Anti-androgens for the treatment of non-metastatic castrate-resistant prostate cancer
Described herein are methods of treating non-metastatic castrate-resistant prostate cancer with anti-androgens.
1. A method of treating a male human with non-metastatic castration-resistant prostate cancer, the method comprising administering an anti-androgen at a dose of about 30 mg per day to about 480 mg per day to a male human in need of such treatment, wherein the anti-androgen is:
4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2 fluoro-N-methylbenzamide,
4-(3-(4-cyano-3-(trifluoromethyl)phenyl)-5,5-dimethyl-4-oxo-2-thioxoimidazolidin-1-yl)-2-fluoro-N-methylbenzamide, or
4-[7-[4-cyano-3-(trifluoromethyl)phenyl]-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide;
wherein said method further comprises administering a gonadotropin releasing hormone (GnRH) agonist.
2. The method of claim 1 , wherein the non-metastatic castration-resistant prostate cancer is a high risk non-metastatic castration-resistant prostate cancer.
3. The method of claim 1 , wherein the anti-androgen is 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide.
4. The method of claim 3 , wherein 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide is administered daily to the male human.
5. The method of claim 3 , wherein 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5, 7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide (ARN-509) is administered orally to the male human at a dose of about 180 mg per day to about 480 mg per day.
6. The method of claim 3 , wherein 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide (ARN-509) is administered orally to the male human at a dose of:
(a) about 30 mg per day;
(b) about 60 mg per day;
(c) about 90 mg per day;
(d) about 120 mg per day; or
(e) about 240 mg per day.
7. The method of claim 3 , wherein 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide is administered orally to the male human on a continuous daily dosage schedule.
8. The method of claim 3 , wherein the GnRH agonist is leuprolide, buserelin, naferelin, histrelin, goserelin or deslorelin.
9. The method of claim 1 , wherein the anti-androgen is 4-(3-(4-cyano-3-(trifluoromethyl)phenyl)-5,5-dimethyl-4-oxo-2-thioxoimidazolidin-1-yl)-2-fluoro-N-methylbenzamide.
10. The method of claim 9 , wherein the GnRH agonist is leuprolide, buserelin, naferelin, histrelin, goserelin or deslorelin.
11. The method of claim 1 , wherein the anti-androgen is 4-[7-[4-cyano-3-(trifluoromethyl)phenyl]-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide.
12. The method of claim 11 , wherein the GnRH agonist is leuprolide, buserelin, naferelin, histrelin, goserelin or deslorelin.
13. The method of claim 1 , wherein the anti-androgen is administered orally to the male human.
14. A method of treating a male human with non-metastatic castration-resistant prostate cancer, the method consisting essentially of administering an anti-androgen at a dose of about 30 mg per day to about 480 mg per day to a male human in need of such treatment, wherein the anti-androgen is:
4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2 fluoro-N-methylbenzamide,
4-(3-(4-cyano-3-(trifluoromethyl)phenyl)-5,5-dimethyl-4-oxo-2-thioxoimidazolidin-1-yl)-2-fluoro-N-methylbenzamide, or
4-[7-[4-cyano-3-(trifluoromethyl)phenyl]-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide;
wherein said method further comprises administering a gonadotropin releasing hormone (GnRH) agonist.
15. The method of claim 14 , wherein the anti-androgen is 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide.
16. The method of claim 15 , wherein the GnRH agonist is leuprolide, buserelin, naferelin, histrelin, goserelin or deslorelin.
17. The method of claim 15 , wherein 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide (ARN-509) is administered orally to the male human at a dose of:
(a) about 30 mg per day;
(b) about 60 mg per day;
(c) about 90 mg per day;
(d) about 120 mg per day; or
(e) about 240 mg per day.
18. The method of claim 9 , wherein the 4-(3-(4-cyano-3-(trifluoromethyl)phenyl)-5,5-dimethyl-4-oxo-2-thioxoimidazolidin-1-yl)-2-fluoro-N-methylbenzamide is administered orally to the male human at a dose of about 160 mg per day.
19. The method of claim 3 , wherein 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide is administered orally to the male human at a dose of about 240 mg per day.
20. The method of claim 3 , wherein the GnRH agonist is leuprolide.
21. The method of claim 3 , wherein the GnRH agonist is buserelin.
22. The method of claim 3 , wherein the GnRH agonist is naferelin.
23. The method of claim 3 , wherein the GnRH agonist is histrelin.
24. The method of claim 3 , wherein the GnRH agonist is goserelin.
25. The method of claim 3 , wherein the GnRH agonist is deslorelin.
26. A method of treating non-metastatic castration-resistant prostate cancer in a male human comprising administering a therapeutically effective amount of an anti-androgen to a male human with a non-metastatic castration-resistant prostate cancer;
wherein the anti-androgen is 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro [3.4]oct-5-yl]-2-fluoro-N-methylbenzamide;
wherein the anti-androgen is administered in an amount of about 180 mg per day or 120 mg per day;
and wherein said method further comprises administering a gonadotropin releasing hormone (GnRH) agonist.
27. The method of claim 26 , wherein the anti-androgen is administered in an amount of about 180 mg per day.
28. The method of claim 26 , wherein the anti-androgen is administered in an amount of about 120 mg per day.
29. The method of claim 26 , wherein the male human was previously treated at 240 mg per day and required dose reduction.
30. The method of claim 26 , wherein the male human was previously treated at 240 mg per day and required dose interruption.
31. The method of claim 26 , wherein the non-metastatic castration-resistant prostate cancer is a high risk non-metastatic castration-resistant prostate cancer.
32. The method of claim 31 , wherein the male human with the high risk non-metastatic castration-resistant prostate cancer has a prostate-specific antigen doubling time (PSADT) that is less than or equal to 10 months.
33. The method of claim 28 , wherein the male human has experienced 3 consecutive rises of PSA, 1 week apart, resulting in two 50% increases over the nadir, with the last PSA>2 ng/ml.
34. The method of claim 26 , wherein the male human is further treated to maintain castrate levels of testosterone of less than 50 ng/dL.
35. The method of claim 26 , wherein the anti-androgen is administered daily to the male human.
36. The method of claim 26 , wherein the anti-androgen is administered orally to the male human.
37. The method of claim 26 , wherein the anti-androgen is administered to the male human orally and on a continuous daily dosing schedule.
38. The method of claim 26 , wherein the male human has previously been treated with either orchiectomy or continuous androgen deprivation therapy (ADT).
39. The method of claim 38 , wherein the continuous androgen deprivation therapy comprises administration of a gonadotropin-releasing hormone (GnRH) agonist or antagonist.
40. The method of claim 39 , wherein the continuous androgen deprivation therapy comprises administration of a gonadotropin-releasing hormone agonist; and wherein the gonadotropin-releasing hormone is leuprolide, buserelin, nafarelin, histrelin, goserelin, or deslorelin.
41. A method of treating non-metastatic castration-resistant prostate cancer in a male human consisting essentially of administering a therapeutically effective amount of an anti-androgen to a male human with a non-metastatic castration-resistant prostate cancer;
wherein the anti-androgen is 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide;
wherein the anti-androgen is administered in an amount of about 180 mg per day or 120 mg per day;
and wherein said method further comprises administering a gonadotropin releasing hormone (GnRH) agonist.
42. The method of claim 41 , wherein the anti-androgen is administered in an amount of about 180 mg per day.
43. The method of claim 41 , wherein the anti-androgen is administered in an amount of about 120 mg per day.
44. The method of claim 41 , wherein the male human was previously treated at 240 mg per day and required dose reduction.
45. The method of claim 41 , wherein the non-metastatic castration-resistant prostate cancer is a high risk non-metastatic castration-resistant prostate cancer.
46. The method of claim 45 , wherein the male human with the high risk non-metastatic castration-resistant prostate cancer has a prostate-specific antigen doubling time (PSADT) that is less than or equal to 10 months.
47. The method of claim 45 , wherein the male human has experienced 3 consecutive rises of PSA, 1 week apart, resulting in two 50% increases over the nadir, with the last PSA>2 ng/mL.
48. The method of claim 41 , wherein the male human is further treated to maintain castrate levels of testosterone of less than 50 ng/dL.
49. The method of claim 41 , wherein the anti-androgen is administered daily to the male human.
50. The method of claim 41 , wherein the anti-androgen is administered orally to the male human.
51. The method of claim 41 , wherein the anti-androgen is administered to the male human orally and on a continuous daily dosing schedule.
52. The method of claim 41 , wherein the male human has previously been treated with either orchiectomy or continuous androgen deprivation therapy (ADT).
53. The method of claim 52 , wherein the continuous androgen deprivation therapy comprises administration of a gonadotropin-releasing hormone (GnRH) agonist or antagonist.
54. The method of claim 53 , wherein the continuous androgen deprivation therapy comprises administration of a gonadotropin-releasing hormone agonist; and wherein the gonadotropin-releasing hormone is leuprolide, buserelin, nafarelin, histrelin, goserelin, or deslorelin.
55. A method of treating non-metastatic castration-resistant prostate cancer in a male human comprising administering a therapeutically effective amount of an anti-androgen to a male human with a non-metastatic castration-resistant prostate cancer;
wherein the anti-androgen is 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide;
wherein the anti-androgen is administered in an amount of about 180 mg per day;
and wherein said method further comprises administering a gonadotropin releasing hormone (GnRH) agonist.
56. A method of treating non-metastatic castration-resistant prostate cancer in a male human consisting essentially of administering a therapeutically effective amount of an anti-androgen to a male human with a non-metastatic castration-resistant prostate cancer;
wherein the anti-androgen is 4-[7-(6-cyano-5-trifluoromethylpyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]oct-5-yl]-2-fluoro-N-methylbenzamide;
wherein the anti-androgen is administered in an amount of about 180 mg per day;
and wherein said method further comprises administering a gonadotropin releasing hormone (GnRH) agonist.