Leuprolide acetate compositions and methods of using the same to treat breast cancer
Compositions and methods for suppressing ovarian function in subjects with hormone receptor-positive breast cancer.
1. A method of suppressing ovarian function during treatment of hormone receptor-positive breast cancer in a subject comprising
subcutaneously administering to the subject in need thereof about every three months a therapeutically effective amount of a flowable, extended release composition comprising
a) N-methyl-2-pyrrolidone,
b) leuprolide or a pharmaceutically acceptable salt thereof, present in an amount to provide about 26 mg to about 30 mg of a free base equivalent of leuprolide, and
c) a biodegradable polymer comprising co-polymer segments of poly (lactide-co-glycolide) (PLG), wherein a molar ratio of lactide to glycolide monomers is about 75:25, wherein the biodegradable polymer has substantially no titratable carboxylic acid groups, and wherein at least one distal end group of the biodegradable polymer is hydroxyl-terminated, and
wherein upon contact of the flowable, extended release composition with a bodily fluid, the organic solvent dissipates and an in situ solid or semi-solid depot forms.
2. The method of claim 1 , wherein the hormone receptor positive breast cancer is human epidermal growth factor receptor 2 (HER2)-negative breast cancer.
3. The method of claim 1 , wherein the subject is a premenopausal woman.
4. The method of claim 1 , comprising administering the flowable, extended release composition concurrently with another therapeutic treatment for breast cancer.
5. The method of claim 4 , wherein the another therapeutic treatment is one or more of an endocrine therapy, chemotherapy, and radiotherapy.
6. The method of claim 5 , wherein the another therapeutic treatment is an endocrine therapy comprising administering one or more of a selective estrogen receptor modulator (SERM), a selective estrogen receptor degrader (SERD), and an aromatase inhibitor (AI).
7. The method of claim 6 , wherein the selective estrogen receptor modulator is tamoxifen.
8. The method of claim 6 , wherein the aromatase inhibitor is one or more of letrozole, anastrozole, and exemestane.
9. The method of claim 1 , wherein administration of the flowable, extended release composition suppresses the subject's mean serum luteinizing hormone (LH) level.
10. The method of claim 1 , wherein administration of the flowable, extended release composition suppresses the subject's estradiol level to less than about 20 pg/mL.
11. The method of claim 1 , wherein administration of the flowable, extended release composition suppresses the subject's follicle stimulating hormone (FSH) level to less than about 40 IU/L.
12. The method of claim 1 , wherein the biodegradable polymer has a weight average molecular weight of from about 15 kDa to about 45 kDa.
13. The method of claim 12 , wherein the weight average molecular weight is from about 17 kDa to about 21 kDa.
14. The method of claim 1 , wherein the biodegradable polymer is present in an amount from about 35 wt % to about 60 wt % of the flowable, extended release composition.
15. The method of claim 1 , wherein the biodegradable polymer has a formula
HO—(P)—C(═O)O—Ra—O(O═)C—(P)—OH
wherein Ra is an alkane diradical comprising about 4 to about 8 carbons and P is a polymeric segment comprising units of lactide, glycolide, or (lactide-co-glycolide).
16. The method of claim 1 , wherein the flowable, extended release composition comprises from about 28 mg to about 32 mg of leuprolide acetate.
17. The method of claim 16 , wherein the flowable, extended release composition comprises about 30 mg of leuprolide acetate.
18. The method of claim 17 , wherein the in situ solid or semi-solid depot releases about 10 mg of leuprolide acetate per month into the subject.
19. The method of claim 1 , wherein the in situ solid or semi-solid depot exhibits an approximately linear release of leuprolide or the pharmaceutically acceptable salt or analog thereof over about 90 days after a post-dose plasma concentration burst into the subject.
20. The method of claim 17 , wherein administration of the flowable, extended release composition results in an Area Under the Curve (AUC) of leuprolide acetate in the subject between about 10 day·ng/mL and about 225 day·ng/mL.