Combinations of drugs (e.g., a benzimidazole and...

Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Having -c- – wherein x is chalcogen – bonded directly to...

Reexamination Certificate

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C514S631000

Reexamination Certificate

active

06693125

ABSTRACT:

BACKGROUND OF THE INVENTION
The invention relates to the treatment of neoplastic disorders such as cancer.
Cancer is a disease marked by the uncontrolled growth of abnormal cells. The abnormal cells may no longer do the work of normal cells, and they crowd out and destroy healthy tissue.
Lung cancer is the most common cancer-related cause of death among men and women. It is the second most commonly occurring cancer among men and women; it has been estimated that there will be more than 164,000 new cases of lung cancer in the U.S. in the year 2000 alone. While the rate of lung cancer cases is declining among men in the U.S., it continues to increase among women. Lung cancer can be lethal; according to the American Lung Association, an estimated 156,900 Americans are expected to die due to lung cancer in 2000.
Cancers that begin in the lungs are divided into two major types, non-small cell lung cancer and small cell lung cancer, depending on how the cells appear under a microscope. Non-small cell lung cancer (squamous cell carcinoma, adenocarcinoma, and large cell carcinoma) generally spreads to other organs more slowly than does small cell lung cancer. Small cell lung cancer is the less common type, accounting for about 20% of all lung cancer.
Other cancers include brain cancer, breast cancer, cervical cancer, colon cancer, gastric cancer, kidney cancer, leukemia, liver cancer, lymphoma, ovarian cancer, pancreatic cancer, prostate cancer, rectal cancer, sarcoma, skin cancer, testicular cancer, and uterine cancer. These cancers, like lung cancer, are sometimes treated with chemotherapy.
Chemotherapeutic drugs currently in use or in clinical trials include paclitaxel, docetaxel, tamoxifen, vinorelbine, gemcitabine, cisplatin, etoposide, topotecan, irinotecan, anastrozole, rituximab, trastuzumab, fludarabine, cyclophosphamide, gentuzumab, carboplatin, interferon, and doxorubicin. The most commonly used anticancer agent is paclitaxel, which is used alone or in combination with other chemotherapy drugs such as: 5-FU, doxorubicin, vinorelbine, cytoxan, and cisplatin.
SUMMARY OF THE INVENTION
We have discovered that the combination of one of the antihelmintic drugs albendazole, mebendazole, or oxibendazole and the antiprotozoal drug pentamidine exhibits substantial antiproliferative activity against cancer cells. Structural and functional analogs of each of these compounds are known, and any of these analogs can be used in the antiproliferative combinations of the invention. Metabolites of albendazole and pentamidine are also known. Many of these metabolites share one or more biological activities with the parent compound and, accordingly, can also be used in the antiproliferative combinations of the invention. Accordingly, the invention features a method for treating a patient having a cancer or other neoplasm, by administering to the patient (i) albendazole, mebendazole, or oxibendazole; and (ii) pentamidine simultaneously or within 14 days of each other in amounts sufficient to inhibit the growth of the neoplasm.
Preferably, the two compounds are administered within ten days of each other, more preferably within five days of each other, and most preferably within twenty-four hours of each other or even simultaneously. The cancer treated according to any of the methods of the invention, described below, can be lung cancer (squamous cell carcinoma, adenocarcinoma, or large cell carcinoma), brain cancer, breast cancer, cervical cancer, colon cancer, gastric cancer, kidney cancer, leukemia, liver cancer, lymphoma, ovarian cancer, pancreatic cancer, prostate cancer, rectal cancer, sarcoma, skin cancer, testicular cancer, or uterine cancer.
In a related aspect, the invention also features a method for treating a patient having a neoplasm such as cancer. In this method, the patient is administered (a) a first compound selected from albendazole, albendazole sulfonate, albendazole sulfone, albendazole sulfoxide, astemizole, benomyl, 2-benzimidazolylurea, benzthiazuron, cambendazole, cyclobendazole, domperidone, droperidol, fenbendazole, flubendazole, frentizole, 5-hydroxymebendazole, lobendazole, luxabendazole, mebendazole, methabenzthiazuron, mercazole, midefradil, nocodozole, omeprazole, oxfendazole, oxibendazole, parbendazole, pimozide, and tioxidazole (or a salt of any of the above), NSC181928 (ethyl 5-amino-1,2-dihydro-3-[(N-methylanilino)methyl]-pyrido[3,4-b]pyrazin-7-ylcarbamate), and TN-16 (3-(1-anilinoethylidene)-5-benzyl-pyrrodiline-2,4-dione); and (b) a second compound selected from pentamidine, propamidine, butamidine, heptamidine, nonamidine, stilbamidine, hydroxystilbamidine, diminazene, benzamidine, phenamidine, dibrompropamidine, 1,3-bis(4-amidino-2-methoxyphenoxy)propane, phenamidine, and amicarbalide (or a salt of any of the above). Alternatively, the second compound can be a functional analog of pentamidine, such as netropsin, distamycin, bleomycin, actinomycin, or daunorubicin. The first and second compounds are preferably administered simultaneously or within 14 days of each other and in amounts sufficient to inhibit the growth of the neoplasm.
In another related aspect, the invention also features a method for treating a patient having a neoplasm such as cancer by administering the following:
a) a first compound having the formula (I):
wherein:
R
1
is selected from the group consisting of:
R
2
is selected from the group consisting of:
 each of R
3
and R
4
is independently selected from the group consisting of:
and
b) a second compound having the formula (II):
 wherein each of Y and Z is, independently, O or N; each of R
5
and R
6
is, independently, —H, —OH, -halogen, —O—C
1-10
alkyl, —OCF
3
, —NO
2
, or NH
2
; n is an integer between 2 and 6, inclusive; and each of R
7
and R
8
is, independently, at the meta or para position and is selected from the group consisting of:
 wherein the first and second compounds are administered simultaneously or within 14 days of each other in amounts sufficient to inhibit the growth of the neoplasm.
In another related aspect, the invention also features a method for treating a patient having a neoplasm such as cancer by administering the following:
a) a first compound having the formula (III):
wherein:
A is selected from the group consisting of O, S, and NR
12
;
R
9
is selected from the group consisting of:
 each of R
10
and R
11
is independently selected from the group consisting of —H, -halo, —NO
2
, —OH, —SH, —O—C
1-10
alkyl, —O—(C
1-10
)
0-1
-aryl, —O—(C
1-10
alkyl)
0-1
-heteroaryl, —O—(C
1-10
alkyl)
0-1
-heterocyclyl, —C
1-10
alkoxycarbonyl, —S(O)
0-2
—C
1-10
alkyl, —S(O)
0-2
—(C
1-10
alkyl)
0-1
-aryl, —S(O)
0-2
—(C
1-10
alkyl)
0-1
-heteroaryl, —S(O)
0-2
—C
1-10
alkyl)
0-1
-heterocyclyl, and —C
1-10
alkyl or —C
2-10
alkenyl that is unsubstituted or substituted by one or more substituents selected from the group consisting of -aryl, -heteroaryl, -heterocyclyl, —O—C
1-10
alkyl, —O—(C
1-10
alkyl)
0-1
-aryl, —O—(C
1-10
alkyl)
0-1
-heteroaryl, —O—(C
1-10
alkyl)
0-1
-heterocyclyl, —C
1-10
alkoxycarbonyl, —S(O)
0-2
—C
1-10
alkyl, —S(O)
0-2
—(C
1-10
alkyl)
0-1
-aryl, —S(O)
0-2
—(C
1-10
alkyl)
0-1
-heteroaryl, —S(O)
0-2
—(C
1-10
alkyl)
0-1
-heterocyclyl, —N(R
13
)
2
, —OR
13
, -oxo, -cyano, -halogen, —NO
2
, —OH, and —SH;
R
12
is selected from the group consisting of —H and —C
1-10
alkyl or —C
2-10
alkenyl that is unsubstituted or substituted by one or more substituents selected from the group consisting of -aryl, -heteroaryl, -heterocyclyl, —O—C
1-10
alkyl, —O—(C
1-10
)
0-1
-aryl, —O—(C
1-10
alkyl)
0-1
-heteroaryl, —O—(C
1-10
alkyl)
0-1
-heterocyclyl, —C
1-10
alkoxycarbonyl, —S(O)
0-2
—C
1-10
alkyl, —S(O)
0-2
-(C
1-10
alkyl)
0-1
-aryl, —S(O)
0-2
—(C
1-10
alkyl)
0-1
-heteroaryl, —S(O)
0-2
—(C
1-10
alkyl)
0-1
-heterocyclyl, —N(R
13
)
2
, —OR
13
, -oxo, -cyano, -halo, —NO
2
, —OH, and —SH; and
each R
13
is independently selected from the group consisting of H and C
1-10
alkyl or C
2-10
alkenyl that is unsubstituted or substituted by one or more substi

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