Estrogen receptor ligands and methods of use thereof
The present invention relates to methods for reducing testosterone levels in a male subject and methods of treating, suppressing, reducing the incidence, reducing the severity, or inhibiting prostate cancer, advanced prostate cancer, castration resistant prostate cancer (CRPC), metastatic castration resistant prostate cancer (mCRPC), and methods of reducing high or increasing PSA levels and/or increasing SHBG levels in a subject suffering from prostate cancer, advanced prostate cancer, castration resistant prostate cancer (CRPC) and metastatic castration resistant prostate cancer (mCRPC). The compounds of this invention suppress free or total testosterone levels despite castrate levels secondary to ADT and reduce high or increasing PSA levels. This reduction in testosterone levels may be used to treat prostate cancer, advanced prostate cancer, CRPC and mCRPC without causing bone loss, decreased bone mineral density, increased risk of bone fractures, increased body fat, hot flashes and/or gynecomastia.
1. A method of treating, suppressing, reducing the incidence of, reducing the severity of, or inhibiting the progression of castration resistant prostate cancer (CRPC) and its symptoms, or increasing the overall or progression-free survival of men with castration resistant prostate cancer (CRPC) comprising administering a therapeutically effective amount of a compound of formula I, or its isomer, pharmaceutically acceptable salt, pharmaceutical product, polymorph, hydrate or any combination thereof:
wherein
Y is C(O) or CH 2 ;
R 1 and R 2 are each independently hydrogen, halogen, hydroxyl, alkoxy, cyano, nitro, CF 3 , N(R) 2 , sulfonamide, SO 2 R, alkyl, haloalkyl, aryl, O-Alk-NR 5 R 6 or O-Alk-heterocycle in which the heterocycle is a 3-7 membered substituted or unsubstituted heterocyclic ring, optionally aromatic;
R 3 and R 4 are each independently hydrogen, halogen, hydroxyalkyl, hydroxyl, alkoxy, cyano, nitro, CF 3 , NHCOR, N(R) 2 , sulfonamide, SO 2 R, alkyl, haloalkyl, aryl or protected hydroxyl;
R is alkyl, hydrogen, haloalkyl, dihaloalkyl, trihaloalkyl, CH 2 F, CHF 2 , CF 3 , CF 2 CF 3 , aryl, halogen, alkenyl, CN, NO 2 , or OH;
R 5 and R 6 are independently hydrogen, phenyl, an alkyl group of 1 to 6 carbon atoms, a 3 to 7 membered cycloalkyl, a 3 to 7 membered heterocycle, or a 5 to 7 membered aryl; or R 5 and R 6 form a 3 to 7 membered ring with the nitrogen atom to which they are attached;
j and k are each independently 1-4; and
Alk is a linear alkyl of 1-7 carbons, a branched alkyl of 1-7 carbons, or a cyclic alkyl of 3-8 carbons.
2. The method of claim 1 , wherein said compound of formula I is selected from:
3. The method of claim 1 , wherein said compound of formula I is Compound IV:
4. The method of claim 1 , wherein said subject further receives androgen deprivation therapy (ADT).
5. The method of claim 1 , wherein said method lowers the prostate specific antigen (PSA) levels.
6. The method of claim 1 , wherein said method increases the levels in serum of sex or steroidal hormone binding globulin (SHBG).
7. The method of claim 1 , wherein said method increases radiographic progression free survival (rPFS) in a subject having metastatic cancer.
8. The method of claim 1 , wherein said method increases metastasis-free survival (MFS) in a subject having non-metastatic cancer.
9. The method of claim 1 , wherein said method decreases symptomatic bone fractures in said subject.
10. The method of claim 1 , wherein said CRPC is metastatic CRPC (mCRPC).
11. The method of claim 1 , wherein said CRPC is non-metastatic CRPC (nmCRPC).
12. The method of claim 11 , wherein said nmCRPC is high-risk nmCRPC.
13. The method of claim 4 , wherein said administering of said compound reduces or ameliorates side effects associated with said androgen deprivation therapy (ADT).
14. The method of claim 13 , wherein said side effects are selected from the group consisting of: hot flashes, gynecomastia, increased body fat, bone loss, decreased bone mineral density, and increased risk of bone fracture.
15. The method of claim 1 , wherein said compound or its isomer, pharmaceutically acceptable salt, pharmaceutical product, hydrate or any combination thereof, is administered at a dose of 40 mg per day, 80 mg per day, 125 mg per day, 250 mg per day or 500 mg per day.