METHODS FOR TREATING TESTICULAR AND OVARIAN ADRENAL REST TUMORS
Provided herein are compounds and pharmaceutical compositions for the prevention and treatment of testicular adrenal rest tumors (TART) or ovarian adrenal rest tumors (OART).
1 . A method of treating or preventing testicular adrenal rest tumors (TART) or ovarian adrenal rest tumors (OART), comprising administering to a subject in need thereof a corticotropin-releasing factor type-1 (CRF 1 ) antagonist or a pharmaceutically acceptable salt thereof.
2 . The method of claim 1 , wherein the subject has congenital adrenal hyperplasia (CAH).
3 . The method of claim 1 or 2 , wherein the size and/or number of the tumors is decreased or reduced.
4 . A method of treating or preventing testicular adrenal rest tumors (TART) or ovarian adrenal rest tumors (OART), comprising administering to a subject in need thereof a compound of structural Formula (I):
or a pharmaceutically acceptable salt thereof,
wherein:
R 1 and R 2 are independently ethyl or n-propyl;
R 3 is hydrogen, Cl, Br, methyl, trifluoromethyl, or methoxy; and
R 4 is hydrogen, Br, R a R b N—, methoxymethyl, n-butyl, acetamido, pyridin-4-yl, morpholin-4-yl,
R a and R b are independently hydrogen, C 1 -C 3 alkyl, H 2 NCH 2 CH 2 —, (CH 3 ) 3 COC(O)NHCH 2 CH 2 —, or CH 3 CH 2 CH 2 NHCH 2 CH 2 —.
5 . The method of claim 4 , wherein R 3 is Cl, Br, methyl, or trifluoromethyl.
6 . The method of claim 4 , wherein R 3 is Cl, Br, or methyl.
7 . The method of claim 4 , wherein R 4 is Br, R a R b N—, pyridin-4-yl, morpholin-4-yl, or
8 . The method of claim 4 , wherein R 4 is morpholin-4-yl or
9 . The method of claim 4 , wherein R 4 is hydrogen, Br, R a R b N— and R a and R b are independently C 1 -C 3 alkyl.
10 . The method of claim 4 , wherein the compound is
or a pharmaceutically acceptable salt thereof.
11 . The method of claim 4 , wherein the compound is
or a pharmaceutically acceptable salt thereof.
12 . The method of claim 4 , wherein the compound is
or a pharmaceutically acceptable salt thereof.
13 . The method of claim 4 , wherein the subject has congenital adrenal hyperplasia (CAH).
14 . The method of claim 4 or 13 , wherein the size and/or number of the tumors is decreased or reduced.
15 . The method of any one of claims 4-14 , wherein from about 5 mg to about 1000 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered to the subject.
16 . The method of any one of claims 4-15 , wherein from about 5 mg to about 25 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered to the subject.
17 . The method of any one of claims 4-15 , wherein from about 10 mg to about 400 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered to the subject.
18 . The method of any one of claims 4-15 , wherein from about 100 mg to about 600 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered to the subject.
19 . The method of any one of claims 4-15 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered at a dose of from about 5 mg/day to about 1000 mg/day is administered to the subject.
20 . The method of claim 19 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered at a dose from about 5 mg/day to about 25 mg/day is administered to the subject.
21 . The method of claim 19 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered at a dose from about 10 mg/day to about 400 mg/day is administered to the subject.
22 . The method of claim 19 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered at a dose of from about 100 mg/day to about 600 mg/day is administered to the subject.
23 . The method of any one of claims 4-22 , wherein the compound is administered orally.
24 . The method of any one of claims 4-23 , wherein the compound is formulated as a capsule or tablet.
25 . The method of any one of claims 4-24 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered in the fed state.
26 . The method of any one of claims 4-24 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered in the fasted state.
27 . The method of any one of claims 4-26 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered at least once per day.
28 . The method of any one of claims 4-27 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered at bedtime.
29 . The method of any one of claims 4-27 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered less than about 4 hours before sleep.
30 . The method of any one of claims 4-27 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered less than about 2 hours before sleep.
31 . The method of any one of claims 4-27 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered less than about 30 minutes before sleep.
32 . The method of any one of claims 4-27 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered in the evening.
33 . The method of any one of claims 4-27 , wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered at about 10 pm at night.
34 . A method of treating or preventing testicular adrenal rest tumors (TART) or ovarian adrenal rest tumors (OART), comprising administering to a subject in need thereof a pharmaceutical composition, comprising a compound of structural Formula (I) and a pharmaceutically acceptable excipient:
or a pharmaceutically acceptable salt thereof,
wherein:
R 1 and R 2 are independently ethyl or n-propyl;
R 3 is hydrogen, Cl, Br, methyl, trifluoromethyl, or methoxy; and
R 4 is hydrogen, Br, R a R b N—, methoxymethyl, n-butyl, acetamido, pyridin-4-yl, morpholin-4-yl,
R a and R b are independently hydrogen, C 1 -C 3 alkyl, H 2 NCH 2 CH 2 —, (CH 3 ) 3 COC(O)NHCH 2 CH 2 —, or CH 3 CH 2 CH 2 NHCH 2 CH 2 —.
35 . The method of claim 31 , wherein the compound of Formula (I) has the structure:
or a pharmaceutically acceptable salt thereof.
36 . The method of claim 31 or 32 , wherein the pharmaceutical composition comprises from about 5 mg to about 1000 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof.
37 . The method of any one of claims 34-36 , wherein the pharmaceutical composition comprises from about 5 mg to about 25 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof.
38 . The method of any one of claims 34-36 , wherein the pharmaceutical composition comprises from about 10 mg to about 400 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof.
39 . The method of any one of claims 34-36 , wherein the pharmaceutical composition comprises from about 100 mg to about 600 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof.
40 . The method of any one of claims 34-36 , wherein the pharmaceutical composition comprises about 5 mg, about 10 mg, about 15 mg, about 20 mg, 25 mg, about 50 mg, about 100 mg, about 150 mg, about 200 mg, about 205 mg, about 210 mg, about 215 mg, about 220 mg, about 225 mg, about 230 mg, about 235 mg, about 240 mg, about 245 mg, about 250 mg, about 255 mg, about 260 mg, about 265 mg, about 270 mg, about 275 mg, about 280 mg, about 285 mg, about 290 mg, about 295 mg, about 300 mg, about 305 mg, about 310 mg, about 315 mg, about 320 mg, about 325 mg, about 330 mg, about 335 mg, about 340 mg, about 345 mg, about 350 mg, about 355 mg, about 360 mg, about 365 mg, about 370 mg, about 375 mg, about 380 mg, about 385 mg, about 390 mg, about 395 mg, about 400 mg about 500 mg, or about 600 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof.
41 . The method of any one of claims 34-36 , wherein the pharmaceutical composition is administered at a dose of from about 5 mg/day to about 1000 mg/day.
42 . The method of claim 41 , wherein the pharmaceutical composition is administered at a dose of from about 5 mg/day to about 25 mg/day.
43 . The method of claim 41 , wherein the pharmaceutical composition is administered at a dose of from about 10 mg/day to about 400 mg/day.
44 . The method of claim 41 , wherein the pharmaceutical composition is administered at a dose of from about 100 mg/day to about 600 mg/day.
45 . The method of any one of claims 34-44 , wherein the pharmaceutical composition is administered orally.
46 . The method of any one of claims 34-45 , wherein the pharmaceutical composition is formulated as capsule or a tablet.
47 . The method of any one of claims 34-46 , wherein the pharmaceutical composition is administered in the fed state.
48 . The method of any one of claims 34-46 , wherein the pharmaceutical composition is administered in the fasted state.
49 . The method of any one of claims 34-48 , wherein the pharmaceutical composition is administered at least once per day.
50 . The method of any one of claims 34-49 , wherein the pharmaceutical composition is administered at bedtime.
51 . The method of any one of claims 34-50 , wherein the pharmaceutical composition is administered less than about 4 hours before sleep.
52 . The method of any one of claims 34-51 , wherein the pharmaceutical composition is administered less than about 2 hours before sleep.
53 . The method of any one of claims 34-52 , wherein the pharmaceutical composition is administered less than about 30 minutes before sleep.
54 . The method of any one of claims 34-53 , wherein the pharmaceutical composition is administered in the evening.
55 . The method of any one of claims 34-54 , wherein the pharmaceutical composition is administered at about 10 pm at night.
56 . The method of any one of claims 1-55 , further comprising administering to the subject an additional chemotherapeutic agent.
57 . The method of claim 56 , wherein the additional chemotherapeutic agent is a glucocorticoid, a mineralocorticoid, an ACAT1 inhibitor, or an anti-androgen.
58 . The method of claim 57 , wherein the glucocorticoid is beclomethasone, betamethasone, budesonide, cortisone, dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, or triamcinolone.
59 . The method of claim 57 , wherein the mineralocorticoid is fludrocortisone.
60 . The method of claim 56 , wherein the additional chemotherapeutic agent is another CRF 1 antagonist.
61 . The method of claim 60 , wherein the CRF 1 antagonist is
or a pharmaceutically acceptable salt thereof.
62 . The method of claim 61 , wherein the CRF 1 antagonist is
or a pharmaceutically acceptable salt thereof.
63 . The method of any one of claims 1-62 further comprising an additional treatment selected from surgical resection of the tumors and radiation therapy, or a combination thereof.
64 . The method of claim 63 , wherein the additional therapy is surgical resection and the surgical resection is prior to, after, and/or concurrent with administration of the compound of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition, or any combination thereof.
65 . The method of claim 64 , wherein the surgical resection is prior to administration of the compound of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition.
66 . The method of claim 65 , wherein the surgical resection is after administration of the compound of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition.
67 . The method of claim 66 , wherein the surgical resection is concurrent with administration of the compound of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition.
68 . The method of claim 63 , wherein the additional treatment is radiation therapy and the radiation therapy is prior to, after, and/or concurrent with administration of the compound of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition, or any combination thereof.
69 . The method of claim 68 , wherein the radiation therapy is prior to administration of the CRF 1 antagonist of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition.
70 . The method of claim 68 , wherein the radiation therapy is after administration of the compound of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition.
71 . The method of claim 68 , wherein the radiation therapy is concurrent with administration of the compound of structural Formula (I), or a pharmaceutically acceptable salt thereof or the pharmaceutical composition.