阅读说明：本技术 用于治疗食管癌的crac通道调节剂 (CRAC channel modulators for the treatment of esophageal cancer ) 是由 S·维司瓦纳德哈 S·K·V·S·瓦卡兰卡 于 2018-10-16 设计创作，主要内容包括：本发明涉及钙释放活化钙(CRAC)通道调节剂(例如N-[4-(3,5-二环丙基-1H-吡唑-1-基)苯基]-2-(喹啉-6-基)乙酰胺(化合物(A))或其药学上可接受的盐)或含有这种CRAC通道调节剂的药物组合物用于治疗食管癌的用途。(The present invention relates to the use of Calcium Release Activated Calcium (CRAC) channel modulators, such as N- [4- (3, 5-dicyclopropyl-1H-pyrazol-1-yl) phenyl ] -2- (quinolin-6-yl) acetamide (compound (a)), or a pharmaceutically acceptable salt thereof, or a pharmaceutical composition comprising such CRAC channel modulators, for the treatment of esophageal cancer.)

1. A method of treating esophageal cancer comprising administering to a subject a calcium release-activating calcium channel modulator.

2. The method of claim 1, wherein the modulator of calcium-releasing activated calcium channels is an inhibitor of calcium-releasing activated calcium channels.

3. The method according to claim 1 or 2, wherein the calcium-release activated calcium channel modulator is N- (4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl) -2- (quinolin-6-yl) acetamide or a pharmaceutically acceptable salt thereof.

4. The method according to any one of claims 1-3, wherein the calcium-release activated calcium channel modulator is the hydrochloric acid (HCl) salt of N- (4- (3, 5-dicyclopropyl-lH-pyrazol-1-yl) phenyl) -2- (quinolin-6-yl) acetamide.

5. The method of any one of claims 1-4, wherein the esophageal cancer is Esophageal Squamous Cell Carcinoma (ESCC).

6. The method of any one of claims 1-4, wherein the esophageal cancer is Esophageal Adenocarcinoma (EAC).

7. The method according to any one of claims 1-6, wherein the calcium release-activating calcium channel modulator is administered as a first line treatment of esophageal cancer.

8. The method of any one of claims 1-6, wherein the subject has unresectable esophageal cancer.

9. The method of any one of claims 1-8, wherein the subject is a human.

10. The method of any one of claims 1-9, wherein the calcium-release activated calcium channel modulator is administered to the subject by an oral, intravenous, intramuscular, or intraperitoneal route.

11. The method of claim 10, wherein the calcium-release activated calcium channel modulator is administered by an oral route.

12. The method according to any one of claims 1-11, wherein the calcium-releasing activated calcium channel modulator is administered at the following doses:

i)25 to 1000mg of a water-soluble polymer,

ii) from 25 to 800mg of a compound of formula,

iii) from 25 to 600mg of a,

iv)25 to 400mg or

v)25 to 200 mg.

13. The method of claim 12, wherein the dose is:

i)50 to 1000mg of a water-soluble polymer,

ii)50 to 800mg of a compound of formula,

iii)50 to 600mg of a stabilizer in the reaction mixture,

iv)50 to 400mg or

v)50 to 200 mg.

14. The method of claim 12 or 13, wherein the dose is:

i)100 to 1000mg of the total amount of the composition,

ii)100 to 800mg of a non-woven fabric,

iii)100 to 600mg of a stabilizer in the reaction mixture,

iv)100 to 400mg or

v)100 to 200 mg.

15. The method of any one of claims 1-14, wherein the calcium-releasing activated calcium channel modulator is administered in a single dose or in divided doses.

16. The method of any one of claims 1-15, wherein the calcium release-activating calcium channel modulator inhibits calcium entry for a depot operation, disrupts assembly of SOCE units, alters the functional interaction of proteins forming a calcium channel complex for a depot operation, alters the functional interaction of STIM1 with Orail, or any combination of the foregoing.

17. The method of any one of claims 1-16, wherein the calcium-release activated calcium channel modulator is a SOC channel pore blocker or a CRAC channel pore blocker.

18. The method of any one of claims 1-17, wherein said calcium release activates calcium channel modulators to modulate intracellular calcium.

19. The method of any one of claims 1-18, further comprising administering one or more anti-cancer treatments, one or more cytostatic, cytotoxic, or anti-cancer agents, targeted therapies, or any combination of the foregoing.

20. The method of claim 19, wherein the calcium release-activating calcium channel modulator is administered together with or sequentially to one or more anti-cancer treatments, one or more cytostatic, cytotoxic or anti-cancer agents, or targeted therapies.

21. The method of claim 19 or 20, wherein the anti-cancer agent is selected from: DNA interactive agents, alkylating agents, topoisomerase II inhibitors, topoisomerase I inhibitors, tubulin interactive agents, hormonal agents, thymidylate synthase inhibitors, antimetabolites, tyrosine kinase inhibitors, angiogenesis inhibitors, EGF inhibitors, VEGF inhibitors, CDK inhibitors, SRC inhibitors, c-Kit inhibitors, Herl/2 inhibitors, checkpoint kinase inhibitors, monoclonal antibodies directed against growth factor receptors selected from EGF and Her2, CD20 monoclonal antibodies, B cell targeting monoclonal antibodies, fusion proteins, protein kinase modulators, CHOP (cyclophosphamide, adriamycin, vincristine, prednisone), R-CHOP (rituximab-CHOP), Large CV AD (Large doses of cyclophosphamide, vincristine, adriamycin, dexamethasone, methotrexate, Cytarabine), R-Large CV AD (Rituximab-Large CV AD), FCM (fludarabine, cyclophosphamide, mitoxantrone), R-FCM (rituximab, fludarabine, cyclophosphamide, mitoxantrone), bortezomib and rituximab; temsirolimus and rituximab, temsirolimus and bortezomib, Iodine-131 tositumomab and CHOP, CVP (cyclophosphamide, vincristine, prednisone), R-CVP (rituximab-CVP), ICE (ifosfamide, carboplatin, etoposide), R-ICE (rituximab-ICE), FCR (fludarabine, cyclophosphamide, rituximab), FR (fludarabine, rituximab), and D.T.PACE (dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, etoposide), steroidal anti-inflammatory drugs, non-steroidal anti-inflammatory drugs (NSAID), immunoselective anti-inflammatory derivatives (ImSAID), antiemetics, analgesics, anti-inflammatory drugs, anti-cachetics, or a combination of any of the foregoing.

22. The method of claim 19 or 20, wherein the anti-cancer treatment is selected from chemotherapy, radiation therapy, biological therapy, bone marrow transplantation, stem cell transplantation, or a combination of any of the foregoing.

23. According to a method of inhibiting proliferating esophageal cancer metastatic cells in a subject in need thereof, comprising administering to the subject a calcium release-activated calcium channel modulator.

24. The method of claim 23, wherein the modulator of calcium-releasing activated calcium channels is an inhibitor of calcium-releasing activated calcium channels.

25. The method according to claim 23 or 24, wherein the calcium-release activated calcium channel modulator is N- (4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl) -2- (quinolin-6-yl) acetamide or a pharmaceutically acceptable salt thereof.

26. Calcium channel modulators are activated based on calcium release for the treatment of esophageal cancer.

27. The modulator of calcium-releasing activated calcium channel according to claim 26, wherein the modulator is a calcium-releasing activated calcium channel inhibitor.

28. The calcium release-activated calcium channel modulator according to claim 26 or 27, which is N- (4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl) -2- (quinolin-6-yl) acetamide or a pharmaceutically acceptable salt thereof.

29. The calcium release-activated calcium channel modulator of any one of claims 26-28, wherein the modulator is the hydrochloric acid (HCl) salt of N- (4- (3, 5-dicyclopropyl-lH-pyrazol-1-yl) phenyl) -2- (quinolin-6-yl) acetamide.

30. The calcium release-activated calcium channel modulator according to any one of claims 26-29, wherein the esophageal cancer is squamous cell carcinoma (ESCC).

31. The calcium release-activated calcium channel modulator according to any one of claims 26-29, wherein the esophageal cancer is adenocarcinoma (EAC).

32. The modulator of calcium-releasing activated calcium channel according to any one of claims 26 to 31, wherein the modulator of calcium-releasing activated calcium channel is used as a first line treatment of the esophageal cancer.

33. The calcium release-activated calcium channel modulator according to any one of claims 26-31, wherein the esophageal cancer is a non-resectable esophageal cancer.

34. The calcium-release-activated calcium channel modulator of any one of claims 26-33, wherein the subject is a human.

35. The calcium-releasing activated calcium channel modulator of any one of claims 26-34, wherein the calcium-releasing activated calcium channel modulator is administered to the subject by oral, intravenous, intramuscular, or intraperitoneal route.

36. The modulator of calcium-releasing activated calcium channel according to claim 35, wherein the modulator of calcium-releasing activated calcium channel is administered by oral route.

37. The modulator of calcium-releasing activated calcium channel according to any one of claims 26 to 36, wherein the modulator of calcium-releasing activated calcium channel is administered at the following doses:

i)25 to 1000mg of a water-soluble polymer,

ii) from 25 to 800mg of a compound of formula,

iii) from 25 to 600mg of a,

iv)25 to 400mg or

v)25 to 200 mg.

38. The calcium-release activated calcium channel modulator of claim 37, wherein the dose is:

i)50 to 1000mg of a water-soluble polymer,

ii)50 to 800mg of a compound of formula,

iii)50 to 600mg of a stabilizer in the reaction mixture,

iv)50 to 400mg or

v)50 to 200 mg.

39. The calcium-release-activated calcium channel modulator according to claim 37 or 38, wherein the dose is:

i)100 to 1000 mg;

ii)100 to 800 mg;

iii)100 to 600 mg;

iv)100 to 400mg or

v)100 to 200 mg.

40. The modulator of calcium-releasing activated calcium channel according to any one of claims 26 to 39 wherein the modulator of calcium-releasing activated calcium channel is administered in a single dose or in divided doses.

41. The calcium-releasing activated calcium channel modulator of any one of claims 26-40, wherein the calcium-releasing activated calcium channel modulator inhibits calcium entry for depot manipulation, disrupts assembly of SOCE units, alters functional interactions of proteins forming a calcium channel complex for depot manipulation, alters functional interactions of STIM1 with Orail, or any combination of the foregoing.

42. The calcium-releasing activated calcium channel modulator of any one of claims 26-41, wherein the calcium-releasing activated calcium channel modulator is a SOC channel pore blocker or a CRAC channel pore blocker.

43. The modulator of calcium-releasing activated calcium channel of any one of claims 26-40, wherein the modulator of calcium-releasing activated calcium channel modulates intracellular calcium.

44. The activated calcium channel modulator of calcium release of any one of claims 26-43, wherein the activated calcium channel modulator of calcium release is used in combination with one or more anti-cancer treatments, one or more cytostatic, cytotoxic or anti-cancer agents, targeted therapies, or a combination of any of the foregoing.

45. The calcium release-activated calcium channel modulator of claim 44, wherein the calcium release-activated calcium channel modulator is administered together or sequentially with one or more anti-cancer treatments, one or more cytostatic, cytotoxic or anti-cancer agents, or targeted therapies.

46. The calcium-release-activated calcium channel modulator of claim 44 or 45, wherein the anti-cancer agent is selected from the group consisting of: DNA interactive agents, alkylating agents, topoisomerase II inhibitors, topoisomerase I inhibitors, tubulin interactive agents, hormonal agents, thymidylate synthase inhibitors, antimetabolites, tyrosine kinase inhibitors, angiogenesis inhibitors, EGF inhibitors, VEGF inhibitors, CDK inhibitors, SRC inhibitors, c-Kit inhibitors, Herl/2 inhibitors, checkpoint kinase inhibitors, monoclonal antibodies directed against growth factor receptors selected from EGF and Her2, CD20 monoclonal antibodies, B cell targeting monoclonal antibodies, fusion proteins, protein kinase modulators, CHOP (cyclophosphamide, adriamycin, vincristine, prednisone), R-CHOP (rituximab-CHOP), Large CV AD (Large doses of cyclophosphamide, vincristine, adriamycin, dexamethasone, methotrexate, Cytarabine), R-Large CV AD (Rituximab-Large CV AD), FCM (fludarabine, cyclophosphamide, mitoxantrone), R-FCM (rituximab, fludarabine, cyclophosphamide, mitoxantrone), bortezomib and rituximab; temsirolimus and rituximab, temsirolimus and bortezomib, Iodine-131 tositumomab and CHOP, CVP (cyclophosphamide, vincristine, prednisone), R-CVP (rituximab-CVP), ICE (ifosfamide, carboplatin, etoposide), R-ICE (rituximab-ICE), FCR (fludarabine, cyclophosphamide, rituximab), FR (fludarabine, rituximab), and D.T. PACE (dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, etoposide), steroidal anti-inflammatory drugs, non-steroidal anti-inflammatory drugs (NSAID), immunoselective anti-inflammatory derivatives (ImSAID), antiemetics, analgesics, anti-inflammatory drugs, anti-cachetics, or a combination of any of the foregoing.

47. The calcium release-activated calcium channel modulator of claim 44 or 45, wherein the anti-cancer treatment is selected from chemotherapy, radiation therapy, biological therapy, bone marrow transplantation, stem cell transplantation, or a combination of any of the foregoing.

48. A calcium channel modulator activated on the basis of calcium release for use in inhibiting proliferation of metastatic cells of esophageal cancer in a subject.

49. The modulator of calcium-releasing activated calcium channel according to claim 48, wherein the modulator of calcium-releasing activated calcium channel is an inhibitor of calcium-releasing activated calcium channel.

50. The activated calcium channel modulator of calcium release according to claim 48 or 49, wherein the activated calcium channel modulator of calcium release is N- (4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl) -2- (quinolin-6-yl) acetamide, or a pharmaceutically acceptable salt thereof.

51. The pharmaceutical composition for use in the treatment of esophageal cancer, wherein said pharmaceutical composition comprises a calcium release activated calcium channel modulator and a pharmaceutically acceptable carrier.

52. The pharmaceutical composition according to claim 51, wherein the modulator of calcium-releasing activated calcium channels is an inhibitor of calcium-releasing activated calcium channels.

53. The pharmaceutical composition according to claim 51 or 52, wherein the calcium release-activating calcium channel modulator is N- (4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl) -2- (quinolin-6-yl) acetamide or a pharmaceutically acceptable salt thereof.

54. The pharmaceutical composition of claims 51-53, wherein the composition further comprises one or more cytostatic, cytotoxic, or anticancer agents.

Technical Field

The present invention relates to the use of Calcium Release Activated Calcium (CRAC) channel modulators, such as N- [4- (3, 5-dicyclopropyl-1H-pyrazol-1-yl) phenyl ] -2- (quinolin-6-yl) acetamide (compound (a)), or a pharmaceutically acceptable salt thereof, or a pharmaceutical composition comprising such CRAC channel modulators, for the treatment of esophageal cancer.

Background

Esophageal Cancer (EC) is a cancer caused by the esophagus, which is a food conduit extending between the throat and stomach. Symptoms typically include dysphagia and weight loss. Other symptoms may include pain when swallowing, hoarseness, enlarged periclavicular lymph nodes ("glands"), dry cough, and coughing or vomiting of blood. See Ferri, FF, et al (2012), "EspogelhalTumers" entry, p.389-391Ferri's Clinical Advisor 2013 Mosby (Elsevier) (Philadelphia, Pa.).

The two major subtypes of EC are esophageal squamous cell carcinoma (often abbreviated ESCC) which is more common in developing countries and Esophageal Adenocarcinoma (EAC) which is more common in developed countries. Many unusual types also occur. Squamous cell carcinoma originates in the paraesophageal epithelium. Adenocarcinoma originates from glandular cells present in the lower third of the esophagus and has usually been converted into an intestinal cell type (a disease known as barrett's esophagus). See Montgomery, EA, et al (2014), "oesophagagealcancer", in Stewart, BW; wild, CP, World Cancer Report 2014, World health organization, pp.528-543. The causes of squamous cell types include tobacco, alcohol, hot drinks, poor diet, and chewing areca. The most common causes of adenocarcinoma types are smoking, obesity, and acid regurgitation. See Zhang, HZ et al (Jun 2012), "epidemic differences in emerphapractical Cancer between asians and Westertopulances," Chinese Journal of Cancer,31(6): 281-6.

Esophageal cancer is often ineffective and poorly effective in current treatments. Worldwide, nearly 40 million new cases of esophageal cancer are diagnosed each year-it is the eighth most common cancer and the sixth most common cause of cancer-related mortality.

The incidence of esophageal cancer varies widely depending on geographical area and ethnic background. The incidence of adenocarcinoma at the distal esophagus or the esophagogastric junction has increased significantly in western countries over the last 30 years, while the incidence of Squamous Cell Carcinoma (SCC) has decreased slightly. Previously, esophageal adenocarcinoma accounted for only less than 10% of all esophageal tumors, but recent studies have shown that at least 40% of esophageal tumors are now adenocarcinomas.

The causes of the increased incidence of adenocarcinoma are poorly understood, but obesity, gastroesophageal reflux and barrett's epithelium may be contributing factors. In contrast, the risk of SCC in the esophagus and head and neck is associated with smoking and drinking. See Katsuhiko Higuchiet al, Gastrointest Cancer Res.2009Jul-Aug; 3(4):153-161.

Esophageal cancer is one of the most common cancers and is considered a serious malignancy in terms of prognosis and mortality. Despite many advances in diagnosis and treatment, esophageal cancer remains an invasive disease characterized by high rates of local and distant recurrence and low overall survival. Surgery is a major component of the treatment of resectable esophageal cancer, particularly adenocarcinoma. While remote control and complete resection rate remain surgical problems, in the past, surgery has been considered as the primary means of curing esophageal cancer. The postoperative mortality and higher recurrence rates of esophagectomy have prompted multidisciplinary treatment studies, such as chemotherapy with or without surgery. However, the most suitable treatment for esophageal cancer remains controversial.

Over the past decade, several studies investigating the healing potential of CCRT have challenged the idea that surgery is an essential part of healing therapy. Factors involved in treatment decision making include baseline clinical stage, primary site and histology. See Miao-Fen Chen et al, Scientific Reports,2017, DOI:10.1039/srep 46139.

The rising incidence and poor prognosis of esophageal cancer represent major public health problems worldwide. In 2013, it was estimated that 17990 new cases of esophageal cancer would be diagnosed in the united states, with only 15% of patients surviving. Although SCC cases have steadily declined over the last decades, the incidence of Adenocarcinoma (AC) has increased at a dramatic rate (> 6-fold) in western countries. SCC and AC differ greatly in their underlying etiology and tumorigenesis. Previous head and neck cancer and human papillomavirus infections are risk factors for SCC when smoking and drinking; gastroesophageal reflux disease (GERD) and obesity are associated with an increased risk of AC. SCC develops from premalignant lesions originating from the natural squamous epithelium, while AC development is triggered by intestinal metaplastic lesions (Barrett's esophagus, BE) to GERD.

In addition to surgical resection, the current standard of care for patients with SCC or AC is cisplatin and 5-fluorouracil (5-FU) and chemotherapy in combination with other drugs (e.g., oxaliplatin and irinotecan). Unfortunately, since the 5-year survival rate of the disease is still below 15%, most patients in the advanced stages of the disease cannot benefit from these treatments, highlighting the urgent need for more effective therapies. Therefore, there is an urgent need to identify potential molecular changes in SCC and AC and characterize molecular features to distinguish between the two types of esophageal cancer. The review by Abbes Belkhiri et al (Oncotarget, 2015, 6 (3): 1348-.

Despite advances, significant challenges remain in the treatment of esophageal cancer. Thus, there remains an unmet and urgent need for drugs for the treatment and/or amelioration of esophageal cancer.

Summary of The Invention

The present invention relates to the use of Calcium Release Activated Calcium (CRAC) channel modulators, such as CRAC channel inhibitors, for the treatment of esophageal cancer, including Esophageal Squamous Cell Carcinoma (ESCC).

The present inventors have surprisingly found that the CRAC channel inhibitor N- (4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl) -2- (quinolin-6-yl) acetamide (compound (a), shown below) exhibits excellent activity against esophageal cancer, including Esophageal Squamous Cell Carcinoma (ESCC).

One embodiment is the use of CRAC channel modulators, such as CRAC channel inhibitors, for the treatment of esophageal cancer (e.g., ESCC). A preferred embodiment is the use of CRAC channel inhibitor compound (a) or a pharmaceutically acceptable salt thereof for the treatment of esophageal cancer (e.g., ESCC). CRAC channel modulators may be administered as first line therapy or as second line therapy.

Another embodiment is a method of treating esophageal cancer in a subject comprising administering to the subject an effective amount of a CRAC channel modulator. In one embodiment, the CRAC channel modulator is a CRAC channel inhibitor.

A preferred embodiment is a method of treating esophageal cancer in a subject (preferably a human subject), comprising administering to the subject (preferably a human subject) an effective amount of compound (a) or a pharmaceutically acceptable salt thereof.

Yet another embodiment is a method of modulating CRAC channels in a subject (preferably a human subject) with esophageal cancer by administering an effective amount of a CRAC channel modulator to the subject. In a preferred embodiment, the CRAC channel modulator is Compound (A) or a pharmaceutically acceptable salt thereof.

Yet another embodiment is a method of inhibiting (or suppressing) proliferation of esophageal cancer metastasis cells in a subject, preferably a human subject, comprising administering to the subject an effective amount of a CRAC channel modulator, e.g., compound (a) or a pharmaceutically acceptable salt thereof.

An object of the present invention relates to the use as described herein for the treatment of a subject, in particular a human subject.

An object of the present invention is the use of compound (a) or a pharmaceutically acceptable salt thereof for the manufacture of a medicament intended for the treatment of esophageal cancer.

An object of the present invention is the use of compound (a) or a pharmaceutically acceptable salt thereof for the manufacture of a medicament intended for the treatment of esophageal cancer, wherein the medicament is intended to be administered by the oral route.

In a preferred embodiment, the esophageal cancer is Esophageal Squamous Cell Carcinoma (ESCC).

In a further embodiment, the esophageal cancer is Esophageal Adenocarcinoma (EAC).

In yet another embodiment, the subject has unresectable esophageal cancer.

In a preferred embodiment, compound (a) is administered as the hydrochloride salt of compound (a). For example, compound (a) may be administered as N- (4- (3, 5-bicyclopropyl-1H-pyrazol-1-yl) phenyl) -2- (quinolin-6-yl) acetamide hydrochloride.

CRAC channel modulators, e.g. compound (a) or a pharmaceutically acceptable salt thereof, may be administered to a subject by an oral route, intravenous route, intramuscular route, or intraperitoneal route. In a preferred embodiment, the CRAC channel modulator is administered orally.

In one embodiment, the CRAC channel modulator, e.g., compound (a) or a pharmaceutically acceptable salt thereof, is administered as a first line therapy for esophageal cancer.

In additional embodiments, the CRAC channel modulator, e.g., compound (a) or a pharmaceutically acceptable salt thereof, is administered as a second line therapy for esophageal cancer.

In yet another embodiment, in the use of CRAC channel modulators described herein, the CRAC channel modulators are used (together or sequentially administered) in combination with an anti-cancer therapy, one or more cytostatic, cytotoxic or anti-cancer agents, targeted therapy, or any combination or any of the foregoing.

In yet another embodiment, in the methods described herein, the CRAC channel modulator is used in combination (together or sequentially administered) with an anti-cancer therapy, one or more cytostatic, cytotoxic or anti-cancer agents, targeted therapy, or any combination or any of the foregoing.

Suitable anti-cancer treatments include radiation therapy. Suitable cytostatic, cytotoxic and anticancer agents include, but are not limited to: DNA interactive agents, such as cisplatin or doxorubicin; topoisomerase II inhibitors, such as etoposide; topoisomerase I inhibitors, such as CPT-11 or topotecan; a tubulin interacting agent, such as paclitaxel, docetaxel, or an epothilone (e.g., ixabepilone), natural or synthetic; hormonal agents, such as tamoxifen; thymidylate synthase inhibitors, such as 5-fluorouracil; and antimetabolites, e.g. methotrexate, other tyrosine kinase inhibitors, e.g. gefitinib (trade mark: gefitinib)) And erlotinib (also known as OSI-774)(ii) a An angiogenesis inhibitor; an EGF inhibitor; a VEGF inhibitor; a CDK inhibitor; a SRC inhibitor; c-Kit inhibitors; herl/2 inhibitors and monoclonal antibodies against growth factor receptors, such as Erbitux (EGF) and herceptin (Her2), and other protein kinase modulators.

In yet another embodiment is compound (a) or a pharmaceutically acceptable salt thereof, suitable for first line treatment of esophageal cancer.

In yet another embodiment is compound (a) or a pharmaceutically acceptable salt thereof, suitable for use in the second line treatment of unresectable esophageal cancer.

In yet another embodiment suitable for use in inhibiting (or suppressing) proliferation of metastatic cells of esophageal cancer is compound (a) or a pharmaceutically acceptable salt thereof.

In yet another embodiment is a pharmaceutical composition for the treatment of esophageal cancer comprising a CRAC channel modulator, e.g. a CRAC channel inhibitor, preferably compound (a) or a pharmaceutically acceptable salt thereof, optionally together with one or more pharmaceutically acceptable carriers or excipients.

In a preferred embodiment, the CRAC channel modulator is the hydrochloric acid (HC1) salt of Compound (A).

In one embodiment, the pharmaceutical composition further comprises one or more cytostatic, cytotoxic or anticancer agents.

In one embodiment, the pharmaceutical composition is used in combination with one or more anti-cancer treatments, one or more cytostatic, cytotoxic or anti-cancer agents, targeted therapy, or any combination or any one of the foregoing. The CRAC channel modulators may be used with one or more anti-cancer treatments, one or more cytostatic, cytotoxic or anti-cancer agents, targeted therapies, or any combination or sequence of the foregoing.

In a preferred embodiment, the pharmaceutical composition is suitable for oral administration. In a more preferred embodiment, the CRAC channel modulator in the pharmaceutical composition for oral administration is the hydrochloride salt of compound (a).

In further embodiments, compound (a) or a pharmaceutically acceptable salt thereof is administered at a dose of 25 to 1000mg, more preferably at a dose of 25 to 800mg, 25 to 600mg, 25 to 400mg, or 25 to 200 mg.

In yet another embodiment, compound (a) or a pharmaceutically acceptable salt thereof is administered at a dose of 50 to 1000mg, more preferably at a dose of 50 to 800mg, 50 to 600mg, 50 to 400mg, or 50 to 200 mg.

In a preferred embodiment, compound (a) or a pharmaceutically acceptable salt thereof is administered at a dose of 100 to 1000mg, more preferably at a dose of 100 to 800mg, 100 to 600mg, 100 to 400mg or 100 to 200 mg.

In a further embodiment, compound (a) or a pharmaceutically acceptable salt thereof is administered at a dose of 25 to 1000mg per day, preferably at a dose of 50 to 500mg per day, more preferably at a dose of 100 to 400mg per day.

Compound (a) or a pharmaceutically acceptable salt thereof is administered in a single dose or divided dose.

In additional embodiments, compound (a) or a pharmaceutically acceptable salt thereof is administered once daily.

In yet another embodiment, compound (a) or a pharmaceutically acceptable salt thereof is administered twice daily.

Brief Description of Drawings

Figure 1A is a graph of anti-tumor activity as measured by tumor volume as described in example 2 of compound a, compared to vehicle.

Figure 1B is a graph of the antitumor activity as measured by tumor weight as described in example 2 of compound a compared to vehicle.

Detailed Description

Definition of

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood in the art to which the subject matter belongs. If there are multiple definitions of terms herein, the definitions in this section prevail. Where a URL or other such identifier or address is mentioned, it will be appreciated that such identifiers will typically change and particular information on the internet comes and goes, but equivalent information can be found by searching the internet. Reference thereto demonstrates the availability and public dissemination of such information.

It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of any subject matter. In this application, the use of the singular includes the plural unless specifically stated otherwise. It must be noted that, as used in the specification, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise. In this application, the use of "or" means "and/or" unless stated otherwise. Furthermore, the use of the terms "including" and other forms, such as "comprises," "comprising," and "having," are not limiting.

Definitions OF standard chemical and MOLECULAR biological terms can be found in reference works, including, but not limited to, Careyand Sundberg "ADVANCED ORGANIC CHEMISTRY 4th edition" Vols.A (2000) and B (2001), Plenum Press, New York and "MOLECULAR BIOLOGY OF THE CELL 5th edition" (2007), Garland Science, New York. Unless otherwise indicated, conventional methods of mass spectrometry, NMR, HPLC, protein chemistry, biochemistry, recombinant DNA techniques, and pharmacology are within the scope of the embodiments disclosed herein.

Unless specific definitions are provided, the terms related to analytical chemistry and pharmaceutical chemistry and laboratory procedures and techniques described herein are terms that are commonly used. In some embodiments, standard techniques are used for chemical analysis, drug preparation, formulation and delivery, and patient treatment. In other embodiments, standard techniques are used for recombinant DNA, oligonucleotide synthesis, and tissue culture and transformation (e.g., electroporation, lipofection). In certain embodiments, for example, the reaction and purification techniques are performed using a manufacturer-specified kit or as described herein. The foregoing techniques and processes are generally performed by conventional methods and are described in various general and more specific references that are cited and discussed throughout this specification.

Additionally, the CRAC channel modulators described herein, including compound (a) and pharmaceutically acceptable salts thereof, include compounds that differ only in the presence of one or more isotopically enriched atoms, for example, replacement of hydrogen with deuterium.

The term "subject" or "patient" includes mammals and non-mammals. Examples of mammals include, but are not limited to, any member of the mammalian class: humans, non-human primates (e.g., chimpanzees) and other apes and monkey species; livestock, such as cattle, horses, sheep, goats, and pigs; domestic animals such as rabbits, dogs and cats; laboratory animals including rodents, such as rats, mice and guinea pigs. Examples of non-mammals include, but are not limited to, birds, fish, and the like. In a preferred embodiment of the methods, uses and compositions provided herein, the mammal is a human.

As used herein, the term "treating" includes alleviating or ameliorating a disease, disorder or condition, preventing other symptoms, ameliorating or preventing the root cause of a symptom, inhibiting a disease, disorder or condition, e.g., arresting the development of a disease, disorder or condition, ameliorating a disease, disorder or condition, causing regression of a disease, disorder or condition, ameliorating a condition caused by a disease, disorder or condition, or stopping the symptoms of a disease, disorder or condition prophylactically and/or therapeutically.

The term "first line therapy" refers to the first therapy for a disease. It is usually part of a standard set of treatments, such as chemotherapy and radiation therapy following surgery. First line therapy, when used alone, is the best accepted therapy. If it does not cure the disease or causes serious side effects, other treatments may be added or used. It is also known as induction therapy, primary therapy and primary therapy.

The term "second line therapy" refers to therapy that is performed when the initial therapy (first line therapy) is not effective enough or ceases to be effective enough.

As used herein, the term "target protein" refers to a protein or a portion of a protein that is capable of binding to or interacting with a compound described herein, e.g., a compound that is capable of modulating a STIM protein and/or an Orai protein. In certain embodiments, the target protein is a STIM protein. In other embodiments, the target protein is an Orai protein, and in other embodiments, the compound targets both STIM and Orai proteins.

The term "STIM protein" refers to any protein located in the endoplasmic reticulum or plasma membrane that activates an increase in the flow rate of calcium into cells through CRAC channels. (STIM refers to matrix interacting molecules). As used herein, "STIM protein" includes, but is not limited to, mammalian STIM-1, such as human and rodent (e.g., mouse) STIM-1, Drosophila D-STIM, C-STIM, E.gambiae, and mammalian STIM-2, such as human and rodent (e.g., mouse) STIM-2. As described herein, these proteins have been identified as involved in, and/or providing calcium entry or regulation of depot manipulation, cytoplasmic calcium buffering and/or regulation of calcium levels, entry of calcium into intracellular calcium stores (e.g., endoplasmic reticulum), movement within or from cells.

It will be understood by "activate" or "activation," which refers to the ability of STIM proteins to up-regulate, stimulate, enhance or otherwise promote calcium influx into cells through CRAC channels. It is envisaged that cross-talk between STIM proteins and CRAC channels may occur by direct or indirect molecular interactions. Suitably, the STIM protein is a transmembrane protein associated with or in close proximity to the CRAC channel.

STIM1 is known in the art as an essential component of CRAC channel activation. The inventors have observed that STIM1 and STIM2 are expressed in certain ESCC cell lines. In addition, CRACM1/Orail and CRACM3/Orai3 are overexpressed in certain ESCC cell lines. While not wishing to be bound by any particular theory, CRAC and STIM proteins may help to activate proliferative pathways in ESCC cells in the following ways: (i) excessive dysregulation of STIM in ESCC cells leads to incorrect plasma membrane accumulation of STIM, and (ii) on the plasma membrane, STIM activates CRAC (through direct or indirect interactions), resulting in excessive calcium influx into the cells and promoting transcription, proliferation and invasiveness of ESCC cells. Therefore, inhibition of the CRAC channel or STIM pathway is an effective treatment for ESCC.

As used herein, "Orai protein" includes Orai (SEQ ID NO: 1 as described in WO 07/081,804), Orai2 (SEQ ID NO: 2 as described in WO 07/081,804), or Orai3 (SEQ ID NO: 3 as described in WO 07/081,804). The Orail nucleic acid sequence corresponds to GenBank accession No. NM-032790, the Orai2 nucleic acid sequence corresponds to GenBank accession No. BC069270 and the Orai3 nucleic acid sequence corresponds to GenBank accession No. NM-152288. As used herein, Orai refers to any Orai gene, such as Orail, Orai2 and Orai3 (see table 1 in WO 07/081,804). As described herein, these proteins have been identified as involved in, and/or providing calcium entry or regulation of depot manipulation, cytoplasmic calcium buffering and/or regulation of calcium levels, entry of calcium into intracellular calcium stores (e.g., endoplasmic reticulum), movement within or from cells. In alternative embodiments, the Orai protein may be tagged with a tag molecule, by way of example only, an enzyme fragment, a protein (e.g., c-myc or other tag protein or fragment thereof), an enzyme tag, a fluorescent tag, a fluorophore tag, a chromophore tag, a raman-activated tag, a chemiluminescent tag, a quantum dot tag, an antibody, a radioactive tag, or a combination thereof.

The term "fragment" or "derivative" when referring to a protein (e.g., STIM, Orai) refers to a protein or polypeptide that retains substantially the same biological function or activity as the native protein in at least one assay. For example, by calcium influx assay, a fragment or derivative of the reference protein preferably retains at least about 50% of the activity of the native protein, at least 75% or at least about 95% of the activity of the native protein, e.g., as determined.

As used herein, "ameliorating" refers to amelioration of a disease or disorder or at least partial alleviation of symptoms associated with a disease or disorder. As used herein, ameliorating a symptom of a particular disease, disorder, or condition by administering a particular compound or pharmaceutical composition refers to reducing any severity, delay in onset, slowing of progression, or shortening in duration, whether permanent or temporary, due to persistence or transiently associated with administration of the compound or composition.

As used herein, the term "modulate" refers to interacting with a target protein, either directly or indirectly, to alter the activity of the target protein, including, by way of example only, inhibiting the activity of the target, or limiting or reducing the activity of the target.

As used herein, the term "modulator" refers to a compound that alters the activity of a target (e.g., a target protein). For example, in some embodiments, a modulator causes an increase or decrease in the magnitude of a certain activity of a target as compared to the magnitude of the activity in the absence of the modulator. In certain embodiments, the modulator is an inhibitor that reduces the magnitude of one or more activities of the target. In certain embodiments, the inhibitor completely prevents one or more activities of the target.

As used herein, "modulation" with respect to intracellular calcium refers to any alteration or modulation of intracellular calcium, including, but not limited to, changes in calcium concentration in the cytoplasm and/or intracellular calcium storage organelles (e.g., the endoplasmic reticulum), or kinetic changes in calcium flux into, out of, and into a cell. In one aspect, modulation refers to reduction.

The terms "inhibit", "inhibit" or "inhibiting" SOC channel activity or CRAC channel activity as used herein refer to calcium channel activity that inhibits calcium channel activity or calcium release activation of storage operations.

The term "acceptable" as used herein with respect to a formulation, composition or ingredient means that there is no lasting deleterious effect on the overall health of the subject being treated.

As used herein, "pharmaceutically acceptable" refers to a material, such as a carrier or diluent, that does not eliminate the biological activity or properties of the compound and is relatively non-toxic, i.e., the material is administered to an individual without causing an adverse biological effect or interacting in a deleterious manner with any of the components of the composition in which it is contained.

Pharmaceutically acceptable salts forming part of the invention include salts derived from inorganic bases such as Li, Na, K, Ca, Mg, Fe, Cu, Zn and Mn; organic base salts such as Ν, Ν' -diacetylethylenediamine, glucosamine, triethylamine, choline, hydroxide, dicyclohexylamine, metformin, benzylamine, trialkylamine, thiamine, and the like; chiral bases, such as alkylanilines, glycols and phenylglycols, salts of natural amino acids, such as glycine, alanine, valine, leucine, isoleucine, norleucine, tyrosine, cystine, cysteine, methionine, proline, hydroxyproline, histidine, ornithine, lysine, arginine and serine; the inventionQuaternary ammonium salts of the compounds with alkyl halides, and alkyl sulfates such as Mel and (Me)₂SO₄Unnatural amino acids such as D-isomers or substituted amino acids; guanidine, substituted guanidines, wherein the substituents are selected from nitro, amino, alkyl, alkenyl, alkynyl, ammonium or substituted ammonium salts and aluminum salts. Salts may suitably include acid addition salts which are sulphate, nitrate, phosphate, perchlorate, borate, hydrohalide, acetate, tartrate, maleate, citrate, fumarate, succinate, palmitate, methanesulphonate, benzoate, salicylate, benzenesulphonate, ascorbate, glycero-phosphato-ketoglutarate. The pharmaceutically acceptable solvate may be a hydrate or comprise other crystallization solvents, such as alcohols.

The term "pharmaceutical composition" refers to a composition comprising a CRAC channel modulator with one or more other chemical components, such as carriers, stabilizers, diluents, dispersing agents, suspending agents, thickening agents, and/or excipients.

The compounds and pharmaceutical compositions of the present invention may be administered by a variety of routes of administration, including but not limited to intravenous, oral, aerosol, parenteral, ophthalmic, pulmonary and topical administration.

As used herein, the term "effective amount" or "therapeutically effective amount" refers to a sufficient amount of an agent or compound administered that will alleviate one or more symptoms of the disease or disorder being treated to some extent. The result is a reduction and/or alleviation of the signs, symptoms, or causes of disease, or any other desired alteration of a biological system. For example, an "effective amount" for therapeutic use is the amount of a compound of the present invention required to provide clinically significant relief from the symptoms of the disease. In some embodiments, a suitable "effective" amount in any case is determined using techniques such as dose escalation studies.

The term "enhance" as used herein refers to increasing or prolonging the efficacy or duration of a desired effect. Thus, with respect to enhancing the effect of a therapeutic agent, the term "enhance" refers to the ability to increase or prolong the effect of other therapeutic agents on the system in terms of efficacy or duration. As used herein, "enhancing effective amount" refers to an amount sufficient to enhance the effect of another therapeutic agent in a desired system.

As used herein, the term "carrier" refers to a relatively non-toxic compound or agent that facilitates incorporation of the compound into a cell or tissue.

The term "diluent" refers to a compound used to dilute a compound of interest prior to delivery. In some embodiments, diluents are used to stabilize the compounds because they provide a more stable environment. Salts dissolved in buffered solutions (which may also provide control or maintenance of pH) may be used as diluents, including but not limited to phosphate buffered saline solutions.

As used herein, "intracellular calcium" refers to calcium that is located in a cell without a specific cellular location. Conversely, "cytosolic" or "cytosolic" with respect to calcium refers to calcium located in the cytoplasm of the cell.

As used herein, an effect on intracellular calcium is any alteration in any aspect of intracellular calcium, including but not limited to alterations in intracellular calcium levels and the location and movement of calcium into or out of a cell or intracellular calcium storage or organelle. For example, in some embodiments, the effect on intracellular calcium is a change in a property of calcium flux or movement, such as kinetics, sensitivity, rate, amplitude, and electrophysiological properties, that occurs in a cell or portion thereof. In some embodiments, the effect on intracellular calcium is an alteration in any intracellular calcium regulation process, including calcium entry for depot manipulation, cytosolic calcium buffering, and calcium level entry or exit into, and mobilization in, or within the intracellular calcium reservoir. Any of these aspects may be assessed in a variety of ways, including but not limited to assessment of calcium or other ion (particularly cation) levels, movement of calcium or other ion (particularly cation), fluctuations in calcium or other ion (particularly cation) levels, kinetics of calcium or other ion (particularly cation) flux and/or transport of calcium or other ion (particularly cation) through the membrane. A change is any change of statistical significance. Thus, for example, in some embodiments, if it is said that intracellular calcium is different in the test cell and the control cell, then such difference is a statistically significant difference.

Modulation of intracellular calcium is any alteration or modulation of intracellular calcium, including but not limited to alteration of calcium concentration or level in the cytoplasm and/or intracellular calcium storage organelles (e.g., endoplasmic reticulum), alteration of cellular entry or exit into or out of the cell or movement of calcium in intracellular calcium storage or organelles, alteration of calcium location within the cell, and alteration of the kinetics or other properties of calcium flux ingress, egress and entry into the cell. In some embodiments, intracellular calcium modulation involves altering or modulating, for example, reducing or inhibiting depot-manipulated calcium entry, cytosolic calcium buffering, intracellular calcium depot or intracellular calcium levels or calcium mobilization within, outside or within an organelle, and/or basal or quiescent cytosolic calcium levels. Modulation of intracellular calcium involves alteration or modulation of receptor-mediated ion (calcium) movement, second messenger-manipulated ion (calcium) movement, calcium influx or efflux into the cell, and/or ion (calcium) uptake or release into intracellular compartments, including, for example, endosomes and lysosomes.

As used herein, with respect to the relationship between a protein and intracellular calcium or aspects of intracellular calcium regulation, "engage" refers to a simultaneous or correlated reduction, alteration or elimination of one or more aspects of intracellular calcium or intracellular calcium regulation when the expression or activity of the protein in a cell is reduced, altered or eliminated. Such changes or decreases in expression or activity occur due to changes in expression of the gene encoding the protein or by altering the level of the protein. Thus, a protein involved in an aspect of intracellular calcium, e.g., calcium entry for depot manipulation, is a protein that provides or participates in an aspect of intracellular calcium or intracellular calcium regulation. For example, the protein providing calcium access for storage operations is a STIM protein and/or an Orai protein.

As used herein, a protein that is a component of a calcium channel is a protein that participates in the formation of a multi-protein complex of the channel.

As used herein, "cation entry" or "calcium entry" refers to entry of a cation, such as calcium, into an intracellular location, such as the cytoplasm of a cell, or into the lumen of an intracellular organelle or storage site. Thus, in some embodiments, cation entry is, for example, the process of cation entry into the cytoplasm from the extracellular medium or intracellular organelles or storage sites, or the process of cation entry into intracellular organelles or storage sites from the cytoplasm or extracellular medium. The movement of calcium from intracellular organelles or storage sites into the cytoplasm is also referred to as "liberating calcium" from the organelles or storage sites.

As used herein, "immune cell" includes cells of the immune system and cells that perform a function or activity in an immune response, such as, but not limited to, T cells, B cells, lymphocytes, macrophages, dendritic cells, neutrophils, eosinophils, basophils, mast cells, plasma cells, leukocytes, antigen presenting cells, and natural killer cells.

"calcium entry for depot operation" or "SOCE" refers to a mechanism by which the release of calcium ions from intracellular reservoirs is coordinated with ion influx across the plasma membrane.

Cellular calcium homeostasis is the result of the sum of regulatory systems involved in intracellular calcium levels and motor control. Cellular calcium homeostasis is achieved, at least in part, by calcium binding and movement of calcium through the cell membranes of intracellular organelles (including, e.g., endoplasmic reticulum, sarcoplasmic reticulum, mitochondria and endocytic organelles, including endosomes and lysosomes) through the plasma membrane into and out of the cell and within the cell.

The movement of calcium across cell membranes is accomplished by specialized proteins. For example, calcium from the extracellular space enters the cell through various calcium channels and sodium/calcium exchangers and is actively expressed from the cell by calcium pumps and sodium/calcium exchangers. Calcium is also released from internal stores via inositol triphosphate or ranoladine receptors and may be taken up by these organelles via calcium pumps.

Calcium enters cells through any of several conventional channels, including but not limited to Voltage Operated Calcium (VOC) channels, Storage Operated Calcium (SOC) channels, and sodium/calcium exchangers operating in reverse mode. VOC channels are activated by membrane depolarization and are found in excitatory cells such as nerves and muscles, but not in most non-excitatory cellsThere are. In some cases, Ca²⁺Also through Na⁺-Ca²⁺The exchanger enters the cell in reverse mode.

Endocytosis provides another process by which cells take up calcium from the extracellular medium through the endosome. In addition, some cells, such as exocrine cells, release calcium by exocytosis.

In mammalian cells, cytosolic calcium concentrations are tightly regulated at resting levels, usually at about 0.1. mu.M in a quiescent state, while extracellular calcium concentrations are usually about 2 mM. This tight regulation helps to conduct signals into the cell and intracellularly through transient calcium fluxes across the plasma membrane and intracellular organelle membranes. There are a variety of intracellular calcium transport and buffering systems in cells that can be used to shape intracellular calcium signals and maintain low resting cytoplasmic calcium concentrations. In quiescent cells, the main components that maintain basal calcium levels are the calcium pump and the leakage of the endoplasmic reticulum and plasma membrane. Disturbances in quiescent cytosolic calcium levels affect the transmission of such signals and cause defects in many cellular processes. For example, cell proliferation involves prolonged calcium signaling sequences. Other cellular processes include, but are not limited to, secretion, signaling and fertilization, involving calcium signaling.

Production of cytosolic Ca from intracellular and extracellular sources by phospholipase C (PLC) -activating cell surface receptors²⁺A signal. [ Ca ]²⁺]The initial transient increase in i (intracellular calcium concentration) is the release of Ca from the Endoplasmic Reticulum (ER)²⁺This is caused by the PLC product inositol 1,4, 5-triphosphate (P3), opening the IP3 receptor in the ER (Streb et al nature 306,67-69,1983). Then, Ca passes through calcium ion (SOC) channels exclusively stored in the plasma membrane (for immune cells, SOC channels are calcium-releasing activated calcium (CRAC) channels), Ca²⁺The next stage of sustained access to the plasma membrane ensues. Ca for storage operation²⁺Entry (SOCE) is a process in which Ca is present²⁺Depletion of the reservoir itself activates Ca in the plasma membrane²⁺Channels to help refill the memory banks (Putney, Cell Calcium,7,1-12,1986; Parekh et al, Physiol. Rev.757-810; 2005). SOCE not only provides simple Ca²⁺For supplementing storage, also fromProduce sustained Ca²⁺Signals to control essential functions such as gene expression, cellular metabolism and exocytosis (Parekh and Putney, Physiol. Rev.85,757-810 (2005)).

In lymphocytes and mast cells, activation of antigens or Fc receptors results in Ca²⁺Is released from intracellular storage, resulting in Ca²⁺Flows in through CRAC channels in the plasma membrane. Subsequent intracellular Ca²⁺The elevation of (a) activates calcineurin, a phosphatase that regulates the transcription factor NFAT. In quiescent cells, NFAT is phosphorylated and resides in the cytoplasm, but when dephosphorylated by calcineurin, NFAT will translocate to the nucleus and activate different genetic programs depending on the stimulation conditions and cell type. To combat infection and transplant rejection, NFAT binds to the transcription factor AP-1(Fos-Jun) in the nucleus of "effector" T cells, thereby activating cytokine genes, genes that regulate T cell proliferation, and other genes that coordinate active immune responses (Rao et al, Annu Rev Immunol, 1997; 15: 707-47). In contrast, in T cells that recognize autoantigens, NFAT is activated in the absence of AP-1 and activates a Transcriptional program called "anergy" that suppresses the autoimmune response (Macian et al, transcription mechanisms underslung lymphocyte cancer. cell.2002Jun.14; 109(6): 719-31). In a sub-class of T-cells called regulatory T-cells, N-cells suppress autoimmunity mediated by autoreactive effector T-cells, NFAT binds to the transcription factor FOXP3 to activate genes responsible for inhibitory function (Wu et al, Cell,2006 Jul.28; 126(2): 375-87; Rudensky AY, Gavin M, Zheng Y.cell.2006Jul.28; 126(2): 253-.

The Endoplasmic Reticulum (ER) performs various processes. ER is both agonist sensitive Ca²⁺The reservoir, again the reservoir, the folding/processing of the protein takes place within its cavity. Here, much depends on Ca²⁺The chaperones of (a) ensure that the newly synthesized protein is correctly folded and sent to the appropriate destination. ER is also involved in vesicle trafficking, releasing stress signals, regulating cholesterol metabolism and apoptosis. Many of these processes require intraluminal Ca²⁺And elimination of Ca for a long time²⁺ER ofProtein misfolding, endoplasmic reticulum stress response, and apoptosis may be induced. Due to its function as Ca²⁺Apparently, ER Ca²⁺The content must be reduced after stimulation. However, to maintain the functional integrity of ER, it is critical that Ca be present²⁺The content is not reduced too low or kept at a low level. Thus, Ca²⁺ER supplementation is an important process in all eukaryotic cells. Due to ER Ca²⁺The decrease in the content activates the storage operation Ca in the plasma membrane²⁺Channels, therefore the Ca²⁺The major function of the entry pathway is believed to be maintenance of ER Ca²⁺Which is necessary for proper protein synthesis and folding. However, store operated Ca²⁺The channels have other important roles.

Electrophysiological studies provide an understanding of calcium entry for storage operations, which confirm that the process of emptying storage activates Ca in mast cells²⁺Electric current, called Ca²⁺Release of activated Ca²⁺Current or ICRAC. ICRAC is non-voltage activated, commutates inward, and is specific to Ca²⁺Has remarkable selectivity. It is found in several cell types of major hematopoietic origin. ICRAC is not the only current of a memory operation, and it is now clear that the inrush of a memory operation covers a range of Ca' s²⁺Permeable channels, with different properties in different cell types. ICRAC is Ca for the first described storage operation²⁺Current, and still a popular model to study the inflow of memory operations.

Methods of treatment and uses

In the methods of treatment and uses described herein, one or more additional active agents may be administered with compound (a) or a pharmaceutically acceptable salt thereof. For example, compound (a) or a pharmaceutically acceptable salt thereof may be used in combination (administered together or sequentially) with one or more anticancer therapies, such as chemotherapy, radiotherapy, biotherapy, bone marrow transplantation, stem cell transplantation or any other anticancer therapy, or one or more cytostatic, cytotoxic or anticancer agents or targeted therapies, whether alone or in combination, such as, but not limited to, for example, DNA cross-referencing(ii) an agonist, such as fludarabine, cisplatin, chlorambucil, bendamustine or doxorubicin; alkylating agents, such as cyclophosphamide; topoisomerase II inhibitors, such as etoposide; topoisomerase I inhibitors such as CPT-11 or topotecan; a tubulin interacting agent, such as paclitaxel, docetaxel or an epothilone (e.g., ixabepilone), natural or synthetic; hormonal agents, such as tamoxifen; thymidylate synthase inhibitors, such as 5-fluorouracil; antimetabolites, such as methotrexate; other tyrosine kinase inhibitors such as gefitinib (labeled as Gefitinib)) And erlotinib (also known as OSI-774); an angiogenesis inhibitor; an EGF inhibitor; a VEGF inhibitor; a CDK inhibitor; a SRC inhibitor; c-Kit inhibitors; herl/2 inhibitors, checkpoint kinase inhibitors and monoclonal antibodies against growth factor receptors, such as Erbitux (EGF) and herceptin (Her 2); CD20 monoclonal antibodies such as rituximab, ublixumab (TGR-1101), ofatumumab (HuMax; Intracel), ocrelizumab, veltuzumab, GA101(obinutuzumab), ocartatuzumab (AME-133v, LY2469298, Applied Molecular Evolution, Mentrik Biotech), PR0131921, tositumomab, Vituzumab (hA-20, Immunomedics, Inc.), ibrituitant-tiuxetan, BLX-301(Biolex Therapeutics), Reditux (Dr. Reddy's laboratories), PRO70769 (described in WO 2004/056312); other B-cell targeting monoclonal antibodies such as belimumab, atacicept or fusion proteins such as blinibimod and BR3-Fc, other monoclonal antibodies such as alemtuzumab and other protein kinase modulators.

The methods of treatment and uses described herein also include the use of one or more additional active agents administered with compound (a) or a pharmaceutically acceptable salt thereof. Such as CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone); R-CHOP (rituximab-CHOP); large CVAD (high dose cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate, cytarabine); r-large CVAD (rituximab-large CVAD); FCM (fludarabine, cyclophosphamide, mitoxantrone); R-FCM (Rituximab, fludarabine, cyclophosphamide, mitoxantrone); bortezomib and rituximab; instead ofSirolimus and rituximab; tesirolimus and bortezomibIodine-131 tositumomabAnd CHOP; CVP (cyclophosphamide, vincristine, prednisone); R-CVP (rituximab-CVP); ICE (ifosfamide, carboplatin, etoposide); R-ICE (Rituximab-ICE); FCR (fludarabine, cyclophosphamide, rituximab); FR (fludarabine, rituximab); pace (dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, etoposide).

CRAC modulators, including compound (a) and pharmaceutically acceptable salts thereof, may also be used in combination (together or sequentially) with one or more steroidal anti-inflammatory drugs, non-steroidal anti-inflammatory drugs (NSAIDs) or immunoselective anti-inflammatory derivatives (ImSAIDs).

According to the invention, CRAC channel modulators, such as Compound (A) or a pharmaceutically acceptable salt thereof, may also be administered in combination with one or more other active ingredients useful in one of the pathologies mentioned above, such as antiemetic, analgesic, anti-inflammatory or anti-cachexia agents.

CRAC channel modulators, such as Compound (A) or a pharmaceutically acceptable salt thereof, may also be combined with radiation therapy.

CRAC channel modulators, such as Compound (A) or a pharmaceutically acceptable salt thereof, may also be combined with surgery, including pre-surgery, post-surgery, or during surgery.

These treatments may be administered simultaneously, separately, sequentially and/or at timed intervals.

CRAC modulators

CRAC modulators may be any known in the art, such as those described in international publication No. WO2011/042798, which is incorporated herein by reference. CRAC modulators (e.g., compound (a) or pharmaceutically acceptable salts thereof) may inhibit calcium ion-manipulated calcium ion entry, interrupt assembly of SOCE units, alter functional interactions of proteins forming calcium ion-manipulated calcium channel complexes, and alter functional interactions of STIM1 with Orail. The CRAC channel modulator is an SOC channel pore blocker and is a CRAC channel pore blocker.

The compounds described herein modulate intracellular calcium and are useful in the treatment of diseases, disorders, or conditions in which modulating intracellular calcium has a beneficial effect. In one embodiment, the compounds of the invention described herein inhibit calcium entry in storage operations. In one embodiment, the compounds of the invention capable of modulating intracellular calcium levels interrupt assembly of SOCE units. In another embodiment, a compound of the invention capable of modulating intracellular calcium levels alters the functional interaction of proteins that form stored calcium channel complexes. In one embodiment, the compounds of the invention capable of modulating intracellular calcium levels alter the functional interaction of STIM1 with Orail. In other embodiments, the compounds of the invention capable of modulating intracellular calcium levels are SOC channel pore blockers. In other embodiments, the compounds of the invention capable of modulating intracellular calcium levels are CRAC channel pore blockers.

In one aspect, the compounds capable of modulating intracellular calcium levels of the present invention inhibit electrophysiological current (ISOC) directly associated with activated SOC channels. In one aspect, compounds capable of modulating intracellular calcium levels inhibit the electrophysiological current (ICRAC) directly associated with activated CRAC channels.

Compound (A) (N- [4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl ] -2- (quinolin-6-yl) acetamide) and salts thereof may be prepared as described in International publication No. WO 2011/042798.

Compound (a) and salts thereof modulate the activity of, interact with or bind to or interact with at least a portion of a protein in a storage-manipulated calcium channel complex. In one embodiment, the compounds of the invention described herein modulate the activity of, interact with, bind to, or interact with at least a portion of a protein in a calcium release activated calcium channel complex. In one embodiment, the compounds of the invention described herein reduce the level of calcium channel complexes for functional storage procedures. In another embodiment, the compounds of the invention described herein reduce the level of activated storage-manipulated calcium channel complexes. In another embodiment, the calcium channel complex of the depot operation is a calcium release activated calcium channel complex.

Pharmaceutical composition

The pharmaceutical composition may comprise a CRAC channel modulator, preferably a CRAC channel inhibitor, e.g. compound (a) or a pharmaceutically acceptable salt thereof, and optionally one or more pharmaceutically acceptable carriers or excipients.

In one embodiment, the pharmaceutical composition includes a therapeutically effective amount of a CRAC channel modulator, e.g., compound (a) or a pharmaceutically acceptable salt thereof. The pharmaceutical composition may comprise one or more of the other active ingredients described herein.

The pharmaceutical carrier and/or excipient may be selected from diluents, fillers, salts, disintegrants, binders, lubricants, glidants, wetting agents, controlled release matrices, colorants, flavoring agents, buffering agents, stabilizers, solubilizers, and any combination of any of the foregoing.

The pharmaceutical compositions may be administered alone or in combination with one or more other active agents. Where desired, one or more CRAC channel modulators and one or more other agents may be mixed into the formulation, or the two components may be formulated as separate formulations for separate or simultaneous use.

The pharmaceutical composition may be administered together with one or more other active agents or in a sequential manner. Where desired, the CRAC channel modulator and other agent may be co-administered, or the two components may be administered sequentially to be used in combination.

The CRAC channel modulators and pharmaceutical compositions described herein may be administered by any route capable of delivering the CRAC channel modulator to the site of action, such as, for example, orally, intranasally, topically (e.g., transdermally), intraduodenally, parenterally (e.g., including intravenously, intraarterially, intramuscularly, intravascularly, intraperitoneally, or by injection or infusion), intradermally, intralactically, intrathecally, intraocularly, retrobulbally, intrapulmonary (e.g., aerosolized drugs), or subcutaneously (including long-term release long-acting drugs, such as buried in the splenic sac, brain, or under the cornea), sublingually, anally, rectally, vaginally, or by surgical implantation (buried under the splenic sac, brain, or cornea).

The pharmaceutical compositions may be administered in solid, semi-solid, liquid or gaseous form, or may be administered in a dry powder, e.g., lyophilized form. Pharmaceutical compositions can be packaged in forms convenient for delivery, including, for example, solid dosage forms such as capsules, sachets, cachets, gelatin, paper, tablets, suppositories, pills, lozenges and troches. The type of packaging generally depends on the desired route of administration. Implantable sustained release formulations, such as transdermal formulations, are also contemplated.

The pharmaceutical compositions may be in a form suitable for oral administration, such as tablets, capsules, pills, powders, sustained release formulations, solutions, suspensions, parenteral injections for sterile form, suspensions or emulsions, for topical administration in ointments or creams, or for rectal administration in the form of suppositories. The pharmaceutical composition may be in unit dosage form suitable for single administration of precise dosages.

Oral Solid dosage forms are generally described in Remingtons Pharmaceutical Sciences,20th ed., Lippincott Williams & Wilkins, 2000, Chapter 89, "Solid materials for inclusion, capsules, piles, troches or lozenges, and cachets or pelles". Likewise, liposomes or proteoid encapsulation can be used to formulate compositions (e.g., proteoid microspheres as reported in U.S. Pat. No. 4,925,673). Liposome encapsulation can include liposomes derivatized with various polymers (e.g., U.S. Pat. No. 5,013,556). The pharmaceutical compositions may comprise CRAC channel modulators and inert ingredients that prevent degradation in the stomach and allow release of the biologically active substance in the intestine.

The amount of CRAC channel modulator (e.g., compound (a) or a pharmaceutically acceptable salt thereof) administered will depend on the mammal being treated, the severity of the disease or condition, the rate of administration, the configuration of the compound and the discretion of the prescribing physician. However, an effective dose is in the range of about 0.001 to about 100mg per kilogram of body weight per day, preferably about 1 to about 35 mg/kg/day, in single or divided doses. For a 70 kg body weight person, this would correspond to about 0.05 to 7 g/day, preferably about 0.05 to about 2.5 g/day. An effective amount of a compound of the present invention may be administered in a single or multiple doses (e.g., twice or three times a day).

As used herein, the terms "co-administration," "co-administration with … …," and grammatical equivalents thereof, include the administration of two or more drugs to a subject such that both drugs and/or metabolites thereof are present in the animal at the same time. Co-administration includes simultaneous administration in separate compositions, administration at different times in separate compositions or administration in a composition where both agents are present.

More preferably, the CRAC channel modulator is compound (a) or a pharmaceutically acceptable salt thereof. In a preferred embodiment, compound (A) is in the form of its hydrochloride salt, for example N- [4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl ] -2- (quinolin-6-yl) acetamide hydrochloride. For example, in one embodiment, the pharmaceutical composition comprises N- [4- (3, 5-dicyclopropyl-lH-pyrazol-l-yl) phenyl ] -2- (quinolin-6-yl) acetamide hydrochloride.

Another embodiment of the present invention relates to a method of treating esophageal cancer, comprising administering to a subject (preferably, a human subject) in need thereof a therapeutically effective amount of a pharmaceutical composition described herein.

Another embodiment of the invention relates to the use of a pharmaceutical composition as described herein for the manufacture of a medicament for the treatment of esophageal cancer, such as Esophageal Squamous Cell Carcinoma (ESCC) or Esophageal Adenocarcinoma (EAC).

The following general methodology described herein provides means and processes for using CRAC channel modulators and is illustrative and not limiting. Further modifications of the provided method, as well as additional novel methods, can also be devised in order to achieve and attain the objectives of the present invention. It is therefore to be understood that other embodiments may exist which fall within the spirit and scope of the invention as defined by the description.

Route of administration

In the methods and uses according to the present invention, CRAC channel modulators and pharmaceutical compositions may be administered by a variety of routes. For example, the CRAC channel modulators and pharmaceutical compositions may be administered by injection, or by oral, nasal, transdermal or other forms of administration, including, for example, by intravenous, intradermal, intramuscular, intramammary, intraperitoneal, intrathecal, intraocular, retrobulbar, intrapulmonary (e.g., aerosolized drugs) or subcutaneous injection (including depot administration for long-term release, buried under spleen capsules, cerebral or corneal), by sublingual, anal or vaginal administration, or by surgical implantation, buried under spleen capsules, brain or cornea. The treatment may consist of a single dose or multiple doses over a period of time. In general, the methods of the invention include administering an effective amount of a CRAC channel modulator along with one or more pharmaceutically acceptable diluents, preservatives, solubilizers, emulsifiers, adjuvants and/or carriers as described above.

The invention will now be further illustrated by means of biological examples.

Examples

Biological evaluation demonstrated the effect of compound (a) on esophageal cancer.