METHODS OF USE FOR CYCLOPAMINE ANALOGS
The invention provides methods for treating various conditions using derivatives of cyclopamine having the following formula:
1 - 21 . (canceled)
22 . A method of treating cancer of the hematopoietic system comprising administering to a patient a therapeutically effective amount of a compound of the formula:
or a pharmaceutically acceptable salt thereof, wherein:
R 1 is H, alkyl, —OR, amino, sulfonamido, sulfamido, —OC(O)R 5 , —N(R 5 )C(O)R 5 or a sugar;
R 2 is H, alkyl, alkenyl, alkynyl, aryl, cycloalkyl, nitrile, or heterocycloalkyl;
or R 1 and R 2 taken together form ═O, ═S, ═N(OR), ═N(R), ═N(NR 2 ), or ═C(R) 2 ;
R 3 is H, alkyl, alkenyl, or alkynyl;
R 4 is H, alkyl, alkenyl, alkynyl, aryl, cycloalkyl, heterocycloalkyl, aralkyl, heteroaryl, heteroaralkyl, haloalkyl, —OR, —C(O)R 5 , —CO 2 R 5 , —SO 2 R 5 , —C(O)N(R 5 )(R 5 ), —[C(R) 2 ] q —R 5 , —[(W)—N(R)C(O)] q R 5 , —[(W)—C(O)] q R 5 , —[(W)—C(O)O] q R 5 , —[(W)—OC(O)] q R 5 , —[(W)—SO 2 ] q R 5 , —[(W)—N(R 5 )SO 2 ] q R 5 , —[(W)—C(O)N(R 5 )] q R 5 , —[(W)—O] q R 5 , —[(W)—N(R)] q R 5 , —W—NR 3 + X − or —[(W)—S] q R 5 ;
wherein each W is, independently, a diradical;
each q is independently for each occurrence 1, 2, 3, 4, 5, or 6;
X − is a halide;
each R 5 is, independently, H, alkyl, alkenyl, alkynyl, aryl, cycloalkyl, heterocycloalkyl, aralkyl, heteroaryl, heteroaralkyl or —[C(R) 2 ] p —R 6 ; wherein p is 0-6; or
any two occurrences of R 5 on the same substituent can be taken together to form a 4-8 membered optionally substituted ring which contains 0-3 heteroatoms selected from N, O, S, and P;
each R 6 is independently hydroxyl, —N(R)COR, —N(R)C(O)OR, —N(R)SO 2 (R), —C(O)N(R) 2 , —OC(O)N(R)(R), —SO 2 N(R)(R), —N(R)(R), —COOR, —C(O)N(OH)(R), —OS(O) 2 OR, —S(O) 2 OR, —OP(O)(OR)(OR), —NP(O)(OR)(OR), or —P(O)(OR)(OR); and
each R is independently H, alkyl, alkenyl, alkynyl, aryl, cycloalkyl or aralkyl;
provided that when R 2 , R 3 , and R 4 are H; R 1 is not hydroxyl or a sugar; further
provided that when R 4 is hydroxyl, then R 1 is not a sugar or hydroxyl; further
provided that when R 4 is hydroxyl, then R 1 and R 2 together are not C═O.
23 . The method of claim 22 , wherein R 1 is H, —OR, amino, sulfonamido, sulfamido, OC(O)R 5 or N(R 5 )C(O)R 5 .
24 . The method of claim 22 , wherein R 1 is sulfonamido.
25 . The method of claim 22 , wherein R 2 is H or heterocycloalkyl.
26 . The method of claim 25 , wherein R 2 is H.
27 . The method of claim 22 , wherein R 3 is H.
28 . The method of claim 22 , wherein R 4 is H, alkyl, aralkyl, —[(W)—C(O)N(R)] q R 5 or —[(W)—N(R)C(O)] q R 5 .
29 . The method of claim 28 , wherein R 4 is H.
30 . The method of claim 22 , wherein said compound is epimerically pure.
31 . The method of claim 22 , wherein the compound is:
or a pharmaceutically acceptable salt thereof.
32 . The method of claim 22 , wherein the compound is:
or a pharmaceutically acceptable salt thereof.
33 . The method of claim 32 , wherein the cancer of the hematopoietic system is myeloma, leukemia or lymphoma.
34 . The method of claim 33 , wherein the myeloma is multiple myeloma.
35 . The method of claim 33 , wherein the leukemia is acute lymphatic leukemia, acute myelocytic leukemia, chronic myelocytic leukemia or chronic lymphocytic leukemia.
36 . The method of claim 33 , wherein the lymphoma is non-Hodgkin's lymphoma.
37 . The method of claim 32 , wherein the cancer of the hematopoietic system is myelodysplastic syndrome.
38 . The method of claim 32 , wherein the compound is used in combination with one or more other chemotherapeutic agent, anti-cancer agent or anti-cancer treatment.
39 . The method of claim 38 , wherein the chemotherapeutic agent is doxorubicin, dexamethasone, prednisolone, chlorambucil, methotrexate, vinblastine, bortezomib, melphalan, carmustine, cyclophosphamide, vincristine, lenalidomide, thalidomide, cytarabine, fludarabine or idarubicin.
40 . The method of claim 38 , wherein the other anti-cancer agent is a corticosteroid or an interferon.
41 . The method of claim 38 , wherein the other anti-cancer treatment is radiation or surgery.
42 . The method of claim 32 , wherein the compound is administered locally to a tumor.
43 . The method of claim 32 , wherein the compound is administered systemically.
44 . The method of claim 32 , wherein the mode of administration of said compound is inhalation, oral, intravenous, sublingual, ocular, transdermal, rectal, vaginal, topical, intramuscular, intra-arterial, intrathecal, subcutaneous, buccal, or nasal.
45 . The method claim 44 , wherein the mode of administration is oral, intravenous, or topical.
46 . The method of claim 32 , wherein the pharmaceutically acceptable salt is a hydrochloride salt.