Glucocorticoid receptor modulators to treat pancreatic cancer

1. A method of treating a subject hosting a non-ACTH-secreting pancreatic tumor, the method comprising administering to the subject an effective amount of a chemotherapeutic agent, and administering to the subject a dose of a nonsteroidal selective glucocorticoid receptor modulator of between about 20 milligrams per day (mg/day) to about 1000 mg/day to reduce the tumor load of the pancreatic tumor, wherein the nonsteroidal selective glucocorticoid receptor modulator is a compound comprising a fused azadecalin structure having the formula:

wherein

L 1 and L 2 are members independently selected from a bond and unsubstituted alkylene;

R 1 is a member selected from unsubstituted alkyl, unsubstituted heteroalkyl, unsubstituted heterocycloalkyl, —OR 1A , NR 1C R 1D , —C(O)NR 1C R 1D , and —C(O)OR 1A , wherein

R 1A is a member selected from hydrogen, unsubstituted alkyl and unsubstituted heteroalkyl,

R 1c and R 1D are members independently selected from unsubstituted alkyl and unsubstituted heteroalkyl,

wherein R 1C and R 1D are optionally joined to form an unsubstituted ring with the nitrogen to which they are attached, wherein said ring optionally comprises an additional ring nitrogen;

R 2 has the formula:

wherein

R 2G is a member selected from hydrogen, halogen, unsubstituted alkyl, unsubstituted heteroalkyl, unsubstituted cycloalkyl, unsubstituted heterocycloalkyl, —CN, and —CF 3 ;

J is phenyl;

t is an integer from 0 to 5;

X is —S(O 2 )—; and

R 5 is phenyl optionally substituted with 1-5 R 5A groups, wherein

R 5A is a member selected from hydrogen, halogen, —OR 5A1 , S(O 2 )NR 5A2 R 5A3 , —CN, and unsubstituted alkyl, wherein

R 5A1 is a member selected from hydrogen and unsubstituted alkyl, and

R 5A2 and R 5A3 are members independently selected from hydrogen and unsubstituted alkyl,

or salts and isomers thereof,

whereby said subject hosting a non-ACTH-secreting pancreatic tumor is treated.

2. The method of claim 1 , wherein the chemotherapeutic agent is selected from the group consisting of taxanes, alkylating agents, topoisomerase inhibitors, endoplasmic reticulum stress inducing agents, antimetabolites, mitotic inhibitors and combinations thereof.

3. The method of claim 2 , wherein the chemotherapeutic agent is selected from the group consisting of nab-paclitaxel, 5-fluorouracil (5-FU), gemcitabine, cisplatin and capecitabine.

4. The method of claim 1 , wherein the nonsteroidal selective glucocorticoid receptor modulator is the compound comprising a fused azadecalin structure having the formula:

5. The method of claim 1 , wherein administering said nonsteroidal selective glucocorticoid receptor modulator comprises daily administration for at least one week.

6. The method of claim 1 , wherein the dose of nonsteroidal selective glucocorticoid receptor modulator is between about 50 mg/day to about 500 mg/day.

7. A method of treating a subject hosting a non-ACTH-secreting pancreatic tumor, the method comprising administering to the subject an effective amount of a chemotherapeutic agent, and administering to the subject a dose of a nonsteroidal selective glucocorticoid receptor modulator of between about 20 milligrams per day (mg/day) to about 1000 mg/day to reduce the tumor load of the pancreatic tumor, wherein the nonsteroidal selective glucocorticoid receptor modulator is a compound comprising a heteroaryl-ketone fused azadecalin structure having the formula:

wherein

R 1 is a heteroaryl ring having from 5 to 6 ring members and from 1 to 4 heteroatoms each independently selected from the group consisting of N, O and S, optionally substituted with 1-4 groups each independently selected from R 1a ,

each R 1a is independently selected from the group consisting of hydrogen, C 1-6 alkyl, halogen, C 1-6 haloalkyl, C 1-6 alkoxy, C 1-6 haloalkoxy, CN, N-oxide, C 3-8 cycloalkyl, and C 3-8 heterocycloalkyl;

ring J is selected from the group consisting of a cycloalkyl ring, a heterocycloalkyl ring, an aryl ring and a heteroaryl ring, wherein the heterocycloalkyl and heteroaryl rings have from 5 to 6 ring members and from 1 to 4 heteroatoms each independently selected from the group consisting of N, O and S;

each R 2 is independently selected from the group consisting of hydrogen, C 1-6 alkyl, halogen, C 1-6 haloalkyl, C 1-6 alkoxy, C 1-6 haloalkoxy, C 1-6 alkyl-C 1-6 alkoxy, CN, OH, NR 2a R 2b , C(O)R 2a , C(O)OR 2a , C(O)NR 2a R 2b , SR 2a , S(O)R 2a , S(O) 2 R 2a , C 3-8 cycloalkyl, and C 3-8 heterocycloalkyl, wherein the heterocycloalkyl groups are optionally substituted with 1-4 R 2c groups;

alternatively, two R 2 groups linked to the same carbon are combined to form an oxo group (═O);

alternatively, two R 2 groups are combined to form a heterocycloalkyl ring having from 5 to 6 ring members and from 1 to 3 heteroatoms each independently selected from the group consisting of N, O and S, wherein the heterocycloalkyl ring is optionally substituted with from 1 to 3 R 2d groups;

R 2a and R 2b are each independently selected from the group consisting of hydrogen and C 1-6 alkyl;

each R 2c is independently selected from the group consisting of hydrogen, halogen, hydroxy, C 1-6 alkoxy, C 1-6 haloalkoxy, CN, and NR 2a R 2b ,

each R 2d is independently selected from the group consisting of hydrogen and C 1-6 alkyl, or two R 2d groups attached to the same ring atom are combined to form (═O);

R 3 is selected from the group consisting of phenyl and pyridyl, each optionally substituted with 1-4 R 3a groups;

each R 3a is independently selected from the group consisting of hydrogen, halogen, and C 1-6 haloalkyl; and

subscript n is an integer from 0 to 3;

or salts and isomers thereof,

whereby said subject hosting a non-ACTH-secreting pancreatic tumor is treated.

8. The method of claim 7 , wherein the chemotherapeutic agent is selected from the group consisting of taxanes, alkylating agents, topoisomerase inhibitors, endoplasmic reticulum stress inducing agents, antimetabolites, mitotic inhibitors and combinations thereof.

9. The method of claim 8 , wherein the chemotherapeutic agent is selected from the group consisting of nab-paclitaxel, 5-fluorouracil (5-FU), gemcitabine, cisplatin and capecitabine.

10. The method of claim 7 , wherein the nonsteroidal selective glucocorticoid receptor modulator is the compound comprising a heteroaryl-ketone fused azadecalin having the formula:

11. The method of claim 7 , wherein administering said nonsteroidal selective glucocorticoid receptor modulator comprises daily administration for at least one week.

12. The method of claim 7 , wherein the dose of nonsteroidal selective glucocorticoid receptor modulator is between about 50 mg/day to about 500 mg/day.

13. A method of treating a subject hosting a non-ACTH-secreting pancreatic tumor, the method comprising administering to the subject an effective amount of a chemotherapeutic agent and administering to the subject a dose of a nonsteroidal selective glucocorticoid receptor modulator of between about 20 milligrams per day (mg/day) to about 1000 mg/day to reduce the tumor load of the pancreatic tumor, wherein the nonsteroidal selective glucocorticoid receptor modulator is a compound comprising an octahydro fused azadecalin structure has the formula:

wherein

R 1 is a heteroaryl ring having from 5 to 6 ring members and from 1 to 4 heteroatoms each independently selected from the group consisting of N, O and S, optionally substituted with 1-4 groups each independently selected from R 1a ,

each R 1a is independently selected from the group consisting of hydrogen, C 1-6 alkyl, halogen, C 1-6 haloalkyl, C 1-6 alkoxy, C 1-6 haloalkoxy, N-oxide, and C 3-8 cycloalkyl;

ring J is selected from the group consisting of an aryl ring and a heteroaryl ring having from 5 to 6 ring members and from 1 to 4 heteroatoms each independently selected from the group consisting of N, O and S;

each R 2 is independently selected from the group consisting of hydrogen, C 1-6 alkyl, halogen, C 1-6 haloalkyl, C 1-6 alkoxy, C 1-6 haloalkoxy, C 1-6 alkyl-C 1-6 alkoxy, CN, OH, NR 2a R 2b , C(O)R 2a , C(O)OR 2a , C(O)NR 2a R 2b , SR 2a , S(O)R 2a , S(O) 2 R 2a , C 3-8 cycloalkyl, and C 3-8 heterocycloalkyl having from 1 to 3 heteroatoms each independently selected from the group consisting of N, O and S;

alternatively, two R 2 groups on adjacent ring atoms are combined to form a heterocycloalkyl ring having from 5 to 6 ring members and from 1 to 3 heteroatoms each independently selected from the group consisting of N, O and S, wherein the heterocycloalkyl ring is optionally substituted with from 1 to 3 R 2c groups;

R 2a , R 2b and R 2c are each independently selected from the group consisting of hydrogen and C 1-6 alkyl;

each R 3a is independently halogen; and

subscript n is an integer from 0 to 3,

or salts and isomers thereof,

whereby said subject hosting a non-ACTH-secreting pancreatic tumor is treated.

14. The method of claim 13 , wherein the chemotherapeutic agent is selected from the group consisting of taxanes, alkylating agents, topoisomerase inhibitors, endoplasmic reticulum stress inducing agents, antimetabolites, mitotic inhibitors and combinations thereof.

15. The method of claim 14 , wherein the chemotherapeutic agent is selected from the group consisting of nab-paclitaxel, 5-fluorouracil (5-FU), gemcitabine, cisplatin and capecitabine.

16. The method of claim 13 , wherein the nonsteroidal selective glucocorticoid receptor modulator is the compound comprising an octahydro fused azadecalin which has the following structure:

17. The method of claim 13 , wherein administering said nonsteroidal selective glucocorticoid receptor modulator comprises daily administration for at least one week.

18. The method of claim 13 , wherein the dose of nonsteroidal selective glucocorticoid receptor modulator is between about 50 mg/day to about 500 mg/day.

19. The method of claim 1 , further comprising administration of an anticancer treatment selected from surgery, radiation treatment, immunotherapy administration, growth factor inhibitor administration, and administration of an anti-angiogenesis factor.

20. The method of claim 7 , further comprising administration of an anticancer treatment selected from surgery, radiation treatment, immunotherapy administration, growth factor inhibitor administration, and administration of an anti-angiogenesis factor.

21. The method of claim 13 , further comprising administration of an anticancer treatment selected from surgery, radiation treatment, immunotherapy administration, growth factor inhibitor administration, and administration of an anti-angiogenesis factor.