
  • 3. The pharmaceutical composition of claim 2, wherein the A1 is glutamic acid, the A2 is glycine.
  • 4. The pharmaceutical composition of claim 1, wherein the in is 2 to 6, more preferably, in is 2 or 3.
  • 5. The pharmaceutical composition of claim 1, wherein n is 0, 1, 2 or 3.
  • 6. The pharmaceutical composition of claim 1, wherein the PEG is a straight-chain, Y-type or multi-branched polyethylene glycol residue.
  • 7. The pharmaceutical composition of claim 1, wherein the PEG is a straight-chain polyethylene glycol residue having the structure of general formula
  • 8. The pharmaceutical composition of claim 1, wherein the PEG is a multi-branched polyethylene glycol residue having the structure of general formula (IV):
  • 9. The pharmaceutical composition of claim 1, wherein the pH adjuster is one or a combination of more than two selected from the group consisting of hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, carbonic acid, toluenesulfonic acid, methanesulfonic acid, acetic acid, citric acid, malonic acid, tartaric acid, succinic acid, benzoic acid, ascorbic acid, α-ketoglutaric acid and α-glycerophosphoric acid, the pH adjuster is used to adjust the pH of the aqueous solution for injection comprising the polyethylene glycol-modified camptothecin derivative to 3.0 to 4.0.
  • 10. The pharmaceutical composition of claim 9, wherein the pH adjuster is one or a combination more than two selected from the group consisting of hydrochloric acid, acetic acid and phosphoric acid.
  • 11. The pharmaceutical composition of claim 1, wherein in addition to the polyethylene glycol-modified camptothecin derivative, the pH adjuster and the water for injection, the component further comprises a lyophilized excipient.
  • 12. The pharmaceutical composition of claim 11, wherein the lyophilized excipient is mannitol and/or lactose.
  • 13. The pharmaceutical composition of claim 11, wherein the addition of the lyophilized excipient is 0 to 10% of the aqueous solution for injection comprising the polyethylene glycol-modified camptothecin derivative by weight/volume ratio.
  • 14. The pharmaceutical composition of claim 1, wherein the pharmaceutical composition is a solution injection, a suspension injection, an emulsion injection or sterile powder for injection.
  • 15. The pharmaceutical composition of claim 14, wherein the pharmaceutical composition is sterile powder for injection.
  • 16. The pharmaceutical composition of claim 15, wherein the pharmaceutical composition is a lyophilized preparation for injection.
  • 17. A preparation method of the pharmaceutical composition of the polyethylene glycol-modified camptothecin derivative of claim 1, comprising the following steps: (1) taking the polyethylene glycol-modified camptothecin derivative and lyophilized excipient, adding water for injection with a total volume of water for injection in the composition of 70% to 90%, stirring to make the solution completely dissolved; (2) adjusting the pH to 3.0 to 4.0 with pH adjuster, adding water for injection to a full dose; (3) freeze-drying to obtain the product.
  • 18. The preparation method of claim 17, wherein the total volume of the water for injection added into components in the step (1) is 90%; stirring in the step (1) is stirring to make the solution completely dissolved, and the pH is adjusted to 3.0 to 4.0 with the pH adjuster in the step (2), the temperature in the process of adding water for injection to the full dose is lower than 30° C.
  • 19. An application of the pharmaceutical composition of claim 1 in the manufacture of a medicament for the treatment of cancer.
Priority Claims (1)
Number Date Country Kind
201410739978.X Dec 2014 CN national
CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation application of International patent application No. PCT/CN2015/096151, filed on Dec. 1, 2015, which claims the benefit and priority of Chinese patent application No. CN201410739978.X, filed on Dec. 5, 2014, each of which is incorporated herein by reference in its entirety and for all purposes.

Continuations (1)
Number Date Country
Parent PCT/CN2015/096151 Dec 2015 US
Child 15613097 US