Patent Application
20140004192
Indibulin is a synthetic small-molecule tubulin inhibitor with significant antitumor activity in vitro and in vivo. It inhibits polymerization of microtubules in tumor cells, as well as in a cell-free system. The binding site of indibulin does not appear to overlap with the tubulin-binding sites of the well-characterized microtubule-destabilizing agents taxol, vincristine and colchicine. Furthermore, the molecule selectively blocks cell cycle progression at metaphase.
In vitro, indibulin exerts significant antitumor activity against a variety of malignancies (e.g., prostate, brain, breast, pancreas, and colon). Indibulin displays high in vivo anti-neoplastic efficacy in animals. Based on its mechanism of action, it is expected to target all types of solid tumors. It is also expected to exhibit anti-asthmatic, anti-allergic, immuno-suppressant and immune-modulating actions.
Indibulin has previously been shown to have limited solubility in aqueous environments and low bioavailability when administered orally. For example, it is practically insoluble in water, methanol, ethanol or 2-propanol. A number of formulation strategies have attempted to improve indibulin oral bioavailability, with limited success. Therefore, a need exists for a new pharmaceutical formulation of indibulin which exhibits improved bioavailability of indibulin.
The present invention relates to a spray-dried solid dispersion, or spray-dried dispersion (SDD), comprising indibulin and at least one matrix polymer. The SDD of indibulin provides enhanced solubility of indibulin in aqueous solutions, as compared to crystalline indibulin. In some embodiments, the SDD of indibulin further provides enhanced solubility of indibulin in aqueous solutions, as compared to dry blend formulations of indibulin, such as those as recited in WO2011/028743. Exemplary such formulations comprise bioavailability enhancer excipients, such as Gelucire. One dry blend formulation from WO2011/028743 (Formulation B) that may be used for comparison purposes contains by weight: 36.4% indibulin; 10% Gelucire 50/13; 5% Polysorbate 80; 45.6% Microcrystalline Cellulose; 1% Croscarmellose Sodium (added prior to granulation); 1% Croscarmellose Sodium (added after granulation was complete), 0.5% Colloidal Silicon Dioxide, and 0.5% Sodium Stearyl Fumarate.
Furthermore, in pharmacokinetic studies in rats and cancer patients, such as those provided herein, oral administration of the SDD of indibulin provides unexpectedly enhanced plasma concentration of indibulin, indicating a much improved bioavailability of the drug, as compared to orally administering an equivalent quantity of undispersed crystalline indibulin and even compared to predictions of bioavailability for spray-dried indibulin dispersion formulations. The significant enhancement in oral bioavailability of the drug reported herein was surprising and unexpected based on data and information available for indibulin.
The present invention also provides a process for making a SDD comprising indibulin, where the process includes forming a solution comprising indibulin, at least one matrix polymer, water and a water-miscible solvent in which both indibulin and at least one matrix polymer are soluble; and spray-drying the solution.
Another aspect of the present invention provides an oral dosage formulation comprising the indibulin SDD as disclosed herein. For example, the present invention provides a tablet formulation comprising the indibulin SDD.
In another aspect, the present invention provides a treatment regimen or a method for treating asthmatic, allergic, autoimmune-based conditions as well as hyper-proliferative conditions, such as cancer, and/or angiogenesis in a subject. Such methods include administering to a subject in need thereof the indibulin SDD or an oral dosage formulation comprising the dispersion. In certain embodiments, the treatment regimen or method further comprises conjointly administering to the subject one or more other therapeutic agents. In some embodiments, the combination shows efficacy that is greater than the efficacy of either agent administered alone.
In a further aspect, the present invention provides a kit comprising the indibulin SDD (e.g., as an oral dosage formulation), and a second formulation comprising at least one other therapeutic agent.
The present invention provides a spray-dried solid dispersion (SDD) comprising indibulin and at least one matrix polymer, herein referred to as indibulin SDD, SDD indibulin or SDD of indibulin.
“Solid dispersion” as used herein refers to a solid material, in which a drug is dispersed in the solid matrix polymer. Such solid dispersions are also referred to in the art as “molecular dispersions” or “solid solutions” of the drug in the polymer.
“Spray-dried solid dispersion” or “spray-dried dispersion” (SDD), as used herein means a solid dispersion produced using spray-drying technology. The term “spray-drying” is used conventionally and refers to processes involving breaking up liquid mixtures into small droplets (atomization) and rapidly removing solvent from the mixture in a container (spray-drying apparatus), in which there is a strong driving force for evaporation of solvent from the droplets. Spray-drying processes and spray-drying equipment or apparatus are described generally in Perry's Chemical Engineers' Handbook, pages 20-54 to 20-57 (Sixth Edition 1984). More details on spray-drying processes and equipment are reviewed by Marshall, “Atomization and Spray-Drying,” 50 Chem. Eng. Prog. Monogr. Series 2 (1954), and Masters, Spray Drying Handbook (Fourth Edition 1985). The strong driving force for solvent evaporation is generally provided by maintaining the partial pressure of solvent in the spray-drying apparatus well below the vapor pressure of the solvent at the temperature of the drying droplets. This is accomplished by (1) maintaining the pressure in the spray-drying apparatus at a partial vacuum (e.g., 0.01 to 0.50 atm); or (2) mixing the liquid droplets with a warm drying gas; or (3) both (1) and (2). In addition, at least a portion of the heat required for evaporation of solvent may be provided by heating the spray solution. Spray-drying processes and apparatus suitable for use in the present invention include those disclosed in U.S. Pat. Nos. 7,780,988 and 7,887,840, the relevant disclosures of which are incorporated herein by reference.
“Matrix polymers”, also referred to in the field as “concentration-enhancing polymers” or “dispersion polymers”, suitable for use in the present invention are discussed in detail in the U.S. Pat. Nos. 7,780,988 and 7,887,840, the relevant disclosures of which are incorporated herein by reference.
In some embodiments of the present invention, the matrix polymer used in the spray-dried dispersion is selected from hydroxypropyl methyl cellulose acetate succinate (HPMCAS), such as L, M and H grades (either as granular LG, MG and HG, or as fine powder LF, MF and HF), available from Shin-Etsu; cellulose acetate phthalate (CAP), such as the HF and CE grades available from Eastman Chemical; hydroxypropyl methyl cellulose phthalate (HPMCP), such as the NF grade available from Eastman Chemical, cellulose acetate trimellitate (CAT), available from Eastman Chemical; and hydroxypropyl methyl cellulose such as the E3 PremLV grade available from Dow. In a particular embodiment, the matrix polymer is HPMCAS, either M grade (HPMCAS-M) or H grade (HPMCAS-H). In certain embodiments of the present invention, the matrix polymer used in the spray-dried dispersion is HG (high grade granular) hydroxypropyl methyl cellulose acetate succinate (HPMCAS).
The amount of indibulin relative to the amount of matrix polymer present in the spray-dried dispersions of the present invention may vary from an indibulin-to-polymer weight ratio of about 0.01 to about 5. In some embodiments of the spray-dried dispersion, indibulin is present in the dispersion in an amount in the range of about 5% to about 60% by weight. In some embodiments, indibulin is present in an amount in the range of from about 5% to about 30%, about 5% to about 15%, about 8% to about 12% by weight, or another range within the values provided herein.
In some embodiments, the spray-dried solid dispersion of the present invention is amorphous, such as an amorphous powder.
As used herein, “amorphous” means that the solid material is in a non-crystalline state. The term “crystalline” refers to solid material in which atoms or molecules are arranged in a definite pattern that is repeated regularly in three dimensions. The term “non-crystalline” refers to solid material that is not crystalline, and therefore does not have long-range three-dimensional translational order. As used herein, material in a non-crystalline state is referred to as being in an amorphous state. The term “amorphous” is intended to include not only material which has essentially no order, but also material which may have some small degree of order, the order is in less than three dimensions and/or is only very short distances. Partially crystalline materials, liquid crystals, and disordered crystals are included as well. Amorphous or crystalline material may be characterized by techniques known in the art such as powder x-ray diffraction (PXRD), crystallography, solid state NMR, or thermal techniques such as differential scanning calorimetry (DSC).
“Crystalline indibulin”, “bulk crystalline indibulin” or “undispersed crystalline indibulin”, as used herein refers to indibulin in a crystalline powder or micronized form that has a powder X-ray diffraction pattern as shown in
In some embodiments, the spray-dried solid dispersion as disclosed herein comprises whole and collapsed spherical particles, as observed, for example, using a Scanning Electron Microscope (SEM).
The spray-dried solid dispersion of the present invention can be a plurality of particles having an average diameter of less than 100 microns. “Average particle diameter” as used herein means volume based particle size, which equals the diameter of the sphere that has same volume as a given particle. The particle size distribution (PSD) of the dispersion disclosed herein can be determined using routine methods known in the art. Suitable methods include, for example, light scattering analysis using suitable Particle Size Analyzers, such as an LA-910 Particle Size Analyzer (Horiba Co. of Irvine, Calif.).
The present invention also provides a spray-dried solid dispersion having a bulk specific volume in the range of about 1.0 to about 10, about 2.5 to about 8.0, about 3.5 to about 7.0, or even about 4.0 to about 6.0 ml/g, or another range within the values provided herein. “Bulk specific volume” as used herein is the initial volume of the dispersion in a measuring apparatus (or container) divided by the weight, which may be expressed in ml/g (cc/g or cm3/g) dispersion.
In some embodiments, the spray-dried solid dispersion has a tapped specific volume in the range of about 0.5 to about 6.0, about 1.5 to about 4.5, or about 2.5 to about 3.5 ml/g, or another range within the values provided herein. “Tapped specific volume” means the volume of the dispersion, measured after mechanically tapping a measuring apparatus (or container) containing the dispersion, divided by the weight, which may be expressed in ml/g (cc/g or cm3/g) dispersion. Bulk and tapped specific volume of solid dispersions or powders can be measured using routine methods in the art. Suitable methods and measuring apparatus (or containers) include, for example, those disclosed in U.S. Pat. Nos. 7,780,988 and 7,887,840, the relevant disclosures of which are incorporated herein by reference.
In some embodiments of the present invention, the spray-dried dispersion has a single glass transition temperature (Tg) in the range of about 40 to about 140, about 50 to about 125, about 65 to about 115, or about 70 to about 110° C., or another range within the values provided herein. “Glass transition temperature (Tg)” as used herein is the characteristic temperature where a glassy material, upon gradual heating, undergoes a relatively rapid (e.g., in about 10 to about 100 seconds) physical change from a glassy state (a hard and relatively brittle state) to a rubbery state (a rubber-like state). In some embodiments of the present invention, the spray-dried solid dispersion has a single Tg. A single Tg typically indicates that the dispersion is substantially homogeneous. This contrasts with a simple physical mixture of pure amorphous drug particles and pure amorphous polymer particles, which generally display two distinct Tgs, one being that of the drug and one that of the polymer. The Tg of an amorphous material such as a polymer, drug or dispersion can be measured by several techniques, including by a Dynamic Mechanical Analyzer (DMA), by a dilatometer, by a dielectric analyzer or by DSC. The exact values measured by each technique can vary somewhat but usually fall within about 10 to about 30° C. of each other. Regardless of the technique used, when an amorphous dispersion exhibits a single Tg, this typically indicates that the dispersion is substantially homogenous. Dispersions of the present invention that are substantially homogeneous generally are more physically stable and have improved concentration-enhancing properties and in turn, improved bioavailability relative to non-homogeneous dispersions.
The spray-dried dispersions of the present invention may be evaluated by in vitro dissolution tests or an in vivo relative bioavailability test. Suitable in vitro and in vivo tests for use in the present invention are discussed in the examples herein and in U.S. Pat. Nos. 7,780,988 and 7,887,840, the relevant disclosures of which are incorporated herein by reference.
In some embodiments, the spray-dried dispersions as disclosed herein provide enhanced concentrations of indibulin, relative to a control composition comprising an equivalent quantity of the undispersed crystalline indibulin, in an in vitro environment of a test solution. As used herein, the “concentration of drug” in solution refers to indibulin that may be dissolved in the form of solvated monomeric molecules (or “free drug”), or any other drug-containing submicron structure, assembly, aggregate, colloid, or micelle. Suitable test solutions for the present invention include phosphate buffered saline (PBS) or a Model Fasted Duodenal solution (MFDS). An exemplary PBS solution is an aqueous solution comprising 20 mM sodium phosphate, 47 mM potassium phosphate, 87 mM NaCl and 0.2 mM KCl, adjusted to pH 6.5. An exemplary MFDS is the same PBS solution where 7.3 mM sodium taurocholic acid and 1.4 mM of 1-palmitoyl-2-oleyl-sn-glycero-3-phosphocholine are added.
In some embodiments, the spray-dried solid dispersion as disclosed herein can be dissolution-tested by adding it to a PBS solution or an MFDS and agitating to promote dissolution. For example, the dissolution of the spray-dried solid dispersion of the present invention may be tested in a microcentrifuge test. Some embodiments of the spray-dried solid dispersion provides a maximum concentration of indibulin that is higher by a factor of at least about 5, about 8, about 10, about 12, about 15, about 20 or about 25 relative to a control composition comprising an equivalent quantity of crystalline indibulin (e.g., 200 μg indibulin per mL), in an in vitro microcentrifuge dissolution assay using a phosphate buffer solution or an MFDS of pH 6.5, at 37±0.5° C., and at centrifuge speed 50±2 rpm. In an exemplary embodiment, the control composition contains by weight: about 36.4% indibulin; about 10% Gelucire 50/13; 5% about Polysorbate 80; 45.6% about Microcrystalline Cellulose; 1% about Croscarmellose Sodium (added prior to granulation); 1% about Croscarmellose Sodium (added after granulation was complete), 0.5% about Colloidal Silicon Dioxide, and 0.5% about Sodium Stearyl Fumarate.
Alternatively, in the microcentrifuge test, the spray-dried solid dispersion of the present invention provides a dissolution area under the curve (dissolution AUC) for any period of about 90 minutes between the time of introduction into the phosphate buffer solution and about 270 minutes following introduction to the solution that is at least 1.5-fold higher than that of a dissolution AUC provided by a control composition comprising an equivalent quantity of undispersed crystalline indibulin. Dissolution AUC is the integration of a plot of the drug concentration versus time over a specified time period. For purposes of determining whether a composition or method is part of this invention, the dissolution AUC is typically calculated over a time period chosen for any time period (such as, about 90 minutes) between the time of introduction into the use environment (time=0) and about 270 minutes following introduction into the use environment. Certain embodiments of the spray-dried solid dispersion provides a dissolution AUC for the first 90 minutes following the introduction into the phosphate buffer solution that is at least about 3-, about 5-, about 8- or about 10-fold that of a dissolution AUC provided by the control composition.
The pharmacokinetic profile for the spray-dried solid dispersions as disclosed herein may be investigated in a subject (e.g., mouse, rat, dog, monkey, human). Such profile provides information regarding concentration of drug in blood plasma or serum (“C”), of the subject, generally expressed as mass per unit volume, typically nanograms per milliliter. This concentration C may also be referred to as the “drug plasma concentration”, “plasma drug concentration” or “plasma concentration”. The plasma drug concentration at any time following drug administration is referenced as Ctime, as in C1h, C9h or C24h, etc. A maximum plasma concentration obtained following administration of a dosage form obtained directly from the experimental data without interpolation is referred to as Cmax. The average or mean plasma concentration obtained during a period of interest is referred to as Cavg or Cmean. “Mean, single dose, maximum plasma concentration” means the mean Cmax obtained over several subjects or multiple administrations to the same subject with sufficient washout in between dosings to allow drug levels to subside to pre-dose levels, following a single administration of a dosage form to each subject.
In some embodiments, orally administering the dispersion of the present invention to a rat results in a plasma Cmax of indibulin that is higher by a factor of at least about 5 relative to orally administering a control composition comprising an equivalent quantity of bulk crystalline indibulin. In certain embodiments, the spray-dried solid dispersion provides a Cmax of indibulin that is at least about 3-, about 4-, about 5-, about 6-, about 7-, about 8-, about 10-, about 15-, about 20-, about 25-, about 30-, about 40- or even about 80-, about 100- and about 120-fold higher relative to a control composition, when orally administered in a rat. In certain embodiments, the spray-dried solid dispersion provides a Cmax of indibulin that is about 3-10, about 3-15, about 3-20, about 3-25, about 3-30, about 3-40, about 3-80, about 3-100, about 3-120, about 5-10, about 5-15, about 5-20, about 5-25, about 5-30, about 5-35, about 5-40, about 5-50, about 5-80, about 5-100, about 5-120, about 10-15, about 10-20, about 10-25, about 10-30, about 10-35, about 10-40, about 10-50, about 10-80, about 10-100, about 10-120, about 15-20, about 15-25, about 15-30, about 15-35, about 15-40, about 15-50, about 15-80, about 15-100, or about 15-120 fold higher relative to a control composition, when orally administered in a rat. In one embodiments, the spray-dried solid dispersion provides a Cmax of indibulin that is 5-30, 10-35, 12-33, or 15-35 fold higher relative to a control composition, when orally administered in a rat.
Similarly, in some embodiments, orally administering the dispersion of the present invention to a human results in a plasma Cmax of indibulin that is higher by a factor of at least about 3 relative to orally administering a control composition comprising an equivalent quantity of bulk crystalline indibulin. In certain embodiments, the spray-dried solid dispersion provides a Cmax of indibulin that is at least about 3-, about 4-, about 5-, about 6-, about 7-, about 8-, about 10-, about 15-, about 20-, about 25-, about 30-, about 40- or even about 80-, about 100- and about 120-fold higher relative to a control composition, when orally administered in a human. In certain embodiments, the spray-dried solid dispersion provides a Cmax of indibulin that is about 3-10, about 3-15, about 3-20, about 3-25, about 3-30, about 3-40, about 3-80, about 3-100, about 3-120, about 5-10, about 5-15, about 5-20, about 5-25, about 5-30, about 5-35, about 5-40, about 5-50, about 5-80, about 5-100, about 5-120, about 7-10, about 7-15, about 7-20, about 7-25, about 7-30, about 7-35, about 7-40, about 7-50, about 7-80, about 7-100, about 7-120, about 10-15, about 10-20, about 10-25, about 10-30, about 10-35, about 10-40, about 10-50, about 10-80, about 10-100, about 10-120, about 15-20, about 15-25, about 15-30, about 15-35, about 15-40, about 15-50, about 15-80, about 15-100, or about 15-120 fold higher relative to a control composition, when orally administered in a human. In one embodiments, the spray-dried solid dispersion provides a Cmax of indibulin that is about 5-30, about 10-35, about 12-33, or about 15-35 fold higher relative to a control composition, when orally administered in a human.
The pharmacokinetic profile for the spray-dried solid dispersions of the present invention also provides an area under the curve (or plasma AUC), which is the area as measured under a plasma drug concentration curve. The plasma AUC is sometimes specified in terms of the time interval across which the plasma drug concentration curve is being integrated, for instance AUCstart-finish. For example, AUC0-48 refers to the AUC obtained from integrating the plasma concentration curve over a period of zero to 48 hours, where zero is conventionally the time of administration of the drug or dosage form comprising the drug to a subject.
In some embodiments, orally administering the dispersion of the present invention to a rat results in an area under the curve (AUC) for plasma indibulin that is higher by a factor of at least about 5 relative to orally administering a control composition comprising an equivalent quantity of bulk crystalline indibulin. In certain embodiments, the dispersion of the present invention provides an AUC for plasma indibulin that is at least about 7-, about 8-, about 9-, about 10-, about 15-, about 18-, about 20-, about 25-, about 35-, about 38-, or about 45-, or even about 80-, about 100- and about 120-fold higher relative to the control composition, when orally administered in a rat. In certain embodiments, the spray-dried solid dispersion of the present invention provides an AUC for plasma indibulin that is at least about 7-10, about 7-15, about 7-20, about 7-25, about 7-30, about 7-35, about 7-40, about 7-50, about 7-80, about 7-100, about 7-120, 8-10, about 8-15, about 8-20, about 8-25, about 8-30, about 8-35, about 8-40, about 8-50, about 8-80, about 8-100, about 8-120, about 9-10, about 9-15, about 9-20, about 9-25, about 9-30, about 9-35, about 9-40, about 9-50, about 9-80, about 9-100, about 9-120, about 10-15, about 10-20, about 10-25, about 10-30, about 10-35, about 10-40, about 10-50, about 10-80, about 10-100, about 10-120, about 15-20, about 15-25, about 15-30, about 15-35, about 15-40, about 15-50, about 15-80, about 15-100, or about 15-120 fold higher relative to the control composition, when orally administered in a rat. In certain embodiments, the dispersion of the present invention provides an AUC for plasma indibulin that is at least about 8-25, about 9-20, about 9-22, about 9-25, about 10-25 fold higher relative to the control composition, when orally administered in a rat.
Similarly, in some embodiments, orally administering the spray-dried solid dispersion of the present invention to a human results in an area under the curve (AUC) for plasma indibulin that is higher by a factor of at least about 5 relative to orally administering a control composition comprising an equivalent quantity of bulk crystalline indibulin. In certain embodiments, the dispersion of the present invention provides an AUC for plasma indibulin that is at least about 8-, about 9-, about 10-, about 15-, about 18-, about 20-, about 25-, about 35-, about 38-, or about 45-, or even about 80-, about 100- or about 120-fold higher relative to the control composition, when orally administered in a human. In certain embodiments, the dispersion of the present invention provides an AUC for plasma indibulin that is at least about 8-10, about 8-15, about 8-20, about 8-25, about 8-30, about 8-35, about 8-40, about 8-50, about 8-80, about 8-100, about 8-120, about 9-10, about 9-15, about 9-20, about 9-25, about 9-30, about 9-35, about 9-40, about 9-50, about 9-80, about 9-100, about 9-120, about 10-15, about 10-20, about 10-25, about 10-30, about 10-35, about 10-40, about 10-50, about 10-80, about 10-100, about 10-120, about 15-20, about 15-25, about 15-30, about 15-35, about 15-40, about 15-50, about 15-80, about 15-100, or about 15-120 fold higher relative to the control composition, when orally administered in a human. In certain embodiments, the dispersion of the present invention provides an AUC for plasma indibulin that is at least about 8-25, about 9-20, about 9-22, about 9-25, or about 10-25 fold higher relative to the control composition, when orally administered in a human.
In an embodiment, the SDD indibulin compositions provides plasma exposures that are about 5-10, about 5-20, about 5-25, about 5-30, about 5-35, about 5-40, about 10-20, about 10-25, about 10-30, about 10-35, about 10-40, about 15-20, about 15-25, about 15-30, about 15-35, or about 15-40 fold higher when compared to the control composition. Plasma exposure can be measured using variables such as Cmax and/or AUC. In another embodiment, the oral bioavailability of SDD indibulin is at least about 5-30, about 10-20, about 10-25, or about 15-30, or about 15-40 fold higher when compared to the control composition.
In another embodiment, the time for maximum plasma concentration to occur (tmax) for SDD indibulin is about 0.5-7 hours, about 1-7 hours, about 1.5-7 hours, about 2-7 hours, about 3-7 hours, about 0.5-6 hours, about 1-6 hours, about 1.5-6 hours, about 2-6 hours, about 3-6 hours, 0.5-5 hours, about 1-5 hours, about 1.5-5 hours, about 2-5 hours, about 3-5 hours, about 0.5-4 hours, about 1-4 hours, about 1.5-4 hours, about 2-4 hours, about 0.5-3 hours, about 1-3 hours, about 1.5-3 hours, or about 2-3 hours. In another embodiment, the time for maximum plasma concentration to occur (tmax) for SDD indibulin is about 0.5 hour, about 1 hour, about 1.5 hours, about 2 hours, about 2.5 hours, about 3 hours, about 3.5 hours, about 4 hours, about 4.5 hours, about 5 hours, about 5.5 hours, about 6 hours, about 6.5 hours, or about 7 hours post administration.
In one embodiment, commonly observed adverse events in subjects administered with the SDD indibulin compositions include anorexia, constipation, cough, nausea, dyspnea, fatigue, vomiting, decreased appetite, and/or diarrhea.
In another aspect, the invention relates to a process for making a spray-dried solid dispersion as disclosed herein, the process comprising the steps of (a) forming a solution comprising indibulin, at least one matrix polymer, water and a water-miscible solvent in which both indibulin and the at least one matrix polymer are soluble; and (b) spray-drying the solution of step (a).
“Water-miscible solvent” as used herein means solvent which is miscible with water at a solvent concentration of less than about 50 wt % of the solvent/water mixture. Such solvents are well known in the art. Examples of water miscible solvents suitable for the present invention include, without limitation, alcohols such as methanol and ethanol; ketones such as acetone and various other solvents such as acetonitrile, and tetrahydrofuran (THF), and the like.
In some embodiments, the water-miscible solvent used in the process of the present invention is THF. In certain embodiments, THF and water used in step (a) of the spray-drying process are in a ratio in the range of 65:35 to 99:1 or 90:10 to 99:1 w/w, or another range within the values provided herein.
SDD of indibulin are generally prepared as follows. Crystalline indibulin and matrix polymer are dissolved in a water-solvent solution to form a spray solution. The water and solvent are subsequently removed during spray-drying using a small-scale spray-drying apparatus such as a GEA-Niro Mobil Minor spray dryer, resulting in a homogenous dispersion in powder form. Examples of suitable small-scale spray-drying apparatus for use in the present invention may be found in U.S. Pat. No. 7,780,988 and U.S. Patent Application Publication No. 2010/0029667 (corresponding to U.S. patent application Ser. No. 12/311,543).
In a first step, a water-solvent mixture is formed. In one embodiment, water and THF are added. In some embodiments, water and THF are added in a stainless-steel tank equipped with a top-mounted mixer. In some embodiments, agitation is achieved using a top-mounted mixer. Indibulin is subsequently added to the mixture. In some embodiments, indibulin is added while a mixer, such as a top-mounted mixer provides adequate agitation. In some embodiments, the solution with indibulin is mixed for a specified period of time. In the embodiment of
In some embodiments, the solvent used for the spray drying includes THF. In some embodiments, 95/5 THF/water is used for warmup and shutdown of the spray dryer. In some embodiments, the mixture is filtered prior to being added to the spray drier. In some embodiments, the filter is ≦100 μm, ≦150 μm, ≦200 μm, ≦250 μm, ≦300 μm, ≦350 μm, ≦400 μm, ≦450 μm, ≦500 μm. In certain embodiments, the material is processed though a secondary drying step. In some embodiments, a tray dryer is used for secondary drying. For example, in some embodiments, the dryer is a convention dryer. The secondary drying is performed for a sufficient period of time to meet product specifications. For example, in some embodiments, secondary drying occurs at 30° C., 35° C., 40° C., 45° C., or 50° C. In some embodiments, the temperature of the secondary drying is from about 35° C. to about 45° C. In some embodiments, the humidity of the secondary drying is controlled. For example, in some embodiments, the humidity is about 40% RH, about 45% RH, about 50% RH, about 55% RH, or about 60% RH. In some embodiments, the secondary drying is performed at about 40-60% RH. In certain embodiments, the drying time is at least about 2, 3, 5, 6, 7, 8, 9, or 10 hours. In certain embodiments, the drying time is about 2-15 hours, 4-12 hours, 5-10 hours or 6-8 hours.
A “dosage form” or “dosage formulation” as used herein means a unit of administration of an active agent. Examples of dosage formulations include tablets, granules, capsules, injections, suspensions, liquids, emulsions, creams, ointments, suppositories, inhalable formulations, transdermal formulations, and the like. By “oral dosage formulation” is meant to include a unit dosage formulation for oral administration.
In some embodiments, the SDD of the present invention is combined with one or more optional excipients to formulate the dispersion into suitable dosage formulations, such as tablets, capsules, suspensions, powders for suspensions, cream, transdermal patches, depots, and the like. The dispersion can also be added to other dosage form ingredients in a manner that advantageously does not substantially alter the indibulin's activity.
Generally, excipients such as surfactants, pH modifiers, fillers, matrix materials, complexing agents, solubilizers, lubricants, glidants, and so forth may be used for customary purposes and in typical amounts without adversely affecting the properties of the compositions. See for example, Remington's Pharmaceutical Sciences (18th ed. 1990).
The addition of pH modifiers such as acids, bases, or buffers may be beneficial, retarding the dissolution of the composition (e.g., acids such as citric acid or succinic acid when the matrix polymer is anionic) or, alternatively, enhancing the rate of dissolution of the composition (e.g., bases such as sodium acetate or amines when the matrix polymer is cationic).
Conventional matrix materials, complexing agents, solubilizers, fillers, diluents, disintegrating agents (disintegrants), preservatives, suspending agents or thickeners, anti-caking agents, or binders may also be added as part of the composition itself or added by granulation via wet or mechanical or other means. These materials may comprise up to 90 wt % of the composition.
Examples of matrix materials, fillers, or diluents include, without limitation, lactose, mannitol, xylitol, microcrystalline cellulose, dibasic calcium phosphate (anhydrous and dihydrate) and starch.
Examples of disintegrants include, without limitation, sodium starch glycolate, sodium alginate, carboxy methyl cellulose sodium, methyl cellulose, and croscarmellose sodium, and crosslinked forms of polyvinyl pyrrolidone such as those sold under the trade name CROSPOVIDONE (available from BASF Corporation).
Examples of binders include, without limitation, methyl cellulose, microcrystalline cellulose, starch, and gums such as guar gum, and tragacanth.
Examples of lubricants include, without limitation, magnesium stearate, calcium stearate, and stearic acid.
Examples of the glidant include, without limitation, metal silicates, silicon dioxides, higher fatty acid metal salts, metal oxides, alkaline earth metal salts, and metal hydroxides. Examples of preservatives include, without limitation, sulfites (an antioxidant), benzalkonium chloride, methyl paraben, propyl paraben, benzyl alcohol and sodium benzoate.
Examples of suspending agents or thickeners, without limitation, include xanthan gum, starch, guar gum, sodium alginate, carboxymethyl cellulose, sodium carboxymethyl cellulose, methyl cellulose, hydroxypropyl methyl cellulose, polyacrylic acid, silica gel, aluminum silicate, magnesium silicate, and titanium dioxide.
Examples of anti-caking agents or fillers, without limitation, include silicon oxide and lactose.
Examples of solubilizers include, without limitation, ethanol, propylene glycol or polyethylene glycol.
One other class of excipients is surfactants, optionally present from about 0 to about 10 wt %. Suitable surfactants include, without limitation, fatty acid and alkyl sulfonates; commercial surfactants such as benzalkonium chloride (HYAMINE™ 1622, available from Lonza, Inc., Fairlawn, N.J.); dioctyl sodium sulfosuccinate (DOCUSATE SODIUM, available from Mallinckrodt Spec. Chem., St. Louis, Mo.); polyoxyethylene sorbitan fatty acid esters (TWEEN™, available from ICI Americas Inc., Wilmington, Del.; LIPOSORB™ O-20, available from Lipochem Inc., Patterson N.J.; CAPMUL™ POE-0, available from Abitec Corp., Janesville, Wis.); and natural surfactants such as sodium taurocholic acid, 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine, lecithin, and other phospholipids and mono- and diglycerides. Such materials can be employed to increase the rate of dissolution by, for example, facilitating wetting, or otherwise increase the rate of drug release from the dosage form.
Other conventional excipients, including pigments, lubricants, flavorants, humectants, solution retarding agents, absorption accelerators, wetting agents, absorbents, and other ones well-known in the art, may be employed in the compositions of this invention. For example, excipients such as pigments, lubricants, flavorants, and so forth may be used for customary purposes and in typical amounts without adversely affecting the properties of the compositions.
In one embodiment, the SDD compositions provided comprises indibulin, hypromellose acetate succinate, microcrystalline cellulose, lactose monohydrate, croscarmelose sodium, colloidal silicon dioxide, and magnesium stearate.
The spray-dried solid dispersion of the present invention may be used in a wide variety of dosage forms for administration by a wide variety of routes, including, but not limited to, oral, nasal, rectal, vaginal, transdermal, buccal, subcutaneous, intravenous, and pulmonary.
In certain embodiments, the spray-dried solid dispersion as disclosed herein is formulated as an oral dosage formulation. Formulations suitable for oral administration may be in the form of capsules, cachets, pills, tablets, lozenges (using a flavored basis, usually sucrose and acacia or tragacanth), powders, granules, or as a solution or a suspension in an aqueous or non-aqueous liquid, or as an elixir or syrup, or as pastilles (using an inert matrix, such as gelatin and glycerin, or sucrose and acacia), and the like, each containing a predetermined amount of an active ingredient. A composition may also be administered as a bolus, electuary, or paste.
In one embodiment, the oral dosage formulation of the present invention is a tablet. A tablet may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared using binder (for example, gelatin or hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (for example, sodium starch glycolate or cross-linked sodium carboxymethyl cellulose), surface-active or dispersing agent. Molded tablets may be made by molding in a suitable machine a mixture of the powdered inhibitor(s) moistened with an inert liquid diluent.
Tablets, and other solid dosage forms, such as dragees, capsules, pills, and granules, may optionally be scored or prepared with coatings and shells, such as enteric coatings and other coatings well known in the pharmaceutical-formulating art. They may also be formulated so as to provide slow or controlled release of the active ingredient therein using, for example, hydroxypropylmethyl cellulose in varying proportions to provide the desired release profile, other polymer matrices, liposomes, and/or microspheres. They may be sterilized by, for example, filtration through a bacteria-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved in sterile water, or some other sterile injectable medium immediately before use. These compositions may also optionally contain opacifying agents and may be of a composition that they release the active ingredient(s) only, or preferentially, in a certain portion of the gastrointestinal tract, optionally, in a delayed manner.
Examples of embedding compositions which can be used include polymeric substances and waxes. The active ingredient can also be in micro-encapsulated form, if appropriate, with one or more of the above-described excipients.
An overview of the manufacturing process for an indibulin SDD tablet is shown in
In certain embodiments, the oral dosage formulation of the present invention comprises a filler, a disintegrant, a glidant and a lubricant.
In some embodiments of the oral dosage formulation as disclosed herein, the spray-dried solid dispersion is present in an amount of from about 20 to about 80%, about 30 to about 60% or about 45 to about 55% by weight, or another range within the values provided herein. In these and other embodiments of the oral dosage formulation, indibulin can be present in an amount of from about 10 to about 150 mg per dose unit. In one embodiment, the indibulin can be present in an amount of 25 mg per dose unit. In one embodiment, the indibulin can be present in an amount of 50 mg per dose unit. In one embodiment, the indibulin can be present in an amount of 100 mg per dose unit.
The spray-dried solid dispersion and the dosage formulation as disclosed herein may be used to treat any condition that is subject to treatment by administering indibulin, including conditions discussed in U.S. Patent Application Publication Nos. 2006/0280787 and 2008/0241274, the relevant disclosures of which publications are incorporated herein by reference. For example, conditions that may be treated by the dispersion or dosage form of the present invention include hyperproliferative disorders, malignancies and neoplasms (e.g., solid tumors). Such hyperproliferative disorders, malignancies, and neoplasms include, but are not limited to, one or more of the following: drug-resistant or metastasizing carcinoma (including development and spread of metastases, tumors sensitive to angiogenesis inhibitors or tumors that are both antitumor agent-resistant and sensitive to angiogenesis inhibitors), adenoid cystic carcinoma, renal cell carcinoma, glioblastoma, cancers of the abdomen, blood, bone, breast, digestive system, liver, lung, pancreas, peritoneum, prostate, vulvar, endocrine glands (adrenal, parathyroid, pituitary, testicles, ovary, thymus, thyroid), eye, head and neck, nervous (central and peripheral), lymphatic system, pelvic, skin, soft tissue, spleen, thoracic, and urogenital. Other hyperproliferative disorders include, but are not limited to, angiogenesis, hypergammaglobulinemia, lymphoproliferative disorders, araproteinemias, purpura, sarcoidosis, Sezary syndrome, Waldenstrom's macroglobulinemia, Gaucher's disease, histiocytosis, and any other hyperproliferative disease, besides neoplasia, located in an organ system listed above. Further conditions that may be treated by the dispersion or dosage form of the present invention include asthma or allergies. In certain embodiments, the dispersion or dosage form as described herein also may be used for suppressing or inducing regression of an immunological response in a subject.
The present invention further provides a method of treating cancer, wherein the method further comprising conjointly administering to the subject one or more other (or additional) therapeutic agents, wherein the combination shows efficacy that is greater than the efficacy of either agent administered alone. For example, in one nonlimiting embodiment, the combination is a synergistic combination. In another nonlimiting embodiment, the combination is an additive combination.
The term “therapeutic agent” is art-recognized and refers to any chemical moiety that is a biologically, physiologically, or pharmacologically active substance that acts locally or systemically in a subject. The term also means any substance intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease or in the enhancement of desirable physical or mental development and/or conditions in an animal or human. In certain embodiments, the therapeutic agents conjointly administered with indibulin are anti-cancer agents, such as conjoint therapies disclosed in U.S. Patent Application Publication No. 2008/0241274, the relevant disclosure of which is incorporated herein by reference.
For example, additional therapeutic agents that can be used in combination with the spray-dried solid dispersion and the dosage formulation as disclosed herein include microtubule binding agents, DNA intercalators or cross-linkers, DNA synthesis inhibitors, DNA and/or RNA transcription regulators, antibodies, enzymes, enzyme inhibitors, gene regulators, and/or angiogenesis inhibitors.
Microtubule binding agent refers to an agent that interacts with tubulin to stabilize or destabilize microtubule formation thereby inhibiting cell division. Examples of microtubule binding agents that can be used in combination with the presently disclosed spray-dried solid dispersion and the dosage formulation include, but are not limited to, paclitaxel, docetaxel, vinblastine, vincristine vindesine, vinorelbine (navelbine), the epothilones, colchicine, dolastatin 15, nocodazole, podophyllotoxin, rhizoxin, cryptophycin, estramustine, indibulin and analogues or derivatives thereof.
Suitable DNA and/or RNA transcription regulators, including, but not limited to, actinomycin D, daunorubicin, doxorubicin and derivatives and analogs thereof also are suitable for use in combination with the presently disclosed spray-dried solid dispersion and the dosage formulation.
DNA intercalators and cross-linking agents useful in certain embodiments include, but are not limited to, cisplatin, carboplatin, oxaliplatin, mitomycins, such as mitomycin C, bleomycin, chlorambucil, cyclophosphamide, palifosfamide, ifosfamide, and derivatives and analogs thereof.
DNA synthesis inhibitors suitable for use as therapeutic agents include, but are not limited to, methotrexate, 5-fluoro-5′-deoxyuridine, 5-fluorouracil, gemcitabine, capecitabine and analogs thereof.
Examples of suitable enzyme inhibitors for use in combination with the presently disclosed spray-dried solid dispersion and the dosage formulation include, but are not limited to, erlotinib, camptothecin, etoposide, formestane, trichostatin and derivatives and analogs thereof.
Suitable therapeutics for use with the presently disclosed spray-dried solid dispersion and dosage formulation, which affect gene regulation include agents that result in increased or decreased expression of one or more genes, include, but are not limited to, raloxifene, 5-azacytidine, 5-aza-2′ deoxycytidine, tamoxifen, 4-hydroxytamoxifen, mifepristone and derivatives and analogs thereof.
Angiogenesis inhibitors are known in the art and examples of suitable angiogenesis inhibitors for use in the present invention include, but are not limited to, angiostatin K1-3, staurosporine, genistein, fumagillin, medroxyprogesterone, suramin, interferon-alpha, metalloproteinase inhibitors, platelet factor 4, somatostatin, thrombospondin, endostatin, thalidomide, bevacizumab, sorafenib, sunitinib, pazopanib, everolimus and derivatives and analogs thereof.
Other therapeutic agents, particularly anti-cancer or anti-tumor agents, that may or may not fall under one or more of the categories above, also are suitable for administration in combination with the presently disclosed compounds. By way of example, such agents include adriamycin, apigenin, rapamycin, zebularine, cimetidine, prednisolone and derivatives and analogs thereof.
In some embodiments, the spray-dried solid dispersion or the dosage formulation is administered in combination with one or more other therapeutic agents selected from vinca alkaloids (e.g., vinblastine, vincristine, and vinorelbine), taxanes (e.g., paclitaxel and docetaxel), epipodophyllotoxins (e.g., etoposide, teniposide), antibiotics (e.g., dactinomycin (actinomycin D), daunorubicin, doxorubicin and idarubicin), anthracyclines, mitoxantrone, bleomycins, plicamycin (mithramycin) and mitomycin, enzymes (L-asparaginase which systemically metabolizes L-asparagine and deprives cells which do not have the capacity to synthesize their own asparagine); antiplatelet agents; antiproliferative/antimitotic alkylating agents such as nitrogen mustards (e.g., mechlorethamine, ifosphamide, palifosfamide, cyclophosphamide and analogs, melphalan, chlorambucil), ethylenimines and methylmelamines (e.g., hexamethylmelamine and thiotepa), alkyl sulfonates (busulfan), nitrosoureas (e.g., carmustine (BCNU) and analogs, streptozocin), trazenes-dacarbazinine (DTIC); antiproliferative/antimitotic antimetabolites such as folic acid analogs (e.g., methotrexate), pyrimidine analogs (e.g., fluorouracil, floxuridine, and cytarabine), purine analogs and related inhibitors (e.g., mercaptopurine, thioguanine, pentostatin and 2-chlorodeoxyadenosine); aromatase inhibitors (e.g., anastrozole, exemestane, and letrozole); and platinum coordination complexes (e.g., cisplatin, carboplatin), procarbazine, hydroxyurea, mitotane, aminoglutethimide; hormones (e.g., estrogen) and hormone agonists such as leutinizing hormone releasing hormone (LHRH) agonists (e.g., goserelin, leuprolide and triptorelin), and organic arsenicals (e.g., darinaparsin). Other chemotherapeutic agents may include mechlorethamine, camptothecin, ifosfamide, tamoxifen, raloxifene, gemcitabine, navelbine, or any analog or derivative variant of the foregoing.
In certain embodiments, the one or more other therapeutic agent is selected from erlotinib, carboplatin, 5-fluorouracil, capecitabine, paclitaxel, tamoxifen, vinorelbine, cisplatin, gemcitabine, estramustine, doxorubicin, vinblastine, etoposide, prednisolone, palifosfamide, ifosfamide, and darinasparin.
“Treating” a condition or disease refers to curing as well as ameliorating at least one symptom of the condition or disease. Treating includes administration of a composition which reduces the frequency of, or delays the onset of, symptoms of a medical condition in a subject relative to a subject which does not receive the composition. Thus, treatment of cancer includes, for example, reducing the number and/or size of detectable cancerous growths in a population of patients receiving a treatment relative to an untreated control population, and/or delaying the appearance of detectable cancerous growths in a treated population versus an untreated control population, e.g., by a statistically and/or clinically significant amount.
A “patient”, “subject”, “individual” or “host” refers to either a human or a non-human animal.
Another aspect of the invention relates to a kit comprising the spray-dried solid dispersion or the dosage formulation as disclosed herein, and a second formulation comprising at least one other therapeutic agent. The other therapeutic agent may be any of the ones discussed above. In some embodiments, the other therapeutic agent suitable for use in the kit is one or more of erlotinib, carboplatin, 5-fluorouracil, capecitabine, paclitaxel, tamoxifen, vinorelbine, cisplatin, gemcitabine, estramustine, doxorubicin, vinblastine, etoposide, prednisolone, palifosfamide, ifosfamide, or darinasparin.
In some embodiments, SDD indibulin compositions described herein are administered at total daily doses of less than about 500 mg, less than about 400 mg, less than about 300 mg, less than about 250 mg, less than about 200 mg, less than about 150 mg, or less than about 100 mg.
In certain embodiments, the SDD indibulin compositions described herein are administered at total daily doses of about 5 mg/kg to about 25 mg/kg. In some embodiments, the compositions described herein are administered at total daily doses of about 10 mg/kg to about 25 mg/kg, or about 15 mg/kg to about 25 mg/kg, or about 10 mg/kg to about 20 mg/kg, or about 10 mg/kg to about 15 mg/kg. In some embodiments, the compositions are administered at total daily doses of about 5 mg/kg, about 10 mg/kg, about 15 mg/kg, about 20 mg/kg, or about 25 mg/kg.
One of ordinary skill in the art will be able to obtain conversions of animal and human equivalent based on body surface area (BSA). For example, human BSA can be calculated using the following: BSA (m2)=SQRT([height (cm)×weight (kg)]/3600) or BSA (m2)=SQRT([height (in)×weight (lbs)]/3131). Additional general guidance can be publically found from the U.S. Food and Drug Administration, for example, on their website (www.fda.gov/downloads/Drugs/ . . . /Guidances/UCM078932.pdf).
In other embodiments, the SDD indibulin compositions described herein are administered at total daily doses of about 5 mg to about 500 mg, or about 5 mg to about 400 mg, or about 5 mg to about 300, or about 5 mg to about 200 mg, or about 5 mg to about 150 mg, or about 5 mg to about 100 mg, or about 10 mg to about 500 mg, or about 10 mg to about 400 mg, or about 10 mg to about 300, or about 10 mg to about 200 mg, or about 10 mg to about 150 mg, or about 10 mg to about 100 mg, or about 15 mg to about 500 mg, or about 15 mg to about 400 mg, or about 15 mg to about 300, or about 15 mg to about 200 mg, or about 15 mg to about 150 mg, or about 15 mg to about 100 mg, or about 20 mg to about 500 mg, or about 20 mg to about 400 mg, or about 20 mg to about 300, or about 20 mg to about 200 mg, or about 20 mg to about 150 mg, or about 20 mg to about 100 mg, or about 25 mg to about 500 mg, or about 25 mg to about 400 mg, or about 25 mg to about 300, or about 25 mg to about 200 mg, or about 25 mg to about 150 mg, about 25 mg to about 100 mg, about 100 mg to about 500 mg, about 100 mg to about 400 mg, about 100 mg to about 300 mg, or about 100 mg to about 275 mg. In some embodiments, the SDD indibulin compositions described herein are administered at total daily doses of about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 225 mg, about 260 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 275 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, or about 500 mg, or any combinations of any of the individual dosage amounts set forth above.
In further embodiments, the SDD indibulin compositions described herein are administered at total daily doses of about 5 mg, about 10 mg, about 15 mg, about 20 mg, about 25 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about 75 mg, about 80 mg, about 90 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 350 mg, about 400 mg, about 450 mg, or about 500 mg.
In some embodiments, the SDD indibulin compositions described herein are dosed once daily. In other embodiments, the SDD indibulin compositions are dosed 1-3 times daily. In further embodiments, the SDD indibulin compositions are dosed 1-2 times daily. In another embodiment, the SDD indibulin compositions are dosed in a treatment cycle for a set period of days. In one embodiment, the SDD indibulin compositions are dosed in a treatment cycle for at least about 3 days, about 5 days, about 8 days, about 10 days, about 15 days, about 20 days, about 30 days, about 2 months, about 3 months, about 6 months, about 1 year at a time or for a lifetime. In another embodiment, following a dosage period of a certain number of dosage days is a set number of days off in between dosage periods in which the subject is not given the compositions. In one embodiment, the set number of days off in between dosage periods is about 3 days, about 6 days, about 9 days, about 12 days, about 15 days, about 20 days, about 30 days, or about 40 days. In some embodiments, when the SDD indibulin composition is dosed once time per day, the plasma Cmax is greater than about 25 ng/mL, greater than about 30 ng/mL, greater than about 35 ng/mL, greater than about 40 ng/mL, greater than about 50 ng/mL, greater than about 60 ng/mL, greater than about 80 ng/mL, greater than about 100 ng/mL, greater than about 120 ng/mL, greater than about 140 ng/mL, or greater than about 160 ng/mL. In some embodiments, when dosed once per day at less than 100 mg/day, the plasma Cmax is greater than about 25 ng/mL, greater than about 30 ng/mL, greater than about 35 ng/mL, greater than about 40 ng/mL, greater than 45 ng/mL, or greater than 50 ng/mL. In some embodiments, when dosed once per day at about 25 mg/day to about 100 mg/day, the plasma Cmax ranges from about 25 ng/mL to about 200 ng/mL, about 25 ng/mL to about 150 ng/mL, about 45 ng/mL to about 120 mg/mL. In some embodiments, when dosed once per day at about 100 mg/day to about 275 mg/day, the plasma Cmax ranges from about 50 ng/mL to about 350 ng/mL, about 50 ng/mL to about 300 ng/mL, about 50 ng/mL to about 250 ng/mL, about 50 ng/mL to about 200 ng/mL, about 50 ng/mL to about 180 mg/mL, about 50 ng/mL to about 160 mg/mL, about 50 ng/mL to about 140 mg/mL, about 50 ng/mL to about 120 mg/mL, or about 50 ng/mL to about 100 mg/mL. In some embodiments, when dosed once per day at about 25 mg/day to about 350 mg/day, the plasma Cmax ranges from about 25 ng/mL to about 300 ng/mL, about 25 ng/mL to about 200 ng/mL, about 25 ng/mL to about 180 ng/mL, about 25 ng/mL to about 160 ng/mL, about 25 ng/mL to about 140 mg/mL, about 25 ng/mL to about 120 mg/mL, about 25 ng/mL to about 100 mg/mL. In some embodiments, when dosed once per day at about 25 mg/day to about 450 mg/day, the plasma Cmax ranges from about 25 ng/mL to about 400 ng/mL, about 25 ng/mL to about 300 ng/mL, about 25 ng/mL to about 200 ng/mL, about 25 ng/mL to about 180 ng/mL, about 25 ng/mL to about 160 ng/mL, about 25 ng/mL to about 140 mg/mL, about 25 ng/mL to about 120 mg/mL, about 25 ng/mL to about 100 mg/mL.
In certain embodiments, when the SDD indibulin composition is dosed once time per day, the SDD indibulin compositions described herein are dosed at about 100 mg to about 500 mg, about 100 mg to about 400 mg, about 100 mg to about 300 mg, or at about 100 mg, about 110 mg, about 120 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, about 180 mg, about 190 mg, about 200 mg, about 225 mg, about 260 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 275 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, or about 500 mg, or any combinations of any of the individual dosage amounts set forth above.
In some embodiments, when the SDD indibulin composition is dosed once time per day, the plasma AUC1-24 is greater than about 200 hr·ng/mL, about 800 hr·ng/mL, or about 1000 hr·ng/mL. In some embodiments, when dosed once per day at less than 100 mg/day, the plasma AUC1-24 is greater than about 100 hr·ng/mL, greater than about 125 hr·ng/mL, greater than about 150 hr·ng/mL or greater than about 200 hr·ng/mL. In some embodiments, when dosed once per day at about 25 mg/day to about 100 mg/day, the plasma AUC1-24 ranges from about 100 hr·ng/mL to about 2000 hr·ng/mL, about 125 hr·ng/mL to about 1050 hr·ng/mL, or about 150 hr·ng/mL to about 1050 hr·ng/mL. In some embodiments, when dosed once per day at about 100 mg/day to about 275 mg/day, the plasma AUC1-24 ranges from about 600 hr·ng/mL to about 3000 hr·ng/mL, about 600 hr·ng/mL to about 1600 hr·ng/mL, about 600 hr·ng/mL to about 1400 hr·ng/mL. In some embodiments, when dosed once per day at about 275 mg/day to about 450 mg/day, the plasma AUC1-24 ranges from about 2000 hr·ng/mL to about 5000 hr·ng/mL, about 2000 hr·ng/mL to about 4000 hr·ng/mL, or about 2000 hr·ng/mL to about 3800 hr·ng/mL.
In an embodiment, the SDD indibulin compositions are dosed to the subject in a fasted state. In an embodiment, the subject is fasted overnight. As used herein, the term “fasted” means that the patient has not eaten any food (clear fluids only) for at least 2 hours, at least 4 hours, for at least 6 hours, for at least 8 hours, for at least 10 hours, or for at least 12 hours prior to administration of a provided formulation. In certain embodiments, the term “fasted” means an overnight fast.
In other embodiments, the compositions are administered to a subject that has not fasted. In another embodiment, the SDD indibulin compositions are dosed to the subject in a fed state. As used herein, the term “fed” means a standard meal (such as a full American breakfast) has been administered after an overnight fast of at least 10 hours and a meal starting 30 minutes prior to drug administration.
In one embodiment, the subject is dosed with the SDD indibulin compositions under a fed state, resulting in a higher plasma exposure level than when the subject is dosed with the SDD indibulin compositions under a fasted state. In one embodiment, the plasma exposure levels are about 1-5 fold higher when the SDD indibulin compositions are dosed to the subject in the fed state when compared to the fasted state. In another embodiment, the plasma exposure levels are about 1-2, about 1-3, about 1-4, about 2-3, about 2-4, about 2-5×, about 3-5, about 3-4, or about 4-5 fold higher when the SDD indibulin compositions are dosed to the subject in the fed state when compared to the fasted state.
In one embodiment, the subject is dosed with the SDD indibulin compositions under a fed state, resulting in a delayed Tmax compared to when the subject is dosed with the SDD indibulin compositions under a fasted state.
The invention now being generally described, it will be more readily understood by reference to the following examples which are included merely for purposes of illustration of certain aspects and embodiments of the present invention, and are not intended to limit the invention in any way.
Other objects, features, and advantages of the present invention will be apparent to those skilled in the art from a consideration of the foregoing detailed description and the following description of preferred exemplary embodiments thereof.
General procedure: Solid spray-dried dispersions of indibulin and HPMCAS were prepared as follows. Crystalline indibulin and matrix polymer HPMCAS were dissolved in a 95:5 w/w tetrahydrofuran (THF) and water solution to form a spray solution. The THF and water were subsequently removed during spray-drying using a small-scale spray-drying apparatus (GEA-Niro Mobil Minor spray dryer), resulting in a homogenous dispersion in powder form. Using this method, 10 percent by weight active drug (% A) HPMCAS-H(HPMCAS high grade), 15% A HPMCAS-H, 20% A HPMCAS-H, 25% A HPMCAS-H, 25% A HPMCAS-M (HPMCAS medium grade) and 50% A HPMCAS-M SDD formulations were prepared.
The mixture is then spray dried under appropriate conditions using a GEA-Niro Mobile Minor Spray Dryer With 6-foot and 9-inch Extension, DPH Gas Disperser, Cooling Fluid, and Nozzle-Centering Device; Pressure Nozzle: Steinen A75; Product Collection: 6-inch outer-diameter cyclone; solution filter less than or equal to 250 micron filter size. A 95:5 w/w THF:water solution was used for warmup and shutdown of the spray dryer. Following the spray drying process, the mixture was processed through a secondary drying step using a tray dryer (Gruenberg).
These SDDs were characterized by differential scanning calorimeter (DSC) and scanning electron microscope (SEM) and powder x-ray diffraction (PXRD). PXRD was taken using the methods and conditions summarized in Table 1 The characterization results are summarized in Table 2.
aNT = Not Tested
Water (353.0 g) and THF (6706.0 g) were mixed in a stainless-steel solution tank. To the THF/water solution was added indibulin (65.6 g) and HPMCAS-HG (590.4 g), forming a spray solution. The resulted spray solution was subsequently spray-dried on a GEA-Niro Mobile Minor Spray Dryer under the conditions listed in Table 3. These conditions were divided into four sets: (A) preheating, (B) warmup, (C) feed-solution processing, and (D) shutdown.
aNA = not applicable.
Bulk and tapped specific volumes and the particle size distribution of the SDD batch of 10% A Indibulin HPMCAS were determined according to the method described in United States Pharmacopoeia Chapter 616. The results are summarized in Table 4 and
The microcentrifuge dissolution test was performed to assess the ability of the indibulin SDD to sustain solubilized drug levels and to determine suspension stability. Using this method, 10% A HPMCAS-H(HPMCAS high grade), 15% A HPMCAS-H, 20% A HPMCAS-H, 25% A HPMCAS-H, 25% A HPMCAS-M (HPMCAS medium grade) and 50% A HPMCAS-M SDD formulations were tested. Specifically, the microcentrifuge dissolution test measures the supersaturation of drug above the crystalline solubility when dosed into the model fasted duodenal solution (MFDS).
In the microcentrifuge dissolution test, indibulin HPMCAS SDDs were each dosed into MFDS, which is 0.5% taurocholic acid, sodium salt hydrate (NaTC)/1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) in phosphate buffer solution (PBS, pH 6.5). In each resulted sample, the concentration of dissolved indibulin would have been 200 μg active drug per mL (200 μgA/mL), if all of the indibulin had dissolved. The samples were centrifuged at 13,000 rpm at 37° C. for 1 minute. The supernatant solution of each sample was then analyzed by HPLC. The remaining sample was mixed and allowed to stand undisturbed until next measurement was taken. Measurements were taken at 4, 10, 20, 40 and 90 minutes.
The 10% A, 15% A, 20% A, and 25% A HPMCAS-H SDDs showed substantially enhanced levels of solubilized drug as seen by maximum drug concentration (Cmax) and an approximate 10-fold improvement in solubilized drug sustainment as seen by area under the curve through 90 minutes (AUC90) when compared to bulk crystalline indibulin. Table 6 and
Suspension stability of 10% A HPMCAS-H and 25% A HPMCAS-H formulations were evaluated using the microcentrifuge dissolution test, as detailed below.
First, a 0.5 wt % Methocel A (Methylcellulose, Methocel A4M Premium, DOW Chemical Company) vehicle was prepared and later used as the suspension vehicle. Specifically, this vehicle was prepared by adding 0.5 g of Methocel A to 30 mL deionized water at 90° C. and stirring until well dispersed. To the resultant dispersion was added 70 mL of water and the mixture was placed into an ice bath and stirred until Methocel A is dissolved.
A 20 mgA/mL indibulin SDD suspension of each of the 10% A HPMCAS-H and 25% A HPMCAS-H formulations was then prepared by adding the indibulin HPMCAS SDD to the aqueous 0.5 wt % Methocel A vehicle (as prepared above). Each suspension was then tested in the microcentrifuge dissolution test (as described above) immediately after constitution in the aqueous 0.5 wt % Methocel A vehicle (O-hour or Initial), and one hour after the constitution in the aqueous 0.5 wt % Methocel A vehicle. The stability of each suspension was determined by comparing the dissolution profile of the one-hour suspension to the performance of the initial suspension. The 10% A and 25% A HPMCAS-H SDDs both showed no change in performance after one hour. These results are shown in
In the ultracentrifuge test, the formulation (SDD or bulk crystalline indibulin) was added to a dissolution medium so that the concentration of dissolved indibulin would have been 200 μg active drug per mL (200 μgA/mL), if all of the indibulin had dissolved. The resulted mixture was then mixed for 90 minutes. The dissolution media used in this test are PBS (pH 6.5), 0.5% NaTC/POPC in PBS (pH 6.5), and 2% NaTC/POPC in PBS (pH 6.5). Following this step, indibulin/polymer colloidal species were then removed by ultracentrifugation at 80000 rpm for 20 minutes at 37° C. The concentration of the drug remaining in the supernatant was then analyzed by HPLC using conditions as specified in Table 8 below.
Free drug levels were measured for the 10% A HPMCAS-H, 15% A HPMCAS-H, 20% A HPMCAS-H, 25% A HPMCAS-H, 25% A HPMCAS-M and 50% A HPMCAS-M SDD formulations, at a dose of 200 ugA/mL in PBS (pH 6.5), 0.5% NaTC/POPC in PBS (pH 6.5), or 2% NaTC/POPC in PBS (pH 6.5) in the ultracentrifuge test, and the results are shown in
The 10% A, 15%, and 20% A HPMCAS-H SDDs have an approximately 10-fold increase in free drug levels compared to the bulk crystalline indibulin drug in MFDS, while the HPMCAS-M SDDs and the 25% A HPMCAS-H SDD provided about a 5-fold increase in free drug solubility in this medium. In 2% NaTC/POPC, pH 6.5 dissolution media (simulating fed state conditions) the HPMCAS-H SDDs provide a 50- to 60-fold increase in free drug levels compared to bulk crystalline drug. The HPMCAS-M SDDs provide about a 20-fold enhancement in free drug levels compared to bulk crystalline drug in 2% NaTC/POPC, pH=6.5 media.
The micelle partition coefficient (Kp) of the bulk crystalline indibulin was also determined using ultracentrifugation at 37° C. in a temperature-controlled box. A typical procedure for determining the Kp value is described as follows:
Kp can be calculated using the equation: [Dt/Df]=Vm*Kp+1, where: Dt=Average drug concentration (mg/mL); Vm=Wt % micelles in solution; Kp=Micelle partition coefficient, Df=Drug concentration in aq. solution (mg/mL) (i.e. PBS, no micelles), (1-Vm)=Aq. volume fraction (the volume of micelles is very small compared to the volume of aqueous solution so (1-Vm) can simply be 1.
The 10% A HPMCAS-H(HPMCAS high grade), 15% A HPMCAS-H, 20% A HPMCAS-H, 25% A HPMCAS-H, 25% A HPMCAS-M (HPMCAS medium grade) and 50% A HPMCAS-M SDD formulations were also evaluated in a membrane-permeation test at 37° C. in a temperature-controlled box. Test procedures were described, for example, in U.S. Pat. No. 7,611,630. For example, a membrane-permeation test of 10% A HPMCAS-H indibulin SDD was performed using the following procedures:
A typical membrane permeation set-up that can be used in the above membrane permeation test is shown in
This test assessed the rate of solubilized drug indibulin that passed through a synthetic membrane from aqueous MFDS to an aqueous immiscible organic sink solution. The SDD formulations and the bulk crystalline indibulin all had relatively low fluxes in the membrane-permeation test, with the 10% A HPMCAS-H SDD having the highest flux and drug recovery.
The glass transition temperature (Tg) of the SDD formulations 10% A HPMCAS-H (HPMCAS high grade), 15% A HPMCAS-H, 20% A HPMCAS-H, 25% A HPMCAS-H, 25% A HPMCAS-M (HPMCAS medium grade) and 50% A HPMCAS-M SDD is determined as a function of relative humidity (RH) as shown
Typically, Tgs of the SDD formulations were determined using a modulated differential scanning calorimetry (MDSC) method using the conditions as specific in Table 10 below. A representative MDSC Thermogram of the 10% A HPMCAS-H indibulin SDD is shown in
The results demonstrated that the SDDs have Tgs that are sufficiently high to ensure long-term physical stability of the SDD if protected from high humidity.
Samples of each formulation were also exposed for 24 hours to high temperature and humidity (i.e., 50° C./75% RH). These samples were then analyzed by SEM to determine any physical changes that occurred during storage. Potency was measured by high-performance liquid chromatography (HPLC) to evaluate chemical changes. These results are shown in Table 11. No significant changes in potency were observed. All indibulin SDDs with a drug loading of 25% or lower were free of crystals and particle fusing. Crystals, however, were observed by SEM on the 50% A HPMCAS-M SDD. This result was expected because the Tg and the storage temperature for this SDD are the same at 50/75% RH, which likely allows sufficient mobility and crystallization of the drug within the polymer matrix.
A 25 milligrams active drug (mgA) indibulin spray-dried intermediate (SDi) tablet formulation was developed. The composition of the tablet formulation is summarized in Table 12.
cNA = not applicable.
dNF = National Formulary.
The 25 mgA indibulin SDi tablets were prepared following the procedures as described in
During the granulation step, a Gerteis Mini-Pactor Roller was used to roller compact the pre-granulation blend into ribbons (see Table 13 for parameters). Comil Model 197 was then used with a 050G screen size for producing a granulation mixture to a target solid fraction of 0.65 (±0.02) using a true density of 1.400 g/cm3.
The PK Blend Master Lab Blender with a 20 mesh screen size with was used for the final blending step. A bulk density of 0.40 g/cc was used. Colloidal silicon dioxide was blended with a portion of the granulation mixture manually and passed through the screen. The resulting mixture was then returned to the blender and blended at 12 rpm for about 15 minutes. Afterwards, magnesium stearate lubricant was manually mixed with a portion of the blender mixture and passed through a 20 mesh screen. The resulting mixture was then returned to the blender and blended at 12 rpm for about 5 minutes.
A Korsch XL100 tablet press was used according to the parameters in Table 14.
The 50 mgA indibulin tablets were prepared using procedures similar to those described above for the 25 mgA tablets with appropriate adjustment of ingredient amount and process parameters.
aRecommended or expected valued based on development experience; may need to be adjusted to meet local procedures and to maintain tablet characteristics within specifications.
bValues used during development and provided for set-up guidance; actual compression force and resultant tablet thickness may need to be varied to meet target weight and hardness specifications.
aSOP = standard operating procedure.
In order to obtain an improved formulation of indibulin with enhanced solubility, improved bioavailability and decreased variability in plasma pharmacokinetics, a SDD formulation of indibulin was developed. Several different formulations and active strengths were tested in vitro for performance, long term stability and manufacturability. Solubility and dissolution parameters were compared with those obtained with the crystalline indibulin. See, for example,
First Study: Indibulin Rat Plasma Concentration after Dosing with 10% A and 25% A Indibulin HPMCAS-H SDDs
In the first study, the crystalline indibulin, 10% A and 25% A SDDs were administered p.o. at 10 and 15 mg/kg to rats (Sprague Dawley, male) and plasma concentrations of indibulin were determined at several time points.
In particular, all rats used in this study were fasted 12 hours prior to dose, and food was returned 4 hours post dose. 10% A and 25% A indibulin HPMCAS SDD formulations (as prepared in Example 1(a)) were used in this study. Indibulin in crystalline form was suspended in 0.5% Methocel A at 10 mg/kg, and 15 mg/kg by vortexing and sonicating. The indibulin SDD formulations were made by combining 10% active indibulin SDD at 10 mg/kg and 15 mg/kg, 25% active indibulin SDD at 10 mg/kg and 15 mg/kg using a mortar with 0.5% Methocel A and using a pestle to gradually mix in to solution. There were six rats per group, all animals were weighed and dose volume calculated so that each rat received test article orally at a volume of 10 mL/kg. The first three rats in each group were bled at 0.5, 2, and 6 hours post dose; the remaining three rats in each group were bled at 1, 4, and 10 hours post dose. For blood collection at all time points all animals were anesthetized with an inhalation of 4% isoflurane and 1.5% oxygen, once it was determined that the animal was adequately anesthetized (no reaction to physical stimulation) using a capillary tube the orbital venous plexus was punctured and a volume of 1 mL of blood was collected in to a sodium heparin tube. Once the blood was collected the sodium heparin tube was inverted ten times, and placed on ice until centrifuged for 10 minutes at 2510 rpm. The plasma was decanted in to labeled Eppendorfs and stored at −80° C. until analyzed by HPLC with MS/MS Detection. All data were acquired using Applied Biosystems/MDS-Sciex Analyst Version 1.5, processed; reported using Watson Version 7.3.0.01TM, Thermo Fisher Scientific, Inc.; and are summarized in
aAUC0-1.5, quantifiable concentrations up to 1.5 hr after IV dosing at 0.25 mg/kg
bPartial AUC truncated from AUC0-24 for comparison purpose; AUC0-24 = 1204 hr · ng/mL
cCalculated based on ratio of dose-normalized AUC0-10Â after oral and IV administration; AUC0-∞ cannot be determined due to inadequate sampling time on the terminal phase
The maximum plasma indibulin (Cmax) occurred at about 1 hour post administration for all formulations tested. At 15 mg/kg dosage, the average Cmax for the 10% A formulation was about 319 ng/ml, for the 25% A formulation, the average Cmax was 177 mg/ml, both of which are significantly higher than the 13 ng/ml Cmax for crystalline indibulin.
The ratio of Cmax of the 10% SDD solution to the Cmax of the crystalline formulation is 11.9 and 19.4, for the 10 mg/kg and 15 mg/kg doses, respectively. The ratio of AUC of the 10% SDD solution to the AUC of the crystalline formulation is 15.0 and 20.8, for the 10 mg/kg and 15 mg/kg doses, respectively. These data confirm plasma exposure that are at least about 12-21 times higher with the 10% SDD indibulin, compared to crystalline indibulin. Moreover, the absolute oral bioavailability was 37% for SDD indibulin compared to 2.4% for crystalline indibulin. These improvements in plasma exposure are unexpected in view of predictive models, which predicted a more modest improvement in drug absorption, if any.
Second Study: Dose Response of Indibulin Rat Plasma Concentration after Dosing with 10% A Indibulin SDD
The second study was designed to determine the dose response of indibulin plasma concentration with the 10% A SDD formulation. In general, 10% A SDD was administered p.o. at 10, 15 and 20 mg/kg and plasma indibulin concentrations were determined at several time points.
All rats used in the second study were fasted 12 hours prior to dose, and food was returned 4 hours post dose. Indibulin in crystalline form was suspended in 0.5% Methocel A at 10 mg/kg, 15 mg/kg and 20 mg/kg by vortexing and sonicating. The indibulin SDD formulations were made by combining 10% active indibulin SDD at 10 mg/kg, 15 mg/kg and 20 mg/kg in a mortar with 0.5% Methocel A and using a pestle to gradually mix in to solution. There were six rats per group, all animals were weighed and the dose volume calculated so that each rat received the test article orally at a volume of 10 mL/kg. The first three rats in each group were bled at 0, 5, 2, and 6 hours post dose; the remaining three rats in each group were bled at 1, 4, and 10 hours post dose. For blood collection at all time points, all animals were anesthetized with an inhalation of 4% isoflurane and 1.5% oxygen; once it was determined that the animal was adequately anesthetized (no reaction to physical stimulation) using a capillary tube the orbital venous plexus was punctured and a volume of 1 mL of blood was collected in to a sodium heparin tube. Once the blood was collected the sodium heparin tube was inverted ten times, and placed on ice until centrifuged for 10 minutes at 2510 rpm. The plasma was decanted into labeled Eppendorfs and stored at −80° C. until analyzed by HPLC with MS/MS Detection. All data were acquired using Applied Biosystems/MDS-Sciex Analyst Version 1.5; processed, and reported using Watson Version 7.3.0.01TM, Thermo Fisher Scientific, Inc.; and are summarized in
The result demonstrated that there was a marked dose response, in particular, an clear increase in indibulin plasma concentration with increasing doses, when the 10% A SDD was orally administered. Furthermore, the Cmax for the 10% A SDD is about 33-fold higher than that of crystalline indibulin at 20 mg/kg dose, signifying a much improved bioavailability.
A phase I study was conducted to determine the maximum tolerated dose (MTD) of indibulin SDD tablets when administered to subjects in an open-label, single-arm, multi-center study for 5 days followed by a 9 day rest (5-9) using a standard, 3+3 dose escalation scheme. Additional objectives of the study included evaluating the safety and pharmacokinetics (PK) of indibulin as well as describing the overall toxicity rates during a 28 day treatment cycle and estimating the overall response rate and the proportion of subjects who are progression-free at 4 months.
Key eligibility criteria for inclusion of subjects in the study were histologic or cytologic confirmation of carcinoma of the breast; metastatic disease or locally advanced disease not amenable to curative therapy; measurable or non-measurable lesions; any number of prior endocrine, biologic or chemotherapy regimens is permitted; prior radiation therapy is permitted; ECOG performance status of (0-2); age≧18 years; life expectancy≧12 weeks; adequate bone marrow, liver and renal function (Creatinine≦1.5×upper limit of normal (ULN); total bilirubin≦1.5×ULN; ALT or AST≦2.5×ULN; ANC≧1.5×109/L; Platelets≧100×109/L; Hemoglobin≧9 g/dL); and women of child bearing potential must use appropriate contraception.
Subjects excluded from the study included those with untreated symptomatic CNS metastases; uncontrolled gastrointestinal malabsorption; ≧Grade 2 peripheral neuropathy; history of an invasive second primary malignancy diagnosed within the
previous 3 years (except endometrial or cervical carcinoma or prostate carcinoma treated surgically; or non-melanoma skin cancer for Stage I endometrial or cervical carcinoma or
prostate carcinoma treated surgically, and non-melanoma skin cancer); any medical psychological or social condition that may interfere with the subject's ability to safely participate in the study; pregnant or nursing women.
Dose limiting toxicity (DLT) observation period was during days 1 to 15 of cycle 1. Serial blood collection was used for pharmacokinetic evaluation (see example 7). Tumor assessments for efficacy was conducted at baseline, at 8 week intervals for the first 6 months, and then every 12 weeks thereafter. Subjects were treated until disease progression or unacceptable toxicity. Adverse events (AEs) were graded by CTCAE v 4.0. Objective disease status was evaluated according to RECIST 1.1.
The phase I dose escalation cohorts was also used for a cross-over study for food-effect PK assessment. Cohorts 1 to 7 were subjects treated with a total dose (once daily) of 25 mg fasted, 50 mg fasted, 100 mg fasted, 150 mg fasted, 200 mg fasted, 275 mg fasted and fed, and 350 mg fed, respectively. The 25 subjects included 24 female and 1 male subjects with a median age of 58 (range 32-81), a median number of prior therapies of 5 (range 1-12), and an ECOG status of 0 (5 subjects), 1 (18 subjects), 2 (2 subjects). The majority of related toxicities are GI-related, mild to moderate in serverity and reversible. The most frequent and related AEs include decreased apetite, diarrhea, nausea, vomiting, and fatigue. No grade 3, 4, 5, or serious adverse events (SAEs) were reported as related to study medication. Two subjects had prolonged stable disease (SD). Specifically, one subject was progression free beyond 4 months after administration of 275 mg fasted (stable disease after cycle 6 of study) and one subject was progression free up to 4 months after administration of 150 mg fasted. The elimination of half-life of indibulin ranged from 6-12 hours.
Crystalline indibulin capsules and indibulin SDD tablets were administered p.o. to breast cancer patients. The crystalline indibulin capsules were dosed at 600 mg and 800 mg, three times per day (TID) for a total daily dose of 1800 mg/day and 2400 mg/day. The SDD indibulin tablets were dosed under fasted conditions (i.e., clear fluids only from midnight until 2 hours post-dose) once per day (QD) for a total daily dose of 25 mg/day, 50 mg/day, 100 mg/day, 150 mg/day, 200 mg/day, and 275 mg/day (normalized to body surface area (BSA in m2) ranging from 14-177 mg/m2). Thus, total daily dose for the SDD tablet formulation was between 1-6% of the total daily dose for the crystalline capsules. The SDD indibulin tablets were also dosed under fed conditions once per day (QD) for a total daily dose of 275 mg/day (normalized to BSA ranging from 164-182 mg/m2) and 350 mg/day (normalized to BSA ranging from about 199-224 mg/m2). For each study, plasma concentrations of indibulin were determined. The data under fasted conditions are shown in Table 19, which is a summary of the plasma pharmacokinetic data for the two different indibulin formulations, at different doses. The data under fed conditions are shown in Table 20, which is a summary of the plasma pharmacokinetic data for the two different doses of indibulin SDD.
At 25 mg/day, the average Cmax for the SDD formulation was about 50 ng/ml, at 50 mg/day, the average Cmax for the SDD formulation was about 57 ng/ml, at 100 mg/day, the average Cmax for the SDD formulation was about 120 ng/ml, at 150 mg/day, the average Cmax for the SDD formulation was about 119 ng/ml, at 200 mg/day, the average Cmax for the SDD formulation was about 165 ng/ml, and at 275 mg/day, the average Cmax for the SDD formulation was about 158 ng/ml. In comparison, the average Cmax for the crystalline formulation, which was dosed 6-96 times higher, was about 122 for the 1800 mg/day dose and about 178 for the 2400 mg/day dose.
The ratio of Cmax for the SDD tablets to the Cmax of the crystalline capsules (1800 mg/day) is 16.9 and 17.6, for the 50 mg/day and 100 mg/day doses, respectively. The ratio of Cmax for the SDD tablets to the Cmax of the crystalline capsules (2400 mg/day) is 15.5 and 16.2, for the 50 mg/day and 100 mg/day doses, respectively. The ratio of AUC for the SDD tablets to the AUC of the crystalline capsules (1800 mg/day) is 13.5 and 15.3, for the 50 mg/day and 100 mg/day doses, respectively. The ratio of AUC for the SDD tablets to the AUC of the crystalline capsules (2400 mg/day) is 13.3 and 15.2, for the 50 mg/day and 100 mg/day doses, respectively. These data are consistent with the data observed in rats and confirm plasma exposures that are about 10-20 times higher with the SDD indibulin, compared to crystalline indibulin. These data, along with the rat data, suggest the oral bioavailability of SDD indibulin is at least about 10-20 times higher than that of crystalline indibulin. As with the data observed in the rat model, the in vivo data suggest unexpectedly enhanced bioavailability of the SDD formulations. Moreover, the Cmax at 100 mg (QD) of the SDD tablet formulation is comparable to that at 18-24 times the dose of the crystalline capsule formulation. Specifically, the Cmax values in patients receiving 100 mg of the SDD formulation were comparable to the Cmax values for patients receiving a dose that was 18 times higher in the crystalline formulation, dosed three times per day. Additionally, exposures were less variable for the SDD formulation compared to the crystalline formulation.
The data for the 275 mg daily dose under fed conditions indicated that plasma Cmax and AUC were about 2-3× higher under fed conditions compared to the 275 mg daily dose under fasted conditions. Additionally, the Tmax is delayed under fed conditions when compared to the Tmax under fasted conditions.
All of the above-cited references and publications are hereby incorporated by references in their entirety. Particular references incorporated herein by reference in their entirety include U.S. Pat. Nos. 6,232,327 and 6,693,119, and U.S. Patent Application Publication Nos. 2006/0280787, 2008/0241274 and 2006/0110462 and PCT International Publication No. 2011/028743.
Those skilled in the art would readily appreciate that all parameters and examples described herein are meant to be exemplary and that actual parameters and examples will depend upon the specific application for which the composition and methods of the present invention are used. Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments of the invention described herein. It is, therefore, to be understood that the foregoing embodiments are presented by way of example only and that the invention may be practiced otherwise than as specifically described. Accordingly, those skilled in the art would recognize that the use of a composition or method in the examples should not be limited as such. The present invention is directed to each individual composition, or method described herein. In addition, any combination of two or more such compositions or methods, if such composition or methods are not mutually inconsistent, is included within the scope of the present invention.
The present application claims priority to U.S. Application No. 61/623,964 filed on Apr. 13, 2012 and U.S. Application No. 61/704,882 filed on Sep. 24, 2012, the entire contents of these applications being incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 61623964 | Apr 2012 | US | |
| 61704882 | Sep 2012 | US |
