plinabulin compositions and their use

专利摘要:
compositions and methods of prevention and / or treatment or reduction of adverse events mediated by immunotherapy through the administration of plinabulin are disclosed here. some modalities refer to the treatment of inflammation related to immunotherapy through the administration of plinabulin. some modalities are related to the treatment of psoriasis and / or inflammation by the administration of plinabulin.
公开号:BR112019018880A2
申请号:R112019018880
申请日:2018-03-12
公开日:2020-04-14
发明作者:Kenneth Lloyd George；Huang Lan；Mohanlal Ramon
申请人:Beyondspring Pharmaceuticals Inc；
IPC主号:

专利说明:

“PLINABULIN COMPOSITIONS AND THEIR USE” DESCRIPTION REPORT
BACKGROUND
Field [0001] The present invention relates to the field of chemistry and medicine. More particularly, the present application relates to plinabulin, compositions containing plinabulin and their analogues and use.
Description of the related technique [0002] Immunotherapy-related adverse events (ARI) are a frequently seen consequence of immunostimulatory antibody therapy. IRAEs can be serious and even fatal. ARIEs include autoimmune responses, such as diarrhea, enterocolitis, dermatitis, hypophysitis, panhypopituitarism, rash, itching and other inflammatory reactions. Severe AKIs can result in modification of the drug dosage and less effective treatment or termination of cancer treatment. It is necessary to develop an effective treatment for IRAEs.
[0003] Phosphodiesterases (pds) are enzymes that hydrolyze and degrade the field. Pde4 is a field phosphodiesterase widely expressed in hematopoietic cells (eg, myeloid, lymphoid), non-hematopoietic cells (eg, smooth muscle, endothelial keratinocyte) and sensory / memory neurons. The four pde4 genes (a, b, c and d) exhibit distinct target and regulatory properties. Each of these genes can produce multiple protein products due to mRNA splice variants, resulting in approximately 19 different p4 proteins that fall into short or long isoform categories. The regulation of field activity is important in many biological processes and is
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2/70 it is necessary to develop effective pde4 inhibitors that can be used to treat various diseases.
SUMMARY [0004] Some modalities refer to a method of prevention and / or treatment of an adverse event mediated by immunotherapy in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it, in which the mediated adverse event immunotherapy is selected from the group consisting of pancreatitis, pneumonitis, colitis, hepatitis, nephritis and renal dysfunction, hypothyroidism and hyperthyroidism, uveitis, demyelination, autoimmune neuropathy, adrenal insufficiency, facial and abducent nerve paresis, hypophysitis, diabetic ketoacidosis, hypopituitarism, Guillain-Barré syndrome, myasthenic syndrome, hypophysitis, thyroiditis, type 1 diabetes mellitus, arthritis, exfoliative dermatitis, bullous pemphigoid, myositis, myasthenia gravis, vasculitis, hemolytic anemia, partial seizures that arise in a patient with inflammatory focus in the parenchyma cerebral, dermatitis, rash, itching, meningitis, sarcoidosis and, pericarditis, fatal myocarditis, angiopathy, temporal arteritis, vasculitis, polymyalgia rheumatica, conjunctivitis, blepharitis, episcleritis, scleritis, iritis, leukocytoclastic vasculitis, erythema multiforme, psoriasis, arthritis, autoimmune thyroiditis, autoimmune central neuropathy, encephalitis (encephalitis) and ocular myositis and hemolytic anemia.
[0005] Some modalities refer to a method of treating or ameliorating immunotherapy-mediated pancreatitis in a subject, comprising administering an effective amount of plinabulin to the subject in need of it, wherein immunotherapy comprises administering an inhibitor of PD-1 is a CTLA-4 inhibitor.
[0006] Some modalities refer to a method of
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3/70 treatment of an inflammatory disorder of the skin or joint in a subject, comprising the topical administration of an effective amount of plinabulin to the subject in need of it [0007] Some modalities refer to a method of treating an inflammatory disease in a subject, comprising administering an effective amount of plinabulin to the subject in need, in which the inflammatory disease is selected from the group consisting of chronic joint rheumatism, chronic obstructive pulmonary disease, asthma, ankylosing spondylitis, psoriatic arthritis, sarcoidosis, systemic lupus erythematosus, inflammatory bowel disease, atopic dermatitis and multiple sclerosis, irritable bowel syndrome, inflammatory bowel disease and allergic dermatitis.
[0008] Some modalities refer to a method of treating chronic obstructive pulmonary disease or asthma in a subject that includes administering an effective amount of plinabulin to the subject in need of it through an inhaler.
[0009] Some modalities refer to a method of treating inflammation induced by immunotherapy in a subject, comprising administering an effective amount of plinabulin to the subject in need of it, in which the subject is administered with one or more point inhibitors immunological verification.
[0010] Some modalities refer to a topical formulation, comprising plinabulin at a concentration effective to inhibit PDE4 activity without reducing vascular proliferation or density.
[0011] Some modalities refer to a formulation
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4/70 topical, comprising plinabulin at a concentration in the range of about 0.1% to about 10% by weight of the total formulation.
BRIEF DESCRIPTION OF THE DRAWINGS [0012] Figure 1 shows the percentage of patients showing steroid-related adverse events during treatment with plinabulin.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT [0013] Plinabulin, (3Z, 62) -3-Benzylidene-6 - {[5- (2-methyl-2propanyl) -1H-imidazol-4-yl] methylene} -2,5- piperazinadione, is a synthetic analogue of the natural compound phenylhistine. Plinabulin can be readily prepared according to methods and procedures detailed in US Patent Nos. 7,064,201 and 7,919,497, which are incorporated herein by reference in their entirety. In some modalities, Plinabulin can efficiently inhibit PED4 activity. Plinabulin, as described herein, includes pharmaceutically acceptable salts, polymorphs and solvates.
[0014] Plinabulin can be effective in reducing the incidence and severity of AKI and, when used in combination with anticancer immunotherapy, can help to achieve a more effective and safe treatment. In addition to treating and preventing AKI, Plinabulin can also improve the immune response during treatment with immunotherapy and achieve a synergistic effect. Plinabulin can target cancer cells and reduce tumor size through immune modulation of the cancer cell, and / or the tumor microenvironment to promote cancer-improving effects. anticancer / anti tumor immunity and act in synergy with immunotherapy. Therefore, plinabulin not only reduces the risk of adverse events related to immunotherapy and improves the safety of therapy, but also promotes the effectiveness of immunotherapy anti-cancer treatment.
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5/70 [0015] Phosphodiesterase 4 (PDE4) is an essential enzyme in the degradation of cyclic adenosine monophosphate and is involved in the production of inflammatory cell cytokines, in angiogenesis and in the functional properties of other types of cells, such as keratinocytes. Plinabulin can inhibit PDE4 activity and have anti-inflammatory properties. Plinabulin can be effective in the treatment of inflammatory diseases, including inflammation mediated by immunotherapy and other chronic human inflammatory diseases, such as psoriasis and psoriatic arthritis. Plinabulin can be used to treat chronic inflammatory diseases, such as those of the skin and joints.
Definitions [0016] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as is commonly understood by one versed in the technique to which this disclosure belongs. All patents, orders, published orders and other publications are incorporated by reference in their entirety. In the event that there are a plurality of definitions for a term here, those contained in this section prevail, unless otherwise stated.
[0017] "Subject", as used in the present invention, means a human or non-human mammal, for example, a dog, a cat, a mouse, a rat, a cow, a sheep, a pig, a goat, a primate non-human or a bird, for example, a chicken, as well as any other vertebrate or invertebrate.
[0018] The term "mammal" is used in its usual biological sense. Thus, it specifically includes, but is not limited to, primates, including apes (chimpanzees, large monkeys, monkeys) and humans, cattle, horses, sheep, goats, pigs, rabbits, dogs, cats, rodents, mice, mice, guinea pigs, or the like.
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6/70 [0019] An "effective amount" or "therapeutically effective amount", as used in the present invention, refers to an amount of a therapeutic agent that is effective to relieve, to some extent, or reduce the likelihood of onset one or more of the symptoms of a disease or condition and includes curing a disease or condition.
[0020] "Treat", "treatment" or "treating", as used in the present invention, refers to the administration of a pharmaceutical compound or composition to a subject for prophylactic and / or therapeutic purposes. The term “prophylactic treatment” refers to the treatment of a subject who does not yet show symptoms of a disease or condition, but who is susceptible to, or otherwise at risk of, having a specific disease or condition, for which treatment reduces the likelihood that the patient will develop the disease or condition. The term "therapeutic treatment" refers to the administration of treatment to a subject who is already suffering from a disease or condition.
[0021] The term "pharmaceutically acceptable salt" refers to salts that retain the biological effectiveness and properties of a compound and that are not biologically or otherwise undesirable for use in a pharmaceutical product. In many cases, the compounds disclosed herein are capable of forming acid and / or base salts by virtue of the presence of amino and / or carboxyl groups or groups similar to them. Pharmaceutically acceptable acid addition salts can be formed with inorganic acids and organic acids. Inorganic acids from which salts can be derived include, for example, hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid and the like. The organic acids from which salts can be derived include, for example, acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, benzoic acid , cinnamic acid, mandelic acid, acid
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7/70 methanesulfonic, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like. Pharmaceutically acceptable salts can also be formed using inorganic and organic bases. The inorganic bases from which salts can be derived include, for example, bases containing sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, aluminum and the like; particularly preferred are the ammonium, potassium, sodium, calcium and magnesium salts. In some embodiments, treatment of the compounds disclosed herein with an inorganic base results in the loss of a labile hydrogen of the compound to provide the salt form, including an inorganic cation, such as Li ⁺ , Na ⁺ , K ⁺ , Mg ²⁺ and Ca ²⁺ and the like. The organic bases from which salts can be derived include, for example, primary, secondary and tertiary amines, substituted amines, including naturally substituted amines, cyclic amines, basic ion exchange resins and the like, specifically as isopropylamine, trimethylamine, diethylamine, triethylamine , tripropylamine and ethanolamine. Many of these salts are known in the art, as described in WO 87/05297, Johnston et al., Published on September 11, 1987 (incorporated by reference here in its entirety).
[0022] The term "topical administration" or "topically administration" refers to the application of a pharmaceutical agent on the external surface of the skin, nail, hair, hand or foot, so that the agent crosses the external surface of the skin, nail, hair, hand or foot, and enter the underlying tissues. Topical administration includes applying the composition to the intact skin, nail, hair, hand or foot, or to a broken, gross or open wound on the skin, nail, hair, hand or foot. Topical administration of a pharmaceutical agent can result in limited distribution of the agent to the skin and surrounding tissues or, when the agent is removed from the treatment area by the bloodstream, it can result in systemic distribution of the agent.
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8/70 [0023] PD-1 is an essential immunological checkpoint receptor expressed by activated T and B cells and mediates immunosuppression. PD-1 is a member of the CD28 receptor family, which includes CD28, CTLA-4, ICOS, PD-1 and BTLA. The term "PD-1", as used in the present invention, includes human PD-1 (hPD-1), variants, isoforms and homologues of hPD-1 species and analogs with at least one common epitope with hPD-1.
[0024] Several cell surface glycoprotein ligands for PD-1 have been identified, including PD-L1, PD-L2, PD-L3 and PD-L4, which are expressed in antigen presenting cells, as well as in many human cancers, and showed to negatively regulate the activation of Tea cells and cytokine secretion after binding to PD-1. The term "PD-L1", as used in the present invention, includes human PD-L1 (hPD-Ll), variants, isoforms and homologs of hPD-Ll species and analogs with at least one common epitope with hPD-Ll. The term "PDL2", as used in the present invention, includes human PD-L2 (hPD-L2), variants, isoforms and homologues of hPD-L2 species and analogs with at least one common epitope with hPD-L2. The term "PD-L3", as used in the present invention, includes human PD-L3 (hPD-L3), variants, isoforms and homologues of hPD-L3 species and analogs with at least one common epitope with hPD-L3. The term "PD-L4", as used in the present invention, includes human PD-L4 (hPD-L4), variants, isoforms and homologues of hPD-L4 species and analogs with at least one common epitope with hPD-L4.
[0025] CTLA-4 (protein 4 associated with cytotoxic T lymphocytes) is a protein receptor that, acting as an immunological checkpoint, negatively regulates the immune system. CTLA4 is found on the surface of T cells, it is also a member of the immunoglobulin (Ig) superfamily; CTLA-4 comprises a single extracellular Ig domain. CTLA-4 transcripts have been found in populations of T cells with cytotoxic activity, suggesting that the
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9/70
CTLA-4 can function in the cytolytic response.
Treatment Method
1. [0026] Some modalities refer to a method of treatment or prevention of an adverse event related to immunotherapy in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it, in which the subject is administered with a or more inhibitors of immunological checkpoints. In some modalities, immunotherapy is anti-cancer immunotherapy. In some modalities, the subject also receives radiation therapy in addition to anti-cancer immunotherapy.
[0026] Some modalities refer to a method of treatment or prevention of inflammation induced by immunotherapy in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it, in which the subject is administered with one or more inhibitors immunological checkpoints. In some modalities, immunotherapy is anti-cancer immunotherapy.
[0027] Some modalities refer to a method of treatment, prevention or improvement of an adverse event mediated by immunotherapy in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it. The adverse event mediated by immunotherapy may include, among others, the adverse events or conditions disclosed in the pembrolizumab, nivolumab, atezolizumab, durvalumab, avelumab, ipilimumab and tremelimumab package inserts, which have been incorporated by reference in their entirety for this purpose.
[0028] In some modalities, the adverse event mediated by immunotherapy is selected from the group consisting of pancreatitis, pneumonitis, colitis, hepatitis, nephritis and renal dysfunction, hypothyroidism and
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10/70 hyperthyroidism, uveitis, demyelination, autoimmune neuropathy, adrenal insufficiency, paresis of the facial nerve and abdomen, hypophysitis, diabetic ketoacidosis, hypopituitarism, Guillain-Barré syndrome, myasthenic syndrome, hypotitis, thyroiditis, type 1 diabetes mellitus, arthritis, exfoliative dermatitis, bullous pemphigoid, myositis, myasthenia gravis, vasculitis, hemolytic anemia, partial seizures in a patient with inflammatory foci in the brain parenchyma, dermatitis, rash, pruritus, meningitis, sarcoidosis, pericarditis, fatal myocarditis, angiopathy, arteritis, arteritis, arteritis , polymyalgia rheumatica, conjunctivitis, blepharitis, episcleritis, scleritis, iritis, leukocytoclastic vasculitis, erythema multiforme, psoriasis, arthritis, autoimmune thyroiditis, autoimmune neuropathy, polymyositis and ocular myositis and hemolytic anemia. In some modalities, the adverse event mediated by immunotherapy is selected from the group consisting of pancreatitis, pneumonitis, colitis, hepatitis, nephritis, renal dysfunction, hypothyroidism, hyperthyroidism and uveitis. In some modalities, the adverse event mediated by immunotherapy is pancreatitis. In some embodiments, immunotherapy is the administration of one or more checkpoint inhibitors.
[0029] In some modalities, the adverse event related to immunotherapy is selected from fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, asthenia, cough, dyspnea, constipation, decreased appetite, back pain, arthralgia, infection of the upper respiratory tract, pyrexia, headache, abdominal pain.
[0030] In some modalities, the adverse event related to immunotherapy is selected from the group consisting of Pneumonitis, Colitis, Hepatitis, Endocrinopathies, Nephritis and Renal Dysfunction, Adverse Skin Reactions and Encephalitis. In some modalities, the adverse event related to immunotherapy is selected from the infusion reaction, complications of halogen hematopoietic stem cell (HSCT) transplantation, embryonic-fetal toxicity. Pneumonitis
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11/70 immunological related: In some modalities, the adverse event related to immunotherapy is pneumonitis. In some modalities, the adverse event related to immunotherapy is colitis. In some modalities, the adverse event related to immunotherapy is hepatitis. In some modalities, the adverse event related to immunotherapy is transaminase or total elevation of bilirubin. In some modalities, the adverse event related to immunotherapy and endocrinopathy. In some modalities, the adverse event related to immunotherapy is hypophysitis. In some modalities, the adverse event related to immunotherapy is adrenal insufficiency. In some modalities, adverse events related to immunotherapy are changes in thyroid function. In some modalities, the adverse event related to immunotherapy is hyperglycemia. In some modalities, the adverse event related to immunotherapy is nephritis and renal dysfunction. In some modalities, the adverse event related to immunotherapy is an increase in serum creatinine. In some modalities, the adverse event related to immunotherapy is related to adverse skin reactions. In some modalities, the adverse event related to immunotherapy is a rash. In some modalities, the adverse event related to immunotherapy is Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis. In some modalities, the adverse event related to immunotherapy is encephalitis. In some modalities, the adverse event related to immunotherapy is related to changes in neurological function. In some modalities, the adverse event is grade 2. In some modalities, the adverse event is grade 3 or 4. In some modalities, the adverse event is grade 3. In some modalities, the adverse event is grade 4. In some modalities, the adverse event is serious or life-threatening.
[0031] Some modalities refer to a method of treatment, prevention or improvement of pancreatitis mediated by
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12/70 immunotherapy in a subject, comprising administering an effective amount of plinabulin to the subject in need of it Some modalities refer to a method of treatment, prevention or amelioration of pneumonitis mediated by immunotherapy in a subject, comprising administering a effective amount of plinabulin to the subject in need of it Some modalities refer to a method of treatment, prevention or improvement of colitis mediated by immunotherapy in a subject, comprising administering an effective amount of plinabulin to the subject in need of it. Some modalities refer to a method of treatment, prevention or improvement of hepatitis mediated by immunotherapy in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it. Some modalities refer to a method of treatment, prevention or improvement of endocrinopathies mediated by immunotherapy in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it. Some modalities refer to a method of treatment, prevention or improvement of nephritis mediated by immunotherapy and renal dysfunction in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it. Some modalities refer to a method of treatment, prevention or improvement of adverse skin reactions mediated by immunotherapy in a subject, including the administration of an effective amount of plinabulin to the subject in need of it. Some modalities refer to a method of treatment, prevention or improvement of immunotherapy-mediated encephalitis in a subject, comprising the administration of an effective amount of plinabulin to the subject in need of it. In some embodiments, immunotherapy comprises the administration of a PD-1 inhibitor and a CTLA-4 inhibitor. In some modalities, the
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Immunotherapy comprises the administration of a PD-1 inhibitor. In some embodiments, immunotherapy comprises the administration of nivolumab. In some embodiments, immunotherapy comprises the administration of pembrolizumab. In some embodiments, immunotherapy comprises the administration of nivolumab in combination with ipilimumab.
[0032] In some modalities, the method described here also includes the identification of a patient at risk of having a serious adverse event related to immunotherapy. In some modalities, the identification of a patient at risk of having a serious adverse event related to immunotherapy comprises assessing the patient's history (and family history), general physical condition, autoimmune diseases, basic laboratory tests and radiological exams [mainly computed tomography scans (CT) of the chest, abdomen / pelvis and, often, brain magnetic resonance (MRI)]. In some modalities, identifying a patient at risk of having a serious adverse event related to immunotherapy involves identifying patients with a history of autoimmune disease or who are being actively treated for an autoimmune disease. In some modalities, identifying a patient at risk of having a serious adverse event related to immunotherapy includes identifying patients with AKI during previous immunotherapy.
[0033] In some modalities, the method described here comprises the identification of a patient with a serious adverse event related to immunotherapy. In some modalities, the method described here comprises the identification of a patient with an adverse event related to grade 3 or 4 immunotherapy. In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises assessing the severity of the event adverse effect (AE) of the skin through the evaluation by a careful and complete physical examination of the skin, including the areas of the mucosa, a
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14/70 assessment of the patient's general condition (fever, enlarged lymph nodes, etc.) and, if necessary, a biological examination, including blood cell count, liver and kidney tests. In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises the elimination of the possibility of a dermatological emergency, such as rash with eosinophilia and systemic symptoms (DRESS), acute febrile neutrophilic dermatosis (Sweet's syndrome), syndrome Stevens-Johnson syndrome or toxic epidermal necrolysis (NET). In some modalities, IRAE can be classified using the Common Toxicity Criterion of the National Cancer Institute version 4.0, which is incorporated by reference in its entirety. In some modalities, the IRAE can be classified using the American Society of Clinical Oncology Clinical Practice Guideline, which is incorporated by reference in its entirety. In some modalities, IRAE can be classified using the American Society of Clinical Oncology Clinical Practice Guidelines (Management of Toxicities from Immunotherapy: EMSO Clinical Practice Guidelines: Ann Oncol (2017) 28 (suppl 4): ivl 19-ivl42.) , which is incorporated by reference in its entirety.
[0034] In some modalities, to measure the severity of skin AE, the Common Terminology Criteria for Adverse Events (CTCAE) classification can be used, which is incorporated by reference in its entirety. Regarding a maculopapular rash, the most frequent event with checkpoint inhibitors, the fourth version of the CTCAE classification includes: Grade 1: macules / papules covering <10% of the body surface area (BSA) with or without symptoms (for example, itching, burning, tightness); Grade 2: macules / papules covering 10% to 30% of BSA with or without symptoms (for example, itching, burning, tightness); limitation of instrumental activities of daily living (ADL); Grade 3: macules / papules> 30% BSA with or without associated symptoms; ADL limitation of
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15/70 self-care; and Grade 4: papulopustular rash associated with life-threatening superinfection; Stevens-Johnson syndrome, TEN and bullous dermatitis coverage> 30% BSA and requirement for admission to the intensive care unit (ICU).
[0035] In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises measuring the levels of thyroid stimulating hormone (TSH), triiodothyronine and thyroxine (FT3, FT4) and anti-thyroid antibodies (Abs) from patient. In some modalities, the identification of a patient with a serious adverse event related to immunotherapy involves monitoring the patient's blood glucose levels in order to detect the onset of DM. In some embodiments, the method described here includes monitoring during the treatment of TFTs at each cycle of ornTFTs 4-6 weeks after cycle 4 (ie, with new CT staging) for Anti-CTLA4 (including combination with antiPD-1 ). In some modalities, the method described in this document includes monitoring during the treatment of TFTs at each cycle for the first 3 months, at each second cycle to follow (in the case of a 2-week schedule) when Anti-PD-1 / Anti-PD -Ll is used.
[0036] In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises the assessment of severe symptoms of mass effect, that is, severe headache, any visual disturbance or severe hypo adrenalism, that is, hypotension , severe electrolyte disturbance. In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises the assessment of moderate symptoms, that is, headache, but without visual disturbances or fatigue / mood changes, but hemodynamically stable, without electrolyte disturbances. In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises following the pituitary MRI protocol or excluding metastases
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16/70 brain.
[0037] In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises the assessment of ICPi-related toxicity: management of hepatitis. In some modalities, to assess the severity of the adverse event, the following standards can be used - Grade 1: ALT or AST> ULN-3x ULN; Grade 2: ALT or AST 3-5x ULN; Grade 3: ALT or AST 5-20x ULN; and grade 4: ALT or AST> 20x ULN.
[0038] In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises the assessment of ICPi-related toxicity: diarrhea and colitis. In some modalities, a serious adverse event (grade 3/4) includes more than 6 liquid stools per day above the baseline or if episodes occur within 1 h after ingestion. In some modalities, a moderate adverse event (grade 2) includes 4-6 liquid stools per day on the baseline or abdominal pain or blood in the stool or nausea or nighttime episodes. In some modalities, a mild adverse event (note 1) includes less than 4 liquid stools per day above the baseline.
[0039] In some modalities, the identification of a patient with a serious adverse event related to immunotherapy comprises the assessment of ICPi-related toxicity: management of pneumonitis In some modalities, a mild adverse event (grade 1) includes only radiographic changes. In some modalities, a moderate adverse event (grade 2) includes new mild / moderate symptoms, dyspnea, cough, chest pain. In some modalities, a serious adverse event (grade 3/4) includes new severe symptoms; New / worsens hypoxia; Life risk; Difficulty breathing, ARDS.
[0040] In some embodiments one or more checkpoint inhibitors are selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, a PD-L2 inhibitor, an inhibitor of
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PD-L3, an inhibitor of PD-L4, an inhibitor of CTLA-4, an inhibitor of LAG3, an inhibitor of B7-H3, an inhibitor of B7-H4, an inhibitor of KIR and an inhibitor of IT M3. In some embodiments, the immunological checkpoint inhibitor is a PD-1 inhibitor. In some embodiments, the immunological checkpoint inhibitor is a PD-L1 inhibitor. In some embodiments, the immunological checkpoint inhibitor is a CTLA-4 inhibitor.
[0041] In some embodiments the subject is administered with a first immunological checkpoint inhibitor and a second immunological checkpoint inhibitor and in which the first immunological checkpoint inhibitor is different from the second immunological checkpoint inhibitor. In some embodiments, the first and second immunological checkpoint inhibitors are independently an inhibitor selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, a PD-L2 inhibitor, a PD inhibitor -L3, a PD-L4 inhibitor, a CTLA-4 inhibitor, a LAG3 inhibitor, a B7-H3 inhibitor, a B7-H4 inhibitor, a KIR inhibitor and a TIM3 inhibitor. In some embodiments, the first checkpoint inhibitor is a PD-1 inhibitor or a PD-L1 inhibitor, and the second checkpoint inhibitor is a CTLA-4 inhibitor.
[0042] In some embodiments, immunotherapy is a monotherapy and in which monotherapy comprises the administration of a single checkpoint inhibitor selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, an inhibitor of PD-L2, an inhibitor of PD-L3, an inhibitor of PD-L4, an inhibitor of CTLA-4, an inhibitor of LAG3, an inhibitor of B7-H3, an inhibitor of B7-H4, an inhibitor of KIR and a TIM3 inhibitor. In some embodiments, the checkpoint inhibitor is a PD-1 inhibitor. In some embodiments, the checkpoint inhibitor is a PD-L1 inhibitor. In some embodiments, the point inhibitor
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18/70 verification is a CTLA-4 inhibitor.
[0043] In some embodiments, immunotherapy is a combination therapy, and in which the combination therapy comprises the administration of two or more checkpoint inhibitors selected from the group consisting of a PD-1 inhibitor, an inhibitor of PD-L1, a PD-L2 inhibitor, a PD-L3 inhibitor, a PD-L4 inhibitor, a CTLA-4 inhibitor, a LAG3 inhibitor, a B7-H3 inhibitor, a B7-H4 inhibitor , a KIR inhibitor and a TIM3 inhibitor. In some embodiments, the combination therapy comprises the administration of a PD-L1 inhibitor and a CTLA-4 inhibitor.
[0044] In some embodiments, the PD-1 or PD-L1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, atezolizumab, durvalumab and avelumab. In some embodiments, the PD-1 inhibitor is nivolumab or pembrolizumab. In some embodiments, the PD-L1 inhibitor is atezolizumab, durvalumab or avelumab. In some embodiments, the CTLA-4 inhibitor is ipilimumab or tremelimumab. In some embodiments, the checkpoint inhibitor is pembrolizumab. In some embodiments, the checkpoint inhibitor is nivolumab.
[0045] In some embodiments, the amount of plinabulin used to treat the indications described here is effective in inhibiting PDE4 activity without reducing avascular proliferation or density.
[0046] In some modalities, immunotherapy is used to treat or prevent melanoma, non-small cell lung cancer (NSCLC), squamous cell head and neck cancer (HNSCC), classic Hodgkin's lymphoma (cHL), carcinoma urothelial, microsatellite instability High cancer (MSI-H cancer), gastric cancer, advanced renal cell carcinoma, metastatic squamous carcinoma of the head and neck (SCCHN), colorectal cancer
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19/70 metastatic, hepatocellular carcinoma (HOC) or microsatellites with high instability (MSI-H) or metastatic colorectal cancer (CRM) deficient in inadequate repair (dMMR). In some modalities, immunotherapy is used to treat or prevent melanoma, non-small cell lung cancer (NSCLC), squamous cell head and neck cancer (HNSCC), classic Hodgkin's lymphoma (cHL), urothelial carcinoma, cancer microsatellite instability (MSI-H Cancer) or Gastric Cancer.
[0047] Some modalities refer to the treatment of an inflammatory disease or condition in a subject, comprising the administration of plinabulin to the subject in need, with the proviso that the inflammatory disease or condition is not rheumatoid arthritis, chronic joint rheumatism, psoriasis, retinopathy diabetic, neovascular glaucoma, retinopathy of prematurity, macular degeneration, corneal graft rejection, retrolental fibroplasia, rubella, capillary proliferation in atherosclerotic plaques or osteoporosis.
[0048] In some embodiments, plinabulin is administered at a dose in the range of about 1-50 mg / m ² of the body surface area. In some embodiments, plinabulin is administered at a dose in the range of about 5 to about 50 mg / m ² of the body surface area. In some embodiments, plinabulin is administered at a dose in the range of about 20 to about 40 mg / m ² of the body surface area. In some embodiments, plinabulin is administered at a dose in the range of about 15 to about 30 mg / m ² of the body surface area. In some embodiments, plinabulin is administered in a dose in the range of about 0.5-1, 0.5-2, 0.5-3, 0.5-4, 0.5-5, 0.5- 6, 0.5-7, 0.5-8, 0.5-9, 0.5-10, 0.5-11, 0.5-12, 0.5-13, 0.5-13, 75, 0.5-14, 0.5-15, 0.5-16, 0.5-17, 0.5-18, 0.519, 0.5-20, 0.5-22.5, 0, 5-25, 0.5-27.5, 0.5-30, 1-2, 1-3, 1-4, 1-5, 1-6, 17, 1-8, 1-9, 1- 10, 1-11, 1-12, 1-13, 1-13.75, 1-14, 1-15, 1-16, 1-17, 1 Petition 870190113870, from 11/06/2019, p. 25/76
20/70
18, 1-19, 1-20, 1-22.5, 1-25, 1-27.5, 1-30, 1.5-2, 1.5-3, 1.5-4, 1, 5-5,
1.5- 6, 1.5-7, 1.5-8, 1.5-9, 1.5-10, 1.5-11, 1.5-12, 1.5-13, 1.5- 13.75,
1.5-14, 1.5-15, 1.5-16, 1.5-17, 1.5-18, 1.5-19, 1.5-20, 1.5-22.5, 1, 5-25,
1.5- 27.5, 1.5-30, 2.5-2, 2.5-3, 2.5-4, 2.5-5, 2.5-6, 2.5-7, 2, 5-8, 2.5-9,
2.5-10, 2.5-11, 2.5-12, 2.5-13, 2.5-13.75, 2.5-14, 2.5-15, 2.5-16, 2, 5-
17, 2.5-18, 2.5-19, 2.5-20, 2.5-22.5, 2.5-25, 2.5-27.5, 2.5-30, 2, 5-7.5,
3- 4, 3-5, 3-6, 3-7, 3-8, 3-9, 3-10, 3-11, 3-12, 3-13, 3- 13.75, 3-14, 315, 3-16, 3-17, 3-18, 3-19, 3-20, 3-22.5, 3-25, 3-27.5, 3-30, 3.5- 6.5,
3.5- 13.75, 3.5-15, 2.5-17.5, 4-5, 4-6, 4-7, 4-8, 4-9, 4-10, 4-11, 4- 12,
4- 13, 4-13.75, 4-14, 4-15, 4-16, 4-17, 4-18, 4-19, 4-20, 4-22.5, 4-25, fl-
27.5, 4-30, 5-6, 5-7, 5-8, 5-9, 5-10, 5-11, 5- 12, 5-13, 5-13.75, 5-14, 515, 5-16, 5-17, 5-18, 5-19, 5-20, 5-22.5, 5-25, 5-27.5, 5-30, 6-7, 6-8, 69, 6-10, 6-11, 6-12, 6-13, 6-13.75, 6-14, 6-15, 6-16, 6- 17, 6-18, 6-19, 6-20, 6-22.5, 6-25, 6-27.5, 6-30, 7-8, 7-9, 7-10, 7-11, 7-12, 7-13, 713.75, 7- 14, 7-15, 7-16, 7-17, 7-18, 7-19, 7-20, 7-22,5, 7-25, 7-27,5, 730, 7.5-12, 5, 7.5-13.5, 7.5-15, 8-9, 8-10, 8-11, 8-12, 8-13, 8-13.75, 814, 8-15, 8- 16, 8-17, 8-18, 8-19, 8-20, 8-22,5, 8-25, 8-27,5, 8-30, 9-10,
9- 11, 9-12, 9-13, 9- 13.75, 9-14, 9-15, 9-16, 9-17, 9-18, 9-19, 9-20, 9-
22.5, 9-25, 9-27.5, 9-30, 10-11, 10-12, 10-13, 10-13.75, 10-14, 10-15,
10-16, 10-17, 10-18, 10-19, 10-20, 10-22.5, 10-25, 10-27.5, 10-30,
11.5- 15.5, 12.5-14.5, 7.5-22.5, 8.5-32.5, 9.5-15.5, 15.5-24.5, 5-35,
17.5- 22.5, 22.5-32.5, 25-35, 25.5-24.5, 27.5-32.5, 2-20, 2.5-22.5 or
9.5- 21.5 mg / m ² , of the body surface area. In some embodiments, plinabulin is administered at a dose of about 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10,
10.5, 11, 11.5, 12, 12.5, 13, 13.5, 14, 14.5, 15, 15.5, 16, 16.5, 17, 17.5,
18, 18.5, 19, 19.5, 20, 20.5, 21, 21.5, 22, 22.5, 23, 23.5, 24, 24.5, 25,
25.5, 26, 26.5, 27, 27.5, 28, 28.5, 29, 29.5, 30, 30.5, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 mg / m ² of body surface area. In some embodiments, plinabulin is administered in a dose less than about 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 5.5, 6 , 6.5, 7, 7.5, 8, 8.5, 9,
9.5, 10, 10.5, 11, 11.5, 12, 12.5, 13, 13.5, 14, 14.5, 15, 15.5, 16, 16.5,
Petition 870190113870, dated 11/06/2019, p. 26/76
21/70
17, 17.5, 18, 18.5, 19, 19.5, 20, 20.5, 21, 21.5, 22, 22.5, 23, 23.5, 24,
24.5, 25, 25.5, 26, 26.5, 27, 27.5, 28, 28.5, 29, 29.5, 30, 30.5, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 mg / m ² of the body surface area. In some embodiments, plinabulin is administered in a dose greater than about 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 5.5, 6 , 6.5, 7, 7.5, 8,
8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 12.5, 13, 13.5, 14, 14.5, 15, 15.5, 16,
16.5, 17, 17.5, 18, 18.5, 19, 19.5, 20, 20.5, 21, 21.5, 22, 22.5, 23, 23.5, 24, 24.5, 25, 25.5, 26, 26.5, 27, 27.5, 28, 28.5, 29, 29.5, 30, 30.5, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50 mg / m ² of the body surface area. In some modalities, plinabulin is administered at a dose of about 10, 13.5, 20 or 30 mg / m ² of the body surface area. In some embodiments, plinabulin is administered at a dose of about 20 mg / m ² of body surface area.
[0049] In some embodiments, the dose of plinabulin is about 5 mg - 100 mg, or about 10 mg - 80 mg. In some embodiments, the dose of plinabulin is about 15 mg - 100 mg, or about 20 mg - 80 mg. In some embodiments, plinabulin is administered at a dose in the range of about 15 mg - 60 mg. In some embodiments, the dose of plinabulin is about 0.5 mg - 3 mg, 0.5 mg -2 mg, 0.75 mg - 2 mg, 1 mg - 10 mg, 1.5 mg - 10 mg, 2 mg
- 10 mg, 3 mg - 10 mg, 4 mg - 10 mg, 1 mg - 8 mg, 1.5 mg - 8 mg, 2 mg
- 8 mg, 3 mg - 8 mg, 4 mg - 8 mg, 1 mg - 6 mg, 1.5 mg - 6 mg, 2 mg - 6 mg, 3 mg - 6 mg, or about 4 mg - 6 mg . In some embodiments, the administered plinabulin is about 2 mg - 6 mg or 2 mg - 4.5 mg. In some embodiments, the administered plinabulin is about 5 mg-7.5 mg, 5 mg-9 mg, 5 mg-10 mg, 5 mg-12 mg, 5 mg-14 mg, 5 mg-15 mg, 5 mg-16 mg , 5 mg-18 mg, 5 mg-20 mg, 5 mg-22 mg, 5 mg-24 mg, 5 mg-26 mg, 5 mg-28mg, 5mg-30mg, 5mg-32mg, 5mg-34mg, 5mg- 36mg, 5mg-38mg, 5mg-40mg, 5mg-42mg, 5mg-44mg, 5mg-46mg, 5mg-48mg, 5mg-50mg, 5mg-52mg, 5mg-54mg, 5mg-56mg, 5mg-58mg, 5mg-60mg,
Petition 870190113870, dated 11/06/2019, p. 27/76
22/70 mg-7.7 mg, 7 mg-9 mg, 7 mg-10 mg, 7 mg-12 mg, 7 mg-14 mg, 7 mg-15 mg, 7 mg-16 mg, 7 mg-18 mg, 7 mg-20 mg, 7 mg-22 mg, 7 mg-24 mg, 7 mg-26 mg, 7 mg-28mg, 7mg-30mg, 7mg-32mg, 7mg-34mg, 7mg-36mg, 7mg-38mg, 7mg-40mg, 7mg -42mg, 7mg-44mg, 7mg-46mg, 7mg-48mg, 7mg-50mg, 7mg-52mg, 7mg-54mg, 7mg-56mg, 7mg-58mg, 7mg-60mg, 9 mg-10 mg, 9 mg-12mg, 9mg-14mg, 9mg-15 mg, 9 mg-16 mg, 9 mg-18 mg, 9 mg-20 mg, 9 mg-22 mg, 9 mg-24 mg, 9 mg-26 mg, 9 mg-28mg, 9mg-30mg, 9mg-32mg, 9mg-34mg, 9mg-36mg, 9mg-38mg, 9mg-40mg, 9mg-42mg, 9mg-44mg, 9mg-46mg, 9mg-48mg, 9mg-50mg, 9mg-52mg, 9mg- 54mg, 9mg-56mg, 9mg-58mg, 9mg-60mg, 10mg-12mg, 10mg14mg, 10mg-15mg, 10mg-16mg, 10mg-18mg, 10mg-20mg, 10mg22mg, 10mg -24 mg, 10 mg-26 mg, 10 mg-28mg, 10mg-30mg, 10mg32mg, 10mg-34mg, 10mg-36mg, 10mg-38mg, 10mg-40mg, 10mg-42mg, 10mg-44mg, 10mg-46mg, 10mg -48mg, 10mg-50mg, 10mg-52mg, 10mg-54mg, 10mg-56mg, 10mg-58mg, 10mg-60mg, 12mg-14mg, 12mg-15 mg, 12 mg-16 mg, 12 mg-18 mg, 12 mg -20 mg, 12 mg-22 mg, 12 mg-24 mg, 12 mg-26 mg, 12 mg-28mg, 12mg-30mg, 12mg-32mg, 12mg-34mg, 12mg-36mg, 12mg-38mg, 12mg-40mg, 12mg-42mg, 12mg-44mg, 12mg-46mg, 12mg-48mg, 12mg-50mg, 12mg -52mg, 12mg-54mg, 12mg-56mg, 12mg-58mg, 12mg-60mg, 15 mg-16 mg, 15 mg-18 mg, 15 mg-20 mg, 15 mg-22 mg, 15 mg-24 mg, 15 mg-26 mg, 15 mg-28mg, 15mg-30mg, 15mg-32mg, 15mg-34mg, 15mg-36mg, 15mg38mg, 15mg-40mg, 15mg-42mg, 15mg-44mg, 15mg-46mg, 15mg-48mg, 15mg- 50mg, 15mg-52mg, 15mg-54mg, 15mg-56mg, 15mg-58mg, 15mg-60mg, 17 mg-18 mg, 17 mg-20 mg, 17 mg-22 mg, 17 mg-24 mg, 17 mg-26 mg, 17 mg-28mg, 17mg-30mg, 17mg-32mg, 17mg-34mg, 17mg-36mg, 17mg-38mg, 17mg-40mg, 17mg-42mg, 17mg-44mg, 17mg-46mg, 17mg-48mg, 17mg-50mg , 17mg-52mg, 17mg-54mg, 17mg-56mg, 17mg-58mg, 17mg-60mg, 20 mg-22 mg, 20 mg-24 mg, 20 mg-26 mg, 20 mg-28mg, 20mg-30mg, 20mg- 32mg, 20mg-34mg, 20mg36mg, 20mg-38mg, 20mg-40mg, 20mg-42mg, 20mg-44mg, 20mg-46mg, 20mg-48mg, 20mg-50mg, 20mg-52mg, 20mg-54mg, 20mg-56mg,
Petition 870190113870, dated 11/06/2019, p. 28/76
23/70
20mg-58mg, 20mg-60mg, 22mg-24mg, 22mg-26mg, 22mg-28mg,
22mg-30mg, 22mg-32mg, 22mg-34mg, 22mg-36mg, 22mg-38mg,
22mg-40mg, 22mg-42mg, 22mg-44mg, 22mg-46mg, 22mg-48mg,
22mg-50mg, 22mg-52mg, 22mg-54mg, 22mg-56mg,
22mg-60mg, 25mg-26mg, 25mg-28mg, 25mg-30mg,
22mg-58mg,
25mg-32mg,
25mg-34mg, 25mg-36mg, 25mg-38mg,
25mg-40mg,
25mg-42mg,
25mg-44mg, 25mg-46mg, 25mg-48mg,
25mg-50mg,
25mg-52mg,
25mg-54mg, 25mg-56mg, 25mg-58mg, 25mg-60mg, 27 mg-28mg,
27mg-30mg,
27mg-40mg,
27mg-50mg,
27mg-60mg,
30mg-40mg,
30mg-50mg,
30mg-60mg,
33mg-42mg,
33mg-52mg,
36mg-38mg,
36mg-48mg,
36mg-58mg,
40mg-48mg,
40mg-58mg,
43mg-52mg,
45mg-48mg,
45mg-58mg,
48mg-56mg,
50mg-56mg,
27mg-32mg,
27mg-42mg,
27mg-52mg,
30mg-32mg,
30mg-42mg,
30mg-52mg,
33mg-34mg,
33mg-44mg,
33mg-54mg,
36mg-40mg,
36mg-50mg,
36mg-60mg,
40mg-50mg,
40mg-60mg,
43mg-54mg,
45mg-50mg,
45mg-60mg,
48mg-58mg,
50mg-58mg,
27mg-34mg,
27mg-44mg,
27mg-54mg,
30mg-34mg,
30mg-44mg,
30mg-54mg,
33mg-36mg,
33mg-46mg,
33mg-56mg,
36mg-42mg,
36mg-52mg,
40mg-42mg,
40mg-52mg,
43mg-46mg,
43mg-56mg,
45mg-52mg,
48mg-50mg,
48mg-60mg,
50mg-60mg,
27mg-36mg,
27mg-46mg,
27mg-56mg,
30mg-36mg,
30mg-46mg,
30mg-56mg,
33mg-38mg,
33mg-48mg,
33mg-58mg,
36mg-44mg,
36mg-54mg,
40mg-44mg,
40mg-54mg,
43mg-48mg,
43mg-58mg,
45mg-54mg,
48mg-52mg,
50mg-52mg,
52mg-54mg,
27mg-38mg
27mg-48mg
27mg-58mg
30mg-38mg
30mg-48mg
30mg-58mg
33mg-40mg
33mg-50mg
33mg-60mg
36mg-46mg
36mg-56mg
40mg-46mg
40mg-56mg
43mg-50mg
42mg-60mg
45mg-56mg
48mg-54mg
50mg-54mg
52mg-56mg
52mg-58mg, or 52mg-60mg. In some embodiments, the dose of plinabulin is greater than about 0.5 mg, 1 mg, 1.5 mg, 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7 mg, 8 mg, 9 mg, about 10 mg, about 12.5 mg, about 13.5 mg, about 15 mg, about 17.5 mg, about 20 mg, about 22.5 mg, about 25 mg, about 27 mg, about 30 mg or
Petition 870190113870, dated 11/06/2019, p. 29/76
24/70 about 40 mg. In some embodiments, the dose of plinabulin is about less than 1 mg, 1.5 mg, 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7 mg, 8 mg, 9 mg, about 10 mg, about 12.5 mg, about 13.5 mg, about 15 mg, about 17.5 mg, about 20 mg, about 22.5 mg, about 25 mg, about 27 mg, about 30 mg, about 40 mg, or about 50 mg.
[0050] The actual dose of the checkpoint inhibitor described here depends on the specific compound and the condition to be treated; the selection of the appropriate dose is within the skill of the art. In some embodiments, the method described herein comprises administering a checkpoint inhibitor at a dose in the range of about 0.01 mg / kg to about 250 mg / kg of body weight, from about 0.1 mg / kg to about 200 mg / kg of body weight, from about 0.25 mg / kg to about 120 mg / kg of body weight, from about 0.5 mg / kg to about 70 mg / kg of body weight, from about 1.0 mg / kg to about 50 mg / kg of body weight, from about 1.0 mg / kg to about 15 mg / kg of body weight, from about 2.0 mg / kg to about 15 mg / kg of body weight, from about 3.0 mg / kg to about 12 mg / kg of body weight, or from about 5.0 mg / kg to about 10 mg / kg body weight. In some procedures, the method described in this document comprises administering a checkpoint inhibitor at a dose in the range of 0.5-1, 0.5-2, 0.5-3, 0.5-4, 0 , 5-5, 0.5-6, 0.5-7, 0.58, 0.5-9, 0.5-10, 1-2, 1-3, 1-4, 1-5, 1 -6, 1-7, 1-8, 1-9, 1-10, 1-20, 1-30,
1-40, 1-50, 1-60, 1-70, 1-80, 1-90, 1-100, 2.5-5, 2.5-10, 2.5-20, 2.5- 30,
2.5-40, 2.5-50, 2.5-60, 2.5-70, 2.5-80, 2.5-90, 2.5-100, 3-5, 3-10, 3-20, 3-30, 3-40, 3-50, 3-60, 3-70, 3-80, 3-90, 3-100, 5-10, 5-20, 5-30, 5- 40,
5-50,5-60, 5-70, 5-80, 5-90, 5-100, 7.5-10, 7.5-20, 7.5-30, 7.5-40, 7.550, 7.5-60, 7.5-70, 7.5-80, 7.5-90, 7.5-100, 10-10, 10-20, 10-30, 1040, 10-50, 10- 60, 10-70, 10-80, 10-90, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20-90, 20-100, 20-150, 20-200, 3040, 30-50, 30-60, 30-70, 30-80, 30-90, 30-100, 30-150, 30-200, 40-50, 40-60, 40-70, 40-80, 40-90, 40-100, 40-150, 40-200, 40-300, 50-60,
Petition 870190113870, dated 11/06/2019, p. 30/76
25/70
50-70, 50-80, 50-90, 50-100, 50-150, 50-200, 50-250, 50-300, 60-80, 60-100, 60-150, 60-200, 70- 100, 70-150, 70-200, 70-250, 70-300, 80100, 80-150, 80-200, 80-250, 80-300, 90-100, 90-150, 90-200, 90- 250, 90-300, 90-350, 90-400, 100-150, 100-200, 100-250, 100-300, 100350, or 100-400 mg / kg of body weight. In some embodiments, the checkpoint inhibitor described herein can be administered at a dose of about 0.1, 0.25, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9 , 10, 11, 12, 13, 14, 15, 16, 17, 18,19, 20, 22,5, 25, 27,5, 30, 35, 40, 45, 50, 55, 60, 65, 70 , 75, 80, 85, 90, 95 or 100 mg / kg body weight. In some embodiments, the method described herein comprises administering a checkpoint inhibitor at a dose of about 3 mg / kg. In some embodiments, the method described herein comprises administering a checkpoint inhibitor at a dose of about 3 mg / kg every three weeks, for a total of four doses.
[0051] In some embodiments, the PD-1 inhibitor is administered in an amount of about 0.5-1, 0.5-2, 0.5-3, 0.5-4, 0.5-5 , 0,5-6, 0,5-7, 0,5-8, 0,5-9, 0,5-10, .2,5-3, 2,5-4, 2,5-5, 2.5-6, 2.57, 2.5-8, 2.5-9, 2.5-10.3-10, 5-10, 1-10, 1-20, 1-30, 1- 40, 1-50, 1-60, 170, 1-80, 1-90, 1-100, 2.5-10, 2.5-20, 2.5-30, 2.5-40, 2, 5-50, 2.5-60,
2.5- 70, 2.5-80, 2.5-90, 2.5-100, 5-10, 5-20, 5-30, 5-40, 5-50.5-60, 570, 5- 80, 5-90, 5-100, 7.5-10, 7.5-20, 7.5-30, 7.5-40, 7.5-50, 7.5-60,
7.5- 70, 7.5-80, 7.5-90, 7.5-100, 10-10, 10-20, 10-30, 10-40, 10-50, 1060, 10-70, 10- 80, 10-90, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20-90, 20-100, 20-150, 20-200, 30-40, 30-50, 3060, 30-70, 30-80, 30-90, 30-100, 30-150, 30-200, 40-50, 40-60, 40-70, 40-80, 40-90, 40-100, 40-150, 40-200, 40-300, 50-60, 50-70, 50-80, 50-90, 50-100, 50- 150, 50-200, 50-250, 50-300, 60-80, 60-100, 60150, 60-200, 70-100, 70-150, 70-200, 70-250, 70-300, 70- 500, 70-750, 70-1000, 70-1500, 70-2000, 70-3000, 80-100, 80-150, 80-200, 80-250, 80-300, 80-500, 80-750, 80-1000, 80-1500, 80-2000, 80-3000, 90-100, 90-150, 90-200, 90-250, 90-300, 90-350, 90-400, 90-500, 90- 750, 90-
Petition 870190113870, dated 11/06/2019, p. 31/76
26/70
1000, 90-1500, 90-2000, 90-3000, 100-150, 100-200, 100-250, 100300, 100-350, 100-400, 100-500, 100-600, 100-700, 100- 800, 100900, 100-1000, 100-1500, 100-2000, 100-2500, 100-3000, 100-3500, 100-4000, 200-500, 200-700, 200-1000, 200-1500, 200- 2000, 2002500, 200-3000, 200-3500, 200-4000, 500-1000, 500-1500, 500-2000, 500-2500, 500-3000, 500-3500, or 500-4000 mg per dose. In some embodiments, the checkpoint inhibitor is administered in an amount of about 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0, 9, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25, 3.5, 3.75, 4, 4.5, 5, 5, 5, 6,
6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 12.5, 15, 17.5, 20, 22.5, 25, 27.5, 30, 40, 50, 60, 70, 80, 90, 100, 150, 200, 250, 300, 350,400, 450, 500, 550, 600, 650, 700, 750, 800, 850, 900, 1000, 1100, 1200, 1250, 1300,
1400, 1500, 1600, 1700, 1800, 1900, 2000, 2100, 2200, 2300,2400,
2500, 2600, 2700, 2800, 2900, 3000, 3100, 3200, 3300, 3400,3500,
3600, 3700, 3800, 3900, 4000, 4100, 4200, 4300, 4400, 4500,4600,
4700, 4800, 4900, or 5000 mg per dose. In some embodiments, the checkpoint inhibitor is administered in an amount of about 25 mg, 50 mg or 100 mg per dose.
[0052] In some embodiments, the method described herein comprises administering a PD-1 inhibitor in a dose in the range of about 0.5-1, 0.5-2, 0.5-3, 0.5 -4, 0.5-5, 0.5-6, 0.5-7, 0.5-8, 0.5-9, 0.5-10, 1-2, 1-3, 1-4 , 1-5, 1-6, 1-7, 1-8, 1-9, 1-10, 1-20, 1-30, 140, 1-50, 1-60, 1-70, 1-80 , 1-90, 1-100, 2-3, 2-4, 2-5, 2-6, 2-7, 2-8, 29, 2-10, 2-20, 2-30, 2-40 , 2-50, 2-60, 2-70, 2-80, 2-90, 2-100, 2.5-3,
2.5- 3.5, 2.5-4, 2.5-5, 2.5-6, 2.5-7, 2.5-9, 2.5-10, 3-4, 3-5, 3-6, 3-7, 3-8, 3-9, 3-10, 5-10, 5-20, 5-30, 5-40, 5-50,5-60, 5-70, 5- 80, 5-90, 5-100,
7.5-10, 7.5-20, 7.5-30, 7.5-40, 7.5-50, 7.5-60, 7.5-70, 7.5-80, 7.5- 90,
7.5- 100, 10-10, 10-20, 10-30, 10-40, 10-50, 10-60, 10-70, 10-80, 1090, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20-90, 20-100, 20-150, 20-200, 30-40, 30-50, 30- 60, 30-70, 30-80, 3090, 30-100, 30-150, 30-200, 40-50, 40-60, 40-70, 40-80, 40-90, 40
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100, 40-150, 40-200, 40-300, 50-60, 50-70, 50-80, 50-90, 50-100, 50150, 50-200, 50-250, 50-300, 60- 80, 60-100, 60-150, 60-200, 70-100, 70-150, 70-200, 70-250, 70-300, 80-100, 80-150, 80-200, 80-250, 80300, 90-100, 90-150, 90-200, 90-250, 90-300, 90-350, 90-400, 100150, 100-200, 100-250, 100-300, 100-350, or 100 -400 mg / kg body weight. In some embodiments, the method described herein comprises administering the PD-1 inhibitor in a dose of about 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 , 0.8, 0.9, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25, 3.5, 3.75 , 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 12.5, 15,
17.5, 20, 22.5, 25, 27.5, 30, 40, 50, 60, 70, 80, 90 or 100 mg / kg of body weight. In some embodiments, the PD-1 inhibitor is administered at a dose of about 3 mg / kg. In some embodiments, the PD-1 inhibitor is administered at a dose of about 2 mg / kg.
[0053] In some embodiments, the PD-1 inhibitor is administered in an amount of about 1-10, 1-20, 1-30, 1-40, 150, 1-60, 1-70, 1-80 , 1-90, 1-100, 1-150, 1-200, 1-250, 1-300, 1-500,
2.5- 3, 2.5-4, 2.5-5, 2.5-6, 2.5-7, 2.5-8, 2.5-9, 2.5-10, 2.5-20, 2.5-30,
2.5- 40, 2.5-50, 2.5-60, 2.5-70, 2.5-80, 2.5-90, 2.5-100, 2.5-200, 2.5250, 2.5-300, 2.5-500, 3-10, 3-20, 3-30, 3-40, 3-50, 3-60, 3-70, 3-80, 3-90, 3-100, 3-200, 3-250, 3-300, 3-500, 5- 10, 5-10, 5-20, 5-30, 5-40, 5-50,5-60, 5-70, 5-80, 5-90, 5-100, 7.5-10, 7.5-20, 7.5-30, 7.5-40, 7.550, 7.5-60, 7.5-70, 7.5-80, 7.5-90, 7.5-100, 10-10, 10-20, 10-30, 1040, 10-50, 10- 60, 10-70, 10-80, 10-90, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20-90, 20-100, 20-150, 20-200, 3040, 30-50, 30-60, 30-70, 30-80, 30-90, 30-100, 30-150, 30-200, 40-50, 40-60, 40-70, 40-80, 40-90, 40-100, 40-150, 40-200, 40-300, 50-60, 50-70, 50-80, 50- 90, 50-100, 50-150, 50-200, 50-250, 50-300, 60-80, 60-100, 60-150, 60-200, 70-100, 70-150, 70-200, 70-250, 70-300, 70500, 70-750, 70-1000, 70-1500, 70-2000, 70-3000, 80-100, 80-150, 80-200, 80-250, 80-300, 80-500, 80-750, 80-1000, 80-1500, 80-2000,
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80-3000, 90-100, 90-150, 90-200, 90-250, 90-300, 90-350, 90-400, 90500, 90-750, 90-1000, 90-1500, 90-2000, 90-3000, 100-150, 100-200, 100-250, 100-300, 100-350, 100-400, 100-500, 100-600, 100-700, 100-800, 100-900, 100- 1000, 100-1500, 100-2000, 100-2500, 1003000, 100-3500, 100-4000, 200-500, 200-700, 200-1000, 200-1500, 200-2000, 200-2500, 200- 3000, 200-3500, 200-4000, 500-1000, 5001500, 500-2000, 500-2500, 500-3000, 500-3500, or 500-4000 mg per dose. In some embodiments, the PD-1 inhibitor is administered in an amount of about 10-30, 10-50, 10-80, 10-100, 10-125, 10150, 10-175, 10-200, 10- 250, 10-300, 10-400, 20-50, 20-100, 20-125, 20-150, 20-175, 20-200, 20-250, 20-300, 20-400, 30-50, 30-80, 30100, 30-125, 30-150, 30-175, 30-200, 30-250, 30-300, 30-400, 40-50, 40-80, 40-100, 40-125, 40-150, 40-175, 40-200, 40-250, 40-300, 40400, 50-80, 50-100, 50-125, 50-150, 50-175, 50-200, 50-250, 50-300, or 50-400 mg per dose. In some embodiments, the PD-1 inhibitor (for example, nivolumab or pembrolizumab) is administered in an amount of about 50-350 mg per dose, about 100-300 mg per dose or about 150-250 mg per dose . In some embodiments, the PD-1 inhibitor (for example, nivolumab or pembrolizumab) is administered in an amount of about 200 mg per dose. In some embodiments, the PD-1 inhibitor (for example, nivolumab or pembrolizumab) is administered in an amount of about 240 mg per dose.
[0054] In some embodiments, the method described herein comprises administering a PD-L1 inhibitor in a dose in the range of about 0.5-1, 0.5-2, 0.5-3, 0.5 -4, 0.5-5, 0.5-6, 0.5-7, 0.5-8, 0.5-9, 0.5-10, 1-2, 1-3, 1-4 , 1-5, 1-6, 1-7, 1-8, 1-9, 1-10, 1-20, 1-30, ΙΤΟ, 1-50, 1-60, 1-70, 1-80 , 1-90, 1-100, 2-3, 2-4, 2-5, 2-6, 2-7, 2-8, 29, 2-10, 2-20, 2-30, 2-40 , 2-50, 2-60, 2-70, 2-80, 2-90, 2-100, 2.5-3,
2.5-3.5, 2.5-4, 2.5-5, 2.5-6, 2.5-7, 2.5-9, 2.5-10, 3-4, 3- 5, 3-6, 3-7, 3-8, 3-9, 3-10, 5-10, 5-20, 5-30, 5-40, 5-50,5-60, 5-70, 5-80, 5-90, 5-100,
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7.5-10, 7.5-20, 7.5-30, 7.5-40, 7.5-50, 7.5-60, 7.5-70, 7.5-80, 7.5- 90,
7.5- 100, 10-10, 10-20, 10-30, 10-40, 10-50, 10-60, 10-70, 10-80, 1090, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20-90, 20-100, 20-150, 20-200, 30-40, 30-50, 30- 60, 30-70, 30-80, 3090, 30-100, 30-150, 30-200, 40-50, 40-60, 40-70, 40-80, 40-90, 40100, 40-150, 40-200, 40-300, 50-60, 50-70, 50-80, 50-90, 50-100, 50150, 50-200, 50-250, 50-300, 60-80, 60-100, 60-150, 60-200, 70-100, 70-150, 70-200, 70-250, 70-300, 80-100, 80-150, 80-200, 80-250, 80300, 90-100, 90-150, 90-200, 90-250, 90-300, 90-350, 90-400, 100150, 100-200, 100-250, 100-300, 100-350, or 100-400 mg / kg of body weight. In some embodiments, the method described herein comprises administering the PD-L1 inhibitor in a dose of about 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 , 0.8, 0.9, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25, 3.5, 3.75 , 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 12.5, 15,
17.5, 20, 22.5, 25, 27.5, 30, 40, 50, 60, 70, 80, 90 or 100 mg / kg of body weight.
[0055] In some embodiments, the PD-L1 inhibitor (for example, atezolizumab) is administered in an amount of about 1-10, 1-20, 1-30, 1-40, 1-50, 1-60 , 1-70, 1-80, 1-90, 1-100, 1-150, 1200, 1-250, 1-300, 1-500, 2.5-3, 2.5-4, 2.5 -5, 2.5-6, 2.5-7, 2.5-8, 2.5-9,
2.5-10, 2.5-20, 2.5-30, 2.5-40, 2.5-50, 2.5-60, 2.5-70, 2.5-80, 2.5- 90,
2.5- 100, 2.5-200, 2.5-250, 2.5-300, 2.5-500, 3-10, 3-20, 3-30, 3-40, 350, 3-60, 3-70, 3-80, 3-90, 3-100, 3-200, 3-250, 3-300, 3-500, 5-10, 510, 5-20, 5-30, 5-40, 5-50,5-60, 5-70, 5-80, 5-90, 5-100, 7.5-10, 7.520, 7.5-30, 7.5-40, 7.5-50, 7, 5-60, 7.5-70, 7.5-80, 7.5-90, 7.5-100, 1010, 10-20, 10-30, 10-40, 10-50, 10-60, 10-70, 10-80, 10-90, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20- 90, 20100, 20-150, 20-200, 30-40, 30-50, 30-60, 30-70, 30-80, 30-90, 30100, 30-150, 30-200, 40-50, 40-60, 40-70, 40-80, 40-90, 40-100, 40150, 40-200, 40-300, 50-60, 50-70, 50-80, 50-90, 50-100, 50-150, 50200, 50-250, 50-300, 60-80, 60-100, 60-150, 60-200, 70-100, 70-150,
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70-200, 70-250, 70-300, 70-500, 70-750, 70-1000, 70-1500, 70-2000, 70-3000, 80-100, 80-150, 80-200, 80- 250, 80-300, 80-500, 80-750, 801000, 80-1500, 80-2000, 80-3000, 90-100, 90-150, 90-200, 90-250, 90-300, 90- 350, 90-400, 90-500, 90-750, 90-1000, 90-1500, 90-2000, 90-3000, 100-150, 100-200, 100-250, 100-300, 100-350, 100-400, 100-500, 100-600, 100-700, 100-800, 100-900, 100-1000, 100-1500, 100-2000, 100-2500, 100-3000, 100-3500, 100- 4000, 200-500, 200700, 200-1000, 200-1500, 200-2000, 200-2500, 200-3000, 200-3500, 200-4000, 500-1000, 500-1500, 500-2000, 500- 2500, 500-3000, 5003500, or 500-4000 mg per dose. In some embodiments, the PD-L1 inhibitor is administered in an amount of about 500-1500, 600-1500, 700-1500, 800-1500, 900-1500, 1000-1500 or 1100-1300 mg per dose. In some embodiments, the PD-L1 inhibitor is administered in an amount of about 1200 mg per dose.
[0056] In some embodiments, the method described herein comprises administering the CTLA-4 inhibitor (eg, ipilimumab) at a dose in the range of about 0.5-1, 0.5-2, 0.5- 3, 0.54, 0.5-5, 0.5 -6, 0.5-7, 0.5-8, 0.5-9, 0.5-10, 1-2, 1-3, 1-4, 1-5, 1-6, 1-7,
1- 8, 1-9, 1-10, 1-20, 1-30, 1-40, 1-50, 1-60, 1-70, 1-80, 1-90, 1-100, 23, 2-4, 2 -5, 2-6, 2-7, 2-8, 2-9, 2-10, 2-20, 2-30, 2-40, 2-50, 2-60, 2- 70,
2- 80, 2-90, 2-100, 2.5-3, 2.5-3.5, 2.5-4, 2.5-5, 2.5-6, 2.5-7, 2.5-9, 2.510, 3-4, 3-5, 3 -6, 3-7, 3-8, 3-9, 3-10, 5-10, 5-20, 5-30, 5- 40, 5-50,560, 5-70, 5-80, 5-90, 5-100, 7.5-10, 7.5-20, 7.5-30, 7.5-40, 7.5- 50, 7.560, 7.5-70, 7.5-80, 7.5-90, 7.5-100, 10 -10, 10-20, 10-30, 10-40, 1050, 10-60, 10-70, 10-80, 10-90, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20- 90, 20-100, 20-150, 20-200, 30-40, 3050, 30-60, 30 -70, 30-80, 30-90, 30-100, 30-150, 30-200, 40- 50, 40-60, 40-70, 40-80, 40-90, 40-100, 40-150, 40-200, 40-300, 50-60, 50-70, 50-80, 50-90, 50-100, 50-150, 50-200, 50-250, 50-300 mg / kg of body weight. In some embodiments, the method described herein comprises administering the CTLA-4 inhibitor at a dose of about 0.1,
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0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.25, 1.5, 1.75, 2, 2, 25, 2.5, 2.75, 3, 3.25, 3.5, 3.75, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10,
12.5, 15, 17.5, 20, 22.5, 25, 27.5, 30, 40, 50, 60, 70, 80, 90 or 100 mg / kg of body weight. In some embodiments, the CTLA4 inhibitor is administered at a dose of about 3 mg / kg. In some embodiments, the CTLA-4 inhibitor is administered at a dose of less than 3 mg / kg. In some embodiments, the CTLA-4 inhibitor is administered at a dose of about 0.5, 1, 1.5, 2, 2.5, 3, 3.5 or 4 mg / kg. In some embodiments, the CTLA-4 inhibitor (eg, ipilimumab) is administered at a dose of about 3 mg / kg.
[0057] In some embodiments, the CTLA-4 inhibitor is administered in an amount of about 1-10, 1-20, 1-30, 1-40, 150, 1-60, 1-70, 1-80 , 1-90, 1-100, 1-150, 1-200, 1-250, 1-300, 1-500,
2.5-3, 2.5-4, 2.5-5, 2.5-6, 2.5-7, 2.5-8, 2.5-9, 2.5-10, 2.5- 20, 2.5-30,
2.5- 40, 2.5-50, 2.5-60, 2.5-70, 2.5-80, 2.5-90, 2.5-100, 2.5-200, 2.5250, 2, 5-300, 2.5-500, 3-10, 3-20, 3-30, 3-40, 3-50, 3-60, 3-70, 3-80,
3-90, 3-100, 3-200, 3-250, 3-300, 3-500, 5-10, 5-10, 5-20, 5-30, 5-40, 5-50,5- 60, 5-70, 5-80, 5-90, 5-100, 7.5-10, 7.5-20, 7.5-30, 7.5-40, 7.550, 7.5-60, 7.5-70, 7.5-80, 7.5-90, 7.5-100, 10-10, 10-20, 10-30, 1040, 10-50, 10-60, 10-70, 10-80, 10-90, 10-100, 10-150, 10-200, 20-30, 20-40, 20-50, 20-60, 20-70, 20-80, 20-90, 20- 100, 20-150, 20-200, 3040, 30-50, 30-60, 30-70, 30-80, 30-90, 30-100, 30-150, 30-200, 40-50, 40- 60, 40-70, 40-80, 40-90, 40-100, 40-150, 40-200, 40-300, 50-60, 50-70, 50-80, 50-90, 50-100, 50-150, 50-200, 50-250, 50-300, 60-80, 60-100, 60-150, 60-200, 70-100, 70-150, 70-200, 70-250, 70- 300, 70500, 70-750, 70-1000, 70-1500, 70-2000, 70-3000, 80-100, 80-150, 80-200, 80-250, 80-300, 80-500, 80- 750, 80-1000, 80-1500, 80-2000, 80-3000, 90-100, 90-150, 90-200, 90-250, 90-300, 90-350, 90-400, 90500, 90- 750, 90-1000, 90-1500, 90-2000, 90-3000, 100-150, 100-200, 100-250, 100-300, 100-350, 100-400, 100-500, 100-600, 100-700, 100-800, 100-900, 100-1000, 100-1500, 100-2000, 100- 2500, 100
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3000, 100-3500, 100-4000, 200-500, 200-700, 200-1000, 200-1500, 200-2000, 200-2500, 200-3000, 200-3500, 200-4000, 500-1000, 5001500, 500-2000, 500-2500, 500-3000, 500-3500, or 500-4000 mg per dose. In some embodiments, the CTLA-4 inhibitor is administered in an amount of about 10-30, 10-50, 10-80, 10-100, 10-125, 10-150, 10-175, 10-200, 10-250, 10-300, 10-400, 20-50, 20-100, 20125, 20-150, 20-175, 20-200, 20-250, 20-300, 20-400, 30-50, 30-80, 30-100, 30-125, 30-150, 30-175, 30-200, 30-250, 30-300, 30-400, 4050, 40-80, 40-100, 40-125, 40-150, 40-175, 40-200, 40-250, 40-300, 40-400, 50-80, 50-100, 50-125, 50-150, 50-175, 50-200, 50- 250, 50300, or 50-400 mg per dose.
[0058] In some modalities, the use of plinabulin may reduce the incidence of adverse events related to Grade 3/4 immunotherapy by at least about 1%, 2%, 3%, 4%, 5%, 10%, 12 , 5%, 15%, 17.5%, 20%, 22.5%, 25%, 27.5%, 30%, 32.5%, 35%, 37.5%, 40%, 42.5 %, 45%, 47.5%, 50%, 52.5%, 55%, 57.5%, 60%, 62.5%, 65%, 67.5%, 70%, 72.5%, 75%, 77.5%, 80%, 82.5%, 85%, 87.5%, 90%, 95% or 100%. In some modalities, the use of plinabulin can reduce the incidence of adverse events related to Grade 3/4 immunotherapy by at least about 5%, 10%, 12.5%, 15%, 17.5%, 20%, 22.5%, 25%, 27.5%, 30%, 32.5%, 35%, 37.5%, 40%, 42.5%, 45%, 47.5%, 50%, 52, 5%, 55%, 57.5%, 60%, 62.5%, 65%, 67.5%, 70%, 72.5%, 75%, 77.5%, 80%, 82.5% , 85%, 87.5%, 90%, 95% or 100%. In some modalities, the use of plinabulin can reduce the incidence of adverse events related to Grade 3/4 immunotherapy by less than about 5%, 10%, 12.5%, 15%, 17.5%, 20%, 22.5%, 25%, 27.5%, 30%, 32.5%, 35%, 37.5%, 40%, 42.5%, 45%, 47.5%, 50%, 52, 5%, 55%, 57.5%, 60%, 62.5%, 65%, 67.5%, 70%, 72.5%, 75%, 77.5%, 80%, 82.5% , 85%, 87.5%, 90%, 95% or 100%. In some modalities, the use of plinabulin can reduce the incidence of adverse events related to Grade 3/4 immunotherapy in the range of about 1% - 5%, 1% -10%,
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1% -15%, 1% - 20%, 1% - 30%, 1% - 40%, 1% -50%, 2.5% -10%, 2.5% · 15%, 2.5% - 20%, 2.5% - 30%, 5% -10%, 5% -15%, 5% - 20%, 5% 30%, 5% - 40%, 10% -40%, 12.5% - 40%, 5% - 50%, 10% -50%, 12.5% 50%, 15% -50%, 17.5% -50%, 20% -50%, 25% -50%, 27.5% -50%, 30% 50%, 5% - 60%, 10% -60%, 12.5% -60%, 15% -60%, 17.5% -60%, 20% · 60%, 25% -60% , 27.5% -60%, 30% -60%, 35% -60%, 37.5% -60%, 40% · 60%, 45% -70%, or 50% -80%.
[0059] In some modalities, the use of plinabulin may reduce the duration of the adverse event related to Grade 3/4 immunotherapy by about 1%, 2%, 3%, 4%, 5%, 10%, 12.5 %, 15%, 17.5%,
20%, 22.5%, 25%, 27.5%, 30%, 32.5%, 35%, 37.5%, 40%, 42.5%, 45% _;
47.5%, 50%, 52.5%, 55%, 57.5%, 60%, 62.5%, 65%, 67.5%, 70% _;
72.5%, 75%, 77.5%, 80%, 82.5%, 85%, 87.5%, 90%, 95%, 100%, 110% _;
120%, 130%, 140%, 150%, 160%, 170%, 180%, 190%, 200%, 225%,
250%, 275%, 300%, 350% 400%, 450%, 500%, 600%, 700%, 800%,
900%, 10 times, 11 times, 12 times, 13 times, 14 times, 15 times or 16 times. In some modalities, the use of plinabulin may reduce the duration of the adverse event related to Grade 3/4 immunotherapy by more than 1%, 2%, 3%, 4%, 5%, 10%, 12.5%, 15 %, 17.5%, 20%, 22.5%.
25%, 27.5%, 30%, 32.5%, 35%, 37.5%, 40%, 42.5%, 45%, 47.5%, 50% _;
52.5%, 55%, 57.5%, 60%, 62.5%, 65%, 67.5%, 70%, 72.5%, 75% _;
77.5%, 80%, 82.5%, 85%, 87.5%, 90%, 95%, 100%, 110%, 120% _:
130%, 140%, 150%, 160%, 170%, 180%, 190%, 200%, 225%, 250% _;
275%, 300%, 350% 400%, 450%, 500%, 600%, 700%, 800%, 900%, 10 times, 11 times, 12 times, 13 times, 14 times, 15 times or 16 times. In some modalities, the use of plinabulin may reduce the duration of the adverse event related to Grade 3/4 immunotherapy by less than about 5%, 10%, 12.5%, 15%, 17.5%, 20%, 22.5%, 25%, 27.5%, 30%,
32.5%, 35%, 37.5%, 40%, 42.5%, 45%, 47.5%, 50%, 52.5%, 55% _;
57.5%, 60%, 62.5%, 65%, 67.5%, 70%, 72.5%, 75%, 77.5%, 80% _;
82.5%, 85%, 87.5%, 90%, 95%, 100%, 110%, 120%, 120%, 130% _;
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140%, 150%, 160%, 170%, 180%, 190%, 200%, 225%, 250%, 275%, 300%, 350% 400%, 450%, 500%, 600%, 700%, 700%, 800%, 900%, 10 times, 11 times, 12 times, 13 times, 14 times, 15 times or 16 times. In some modalities, the use of plinabulin may reduce the duration of the adverse event related to Grade 3/4 immunotherapy in the range of about 5% -10%, 5% -20%, 5% - 30%, 5% - 40 %, 5% - 50%, 5% - 60%, 5% - 70%, 5% - 80%, 5% - 100%, 5% - 5 times, 5% -15 times, 20% - 10 times, or 50% to 500%.
[0060] Some modalities refer to a method to treat or prevent an inflammatory disorder of the skin or joint in a subject, comprising the topical administration of an effective amount of plinabulin to the subject in need of it.
[0061] In some modalities, the skin or joint disorder is psoriasis. In some embodiments, the skin or joint disorder is arthritis. In some embodiments, the skin or joint disorder is rheumatoid arthritis. In some modalities, the skin or joint disorder is selected from ankylosing spondylitis, psoriatic arthritis, sarcoidosis, systemic lupus erythematosus or atopic dermatitis.
[0062] Some modalities refer to a method to treat or prevent an inflammatory disease in a subject, comprising administering an effective amount of plinabulin to the subject in need of it, in which the inflammatory disease is selected from the group consisting of in chronic joint rheumatism, chronic obstructive pulmonary disease, asthma, ankylosing spondylitis, psoriatic arthritis, sarcoidosis, systemic lupus erythematosus, inflammatory bowel disease, atopic dermatitis and multiple sclerosis.
[0063] In some embodiments, plinabulin is administered parenterally. In some embodiments, plinabulin is administered orally. In some modalities, plinabulin is
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[0064] Some modalities refer to a method to treat or prevent chronic obstructive pulmonary disease or asthma in a subject that includes administering an effective amount of plinabulin to the subject in need of it through an inhaler.
Composition and Administration [0065] The methods described herein can include administering a composition comprising plinabulin. In some embodiments, the composition described herein may further include one or more pharmaceutically acceptable diluents. In some embodiments, the pharmaceutically acceptable diluent may include Kolliphor® (Polyoxyll5 hydroxystearate). In some embodiments, the pharmaceutically acceptable diluent may include Kolliphor® EL, Kolliphor® RH40, Kolliphor® P 188, Kolliphor® P 407 and Kolliphor® F-68. In some embodiments, the pharmaceutically acceptable diluent may include glycol propylene In some embodiments, the pharmaceutically acceptable diluents may include kolliphor and propylene glycol In some embodiments, pharmaceutically acceptable diluents may include kolliphor and propylene glycol, where the kolliphor is about 40% by weight and propylene glycol is about 60% by weight based on the total weight of the diluents. In some embodiments, the composition may further include one or more other pharmaceutically acceptable excipients.
[0066] Some modalities refer to a topical formulation, comprising plinabulin at a concentration effective to inhibit PDE4 activity without reducing vascular proliferation or density.
[0067] The amount of plinabulin in the topical formulation,
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36/70 when applied to the skin, nails, hair, hands or feet, is sufficient to produce the desired pharmacological result locally at the application site or systemically as a result of the transdermal passage of an active ingredient in the material.
[0068] Some modalities refer to a topical formulation, comprising plinabulin at a concentration in the range of about 0.1% to about 10% by weight of the total formulation. In some embodiments, plinabulin is at a concentration in the range of about 0.05% -0.1%, 0.05% -0.2%, 0.05% -0.3, 0.05% -0 , 4%,
0.05% -0.5%, 0.05% -1%, 0.05% -2%, 0.05% -3%, 0.05% -4%, 0.05%
5%, 0.05% -6%, 0.05% -7%, 0.05% -8%, 0.05% -9%, 0.05% - 10%, 0.1%
-0.2%, 0.1% -0.3, 0.1% -0.4%, 0.1% -0.5%, 0.1% -1%, 0.1% -2% , 0.1%
3%, 0.1% -3%, 0.1% -4%, 0.1% -5%, 0.1% -6%, 0.1% -7%, 0.1% -8% _;
0.1% -9%, 0.1% -10%, 0.5% -1%, 0.5% -2%, 0.5% -3%, 0.5% -4%, 0, 5%
-5%, 0.5% -6%, 0.5% -7%, 0.5% -8%, 0.5% -9%, 0.1% -0.2%, 1% -2 %, 1% -3%, 1% -4%, 1% -5%, 1% -6%, 1% -7%, 1% -8%, 1% -9%, 1% 10%, 2 % -3%, 2% -4%, 2% -5%, 2% -6%, 2% -7%, 2% -8%, 2% -9%, 2% -10%, 3% - 4%, 3% -5%, 3% -6%, 3% -7%, 3% -8%, 3% -9%, 3% -10%, 4% -5%, 4% -6% , 4% -7%, 4% -8%, 4% -9%, 4% -10%, 5% -6%, 5%
7%, 5% -8%, 5% -9%, 5% -10%, 6% -7%, 6% -8%, 6% -9%, 6% -10% _;
7% -8%, 7% -9%, 7% -10%, 8% -9%, 9% -10%, 1% -20% or 5% -20% by weight of the total formulation. In some embodiments, the concentration of plinabulin is in the range of about 0.5% -2.5%, 1% -3% or 2% -4% by weight of the total formulation. In some embodiments, plinabulin has a concentration of about 0.5%, 1%, 1.5%, 2%, 2.5%, 3%, 3.5%, 4%, 4.5%, 5 %, 6%, 7%, 8%, 9% or 10% by weight of the total formulation. In some embodiments, plinabulin has a concentration greater than about 0.5%, 1%, 1.5%, 2%, 2.5%, 3%, 3.5%, 4%, 4.5%, 5%, 6%, 7%, 8%, 9% or 10% by weight of the total formulation. In some embodiments, plinabulin has a concentration of less than about 2%, 2.5%, 3%, 3.5%, 4%, 4.5%, 5%, 6%, 7%, 8%, 9 % or 10% by weight
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37/70 of the total formulation. In some embodiments, plinabulin has a concentration of about 0.1%, 0.2%, 0.3%, 0.5%, 1%, 1.5%, 2%, 2.5%, 3% , 3.5%, 4%, 4.5%, 5%, 6%, 7%, 8%, 9% or 10% by weight of the total formulation.
[0069] In some modalities, the topical formulation one or more ingredients selected from white petrolatum, propylene glycol, mono- and diglycerides, paraffin, butylated hydroxytoluene or disodium calcium edetate. In some embodiments, the topical formulation includes polyoxyl hydroxystearate 15.
[0070] The topical formulation may include fluid or semi-solid vehicles which may include, but are not limited to, polymers, thickeners, buffers, neutralizers, chelating agents, preservatives, surfactants or emulsifiers, antioxidants, waxes or oils, emollients, sunscreens and a solvent or mixed solvent system. The solvent or mixed solvent system is important for the formation because it is the main responsible for the dissolution of the drug. The best solvent or mixed solvent systems are also able to maintain clinically relevant levels of the drug in solution, despite the addition of a poor solvent to the formulation. Topical compositions useful in the present invention can be transformed into a wide variety of product types. This includes, but is not limited to, patches, lotions, creams, gels, sticks, sprays, ointments, pastes, foams, mousses, masks, eye ointments, eye drops, eye drops or ears, impregnated dressings, wipes, cleaning products, including soaps , body washes, shampoos and makeup products, such as bases, blushes, lipsticks and eye shadows, among others. These types of products can comprise several types of carrier systems, including, but not limited to, particles, nanoparticles and liposomes. The formulation can be selected to maximize delivery to a desired target location on the body. Formulations can also include various dyes
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38/70 conventional, fragrances, thickeners, preservatives, humectants, emollients, demulcents, solubilizing excipients, dispersants, penetration enhancers, plasticizers, preservatives, stabilizers, demulsifiers, wetting agents, sunscreens, emulsifiers, moisturizers, astringents, deodorants and the like , which can be added to provide additional benefits, such as improving the feel and / or appearance of the topical preparation.
[0071] In some modalities, the formulation is in the form of lotion, cream, ointment, gel, emulsion or suspension.
[0072] Lotions, which are preparations that must be applied to the skin, nail, hair, claw or frictionless hull surface, are typically liquid or semi-liquid preparations in which disperses solid, wax or finely divided liquid. Lotions will typically contain suspending agents to produce better dispersions, as well as compounds useful for locating and maintaining the active agent in contact with the skin, nail, hair, claw or shell, for example, methyl cellulose, sodium carboxymethyl cellulose or the like.
[0073] Creams containing the active agent for delivery according to the present invention are viscous or semi-solid liquid emulsions, oil in water or water in oil. The cream bases are water washable and contain an oil phase, an emulsifier and an aqueous phase. The oily phase is usually composed of petrolatum or fatty alcohol, such as cetyl or stearyl alcohol; the aqueous phase generally, although not necessarily, exceeds the oil phase by volume and generally contains a humectant.
[0074] Gel formulations can also be used in connection with the present invention. As will be appreciated by those working in the field of topical drug formulation, gels are semi-solid. Single-phase gels contain organic macromolecules distributed substantially evenly throughout the vehicle
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39/70 liquid, which is typically aqueous, but can also be a solvent or a mixture of solvents. In various embodiments, conventional gelling agents can be used. In an exemplary embodiment, cellulose or its derivatives are used. In an exemplary embodiment, hydroxypropylmethylcellulose, such as Methocel E4M, is used. Other gelling agents include methylcellulose, hydroxypropyl cellulose, hydroxypropyl methyl cellulose, cellulose acetate, ethyl cellulose, methyl hydroxy ethyl cellulose, hydroxy ethyl cellulose and cellulose gum. Cellulose-based gelling agents, particularly hydroxy methyl cellulose and hydroxy propyl methyl cellulose, are also useful in some embodiments. In some embodiments, cross-linked acrylic polymers including Carbopol can be used.
[0075] In one embodiment, the formulation of the invention is viscous enough to form a firm gel. In one embodiment, the viscosity is in the range of 25,000 to 300,000 cps (centipoise) or 75,000 to 200,000 cps, based on Brookfield's analysis (LV).
[0076] To facilitate preparation, it may be convenient to prepare a first gel composition, called speed-gel, which can be used to add to other components in the formulation of a final composition for topical administration. There are several possible formulations of speed-gel. For example, a speed gel can be prepared by mixing lecithin organogel (LO), as a 1: 1 (w / w) mixture of lecithin and isopropyl myristate, with LI D oil (a 1: 1 [w / w mixture] LO and sodium docusate), dissolving additional sodium docusate powder in this mixture and adding aqueous urea.
[0077] Ointments, which are semi-solid preparations, are typically based on petrolatum or other petroleum derivatives. As will be appreciated by those skilled in the art, the specific ointment base to be used is one that provides the ideal delivery for the active agent chosen for a given formulation and, preferably,
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40/70 provides other desired characteristics, for example, softness or taste. As in other carriers or vehicles, an ointment base must be inert, stable, non-irritating and non-sensitizing. As explained in Remington: The Science and Practice of Pharmacy, 19th Ed. (Easton, Pa .: Mack Publishing Co., 1995), on pages 1399-1404, ointment bases can be grouped into four classes: oil bases; emulsifiable bases; emulsion bases; and water-soluble bases. Oleaginous ointment bases include, for example, vegetable oils, fats obtained from animals and semi-solid hydrocarbons obtained from petroleum. Examples of oilseed ointment bases include White Ointment USP, Yellow Ointment NF, Oleic Acid USP, Olive Oil USP, Paraffin USP, Petrolatum NF, Petrolatum White USP, Spermaceti Wax USP, Spermaceti NF, Spermaceti NF, Spermaceti NF, Spermaceti NF, Starch White Wax USP and Yellow Wax USP. Emulsifiable ointment bases, also known as absorbent ointment bases, contain little or no water and include, for example, hydroxystearin sulfate, anhydrous lanolin and hydrophilic petrolatum. Emulsion ointment bases are water-in-oil (W / O) emulsions or oil-in-water (O / W) emulsions and include, for example, cetyl alcohol, glyceryl monostearate, lanolin and stearic acid. The preferred water-soluble ointment bases are prepared from polyethylene glycols of varying molecular weight; Again, reference can be made to Remington: The Science and Practice of Pharmacy, supra, for more information.
[0078] Useful formulations of the invention also include sprays and aerosols. Sprays generally provide the active agent in an aqueous and / or alcoholic solution that can be sprayed on the skin, nails, hair, claws or hull for delivery. Such sprays include those formulated to provide the concentration of the active agent solution at the administration site after administration, for example, the spray solution may be primarily composed of alcohol or other liquid
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41/70 similar volatile in which the drug or active agent can be dissolved. After delivery to the skin, nails, hair, claws or hull, the vehicle evaporates, leaving the active agent concentrated at the administration site. Examples of aerosol technology are disclosed in US Patent 6,682,716; 6,716,415; 6,716,417; 6,783,753; 7,029,658; and 7,033,575.
[0079] Topical pharmaceutical compositions may also comprise suitable solid phase or gel vehicles. Examples of such vehicles include, but are not limited to, calcium carbonate, calcium phosphate, various sugars, starches, cellulose derivatives, gelatin and polymers such as polyethylene glycols.
[0080] Topical pharmaceutical compositions can also comprise a suitable emulsifier which refers to an agent that improves or facilitates the mixing and suspension of oil in water or water in oil. The emulsifying agent used herein may consist of a single emulsifying agent or may be a nonionic, anionic, cationic or amphoteric surfactant or a mixture of two or more of these surfactants; Preferred ones for use here are nonionic or anionic emulsifiers. Such surfactants are described in "McCutcheon's Detergent and Emulsifiers," North American Edition, 1980 Annual published by the McCutcheon Division, MC Publishing Company, 175 Rock Road, Glen Rock, N.J. 07452, USA.
[0081] Examples of useful ionic surfactants include sodium caproate, sodium caprylate, sodium caprate, sodium laurate, sodium myristate, sodium myristate, sodium palmitate, sodium palmitoleate, sodium oleate, sodium ricinoleate, linoleate sodium, sodium linolenate, sodium stearate, sodium lauryl sulfate (dodecyl), sodium tetradecyl sulfate, sodium lauryl sarcosinate, sodium dioctyl sulfosuccinate, sodium cholate, sodium taurocholate, sodium glycolate, sodium deoxycholate, sodium taurodesoxycholate, glycodoxicolate
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42/70 sodium, sodium ursodeoxycholate, sodium taxodeoxycholate, sodium colylsarcosinate deodorizolate, sodium N-methyl taurocholate, egg yolk phosphatides, hydrogenated soy lecithin, dimiristoyl lecithin, lecithin, hydroxylated lecithin, lysithosphiolate, lysithephiolate phosphatidylcholine, phosphatidyl ethanolamine, phosphatidyl ethanolamine, phosphatidyl ethylamine diets, dietatidine Ids, polyoxyethylene-10 oleyl ether phosphate, fatty alcohol esterification products or fatty alcohol ethoxylates, with phosphoric acid or anhydride, by carboxylate ether group. , fatty alcohol ethoxylates), succinylated monoglycerides, sodium stearyl fumarate, glycol stearoyl propylene hydrogen succinate, mono- and diglycerides tartaric acid mono- / diglyceride esters, citric acid esters of mono-, diglycerides, glyceryl ester esters fatty acids, acyl-lactylates, esters of fatty acids fatty acids, sodium stearoyl-2-lactylate, stearoyl lactate, alginate salts, propylene glycol alginate, ethoxylated alkyl sulphates, alkyl benzene sulphates, a-olefin sulphonates, acyl isonionates, acyl taurates, glycerol ether ethers, alkylglyceryl ether, sodium octyl sulfosuccinate, sodium undecylenametrametamethylsulfonate, sodium bisulfonate, decyl trimethyl ammonium bromide, cetyl trimethyl ammonium bromide, dodecyl ammonium chloride, alkylbenzyl dimethylsomethyl salts, monomethyl salts (trialkylglycine), lauryl betaine (N-lauryl, N, Ndimethylglycine) and ethoxylated amines (polyoxyethylene-15 coconut amine). For simplicity, typical counterions are provided above. It will be appreciated by one skilled in the art, however, that any bioacceptable counterion can be used. For example, although fatty acids are shown as sodium salts, other cation ions can also be used, such as alkali metal or ammonium cations. The formulations of the invention can include one or more of the above ionic surfactants.
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43/70 [0082] Some high molecular weight alcohols include cetearyl alcohol, cetyl alcohol, stearyl alcohol, emulsifying wax, glyceryl monostearate and oleyl alcohol. Other examples are ethylene glycol distearate, sorbitan tristearate, propylene glycol monostearate, sorbitan monooleate, sorbitan monostearate (SPAN 60), diethylene glycol monolaurate, diethylene monopalmitate, sorbitan monopalmitate, sucrose stearate (sucrose stearate) CRODESTA F-160), CRODESTA F-160, polyoxyethylene (2) stearyl ether (BRIJ 72), polyoxyethylene ether (21) stearyl ether (BRIJ 721), polyoxyethylene monostearate (Myrj 45), polyoxyethylene monolaurate (20) sorbitan (TWEEN 20, polysorbate 20), polyoxyethylene monopuritanate (20) (TWEEN 40, polysorbate 40), polyoxyethylene monostearate (20) sorbitan (TWEEN 60, polysorbate 60), polyoxyethylene monooleate (20) sorbitan (TWEEN 80, polysorbate 80), other non-ionic polyoxyalkylene derivatives of long chain partial fatty acid anhydride esters and sodium oleate. In an exemplary embodiment, the emulsifier is octyldodecanol. In an exemplary embodiment, xanthan gum or a mixture of xanthan gum is used. Cholesterol and cholesterol derivatives can also be used in emulsions used externally and to promote massless emulsions.
[0083] Some suitable nonionic emulsifying agents are those with hydrophilic-lipophilic (HLB) scales of about 3 to 6 for the w / o system and 8 to 18 for the w / o system, as determined by the method described by Paul L Lindner in “Emulsions and Emulsion“, edited by Kenneth Lissant, published by Dekker, New York, NY, 1974, pages 188-190. Most preferred for use in this document are one or more nonionic surfactants that produce a system with an HLB of about 8 to about 18.
[0084] Examples of such nonionic emulsifiers include, but are not limited to, "BRIJ 72", the trade name of a stearyl polyoxyethylene (2) ether with an HLB of 4.9; “BRIJ 721”, the name
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44/70 commercial for a polyoxyethylene stearyl ether (21) with an HLB of
15.5, “Brij 30”, the trade name for polyoxyethylene lauryl ether with an HLB of 9.7; “Polawax”, the trade name for emulsifying wax with an HLB of 8.0; “Span 60”, the trade name of sorbitan monostearate with an HLB of 4.7; “Crodesta F-160”, the trade name for sucrose stearate “with an HLB of 14.5. All of these materials are available from Ruger Chemicals Inc .; Croda; ICI Americas, Inc .; Spectrum chemicals; and BASF. When the topical formulations of the present invention contain at least one emulsifying agent, each emulsifying agent is present in amounts of about 0.5 to about 2.5% by weight, preferably 0.5 to 2.0%, more preferably 1.0% or 1.8%. Preferably, the emulsifying agent comprises a mixture of stearin 21 (about 1.8%) and stearin 2 (about 1.0%).
[0085] Topical pharmaceutical compositions can also comprise suitable emollients. Emollients are materials used for the prevention or relief of dryness, as well as for the protection of the skin, nails, hair, claws or hooves. Useful emollients include, but are not limited to, hydrocarbon oils, waxes, silicone, cetyl alcohol, isopropyl myristate, stearyl alcohol, oleyl alcohol, octyl hydroxystearate, glycerin, other fatty alcohols, including short or medium fatty alcohols of a length carbon dioxide up to 18, medium or short chain fatty acid triglycerides, esters such as fatty acid esters, lecithins and related polar compounds, such as phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, phosphatidylinositol, phosphatidic acid, lysphosphidylsolidine and lysphosphatidylsolin. Other suitable emollients include triglyceride oils, such as vegetable oils, such as wheat germ, corn, sunflower, shea, castor, sweet almond, macadamia, apricot, soy, cottonseed, alfalfa, poppy, pumpkin seed, sesame, cucumber, rapeseed , avocado, hazelnut, grape seed, blackcurrant seed,
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45/70 evening primrose, corn, barley, quinoa, olive, rye, safflower, candlenut, soy, palm, passion fruit or musk rose oil; caprylic / capric acid triglycerides, such as those sold under the trade names MIGLYOL® (Condea Chemie, Germany) and CRODAMOL (Croda, Inc., Edison, NJ); fatty alcohols such as caprylic alcohol, lauryl alcohol, myristyl alcohol, cetyl alcohol and stearyl alcohol; and fatty esters, such as oleyl acetate, isotridecyl benzoate, diisooctyl sebacate, isopropyl myristate, cetyl octanoate, isopropyl palmitate, butyl stearate, hexyl laurate, myristyl myristate, butyl stearate, laurate myristyl myristate, butyl stearate, ethyl stearate, ethyl stearate, ethyl acetate, ethyl lanylate, isocetyl cetyl isocetyl, cholesteryl 12-hydroxystearate, dipentaerythritola fatty acid ester and isostearyl malate. A wide variety of suitable emollients are known and can be used here. See, for example, Sagarin, Cosmetics, Science and Technology, 2nd Edition, Vol. 1, pp. 32-43 (1972), and US Patent 4,919,934, to Deckner et al., Published April 24, 1990, which are hereby incorporated by reference in their entirety. These materials are available from Ruger Chemical Co, (Irvington, NJ).
[0086] When the topical formulations of the present invention contain at least one emollient, each emollient is present in an amount of about 0.1 to 15%, preferably 0.1 to about 3.0, more preferably 0.5 , 1.0 or 2.5% by weight. Preferably, the emollient is a mixture of cetyl alcohol, isopropyl myristate and stearyl alcohol in a 1/5/2 ratio. The emollient can also be a mixture of cetyl alcohol and stearyl alcohol in the proportion of 1/2.
[0087] Topical pharmaceutical compositions can also comprise suitable antioxidants, substances known to inhibit oxidation. Antioxidants suitable for use in accordance with the present invention include, but are not limited to, hydroxytoluene
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46/70 butylated, ascorbic acid, sodium ascorbate, calcium ascorbate, ascorbic palmitate, butylated hydroxyanisole, 2,4,5-trihydroxybutyrophenone, 4-hydroxymethyl-2,6-di-tert-butylphenol, erythorbic acid, guaiac gum, propyl gamma, thiodipropionic acid, dilauryl thiodipropionate, tert-butyl hydroquinone and tocopherols, such as vitamin E, and the like, including pharmaceutically acceptable salts and esters of these compounds. Preferably, the antioxidant is butylated hydroxytoluene, butylated hydroxyanisol, propyl gamma, ascorbic acid, pharmaceutically acceptable salts or esters or esters thereof, or mixtures thereof. Most preferably, the antioxidant is butylated hydroxytoluene. These materials are available from Ruger Chemical Co, (Irvington, NJ). Antioxidants that can be incorporated into the formulations of the invention include natural antioxidants prepared from plant extracts, such as aloe vera extracts; avocado; chamomile; echinacea; biloba ginko; ginseng; green tea; heather; jojoba; lavender; lemon grass; licorice; mauve; oats; pepper mint; Saint John's herb; Willow tree; wintergreen; wild wheat yam extract; marine extracts; and their mixtures.
[0088] When the topical formulations of the present invention contain at least one antioxidant, the total amount of antioxidant present is about 0.001 to 0.5% by weight, preferably 0.05 to about 0.5% by weight, with most preferably 0.1%.
[0089] Topical pharmaceutical compositions can also comprise suitable preservatives. Preservatives are compounds added to a pharmaceutical formulation to act as an antimicrobial agent. Preservatives known in the art to be effective and acceptable in parenteral formulations include benzalkonium chloride, benzethonium, chlorhexidine, phenol, m-cresol, benzyl alcohol, methylparaben, propylparaben and other parabens, chlorobutanol, ocresol, p-cresol, chlorocresol, nitrate phenylmercuric, thimerosal, acid
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47/70 benzoic and various mixtures thereof. See, for example, Wallhausser, Κ.-H., Develop. Biol. Standard, 24: 9-28 (1974) (S. Krager, Basel). Preferably, the preservative is selected from methylparaben, propylparaben and mixtures thereof. These materials are available from Inolex Chemical Co (Philadelphia, Pa.) Or Spectrum Chemicals.
[0090] When the topical formulations of the present invention contain at least one preservative, the total amount of preservative present is from about 0.01 to about 0.5% by weight, preferably from about 0.1 to 0.5 %, more preferably from about 0.03 to about 0.15. Preferably, the preservative is a mixture of methylparaben and propylbarbene in the proportion of 5/1. When alcohol is used as a preservative, the amount is usually 15 to 20%.
[0091] Topical pharmaceutical compositions can also comprise chelating agents suitable for forming complexes with metal cations that do not cross a lipid bilayer. Examples of suitable chelating agents include ethylene diamine tetraacetic acid (EDTA), ethylene glycol-bis (beta-aminoethylethyl ether) -N, N, N ', N'-tetra-acetic (EGTA) and 8-Amino-2 - [( 2 -amino-5-methylphenoxy) methyl] -6-methoxyquinoline-N, N, N ', N'-tetraacetic acid, tetrapotassium salt (QUIN-2). Preferably, the chelating agents are EDTA and citric acid. A chelating agent can comprise salts of the above, such as disodium edetate, for example. These materials are available from Spectrum Chemicals.
[0092] When the topical formulations of the present invention contain at least one chelating agent, the total amount of chelating agent present is from about 0.005% to 2.0% by weight, preferably from about 0.05% to about 0 , 5% by weight, more preferably about 0.1% by weight.
[0093] Topical pharmaceutical compositions can also
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48/70 comprise suitable neutralizing agents used to adjust the pH of the formulation within a pharmaceutically acceptable range. Examples of neutralizing agents include, but are not limited to, trolamine, tromethamine, sodium hydroxide, hydrochloric acid, sodium carbonate, citric acid, acetic acid and corresponding acids or bases. These materials are available from Spectrum Chemicals (Gardena, California).
[0094] When the topical formulations of the present invention contain at least one neutralizing agent, the total amount of neutralizing agent present is from about 0.1% by weight to about 10% by weight, preferably 0.1% by weight at about 5.0% by weight, and more preferably about 1.0% by weight. The neutralizing agent is generally added in any amount necessary to bring the formulation to the desired pH. In one embodiment, the pH is about 6.0 to about 8.0. In one embodiment, the pH is about 3.0 to about 4.0.
[0095] Topical pharmaceutical compositions can also comprise suitable thickening or viscosity-enhancing agents. These components are diffusible compounds capable of increasing the viscosity of a solution containing polymer through the interaction of the agent with the polymer. For example, CARBOPOL ULTREZ 10, polymethylmethacrylate (PMMA) and fumed silica can be used as a viscosity-increasing agent. These materials are available from Noveon Chemicals, Cleveland, Ohio. Other examples of thickeners include monoglycerides and fatty alcohols, fatty acid esters of alcohols with about 3 to about 16 carbon atoms. Examples of suitable monoglycerides are glyceryl monostearate and glyceryl monopalmitate. Examples of fatty alcohols are cetyl alcohol and stearyl alcohol. Examples of suitable esters are myristyl stearate and cetyl stearate. The monoglyceride also functions as an auxiliary emulsifier. Other emollients or
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49/70 oleaginous materials that can be used include petrolatum, glyceryl monooleate, myristyl alcohol and isopropyl palmitate. In one embodiment, the thickener is used in combination with an emulsifying agent.
[0096] When the topical formulations of the present invention contain at least one viscosity enhancing agent, the total amount of viscosity enhancing agent present is from about 0.25% to about 5.0% by weight, preferably from about 0.25% to about 1.0% by weight, and more preferably from about 0.4% to about 0.6% by weight.
[0097] Topical pharmaceutical compositions may also comprise a disintegrating agent, including starch, for example, natural starch such as corn starch or potato starch, pregelatinized starch such as National 1551 or Amijele® or sodium starch glycolate such as Promogel® or Explotab ® ; a cellulose as a wood product, microcrystalline cellulose, for example, Avicel®, Avicel® PH101, Avicel® PH102, Avicel® PH105, Elcema® PI00, Emcocel®, Vivacel®, Ming Tia® and Solka-Floc®, methylcellulose, croscarmellose or cross-linked cellulose, such as cross-linked sodium carboxymethyl cellulose (Ac-Di-Sol®), cross-linked carboxymethyl cellulose or cross-linked croscarmellose; a cross-linked starch such as sodium starch glycolate; a cross-linked polymer, such as povidone; a cross-linked polyvinylpyrrolidone; alginate as alginic acid or an alginic acid salt like sodium alginate; a clay like Veegum® HV (aluminum and magnesium silicate); a gum like agar, guar, carob, Karaya, pectin or tragacanth; sodium starch glycolate; bentonite; a natural sponge; a surfactant; a resin such as a cation exchange resin; citrus pulp; Sodium lauryl sulfate; sodium lauryl sulfate in combined starch; It's similar.
[0098] Topical pharmaceutical compositions can also
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50/70 understand appropriate nail penetration enhancers. Examples of nail penetration enhancers include mercaptan compounds, sulfites and bisulfites, keratolytic agents and surfactants. Nail penetration enhancers suitable for use in the invention are described in more detail in Malhotra et al., J. Pharm. Sci., 91: 2, 312 [0099] Topical pharmaceutical compositions may also comprise an anti-foaming anti-whitening agent that enhances the elegance of the cream or lotion and inhibits the formation of a white soap appearance when rubbing the cream or lotion on the skin . An example of such a material includes silicone fluid. Other antifoaming agents include simethicone, polyglycol and sorbitan sesquioleate.
[0100] Topical pharmaceutical compositions can also comprise a foaming agent. “Post-foaming” refers to a gel that remains a gel as it is expelled from a container, but that foam after it spreads over the skin. Post-foaming agents include saturated aliphatic hydrocarbons with 4-6 carbon atoms, such as butane, pentane and hexane (in particular it is opentane and isobutene). Other suitable foam post-forming agents include partially or fully halogenated hydrocarbons, such as trichlorofluorethane. In addition, mixtures of aliphatic and halogenated hydrocarbon propellants or foaming agents can be used. Generally suitable post-foaming agents are those substances with low water solubility, for example, less than about 20 cc of gas in 100 grams of water in an atmosphere and 20 ° C.
[0101] Topical pharmaceutical compositions can also comprise one or more suitable solvents. The ability to
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51/70 any solid substance (solute) dissolves in any liquid substance (solvent) depends on the physical properties of the solute and the solvent. When solutes and solvents have similar physical properties, the solubility of the solute in the solvent will be the greatest. This gives rise to the traditional understanding that “the equal is dissolved”. The solvents can be characterized at one end as non-polar lipophilic oils, while at the other end as polar hydrophilic solvents. Oily solvents dissolve other non-polar substances by Van der Waals interactions, while water and other hydrophilic solvents dissolve polar substances by ionic, dipole or hydrogen interactions. All solvents can be listed along a continuum, from the least polar, that is, hydrocarbons, such as decane, to the most polar solvent, being water. A solute will have its greatest solubility in solvents with equivalent polarity. Thus, for drugs with minimal water solubility, less polar solvents will provide better solubility with the solvent having polarity almost equivalent to the solute, providing maximum solubility. Most drugs have intermediate polarity and therefore have maximum solubility in solvents such as propylene glycol or ethanol, which are significantly less polar than water. If the drug has greater solubility in propylene glycol (for example, 8% (w / w)) than in water (for example, 0.1% (w / w)), adding water to propylene glycol should decrease the maximum amount of drug solubility for the solvent mixture compared to pure propylene glycol. The addition of a poor solvent to an excellent solvent will decrease the maximum solubility of the mixture compared to the maximum solubility of the excellent solvent.
[0102] When the compounds are incorporated in topical formulations the concentration of active ingredient in the formulation can be limited by the solubility of the active ingredient in the chosen solvent and / or vehicle. Non-lipophilic drugs typically exhibit a
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52/70 very low solubility in pharmaceutically acceptable solvents and / or vehicles. For example, the solubility of some compounds of the invention in water is less than 0.00025% by weight / weight. The solubility of the same compounds in the invention can be less than about 2% by weight / weight in propylene glycol or isopropyl myristate.
[0103] Examples of solubilizing excipients include polyethoxylated fatty acids, PEG-fatty acid diesters, mixtures of PEG-fatty acid monoesters and diesters, glycerol fatty acid polyethylene glycol esters, alcohol transesterification products -oil, polyglycerized fatty acids, propylene glycol fatty acid esters, mixtures of propylene glycol esters-glycerol esters, mono- and diglycerides, sterol and sterol derivatives, polyethylene glycol sorbitan esters, fatty acid esters, alkyl polyethylene glycol ethers, ethers sugar, polyethylene glycol alkyl phenols, sugar esters, polyethylene glycol alkyl phenols, polyoxyethylene polyoxypropylene block copolymers, sorbitan fatty acid esters, low alcohol fatty acid esters, ionic surfactants, tocopherol esters and esters . In one embodiment of the present invention, ethylhexyl hydroxystearate is the solvent used to dissolve the compounds described herein. In one embodiment of the present invention, monoethyl diethylene glycol ether (DGME) is the solvent used to dissolve the compounds described herein. In one embodiment of the present invention, diethylene glycol monoethyl ether (DGME) is the solvent used to dissolve a compound of the invention. The compounds of the invention useful in the present formulation have a solubility of about 10% by weight / weight to about 25% by weight / weight in DGME. In another embodiment, a DGME water co-solvent system is used to dissolve the compounds described herein. In another embodiment, a DGME water co-solvent system is used to dissolve a compound of the invention. DGME's solvent capacity decreases when water is added; however, the
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53/70 DGME co-solvent / water can be designed to maintain the desired concentration of about 0.1% to about 5% by weight / weight of active ingredient. Preferably, the active ingredient is present from about 0.5% to about 3% by weight / weight, and more preferably at about 1% by weight / weight, in the applied topical formulations. As DGME is less volatile than water, as the topical formulation evaporates after application, the active agent becomes more soluble in the cream formulation. This increased solubility reduces the likelihood of reduced bioavailability caused by the drug that precipitates on the surface of the skin, nail, hair, claw or hoof.
[0104] In one embodiment, the vehicle is lipophilic. Lipophilic materials include oleaginous material, such as petrolatum, thickened mineral oil or gelled with polyethylene, high molecular weight paraffin waxes, mono and diglycerides of fatty acids gelled with high molecular weight fatty acids or hydroxystearate polyamide complex, propylene isostearate glycol or isostearyl alcohol high molecular weight fatty acids and their mixtures.
[0105] Standard pharmaceutical formulation techniques can be used to make the pharmaceutical compositions described herein, such as those described in The Science and Practice of Pharmacy, 21st Ed., Lippincott Williams & Wilkins (2005) by Remington, incorporated herein by reference in its entirety. Accordingly, some embodiments include pharmaceutical compositions comprising: (a) a safe and therapeutically effective amount of Plinabulin or the pharmaceutically acceptable salts thereof; and (b) a pharmaceutically acceptable carrier, diluent, excipient or combination thereof.
[0106] In addition to a topical route of administration, some modalities include administration through any of the other accepted modes of administration for agents serving similar utilities, including, but not limited to, orally,
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54/70 sublingual, buccal, subcutaneous, intravenous, intranasal, intradermally, intraperitoneally, intramuscularly, intrapulmonary, vaginally, rectally or intraocularly.
[0107] The term "pharmaceutically acceptable carrier" or "pharmaceutically acceptable excipient" includes any and all solvents, dispersion medium, coatings, antibacterial and antifungal agents, isotonic agents and absorption retardants and the like. The use of such means and agents for pharmaceutically active substances is well known in the art. Except to the extent that any conventional medium or agent is incompatible with the active ingredient, its use in therapeutic compositions is contemplated. In addition, various adjuvants, such as those commonly used in the art, can be included. Considerations for the inclusion of various components in pharmaceutical compositions are described, for example, in Gilman et al. (Eds.) (1990); Goodman and Gilman's:. The Pharmacological Basis of Therapeutics, 8th Ed, Pergamon Press, which is incorporated herein by reference in its entirety.
[0108] Some examples of substances that can serve as pharmaceutically acceptable carriers or components are sugars, such as lactose, glucose and sucrose; starches, such as corn starch and potato starch; cellulose and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and methyl cellulose; powdered tragacanth; malt; gelatine; baby powder; solid lubricants, such as stearic acid and magnesium stearate; Calcium Sulfate; vegetable oils, such as peanut oil, cottonseed oil, sesame oil, olive oil, corn oil and theobroma oil; polyols such as propylene glycol, glycerin, sorbitol, mannitol and polyethylene glycol; alginic acid; emulsifiers, such as TWEENS; wetting agents, such as sodium lauryl sulfate; coloring agents; flavoring agents; tablet agents, stabilizers; antioxidants; preservatives; pyrogen-free water; isotonic saline solution; and phosphate buffer solutions.
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55/70 [0109] The compositions described herein are preferably supplied in unit dosage form. As used herein, a "unit dosage form" is a composition that contains an amount of a compound or composition that is suitable for administration to an animal, preferably a mammalian subject, in a single dose, in accordance with good medical practice. The preparation of a single or unit dosage form, however, does not imply that the dosage form is administered once a day or once per course of therapy. Such dosage forms are contemplated to be administered once, twice, three or more a day and can be administered as an infusion over a period of time (for example, from about 30 minutes to about 2-6 hours) or administered as a continuous infusion, and can be administered more than once during a course of therapy, although a single administration is not specifically excluded. The person skilled in the art will recognize that the formulation does not specifically cover the entire course of therapy and these decisions are left to those skilled in the treatment technique, rather than being formulated.
[0110] Some modalities include compositions in any of a variety of forms suitable for a variety of routes for administration other than topical, for example, for oral, sublingual, buccal, nasal, rectal, intradermal, ocular, intracerebral, intracranial, intrathecal , intra-arterial, intravenous, intramuscular or other parenting routes. The person skilled in the art will appreciate that oral and nasal compositions include compositions that are administered by inhalation and made using available methodologies. Depending on the particular route of administration desired, a variety of pharmaceutically acceptable carriers well known in the art can be used. Pharmaceutically acceptable vehicles include, for example, solid or liquid fillers, diluents, hydrotropies, surfactants and substances
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56/70 encapsulants. Optional pharmaceutically active materials can be included, which do not substantially interfere with the activity of the compound or composition. The amount of vehicle used in conjunction with the compound or composition is sufficient to provide a practical amount of material for administration per unit dose of the compound. Techniques and compositions for making dosage forms useful in the methods described herein are described in the following references, all incorporated herein by reference:. Modern Pharmaceutics, 4th Ed, Chapters 9 and 10 (Banker & Rhodes, editors, 2002); Lieberman et al., Pharmaceutical Dosage Forms: Tablets (1989); and Ansel, Introduction to Pharmaceutical Dosage Forms 8 Edition (2004).
[Olli] Various oral dosage forms can be used, including solid forms such as tablets, capsules (for example, liquid gel capsule and solid gel capsule), granules and bulk powders. The tablets can be compressed, crushed, enteric coated, sugar, film or multiple compressed, containing suitable binders, lubricants, diluents, disintegrating agents, colorants, flavoring agents, flow-inducing agents and melting agents. Liquid oral dosage forms include aqueous solutions, emulsions, suspensions, solutions and / or suspensions reconstituted from non-effervescent granules and effervescent preparations reconstituted from effervescent granules, containing solvents, preservatives, emulsifying agents, suspending agents, diluents, sweeteners, melting agents, dyes and flavorings.
[0112] Pharmaceutically acceptable carriers suitable for the preparation of unit dosage forms for peroral administration are well known in the art. The tablets typically comprise conventional pharmaceutically compatible adjuvants as inert diluents, such as calcium carbonate, sodium carbonate, mannitol, lactose and cellulose; binders such as starch, gelatin and
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57/70 sucrose; disintegrants such as starch, alginic acid and croscarmellose; lubricants such as magnesium stearate, stearic acid and talc. Sliding agents, such as silicon dioxide, can be used to improve the flow characteristics of the powder mixture. Coloring agents, such as FD&C dyes, can be added for appearance. Sweeteners and flavoring agents, such as aspartame, saccharin, menthol, peppermint, sucrose and fruit flavors, are useful adjuvants for chewable tablets. The capsules typically comprise one or more solid diluents disclosed above. The selection of vehicle components depends on secondary considerations, such as taste, cost and shelf stability, which are not critical and can be readily made by one skilled in the art.
[0113] Peroral compositions also include liquid solutions, emulsions, suspensions, and the like. Pharmaceutically acceptable carriers suitable for the preparation of such compositions are well known in the art. Typical vehicle components for syrups, elixirs, emulsions and suspensions include ethanol, glycerol, propylene glycol, polyethylene glycol, liquid sucrose, sorbitol and water. For a suspension, typical suspending agents include methyl cellulose, sodium carboxymethyl cellulose, AVICEL RC-591, tragacanth and sodium alginate; typical wetting agents include lecithin and polysorbate 80; and typical preservatives include methyl paraben and sodium benzoate. Liquid oral compositions may also contain one or more components, such as sweeteners, flavoring agents and coloring agents disclosed above.
[0114] Such compositions can also be coated by conventional methods, typically with pH or time dependent coatings, so that the composition in question is released into the gastrointestinal tract in the vicinity of the desired topical application or at various times to extend the desired action. Such dosage forms typically include, but are not limited to, one or more
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58/70 cellulose acetate phthalate, polyvinylacetate phthalate, hydroxypropyl methylcellulose phthalate, ethyl cellulose, Eudragit coatings, waxes and shellac.
[0115] The compositions described herein can optionally include other drug assets.
[0116] Other compositions useful for achieving systemic application of the compounds in question include sublingual, oral and nasal dosage forms. Such compositions typically comprise one or more soluble fillers, such as sucrose, sorbitol and mannitol; and binders such as acacia, microcrystalline cellulose, carboxymethyl cellulose and hydroxypropyl methyl cellulose. The glidants, lubricants, sweeteners, dyes, antioxidants and flavorings disclosed above can also be included.
[0117] A liquid composition, which is formulated for ophthalmic use, is formulated so that it can be administered to the eye. Comfort can be maximized as much as possible, although sometimes considerations about the formulation (for example, drug stability) may require less than ideal comfort. In the event that comfort cannot be maximized, the liquid can be formulated so that the liquid is tolerable for the patient for topical ophthalmic use. In addition, an ophthalmically acceptable liquid can be packaged for single use or contain a preservative to prevent contamination from multiple uses.
[0118] For ophthalmic application, solutions or drugs are often prepared using a physiological saline solution as the main vehicle. Ophthalmic solutions can preferably be maintained at a comfortable pH with an appropriate buffer system. The formulations can also contain conventional, pharmaceutically acceptable preservatives, stabilizers and surfactants.
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59/70 [0119] The preservatives that can be used in the pharmaceutical compositions disclosed herein include, but are not limited to, benzalkonium chloride, PHMB, chlorobutanol, thimerosal, phenylmercuric, acetate and phenylmercuric nitrate. A useful surfactant is, for example, Tween 80. Likewise, several useful vehicles can be used in the ophthalmic preparations disclosed herein. These vehicles include, but are not limited to, polyvinyl alcohol, povidone, hydroxypropylmethylcellulose, poloxamers, carboxymethylcellulose, hydroxyethylcellulose and purified water.
[0120] Tonicity adjusters can be added as needed or convenient. They include, but are not limited to, salts, particularly sodium chloride, potassium chloride, mannitol and glycerin, or any other suitable ophthalmically acceptable tonicity adjuster.
[0121] Various buffers and means for adjusting the pH may be used, provided the resulting preparation is ophthalmically acceptable. For many compositions, the pH will be between 4 and 9. Therefore, buffers include acetate buffers, citrate buffers, phosphate buffers and borate buffers. Acids or bases can be used to adjust the pH of these formulations as needed.
[0122] Ophthalmically acceptable antioxidants include, but are not limited to, sodium metabisulfite, sodium thiosulfate, acetylcysteine, butylated hydroxyanisole and butylated hydroxytoluene.
[0123] The other components of the excipient that can be included in ophthalmic preparations are chelating agents. A useful chelating agent is disodium edetate (EDTA), although other chelating agents can also be used on site or in conjunction with it.
[0124] For intravenous administration, the compositions here
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60/70 described can be dissolved or dispersed in a pharmaceutically acceptable diluent, such as a saline or dextrose solution. Suitable excipients can be included to achieve the desired pH, including but not limited to NaOH, sodium carbonate, sodium acetate, HCI and citric acid. In various embodiments, the pH of the final composition ranges from 2 to 8, or preferably from 4 to 7. The antioxidant excipients can include sodium bisulfite, sodium acetone bisulfite, sodium formaldehyde, sulfoxylate, thiourea and EDTA. Other non-limiting examples of suitable excipients found in the final intravenous composition may include sodium or potassium phosphates, citric acid, tartaric acid, gelatin and carbohydrates, such as dextrose, mannitol and dextran. Additional acceptable excipients are described in Powell, et al., Compendium of excipients for parenteral formulations, PDA J Pharm Sei and Tech 1998, 52 238-311 and Nema et al., Excipients and their role in approved injectable products: Current Usage and Future Directions, PDA J Pharm Sei and Tech 2011, 65 287332, both of which are incorporated herein by reference in their entirety. Antimicrobial agents can also be included to obtain a bacteriostatic or fungistatic solution, including, but not limited to, phenylmercuric nitrate, thimerosal, benzethonium chloride, benzalkonium chloride, phenol, cresol and chlorobutanol.
[0125] Compositions for intravenous administration can be provided to caregivers in the form of a more solids that are reconstituted with a suitable diluent, such as sterile water, saline or dextrose in water shortly before administration. In other embodiments, the compositions are provided in a solution ready for parenteral administration. In still other embodiments, the compositions are supplied in a solution that is further diluted before administration. In embodiments that include the administration of a combination of a compound described herein and another agent, the combination can be provided to
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61/70 caregivers as a mixture, or caregivers can mix the two agents before administration, or the two agents can be administered separately.
[0126] The administration period can be a treatment cycle of several weeks, as long as the inflammation remains under control and the regimen is clinically tolerated. In some embodiments, a single dosage of plinabulin or another therapeutic agent can be administered once a week, and preferably once every day 1 and 8 of a three-week (21-day) treatment cycle. In some embodiments, a single dose of plinabulin or another therapeutic agent can be administered once a week for two weeks, three weeks, four weeks, five weeks, six weeks, seven weeks or eight weeks, preferably on the first day of each week. In some modalities, a single dose of plinabulin or another therapeutic agent can be administered once a week, twice a week, three times a week, four times a week, five times a week, six times a week or daily for a week , two weeks, three weeks, four weeks or five weeks of treatment. Administration can occur on the same day or each day of the week in the treatment cycle.
[0127] In some embodiments, the administration schedule for plinabulin may be the same as for the checkpoint inhibitor. In some embodiments, the schedule of administration of plinabulin may be different from that of the checkpoint inhibitor. In some embodiments, plinabulin and the checkpoint inhibitor (eg, nivolumab) are administered every two weeks (for example, on days 1 and 15 of a 28-day cycle). In some embodiments, the checkpoint inhibitor (for example, nivolumab) is administered on days 1 and 15 of a 28-day cycle and plinabulin is administered on days 1, 8, 15 and 22 of a 28-day cycle
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62/70 days. In some embodiments, plinabulin and the checkpoint inhibitor (for example, pembrolizumab) are administered every three weeks (for example, days 1 and 22 in a 42-day cycle). In some embodiments, when plinabulin is used in combination with the first and second checkpoint inhibitors, plinabulin is administered following the same schedule and on the same day as the administration of the first checkpoint inhibitor, as the first inhibitor of the checkpoint. checkpoint (eg nivolumab at 1 mg / kg) and plinabulin are co-administered once every 3 weeks for 4 doses, followed by administration of a second checkpoint inhibitor (eg ipilimumab) on the same day, after the first checkpoint inhibitor (eg, nivolumab at 240 mg per) and plinabulin are co-administered every two weeks for two doses without the second checkpoint inhibitor. In some embodiments, plinabulin is administered before the first immunological checkpoint inhibitor. In some embodiments, plinabulin is administered shortly after (for example, about 30 minutes, 1 hour, 2 hours or 4 hours) the administration of the first immunological checkpoint inhibitor. In some embodiments, plinabulin is administered simultaneously with the first immunological checkpoint inhibitor. [0130] The treatment cycle can be repeated as long as the regimen is clinically tolerated. In some modalities, the treatment cycle is repeated n times, where n is an integer in the range of 2 to 30. In some modalities, n is 2, 3, 4, 5, 6, 7, 8, 9 or
10. In some modalities, a new treatment cycle may occur immediately after the completion of the previous treatment cycle. In some embodiments, a new treatment cycle may occur a period of time after the completion of the previous treatment cycle.
Examples
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Example 1 [0128] Plinabulin was tested using phosphodiesterase assays, including PDE3, PDE4 and PDE5 assays. The source for the PDE3 and PDE5 assays were human platelets and, for the PDE4 assay, were human U937 cells. The substrate for all three assays was 1.01 μΜ [, H] cAMP + cAMP. In the three assays, the pre-incubation time was 15 minutes, the incubation time was 20 minutes and the pre-incubation and incubation temperature was 25 ° C. The quantification method involves the quantification of [ ³ H] adenosine, and the significant criteria has been set for 50% stimulation or max inhibition. The test results are shown in Table 1.
Table 1. Phosphodiesterase bioassay screening
n Plinabulin concentration % inhibition PDE3 2 10 μπι 7 PDE4 2 10 μπι 77 PDE5 2 10 μπι 25
[0129] As shown in Table 1, plinabulin showed better inhibitory activity against PDE4 than other PDE3 and PDE5.
Example 2 [0130] Patients received either docetaxel plus plinabulin (DN) or docetaxel alone (75 mg / m ² ) (D) treatment. Two dosage cohorts were investigated:
1) 30 mg / m ² dosage cohort: patients were randomized (1: 1) to receive docetaxel plus plinabulin at 30 mg / m ² (DN 30 mg / m ² arm) or docetaxel alone (arm D);
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2) 20 mg / m ² dosage cohort: patients were randomized (2: 1) to receive docetaxel plus plinabulin at 20 mg / m ² (DN 20 mg / m ² arm) or docetaxel (arm D) alone.
Dosing regimen [0131] Patients received therapy on day 1 and day 8 in 3-week cycles. Therapy on day 1 consisted of 75 mg / m ² of docetaxel given by intravenous (IV) infusion over 1 hour, followed 2 hours later (from the time the docetaxel infusion started) by placebo (arm D) or 30 mg / m ² or 20 mg / m ² of plinabulin (Arm DN) administered by intravenous (IV) infusion over 30 minutes. Oral dexamethasone (16 mg) was administered the day before, the day and the day after the docetaxel infusion (day 1). Therapy on day 8 consisted of placebo (arm D) or 30 mg / m ² or 20 mg / m ² plinabulin (Arm DN) administered via intravenous (IV) infusion over 30 minutes.
[0132] In patients with drug-related Grade> 2 treatment-related adverse events (except alopecia, anorexia and fatigue) according to CTCAE treatment (v3.0), it may be postponed until the adverse event recovers to <Grade 1. Laboratory safety tests met the following criteria before treatment with docetaxel at the beginning of each subsequent cycle: AST <2.5 x ULN, ALT <2.5 x ULN (<1.5 x ULN if alkaline phosphatase is > = 2.5 x ULN); bilirubin <= ULN; hemoglobin> = 9 g / dL, absolute neutrophil count> = 1.5 x 10 ⁹ / L and platelets> = 100 x 10 ⁹ / EU. Dose reductions have been implemented for patients who have severe recurrent or specific toxicities.
[0133] The initial dose of plinabulin was 30 mg / m ² or 20 mg / m ² . Dose adjustments depended on the adverse events observed. The volume of administration varied based on the assigned dose and the patient's body surface area. The formulation
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65/70 clinic was supplied as a solution concentrated in 40% Solutol® HS-15/60% propylene glycol in amber flasks containing 80 mg of drug in 20 mL (4 mg / mL) and stored at room temperature. Each bottle is designed for single use. The correct volume of the drug (at a concentration of 4 mg / mL in the vial) was diluted in 5% dextrose in water (D5W) at a 1:20 dilution and administered intravenously or centrally. The infusion time may be increased as clinically indicated, under the direction of the Sponsor. Plinabulin and placebo should be administered within 6 hours after dilution.
[0134] The initial dose of docetaxel was 75 mg / m ² . Dose adjustments depended on the adverse events observed. Administration was performed with an intravenous infusion of 1 hour by institutional protocol at the dose prescribed by this clinical trial protocol. Oral dexamethasone (16 mg) was administered the day before, the day and the day after the docetaxel infusion (day 1). A similar pre-medication regimen with corticosteroids was used in accordance with local institutional practices. The dose of dexamethasone or another corticosteroid was adequately reduced in patients who were already using corticosteroids.
[0135] Baseline assessments: (within 14 days of starting treatment, ie days 14 to 1) Physical examination, vital signs, ECOG performance status, concomitant drug use, laboratory safety tests.
[0136] Treatment phase: Safety assessments (including a complete physical examination) were performed prior to the infusion of the study drug. Safety assessments (including complete physical examination) were carried out before each subsequent cycle (2+). In addition, the following were evaluated: CBC with differential / platelets and clinical chemistry were performed within 72 hours
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66/70 before day 1 of each cycle; an additional evaluation took place in cycle 1 / day 15; Vital signs (heart rate, respiratory rate, blood pressure and temperature) were obtained on the days of the infusion immediately before and after each infusion of the drug under study and at 30 and 60 minutes after the last infusion in the first cycle. During subsequent cycles, vital organs were collected before and after each infusion during physical examination.
[0137] Assessment of response to treatment occurred during the rest period of the second cycle (and approximately every 2 cycles thereafter).
[0138] Treatment continued until there was evidence of progressive disease, unacceptable adverse events related to treatment, and then the study was terminated or the patient was withdrawn from the study (due to withdrawal of consent or the Investigator's judgment).
[0139] SAFETY ASSESSMENTS: Adverse events spontaneously reported by patients or observed during physical examination, vital signs, ECOG performance status and laboratory tests. The results of treatment-related adverse events (TAEE) related to dexamethasone are shown in Table 2. Figure 1 illustrates the percentage of patients showing steroid-related effects with the administration of plinabulin.
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Table 2. Distribution of any emerging adverse events related to dexamethasone treatment
30 mg / m ⁵ cohort 20 mg / m ⁵ cohortDN arm Arm D DN arm Arm D(N = 50) (N = 55) (N = 40) (N = 18) Number of patients (%) 25 (50%) 17 (30.9%) 15 (37.5%) 5 (27.8%) D = docetaxel, DN = docetaxel = plinabulin; Adverse TAEE emerging from treatment = event
[0140] Figure 1 showed that plinabulin caused a dose-dependent increase in adverse events related to steroids (dexamethasone). Adverse events related to steroids for patients receiving 30 mg / m ² of plinabulin were statistically more significant (p = 0.026) than patients who did not receive plinabulin. The results suggested that the inhibitory effect of PDE4 plinabulin can be translated into a relevant pharmacological effect of PDE4.
Example 3 [0141] The effects of plinabulin on AEs related to immunity with the combination of Nivolumab / Plinabulin have been studied. In the two phase 1 studies in patients with NSCLC, a total of 10 patients have been enrolled to date and received nivolumab (240 mg or 3 mg / kg) in combination with plinabulin 13.5 mg / m2 (n = 3) or 20 mg / m2 (n = 5) or 30 mg / m2 (n = 2). Two patients developed grade 1 or 2 IR AEs, without the need for steroid treatment. Grade 3/4 IV AE was not observed. The results of the study showed that plinabulin is a
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68/70 potent PDE4 inhibitor and clinically exerted steroid-like effects. Therefore, Plinabulin is therefore a viable alternative to steroids. Preliminary clinical data suggested that the addition of plinabulin to checkpoint inhibitor therapy may prevent AEs of IR.
[0142] In a phase 1 study, patients were selected only after meeting at least the following inclusion criteria: 1) Subjects with histologically or cytologically confirmed metastatic NSCLC whose disease progressed during / after treatment with at least one chemotherapy regimen containing platinum. 2) At least 1 previous systemic therapy for metastatic disease. Adjuvant chemotherapy or concomitant chemoradiation for early-stage disease does not count as prior therapy unless patients progress within 6 months of completing chemotherapy. 3) Previous chemotherapy must have been completed at least 4 weeks or at least 5 half-lives (whichever is greater) before the study drug is administered, and all adverse events have returned to baseline or stabilized. 4) Prior definitive radiotherapy must have been completed at least 4 weeks before the study drug is administered. Previous palliative radiotherapy must be completed at least 2 weeks before the study drug is administered. Whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) and focal radiation at sites of pain or bronchial obstruction will be considered palliative. No radiopharmaceutical (strontium, samarium) within 8 weeks prior to the administration of the study drug. 5) The previous major surgery must be completed at least 4 weeks before the study drug is administered. Previous minor surgery must be completed at least 1 week before the study drug is administered and the subjects must be recovered. Percutaneous biopsies must be completed at least 10 days before drug administration in
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69/70 study. In this study, nivolumab (240 mg) was administered to patients via iv on days 1 and 15 until disease progression; and Plinabulin was administered to patients via iv in three different doses (13.5 mg / m ² , 20 mg / m ² , 30 mg / m ² ) and will be administered at 40 mg / m ² to different groups on days 1, 8 and 15 until disease progression. The courses are repeated every 28 days in the absence of disease progression or unacceptable toxicity.
[0143] In the other phase 1 study, patients were selected only after meeting at least the following inclusion criteria: 1) Subjects must have small non-small cell lung cancer (NSCLC), histologically or cytologically documented, stage IIIB or stage IV, recurrent or metastatic; 2) Subjects must have received prior treatment with platinum doublet (up to 2 lines of previous systemic therapy for metastatic disease are allowed; adjuvant chemotherapy or concomitant chemoradiation for early disease does not count as prior therapy unless the individual progresses within. 6 months after completion of treatment). Patients with known activating mutations in the epidermal growth factor receptor (EGFR) or known translocation in anaplastic lymphoma kinase (ALK) or ROS-1 are eligible, provided they have progressed or are intolerant to the targets approved by the Food and Drug Administration (FDA) therapy); 3) The subjects must have a performance status of the Eastern Cooperative Oncology Group (ECOG) from 0 to 2; 4) The subjects, including those in the dose increase part of the study, must have measurable disease according to the criteria for Evaluation of Solid Tumor Response (RECIST) 1.1; the image must be within 28 days after enrollment in the study (target lesions may be located in a previously irradiated field if there is a documented (radiographic) progression of the disease in that location prior to enrollment in the study); 5) Absolute neutrophil count (CAN)> = 1000 / mm ³ ; 6)
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Platelets> = 75,000 / dL; 7) Hemoglobin> = 9 g / dL; 8) Total bilirubin = <1.5 mg / dL x upper limit of normal (ULN) (except subjects with Gilbert's syndrome who may have total bilirubin = <3.0 mg / dL); 9) Serum creatinine = <1.5 mg / dL or creatinine clearance> = 60 mL / min; 10) Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) = <2.5 times the upper limit of normal if there is no liver involvement or = <5 times the upper limit of normal with liver involvement. During the study, patients received plinabulin IV for 30 minutes and nivolumab IV (3mg / kg) for 60 minutes on days 1 and 15. The courses are repeated every 28 days in the absence of disease progression or unacceptable toxicity. Two doses of plinabulin (20 mg / m ² and 30 mg / m ² ) were tested. The percentage of patients with grade 3 or higher adverse events (adverse events classified in the Common Toxicity Criterion of the National Cancer Institute version 4.0) was studied.

权利要求:
Claims (47)
[1]
1. Method to Treat or Prevent an Adverse Event Related to Immunotherapy in an Individual, comprising the administration of an effective amount of plinabulin to the individual in need of it, characterized in that the individual is administered with one or more immunological checkpoint inhibitors .
[2]
2. Method for Treating or Preventing an Adverse Event
Related to Immunotherapy in an Individual, according to Claim 1, characterized by the fact that the one or more checkpoint inhibitors are selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, a PD-L2 inhibitor, PD-L3 inhibitor, PD-L4 inhibitor, CTLA-4 inhibitor, LAG3 inhibitor, B7-H3 inhibitor, B7-H4 inhibitor, KIR inhibitor and a TIM3 inhibitor.
[3]
3. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual according to Claim 1 or 2, characterized by the fact that the immunological checkpoint inhibitor is a PD-1 inhibitor.
[4]
4. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual according to Claim 1 or 2, characterized by the fact that the immunological checkpoint inhibitor is a PD-L1 inhibitor.
[5]
5. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to claim 1 or 2, characterized by the fact that the immunological checkpoint inhibitor is a CTLA-4 inhibitor.
[6]
6. Method to Treat or Prevent an Adverse Event
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Related to Immunotherapy in an Individual, according to claim 1, characterized by the fact that the individual is administered with a first immunological checkpoint inhibitor and a second immunological checkpoint inhibitor, and in which the first immunological checkpoint inhibitor immunological check is different from the second immunological checkpoint inhibitor.
[7]
7. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to claim 6, characterized by the fact that the first and second inhibitors of immunological checkpoints are independently an inhibitor selected from the group consisting of an inhibitor of PD-1, an inhibitor of PD-L1, an inhibitor of PD-L2, an inhibitor of PD-L3, an inhibitor of PD-L4, an inhibitor of CTLA-4, an inhibitor of LAG3, an inhibitor of B7-H3, a B7-H4 inhibitor, a KIR inhibitor and a TIM3 inhibitor.
[8]
8. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to claim 7, characterized by the fact that the first checkpoint inhibitor is a PD-1 inhibitor or a PD-L1 inhibitor , and the second checkpoint inhibitor is a CTLA-4 inhibitor.
[9]
9. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to claim 1, characterized by the fact that immunotherapy is a monotherapy that comprises the administration of a single checkpoint inhibitor selected from the group that consists of a PD-1 inhibitor, a PD-L1 inhibitor, a PD-L2 inhibitor, a PD-L3 inhibitor, a PD-L4 inhibitor, a CTLA-4 inhibitor, a LAG3 inhibitor, a inhibitor of B7-H3, an inhibitor of B7-H4, an inhibitor of KIR and an inhibitor of TIM3.
[10]
10. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to the
Petition 870190090313, of 9/11/2019, p. 133/173
3/9 claim 9, characterized by the fact that the checkpoint inhibitor is a PD-1 inhibitor.
[11]
11. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to claim 9, characterized by the fact that the checkpoint inhibitor is a PD-L1 inhibitor.
[12]
12. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to claim 9, characterized by the fact that the checkpoint inhibitor is a CTLA-4 inhibitor.
[13]
13. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to claim 1, characterized by the fact that immunotherapy is a combination therapy, and in which the combination therapy comprises the administration of two or more checkpoint inhibitors selected from the group consisting of a PD-1 inhibitor, a PD-L1 inhibitor, a PD-L2 inhibitor, a PD-L3 inhibitor, a PD-L4 inhibitor, an inhibitor of CTLA-4, an LAG3 inhibitor, a B7H3 inhibitor, a B7-H4 inhibitor, a KIR inhibitor and a TIM3 inhibitor.
[14]
14. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to claim 13, characterized in that the combination therapy comprises the administration of a PD-1 inhibitor and a CTLA-4 inhibitor .
[15]
15. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to claim 13, characterized in that the combination therapy comprises the administration of a PD-L1 inhibitor and a CTLA-4 inhibitor .
[16]
16. Method for Treating or Preventing an Adverse Event
Petition 870190090313, of 9/11/2019, p. 134/173
4/9
Related to Immunotherapy in an Individual, according to any one of claims 13 to 15, characterized by the fact that the amount of plinabulin is effective to inhibit PDE4 activity without reducing vascular proliferation or density.
[17]
17. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to any one of claims 13 to 16, characterized by the fact that the amount of plinabulin is in the range of 1 mg to 100 mg.
[18]
18. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to any of claims 1 to 17, characterized by the fact that the immunotherapy-related adverse event is a grade 3/4 adverse event.
[19]
19. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to any one of claims 1 to 18, characterized by the fact that it comprises the identification of an individual at risk of developing an adverse event related to immunotherapy of grade 3/4.
[20]
20. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to any of claims 1 to 19, characterized by the fact that the immunotherapy-related adverse event is selected from the group consisting of Pneumonitis, Colitis, Hepatitis, Endocrinopathies, Nephritis and Renal Dysfunction, Adverse Skin Reactions and Encephalitis.
[21]
21. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to claim 20, characterized by the fact that the immunotherapy-related adverse event is pancreatitis, and in which immunotherapy comprises the administration of an inhibitor of PD-1 is a CTLA-4 inhibitor.
Petition 870190090313, of 9/11/2019, p. 135/173
5/9
[22]
22. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to any one of claims 1 to 20, characterized by the fact that the adverse event related to immunotherapy is inflammation induced by immunotherapy.
[23]
23. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to claim 22, characterized by the fact that immunotherapy-induced inflammation is selected from the group consisting of pancreatitis, pneumonitis, colitis, hepatitis , nephritis and renal dysfunction, hypothyroidism and hyperthyroidism, uveitis, demyelination, autoimmune neuropathy, adrenal insufficiency, facial and abdominal nerve paresis, hypophysitis, diabetic ketoacidosis, hypopituitarism, GuillainBarré syndrome, myasthenic syndrome, hypothyroidism, type 1 thyroiditis , arthritis, exfoliative dermatitis, bullous pemphigoid, myositis, myasthenia gravis, vasculitis, hemolytic anemia, partial seizures in a patient with inflammatory foci in the brain parenchyma, dermatitis, skin rash, itching, meningitis, sarcoidosis, pericarditis, myocarditis, fatal myocarditis, angiopathy temporal, vasculitis, polymyalgia rheumatica, conjunctivitis , blepharitis, episcleritis, scleritis, iritis, leukocytoclastic vasculitis, erythema multiforme, psoriasis, arthritis, autoimmune thyroiditis, autoimmune neuropathy, polymyositis and ocular myositis and hemolytic anemia.
[24]
24. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to any one of claims 1 to 23, characterized by the fact that it also comprises the identification of an individual with the immunotherapy-related adverse event prior to administration of an effective amount of plinabulin to the individual.
[25]
25. Method for Treating or Preventing an Adverse Event Related to Immunotherapy in an Individual, according to any one of claims 1 to 24, characterized by the fact that
Petition 870190090313, of 9/11/2019, p. 136/173
6/9 also includes the identification of an individual with an adverse event related to grade 3/4 immunotherapy prior to the administration of an effective amount of plinabulin to the individual
[26]
26. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to any one of claims 1 to 25, characterized by the fact that the incidence of an immunotherapy-related adverse event is reduced by at least 10%.
[27]
27. Method for Treating or Preventing an Immunotherapy-Related Adverse Event in an Individual, according to any of claims 1 to 26, characterized by the fact that the severity of the immunotherapy-related adverse event is reduced by at least 10%.
[28]
28. Method to Reduce the Incidence of an Adverse Event Related to Immunotherapy, characterized by the fact that it comprises the administration of an effective amount of plinabulin to the individual in need of it, in which the individual is administered with one or more inhibitors of immunological verification.
[29]
29. Method to Reduce the Duration of an Adverse Event Related to Immunotherapy, characterized by the fact that it comprises the administration of an effective amount of plinabulin to the individual in need of it, in which the individual is administered with one or more inhibitors of immunological verification.
[30]
30. Method according to any one of claims 1 to 29, characterized in that the individual also receives radiation therapy.
[31]
31. Method to Treat or Prevent an Inflammatory Skin or Joint Disorder in an Individual, characterized by the fact that it comprises the topical administration of an effective amount of plinabulin to the individual in need of it.
Petition 870190090313, of 9/11/2019, p. 137/173
7/9
[32]
32. Method for Treating or Preventing an Inflammatory Skin or Joint Disorder in an Individual, according to claim 31, characterized by the fact that the skin or joint disorder is psoriasis.
[33]
33. Method for Treating or Preventing an Inflammatory Skin or Joint Disorder in an Individual, according to claim 31, characterized by the fact that the skin or joint disorder is arthritis.
[34]
34. Method for Treating or Preventing an Inflammatory Skin or Joint Disorder in an Individual, according to claim 31, characterized by the fact that the skin or joint disorder is rheumatoid arthritis.
[35]
35. Method for Treating or Preventing an Inflammatory Skin or Joint Disorder in an Individual according to claim 31, characterized by the fact that the skin or joint disorder is selected from ankylosing spondylitis, psoriatic arthritis, sarcoidosis, lupus systemic erythematosus or atopic dermatitis.
[36]
36. Method to Treat or Prevent an Inflammatory Disease in an Individual, characterized by the fact that it comprises the administration of an effective amount of plinabulin to the individual in need, in which the inflammatory disease is selected from the group consisting of rheumatism chronic joint disease, chronic obstructive pulmonary disease, asthma, ankylosing spondylitis, psoriatic arthritis, sarcoidosis, systemic lupus erythematosus, inflammatory bowel disease, atopic dermatitis and multiple sclerosis.
[37]
37. Method for Treating or Preventing an Inflammatory Disease in an Individual, according to claim 36, characterized by the fact that plinabulin is administered parenterally.
[38]
38. Method for Treating or Preventing an Inflammatory Disease in an Individual, according to claim 36, characterized by the fact
Petition 870190090313, of 9/11/2019, p. 138/173
8/9 that plinabulin is administered orally.
[39]
39. Method for Treating or Preventing an Inflammatory Disease in an Individual, according to claim 36, characterized by the fact that plinabulin is administered topically.
[40]
40. Method to Treat or Prevent Chronic Obstructive Pulmonary Disease or Asthma in an Individual, characterized by the fact that it comprises the administration of an effective amount of plinabulin to the individual in need of it through an inhaler.
[41]
41. Topical Formulation, characterized by the fact that it comprises plinabulin in an effective concentration to inhibit PDE4 activity without reducing vascular proliferation or density.
[42]
42. Topical Formulation, characterized by the fact that it comprises plinabulin at a concentration in the range of 0.1% to 10% by weight of the total formulation.
[43]
43. Topical formulation according to claim 41 or 42, characterized by the fact that the concentration of plinabulin is in the range of 0.5% to 5% by weight of the total formulation.
[44]
44. Topical formulation according to any one of claims 41 to 43, characterized in that it further comprises one or more excipients.
[45]
45. Topical formulation according to any one of claims 41 to 44, characterized in that it further comprises one or more ingredients selected from white petrolatum, propylene glycol, mono- and diglycerides, paraffin, butylated hydroxytoluene or disodium calcium edetate .
[46]
46. Topical formulation according to any one of claims 41 to 45, characterized in that it further comprises polyoxyl 15 hydroxystearate.
[47]
47. Topical Formulation, according to any of the
Petition 870190090313, of 9/11/2019, p. 139/173
9/9 claims 41 to 46, characterized by the fact that the formulation is in the form of a cream, ointment, gel, emulsion or suspension.

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引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

US7935704B2|2003-08-01|2011-05-03|Nereus Pharmaceuticals, Inc.|Dehydrophenylahistins and analogs thereof and the synthesis of dehydrophenylahistins and analogs thereof|

---

US7919497B2|2002-08-02|2011-04-05|Nereus Pharmaceuticals, Inc.|Analogs of dehydrophenylahistins and their therapeutic use|

---

EP1711487A1|2004-02-04|2006-10-18|Nereus Pharmaceuticals, Inc.|Dehydrophenylahistins and analogs thereof and the synthesis of dehydrophenylahistins and analogs thereof|

---

WO2012035436A1|2010-09-15|2012-03-22|Tokyo University Of Pharmacy And Life Sciences|Plinabulin prodrug analogs and therapeutic uses thereof|

---

DK3076972T3|2013-10-11|2022-01-03|Beyondspring Inc|CANCER TREATMENT WITH COMBINATION OF PLINABULIN AND TAXAN|

---

NZ734256A|2015-02-12|2019-02-22|Beyondspring Pharmaceuticals Inc|Use of plinabulin in combination with immune checkpoint inhibitors|

---

JP2019511565A|2016-02-08|2019-04-25|ビヨンドスプリング ファーマシューティカルズ，インコーポレイテッド|Composition comprising tucarezole or an analogue thereof|RU2736045C2|2015-03-06|2020-11-11|Бейондспринг Фармасьютикалс, Инк.|Method of treating cancer associated with a ras mutation|

---

JP6904570B2|2015-03-06|2021-07-21|ビヨンドスプリング ファーマシューティカルズ，インコーポレイテッド|How to treat brain tumors|

---

CN108026075B|2015-07-13|2021-06-29|大连万春布林医药有限公司|Plinabulin compositions|

---

JP2019511565A|2016-02-08|2019-04-25|ビヨンドスプリング ファーマシューティカルズ，インコーポレイテッド|Composition comprising tucarezole or an analogue thereof|

---

MX2018015100A|2016-06-06|2019-09-04|Beyondspring Pharmaceuticals Inc|Composition and method for reducing neutropenia.|

---

GB201713760D0|2017-08-28|2017-10-11|Univ Leuven Kath|Treatment of epilepsy|

---

WO2019232257A1|2018-06-01|2019-12-05|Beyondspring Pharmaceuticals, Inc.|Composition and method of treating cancer associated with egfr mutation|

---

GB201913988D0|2019-09-27|2019-11-13|Celleron Therapeutics Ltd|Novel treatment|

---

CN113613654A|2019-10-15|2021-11-05|大连万春布林医药有限公司|Compositions and methods for treating iron disorders|

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WO2021225908A1|2020-05-04|2021-11-11|Beyondspring Pharmaceuticals, Inc.|Triple combination therapy for enhancing cancer cell killing in cancers with low immunogenicity|

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法律状态:
2021-07-20| B07D| Technical examination (opinion) related to article 229 of industrial property law [chapter 7.4 patent gazette]|Free format text: DE ACORDO COM O ARTIGO 229-C DA LEI N? 10196/2001, QUE MODIFICOU A LEI N? 9279/96, A CONCESS?O DA PATENTE EST? CONDICIONADA ? ANU?NCIA PR?VIA DA ANVISA. CONSIDERANDO A APROVA??O DOS TERMOS DO PARECER N? 337/PGF/EA/2010, BEM COMO A PORTARIA INTERMINISTERIAL N? 1065 DE 24/05/2012, ENCAMINHA-SE O PRESENTE PEDIDO PARA AS PROVID?NCIAS CAB?VEIS. |

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2021-09-08| B07G| Grant request does not fulfill article 229-c lpi (prior consent of anvisa) [chapter 7.7 patent gazette]|Free format text: NOTIFICACAO DE DEVOLUCAO DO PEDIDO EM FUNCAO DA REVOGACAO DO ART. 229-C DA LEI NO 9.279, DE 1996, POR FORCA DA LEI NO 14.195, DE 2021 |

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2021-10-19| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

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申请号 | 申请日 | 专利标题

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US201762470802P| true| 2017-03-13|2017-03-13|

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US201862621528P| true| 2018-01-24|2018-01-24|

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PCT/US2018/022064|WO2018169887A1|2017-03-13|2018-03-12|Compositions of plinabulin and use thereof|

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