NZ716226B2 - Therapeutically active compounds and their methods of use - Google Patents
Therapeutically active compounds and their methods of use Download PDFInfo
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- NZ716226B2 NZ716226B2 NZ716226A NZ71622614A NZ716226B2 NZ 716226 B2 NZ716226 B2 NZ 716226B2 NZ 716226 A NZ716226 A NZ 716226A NZ 71622614 A NZ71622614 A NZ 71622614A NZ 716226 B2 NZ716226 B2 NZ 716226B2
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Abstract
Provided is an isolated crystalline form of 2-methyl-1-[(4-(6-(trifluoromethyl)pyridine-2-yl]-6-{[2-(trifluoromethyl)pyridine-4-yl]amino}-1,3,5-triazin-2-yl)amino]propan-2-ol methanesulfonate characterized by an X-ray powder diffraction pattern, and its use in the treatment of cancer. The claimed form has improved physicochemical properties that influence in vivo dissolution rate for formulation purposes. orm has improved physicochemical properties that influence in vivo dissolution rate for formulation purposes.
Description
(12) Granted patent specificaon (19) NZ (11) 716226 (13) B2
(47) aon date: 2021.12.24
(54) THERAPEUTICALLY ACTIVE COMPOUNDS AND THEIR METHODS OF USE
(51) Internaonal Patent Classificaon(s):
A61K 31/5377A61K 31/53 C07D 401/12
(22) Filing date: (73) Owner(s):
2014.08.01 AGIOS PHARMACEUTICALS, INC.
(23) te specificaon filing date: (74) Contact:
2014.08.01 HENRY HUGHES IP D
(30) Internaonal Priority Data: (72) Inventor(s):
US 61/861,884 8.02 GU, Chong-Hui
CN 2013.08.09 AGRESTA, Samuel, V.
US ,098 2014.02.12 SCHENKEIN, David
US 61/975,448 2014.04.04 YANG, Hua
US 62/011,948 2014.06.13 GUO, Liting
TANG, Zhen
(86) Internaonal Applicaon No.: WANG, Jianming
ZHANG, Yanfeng
ZHOU, Yan
(87) Internaonal Publicaon number:
WO/2015/017821
(57) Abstract:
Provided is an isolated crystalline form of 2-methyl[(4-(6-(trifluoromethyl)pyridineyl]{[2-
oromethyl)pyridineyl]amino}-1,3,5-triazinyl)amino]propanol methanesulfonate
characterized by an X-ray powder diffracon paern, and its use in the treatment of cancer. The
claimed form has improved physicochemical properes that influence in vivo dissoluon rate for
formulaon purposes.
NZ 716226 B2
THERAPEUTICALLY ACTIVE COMPOUNDS AND THEIR METHODS OF USE
This application claims priority from U.S. Application Serial No. 61/861,884 filed
August 2, 2013, ational Application Serial No. filed August 9, 2013,
U.S. ation Serial No. 61/939,098 filed ry 12, 2014, U.S. Application Serial No.
61/975,448 filed April 4, 2014, and U.S. Application Serial No. ,948 filed June 13, 2014,
each of which is incorporated herein by reference in its entirety.
Isocitrate dehydrogenases (IDHs) catalyze the oxidative decarboxylation of isocitrate to
2-oxoglutarate (i.e., a-ketoglutarate). These enzymes belong to two distinct subclasses, one of
which utilizes NAD( +) as the electron or and the other NADP( + ). Five isocitrate
dehydrogenases have been reported: three NAD(+ )-dependent isocitrate dehydrogenases, which
localize to the ondrial matrix, and two NADP(+)-dependent isocitrate dehydrogenases,
one of which is mitochondrial and the other predominantly cytosolic. Each NADP( +)-dependent
isozyme is a homodimer.
IDH2 (isocitrate dehydrogenase 2 (NADP+ ), mitochondrial) is also known as IDH; IDP;
IDHM; IDPM; ICD-M; or mNADP-IDH. The protein encoded by this gene is the
NADP( +)-dependent isocitrate dehydrogenase found in the mitochondria. It plays a role in
intermediary metabolism and energy production. This protein may tightly associate or interact
with the pyruvate dehydrogenase complex. Human IDH2 gene encodes a n of 452 amino
acids. The nucleotide and amino acid sequences for IDH2 can be found as GenBank entries
NM_002168.2 and NP 002159.2 respectively. The nucleotide and amino acid sequence for
human IDH2 are also described in, e.g., Huh et al., Submitted (NOV-1992) to the
EMBL/GenBank/DDBJ databases; and The MGC Project Team, Genome Res.
14:2121-2127(2004).
Non-mutant, e.g., wild type, IDH2 catalyzes the oxidative decarboxylation of isocitrate to
glutarate (a-KG) thereby reducing NAD+ (NADP+) to NADH (NADPH), e.g., in the
forward on:
Isocitrate + NAD+ (NADP+) ~a-KG+ C02 + NADH (NADPH) + H+.
It has been discovered that mutations of IDH2 present in certain cancer cells result in a
new ability of the enzyme to catalyze the NADPH-dependent reduction of a-ketoglutarate to
R(-)hydroxyglutarate . 2-HG is not formed by wild-type IDH2. The production of 2-
HG is believed to bute to the formation and progression of cancer (Dang, L et al, Nature
2009, 462:739—44).
The inhibition of mutant IDH2 and its neoactivity is ore a potential therapeutic
treatment for cancer. Accordingly, there is an ongoing need for inhibitors of IDH2 mutants
having alpha hydroxyl ivity.
A y concern for the cture of large—scale pharmaceutical compositions is that
the active ingredient should have a stable crystalline morphology to ensure consistent processing
parameters and pharmaceutical quality. The active ingredient must possess acceptable properties
with respect to hygroscopicity, solubility, and stability, which can be consistently reproduced
despite the impact of various environmental conditions such as temperature and humidity. If an
unstable crystalline form is used, crystal morphology may change during manufacture and/or
storage resulting in quality control ms, and formulation irregularities. Such a change may
affect the reproducibility of the manufacturing process and thus lead to ceutical
formulations that do not meet the high y and stringent requirements imposed on
formulations of pharmaceutical compositions.
When a compound crystallizes from a solution or slurry, it may crystallize with different
spatial lattice arrangements, a property referred to as “polymorphism.” Each of the l forms
is a “polymorph.” While polymorphs of a given substance have the same chemical composition,
they may differ from each other with respect to one or more physical properties, such as
solubility and dissociation, true density, melting point, crystal shape, compaction or, flow
properties, and/or solid state stability.
The polymorphic behavior of pharmaceutically active substances is of great importance
in pharmacy and pharmacology. The differences in physical properties exhibited by polymorphs
affect practical parameters such as storage stability, ssibility and density (important in
pharmaceutical composition cturing), and dissolution rates (an important factor in
determining bio—availability of an active ingredient). Differences in stability can result from
changes in chemical reactivity (e.g., differential oxidation, such that a dosage form discolors
more rapidly when it is one polymorph than when it is another rph) or ical
changes (e.g., tablets e on storage as a kinetically favored polymorph converts to
thermodynamically more stable polymorph) or both (e.g., tablets of one polymorph are more
susceptible to breakdown at high humidity than r polymorph). In addition, the physical
properties of the l may be important in sing: for example, one polymorph might be
more likely to form solvates that cause the solid form to aggregate and increase the difficulty of
solid handling, or might be ult to filter and wash free of impurities (i.e., particle shape and
size distribution might be different between one polymorph relative to other).
While pharmaceutical formulations having improved chemical and physical properties
are desired, there is no predictable means for preparing new crystalline forms (e.g., polymorphs)
of ng molecules for such formulations. There is a need for crystalline forms of inhibitors of
mutant IDH2 that possess consistent physical properties over the range of nments that may
be encountered during pharmaceutical formulation manufacturing and storage. Such crystalline
forms would have utility in treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or ma (e.g., T-cell lymphoma),
each characterized by the presence of a mutant allele of IDH2, as well as having properties
suitable for large-scale manufacturing and formulation.
PCT Publication No. and US ation No. US 2013/0190287
hereby incorporated by reference in their entirety, disclose compounds that inhibit IDH2 mutants
(e.g., IDH2R140Q and IDH2Rl 72K). These applications additionally disclose methods for the
preparation of inhibitors of mutant IDH2, pharmaceutical compositions containing these
compounds, and s for the y of diseases, disorders, or ions (e.g., cancer)
associated with overexpression and/or amplification of mutant IDH2.
SUMMARY OF INVENTION
Particularly provided herein is an isolated crystalline form of 2-methyl[(4-[6-
(trifluoromethyl)pyridineyl]{[2-(trifluoromethyl)pyridineyl]amino}-1,3,5-triazin
yl)amino]propanol methanesulfonate, characterized by an X-ray powder ction pattern
having peaks at 2 angles of 7.5, 9.3, 14.5, 18.8, 21.3, and 24.8° ± 0.2°. The crystalline form
may be characterized by an X-ray powder diffraction pattern substantially similar to FIGURE
Disclosed herein are s of treating advanced hematologic malignancies, such as
acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), d sarcoma, multiple myeloma, or lymphoma (e.g.,
T-cell lymphoma or B-cell lymphoma), each characterized by the presence of a mutant allele of
IDH2.
(followed by 3A)
Thus also provided herein is the use of a crystalline form as described in the
manufacture of a medicament for treatment of an advanced hematologic malignancy selected
from acute myelogenous leukemia, myelodysplastic syndrome, chronic myelomonocytic
leukemia, myeloid sarcoma, multiple myeloma, and lymphoma, each characterized by the
presence of a mutant allele of IDH2.
Also provided herein is a pharmaceutical composition comprising the crystalline form
as described and a pharmaceutically acceptable carrier.
These and other embodiments are described r below. Certain s and
embodiments may not form the subject of the present application but are nevertheless
described herein for completeness.
BRIEF DESCRIPTION OF THE GS
FIGURE 1 is an X-ray powder diffractogram (XRPD) of nd 3 Form 1.
FIGURE 2 is an X-ray powder diffractogram (XRPD) of compound 3 Form 2.
(followed by 4)
FIGURE 3 is a differential scanning calorimetry (DSC) profile of compound 3 Form 2.
FIGURE 4 is a thermal graVimetric analysis (TGA) profile of nd 3 Form 2.
FIGURE 5 is an X—ray powder diffractogram (XRPD) of compound 1 Form 3.
FIGURE 6 is a differential scanning calorimetry (DSC) profile of compound 1 Form 3.
FIGURE 7 is a thermal graVimetric analysis (TGA) profile of compound 1 Form 3.
FIGURE 8 is a dynamic vapor sorption (DVS) profile of compound 1 Form 3.
FIGURE 9 is an X—ray powder diffractogram (XRPD) of compound 1 Form 4.
FIGURE 10 is a differential scanning calorimetry (DSC) and thermal graVimetric analysis (TGA)
profile of nd 1 Form 4.
FIGURE 11 is an X—ray powder diffractogram (XRPD) of compound 1 Form 5.
FIGURE 12 is a differential scanning calorimetry (DSC) and thermal graVimetric analysis (TGA)
profile of compound 1 Form 5.
FIGURE 13 is an X—ray powder diffractogram (XRPD) of compound 1 Form 6.
FIGURE 14 is a differential scanning calorimetry (DSC) and l graVimetric analysis (TGA)
profile of compound 1 Form 6.
FIGURE 15 is an X—ray powder diffractogram (XRPD) of compound 1 Form 7.
FIGURE 16 is a differential ng metry (DSC) and thermal graVimetric analysis (TGA)
profile of compound 1 Form 7.
FIGURE 17 is a X—ray powder diffractogram (XRPD) of compound 1 Form 8.
FIGURE 18 is a differential scanning calorimetry (DSC) and thermal graVimetric analysis (TGA)
profile of compound 1 Form 8.
FIGURE 19 is an X—ray powder diffractogram (XRPD) of compound 1 Form 9.
FIGURE 20 is a differential scanning calorimetry (DSC) and l graVimetric analysis (TGA)
profile of compound 1 Form 9.
FIGURE 21 is an X—ray powder diffractogram (XRPD) of compound 1 Form 10.
FIGURE 22 is a ential scanning metry (DSC) and thermal graVimetric is (TGA)
profile of compound 1 Form 10.
FIGURE 23 is an X—ray powder diffractogram (XRPD) of compound 1 Form 11.
FIGURE 24 is a differential scanning calorimetry (DSC) profile of compound 1 Form 11.
FIGURE 25 is a thermal graVimetric analysis (TGA) profile of compound 1 Form 11.
FIGURE 26 is an X—ray powder diffractogram (XRPD) of compound 1 Form 12.
FIGURE 27 is a differential scanning calorimetry (DSC) and thermal gravimetric analysis (TGA)
profile of compound 1 Form 12.
FIGURE 28 is a X—ray powder diffractogram (XRPD) of compound 1 Form 13.
FIGURE 29 is a differential scanning calorimetry (DSC) and thermal gravimetric analysis (TGA)
profile of compound 1 Form 13.
FIGURE 30 is an X—ray powder diffractogram (XRPD) of compound 1 Form 14.
FIGURE 31 is a differential scanning calorimetry (DSC) and thermal gravimetric analysis (TGA)
profile of compound 1 Form 14.
FIGURE 32 is an X—ray powder diffractogram (XRPD) of compound 1 Form 15.
FIGURE 33 is a differential scanning calorimetry (DSC) and thermal gravimetric analysis (TGA)
profile of compound 1 Form 15.
FIGURE 34 is an X—ray powder diffractogram (XRPD) of compound 3 Form 16.
FIGURE 35 is a differential scanning calorimetry (DSC) profile of compound 3 Form 16.
FIGURE 36 is a thermal gravimetric analysis (TGA) profile of compound 3 Form 16.
FIGURE 37 is an X—ray powder ctogram (XRPD) of nd 3 Form 17.
FIGURE 38 is an X—ray powder diffractogram (XRPD) of nd 3 Form 18.
FIGURE 39 is an X—ray powder ctogram (XRPD) of nd 3 Form 19.
DETAILED DESCRIPTION OF THE INVENTION
The details of construction and the ement of components set forth in the following
description or illustrated in the drawings are not meant to be limiting. Other embodiments and
different ways to practice the invention are expressly included. Also, the phraseology and
terminology used herein is for the purpose of description and should not be regarded as limiting.
The use of “including,77 4‘comprising,” or “having,77 aining77 4‘
, involving”, and variations
thereof herein, is meant to ass the items listed thereafter and equivalents f as well
as additional items.
Definitions:
As used above, and throughout the description of the invention, the following terms,
unless otherwise indicated, shall be understood to have the ing meanings.
As used herein, the term “elevated levels of 2—HG” means 10%, 20% 30%, 50%, 75%,
100%, 200%, 500% or more 2—HG then is present in a subject that does not carry a mutant IDH
allele (e. g., a mutant IDH2 allele). The term ted levels of 2—HG” may refer to the amount
of 2—HG Within a cell, Within a tumor, Within an organ comprising a tumor, or Within a bodily
fluid.
The term “bodily fluid” includes one or more of amniotic fluid surrounding a fetus,
aqueous humour, blood (e.g., blood plasma), serum, Cerebrospinal fluid, cerumen, chyme,
Cowper's fluid, female ejaculate, interstitial fluid, lymph, breast milk, mucus (e.g., nasal
drainage or phlegm), pleural fluid, pus, saliva, sebum, semen, serum, sweat, tears, urine, vaginal
secretion, or vomit.
As used herein, the terms it” or “prevent” include both complete and l
inhibition and prevention. An inhibitor may completely or partially inhibit the ed target.
The term an “mutant IDH2 inhibitor” or itor of IDH2 mutant(s)” means a molecule
e.g., a ptide, peptide, or small molecule (e.g., a molecule of less than 1,000 daltons), or
aptomer, that binds to an IDH2 mutant subunit and inhibits ivity, e.g., by inhibiting
formation of a dimer, e.g., a homodimer of mutant IDH2 subunits or a heterodimer of a mutant
and a Wildype subunit. In some embodiments, the ivity inhibition is at least about 60%,
70%, 80%, 90%, 95% or 99%.
The term “treat” means decrease, suppress, attenuate, diminish, arrest, or ize the
development or progression of a disease/disorder (e.g., an advanced logic malignancy,
such as acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), myeloid sarcoma, multiple a, or lymphoma (e.g.,
T—cell lymphoma), each characterized by the presence of a mutant allele of IDH2), lessen the
severity of the disease/disorder or improve the symptoms associated with the disease/disorder.
As used herein, an amount of a compound, including a crystalline form thereof, effective
to treat a disorder, or a “therapeutically effective ” or “therapeutically effective dose”
refers to an amount of the compound, or a pharmaceutically acceptable salt thereof, including a
crystalline form thereof, which is effective, upon single or multiple dose administration to a
subject, in treating a cell, or in curing, alleviating, relieving or improving a subject with a
disorder beyond that expected in the absence of such treatment.
As used herein, the term “subject” is intended to mean human. Exemplary human
subjects include a human patient (referred to as a t) having a disorder, e.g., a disorder
bed herein or a normal subject.
“Free—base equivalent” or “free—base equivalent th” is the amount of compound 1
or another pharmaceutically able salt of compound 3 that is equivalent to the free—base
compound 3 dose. For example 30 mg (free—base equivalent strength) would equal 36 mg of
compound 1, 50 mg (free—base equivalent strength) would equal 60 mg of compound 1, 75 mg
base lent strength) would equal 90 mg, 100 mg (free—base equivalent strength) would
equal 120 mg, and 125 mg (free—base equivalent strength) would equal 150 mg.
"Form 1" or "compound 3 Form 1" are used interchangeably, and describe Form 1 of
compound 3, as synthesized in Example 3A, in the Examples section below, and as described
below, and represented by data shown in
"Form 2" or und 3 Form 2" are used interchangeably, and describe Form 2 of
compound 3, as synthesized in Example 4A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 2, 3, and 4.
"Form 3" or und 1 Form 3" are used hangeably, and describe Form 3 of
compound 1, as synthesized in Example 6A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 5, 6, 7, and 8.
"Form 4" or "compound 1 Form 4" are used interchangeably, and be Form 4 of
compound 1, as synthesized in Example 7A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 9 and 10.
"Form 5" or "compound 1 Form 5" are used interchangeably, and describe Form 5 of
compound 1, as synthesized in Example 8A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 11 and 12.
"Form 6" or "compound 1 Form 6" are used interchangeably, and describe Form 6 of
compound 1, as synthesized in Example 9A, in the Examples section below, and as bed
below, and represented by data shown in FIGS. 13 and 14.
"Form 7" or "compound 1 Form 7" are used interchangeably, and describe Form 7 of
nd 1, as synthesized in Example 10A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 15 and 16.
"Form 8" or "compound 1 Form 8" are used interchangeably, and be Form 8 of
compound 1, as synthesized in Example 11A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 17 and 18.
2014/049469
"Form 9" or "compound 1 Form 9" are used interchangeably, and describe Form 9 of
compound 1, as synthesized in e 12A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 19 and 20.
"Form 10" or "compound 1 Form 10" are used interchangeably, and be Form 10 of
compound 1, as synthesized in Example 13A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 21 and 22.
"Form 11" or "compound 1 Form 11" are used interchangeably, and describe Form 11 of
compound 1, as synthesized in Example 14A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 23, 24, and 25.
"Form 12" or "compound 1 Form 12" are used interchangeably, and be Form 12 of
compound 1, as synthesized in Example 15A, in the Examples section below, and as bed
below, and ented by data shown in FIGS. 26 and 27.
"Form 13" or "compound 1 Form 13" are used interchangeably, and describe Form 13 of
compound 1, as synthesized in Example 16A, in the Examples n below, and as described
below, and represented by data shown in FIGS. 28 and 29.
"Form 14" or "compound 1 Form 14" are used interchangeably, and describe Form 14 of
compound 1, as sized in Example 17A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 30 and 31.
"Form 15" or und 1 Form 15" are used interchangeably, and describe Form 15 of
compound 1, as synthesized in Example 18A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 32 and 33.
"Form 16" or "compound 3 Form 16" are used interchangeably, and describe Form 16 of
compound 3, as synthesized in Example 2A, in the Examples section below, and as described
below, and represented by data shown in FIGS. 34, 35 and 36.
"Form 17" or "compound 3 Form 16" are used interchangeably, and describe Form 16 of
compound 3, as synthesized in Example 20A, in the Examples section below, and as described
below, and represented by data shown in .
"Form 18" or "compound 3 Form 16" are used interchangeably, and describe Form 16 of
compound 3, as synthesized in Example 21A, in the Examples section below, and as described
below, and represented by data shown in .
"Form 19" or "compound 3 Form 16" are used hangeably, and describe Form 16 of
compound 3, as synthesized in e 22A, in the Examples section below, and as described
below, and represented by data shown in .
As used , "crystalline" refers to a solid having a highly regular chemical structure.
In particular, a crystalline compound 3 or compound 1 may be produced as one or more single
crystalline forms of the compound 3 or compound 1. For the purposes of this application, the
terms "crystalline form", "single crystalline form" and "polymorph" are synonymous; the terms
distinguish between ls that have different properties (e.g., different XRPD patterns and/or
different DSC scan results). The term "polymorph" includes pseudopolymorphs, which are
typically different solvates of a material, and thus their properties differ from one another. Thus,
each distinct polymorph and pseudopolymorph of the compound 3 or compound 1 is ered
to be a distinct single crystalline form herein.
"Substantially crystalline" refers to forms that may be at least a particular weight t
crystalline. ular weight percentages are 10%, 20%, 30%, 40%, 50%, 60%, 70%, 75%,
80%, 85%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.5%,
99.9%, or any percentage between 10% and 100%. In some embodiments, substantially
crystalline refers to a compound 3 or nd 1 that is at least 70% crystalline. In other
embodiments, substantially crystalline refers to a compound 3 or compound 1 that is at least 90%
crystalline.
As used herein, the terms "isolated" refers to forms that may be at least a particular
weight percent of a particular crystalline form of compound 1 or compound 3. Particular weight
percentages are 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.5%, 99.9%, or any
percentage between 90% and 100%.
The term "solvate or solvated" means a physical ation of a compound, including a
crystalline form thereof, of this ion with one or more solvent les. This physical
association includes hydrogen bonding. In certain instances the solvate will be capable of
isolation, for example when one or more solvent molecules are incorporated in the crystal lattice
of the crystalline solid. "Solvate or solvated" encompasses both solution—phase and isolable
solvates. Representative es e, for example, a hydrate, ethanolates or a methanolate.
The term te" is a solvate wherein the solvent molecule is H20 that is present in a
defined stoichiometric amount, and may, for example, e hemihydrate, monohydrate,
dihydrate, or trihydrate.
The term "mixture" is used to refer to the combined elements of the mixture regardless of
the phase—state of the combination (e.g., liquid or liquid/ crystalline).
The term "seeding" is used to refer to the addition of a crystalline material to initiate
recrystallization or crystallization.
The term "antisolvent" is used to refer to a solvent in which compounds, ing
lline forms thereof, are poorly soluble.
As used herein, the term “about” means approximately, in the region of, roughly, or
around. When the term ” is used in conjunction with a numerical range, it modifies that
range by extending the boundaries above and below the numerical values set forth. In general,
the term “about” is used herein to modify a numerical value above and below the stated value by
a variance of 10%.
Pharmaceutical Compositions and Methods of Treatment
Provided is a method of treating advanced logic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid a, multiple myeloma, or lymphoma (e.g., T—cell lymphoma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprising
administering to subject in need thereof a therapeutically effective amount of a mutant IDH2
inhibitor.
Also provided is a method of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic onocytic
leukemia (CMML), or lymphoma (e.g., T—cell lymphoma), each characterized by the ce of
a mutant allele of IDH2, comprising administering to t in need thereof a therapeutically
effective amount of a mutant IDH2 tor.
Also provided is a method of treating an advanced hematologic malignancy selected from
acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), myeloid a, multiple myeloma, and lymphoma (e.g.,
T—cell lymphoma or B—cell lymphoma), each terized by the presence of a mutant allele of
IDH2, comprising administering to a t in need thereof a therapeutically effective amount
of compound 3, or a pharmaceutically acceptable salt thereof.
Also provided is a method of treating advanced logic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell ma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprising
administering to t in need f a therapeutically effective amount of compound 1.
Also provided is a method of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell lymphoma),
each characterized by the presence of a mutant allele of IDH2, comprising administering to
t in need thereof a eutically effective amount of 2—Methyl— l—[(4—[6—
(trifluoromethyl)pyridin—2—yl] —6—{ [2—(trifluoromethyl)pyridin—4—yl] amino } — l ,3 ,5—triazin—2—
yl)amino]propan—2—ol esulfonate (compound 1).
Also provided is a method of treating advanced hematologic malignancies, such as acute
enous leukemia (AML), ysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid a, multiple myeloma, or lymphoma (e.g., T—cell lymphoma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, sing
administering to subject in need thereof a pharmaceutical composition comprising a
therapeutically effective amount of a mutant IDH2 inhibitor, and one or more pharmaceutically
acceptable carrier(s).
Also provided is a method of treating an advanced hematologic malignancy selected from
acute myelogenous leukemia (AML), ysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, and lymphoma (e.g.,
T—cell lymphoma or B—cell lymphoma), each characterized by the ce of a mutant allele of
IDH2, comprising administering to subject in need thereof a pharmaceutical composition
comprising a therapeutically effective amount of compound 3, or a pharmaceutically acceptable
salt thereof, and one or more pharmaceutically able carrier(s).
Also provided is a method of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, le myeloma, or lymphoma (e.g., T—cell lymphoma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprising
stering to subject in need thereof a ceutical composition comprising a
therapeutically effective amount of nd 1, and one or more pharmaceutically acceptable
carrier(s).
Also provided is a method of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell ma),
each characterized by the ce of a mutant allele of IDH2, comprising administering to
subject in need thereof a pharmaceutical composition comprising a therapeutically effective
amount of compound 1, and one or more pharmaceutically acceptable carrier(s).
Also provided is a method of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), ysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), or lymphoma (e.g., T—cell lymphoma), each characterized by the presence of
a mutant allele of IDH2, comprising administering to subject in need thereof a pharmaceutical
composition comprising a therapeutically effective amount of compound 1, and one or more
ceutically acceptable r(s).
Also provided is a method of treating advanced logic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell lymphoma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprising
stering to subject in need thereof a therapeutically effective amount of compound 1, or a
crystalline form thereof; or a therapeutically effective dose of compound 3, or a lline form
thereof.
Also provided is a method of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell lymphoma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprising
administering to subject in need thereof a pharmaceutical composition comprising a
therapeutically effective amount of nd 1, or a crystalline form thereof; or a
therapeutically effective dose of compound 3, or a lline form thereof; and one or more
pharmaceutically acceptable carrier(s).
Also ed is a method of treating advanced logic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), or lymphoma (e.g., T—cell lymphoma), each characterized by the presence of
a mutant allele of IDH2, comprising administering to subject in need f a pharmaceutical
composition comprising a therapeutically effective amount of nd 1, or a crystalline form
thereof; or a therapeutically effective dose of compound 3, or a crystalline form thereof; and one
or more pharmaceutically acceptable carrier(s).
Also provided is a method of treating an advanced hematologic malignancy selected from
acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), c
myelomonocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, and lymphoma (e.g.,
T—cell lymphoma or B—cell lymphoma), each characterized by the presence of a mutant allele of
IDH2, comprising administering to a subject in need thereof a therapeutically effective dose of a
pharmaceutically acceptable salt of compound 3, n the therapeutically ive dose is
from about 30 mg to about 300 mg (free—base equivalent strength), once daily or twice daily
(e.g., about 30 mg to about 200 mg once daily or twice daily; or about 30 mg to about 150 mg
once daily or twice daily). In one embodiment, the therapeutically effective dose is a free—base
equivalent strength of 30 mg, once daily or twice daily. In another ment, the
therapeutically ive dose is a free—base equivalent strength of 50 mg, once daily or twice
daily. In another embodiment, the therapeutically effective dose is a free—base equivalent
strength of 75 mg, once daily or twice daily. In another embodiment, the therapeutically
effective dose is a free—base equivalent strength of 100 mg, once daily or twice daily. In another
embodiment, the therapeutically effective dose is a free—base equivalent strength of 125 mg, once
daily or twice daily. In another ment, the eutically effective dose is a ase
equivalent strength of 150 mg, once daily or twice daily. In another embodiment, the
therapeutically effective dose is a free—base lent th of 175 mg, once daily or twice
daily. In another embodiment, the therapeutically effective dose is a free—base equivalent
strength of 200 mg, once daily or twice daily. In another embodiment, the eutically
effective dose is a free—base equivalent strength of 225 mg, once daily or twice daily. In another
embodiment, the therapeutically effective dose is a free—base equivalent strength of 250 mg, once
daily or twice daily. In another embodiment, the therapeutically effective dose is a free—base
equivalent strength of 275 mg, once daily or twice daily. In another embodiment, the
eutically effective dose is a free—base equivalent strength of 300 mg, once daily or twice
daily.
In some embodiments, in the methods of the present invention, a pharmaceutically
able salt of nd 3 is administered orally as any combination of 5, 10, 50, or 200 mg
free—base equivalent strength s, twice daily or once daily. In some embodiments,
compound 1 is administered orally as any combination of 5, 10, 50, or 200 mg free—base
equivalent strength tablets, twice daily or once daily. In some embodiments, a crystalline form
of compound 1 is stered orally as any combination of 5, 10, 50, or 200 mg free—base
equivalent strength tablets, twice daily or once daily.
In some embodiments, in the methods of the present ion, a pharmaceutically
acceptable salt of compound 3 is administered orally as any combination of 5, 10, 50, 100, 150
or 200 mg free—base lent strength tablets, twice daily or once daily. In some embodiments,
compound 1 is administered orally as any combination of 5, 10, 50, 100, 150 or 200 mg free—
base equivalent strength tablets, twice daily or once daily. In some embodiments, a crystalline
form of compound 1 is administered orally as any combination of 5, 10, 50, 100, 150 or 200 mg
free—base equivalent strength tablets, twice daily or once daily.
Also provided is a method of ng advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), c myelomonocytic
leukemia , myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell lymphoma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprising
administering to a subject in need thereof compound 1 at a dose of at least about 30 mg (free—
base equivalent strength) (e.g., in an amount from about 30 mg to about 300 mg; about 30 mg to
about 200 mg; or about 30 mg to about 150 mg (free—base equivalent strength)) twice daily.
Also provided is a method of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia , myeloid sarcoma, multiple a, or ma (e.g., T—cell lymphoma),
each characterized by the presence of a mutant allele of IDH2, comprising administering to a
subject in need thereof compound 1 at a dose of at least about 30 mg (free—base equivalent
strength) (e.g., in an amount from about 30 mg to about 300 mg; about 30 mg to about 200 mg;
or about 30 mg to about 150 mg (free—base equivalent strength)) twice daily.
In some embodiments, the method of treating advanced hematologic malignancies, such
as acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g.,
T—cell lymphoma or B—cell lymphoma), each characterized by the presence of a mutant allele of
IDH2, comprising administering to subject in need thereof compound 1, or a crystalline form
thereof; or compound 3, or a crystalline form thereof, at a dose of at least about 30 mg (free—base
equivalent strength) (e.g., in an amount from about 30 mg to about 300 mg; about 30 mg to about
200 mg; or about 30 mg to about 150 mg (free—base equivalent strength)) twice daily.
In some embodiments, the method of treating advanced hematologic malignancies, such
as acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), or lymphoma (e.g., T—cell lymphoma), each characterized
by the presence of a mutant allele of IDH2, comprises administering to subject in need thereof
nd 1, or a crystalline form thereof; or compound 3, or a lline form thereof, at a dose
of from about 30 mg to about 300 mg (free—base equivalent strength) (e.g., in an amount from
about 30 mg to about 300 mg; about 30 mg to about 200 mg; or about 30 mg to about 150 mg
(free—base lent strength)) twice daily.
In some embodiments, the second daily administration is ed between about 8 hours
and about 16 hours after the first stration.
In one embodiment, the dose of 30 mg (free—base equivalent strength), twice daily. In
another ment, the dose of 50 mg (free—base equivalent strength), twice daily. In another
embodiment, the dose of 75 mg (free—base equivalent strength), twice daily. In another
ment, the dose of 100 mg (free—base equivalent strength), twice daily. In another
ment, the dose of 125 mg (free—base equivalent strength), twice daily. In another
embodiment, the dose of 150 mg (free—base equivalent strength), twice daily. In another
embodiment, the dose of 175 mg (free—base equivalent strength), twice daily. In another
embodiment, the dose of 200 mg (free—base lent strength), twice daily. In another
ment, the dose of 225 mg (free—base equivalent strength), twice daily. In another
embodiment, the dose of 250 mg (free—base equivalent strength), twice daily.
In some embodiments, the method of ng advanced hematologic ancies, such
as acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), or chronic
myelomonocytic leukemia (CMML), each terized by the presence of a mutant allele of
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IDH2, comprises administering to subject in need thereof compound 1, or a crystalline form
thereof; or compound 3, or a lline form thereof, at a dose of from about 75 mg to about 150
mg (free—base equivalent strength) twice daily.
In one embodiment, the method is a method of treating AML characterized by the
ce of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 75 mg to about 150 mg (free—base lent strength) twice daily.
In one ment, the method is a method of treating AML characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof, in the oral dosage form of a tablet, at a dose of from
about 75 mg to about 150 mg (free—base equivalent strength), twice daily.
In one embodiment, the method is a method of treating MDS characterized by the
presence of a mutant allele of IDH2 ses administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 75 mg to about 150 mg (free—base equivalent strength), twice daily.
In one embodiment, the method is a method of treating MDS characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
nd 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 75 mg to about 150 mg (free—base equivalent
strength), twice daily.
In one embodiment, the method is a method of treating CMML characterized by the
presence of a mutant allele of IDH2 ses administering to subject in need f
compound 1, or a crystalline form thereof; or compound 3, or a lline form thereof at a dose
of from about 75 mg to about 150 mg (free—base equivalent strength), twice daily.
In one embodiment, the method is a method of treating CMML characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
nd 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 75 mg to about 150 mg base equivalent
strength), twice daily.
In one embodiment, the method is a method of treating myeloid sarcoma characterized by
the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a lline form f; or compound 3, or a crystalline form thereof at a dose
of from about 75 mg to about 150 mg (free—base lent th), twice daily.
In one embodiment, the method is a method of treating d sarcoma characterized by
the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 75 mg to about 150 mg (free—base equivalent
strength), twice daily.
In one embodiment, the method is a method of treating multiple myeloma characterized
by the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a lline form thereof at a dose
of from about 75 mg to about 150 mg (free—base equivalent strength), twice daily.
In one embodiment, the method is a method of treating multiple myeloma characterized
by the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or nd 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 75 mg to about 150 mg (free—base equivalent
strength), twice daily.
In one embodiment, the method is a method of treating ma characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form f at a dose
of from about 75 mg to about 150 mg (free—base equivalent strength), twice daily.
In one embodiment, the method is a method of treating lymphoma characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need f
compound 1, or a crystalline form f; or nd 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 75 mg to about 150 mg (free—base equivalent
strength), twice daily.
In one embodiment, the method is a method of treating T—cell lymphoma characterized by
the presence of a mutant allele of IDH2 comprises administering to t in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 75 mg to about 150 mg (free—base equivalent strength), twice daily.
In one embodiment, the method is a method of treating T—cell lymphoma characterized by
the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
nd 1, or a crystalline form f; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 75 mg to about 150 mg (free—base equivalent
strength), twice daily.
In one embodiment, the method is a method of treating B—cell ma characterized
by the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 75 mg to about 150 mg (free—base equivalent strength), twice daily.
In one embodiment, the method is a method of treating B—cell lymphoma characterized
by the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a , at a dose of from about 75 mg to about 150 mg (free—base equivalent
th), twice daily.
In some embodiments, the second daily administration is provided between about 10
hours and about 14 hours after the first daily administration.
In some embodiments, the methods bed herein include oral administration of
compound 1, or a crystalline form f; or compound 3, or a crystalline form thereof to a
t at a dose of about 30 mg, about 50 mg, about 75 mg, about 100 mg, 125 mg, about 150
mg, about 175 mg, about 200 mg, about 225 mg, or about 250 mg (each of which is the free—base
equivalent strength) twice a day. In one embodiment, the second daily dose is given 4, 5, 6, 7, 8,
9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 hours after the l daily dose.
In some ments, the method of treating advanced hematologic malignancies, such
as acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), c
myelomonocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g.,
T—cell lymphoma or B—cell lymphoma), each characterized by the presence of a mutant allele of
IDH2, comprises administering to subject in need thereof compound 1 at a dose of from about 75
mg to about 300 mg (free—base equivalent strength), once daily (e.g., about 75 mg to about 200
mg (free—base equivalent strength), once daily).
In some embodiments, the method of treating advanced hematologic malignancies, such
as acute myelogenous leukemia (AML), ysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g.,
T—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprises
administering to subject in need thereof compound 1, or a crystalline form f; or compound
3, or a crystalline form thereof, at a dose of from about 75 mg to about 3000 mg (free—base
equivalent strength), once daily (e.g., about 75 mg to about 200 mg (free—base equivalent
strength), once daily).
In some embodiments, the method of treating advanced hematologic malignancies, such
as acute myelogenous ia (AML), myelodysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), or lymphoma (e.g., T—cell lymphoma), each characterized
by the presence of a mutant allele of IDH2, ses administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 75 mg to about 300 mg (free—base lent strength), once daily (e.g., about 75
mg to about 200 mg (free—base equivalent strength), once daily).
In one ment, the dose of 100 mg (free—base lent strength), once daily. In
one embodiment, the dose of 150 mg (free—base equivalent strength), once daily. In one
ment, the dose of 175 mg (free—base equivalent strength), once daily. In one
embodiment, the dose of 200 mg (free—base lent strength), once daily. In one
embodiment, the dose of 225 mg (free—base equivalent strength), once daily. In one
embodiment, the dose of 250 mg (free—base equivalent strength), once daily. In one
embodiment, the dose of 275 mg (free—base equivalent strength), once daily.
In some embodiments, the method of treating advanced hematologic malignancies, such
as acute enous leukemia (AML), ysplastic syndrome (MDS), or chronic
myelomonocytic ia (CMML), each characterized by the presence of a mutant allele of
IDH2, comprises administering to subject in need thereof compound 1, or a crystalline form
thereof; or compound 3, or a crystalline form thereof at a dose of from about 150 mg to about
300 mg base equivalent strength), once daily (e.g., about 150 mg to about 200 mg (free—
base lent strength), once daily).
In one embodiment, the method is a method of treating AML characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg (free—base equivalent strength), once daily (e.g., about
150 mg to about 200 mg (free—base equivalent strength), once daily).
In one embodiment, the method is a method of treating AML characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof, in the oral dosage form of a tablet, at a dose of from
about 150 mg to about 300 mg (free—base equivalent strength) once daily.
In one embodiment, the method is a method of treating MDS characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg (free—base equivalent strength) once daily.
In one embodiment, the method is a method of treating MDS characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form f, in the
oral dosage form of a tablet, at a dose of from about 150 mg to about 300 mg (free—base
equivalent strength) once daily.
In one embodiment, the method is a method of treating CMML characterized by the
presence of a mutant allele of IDH2 comprises administering to t in need thereof
nd 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg (free—base equivalent strength) once daily.
In one embodiment, the method is a method of treating CMML characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form f; or nd 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 150 mg to about 300 mg (free—base
equivalent strength) once daily.
In one embodiment, the method is a method of treating myeloid sarcoma characterized by
the presence of a mutant allele of IDH2 ses stering to subject in need thereof
compound 1, or a lline form thereof; or nd 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg (free—base equivalent strength) once daily.
In one embodiment, the method is a method of ng myeloid sarcoma characterized by
the ce of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 150 mg to about 300 mg (free—base
equivalent strength) once daily.
In one embodiment, the method is a method of treating multiple myeloma characterized
by the presence of a mutant allele of IDH2 comprises administering to subject in need f
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg (free—base equivalent strength) once daily.
In one embodiment, the method is a method of treating multiple myeloma characterized
by the presence of a mutant allele of IDH2 comprises stering to subject in need thereof
compound 1, or a lline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 150 mg to about 300 mg (free—base
equivalent strength) once daily.
In one ment, the method is a method of treating lymphoma characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a lline form f; or nd 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg base equivalent strength) once daily.
In one embodiment, the method is a method of treating lymphoma characterized by the
presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 150 mg to about 300 mg base
equivalent strength) once daily.
In one embodiment, the method is a method of treating T—cell lymphoma terized by
the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or nd 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg (free—base equivalent strength) once daily.
In one embodiment, the method is a method of treating T—cell lymphoma characterized by
the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a lline form thereof, in the
oral dosage form of a tablet, at a dose of from about 150 mg to about 300 mg (free—base
equivalent strength) once daily.
In one embodiment, the method is a method of treating B—cell lymphoma characterized
by the presence of a mutant allele of IDH2 comprises administering to subject in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof at a dose
of from about 100 mg to about 300 mg base equivalent strength) once daily.
In one embodiment, the method is a method of treating B—cell lymphoma terized
by the presence of a mutant allele of IDH2 comprises administering to t in need thereof
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, in the
oral dosage form of a tablet, at a dose of from about 150 mg to about 300 mg (free—base
equivalent strength) once daily.
In some embodiments, the method es oral administration of compound 1, or a
crystalline form thereof; or compound 3, or a crystalline form f to a t at a dose of
about 75, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225
mg, about 250 mg, about 275 mg, or about 300 mg (each of which is the free—base lent
strength) once daily.
It will be understood that a therapeutically effective dose of compound 1, or a crystalline
form thereof; or a therapeutically effective dose of nd 3, or a crystalline form thereof,
may be taken at any time of the day or night. In some embodiments, a therapeutically effective
dose of compound 1 is taken in the morning. In other embodiments, a therapeutically effective
dose of compound 1, or a crystalline form thereof; or a therapeutically effective dose of
compound 3, or a crystalline form thereof is taken in the evening. It will be understood that a
therapeutically effective dose of compound 1, or a crystalline form thereof; or a therapeutically
effective dose of compound 3, or a crystalline form f may be taken with or without food.
In some embodiments, a therapeutically effective dose of compound 1, or a crystalline form
thereof; or a therapeutically effective dose of compound 3, or a crystalline form thereof, is taken
with a meal (e.g., administration of single oral dose 30 s after the start of a high—fat meal
fat Food and Drug Administration standard meal: for example, 2 extra—large eggs cooked
in butter, 2 pieces cured, cooked bacon, 2 pieces enriched white bread with butter, 4 ounces
hashed brown potatoes, and 8 ounces whole milk (3.3%)]). In some embodiments, subjects are
required to fast for at least 4 hours following a therapeutically effective dose of compound 1, or a
crystalline form thereof; or a therapeutically effective dose of compound 3, or a crystalline form
thereof. Water is allowed ad libitum except 1 hour before until 1 hour after dosing of compound
1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, (with the exception
of 240 mL of water provided with dosing).
In some embodiments, a therapeutically effective dose of compound 1, or a crystalline form
thereof; or a therapeutically effective dose of compound 3, or a crystalline form thereof is taken
while fasting (e.g., administration of single oral dose ing lO—hour overnight fast).
In one embodiment, the invention encompasses an oral dosage form comprising a
therapeutically effective dose of compound 1, or a crystalline form thereof; or a eutically
effective dose of compound 3, or a crystalline form thereof. In another embodiment, the
invention encompasses a 5 mg, 10 mg, 25mg, 50 mg, 100 mg, 150 mg, or 200 mg (each of which
is the free—base equivalent strength) oral dosage form, comprising compound 1, or a crystalline
form thereof; or compound 3, or a crystalline form thereof. In one embodiment, the oral dosage
form further comprises one or more pharmaceutically acceptable carrier(s).
In one embodiment, the invention encompasses compound 1, or a lline form
thereof; or nd 3, or a crystalline form thereof, for use in a method of treating ed
hematologic malignancies, such as acute myelogenous leukemia (AML), myelodysplastic
me (MDS), chronic myelomonocytic leukemia (CMML), myeloid sarcoma, multiple
a, or lymphoma (e.g., T—cell lymphoma or B—cell lymphoma), each characterized by the
presence of a mutant allele of IDH2 in a subject in need thereof. In one embodiment, the
invention encompasses a pharmaceutical composition comprising a therapeutically effective dose
of compound 1, or a crystalline form thereof; or a therapeutically effective dose of compound 3,
or a crystalline form thereof, and one or more pharmaceutically acceptable carrier(s) for use in a
method of treating advanced logic malignancies, such as acute myelogenous leukemia
(AML), myelodysplastic syndrome (MDS), chronic myelomonocytic leukemia (CMML),
myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell lymphoma or B—cell lymphoma),
each characterized by the presence of a mutant allele of IDH2 in a subject in need thereof.
Also ed is a method of decreasing a eatment or baseline level (e.g., Day —3
pre—treatment in ts, or levels measured in subjects t IDH—2 gene mutated disease) of
2—HG a pre—treatment or baseline level (e.g., Day —3 eatment in patients, or
, decreasing
levels ed in subjects without IDH—2 gene mutated disease) of bone marrow and/or
eral blood blast cells, and/or increasing a pre—treatment or baseline level (e.g., Day —3 pre—
treatment in patients, or levels measured in subjects without IDH—2 gene d disease) of
neutrophil count, in a subject having an advanced hematologic malignancy, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g., T—cell lymphoma),
each characterized by the presence of a mutant allele of IDH2, sing administering to the
subject (a) compound 1, or a crystalline form thereof; or compound 3, or a crystalline form
thereof at a dose of at least about 30 mg (free—base equivalent th), once daily or twice daily
(e.g., in an amount from about 30 mg to about 300 mg equivalent to free—base compound 3 (e.g.,
about 30 mg to about 200 mg once daily or twice daily; or about 30 mg to about 150 mg once
daily or twice daily), or (b) a pharmaceutical composition comprising a nd 1, or a
crystalline form f; or compound 3, or a lline form thereof at a dose of at least about
mg (free—base equivalent strength) (e.g., in an amount from about 30 mg to about 300 mg
equivalent to free—base compound 3 (e.g., about 30 mg to about 200 mg once daily or twice
daily; or about 30 mg to about 150 mg once daily or twice daily), and one or more
ceutically acceptable carrier(s).
Also provided is a method of decreasing a eatment or baseline level (e.g., Day —3
pre—treatment in patients, or levels ed in subjects without IDH—2 gene mutated disease) of
bone marrow and/or peripheral blood blast cells (e.g., by at least 50%) in a subject having an
advanced hematologic malignancy, such as acute myelogenous leukemia (AML),
myelodysplastic syndrome (MDS), chronic myelomonocytic leukemia (CMML), myeloid
sarcoma, multiple myeloma, or lymphoma (e.g., T—cell lymphoma or B—cell lymphoma), each
characterized by the presence of a mutant allele of IDH2, comprising:
ing knowledge of the pre—treatment or baseline level (e.g., measuring the pre—
treatment or baseline level) of bone marrow and/or peripheral blood blast cells in the subject;
stering to the subject (a) compound 1, or a crystalline form thereof; or compound
3, or a crystalline form thereof at a dose of at least about 30 mg (free—base equivalent strength)
(e.g., in an amount from about 30 mg to about 300 mg equivalent to free—base compound 3 (e.g.,
about 30 mg to about 200 mg once daily or twice daily; or about 30 mg to about 150 mg once
daily or twice daily), or (b) a pharmaceutical composition comprising compound 1, or a
crystalline form thereof; or compound 3, or a lline form thereof at a dose of at least about
mg (free—base equivalent strength) (e.g., in an amount from about 30 mg to about 300 mg
equivalent to free—base compound 3 (e.g., about 30 mg to about 200 mg once daily or twice
daily; or about 30 mg to about 150 mg once daily or twice daily), and one or more
pharmaceutically acceptable carrier(s);
acquiring knowledge of the post—treatment level (e.g., measuring the post—treatment level)
of bone marrow and/or peripheral blood blast cells in the subject;
comparing the post—treatment level of bone marrow and/or peripheral blood blast cells in
the subject with the pre—treatment or baseline level; and
determining that the level of bone marrow and/or peripheral blood blast cells is decreased
(e.g., by at least 50%).
In some embodiments, the method comprises decreasing the level of bone marrow and/or
eral blood blast cells by at least 50% (e.g., 50%, 50.5%, 51%, 51.5%, 52%, 52.5%, 53%,
53.5%, 54%, or 54.5%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95%) as compared to a
pre—treatment or baseline level (e.g., Day —3 pretreatment in patients, or levels measured in
subjects without IDH—2 gene mutated disease). In some embodiments, the method ses
decreasing the level of bone marrow and/or peripheral blood blast cells to less than 5% (e. g.,
0.1%, 0.2%, 0.3%, 0.4%, 0.5%, 0.6%, 0.7%, 0.8%, 0.9%, 1%, 1.1%, 1.2%, 1.3%, 1.4%, 1.5%,
1.6%, 1.7%, 1.8%, 1.9%, 2%, 2.25%, 2.5%, 2.75%, 3%, 3.25%, 3.5%, 3.75%, 4%, 4.25%, 4.5%,
4.75%, or 5%) of the total bone marrow cells as compared to a pre—treatment or baseline level.
Also provided is a method of sing a pre—treatment or ne level (e.g., Day —3
eatment in patients, or levels measured in subjects without IDH—2 gene mutated disease) of
neutrophil count (e.g., to at least 1.0 x 109/L), in a subject having an advanced hematologic
malignancy, such as acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS),
chronic myelomonocytic leukemia , myeloid sarcoma, multiple myeloma, or lymphoma
(e. g., T—cell lymphoma), each characterized by the presence of a mutant allele of IDH2,
comprising:
acquiring knowledge of the pre—treatment or baseline level (e.g., ing the pre—
treatment or baseline level) of neutrophil count in the subject;
administering to the subject (a) nd 1, or a crystalline form thereof; or compound
3, or a crystalline form thereof at a dose of at least about 30 mg base equivalent strength)
(e. g., in an amount from about 30 mg to about 300 mg equivalent to free—base compound 3 (e. g.,
about 30 mg to about 200 mg once daily or twice daily; or about 30 mg to about 150 mg once
daily or twice daily), or (b) a pharmaceutical composition comprising a compound 1, or a
crystalline form thereof; or compound 3, or a crystalline form thereof at a dose of at least about
mg (free—base equivalent strength) (e.g., in an amount from about 30 mg to about 300 mg
2014/049469
lent to free—base compound 3(e.g., about 30 mg to about 200 mg once daily or twice daily;
or about 30 mg to about 150 mg once daily or twice daily), and one or more pharrnaceutically
acceptable carrier(s);
acquiring knowledge of the post—treatment level (e.g., measuring the post—treatment level)
of neutrophil count in the subject;
comparing the post—treatment level of neutrophil count in the subject with the pre—
treatment or baseline level; and
ining that the level of neutrophil count is increased (e.g., to at least 1.0 x lOg/L).
In some embodiments, the method comprises increasing the neutrophil count in a subject,
to at least 1.0 x 109/L, (e.g., 1.0 x 10%, 1.5x 109/L, 2.0 x 109/L, 2.5 x 10%, 3.0 x 10%, 3.5x
109/L, 4.0 x 109/L, 4.5 x 109/L, 5.0 x 10%, 5.5x 109/L, 6.0 x 10%, 6.5 x 109/L, 7.0 x 109/L, or
7.5 x lOg/L). In some embodiments, the method comprises increasing the neutrophil count in a
subject to at least 0.5 x 109/L, (e.g., 0.5 x 10%, 0.6 x 109/L, 0.7 x 10%, 0.8 x 10%, 0.9 x
109/L, or 1.0 x 109/L).
In one embodiment the mutant IDH2 inhibitor is a polypeptide. In an embodiment the
polypeptide acts as a dominant negative with respect to the neoactivity of the mutant enzyme.
The polypeptide can correspond to full length IDH2 or a fragment thereof. The polypeptide need
not be identical with the corresponding es of wildtype IDH2, but in ments has at
least 60, 70, 80, 90 or 95 % homology with pe IDH2.
In one embodiment the mutant IDH2 inhibitor decreases the ty of an IDH2
neoactive mutant protein for NADH, NADPH or a divalent metal ion, e.g., Mg2+ or Mn2+, or
decreases the levels or availability of NADH, NADPH or divalent metal ion, e.g., Mg2+ or Mn2+,
e.g., by competing for binding to the mutant enzyme. In an embodiment the enzyme is inhibited
by replacing Mg2+ or Mn2+ with Ca2+.
In one embodiment the mutant IDH2 inhibitor reduces the level a neoactivity of IDH2,
e.g., 2—HG neoactivity.
In one embodiment the mutant IDH2 inhibitor reduces the level of the product of a
mutant having a neoactivity of an IDH2 , e.g., it reduces the level of 2—HG, e.g., R—2—HG.
In an embodiment the mutant IDH2 inhibitor interacts directly with, e.g., binds, either the
mutant IDH2 protein or interacts directly with, e.g., binds, the mutant IDH2 mRNA.
2014/049469
In an ment the mutant IDH2 inhibitor interacts directly With, e.g., it binds to, the
mutant IDH2 protein.
In an embodiment the mutant IDH2 inhibitor interacts directly With, e.g., it binds to, the
mutant IDH2 mRNA.
In an embodiment the mutant IDH2 inhibitor reduces the amount of neoactive enzyme
actiVity, e.g., by interacting With, e.g., binding to, mutant IDH2 n.
In an embodiment the mutant IDH2 inhibitor is a small molecule, e.g., compound 1, and
interacts With, e.g., binds, the mutant RNA, e.g., mutant IDH2 mRNA.
In some ments, the mutant IDH2 inhibitor may also comprise one or more
isotopic substitutions. For example, H may be in any isotopic form, including 1H, 2H (D or
deuterium), and H (T or tritium); C may be in any isotopic form, including 11C, 12C, 13C, and
14C; N may be in any isotopic form, including 13N, 14N and 15N; 0 may be in any isotopic form,
including 150, 16O and 18O; F may be in any isotopic form, including 18F; and the like. For
example, the compound is ed in a specific isotopic form of H, C, N, O and/or F by at least
about 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%. For example,
isotopic substitutions to compound 1 or compound 3 may include deuterium substituted
compound 1 or 2 at one or more en atoms of compound 1 or 2. Isotopic substitutions to
compound 1 or compound 3 may include 2—Methyl—l—[(4—[6—(trifluoromethyl)pyridin—2—yl]—6—{ [2—
(trifluoromethyl)pyridin—4—yl] amino } — l ,3,5—triazin—2—yl—4— 14C)amino]propan—2—ol; l—((4—(6—
(difluoro(fluoro—18F)methyl)pyridin—2—yl)—6—((2—(trifluoromethyl)pyridin—4—yl)amino)— l ,3 ,5—
triazin—2—yl)amino)—2—methylpropan—2—ol, l—((4—((2—(difluoro(fluoro—18F)methyl)pyridin—4—
yl)amino)—6—(6—(trifluoromethyl)pyridin—2—yl)— l ,3,5—triazin—2—yl)amino)—2—methylpropan—2—ol, 2—
(((4— (6—(trifluoromethyl)pyridin—2—yl)—6— ((2—(trifluoromethyl)pyridin—4—yl)amino)— l ,3 ,5—triazin—2—
yl)amino)methyl)propan— l , l , l ,3,3,3—d6—2—ol; 2—methyl— l —((4— (6—(trifluoromethyl)pyridin—2—yl)—6—
((2—(trifluoromethyl)pyridin—4—yl)amino)— l ,3,5—triazin—2—yl)amino)propan— l , l —d2—2—ol or
pharmaceutically able salts thereof (e.g., 2—Methyl—l—[(4—[6—(trifluoromethyl)pyridin—2—
yl] —6—{ [2— (trifluoromethyl)pyridin—4—yl] amino } — l ,3,5—triazin—2—yl—4—14C)amino]propan—2—ol
methanesulfonate; l—((4—(6—(difluoro(fluoro—18F)methyl)pyridin—2—yl)—6—((2—
(trifluoromethyl)pyridin—4—yl)amino)— l ,3 ,5—triazin—2—yl)amino)—2—methylpropan—2—ol
esulfonate, l—((4—((2—(difluoro(fluoro— l 8F)methyl)pyridin—4—yl)amino)—6—(6—
(trifluoromethyl)pyridin—2—yl)— l ,3 azin—2—yl)amino)—2—methylpropan—2—ol) methanesulfonate,
2—(((4— (6— (trifluoromethyl)pyridin—2—yl)—6— ((2— (trifluoromethyl)pyridin—4—yl)amino)— l ,3 ,5—triazin—
2—yl)amino)methyl)propan— l , l , l ,3,3,3—d6—2—ol methanesulfonate; 2—methyl— l—((4—(6—
(trifluoromethyl)pyridin—2—yl)—6—((2—(trifluoromethyl)pyridin—4—yl)amino)— l ,3 ,5—triazin—2—
yl)amino)propan— l , l —d2—2—ol methanesulfonate).
These methods of treatment and pharmaceutical compositions are further illustrated by
the ed descriptions and illustrative examples given below.
Compositions and routes of stration
The mutant IDH2 inhibitors, e.g.
, compound 1, or a crystalline form f; or
compound 3, or a crystalline form thereof utilized in the methods described herein may be
formulated together with one or more pharmaceutically acceptable carrier(s) or adjuvant(s) into
pharmaceutically acceptable compositions prior to being administered to a subject.
The term “pharmaceutically acceptable carrier or adjuvant” refers to a carrier or adjuvant
that may be administered to a subject, together with a compound described herein, and which
does not destroy the pharmacological activity thereof and is nontoxic when administered in doses
sufficient to deliver a therapeutic amount of the nd.
In some ments, ceutically acceptable rs, adjuvants and vehicles that
may be used in the pharmaceutical compositions include, but are not limited to, ion exchangers,
alumina, um te, lecithin, mulsifying drug delivery systems (SEDDS) such as
d—a—tocopherol polyethyleneglycol 1000 ate, surfactants used in pharmaceutical dosage
forms such as Tweens or other r polymeric delivery matrices, serum proteins, such as
human serum n, buffer substances such as phosphates, glycine, sorbic acid, potassium
sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes,
such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate,
sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone,
cellulose—based substances, polyethylene , sodium carboxymethylcellulose, polyacrylates,
waxes, hylene—polyoxypropylene—block polymers, polyethylene glycol and wool fat.
Cyclodextrins such as (x—, [3—, and y—cyclodextrin, or chemically modified derivatives such as
hydroxyalkylcyclodextrins, including 2— and 3—hydroxypropyl—B—cyclodextrins, or other
solubilized derivatives may also be advantageously used to enhance delivery of compounds of
the formulae described herein.
In some embodiments, the ceutical compositions may be administered ,
parenterally, by inhalation spray, topically, rectally, nasally, buccally, vaginally or via an
implanted reservoir, preferably by oral administration or administration by injection. The
pharmaceutical compositions of one aspect of this ion may contain any conventional
non—toxic pharmaceutically—acceptable carriers, nts or vehicles. In some cases, the pH of
the formulation may be adjusted with pharmaceutically acceptable acids, bases or buffers to
enhance the stability of the formulated compound or its delivery form. The term parenteral as
used herein includes subcutaneous, intracutaneous, intravenous, uscular, intraarticular,
intraarterial, intrasynovial, intrasternal, intrathecal, intralesional and intracranial injection or
infusion ques.
In some embodiments, the pharmaceutical compositions may be in the form of a sterile
injectable preparation, for example, as a sterile injectable aqueous or nous suspension. This
suspension may be formulated ing to techniques known in the art using suitable dispersing
or wetting agents (such as, for example, Tween 80) and suspending agents. The sterile injectable
preparation may also be a sterile injectable solution or suspension in a non—toxic parenterally
acceptable diluent or t, for example, as a solution in l,3—butanediol. Among the acceptable
vehicles and solvents that may be employed are mannitol, water, Ringer’s solution and isotonic
sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent
or suspending medium. For this purpose, any bland fixed oil may be ed including
synthetic mono— or diglycerides. Fatty acids, such as oleic acid and its glyceride derivatives are
useful in the preparation of injectables, as are natural pharmaceutically—acceptable oils, such as
olive oil or castor oil, especially in their polyoxyethylated versions. These oil solutions or
suspensions may also contain a long—chain alcohol diluent or dispersant, or ymethyl
cellulose or similar dispersing agents which are commonly used in the formulation of
pharmaceutically acceptable dosage forms such as emulsions and or suspensions. Other
commonly used surfactants such as Tweens or Spans and/or other similar emulsifying agents or
bioavailability enhancers which are commonly used in the manufacture of pharmaceutically
acceptable solid, , or other dosage forms may also be used for the purposes of formulation.
In some ments, the ceutical itions may be orally stered in
any orally acceptable dosage form including, but not limited to, capsules, tablets, emulsions and
aqueous suspensions, dispersions and solutions. In the case of tablets for oral use, carriers which
WO 17821
are commonly used e lactose and corn starch. Lubricating agents, such as magnesium
stearate, are also typically added. For oral administration in a capsule form, useful diluents
include lactose and dried corn starch. When s suspensions and/or emulsions are
administered , the active ingredient may be suspended or dissolved in an oily phase is
combined with fying and/or suspending agents. If desired, certain sweetening and/or
flavoring and/or coloring agents may be added.
In some embodiments, the pharmaceutical compositions may also be administered in the
form of suppositories for rectal administration. These compositions can be prepared by mixing
compound 1, or a crystalline form thereof; or compound 3, or a lline form thereof with a
suitable non—irritating excipient which is solid at room temperature but liquid at the rectal
temperature and therefore will melt in the rectum to release the active components. Such
materials include, but are not limited to, cocoa , beeswax and polyethylene glycols.
In some embodiments, topical administration of the pharmaceutical compositions is
useful when the d treatment involves areas or organs readily accessible by l
application. For application topically to the skin, the pharmaceutical composition should be
formulated with a suitable ointment containing the active components suspended or dissolved in
a carrier. Carriers for l administration of compound 1, or a crystalline form thereof; or
compound 3, or a crystalline form thereof include, but are not limited to, mineral oil, liquid
eum, white petroleum, propylene glycol, polyoxyethylene polyoxypropylene compound,
emulsifying waX and water. Alternatively, the pharmaceutical ition can be formulated
with a suitable lotion or cream containing the active compound suspended or dissolved in a
r with suitable emulsifying . le carriers include, but are not limited to, mineral
oil, an monostearate, polysorbate 60, cetyl esters waX, cetearyl alcohol, 2—octyldodecanol,
benzyl alcohol and water. The pharmaceutical compositions of one aspect of this invention may
also be topically applied to the lower intestinal tract by rectal suppository formulation or in a
suitable enema formulation. Topically—transdermal patches are also included in one aspect of
this invention.
In some embodiments, the pharmaceutical compositions may be administered by nasal
aerosol or inhalation. Such compositions are prepared according to techniques well—known in
the art of pharmaceutical formulation and may be prepared as solutions in saline, employing
benzyl alcohol or other suitable preservatives, absorption promoters to enhance ilability,
fluorocarbons, and/or other solubilizing or dispersing agents known in the art.
The mutant IDH2 inhibitors, e.g.
, compound 1, or a crystalline form thereof; or
compound 3, or a crystalline form thereof, utilized in the methods described herein can, for
example, be administered by injection, intravenously, intraarterially, subdermally,
intraperitoneally, intramuscularly, or subcutaneously; or orally, buccally, nasally,
transmucosally, topically, in an ophthalmic preparation, or by inhalation, with a dosage ranging
from about 0.5 to about 100 mg/kg of body weight, alternatively dosages between 1 mg and 1000
mg/dose, every 4 to 120 hours, or according to the requirements of the particular drug. The
methods herein plate administration of an effective amount of compound or compound
composition to achieve the desired or stated effect. Typically, the pharmaceutical compositions
may be administered from about 1 to about 6 times per day or alternatively, as a continuous
infusion. Such administration can be used as a chronic or acute therapy. The amount of active
ingredient that may be combined with the r materials to produce a single dosage form will
vary depending upon the host d and the particular mode of administration. A l
preparation will contain from about 5% to about 95% active compound (w/w). Alternatively,
such preparations contain from about 20% to about 80% active compound.
A subject may be administered a dose of a mutant IDH2 inhibitor, e.g., nd 1, or a
crystalline form thereof; or compound 3, or a crystalline form thereof, as described in Example 5.
Lower or higher doses than those recited above may be required. Specific dosage and treatment
ns for any particular subject will depend upon a variety of factors, including the activity of
the ic compound employed, the age, body weight, general health status, sex, diet, time of
administration, rate of excretion, drug ation, the severity and course of the e,
condition or symptoms, the subject’s disposition to the disease, condition or ms, and the
judgment of the treating physician.
Upon improvement of a subject’s condition, a maintenance dose of a compound,
composition, crystalline form or combination of one aspect of this invention may be
stered, if necessary. Subsequently, the dosage or frequency of administration, or both,
may be reduced, as a function of the symptoms, to a level at which the ed condition is
retained when the symptoms have been ated to the desired level. Subjects may, however,
require intermittent treatment on a long—term basis upon any ence of disease symptoms.
Some ments of the invention are directed toward a tablet comprising at least one
pharmaceutically acceptable carrier; and a mutant IDH2 tor.
Some embodiments of the ion are directed toward a tablet sing at least one
pharmaceutically acceptable carrier; and compound 1. Some embodiments of the invention are
directed toward a tablet comprising at least one pharmaceutically acceptable carrier; and
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof.
Some embodiments of the invention are ed toward a tablet comprising at least one
pharmaceutically acceptable carrier or diluent; and compound 1, or a crystalline form thereof; or
compound 3, or a crystalline form thereof. In other embodiments, the crystalline form of
compound 1 or compound 3 is at least 90% by weight of a particular crystalline form; the
particular crystalline form being a form described herein. In other embodiments, the crystalline
form of compound 1 or nd 3 is at least 95% by weight of a particular crystalline form;
the particular crystalline form being a form described herein.
Methods of Use
The inhibitory activities of compound 1 or a crystalline form thereof; or compound 3, or a
crystalline form thereof, against IDH2 mutants (e.g., IDH2R140Q and IDH2R172K) can be
tested by methods described in Example 12 of PCT Publication No. and US
Publication No. US 2013/0190287 hereby incorporated by reference in their entirety, or
analogous methods.
ed is a method for inhibiting a mutant IDH2 activity, comprising contacting a
subject in need thereof with a mutant IDH2 inhibitor. In one embodiment, the method for
inhibiting a mutant IDH2 ty ses contacting a subject in need thereof with compound
1. In one embodiment, the advanced hematologic malignancy described herein, such as acute
myelogenous ia (AML), myelodysplastic syndrome (MDS), c myelomonocytic
leukemia (CMML), myeloid sarcoma, multiple myeloma, or ma (e.g., T-cell lymphoma)
to be treated is characterized by a mutant allele of IDH2 n the IDH2 mutation results in a
new ability of the enzyme to catalyze the NADPH-dependent reduction of α-ketoglutarate to
R(-)hydroxyglutarate in a patient. In one aspect of this embodiment, the mutant IDH2 has an
R140X mutation. In another aspect of this embodiment, the R140X mutation is a R140Q
mutation. In another aspect of this embodiment, the R140X mutation is a R140W mutation. In
another aspect of this embodiment, the R140X mutation is a R140L mutation. In another aspect
of this embodiment, the mutant IDH2 has an R172X mutation. In another aspect of this
embodiment, the R172X mutation is a R172K mutation. In another aspect of this embodiment,
the R172X on is a R172G mutation.
In another embodiment, the method for inhibiting a mutant IDH2 activity comprises
contacting a subject in need thereof with compound 1, or a crystalline form thereof; or compound
3, or a crystalline form thereof. In one embodiment, the advanced hematologic malignancy
described herein, such as acute myelogenous ia (AML), myelodysplastic syndrome
(MDS), chronic onocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, or
lymphoma (e.g., T-cell lymphoma) to be treated is terized by a mutant allele of IDH2
wherein the IDH2 mutation results in a new ability of the enzyme to catalyze the
NADPH-dependent reduction of glutarate to R(-)hydroxyglutarate in a patient. In one
aspect of this embodiment, the mutant IDH2 has an R140X mutation. In another aspect of this
embodiment, the R140X mutation is a R140Q mutation. In another aspect of this embodiment,
the R140X mutation is a R140W mutation. In another aspect of this embodiment, the R140X
mutation is a R140L mutation. In r aspect of this embodiment, the mutant IDH2 has an
R172X mutation. In another aspect of this embodiment, the R172X mutation is a R172K
mutation. In another aspect of this ment, the R172X mutation is a R172G mutation.
Advanced logic malignancies, such as acute myelogenous leukemia (AML),
myelodysplastic syndrome (MDS), chronic myelomonocytic leukemia (CMML), d
sarcoma, multiple myeloma, or lymphoma (e.g., T-cell lymphoma or B-cell lymphoma), each
characterized by the presence of a mutant allele of IDH2, can be analyzed by sequencing cell
samples to determine the presence and specific nature of (e.g., the changed amino acid present
at) a mutation at amino acid 140 and/or 172 of IDH2.
In one embodiment, the efficacy of treatment of advanced hematologic malignancies,
such as acute myelogenous ia (AML), ysplastic syndrome (MDS), chronic
myelomonocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma (e.g.,
T-cell lymphoma), each characterized by the presence of a mutant allele of IDH2, is monitored
by ing the levels of 2HO in the t. lly levels of 2HO are measured prior to
treatment, wherein an elevated level is indicated for the use of compound 1 to treat advanced
hematologic malignancy, such as acute enous leukemia (AML), myelodysplastic
syndrome (MDS), chronic myelomonocytic leukemia (CMML), myeloid sarcoma, multiple
myeloma, or lymphoma (e.g., T—cell ma), each characterized by the presence of a mutant
allele of IDH2.
In one embodiment, the efficacy of treatment of advanced hematologic malignancies,
such as acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic
onocytic ia , myeloid sarcoma, le a, or lymphoma (e.g.,
T—cell lymphoma or B—cell lymphoma), each characterized by the presence of a mutant allele of
IDH2, is monitored by measuring the levels of 2—HG in the subject. Typically levels of 2—HG are
measured prior to treatment, wherein an elevated level is indicated for the use of compound 1, or
a crystalline form thereof; or compound 3, or a crystalline form thereof, to treat an advanced
hematologic ancy, such as acute myelogenous leukemia (AML), myelodysplastic
syndrome (MDS), chronic myelomonocytic leukemia (CMML), myeloid sarcoma, multiple
myeloma, or lymphoma (e.g., T—cell lymphoma or B—cell lymphoma), each terized by the
ce of a mutant allele of IDH2. Once the elevated levels are established, the level of 2—HG
is determined during the course of and/or following termination of treatment to establish
efficacy. In certain aspects, the level of 2—HG is only determined during the course of and/or
following termination of treatment. A reduction of 2—HG levels during the course of ent
and following treatment is indicative of efficacy. Similarly, a determination that 2—HG levels are
not elevated during the course of or ing treatment is also indicative of efficacy. Typically,
the these 2—HG measurements will be utilized together with other well—known determinations of
efficacy of cancer treatment, such as reduction in number and size of tumors and/or other
cancer—associated lesions, tion of bone marrow biopsies and/or aspirates, complete blood
counts, examination of peripheral blood films, improvement in the general health of the subject,
and alterations in other kers that are associated with cancer treatment efficacy.
Also provided is a method of ting 2—HG as compared to a pre—treatment or baseline
level (e. g., Day —3 pre—treatment in patients, or levels measured in subjects without lDH—2 gene
mutated disease) of 2—HG (e.g., by at least 50%) in a subject having an advanced hematologic
malignancy, such as acute myelogenous leukemia (AML), myelodysplastic me (MDS),
chronic myelomonocytic leukemia (CMML), myeloid sarcoma, multiple myeloma, or lymphoma
(e. g., T—cell lymphoma or B—cell lymphoma), each characterized by the presence of a mutant
allele of IDH2, comprising:
acquiring dge of the pre—treatment or baseline level (e.g., measuring the pre—
treatment or baseline level) of 2—HG in the subject;
administering to the subject (a) compound 1, or a crystalline form thereof; or compound
3, or a crystalline form thereof at a dose of at least about 30 mg (free—base equivalent strength)
(e. g., in an amount from about 30 mg to about 300 mg equivalent to free—base compound 3), or
(b) a pharmaceutical composition comprising compound 1, or a crystalline form thereof; or
compound 3, or a crystalline form thereof at a dose of at least about 30 mg (free—base lent
strength) (e. g., in an amount from about 30 mg to about 300 mg equivalent to free—base
compound 3), and one or more pharmaceutically acceptable carrier(s);
acquiring knowledge of the reatment level (e.g., measuring the post—treatment level)
of 2—HG in the subject;
comparing the reatment level of 2—HG in the subject with the pre—treatment or
baseline level; and
ining that the level of 2—HG is inhibited (e.g., by at least 50%).
In some ments, the method comprises inhibiting 2—HG in patients having or
determined to have an IDH2 Rl40Q mutation by at least 50% (e.g., 50%, 55%, 60%, 65%, 70%,
75%, 80%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%,
99%, or 100%) as compared to a pre—treatment or baseline level (e.g., Day —3 pretreatment in
patients, or levels measured in subjects without IDH—2 gene mutated disease). In some
embodiments, the method comprises inhibiting 2—HG in patients having or determined to have an
IDH2 Rl72K mutation by up to 60% (e.g., sing the level of 2—HG by up to 50%, 51%,
52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, or 60%) as compared to a pre—treatment or
baseline level (e.g., Day —3 eatment in patients, or levels measured in subjects without IDH—
2 gene mutated disease). In some embodiments, measuring the 2—HG level in the subject may be
achieved by spectroscopic analysis, e.g., magnetic resonance—based analysis, e.g., MRI and/or
MRS measurement, sample analysis of bodily fluid, such as blood, , urine, bone ,
or spinal cord fluid analysis, or by analysis of surgical material, e.g., by mass—spectroscopy (e.g.
LC—MS, GC—MS).
2—HG can be detected in a sample by the methods of PCT Publication No. WO
2013/102431 and US Publication No. US 2013/0190287 hereby incorporated by reference in
their entirety, or by analogous methods.
In one embodiment 2—HG is directly evaluated.
In another embodiment a derivative of 2—HG formed in process of performing the
ic method is evaluated. By way of example such a derivative can be a derivative formed in
MS analysis. Derivatives can include a salt adduct, e.g., a Na adduct, a hydration variant, or a
hydration variant which is also a salt adduct, e.g., a Na adduct, e.g., as formed in MS analysis.
In another embodiment a metabolic derivative of 2—HG is evaluated. Examples include
s that build up or are elevated, or reduced, as a result of the presence of 2—HG, such as
glutarate or glutamate that will be correlated to 2—HG, e.g., R—2—HG.
Exemplary 2—HG derivatives include dehydrated derivatives such as the compounds
ed below or a salt adduct thereof:
0 O O
H H
O O HO O HO ..\O HO = O
W o o 0
HO OH and
, , , .
In one embodiment, the advanced hematologic malignancy, such as acute myelogenous
ia (AML), myelodysplastic me (MDS), chronic myelomonocytic leukemia
(CMML), myeloid sarcoma, le myeloma, or lymphoma (e.g., T—cell lymphoma or B—cell
lymphoma), each characterized by the presence of a mutant allele of IDH2, is a tumor wherein at
least 30, 40, 50, 60, 70, 80 or 90% of the tumor cells carry an IDH2 mutation, and in particular
an IDH2 Rl40Q, Rl40W, or Rl40L and/or Rl72K or Rl72G mutation, at the time of diagnosis
or treatment.
In some embodiments, the subject has or is ined to have an IDH2 utated
disease (e.g., Rl40Q mutation or Rl72K mutation) at the time of diagnosis or treatment. In
some embodiments, the t also has or is determined to have a on selected from FLT3—
ITD (Fms—related tyrosine kinase 3 (FLT3) internal tandem duplication (ITD)), CEPBA
(CCAAT/enhancer binding protein , NPMl ophosmin (neucleolar phosphoprotein
B23)), and DNMT3A (DNA (cytosine—5—)methyltransferase 3 alpha, ASXLl: additional sex
combs like 1) at the time of diagnosis or treatment.
In some embodiments, the subject has normal cytogenetics prior to treatment. In some
other embodiments, the subject has abnormal or unfavorable cytogenetics, for example, one or
more of: Monosomy 7 (or partial deletion of the long arm of chromosome 7 (7q—)), Trisomy 8,
y ll, translocation t(l7;18), or translocation t(1;13) prior to treatement. Table 8 describes
the cytogenetic classification (IPSS and new 5—group classification).
In one embodiment, the advanced hematologic malignancy to be d is AML. In
some embodiments, the AML is ed and/or primary refractory. In other embodiments, the
AML is untreated. In some embodiments, the AML is relapsed and/or y refractory in
ts 60 years of age and older. In some embodiments, the AML is ted in ts 60
years of age and older. In some embodiments, the AML is relapsed and/or primary tory in
patients under 60 years of age. In one embodiment, compound 1 is administered as a first line
treatment for AML. In one embodiment, nd 1 is administered as a second line, third line,
or fourth line treatment for AML. In one embodiment, compound 1, or a crystalline form
thereof; or compound 3, or a crystalline form thereof, is administered as a first line treatment for
AML. In one embodiment, nd 1, or a crystalline form thereof; or compound 3, or a
lline form thereof, is administered as a second line, third line, or fourth line treatment for
AML. In one embodiment, compound 1, or a crystalline form thereof; or compound 3, or a
crystalline form thereof, is administered after a first relapse. In one embodiment, compound 1 is
administered after primary induction failure. In one embodiment, compound 1 is stered
after re—induction e. In one embodiment, administration of compound 1 can occur prior to,
during, or after transplant. In one embodiment, compound 1 is administered after a relapse that
is post—transplant. In one embodiment, the AML presentation is subsequent to MPD. In one
embodiment, the AML presentation is subsequent to MDS and CMML. In one embodiment,
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, is
administered after primary induction failure. In one embodiment, compound 1, or a crystalline
form thereof; or compound 3, or a crystalline form thereof, is administered after re—induction
failure. In one embodiment, administration of compound 1, or a crystalline form thereof; or
compound 3, or a crystalline form thereof, can occur prior to, during, or after transplant. In one
embodiment, nd 1, or a crystalline form thereof; or compound 3, or a crystalline form
thereof, is administered after a relapse that is post—transplant. In one embodiment, after relapse
and subsequent re—induction failure, compound 1, or a crystalline form thereof; or compound 3,
or a crystalline form thereof, is administered. In one embodiment, after relapse transplant)
and subsequent re—induction failure, compound 1, or a crystalline form thereof; or compound 3,
or a crystalline form thereof, is administered. In one embodiment, the AML presentation is
subsequent to MPD, and compound 1, or a crystalline form f; or compound 3, or a
crystalline form thereof, is administered after y induction failure. In one embodiment,
after primary induction failure and subsequent e (post—transplant), compound 1, or a
crystalline form thereof; or compound 3, or a crystalline form thereof, is administered. In one
ment, the AML presentation is subsequent to MDS and CMML, and after y
induction failure and subsequent re—induction failure, nd 1, or a crystalline form thereof;
or compound 3, or a crystalline form thereof, is administered.
In another embodiment, the advanced hematologic malignancy to be treated is MDS with
refractory anemia with excess blasts (subtype RAEB—l or RAEB—Z). In other embodiments, the
MDS is untreated. In one embodiment, compound 1, or a crystalline form thereof; or compound
3, or a crystalline form thereof, is administered as a first line treatment for MDS. In one
embodiment, compound 1, or a crystalline form thereof; or compound 3, or a crystalline form
thereof, is administered as a second line, third line, or fourth line treatment for MDS. In one
embodiment, nd 1 is administered as a first line treatment for MDS. In one embodiment,
compound 1 is administered as a second line, third line, or fourth line treatment for MDS.In one
embodiment, the MDS tation is subsequent to AML. In one embodiment, the MDS
presentation is subsequent to AML, and compound 1, or a crystalline form thereof; or compound
3, or a crystalline form thereof, is administered as a first line treatment for MDS.
In another embodiment, the advanced hematologic malignancy to be treated is ed
and/or primary refractory CMML. In one embodiment, compound 1 is administered as a first
line treatment for CMML. In one embodiment, nd 1 is administered as a second line,
third line, or fourth line treatment for CMML. In one embodiment, nd 1, or a crystalline
form thereof; or compound 3, or a crystalline form f, is administered as a first line
treatment for CMML. In one embodiment, compound 1, or a crystalline form thereof; or
compound 3, or a crystalline form thereof, is administered as a second line, third line, or fourth
line treatment for CMML. In one embodiment, compound 1, or a crystalline form thereof; or
compound 3, or a lline form thereof, is administered after a second relapse.
In another embodiment, the advanced logic malignancy to be treated is lymphoma
(e. g., Non—Hodgkin lymphoma (NHL) such as B—cell lymphoma (e.g., Burkitt lymphoma,
chronic lymphocytic leukemia/small lymphocytic lymphoma LL), diffuse large B—cell
lymphoma, follicular ma, immunoblastic large cell lymphoma, precursor B—
lymphoblastic lymphoma, and mantle cell lymphoma) and T—cell lymphoma (e.g., mycosis
fungoides, anaplastic large cell lymphoma, and precursor T—lymphoblastic lymphoma).
In another embodiment, the advanced logic malignancy to be treated is ed
and/or primary refractory myeloid sarcoma. In other embodiments, the d sarcoma is
ted. In one embodiment, compound 1 is stered as a first line treatment for myeloid
a. In one embodiment, compound 1 is administered as a second line, third line, or fourth
line treatment for myeloid sarcoma. In one embodiment, compound 1, or a crystalline form
thereof; or compound 3, or a crystalline form thereof, is administered as a first line treatment for
d sarcoma. In one ment, compound 1, or a crystalline form thereof; or compound
3, or a crystalline form thereof, is administered as a second line, third line, or fourth line
ent for myeloid sarcoma. In one embodiment, the myeloid sarcoma presents concurrently
with AML. In one embodiment, the myeloid a presents at relapse of AML.
In another ment, the advanced hematologic malignancy to be treated is relapsed
and/or primary refractory multiple myeloma. In other embodiments, the multiple myeloma is
untreated. In one embodiment, compound 1 is administered as a first line treatment for multiple
a. In one embodiment, compound 1 is administered as a second line, third line, or fourth
line treatment for multiple myeloma. In other embodiments, the multiple myeloma is untreated.
In one ment, compound 1, or a crystalline form thereof; or compound 3, or a crystalline
form thereof, is administered as a first line treatment for multiple myeloma. In one ment,
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, is
stered as a second line, third line, or fourth line treatment for multiple myeloma.
Treatment methods described herein can additionally se various evaluation steps
prior to and/or following treatment with a mutant IDH2 inhibitor, e.g. , compound 1, or a
crystalline form thereof; or compound 3, or a crystalline form thereof.
In one embodiment, prior to and/or after treatment with a mutant IDH2 inhibitor, e.g.
compound 1, or a lline form thereof; or compound 3, or a crystalline form thereof, the
method further comprises the step of evaluating the growth, size, weight, invasiveness, stage
and/or other phenotype of the advanced hematologic malignancy.
In one embodiment, prior to and/or after treatment with a mutant IDH2 inhibitor, e.g.
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, the
method further comprises the step of evaluating the IDH2 genotype of the cancer. This may be
achieved by ordinary methods in the art, such as DNA sequencing, immuno analysis, and/or
evaluation of the presence, distribution or level of 2—HG.
In one embodiment, prior to and/or after treatment with a mutant IDH2 inhibitor, e.g.
compound 1, or a crystalline form thereof; or compound 3, or a crystalline form thereof, the
method further ses the step of ining the 2—HG level in the subject. This may be
achieved by spectroscopic analysis, e.g., magnetic resonance—based analysis, e.g., MRI and/or
MRS measurement, sample is of bodily fluid, such as blood, plasma, urine, bone marrow,
or spinal cord fluid analysis, or by analysis of surgical material, e.g., by mass—spectroscopy (e.g.
LC—MS, GC—MS).
Crystalline Forms
Provided are crystalline forms of compound 1. Also provided are crystalline forms of 2—
Methyl— l —[(4— [6— (trifluoromethyl)pyridin—2—yl] —6—{ [2— (trifluoromethyl)pyridin—4—yl] amino } —
l,3,5—triazin—2—yl)amino]propan—2—ol (compound 3).
In one ment, compound 1 is a single crystalline form, or any one of the single
crystalline forms described herein. Also provided are pharmaceutical compositions comprising
at least one ceutically acceptable carrier or diluent; and compound 1, wherein compound
1 is a single crystalline form, or any one of the lline forms being described herein. Also
provided are uses of compound 1, wherein compound 1 is a single crystalline form, or any one of
the single crystalline forms described herein, to prepare a pharmaceutical composition.
In one embodiment, compound 3 is a single crystalline form, or any one of the single
crystalline forms described herein. Also ed are pharmaceutical compositions comprising
at least one ceutically acceptable carrier or t; and compound 3, wherein compound
3 is a single crystalline form, or any one of the crystalline forms being described herein. Also
ed are uses of compound 3, wherein nd 3 is a single crystalline form, or any one of
the single crystalline forms described herein, to prepare a pharmaceutical ition.
Also ed are methods of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), myeloid sarcoma, le myeloma, or lymphoma (e.g., T—cell lymphoma
or B—cell lymphoma), each characterized by the presence of a mutant allele of IDH2, comprising
administering to subject in need thereof (a) a single crystalline form of compound 1 or
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compound 3, or (b) a ceutical ition comprising (a) and a pharmaceutically
acceptable carrier. In one embodiment, the single lline form in (a) is any percentage
between 90% and 100% pure.
Also provided are methods of treating advanced hematologic malignancies, such as acute
myelogenous leukemia (AML), myelodysplastic syndrome (MDS), chronic myelomonocytic
leukemia (CMML), or lymphoma (e.g., T—cell lymphoma), each terized by the presence of
a mutant allele of IDH2, sing administering to subject in need thereof (a) a single
crystalline form of compound 1 or compound 3, or (b) a pharmaceutical composition comprising
(a) and a pharmaceutically able carrier. In one embodiment, the single crystalline form in
(a) is any percentage between 90% and 100% pure.
Provided herein is an assortment of characterizing information to describe the crystalline
forms of compound 1 and compound 3. It should be tood, however, that not all such
information is required for one skilled in the art to determine that such particular form is present
in a given composition, but that the determination of a particular form can be achieved using any
portion of the characterizing information that one skilled in the art would recognize as sufficient
for establishing the presence of a particular form, e.g., even a single distinguishing peak can be
sufficient for one skilled in the art to appreciate that such particular form is present.
Crystalline forms of compound 1 have physical properties that are suitable for large scale
pharmaceutical formulation manufacture. Many of the crystalline forms of compound 1
described herein exhibit high crystallinity, high melting point, and limited occluded or solvated
solvent. Crystalline forms of compound 1 have improved bioavailability as compared to
amporphous forms of compound 1. In particular, Form 3 is non—hygroscopic, and exhibits
stability ages (e.g., thermodynamic, chemical, or physical stability) at a relative humidity
of up to 40% at room ature for at least 3 months.
In one embodiment, at least a particular tage by weight of compound 3 is
crystalline. Particular weight tages may be 10%, 20%, 30%, 40%, 50%, 60%, 70%, 75%,
80%, 85%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.5%,
99.9%, or any percentage between 10% and 100%. When a particular percentage by weight of
compound 3 is crystalline, the der of compound 3 is the ous form of compound 3.
Non—limiting examples of crystalline compound 3 include a single crystalline form of compound
3 or a mixture of different single crystalline forms. In some ments, compound 3 is at
least 90% by weight crystalline. In some other embodiments, compound 3 is at least 95% by
weight crystalline.
In another ment, a particular tage by weight of the crystalline compound 3
is a specific single crystalline form or a combination of single crystalline forms. Particular
weight percentages may be 10%, 20%, 30%, 40%, 50%, 60%, 70%, 75%, 80%, 85%, 87%, 88%,
89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.5%, 99.9%, or any percentage
between 10% and 100%. In another embodiment, compound 3 is at least 90% by weight of a
single crystalline form. In another embodiment, compound 3 is at least 95% by weight of a
single lline form.
In one embodiment, at least a particular percentage by weight of compound 1 is
crystalline. Particular weight percentages may be 10%, 20%, 30%, 40%, 50%, 60%, 70%, 75%,
80%, 85%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.5%,
99.9%, or any percentage between 10% and 100%. When a particular percentage by weight of
compound 1 is crystalline, the remainder of compound 1 is the amorphous form of compound 1.
Non—limiting examples of crystalline compound 1 include a single crystalline form of compound
1 or a mixture of different single crystalline forms. In some embodiments, compound 1 is at
least 90% by weight crystalline. In some other embodiments, compound 1 is at least 95% by
weight crystalline.
In another ment, a particular percentage by weight of the crystalline nd 1
is a specific single crystalline form or a combination of single crystalline forms. Particular
weight percentages may be 10%, 20%, 30%, 40%, 50%, 60%, 70%, 75%, 80%, 85%, 87%, 88%,
89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.5%, 99.9%, or any percentage
between 10% and 100%. In another embodiment, compound 1 is at least 90% by weight of a
single lline form. In another embodiment, compound 1 is at least 95% by weight of a
single lline form.
In the following description of compound 3, embodiments of the invention may be
described with reference to a ular crystalline form of compound 3, as characterized by one
or more properties as discussed . The descriptions characterizing the crystalline forms
may also be used to describe the mixture of different crystalline forms that may be t in a
crystalline compound 3. However, the particular crystalline forms of compound 3 may also be
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characterized by one or more of the characteristics of the crystalline form as described herein,
with or without regard to referencing a particular crystalline form.
In the following description of compound 1, embodiments of the invention may be
described with reference to a particular crystalline form of compound 1, as characterized by one
or more properties as discussed herein. The descriptions characterizing the crystalline forms
may also be used to describe the e of different crystalline forms that may be present in a
crystalline compound 1. However, the particular crystalline forms of compound 1 may also be
characterized by one or more of the characteristics of the crystalline form as described herein,
with or without regard to ncing a particular crystalline form.
The lline forms are further illustrated by the detailed descriptions and illustrative
es given below. The XRPD peaks described in Tables 1A to 19A may vary by i 02°
depending upon the instrument used to obtain the data. The intensity of the XRPD peaks
described in Tables 1A to 19A may vary by 10%.
Form 1
In one embodiment, a single crystalline form, Form 1, of the compound 3 is characterized
by the X—ray powder ction (XRPD) pattern shown in and data shown in Table 1,
obtained using CuKa radiation. In a particular embodiment, the polymorph can be characterized
by one or more of the peaks taken from as shown in Table 1A. For example, the
polymorph can be terized by one or two or three or four or five or six or seven or eight or
nine of the peaks shown in Table 1A.
Table 1A
Angle Intensity
2-Theta° %
6.7 42.2
8.9 61.8
9.1 41.9
13.0 46.7
16.4 33.2
18.9 100.0
21.4 27.3
23.8 49.2
28.1 47.5
2014/049469
In another embodiment, Form 1 can be characterized by the peaks identified at 20 angles
of 8.9, 13.0, 18.9, 23.8, and 281°. In r embodiment, Form 1 can be characterized by the
peaks identified at 20 angles of 8.9, 18.9, and 24.80.
Form 2
In one embodiment, a single crystalline form, Form 2, of the compound 3 is characterized
by the X—ray powder diffraction (XRPD) pattern shown in and data shown in Table 2A,
ed using CuKa radiation. In a particular embodiment, the polymorph can be characterized
by one or more of the peaks taken from as shown in Table 2A. For example, the
polymorph can be terized by one or two or three or four or five or siX or seven or eight or
nine of the peaks shown in Table 2A.
Table 2A
Angle Intensity
2-Theta° %
8.4 65.2
12.7 75.5
16.9 57.9
17.1 69.4
17.7 48.6
19.2 100.0
23.0 69.7
23.3 61.1
24.2 87.3
In another embodiment, Form 2 can be characterized by the peaks identified at 20 angles
of 12.7, 17.1, 19.2, 23.0, and 242°. In another embodiment, Form 2 can be characterized by the
peaks identified at 20 angles of 12.7, 19.2, and 242°.
In another embodiment, Form 2 can be characterized by the differential scanning
calorimetry profile (DSC) shown in The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a strong endothermic tion with an onset temperature of about 88.2 °C with
a melt at about 91.0 0C.
In another embodiment, Form 2 can be characterized by thermal graVimetric analysis
(TGA) shown in The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 9.9 % of the weight of the sample as the temperature is changed from
about 266°C to 150.0 0C.
Form 3
In one embodiment, a single crystalline form, Form 3, of the compound 1 is characterized
by the X—ray powder diffraction (XRPD) pattern shown in and data shown in Table 3A,
obtained using CuKa ion. In a particular ment, the polymorph can be characterized
by one or more of the peaks taken from as shown in Table 3A. For example, the
polymorph can be terized by one or two or three or four or five or siX or seven or eight or
nine or ten of the peaks shown in Table 3A.
Table 3A
Angle Intensity
2-Theta° %
7.5 100.0
9.0 16.5
9.3 27.2
14.5 48.5
.2 17.2
18.0 17.0
18.8 32.6
19.9 18.7
21.3 19.3
24.8 33.8
In another embodiment, Form 3 can be characterized by the peaks identified at 20 angles
of 7.5, 9.3, 14.5, 18.8, 21.3, and 248°. In a r embodiment, Form 3 can be characterized by
the peaks are fied at 29 angles of 7.5, 14.5, 18.8, and 248°. In another, embodiment, Form
3 can be characterized by the peaks fied at 29 angles of 7.5, 14.5, and 248°.
In another embodiment, Form 3 can be characterized by the differential scanning
calorimetry profile (DSC) shown in The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a strong endothermic transition with an onset temperature of about 210.7 °C
with a melt at about 213.4 °C.
In another embodiment, Form 3 can be characterized by thermal graVimetric analysis
(TGA) shown in The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
ents a loss of about 0.03% of the weight of the sample as the temperature is changed from
about 21°C to 196 °C and about 7.5% of the weight of the sample as the temperature is changed
from about 196°C to 241°C.
In r embodiment, Form 3 is characterized by an X—ray powder diffraction pattern
substantially similar to In another embodiment, Form 3 is characterized by a differential
scanning calorimetry (DSC) profile substantially similar to In another ment,
Form 3 is characterized by a thermal graVimetric analysis (TGA) profile substantially r to
In further embodiments, a single crystalline form of Form 3 is characterized by one or
more of the features listed in this paragraph. In another embodiment, Form 3 is characterized by
a DVS profile substantially similar to
Form 4
In one embodiment, a single crystalline form, Form 4, of the nd 1 is characterized
by the X—ray powder ction (XRPD) pattern shown in and data shown in Table 4A,
obtained using CuKa radiation. In a particular embodiment, the rph can be characterized
by one or more of the peaks taken from as shown in Table 4A. For example, the
polymorph can be characterized by one or two or three or four or five or siX or seven or eight or
nine of the peaks shown in Table 4A.
Table 4A
2-Theta° %
6.2 28.9
6.5 38.0
7.5 29.5
18.6 25.0
19.0 34.8
19.4 58.8
19.9 100.0
22.9 31.0
24.7 36.9
In another embodiment, Form 4 can be characterized by the peaks identified at 29 angles
of 6.5, 19.0, 19.4, 19.9, and 247°. In a further embodiment, Form 4 can be characterized by the
peaks are identified at 29 angles of 6.5, 19.4, and l9.9°.
In another embodiment, Form 4 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
ature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a weak endothermic transition with an onset temperature of about 59.2 °C with
a melt at about 85.5 °C and a strong endothermic transition with an onset ature of about
205.2 0C with a melt at about 209.1 0C.
In another embodiment, Form 4 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA profile graphs the t loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 1.8 % of the weight of the sample as the temperature is changed from
about 44.8 °C to 140.0 0C.
Form 5
In one embodiment, a single crystalline form, Form 5, of the compound 1 is characterized
by the X—ray powder diffraction (XRPD) pattern shown in , and data shown in Table 5,
obtained using CuKa radiation. In a particular embodiment, the polymorph can be characterized
by one or more of the peaks taken from , as shown in Table 5A. For example, the
rph can be characterized by one or two or three or four or five or siX or seven or eight or
nine of the peaks shown in Table 5A.
2014/049469
Table 5A
Angle Intensity
2-Theta° %
7.1 100.0
14.5 40.0
17.1 29.8
19.2 6.1
21.8 47.8
22.7 7.7
23.4 6.5
28.5 2.1
29.4 17.6
In one ment, Form 5 can be characterized by the peaks identified at 29 angles of
7.1, 14.5, 17.1, and 218°. In a further embodiment, Form 5 can be characterized by the peaks
are identified at 29 angles of 7.1 and 218°.
In another embodiment, Form 5 can be terized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a weak endothermic transition with an onset temperature of about 50.1 °C with
a melt at about 77.5 °C and a strong endothermic transition with an onset temperature of about
203.1 0C with a melt at about 208.2 0C.
In another embodiment, Form 5 can be characterized by l graVimetric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 0.3 % of the weight of the sample as the temperature is changed from
about 36.0 °C to 120.0 0C.
Form 6
In one embodiment, a single crystalline form, Form 6, of the compound 1 is characterized
by the X—ray powder diffraction (XRPD) pattern shown in , and data shown in Table 6A,
ed using CuKa radiation. In a particular embodiment, the polymorph can be characterized
by one or more of the peaks taken from , as shown in Table 6A. For example, the
polymorph can be characterized by one or two or three or four or five or siX or seven or eight or
nine of the peaks shown in Table 6A.
Table 6A
Angle Intensity
2-Theta° %
6.3 53.7
7.2 100.0
8.1 71.5
12.2 19.2
12.7 34.0
14.9 37.2
17.9 21.4
18.4 31.0
26.4 20.2
In another embodiment, Form 6 can be terized by the peaks identified at 29 angles
of 6.3, 7.2, 8.1, 12.7, and 149°. In a further embodiment, Form 6 can be characterized by the
peaks are identified at 29 angles of 6.3, 7.2, and 81°.
In r embodiment, Form 6 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by three weak endothermic tions: with an onset temperature of about 61.7 °C
with a melt at about 86.75 0C, an onset temperature of about 140.0 °C with a melt at about 149.0
0C, and an onset temperature of about 175.3 °C with a melt at about 192.1 0C.
In another embodiment, Form 6 can be characterized by thermal etric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of ature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 5.4 % of the weight of the sample as the temperature is changed from
about 31.8 °C to 150.0 0C.
Form 7
In one embodiment, a single crystalline form, Form 7, of the compound 1 is characterized
by the X—ray powder diffraction (XRPD) pattern shown in , and data shown in Table 7A,
obtained using CuKa radiation. In a ular embodiment, the polymorph can be characterized
by one or more of the peaks taken from , as shown in Table 7A. For example, the
polymorph can be characterized by one or two or three or four or five or siX or seven or eight or
nine of the peaks shown in Table 7A.
Table 7A
Angle Intensity
2-Theta° %
9.7 32.5
14.1 59.0
18.6 35.7
19.1 100.0
.2 50.6
21.8 65.9
23.5 72.4
.7 57.7
28.9 27.7
In another embodiment, Form 7 can be characterized by the peaks identified at 29 angles
of 14.1, 19.1, 21.8, 23.5, and 257°. In a further embodiment, Form 7 can be characterized by the
peaks are identified at 29 angles of 19.1, 21.8, and 23.50.
In r embodiment, Form 7 can be terized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a strong endothermic transition with an onset temperature of about 213.6 °C
with a melt at about 214.7 0C.
In another embodiment, Form 7 can be characterized by l graVimetric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the ature rate change being about 10 °C /min. The weight loss
represents a loss of about 0.01 % of the weight of the sample as the temperature is changed from
about 32.2 °C to 150.0 0C.
Form 8
In one embodiment, a single crystalline form, Form 8, of the nd 1 is characterized
by the X—ray powder diffraction (XRPD) pattern shown in , and data shown in Table 8A,
ed using CuKa radiation. In a particular embodiment, the polymorph can be characterized
by one or more of the peaks taken from , as shown in Table 8A. For example, the
polymorph can be characterized by one or two or three or four or five or siX or seven or eight or
nine of the peaks shown in Table 8A.
Table 8A
Angle Intensity
2-Theta° %
9.0 38.7
9.2 39.6
14.1 12.0
16.8 21.9
19.9 53.4
21.9 100.0
22.1 65.9
24.2 56.6
24.6 66.7
In another embodiment, Form 8 can be characterized by the peaks identified at 29 angles
of 9.0, 9.2, 21.9, 22.1, 24.2, and 246°. In a further embodiment, Form 8 can be characterized by
the peaks are fied at 29 angles of 21.9, 22.1, 24.2, and 246°.
In another ment, Form 8 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a , the temperature rate change being about 10 °C /min. The profile is
characterized by a strong endothermic transition with an onset temperature of about 21 1.5 °C
with a melt at about 212.8 0C.
In another embodiment, Form 8 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 0.2 % of the weight of the sample as the temperature is changed from
about 31.2 °C to 150.0 0C.
Form 9
In one embodiment, a single crystalline form, Form 9, of the compound 1 is characterized
by the X—ray powder diffraction (XRPD) pattern shown in , and data shown in Table 9A,
obtained using CuKa radiation. In a particular embodiment, the polymorph can be characterized
by one or more of the peaks taken from , as shown in Table 9A. For example, the
polymorph can be characterized by one or two or three or four or five or siX or seven or eight or
nine of the peaks shown in Table 9A.
Table 9A
Angle ity
a° %
6.5 33.8
.7 21.8
17.7 8.6
18.4 23.7
19.0 13.6
19.6 40.1
.1 100.0
21.6 26.9
29.9 9.9
In r embodiment, Form 9 can be characterized by the peaks identified at 20 angles
of 6.5, 19.6, 20.1, and 216°. In a further embodiment, Form 9 can be terized by the peaks
are identified at 20 angles of 19.6 and 201°.
In another embodiment, Form 9 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
ature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a strong endothermic transition with an onset temperature of about 172.3°C
with a melt at about 175.95 °C and an endothermic transition with an onset temperature of about
192.3 0C with a melt at about 202.1 0C.
In another embodiment, Form 9 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
ents a loss of about 0.7 % of the weight of the sample as the temperature is changed from
about 24.7 0C to 150.0 0C.
Form 10
In one embodiment, a single crystalline form, Form 10, of the compound 1 is
characterized by the X—ray powder diffraction (XRPD) n shown in , and data shown
in Table 10A, obtained using CuKa radiation. In a particular ment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 10A. For
example, the polymorph can be characterized by one or two or three or four or five or siX or
seven or eight or nine of the peaks shown in Table 10A.
Angle Intensity
2-Theta° %
6.7 46.8
7.7 31.0
9.1 100.0
.8 76.9
13.3 11.6
16.0 15.6
19.9 84.6
21.9 52.3
.8 15.2
In another ment, Form 10 can be characterized by the peaks identified at 29 angles
of 6.7, 9.1, 10.8, 19.9, and 219°. In a further embodiment, Form 10 can be characterized by the
peaks are identified at 29 angles of 9.1, 10.8, and 199°.
In another ment, Form 10 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by an endothermic transition with an onset temperature of about 139.9 °C with a
melt at about 150.9 °C and an endothermic transition with an onset temperature of about 197.3
°C with a melt at about 201.3 0C.
In another embodiment, Form 10 can be characterized by thermal gravimetric is
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
ents a loss of about 0.5 % of the weight of the sample as the temperature is changed from
about 31.0 °C to 120.0 0C.
Form 11
In one embodiment, a single crystalline form, Form 11, of the nd 1 is
characterized by the X—ray powder ction (XRPD) pattern shown in , and data shown
in Table 11A, obtained using CuKa radiation. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 11A. For
example, the polymorph can be characterized by one or two or three or four or five or siX or
seven or eight or nine or ten or eleven of the peaks shown in Table 11A.
Angle Intensity
2-Theta° %
6.3 53.1
7.7 32.8
16.3 40.2
17.2 16.8
.0 74.6
.2 100.0
.5 79.2
21.2 89.4
23.2 21.4
26.5 56.0
28.1 17.2
In another embodiment, Form 11 can be characterized by the peaks identified at 29 angles
of 6.3, 20.0, 20.2, 20.5, 21.2, and 265°. In a further embodiment, Form 11 can be characterized
by the peaks are identified at 29 angles of 20.0, 20.2, 20.5, and 212°.
In another embodiment, Form 11 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by an endothermic transition with an onset temperature of about 144.3 °C with a
melt at about 154.5 °C and an endothermic transition with an onset temperature of about 193.4
°C with a melt at about 201.6 0C.
In another embodiment, Form 11 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of ature, the ature rate change being about 10 °C /min. The weight loss
represents a loss of about 3.0 % of the weight of the sample as the temperature is changed from
about 25.7 °C to 98.4 0C.
Form 12
In one ment, a single crystalline form, Form 12, of the compound 1 is
characterized by the X—ray powder diffraction (XRPD) pattern shown in , and data shown
in Table 12A, obtained using CuKa radiation. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 12A. For
example, the rph can be terized by one or two or three or four or five or siX or
seven or eight or nine of the peaks shown in Table 12A.
Angle Intensity
2-Theta° %
7.2 75.7
7.4 100.0
8.0 61.3
8.2 52.4
13.2 9.4
16.5 27.2
18.6 32.7
.2 23.6
.8 18.7
In r embodiment, Form 12 can be characterized by the peaks identified at 29 angles
of 7.2, 7.4, 8.0, 8.2, 16.5, and 186°. In a further embodiment, Form 12 can be characterized by
the peaks are identified at 29 angles of 7.2, 7.4, 8.0, and 82°.
In r embodiment, Form 12 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
ature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by an endothermic transition with an onset temperature of about 80.9 °C with a
melt at about 106.3 0C, an endothermic tion with an onset temperature of about 136.32 °C
with a melt at about 150.3 0C, and a strong endothermic transition with an onset temperature of
about 199.0 °C with a melt at about 203.1 0C.
In another embodiment, Form 12 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA e graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 6.4 % of the weight of the sample as the temperature is changed from
about 25.9 °C to 80.0 0C, and a loss of about 7.2 % of the weight of the sample as the
temperature is changed from about 25.9 °C to 150.0 0C.
Form 13
In one embodiment, a single crystalline form, Form 13, of the nd 1 is
characterized by the X—ray powder diffraction (XRPD) pattern shown in , and data shown
in Table 13A, obtained using CuKa radiation. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 13A. For
example, the polymorph can be characterized by one or two or three or four or five or siX or
seven or eight or nine of the peaks shown in Table 13A.
Angle Intensity
2-Theta° %
6.3 100.0
12.7 30.1
14.9 14.1
18.0 8.4
19.1 10.8
.3 24.3
.8 15.2
22.0 7.2
26.5 18.2
In another embodiment, Form 13 can be characterized by the peaks identified at 20 angles
of 6.3, 12.7, 20.3, 20.8, and 265°. In a further embodiment, Form 13 can be characterized by the
peaks are identified at 20 angles of 6.3, 12.7, and 203°.
In another embodiment, Form 13 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a on of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a weak endothermic transition with an onset temperature of about 144.1 °C with
a melt at about 152.4 0C, and a strong ermic transition with an onset temperature of about
198.1 0C with a melt at about 204.8 0C.
In another embodiment, Form 13 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA profile graphs the t loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 4.1 % of the weight of the sample as the temperature is changed from
about 24.9 °C to 150.0 0C.
Form 14
In one embodiment, a single crystalline form, Form 14, of the compound 1 is
characterized by the X—ray powder diffraction (XRPD) pattern shown in , and data shown
in Table 14A, obtained using CuKa radiation. In a particular embodiment, the rph can be
characterized by one or more of the peaks taken from , as shown in Table 14A. For
e, the polymorph can be characterized by one or two or three or four or five or siX or
seven or eight or nine of the peaks shown in Table 14A.
Table 14A
Angle Intensity
2-Theta° %
8.7 26.9
.3 6.7
13.3 30.8
.1 26.5
17.5 49.6
.8 54.8
23.3 49.1
26.8 33.4
In another embodiment, Form 14 can be characterized by the peaks identified at 20 angles
of 6.6, 17.5, 20.8 and 233°. In a further embodiment, Form 14 can be characterized by the peaks
are identified at 20 angles of 6.6 and 208°.
In another embodiment, Form 14 can be characterized by the differential ng
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a weak endothermic transition with an onset temperature of about 122.3 °C with
a melt at about 134.5 0C, and a strong endothermic transition with an onset temperature of about
207.6 °C with a melt at about 211.8 0C.
In another ment, Form 14 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA e graphs the t loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 5.71 % of the weight of the sample as the temperature is changed from
about 28.1 °C to 150.0 0C.
Form 15
In one embodiment, a single crystalline form, Form 15, of the compound 1 is
characterized by the X—ray powder diffraction (XRPD) pattern shown in , and data shown
in Table 15A, ed using CuKa radiation. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 15A. For
example, the polymorph can be characterized by one or two or three or four or five or siX or
seven or eight or nine of the peaks shown in Table 15A.
Angle Intensity
2-Theta° %
6.4 100.0
11.5 9.2
12.9 18.0
19.5 8.0
.2 12.4
21.6 5.0
23.2 10.2
26.1 19.0
29.4 3.2
In another embodiment, Form 15 can be terized by the peaks identified at 29 angles
of 6.4, 12.9, 20.2, and 261°. In a further embodiment, Form 15 can be characterized by the
peaks are identified at 29 angles of 6.4, 12.9, and 26.10.
In another embodiment, Form 15 can be characterized by the differential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a weak endothermic transition with an onset temperature of about 136.5 °C with
a melt at about 140.1 0C, and a strong endothermic transition with an onset temperature of about
213.1 0C with a melt at about 215.2 0C.
In another ment, Form 15 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 7.6 % of the weight of the sample as the temperature is d from
about 28.7 0C to 150.0 0C.
Form 16
In one embodiment, a single crystalline form, Form 16, of the compound 3 is
characterized by the X—ray powder ction (XRPD) pattern shown in , and data shown
in Table 16A, obtained using CuKa ion. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 16A. For
example, the polymorph can be characterized by one or two or three or four or five or siX or
seven or eight or nine of the peaks shown in Table 16A.
Angle Intensity
2-Theta° %
6.8 35.5
.1 30.7
.6 53.1
13.6 46.0
14.2 63.8
17.2 26.4
18.4 34.0
19.2 100.0
23.5 3.8
In another embodiment, Form 16 can be characterized by the peaks identified at 29 angles
of 6.8, 10.6, 13.6, 14.2, and 192°. In r embodiment, Form 16 can be characterized by the
peaks identified at 29 angles of 10.6, 14.2, and 192°.
In another embodiment, Form 16 can be characterized by the ential scanning
calorimetry profile (DSC) shown in . The DSC graph plots the heat flow as a function of
temperature from a sample, the temperature rate change being about 10 °C /min. The profile is
characterized by a strong endothermic transition with an onset temperature of about 169.7 °C
with a melt at about 172.1 0C.
In r embodiment, Form 16 can be characterized by thermal graVimetric analysis
(TGA) shown in . The TGA profile graphs the percent loss of weight of the sample as a
function of temperature, the temperature rate change being about 10 °C /min. The weight loss
represents a loss of about 0.1 % of the weight of the sample as the temperature is changed from
about 23.9 °C to 150.0 0C.
Form 17
In one embodiment, a single crystalline form, Form 17, of the nd 3 is
terized by the X—ray powder diffraction (XRPD) pattern shown in , and data shown
in Table 17A, obtained using CuKa radiation. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 17A. For
example, the polymorph can be characterized by one or two or three or four or five or six or
seven or eight or nine of the peaks shown in Table 17A.
Angle Intensity
2-Theta° %
7.2 53.3
.1 26.7
11.5 20.5
13.6 100.0
18.5 72.0
19.3 46.9
.3 39.4
21.9 55.4
23.5 77.5
In another embodiment, Form 17 can be characterized by the peaks identified at 29 angles
of 7.2, 13.6, 18.5, 19.3, 21.9, and 235°. In another embodiment, Form 17 can be characterized
by the peaks identified at 29 angles of 13.6, 18.5, and 23.50.
Form 18
In one embodiment, a single lline form, Form 18, of the compound 3 is
characterized by the X—ray powder diffraction (XRPD) n shown in , and data shown
in Table 18A, ed using CuKa radiation. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 18A. For
example, the polymorph can be characterized by one or two or three or four or five or six or
seven or eight or nine of the peaks shown in Table 18A.
Angle Intensity
2-Theta° %
6.4 45.4
8.4 84.0
9.8 100.0
16.1 26.0
16.9 22.7
17.8 43.6
19.7 40.4
21.1 20.5
26.1 15.9
In another embodiment, Form 18 can be characterized by the peaks identified at 20 angles
of 6.4, 8.4, 9.8, 17.8, and 197°. In another embodiment, Form 18 can be characterized by the
peaks identified at 20 angles of 8.4 and 98°.
Form 19
In one embodiment, a single lline form, Form 19, of the compound 3 is
terized by the X—ray powder diffraction (XRPD) pattern shown in , and data shown
in Table 19A, obtained using CuKa radiation. In a particular embodiment, the polymorph can be
characterized by one or more of the peaks taken from , as shown in Table 19A. For
example, the polymorph can be characterized by one or two or three or four or five or siX or
seven or eight of the peaks shown in Table 19A.
Angle Intensity
2-Theta° %
8.1 97.9
11.4 24.9
14.1 51.5
.2 28.4
16.4 85.0
17.3 100.0
.5 54.7
24.1 88.7
In another embodiment, Form 19 can be terized by the peaks identified at 20 angles
of 8.1, 14.1, 16.4, 17.3, 20.5, and 241°. In another embodiment, Form 19 can be characterized
by the peaks identified at 20 angles of 8.1, 16.4, 17.3, and 241°.
Other embodiments are directed to a single crystalline form of nd 1 or compound
3 characterized by a combination of the aforementioned characteristics of any of the single
crystalline forms discussed herein. The characterization may be by any combination of one or
more of the XRPD, TGA, DSC, and DVS described for a particular polymorph. For example,
the single crystalline form of compound 1 or compound 3 may be characterized by any
combination of the XRPD results ing the position of the major peaks in a XRPD scan;
and/or any combination of one or more of parameters d from data ed from a XRPD
scan. The single crystalline form of compound 1 or compound 3 may also be characterized by
TGA determinations of the weight loss associated with a sample over a designated temperature
range; and/or the temperature at which a particular weight loss transition begins. DSC
determinations of the ature ated with the maximum heat flow during a heat flow
transition and/or the temperature at which a sample begins to undergo a heat flow transition may
also characterize the crystalline form. Weight change in a sample and/or change in
sorption/desorption of water per molecule of compound 1 or compound 3 as determined by water
sorption/desorption measurements over a range of relative humidity (e.g., 0% to 90%) may also
characterize a single crystalline form of compound 1 or compound 3.
The combinations of terizations that are discussed above may be used to describe
any of the polymorphs of compound 1 or compound 3 discussed herein, or any combination of
these polymorphs.
Examples
iations
ca approximately
CHCl3 — chloroform
DCM — dichloromethane
DMF — dimethylformamide
EtZO — diethyl ether
EtOH — ethyl alcohol
EtOAc — ethyl acetate
MeOH — methyl alcohol
MeCN — acetonitrile
PE — petroleum ether
THF — tetrahydrofuran
AcOH — acetic acid
HCl — hydrochloric acid
H2S04 — sulfuric acid
NH4Cl — um chloride
KOH — potassium hydroxide
NaOH — sodium hydroxide
NazCO3 — sodium carbonate
TFA — trifluoroacetic acid
NaHCO3 — sodium bicarbonate
DMSO dimethylsulfoxide
DSC differential scanning calorimetry
DVS dynamic vapor on
GC gas chromatography
h hours
HPLC high performance liquid chromatography
min minutes
m/z mass to charge
MS mass um
NMR nuclear magnetic resonance
RT room temperature
TGA thermal graVimetric is
XRPD X—ray powder diffraction / X—ray powder diffractogram / X—ray powder diffractometer
General s
In the following examples, ts may be purchased from commercial sources
(including Alfa, Acros, Sigma Aldrich, TCI and Shanghai Chemical Reagent Company), and
used without further purification. Nuclear magnetic resonance (NMR) spectra may be obtained
on a Brucker AMX—400 NMR (Brucker, Switzerland). Chemical shifts are reported in parts per
million (ppm, 8) downfield from ethylsilane. Mass spectra may be run with electrospray
ionization (ESI) from a Waters LCT TOF Mass ometer (Waters, USA).
For exemplary compounds, including crystalline forms thereof, sed in this section, the
specification of a stereoisomer (e.g., an (R) or (S) stereoisomer) indicates a preparation of that
compound such that the compound is enriched at the specified stereocenter by at least about
90%, 95%, 96%, 97%, 98%, or 99%.
The chemical name of each of the exemplary compound described below is generated by
ChemDraw software.
X-Ray Powder Diffraction (XRPD) parameters: XRPD analysis was med using a
PANalytical Empyrean X—ray powder diffractometer (XRPD) with a 12—auto sample stage. The
XRPD parameters used are listed in Table 20.
Table 20.
Parameters for Reflection Mode
Cu, ka,
X—Ray wavelength Kal (A): 1.540598, Ka2 (A): 1.544426
Ka2/K0t1 intensity ratio: 0.50
X—Ray tube setting 45 kV, 40 mA
Divergence slit Automatic
Scan mode Continuous
Scan range (°2TH) 30—40o
Step size (°2TH) 0.0170
Scan speed (°/min) About 10
For Form 3, XRPD analysis was performed using a LYNXEYE XE Detector r). The
XRPD parameters used are listed in Table 21.
Table 21.
Parameters for Reflection Mode
X—Ray wavelength Kal (A): 1.54060, Ka2 (A): 1.54439
Ka2/K0t1 intensity ratio: 0.50
Scan range (°2TH) 30—40o
Step size (°2TH) 0.012
Differential Scanning Calorimetry (DSC) parameters: DSC is was performed using a
TA Q100, or Q200/Q2000 DSC from TA Instruments. The temperature was ramped from room
temperature to the desired temperature at a heating rate of 10 OC/min using N2 as the purge gas,
with pan crimped.
Thermogravimetric is (TGA) parameters: TGA analysis was performed using a TA
Q500/Q5000 TGA from TA Instruments. The temperature was ramped from room ature
to the desired temperature at a heating rate of 10 OC/min or 20 OC/rnin using N2 as the purge gas.
Dynamic Vapor Sorption (DVS) parameters: DVS was measured Via a SMS (Surface
Measurement Systems) DVS Intrinsic. The relative humidity at 25°C were calibrated against
escence point of LiCl, Mg(NO3)2 and KCl. The DVS Parameters used are listed in Table
Table 22
Temperature 25°C
Sample size 10—20 mg
Gas and flow rate N2, 200 mL/min
dm/dt 0.002%/min
Min. dm/dt stability duration 10 min
Max. equilibrium time 180 min
RH range 95%RH—0%RH—95%RH
% (0%RH—90%RH, 90%RH--0%RH)
RH step size
% (90%RH—95%RH—90%RH)
Example 1: Synthesis of compound 3
Example 1, Step 1: preparation of 6-trifluoromethyl-pyridinecarboxylic acid
Diethyl ether (4.32 L) and hexanes (5.40 L) are added to the reaction vessel under N2
atmosphere, and cooled to —75 °C to —65 °C. Dropwise addition of n—Butyl lithium (3.78 L in 1.6
M hexane) under N2 atmosphere at below —65 °C is followed by dropwise addition of dimethyl
amino ethanol (327.45 g, 3.67 mol) and after 10 min. dropwise addition of 2—trifluoromethyl
pyridine (360 g, 2.45 mol). The reaction is stirred under N2 while maintaining the temperature
below —65 °C for about 20—25 hrs. The reaction mixture is poured over crushed dry ice under
N2, then brought to a temperature of 0 to 5 °C while stirring (approx. 1.0 to 1.5 h) followed by
the addition of water (1.8 L). The reaction mixture is stirred for 5—10 mins and allowed to warm
to 5—10 °C. 6N HCl (900 mL) is added dropwise until the e reached pH 1.0 to 2.0, then
the mixture is d for 10—20 min. at 5—10 °C. The reaction mixture is diluted with ethyl
acetate at 25—35 °C, then washed with brine solution. The reaction is concentrated and rinsed
with n—heptane and then dried to yield 6—trifluoromethyl—pyridine—2—carboxylic acid.
Example I, Step 2: preparation of 6-trifluoromethyl-pyridinecarboxylic acid methyl ester
Methanol is added to the reaction vessel under nitrogen atmosphere. 6—trifluoromethyl—
pyridine—2—carboxylic acid (150 g, 0.785 mol) is added and dissolved at t temperature.
Acetyl chloride (67.78 g, 0.863 mol) is added dropwise at a temperature below 45 °C. The
reaction mixture is ined at 65—70 °C for about 2—2.5 h, and then concentrated at 35—45 °C
under vacuum and cooled to 25—35 °C. The mixture is diluted with ethyl acetate and rinsed with
saturated NaHCO3 on then rinsed with brine solution. The mixture is concentrated at temp
—45 0C under vacuum and cooled to 25—35 °C, then rinsed with n—heptane and concentrated at
temp 35—45 °C under vacuum, then ed to obtain brown solid, which is rinsed with n—
heptane and d for 10—15 minute at 25—35 0C. The sion is cooled to —40 to —30 °C
while stirring, and filtered and dried to provide uoromethyl—pyridine—2—carboxylic acid
methyl ester.
Example I, Step 3: preparation of 6-(6-Trifluoromethyl-pyridin-Z-yl)-1H-1,3,5-triazine-2,4-
dione
l L absolute ethanol is charged to the reaction vessel under N2 atmosphere and Sodium
Metal (l 1.2 g, 0.488 mol) is added in portions under N2 atmosphere at below 50 °C. The
reaction is stirred for 5—10 minutes, then heated to 50—55 °C. Dried Biuret (12.5 g, 0.122 mol) is
added to the reaction vessel under N2 atmosphere at 50—55 °C temperature, and stirred 10—15
minutes. While maintaining 50—55 °C 6—trifluoromethyl—pyridine—2—carboxylic acid methyl ester
(50.0 g, 0.244 mol) is added. The reaction mixture is heated to reflux (75—80 °C) and maintained
for 1.5—2 hours. Then cooled to 35—40 °C, and concentrated at 45—50 °C under vacuum. Water is
added and the e is concentrated under vacuum then cooled to 35—40 °C more water is
added and the mixture cooled to 0 —5 0C. pH is adjusted to 7—8 by slow addition of 6N HCl, and
solid precipitated out and is centrifuged and rinsed with water and centrifuged again. The off
white to light brown solid of 6—(6—Trifluoromethyl—pyridin—2—yl)—1H—1,3,5—triazine—2,4—dione is
dried under vacuum for 8 to 10 hrs at 50 °C to 60 °C under 600mm/Hg pressure to provide 6—(6—
Trifluoromethyl—pyridin—2—yl)—1H—1,3,5—triazine—2,4—dione.
Example I, Step 4: preparation 0f2, 4-Dichlor0(6-triflu0r0methyl-pyridinyl)-1, 3, 5-
triazine
POCl3 (175.0 mL) is d into the reaction vessel at 20— 35 OC, and 6—(6—
Trifluoromethyl—pyridin—2—yl)—1H—1,3,5—triazine—2,4—dione (35.0 g, 0.1355 mol) is added in
portions at below 50 OC. The reaction mixture is de—gassed 5—20 s by purging with N2
gas. Phosphorous pentachloride (112.86 g, 0.542 mol) is added while stirring at below 50 °C
and the resulting slurry is heated to reflux (105—1 10 °C) and maintained for 3—4 h. The reaction
e is cooled to 50—55 °C, and concentrated at below 55 °C then cooled to 20—30 0C. The
reaction mixture is rinsed with ethyl e and the ethyl acetate layer is slowly added to cold
water (temperature ~5 °C) while stirring and maintaining the temperature below 10 °C. The
mixture is d 3—5 minutes at a temperature of between 10 to 20 °C and the ethyl acetate layer
is collected. The reaction mixture is rinsed with sodium bicarbonate solution and dried over
anhydrous sodium sulphate. The material is dried 2—3 h under vacuum at below 45 °C to e
2, 4—Dichloro—6—(6—trifluoromethyl—pyridin—2—yl)—1, 3, 5—triazine.
Example I, Step 5: preparation 0f4-chlor0(6-(triflu0r0methyl)pyridinyl)-N-(2-(trifluoromethyl
)- pyridinyl)-1,3,5-triazinamine
A mixture of THF (135 mL) and 2, 4—Dichloro—6—(6—trifluoromethyl—pyridin—2—yl)—1, 3, 5—
triazine (27.0 g, 0.0915 mol) are added to the reaction vessel at 20 — 35 0C, then 4—amino—2—
(trifluoromethyl)pyridine (16.31 g, 0.1006 mol) and sodium bicarbonate (11.52 g, 0.1372 mol)
are added. The resulting slurry is heated to reflux (75—80 °C) for 20—24 h. The reaction is cooled
to 30—40 °C and THF evaporated at below 45 °C under reduced pressure. The reaction mixture is
cooled to 20—35 °C and rinsed with ethyl acetate and water, and the ethyl e layer collected
and rinsed with 0.5 N HCl and brine solution. The organic layer is concentrated under vacuum
at below 45 °C then rinsed with dichloromethane and hexanes, filtered and washed with hexanes
and dried for 5—6h at 45—50 °C under vacuum to provide 4—chloro—6—(6—(trifluoromethyl)pyridin—
2—yl)—N— (2—(trifluoro—methyl)— pyridin—4—yl)—1,3,5—triazin—2—amine.
Example I, Step 6: ation 0f2-methyl(4-(6-(triflu0r0methyl)pyridinyl)(2-
(trifluoromethyl)- nylamino)-1,3,5-triazinylamin0)pr0panol
THF (290 mL), 4—chloro—6—(6—(trifluoromethyl)pyridin—2—yl)—N—(2—(trifluoro—methyl)—
pyridin—4—yl)—1,3,5—triazin—2—amine (29.0 g, 0.06893 mol), sodium onate (8.68 g, 0.1033
mol), and l,l—dimethylaminoethanol (7.37 g, 1 mol) are added to the reaction vessel at
—35 0C. The resulting slurry is heated to reflux (75—80 °C) for 16—20 h. The reaction is cooled
to 30—40 °C and THF ated at below 45 °C under reduced pressure. The reaction mixture is
cooled to 20—35 °C and rinsed with ethyl acetate and water, and the ethyl acetate layer ted.
The organic layer is concentrated under vacuum at below 45 °C then rinsed with
dichloromethane and hexanes, filtered and washed with hexanes and dried for 8—10h at 45—50 °C
under vacuum to provide 2—methyl—1—(4—(6—(trifluoromethyl)pyridin—2—yl)—6—(2—(trifluoromethyl)—
pyridin—4—ylamino)— 1 ,3 ,5 —triazin—2—ylamino)propan—2—ol.
Example 2: Synthesis of compound 1
Acetone (435.0 mL) and compound 3 (87.0 g, 0.184 mol) are added to the reaction vessel
at 20—35 0C. In a separate vessel, methanesulfonic acid is added over 10 minutes to cold (0—4
°C) acetone (191.4 mL) while stirring to prepare a methane sulfonic acid solution. While
passing through a micron filter, the freshly prepared esulfonic acid solution is added
dropwise to the reaction mixture. The resulting slurry is filtered using nutsche filter and washed
with acetone. The filtered material is dried for 30—40 minutes using vacuum to provide
compound 1.
Example 2A: Synthesis of compound 3 Form 16
Example 2A, Step 1: preparation of 6-triflu0r0methyl-pyridinecarb0xylic acid
Diethyl ether (4.32 L) and s (5.40 L) are added to the reaction vessel under N2
atmosphere, and cooled to —75 °C to —65 °C. Dropwise on of n—Butyl lithium (3.78 L in 1.6
WO 17821
M hexane) under N2 atmosphere at below —65 °C is followed by dropwise addition of dimethyl
amino ethanol (327.45 g, 3.67 mol) and after 10 min. dropwise addition of 2—trifluoromethyl
pyridine (360 g, 2.45 mol). The reaction is stirred under N2 while maintaining the temperature
below —65 °C for about 2.0—2.5 hrs. The reaction mixture is poured over crushed dry ice under
N2, then brought to a temperature of 0 to 5 °C while stirring (approx. 1.0 to 1.5 h) followed by
the addition of water (1.8 L). The reaction mixture is stirred for 5—10 mins and allowed to warm
to 5—10 °C. 6N HCl (900 mL) is added dropwise until the mixture reached pH 1.0 to 2.0, then
the mixture is stirred for 10—20 min. at 5—10 °C. The reaction mixture is diluted with ethyl
acetate at 25—35 °C, then washed with brine solution. The on is concentrated and rinsed
with n—heptane and then dried to yield 6—trifluoromethyl—pyridine—2—carboxylic acid.
Example 2A, Step 2: preparation of 6-triflu0r0methyl-pyridinecarb0xylic acid methyl ester
Methanol is added to the reaction vessel under nitrogen atmosphere. uoromethyl—
ne—2—carboxylic acid (150 g, 0.785 mol) is added and dissolved at ambient temperature.
Acetyl de (67.78 g, 0.863 mol) is added dropwise at a temperature below 45 °C. The
reaction mixture is maintained at 65—70 °C for about 2—2.5 h, and then concentrated at 35—45 °C
under vacuum and cooled to 25—35 °C. The mixture is diluted with ethyl acetate and rinsed with
saturated NaHCO3 solution then rinsed with brine solution. The mixture is concentrated at temp
—45 0C under vacuum and cooled to 25—35 °C, then rinsed with n—heptane and concentrated at
temp 35—45 °C under , then degassed to obtain brown solid, which is rinsed with n—
heptane and stirred for 10—15 minute at 25—35 0C. The suspension is cooled to —40 to —30 °C
while ng, and filtered and dried to provide 6—trifluoromethyl—pyridine—2—carboxylic acid
methyl ester.
Example 2A, Step 3: preparation of 6-(6-Triflu0r0methyl-pyridinyl)-1H-1,3,5-triazine-2,4-
dione
l L te ethanol is charged to the reaction vessel under N2 here and Sodium
Metal (l 1.2 g, 0.488 mol) is added in portions under N2 atmosphere at below 50 °C. The
reaction is stirred for 5—10 minutes, then heated to 50—55 °C. Dried Biuret (12.5 g, 0.122 mol) is
added to the reaction vessel under N2 atmosphere at 50—55 °C ature, and stirred 10—15
minutes. While maintaining 50—55 °C 6—trifluoromethyl—pyridine—2—carboxylic acid methyl ester
(50.0 g, 0.244 mol) is added. The reaction mixture is heated to reflux (75—80 °C) and maintained
for 1.5—2 hours. Then cooled to 35—40 °C, and concentrated at 45—50 °C under . Water is
added and the mixture is concentrated under vacuum then cooled to 35—40 °C more water is
added and the mixture cooled to 0 —5 0C. pH is adjusted to 7—8 by slow addition of 6N HCl, and
solid precipitated out and is fuged and rinsed with water and centrifuged again. The off
white to light brown solid of 6—(6—Trifluoromethyl—pyridin—2—yl)—1H—1,3,5—triazine—2,4—dione is
dried under vacuum for 8 to 10 hrs at 50 °C to 60 °C under 600mm/Hg pressure to provide 6—(6—
Trifluoromethyl—pyridin—2—yl)—1H—1,3,5—triazine—2,4—dione.
Example 2A, Step 4: preparation of 2, 4-Dichlor0(6-triflu0r0methyl-pyridinyl)-1, 3, 5-
triazine
POCl3 (175.0 mL) is charged into the reaction vessel at 20— 35 OC, and 6—(6—
romethyl—pyridin—2—yl)—1H—1,3,5—triazine—2,4—dione (35.0 g, 0.1355 mol) is added in
portions at below 50 OC. The reaction e is de—gassed 5—20 minutes by purging with N2
gas. Phosphorous hloride (112.86 g, 0.542 mol) is added while stirring at below 50 °C
and the resulting slurry is heated to reflux (105—1 10 °C) and maintained for 3—4 h. The reaction
mixture is cooled to 50—55 °C, and concentrated at below 55 °C then cooled to 20—30 0C. The
reaction mixture is rinsed with ethyl acetate and the ethyl acetate layer is slowly added to cold
water (temperature ~5 °C) while stirring and maintaining the temperature below 10 °C. The
mixture is d 3—5 minutes at a temperature of between 10 to 20 °C and the ethyl acetate layer
is collected. The reaction mixture is rinsed with sodium bicarbonate solution and dried over
anhydrous sodium sulphate. The material is dried 2—3 h under vacuum at below 45 °C to provide
2, 4—Dichloro—6—(6—trifluoromethyl—pyridin—2—yl)—1, 3, 5—triazine.
Example 2A, Step 5: preparation 0f4-chlor0(6-(trifluoromethyl)pyridinyl)-N-(2-
(trifluoro-methyl)- pyridinyl)-1,3,5-triazinamine
A mixture of THF (135 mL) and 2, 4—Dichloro—6—(6—trifluoromethyl—pyridin—2—yl)—1, 3, 5—
triazine (27.0 g, 0.0915 mol) are added to the reaction vessel at 20 — 35 0C, then 4—amino—2—
(trifluoromethyl)pyridine (16.31 g, 0.1006 mol) and sodium bicarbonate (11.52 g, 0.1372 mol)
are added. The ing slurry is heated to reflux (75—80 °C) for 20—24 h. The reaction is cooled
to 30—40 °C and THF evaporated at below 45 °C under reduced pressure. The reaction mixture is
cooled to 20—35 °C and rinsed with ethyl e and water, and the ethyl acetate layer collected
and rinsed with 0.5 N HCl and brine solution. The organic layer is concentrated under vacuum
at below 45 °C then rinsed with dichloromethane and hexanes, filtered and washed with hexanes
2014/049469
and dried for 5—6h at 45—50 °C under vacuum to provide 4—chloro—6—(6—(trifluoromethyl)pyridin—
N— (2—(trifluoro—methyl)— pyridin—4—yl)— l riazin—2—amine.
Example 2A, Step 6: preparation 0f2-methyl(4-(6-(triflu0r0methyl)pyridinyl)(2-
(trifluoromethyl)- pyridinylamin0)-1,3,5-triazinylamin0)propan0l compound 3
THF (290 mL), ro—6—(6—(trifluoromethyl)pyridin—2—yl)—N—(2—(trifluoro—methyl)—
pyridin—4—yl)—l,3,5—triazin—2—amine (29.0 g, 0.06893 mol), sodium bicarbonate (8.68 g, 0.1033
mol), and l,l—dimethylaminoethanol (7.37 g, 0.08271 mol) are added to the reaction vessel at
—35 0C. The resulting slurry is heated to reflux (75—80 °C) for 16—20 h. The reaction is cooled
to 30—40 °C and THF evaporated at below 45 °C under reduced pressure. The on e is
cooled to 20—35 °C and rinsed with ethyl acetate and water, and the ethyl acetate layer collected.
The organic layer is concentrated under vacuum at below 45 °C then rinsed with
dichloromethane and hexanes, filtered and washed with hexanes and dried for 8—10h at 45—50 °C
under vacuum to e 2—methyl—l—(4—(6—(trifluoromethyl)pyridin—2—yl)—6—(2—(trifluoromethyl)—
pyridin—4—ylamino)— l ,3 ,5 —triazin—2—ylamino)propan—2—ol.
Example 3A: Synthesis of compound 3 Form 1
Method A:
Slurry conversion is conducted by suspending ca 10 mg of Form 3 in 05—1 .0 mL of
water. After the suspension is stirred at 50°C for 48 h, the remaining solids are centrifuged to
provide Form 1.
Method B:
9.61 mg of Form 3 is dissolved in 0.2 mL of ethanol. The solution is placed at ambient
condition and ethanol is evaporated to get Form 1.
Method C:
6.93 mg of Form 3 is dissolved in 0.2 mL of isopropyl acetate. The solution is placed at
ambient temprerature and isopropyl acetate is evaporated to get Form 1.
Example 4A: Synthesis of compound 3 Form 2
Method A:
Slurry conversion is conducted by suspending ca 10 mg of Form 3 in 0.5—1.0 mL of
water. After the suspension is stirred at RT for 48 h, the remaining solids are centrifuged to
e Form 2.
Method B:
6.07 mg of Form 3 is ded in 1.0 mL of water. The suspension is stirred at room
temperature for about 24 hours. The solid is ed to obtain Form 2.
Example 6A: Synthesis of compound 1 Form 3
While stirring, acetone (961.1 ml) is added to reaction vessel. The reaction is agitated
and cooled to 15 °C then methanesulfonic acid (28.3 g) is added and the reaction is aged for at
least 10 s. Crystallization to Form 3 is accomplished via the following salt formation: 1)
acetone (500 ml, 4.17 vol) is d to the crystallizer, then the mixture is agitated (550 rpm)
for 10 min., 2) compound 3 (120.0 g, 253.5 mmol) is charged into crystallizer via solid charger
over 45 min., 3) the solid charger is rinsed with acetone (100 ml, 0.83 vol), 4) the reaction is
stirred (550 rpm) and heated to 35 °C to obtain a clear solution (in 10 min), 5) a first portion
(2%) of MSA/acetone solution (0.3 mol/L,l8.1 ml,3.8 ml/min) is added over 5 min via a piston
pump, then the pump pipeline is washed with acetone (5 ml, 0.04 vol), 6) the mixture is aged at
°C for 10 tol5 min, while ensuring the solution remains clear, 7) nd 1 seed (2.4 g as
generated in Example 5, 2 wt%) is added, to the clear solution, 8) a second portion (49%) of
MSA/acetone solution (0.3 mom/L, 444 ml, 3.7 ml/min) is added over 2 hrs, 9) the mixture is
aged at 35 °C for 30 min, 10) a third portion (49%) of MSA/acetone solution (0.3 mom/L, 444
ml, 7.4 ) is added over 1 hr, 11) the mixture is aged at 35 °C for 2 hr, 12) the e is
cooled to 20 °C for 1 hr, 13) the mixture is filtered and the cake washed with acetone (240 ml
twice), 17) and dried under vacuum at 30 0C; to provide Form 3 crystals.
Example 7A: Synthesis of compound 1 Form 4
Reactive crystallization is conducted by mixing compound 3 (0.1 mol/L) and
methanesulfonic acid (0.1 mol/L) in MeCN to provide Form 4.
Example 8A: Synthesis of compound 1 Form 5
Reactive crystallization is conducted by mixing compound 3 (0.1 mol/L) and
methanesulfonic acid (0.1 mol/L) in isopropyl alcohol to provide Form 5.
Example 9A: Synthesis of compound 1 Form 6
Slow evaporation is performed by dissolving ca 10 mg of Form 3 in 0.4—3.0 mL of
solvent in a 3—mL glass vial. The vials are covered with foil with about 6 to 8 holes and the
visually clear solutions are subjected to slow evaporation at RT to induce itation. Then the
solids are isolated. Form 6 is ed when the solvent or solvent mixture is MeOH, EtOH,
IPA, THF, MeOH/Toluene=3:l, MeOH/CAN=3:1, MeOH/lPAc=3:l, MeOH/HZO=3:l,
EtOH/Acetone=5:l, EtOH/DCM=5:1, MeOH/Dioxane=3:l, MeOH/MTBE=3:l,
EtOH/Acetonezl : l, and THF/HZO=3:1.
Example 10A: sis of compound 1 Form 7
Reactive crystallization is conducted by quickly adding methanesulfonic acid (0.1 mol/L)
to compound 3 (0.1 mol/L) in acetone or MeCN to provide Form 7.
e 11A: Synthesis of compound 1 Form 8
Method A
Methanesulfonic acid (0.1 mol/L) is y added to compound 3 (0.1 mol/L) in acetone
to provide Form 8.
Method B
Form 12 is heated to 155°C in TGA and cooled to RT to provide Form 8.
Example 12A: Synthesis of compound 1 Form 9
compound 3 (0.1 mol/L) and methanesulfonic acid (0.1 mol/L) is mixed in acetone, and
Form 9 immediately precipitates out of solution.
e 13A: Synthesis of compound 1 Form 10
Form 10 is produced by either heating Form 12 to 80°C at 10°C/min or keeping Form 12
under N2 sweeping condition for l h in TGA.
Example 14A: Synthesis of compound 1 Form 11
2014/049469
Form 11 is obtained by heating Form 6 to 80 °C or heating Form 13 to 100°C in the
XRPD.
e 15A: Synthesis of compound 1 Form 12
Method A
Slow cooling is conducted by dissolving ca10 mg of Form 3 in 03—10 mL solvent or
solvent mixture at 60 OC. Suspensions are filtered at 60 °C and the filtrate is ted. The
saturated on is cooled from 60 °C to 5 °C in an incubator at a rate of 0.05 °C /min. If no
precipitation is observed, the solution is subjected to evaporation at RT to induce precipitation.
The solids are isolated to provide Form 12 When the solvent or solvent mixture is
MeOH/HZO=3:1, n—PrOH/HZO=3:1, or THF/MTBE=3:1.
Method B
Solution vapor diffusion is conducted in ts at RT by dissolving ca 10 mg of Form 3
in MeOH to obtain a clear solution in a 3—mL via1. The via1 is sealed into a 20—mL via1 filled
with ca 3 mL water, and kept at RT for 5 to 7 days, allowing sufficient time to precipitate. The
solids are separated to provide Form 12.
Example 16A: Synthesis of compound 1 Form 13
Method A:
Form 13 is obtained by heating Form 6 to 80 °C and cooling to RT.
Method B:
Slurry conversion is conducted starting from mixtures of Form 6 and Form 12 at water
activity of 0.31 at RT.
Example 17A: Synthesis of compound 1 Form 14
Solution vapor diffusion is ted in solvents at RT by dissolving ca 10 mg of Form 3
in MeOH to obtain a clear solution in a 3—mL via1. The via1 is sealed into a 20—mL via1 filled
with ca 3 mL heptane, and kept at RT for 5 to 7 days, allowing sufficient time to precipitate. The
solids are separated to e Form 14.
Example 18A: Synthesis of compound 1 Form 15
WO 17821
Solution vapor diffusion is conducted in solvents at RT by dissolving ca 10 mg of Form 3
in EtOH to obtain a clear solution in a 3—mL vial. The vial is sealed into a 20—mL vial filled with
ca 3 mL IPAc or MTBE, and kept at RT for 5 to 7 days, allowing sufficient time to precipitate.
The solids are separated to provide Form 15.
Example 20A: Synthesis of compound 3 Form 17
Method A:
.26 mg of Form 16 is ded in 0.4 mL heptane. The suspension is stirred at RT for
about 24 hours. The solid is isolated to obtain Form 17.
Method B:
.10 mg of Form 16 is suspended in 0.2 mL methyl tert—butyl ether. The
suspension is stirred at RT for about 24 hours. The solid is isolated to obtain Form 17.
Example 21A: Synthesis of compound 3 Form 18
8.17 mg of Form 16 is ved in 0.2 mL MeOH. The on is kept at ambient RT
and MeOH is ated to provide Form 18.
Example 22A: Synthesis of compound 3 Form 19
905.61 mg of Form 16 is suspended in 5.0 mL of water. The suspension is stirred at RT
for about 4 hours, and the solid is isolated to provide Form 19.
In es 3, 4, and 5 below, compound 1 may be amorphous, or a mixture of
crystalline forms, or a single crystalline form.
Example 3: In vitro experiments
In this Example 3, the dose strengths of compound 1 are intended to reflect the free—base
equivalent strengths.
Compound I or compound 3 reduces intracellular and extracellular levels of 2-HG in a dosedependent
manner
TF—l/IDH2 (R140Q) mutant cells are treated in vitro for 7 days with vehicle
(dimethylsulfoxide; DMSO) or increasing levels of compound 1 or compound 3 (at
concentrations of 1.6 to 5000 nM). The intracellular levels of 2—HG are reduced in the mutant
cell line (from 15.5 mM with DMSO to 0.08 mM with 5 uM compound 1 or compound 3) and
the ion is concentration—dependent. With this dose titration, the ellular IC50 for 2—HG
inhibition is calculated as 16 nM and the tory concentration, 90% (1C90) is 160 nM.
Coonund I or coonund 3 reduces vimentin levels associated with elevated levels of 2-HGz
indicating a ion in immature (undifierentiated) cell lines
Following 7 days of treatment with nd 1 or compound 3, vimentin expression, a
stem cell marker, induced by IDH2 (Rl40Q) in TF—l cells is d to baseline levels at 2—HG
levels below 1 mM (i.e., compound 1 or compound 3 dose >200 nM).
The functional consequence of inhibiting IDH2 and thereby reducing intracellular 2—HG
levels also is evaluated in the TF—l IDH2 (Rl40Q) mutant cell model.
Com ound I or com ound 3 reduces IDH2 R140 -induced -inde endent rowtli in
TF-I cells
Upon treatment of TF—l IDH2 (Rl40Q) cells with compound 1 or compound 3 (1 uM)
for 7 days, 2—HG production is inhibited by >99% and GM—CSF independent growth conferred
by the expression of TF—l IDH2 (Rl40Q) is reversed.
Com ound I or com ound 3 reduces histone Ii ermetli lation associated with elevated levels 0
Following treatment with compound 1 or compound 3, histone ethylation induced
by IDH2 (Rl40Q) in TF—l cells is reversed based on Western blot analysis. A concentration—
dependent reduction in histone methylation is observed at all 4 histone marks (H3K4me3,
H3K9me3, H3K27me3, and H3K36me3). This effect is most apparent at compound 1 or
compound 3 concentrations known to reduce intracellular 2—HG levels below 1 mM (i.e.,
compound 1 or compound 3 dose >200 nM) in the TF—l IDH2 (Rl40Q) mutant cell system). The
IC50 for e demethylation at H3K4me3 following 7 days of treatment is calculated as 236
nM. This result is consistent with the requirement to dose at >IC90 for compound 1 or compound
3 in order to alter e hypermethylation and is consistent with the 200 nM dose of compound
3 needed to induce s in histone methylation within the first 7 days.
Coonund I or coonund 3 reverses the difierentiation block induced by the IDH2 (RI40121
mutation in TF-I erythroleukemia cell lines
Treatment with compound 1 or compound 3 restores the EPO—induced expression of both
hemoglobin gamma 1/2 and Kruppel—like factor l(KLF—l), a transcription factor that regulates
erythropoiesis, in TF—l IDH2 (R140Q) mutant cells when the 2—HG levels fall below 1 mM.
Treatment 0 rima human AML blast cells with com ound I or com ound 3 leads to an
se in cellular difierentiation
IDH2 (R140Q) mutant t s are treated in an ex vivo assay with compound 1
or compound 3. Living cells are sorted and cultured in the presence or absence of compound 1 or
compound 3 (500, 1000, and 5000 nM). Cells are counted at Days 3, 6, 9, and 13 and normalized
to DMSO control. Upon compound treatment, a proliferative burst is seen starting at Day 6
tent with the onset of cellular differentiation. Following 9 days of treatment ex vivo, the
bone marrow blasts are analyzed for morphology and differentiation status in the presence or
absence of compound 1 or compound 3; the cytologic analysis is blinded with regard to
treatment. Cytology reveals that the percentage of blast cells decreases from 90% to 55% by Day
6 and is further reduced to 40% by Day 9 of treatment with compound 1 or nd 3.
Furthermore, there is a clear increase in the population of more differentiated cells as noted by an
increase in metamyelocytes.
In summary, ex vivo treatment of primary human IDH2 (R140Q) mutant AML cells with
compound 1 or compound 3 results in a decrease in ellular 2—HG and entiation of the
AML blasts through the macrophage and ocytic lineages. These data demonstrate that
inhibition of mutant IDH2 is able to relieve a block in differentiation present in this leukemic
subset.
Example 4: In vivo experiments
In this e 4, the dose strengths of compound 1 are ed to reflect the free—base
equivalent strengths.
In vivo ent with com ound Ior com ound 3 in a mouse xeno ra t model led to a reduction
in tumor 2-HG concentrations
Pharmacokinetic/pharmacodynamic (PK/PD) studies are conducted in female nude mice
inoculated subcutaneously with U87MG IDH2 (R140Q) tumor. Animals receive vehicle or
single or multiple oral doses of compound 1 or compound 3 at doses ranging from 10 to 150
mg/kg.
Tumor 2—HG concentration decreases rapidly following a single oral dose of compound 1
or compound 3. Tumor 2—HG concentration increases when the plasma concentration of
compound 1 or compound 3 decreased below 1000 ng/mL.
In this model, tumor 2—HG levels decrease to baseline, as found in wild—type tissue,
following 3 consecutive nd 1 or nd 3 doses of 25 mg/kg or above (twice daily, 12
hour dosing interval). The estimated area under the nd 1 or compound 3 concentration x
time curve from 0 to 12 hours (AUC0_12hr) that results in sustained 90% tumor 2—HG inhibition
(EAUC90[0_12hr]) and ned 97% tumor 2—HG inhibition (EAUC97[0_12h]) are approximately
5000 and 15200 hr°ng/mL, tively.
Efiect of treatment with comgound I or comgound 3 0r cytarabine on survival, tumor burden,
and tumor difierentiation in tumor bearing mice and naive mice
40 NOD/SCID mice are engrafted on Day 1 with 2*106/mouse of AMM7577—P2
(HuKemia® model, Crown BioScience Inc.) frozen cells that may be thawed out from liquid N2.
Peripheral blood samples are collected weekly for FACS analysis of human leukemia cells
starting at Week 3 post—cell ation. Plasma and urine samples are collected weekly starting
at Week 3 until the termination point. When the tumor growth is about 10% of human CD45+
cell in peripheral blood samples, the engrafted mice may be randomly allocated into 5 groups
using the treatment schedule denoted in Table 1.
Table 1.
Group# Treatment* 11 Route Treatment Survival at
schedule study
termination
Vehicle PO/BID
8/ 16
interval
compound 1 or PO/BID
compound 3 8/ 16
5mg/kg interval
compound 1 or PO/BID
compound 3 8/ 16
g interval
4 compound 1 or 9 PO/BID Day 48—84 9/9
compound 3 8/ 16
45mg/kg interval
cytarabine, 4 5 Days Day 48—52 0/4
2mg/kg
6 Age—matched 5 — No treatment 5/5
naive
* nd 1 is ed as the ase equivalent strength dose
As shown in Table 1, treatment with compound 3 in a mutant positive AML mouse
model, resulted in a dose dependent survival advantage in comparison to cytarabine. In the
group of mice ing the highest dose of compound 3 (Group 4, 45 mg/kg) all 9 mice survived
until the study was completed. A dose dependent decrease in leukemia and ce of normal
differentiation is seen in all compound 3 treated animals.
Example 5:
The clinical study is a Phase 1, multicenter, open—label, dose—escalation, safety, PK/PD,
and clinical activity evaluation of orally administered compound 1 in subjects with ed
hematologic malignancies, such as acute myelogenous leukemia (AML), myelodysplastic
syndrome (MDS), chronic myelomonocytic leukemia (CMML), myeloid sarcoma, multiple
myeloma, or lymphoma (e.g., T—cell lymphoma), that harbor an IDH2 mutation. In this Example
, the dose strengths of compound 1 are intended to reflect the free—base lent strengths
(e.g., when the dose strength of compound 1 is listed as 30 mg, this dose s 30 mg of free—
base compound 3, which is equivalent to 36 mg of compound 1).
Primary study objectives include 1) assessment of the safety and tolerability of treatment
with compound 1 administered continuously as a single agent dosed orally twice daily
(approximately every 12 hours) on Days 1 to 28 of a 28—day cycle in subjects with advanced
hematologic malignancies, and 2) determination of the maximum tolerated dose (MTD) and/or
the ended Phase 2 dose of compound 1 in subjects with advanced hematologic
malignancies. Secondary study objectives include 1) description of the dose—limiting toxicities
(DLTs) of compound 1 in subjects with advanced hematologic malignancies, 2) characterization
of the pharmacokinetics (PK) of compound 1 and its metabolite 6—(6—(trifluoromethyl)pyridin—2—
yl)—N2—(2—(trifluoromethyl)pyridin—4—yl)—l,3,5—triazine—2,4—diamine (compound 2) in subjects
with advanced hematologic malignancies, 3) characterization of the rmacodynamic (PD)
onship of nd 1 and 2—hydroxygluturate (2—HG), and 4) characterization of the
clinical activity associated with compound 1 in subjects with advanced hematologic
malignancies.
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Exploratory study objectives e 1) characterization of the PD effects of compound 1
in subjects with advanced hematologic malignancies by the assessment of changes in the patterns
of cellular differentiation of isocitrate dehydrogenase—2 (IDH2)—mutated tumor cells and changes
in e and deoxyribonucleic acid (DNA) methylation in IDH2—mutated tumor cells, and 2)
evaluation of gene mutation status, global gene expression profiles, and other ial
prognostic markers (cytogenetics) in utated tumor cells, as well as subclonal populations
of non—IDH2 mutated tumor cells, to explore predictors of anti—tumor activity and/or resistance,
and 3) evaluation of changes in the metabolic profiles in IDH2—mutated tumor cells.
The study includes a dose escalation phase to determine MTD followed by expansion
cohorts to further evaluate the safety and tolerability of the MTD. The dose escalation phase
utilizes a standard “3 + 3” design. During the dose escalation phase, consented eligible subjects
are enrolled into sequential cohorts of increasing doses of compound 1. Each dose cohort will
enroll a minimum of 3 subjects. The first 3 subjects enrolled in each dosing cohort during the
dose escalation portion of the study will receive a single dose of study drug on Day —3 (i.e., 3
days prior to the start of twice daily dosing) and undergo safety and PK/PD assessments over 72
hours to evaluate drug concentrations and 2—HG levels. The next dose of study drug is on Cycle
1 Day 1 (ClDl) at which time twice daily dosing begins. If there are le subjects in the
screening process at the time the third subject within a cohort begins treatment, up to 2 additional
subjects may be enrolled with approval of the Medical Monitor. For these additional subjects,
the Day —3 h Day 1 PK/PD assessments are al following discussion with the Medical
Monitor.
Dose ng toxicities are evaluated during Cycle 1 of treatment. Toxicity severity is
graded according to the National Cancer Institute Common Terminology Criteria for Adverse
Events (NCI CTCAE) Version 4.03. A DLT is defined as follows. Non—hematologic includes all
clinically icant non—hematologic toxicities CTCAE ZGrade 3. (For e, alopecia is not
considered a clinically significant event). logic includes prolonged myelosuppression,
defined as persistence of 23 Grade neutropenia or thrombocytopenia (by NCI CTCAE, version
4.03, leukemia—specific ia, i.e., marrow cellularity <5% on Day 28 or later from the start of
study drug without evidence of leukemia) at least 42 days after the initiation of Cycle 1 therapy.
Leukemia—specific g should be used for cytopenias (based on percentage decrease from
baseline: 50 to 75% 2 Grade 3, >75% 2 Grade 4). Due to frequent co—morbidities and concurrent
medications in the population under study, attribution of adverse events (AEs) to a particular
drug is challenging. Therefore, all AEs that cannot clearly be determined to be unrelated to
nd 1 are considered relevant to determining DLTs.
If, after the third subject completes the 28—day DLT evaluation period (i.e., Cycle 1), and
no DLTs are observed, the study will proceed with dose tion to the next cohort following
safety review. If 1 of 3 subjects experiences a DLT during the first cycle, 3 additional subjects
are ed in that cohort. If none of the additional 3 subjects experience a DLT, dose escalation
may continue to the next cohort following safety review. If 2 or more ts in a cohort
experience DLTs during the first cycle, dose escalation is halted and the next lower dose level is
declared the MTD. If the MTD cohort includes only 3 subjects, an additional 3 subjects are
enrolled at that dose level to confirm that <2 of 6 subjects experience a DLT at that dose.
Increases in the dose of nd 1 for each dose cohort is guided by an accelerated
titration design, where the dose is doubled (100% increase) from one cohort to the next until
compound l—related NCI CTCAE Grade 2 or greater toxicity is observed in any subject within
the cohort. Subsequent increases in dose are 50% or less until the MTD is determined. The
te percent increase in the dose is determined by the Clinical Study Team predicated on the
type and ty of any toxicity seen in the prior dose cohorts. If warranted based on the
emerging data, an ative dosing schedule (e.g., once daily or three times daily) may be
explored. The MTD is the highest dose that causes DLTs in <2 of 6 subjects.
If no DLTs are identified during the dose escalation phase, dose escalation may continue
for 2 dose levels above the projected maximum biologically effective dose, as determined by an
ongoing assessment of PK/PD and any ed clinical ty, to determine the recommended
Phase 2 dose.
To optimize the number of subjects treated at a potentially clinically relevant dose, intra—
subject dose escalation is permitted. Following determination of the recommended Phase 2 dose,
3 expansion cohorts (in specific hematologic malignancy indications) of approximately 12
ts each are treated at that dose. The purpose of the expansion cohorts is to evaluate and
confirm the safety and tolerability of the recommended Phase 2 dose in specific disease
indications. Subjects enrolled in these cohorts will undergo the same ures as subjects in
the dose escalation cohorts with the exception that they will not be required to undergo the Day
—3 through Day 1 PK/PD assessments.
The planned study doses of nd 1 are summarized in Table 2. The starting dose for
this study is 30 mg (free—base equivalent strength) administered approximately every 12 hours.
Based on evaluation of the safety, tolerability, and PK/PD data of the previous dose levels, it
may also be decided that escalation will take place at an ediate dose level not specified in
Table 2.
Table 2: Dose Escalation Scheme
Cohort Level Compound 1 Dose” Number of Subjects
—1 15 mg2 3 to 6
2 60 mg 3 to 6
3 120 mg 3 to 6
4 240 mg 3 to 6
, etc. 480 mg3 3 to 6
Expansion Cohorts3 MTD4 365
* Compound 1 is provided as 15, 30, 60, 120, 240, or 480 mg free—base equivalent strength doses
(for example, in Cohort Level 1, 36 mg of compound 1 is equivalent to 30 mg of free—base
compound 3)
Administered as a single agent dosed orally twice daily ximately every 12 hours) on Days
1 to 28 of a 28—day cycle. If warranted based on the emerging data, an alternative dosing
schedule (e.g., once daily or three times daily) may be explored.
If DLTs are observed at Dose Level 1 (30 mg), the dose for the second cohort is sed to 15
mg (Dose Level —1).
Continued doubling of the dose until compound 1—related NCI CTCAE ZGrade 2 toxicity is
observed. Following evaluation of the event(s), subsequent increases in dose 550% until MTD is
determined. The absolute percent increase in the dose is predicated on the type and ty of
any toxicity seen in the prior dose cohorts. Dose escalation will never exceed 100%.
Defined as the highest dose that causes DLTs in <2 of 6 ts. If no DLTs are identified,
dosing will continue for 2 dose levels above the projected maximum biologically effective dose,
as ined by an ongoing assessment of PK/PD and any observed clinical activity to
determine the recommended Phase 2 dose.
To include 3 cohorts of 12 subjects each in ic hematologic malignancy tion.
If warranted based on the emerging data, an alternative dosing schedule (e.g., once daily
or three times daily) may be explored as shown in Table 3.
Table 3: Dose Escalation Scheme
Cohort Level Compound 1 Dose* Number of Subjects
mg1 3 to 6
50 mg1 3 to 6
75 mg1 3 to 6
stered as a single agent dosed orally twice daily (approximately every 12 hours) on Days
1 to 28 of a 28—day cycle.
2Administered as a single agent dosed orally once daily on Days 1 to 28 of a 28—day cycle. A
mean plasma half—life of greater than 40 hours, a favorable PK profile, led to the possibility of
once daily dosing.
* Compound 1 is provided as 30, 50, 75, 100 or 150 mg free—base lent strength doses (for
example, in Cohort Level 1, 36 mg of compound 1 is equivalent to 30 mg of free—base
compound 3).
ts will undergo screening procedures within 28 days prior to the start of study drug
treatment to determine eligibility. Screening procedures include medical, surgical, and
medication history, confirmation of IDH2 mutation in leukemic blasts (if not documented
previously), physical ation, vital signs, Eastern ative Oncology Group (ECOG)
performance status (PS), l2—lead electrocardiogram (ECG), evaluation of left ventricular ejection
fraction (LVEF), clinical laboratory assessments (hematology, chemistry, coagulation, urinalysis,
and serum pregnancy test), bone marrow biopsy and/or aspirate, and blood and urine samples for
2—HG measurement.
Three days prior to starting the twice daily dosing of compound 1 (Day —3), the first 3
ts enrolled in each cohort in the dose escalation phase will receive a single dose of
compound 1 in clinic and have serial blood and urine samples obtained for determination of
blood and urine concentrations of compound 1, its metabolite, and 2—HG. A full 72—hour PK/PD
profile is conducted: subjects are required to remain at the study site for 10 hours on Day —3 and
return on Days —2, —l, and l for 24, 48, and 72 hour samples, respectively. During the in—clinic
period on Day —3, clinical observation and serial l2—lead ECGs and vital signs assessments are
conducted.
Twice daily treatment with compound 1 will begin on ClDl; for subjects who did not
o the Day —3 PK/PD assessments, clinical observation and serial l2—lead ECGs and vital
signs assessments are conducted over 8 hours ing their first dose of compound 1 on ClDl.
Safety ments conducted during the treatment period include physical ation, vital
signs, ECOG PS, l2—lead ECGs, evaluation of LVEF, and clinical laboratory assessments
(hematology, chemistry, coagulation, and urinalysis).
All subjects will undergo PK/PD assessments over a 10—hour period on both ClDlS and
C2Dl. In addition, subjects will collect urine samples at home once every other week (starting
on ClD8) prior to the morning dose for determination of 2—HG levels.
Subjects will have the extent of their e assessed, including bone marrow biopsies
and/or tes and peripheral blood, at screening, on Day 15, Day 29 and Day 57, and every 56
days thereafter while on study drug treatment, independent of dose delays and/or dose
interruptions, and/or at any time when progression of disease is suspected. Response to
treatment is determined by the Investigators based on modified International Working Group
(IWG) se criteria for acute myelogenous ia (AML).
Subjects may continue treatment with compound 1 until disease progression, occurrence
of a DLT, or development of other unacceptable toxicity. All subjects are to undergo an end of
treatment assessment (within approximately 5 days of the last dose of study drug); in addition, a
follow—up ment is to be scheduled 28 days after the last dose.
It is estimated that approximately 57 subjects are enrolled in the study. This assumes that
identification of the MTD requires the evaluation of 6 dose levels of nd 1 with only 3
subjects per dose level, with the exception of the MTD which required 6 subjects (n = 21) with
12 subjects enrolled per cohort in the expansion phase (n = 36). Additional subjects may be
needed for cohort ion during dose tion, for the replacement of non—evaluable
subjects, or for evaluation of alternative dosing ns other than the planned escalation
scheme or the MTD, to optimize the recommended Phase 2 dose.
A patient must meet all of the following inclusion criteria to be enrolled in the clinical
study. 1) Subject must be 218 years of age; 2) Subjects must have ed hematologic
malignancy including: a) Relapsed and/or primary refractory AML as d by World Health
Organization (WHO) criteria, b) untreated AML, 260 years of age and are not candidates for
standard therapy due to age, performance status, and/or adverse risk factors, according to the
treating physician and with approval of the Medical Monitor, c) Myelodysplastic syndrome with
refractory anemia with excess blasts (subtype RAEB—l or RAEB—2), or considered high—risk by
the Revised ational Prognostic Scoring System (lPSS—R) (Greenberg et al. Blood.
2012; l20(l2):2454—65) that is recurrent or refractory, or the patient is intolerant to established
therapy known to provide clinical benefit for their condition (i.e., ts must not be ates
for ns known to provide clinical benefit), according to the treating physician and with
approval of the l Monitor, and d) Subjects with other relapsed and/or y refractory
hematologic cancers, for example CMML, who fulfill the ion/excluding criteria may be
considered on a case—by case basis; 3) subjects must have documented IDH2 gene—mutated
disease based on local evaluation. Analysis of ic blast cells for IDH2 gene mutation is to
be evaluated at screening (if not evaluated previously) by the site’s local laboratory to determine
subject eligibility for the study. If the site does not have local laboratory access for IDH2 gene
mutation analysis, central laboratory tion is acceptable. A pretreatment tumor sample
(from blood and/or bone marrow) is required for all screened subjects for central laboratory
biomarker analysis. Gene mutation analysis of a tumor sample (from blood or bone marrow) is to
be repeated at the End of Treatment visit and submitted to the central laboratory for biomarker
is; 4) Subjects must be amenable to serial bone marrow biopsies, peripheral blood
sampling, and urine sampling during the study (the diagnosis and evaluation of AML or MDS
can be made by bone marrow aspiration when a corebiopsy is unobtainable and/or is not a part of
the rd of care. A bone marrow biopsy is required in case of dry tap or failure y
dilution) with the aspiration); 5) ts or their legal entatives must be able to
understand and sign an informed consent; 6) Subjects must have ECOG PS of 0 to 2; 7) Platelet
count 220,000/uL (Transfusions to achieve this level are allowed.) Subjects with a baseline
platelet count of <20,000/uL due to underlying malignancy are eligible with Medical Monitor
approval; 8) Subjects must have adequate hepatic function as evidenced by: a) Serum total
2014/049469
bilirubin 51.5 x upper limit of normal (ULN), unless considered due to Gilbert’s disease or
leukemic organ involvement, and b) Aspartate aminotransferase, Alanine aminotransferase
(ALT), and alkaline phosphatase (ALP) 53.0 X ULN, unless considered due to leukemic organ
involvement; 9) Subjects must have adequate renal on as evidenced by a serum creatinine
52.0 x ULN or creatinine clearance >40 mL/min based on the Cockroft—Gault glomerular
filtrationrate (GFR) estimation: (140 <(weight in kg) x (0.85 if e)/72 x serum
creatinine; 10) Subjects must be recovered from any clinically relevant toxic effects of any prior
surgery, radiotherapy, or other y intended for the treatment of cancer. (Subjects with
residual Grade 1 toxicity, for example Grade 1 peripheral neuropathy or residual alopecia, are
d with approval of the Medical Monitor.); and ll) Female subjects with reproductive
potential must have a ve serum pregnancy test within 7 days prior to the start of therapy.
ts with reproductive potential are defined as one who is biologically capable of becoming
pregnant. Women of childbearing potential as well as e men and their partners must agree to
abstain from sexual intercourse or to use an effective form of contraception during the study and
for 90 days (females and males) following the last dose of compound 1.
Compound 1 is provided as 5, 10, 50, and 200 mg free—base equivalent strength tablets to
be administered orally, twice daily or once daily. The tablets contain 6, 12, 60, and 240 mg of
compound 1, tively.
Alternatively, compound 1 may be provided as 25, 50, 100 and/or 150 mg free—base
equivalent strength tablets. These tablets contain 30, 60, 120 and/or 180 mg of compound 1,
respectively.
The first 3 subjects in each cohort in the dose escalation portion of the study will receive
a single dose of study drug on Day —3; their next dose of study drug is administered on ClDl at
which time subjects will start dosing twice daily (approximately every 12 hours) on Days 1 to 28
in 28—day cycles. Starting with ClDl, dosing is continuous; there are no inter—cycle rest periods.
Subjects who are not required to o the Day —3 PK/PD assessments will initiate twice daily
dosing (approximately every 12 hours) with nd 1 on ClDl.
Subjects are required to fast (water is allowed) for 2 hours prior to study drug
administration and for 1 hour following study drug administration.
The dose of nd 1 administered to a subject is dependent upon which dose cohort
is open for enrollment when the subject qualifies for the study. The starting dose of compound 1
to be administered to the first cohort of subjects is 30 mg (free—base lent strength)
administered orally twice a day.
Subjects may continue treatment with compound 1 until disease progression, occurrence
of a DLT, or development of other unacceptable toxicity.
Criteria for tion
A 12—lead electrocardiogram (ECG) is to be obtained at screening, on Days 8, 15, and 22
of Cycle 1, on Days 1 and 15 of Cycle 2, on Day 1 of each treatment cycle thereafter, at the End
of Treatment visit, and at the Follow—up visit. Additionally, serial 12—lead ECGs are to be
ed following the first dose of study ent (i.e., on Day —3 for subjects undergoing the
72—hour PK/PD profile or on ClDl for ts who do not attend the Day —3 assessment) at the
following times: predose, and 30 i 10 minutes and 2, 4, 6, and 8 hours (i 15 minutes) post dose
following the morning administration of study drug. Serial ECGs should be obtained following
vital signs assessments. Subjects should be instructed to take their dose of compound 1 in clinic
on these days. The 12—lead ECGs should be obtained following 3 minutes of recumbency.
Subjects are to have left ventricular ejection fraction (LVEF) determined by
echocardiogram (ECHO) or multiple gated acquisition scan (MUGA) within 28 days of ClDl;
repeat assessments are to be conducted on C3D1, Day 1 of every other ent cycle thereafter
(e. g., C5D1, D7D1, etc), at the End of Treatment visit, and at the Follow—up visit. The same
procedure to evaluate LVEF should be ted throughout the study.
The following therapies are not permitted during the study: (1) other antineoplastic
therapy (Hydroxyurea, is allowed prior to enrollment and for up to 28 days after the start of
nd 1 dosing for the initial control of peripheral leukemic blasts in subjects with WBC
0/uL). If alternative therapy is required for treatment of the t’s e, the t
should be discontinued from compound 1 treatment; (2) Corticosteroids, with the exception of
topical cutaneous, ophthalmic, nasal, and inhalational steroids. (Short course steroid therapy is
permitted to treat co—morbidities such as for example, differentiation syndrome.); (3)
Medications that are known to prolong QT interval: amiodarone, arsenic trioxide, astemizole,
azithromycin, bepridil, chloroquine, chlorpromazine, cisapride, citalopram, clarithromycin,
disopyramide, dofetilide, domperidone, droperidol, erythromycin, escitalopram, flecainide,
halofantrine, haloperidol, ibutilide, levomethadyl, mesoridazine, methadone, moxifloxacin,
pentamidine, pimozide, probucol, procainamide, ine, sevoflurane, sotalol, sparfloxacin,
terfenadine, thioridazine, or vandetanib; (4) Sensitive CYP substrate medications that have a
narrow therapeutic range: paclitaxel (CYP2C8) warfarin, phenytoin (CYP2C9), S—mephenytoin
(CYP2Cl9), thioridazine (CYP2D6), theophylline and tizanidine (CYP1A2). Co—administration
of other CYP2C8, 2C9, 2Cl9, 2D6, and 1A2 substrates should be used only if medically
necessary; and (5) P—pg and BCRP transporter—sensitive substrates digoxin and rosuvastatin. Co—
administration of other P—gp or BCRP substrates should be used only if medically ary.
The following consumables are not permitted within 7 days prior to dosing on Day 1 or
during the study: (1) he—counter (OTC) medication (excluding routine vitamins), (2) fruit
juices, (3) charbroiled meats, and (4) vegetables from the mustard green family (e.g., kale,
li, watercress, collard greens, kohlrabi, ls s, d).
The following consumables are not permitted within 14 days prior to dosing on Day 1 or
during the study: (1) citrus fruits such as Seville oranges, grapefruit or grapefruit juice and/or
pomelos, exotic citrus fruits, or grapefruit hybrids, and (2) red wine.
ption of St. John's Wort is not ted within 28 days prior to dosing on Day 1
or during the study. Consumption of caffeine— or xanthene—containing food or beverages are not
permitted for 48 hours prior to dosing until day 6 after dosing.
Medications and ents other than those specified above are permitted during the
study. All intercurrent medical conditions and complications of the underlying ancy is
treated according to standards of medical care. Subjects should receive analgesics, antiemetics,
anti—infectives, antipyretics, and blood products as necessary. Additional permitted medications
include (1) Growth factors (granulocyte colony—stimulating factor [G—CSF], granulocyte—
macrophage colony—stimulating factor [GM—CSF]) can be used to support subjects who have
developed dose—limiting Grade 4 neutropenia or Grade 3 neutropenia with fever and/or infection.
The use of erythropoietin is permitted according to the American y of Clinical gy
Guidelines (Rizzo, et al. Blood. 2010;ll6(20):4045—59); (2) Hydroxyurea is allowed prior to
ment and for up to 28 days after the start of compound 1 dosing for the initial control of
peripheral leukemic blasts in subjects with WBC 0/uL; and (3) steroids for the treatment
of differentiation syndrome, if warranted, as standard of care.
Compound 1 may cause sensitivity to direct and indirect sunlight. The patients should be
warned to avoid direct sun exposure. When re to ht is anticipated for longer than 15
minutes, the patient should be instructed to apply factor 30 or higher sunscreen to exposed areas
and wear protective clothing and sunglasses.
AEs, including determination of DLTs, serious adverse events (SAEs), and AEs leading
to discontinuation; safety laboratory parameters; physical examination findings; vital signs;
d ECGs; LVEF; and ECOG PS are monitored during the clinical study. Determination of
ECOG PS is performed at screening, on Day —3 (for subjects undergoing 72—hour PK/PD profile),
on Days 1 and 15 of Cycle 1, on Day 1 of each treatment cycle fter, at the End of
Treatment visit, and at the Follow—up visit. The ty of AEs is assessed by the NCI CTCAE,
Version 4.03.
Monitoring of adverse events (AEs) is conducted throughout the study. Adverse events
and severe adverse events (SAEs) are recorded in the electronic case report form (eCRF) from
time of the g informed consent through 28 days after the last study drug dose. In addition,
SAEs that are assessed as ly or probably related to study treatment that occur >28 days
post—treatment also are to be reported. All AEs should be red until they are resolved or
are clearly determined to be due to a subject’s stable or c condition or intercurrent
illness(es).
An adverse event (AB) is any untoward medical occurrence associated with the use of a
drug in humans, whether or not considered drug related. An AE (also referred to as an e
experience) can be any unfavorable and unintended sign (e.g., an abnormal laboratory finding),
symptom, or e temporally associated with the use of a drug, without any judgment about
causality. An AE can arise from any use of the drug (e.g., off—label use, use in combination with
r drug) and from any route of administration, formulation, or dose, including an se.
A suspected adverse reaction is any AE for which there is a able possibility that the
drug caused the AE. For the purposes of expedited safety reporting, ‘reasonable possibility’
means there is evidence to suggest a causal relationship between the drug and the AE. An
unexpected AB is one for which the nature or severity of the event is not consistent with the
applicable product information, e.g., the Investigator’s Brochure. An AE or suspected adverse
reaction is considered serious (SAE) if, in the view of either the Investigator or Sponsor, it
results in any of the following outcomes: (a) death; (b) life—threatening (the subject was at
immediate risk of death from the reaction as it ed, i.e., it does not include a reaction which
hypothetically might have caused death had it occurred in a more severe form), (c) in—patient
;hospitalization or prolongation of existing hospitalization (hospitalization admissions and/or
surgical operations scheduled to occur during the study period, but planned prior to study entry
are not considered AEs if the illness or disease existed before the subject was enrolled in the
study, provided that it did not deteriorate in an unexpected manner during the study (e.g., surgery
performed earlier than planned)); (d) a persistent or icant incapacity or substantial
tion of the ability to t normal life functions; (e) congenital anomaly/birth defect; or
(f) an important medical event (an event that may not result in death, be life—threatening, or
require hospitalization but may be considered an SAE when, based upon riate l
judgment, it may jeopardize the patient or t and may require medical or surgical
intervention to prevent one of the outcomes listed in the definitions for SAEs. Examples of such
medical events include allergic bronchospasm requiring intensive treatment in an emergency
room or at home, blood dyscrasias or convulsions that do not result in in—patient hospitalization,
or the development of drug ency or drug abuse).
Intensity of all AEs, ing clinically significant treatment—emergent laboratory
alities, are graded according to the NCI CTCAE Version 4.03. Adverse events not listed
by the CTCAE are graded as follows: (a) Mild: the event is noticeable to the subject but does
not interfere with routine activity; (b) Moderate: the event eres with routine activity but
responds to symptomatic therapy or rest; (c) Severe: the event significantly limits the subject’s
ability to perform routine ties e symptomatic therapy; (d) Life—threatening: an event
in which the subject was at risk of death at the time of the event; or (e) Fatal: an event that results
in the death of the subject.
Relationship to study drug administration is determined by the Investigator according to the
following criteria: (a) Not Related: Exposure to the study treatment did not occur, or the
occurrence of the AB is not reasonably related in time, or the AB is considered unlikely to be
related to the study treatment; (b) Possibly Related: The study treatment and the AE were
reasonably related in time, and the AE could be explained equally well by causes other than
exposure to the study treatment.; or (c) Probably Related: The study treatment and the AE were
reasonably d in time, and the AE was more likely explained by exposure to the study
ent than by other causes, or the study treatment was the most likely cause of the AB.
For the purpose of safety analyses, all AEs that are classified as possible or probable are
considered treatment—related AEs.
Examples of adverse events that may occur are leukocytosis (e.g., Grade 2
hyperleukocytosis, Grade 3 leukocytosis), disease—related differentiation syndrome, ion
(e. g., Grade 3 confusion), and respiratory failure (sepsis) (e.g., Grade 5 respiratory failure),
anorexia (e.g., Grade 3 anorexia), nausea (e.g. Grade 1 nausea), a, diarrhea (e.g., Grade 3
ea), thrombocytopenia, anemia, dizziness, neutropenia (e.g., febrile neutropenia),
peripheral edema, sepsis, cough, fatigue, ia, and rash.
Pharmacokinetics and pharmacodynamics
Serial blood samples are evaluated for determination of tration—time profiles of
nd 1 and its metabolite compound 2. Urine samples are evaluated for determination of
urinary excretion of compound 1 and its metabolite compound 2. Blood, bone marrow, and urine
samples are evaluated for determination of 2—HG levels.
Pharmacokinetic assessments:
Serial blood samples are drawn before and after dosing with compound 1 in order to
determine circulating plasma concentrations of compound 1 (and, if technically feasible, the
metabolite compound 2). The blood samples will also be used for the determination of 2—HG
concentrations.
For the first 3 subjects enrolled in a cohort during the dose escalation phase, a single dose
of compound 1 is stered on Day —3 (i.e., 3 days prior to their scheduled ClDl dose).
Blood samples are drawn prior to the —dose administration of compound 1 and at the
following time points after administration: 30 minutes and l, 2, 3, 4, 6, 8, 10, 24, 48, and 72
hours. After 72 hours of blood sample collection, subjects begin oral twice daily dosing of
compound 1 (i.e., ClDl). The PK/PD profile from Day —3 h Day 1 is optional for
additional subjects enrolled in the dose escalation phase (i.e., for any subjects beyond the 3 l
subjects enrolled in a cohort) and is not required for subjects enrolled in the expansion s.
All subjects undergo lO—hour PK/PD sampling on ClDlS and C2Dl (i.e., on Days 15 and
29 of twice daily dosing). For this profile, one blood sample is drawn immediately prior to that
day’s first dose of compound 1 (i.e., dosing with compound 1 occurs at the clinical site);
subsequent blood samples are drawn at the following time points after dosing: 30 minutes, and 1,
2, 3, 4, 6, 8, and 10 hours. Additionally, one blood sample is drawn at the End of Treatment
Visit.
The timing of blood s drawn for compound 1 concentration ination may be
changed if the ng data indicates that an alteration in the sampling scheme is needed to
better characterize compound 1’s PK profile.
Circulating plasma concentrations of 2—HG for cohorts 1 and 2 of Table 4 and cohorts 1
to 6 of Table 7, are measured as bed herein.
The mean inhibition may be calculated, for example, by determining the difference
between (a) the mean level of 2—HG during the 10—hour ng on C1D15 and C2D1 and (b)
the level of 2—HG at baseline (Day —3 pretreatment), and then dividing the resulting level of 2—
HG by the difference between (a) the level of 2—HG at baseline (Day —3 pretreatment) and (c) the
level of 2—HG in a subject without IDH—2 gene mutated disease, thereby ing for baseline
levels of 2—HG in subjects without IDH—2 gene mutated disease.
When adjusting for baseline levels of 2—HG in subjects without IDH—2 gene mutated
disease, 10—hour sampling on C1D15 and C2D1 shows mean inhibition of 2—HG at greater than
about 90% to up to 100% of baseline (Day —3 pretreatment) in ts with IDH2 R140Q
mutations. For example, in Cohort 1 of Table 4, the mean inhibition of 2—HG is 86% on C1D15
(3 patients) and 95% on C2D1 (1 patient). In Cohort 1 of Table 7, the mean inhibition of 2—HG
is 88% on C1D15 (4 patients) and 97% on C2D1 (2 patients). In Cohort 2 of Table 4, the mean
inhibition of 2—HG is 98% on C1D15 (2 patients) and 100% on C2D1 (4 patients). In Cohort 2
of Table 7, the mean inhibition of 2—HG is 99% on C1D15 (3 patients) and 100% on C2D1 (4
ts). In Cohort 3 of Table 7, the mean inhibition of 2—HG is 103% on C1D15 (3 patients)
and 81% on C2D1 (3 patients). In Cohort 4 of Table 7, the mean inhibition of 2—HG is 102% on
C1D15 (3 patients) and 101% on C2D1 (2 ts). When adjusting for baseline levels of 2—HG
in subjects without IDH—2 gene mutated disease, 10—hour sampling on C1D15 and C2D1 shows
mean inhibition of 2—HG at up to 60% of baseline (Day —3 pretreatment) in two patients with
IDH2 R172K mutations (Table 7). For e, about 50% inhibition of 2—HG is shown in
patient number 5 of Table 4.
Alternatively, the mean inhibition may be calculated with no adjustment for ne
levels of 2—HG in subjects without IDH—2 gene mutated disease, by determining the difference
between (a) the mean level of 2—HG during the 10—hour sampling on ClDl5 and C2Dl and (b)
the level of 2—HG at baseline (Day —3 pretreatment), and then ng the resulting level of 2—
HG by the level of 2—HG at baseline (Day —3 pretreatment). When the mean inhibition is
calculated with no adjustment for subjects without IDH—2 gene mutated disease, r
sampling on ClDl5 and C2Dl shows mean inhibition of 2HG at up to 97% of baseline (Day —3
pretreatment) in 18 patients with IDH2 R140Q mutations. 10—hour sampling on ClDl5 and
C2Dl shows mean inhibition of 2HG at up to 50% of baseline (Day —3 atment) in 2
patients with IDH2 R172K mutations.
Circulating plasma concentrations of nd 1 for cohorts 1 and 2 of Table 4 and
cohorts 1 to 6 of Table 7 are measured as described herein. For cohort 1 of Table 4, 10—hour
sampling on Day —3 (post a single dose of compound 1), ClDl5 and C2Dl shows increased
compound 1 mean plasma exposure from 4.7 AUC0_10hr (h*ug/mL) on Day —3 (4 patients) to 37.7
AUC0_10hr (h*ug/mL) on ClDl5 (3 ts), and 22.6 AUC0_10hr mL) on C2Dl (1 patient).
For cohort 1 of Table 7, 10—hour sampling on Day —3 (post a single dose of compound 1), ClDl5
and C2Dl shows increased compound 1 mean plasma exposure from 4.5 AUC0_10hr (h*ug/mL)
on Day —3 (5 patients) to 41.0 AUC0_10hr (h*ug/mL) on ClDl5 (4 patients), and 47.2 AUC0_10hr
mL) on C2Dl (2 patients). For cohort 2 of Table 4, 10—hour sampling on Day —3 (post a
single dose of compound 1), ClDl5 and C2Dl shows increased compound 1 mean plasma
exposure from 5.4 AUC0_10hr (h*ug/mL) on Day —3 (4 patients) to 58.1 AUC0_10hr (h*ug/mL) on
ClDl5 (3 patients), and 93.8 AUC0_10hr (h*ug/mL) on C2Dl (4 patients). For cohort 2 of Table
7, 10—hour sampling on Day —3 (post a single dose of compound 1), ClDl5 and C2Dl shows
increased compound 1 mean plasma exposure from 5.4 AUC0_10hr (h*ug/mL) on Day —3 (4
patients) to 64.1 AUC0_10hr (h*ug/mL) on ClDl5 (3 ts), and 97.0 AUC0_10hr (h*ug/mL) on
C2Dl (4 patients). For cohort 3 of Table 7, 10—hour sampling on Day —3 (post a single dose of
compound 1), ClDl5 and C2Dl shows increased nd 1 mean plasma exposure from 9.0
AUC0_10hr (h*ug/mL) on Day —3 (4 patients) to 120 AUC0_10hr (h*ug/mL) on ClDl5 (3 patients),
and 146 AUC0_10hr (h*ug/mL) on C2Dl (3 patients). For cohort 4 of Table 7, 10—hour sampling
on Day —3 (post a single dose of compound 1), ClDl5 and C2Dl shows increased nd 1
mena plasma exposure from 8.2 AUC0_10hr (h*ug/mL) on Day —3 (4 patients) to 72.6 0hr
(h*ug/mL) on ClDl5 (3 ts), and 87.1 AUC0_10hr mL) on C2Dl (2 patients).
For the first 3 subjects enrolled in a cohort during the dose escalation phase, urine is
collected on Day —3 prior to and over the first 72 hours ing a single dose of compound 1 to
provide a preliminary estimate of the extent to which compound 1 (and, if technically feasible,
metabolite compound 2) is ated ged in the urine. Samples also are analyzed for 2—
HG concentrations and for urinary creatinine tration.
Five urine collections are obtained during this 72—hour period. An l urine collection
is made prior to compound 1 dosing (at least 20 mL). The 2nd urine collection is obtained over
approximately 10 hours following compound 1 administration, and a subsequent 8—hour urine
collection is obtained between discharge from the clinic and the return visit on the ing day
(for the 24—hour blood draw). The 4th and 5th urine collections are obtained at approximately
the 48—hour and 72—hour blood draws. Additionally, a urine collection (at least 20 mL) occurs at
the End of Treatment Visit.
Urine ng from Day —3 through Day 1 is optional for additional subjects enrolled in the
dose escalation phase (i.e., for any subjects beyond the 3 initial subjects enrolled in a cohort) and
is not required for subjects enrolled in the expansion cohorts.
The volume of each collection is measured and ed and sent to a central laboratory
for determination of the urinary compound 1 concentration.
Pharmacokinetic Drug Interactions:
Human enzyme phenotyping indicates the routes of metabolism for compound 1 are via
multiple rome P450s and uridine diphosphate (UDP)—glucuronosyltransferase .
Cytochrome P450s (CYPs) lA2, 2C8, 2C9 and 3A4 and UGTs 1A1, 1A3, 2B7, 2B15 all appear
to contribute to the metabolism of compound 1, though at low levels as all metabolite peaks are
at or below the limits of quantitation.
Compound 1 and compound 2, are weak inducers of human CYP3A4. Induction of
CYP1A2 or CYP2B6 was not observed for either compound. When used as a marker substrate,
neither compound appears to be a victim of strong CYP3A4 inducers such as icin. This is
consistent with the low turnover seen in the enzyme yping experiments.
Compound 1 is a moderate direct inhibitor of CYP2C8 (IC50= 3.9 to 4.4 uM), CYP2C9
(IC50 = 3.7 uM), CYP2Cl9 (IC50 = 6.3 uM) and CYP 2D6 (IC50 = 21 uM) while compound 2 is a
moderate direct inhibitor of CYP1A2 (IC50 = 0.43 uM), 2C8 (IC50 = 5.3 uM) and CYP 2C9 (IC50
2014/049469
= 30 uM). Neither compound shows time—dependent or metabolism—dependent inhibition of
CYP enzymes.
Compound 1 is characterized as an inhibitor of UGTlAl. Its inhibition of the UGTlAl
*l/*28 and *28/*28 Gilbert’s syndrome genotypes are evaluated. The IC50s for UGTlAl by
genotype are 1.9, 3.5 and 10 uM for the *l/*l, *l/*28 and *28/*28 genotypes, respectively.
In a Caco—2 cell assay, compound 1 showed excellent permeability (Papp >l7.9 X10"6 cm/sec).
The effluX ratio of —>B is < 3 suggesting the active transport of compound 1 across
Caco—2 cells is unlikely and thus does not appear to be a substrate for human P—glycoprotein
(P—gp) or breast cancer resistance protein (BCRP) in vitro. However, compound 1 is a strong
inhibitor of both P—gp (87% and 99% at 5 and 100 uM, tively) and BCRP (100% at 5 and
100 uM).
kodynamic assessments:
Serial blood samples are drawn before and after dosing with compound 1 in order to
determine circulating concentrations of 2—HG. s collected for PK assessments also are
used to assess 2—HG levels. In addition, subjects have blood drawn for determination of 2—HG
levels at the screening assessment.
The timing of blood samples drawn for 2—HG concentration determination may be
changed if the emerging data indicate that an alteration in the sampling scheme is needed to
better characterize the 2—HG response to compound 1 ent.
Bone marrow also is assessed for 2—HG levels.
Urine is collected before and after dosing with compound 1 for the determination of
concentrations of 2—HG. Samples collected for PK ments on Day —3 is also used to assess
2—HG levels. In addition, subjects have urine sample collected for determination of 2—HG levels
at the screening assessment and the End of Treatment visit.
In addition, after initiating twice daily compound 1 treatment, all subjects collect urine
s at home once every two weeks (starting on ClD8) prior to the morning dose. At least 20
mL of urine is ted for each sample. Subjects are instructed on how to store the urine and to
bring all samples collected to the clinic at the next visit.
The volume of each collection is measured and recorded and sent to a central laboratory
for determination of urinary 2—HG concentration. An aliquot from each collection is analyzed
for urinary nine concentration.
al activity
Serial blood and bone marrow ng is evaluated during the clinical study to determine
response to treatment based on modified IWG response criteria in AML. The clinical activity of
compound 1 is ted by assessing response to treatment according to the 2006 modified
IWG criteria for MDS, MDS/myeloproliferative neoplasms (MPN) or AML (Cheson BD, et al. J
Clin Oncol. 2003;2l(24):4642—9, Cheson BD, et al. Blood. 2006;108(2):4l9-25).
Disease response to ent is assessed through the evaluation of bone marrow aspirates
and biopsies, along with complete blood counts and examination of peripheral blood films.
Subjects have the extent of their disease assessed and recorded at screening, on Days 15, 29, and
57, every 56 days thereafter while on study drug treatment, independent of dose—delays and/or
dose interruptions, and/or at any time when progression of disease is suspected. An assessment
also is conducted at the End of Treatment visit for subjects who tinue the study due to
reasons other than disease progression.
Bone marrow aspirates and biopsies are to be obtained at screening, Day 15, Day 29, Day
57, every 56 days fter independent of dose delays and/or interruptions, at any time when
progression of e is ted, and at the End of Treatment visit. Bone marrow aspirates
and core sampling should be performed according to standard of care and analyzed at the local
site’ s laboratory in accordance with the International Council for Standardization in Hematology
(ICSH) Guidelines (Lee SH, et al. Int J Lab Hematol. 2008;30(5):349—64). Bone marrow core
biopsies and aspirate are to be evaluated for logy, flow cytometry, and for karyotype to
assess potential clinical activity. Aliquots of the bone marrow and/or peripheral blood blast cells
also are evaluated at central laboratories for 2—HG levels, gene expression profiles, histone and
DNA methylation patterns, and metabolomic profiling. Peripheral blood for the tion of
leukemic blast cells is to be obtained at screening, DaylS, Day 29, Day 57, every 56 days
thereafter independent of dose delays and/or uptions, at any time when progression of
disease is suspected, and at the End of Treatment visit. Cell counts and flow cytometry are used
to assess the state of differentiation of blast cells collected from bone marrow and peripheral
blood. Side scatter also is analyzed to determine the complexity of the blast cells in response to
compound 1.
Subject demographic data, ing gender, date of birth, age, race, and ethnicity, are
obtained during screening. Table 4 illustrates clinical actiVity for ten AML patients between the
ages of 53 and 74 n age 62.5) with ECOG Performance status of grade 0 or grade 1.
Table 4: Clinical ty
Cohort1 Patient Tumor Characteristics of ses
(d0se*) number Genetics2 Prior Therapy (Cycle)
Induction —> CR —>
Rl40Q, Consolidation —> Relapse —>
FLT3—ITD, Reinduction —> FLT—3
CEPBA inhibitor —> Persistent
Disease
Rl40Q Primary Induction Failure
Induction —> CR —>
1 Consolidation —>
3 RMOQ
Relapse —> Reinduction —>
(30 mg) Persistent Disease
Rl40Q, _ _ . CR
4 y Induction Failure
NPMl (4)
Induction —> CR —>
Rl72K, Consolidation —> transplant
DNMT3A, —> CRp
CEBPA, Relapse —> Decitabine —>
ASXLl Persistent Disease —> MEC
—> Persistent Disease
Induction —> CR —>
Consolidation —>
R140Q
Relapse —> 5-aza —’
2 abine
Induction —> CR —>
(50 mg) R140Q’ CR
Consolidation a Relapse a
NPMl (3)
—aza
Rl40Q, Induction —> CR —> CR
NPMl idation —> Relapse (2)
2014/049469
Rl72K Primary Induction e F21:
R140Q, Induction —> CR —> CRp
NPMl Consolidation —> e (2)
* Compound 1 is provided as 30 mg or 50 mg free—base equivalent strength doses (for
example, in Cohort Level 1, 36 mg of compound 1 is equivalent to 30 mg of free—base nd
nd 1 is administered as a single agent dosed orally twice daily (approximately
every 12 hours) on Days 1 to 28 of a 28—day cycle.
Rl40Q mutation in IDH2, Rl72K mutation in IDH2, FLT3—ITD: Fms—related tyrosine
kinase 3 (FLT3) internal tandem duplication (ITD), CEPBA: enhancer binding protein
alpha, NPMl: nucleophosmin (neucleolar phosphoprotein B23), DNMT3A: DNA (cytosine—5—
)methyltransferase 3 alpha, ASXLl: additional seX combs like 1
Response ia evaluated as defined in Table 5. CR : te Remission, CRp :
Complete Remission, Incomplete Platelet Recovery, PR: Partial Remission, PD: Disease
Progression, NE: not evaluable.
AML treatment is typically divided into two chemotherapy phases (1) remission
induction, which is aimed at eliminating all visible leukemia, and (2) consolidation (post—
remission therapy), which is aimed at treating any remaining leukemia cells and preventing a
e. Reinduction may be pursued following a patient relapse.
The intensity of induction treatment depends upon the patient’s age and health. In
younger patients, such as those under 60, induction often involves treatment with 2 chemo drugs,
cytarabine (ara—C) and an anthracycline drug such as daunorubicin (daunomycin) or idarubicin.
Sometimes a third drug, cladribine (Leustatin, 2—CdA), is given as well. Patients with poor heart
function cannot be treated with anthracyclines, and so may be d with another chemo drug,
such as fludarabine (Fludara) or topotecan. In rare cases where the leukemia has spread to the
brain or spinal cord, chemo may be given into the cerebrospinal fluid (CSF) as well.
Induction destroys most of the normal bone marrow cells as well as the leukemia cells. Most
patients develop ously low blood counts, and the patient may be very ill. Most patients
need antibiotics and blood product transfusions. Drugs to raise white blood cell counts may also
be used. Blood counts tend to stay down for weeks. Usually, the patient stays in the hospital
during this time.
One to two weeks after chemotherapy treatment, bone marrow biopsies are taken, and
should show a reduced number of bone marrow cells and fewer than 10% blasts, otherwise more
chemotherapy may be given. Sometimes a stem cell transplant is recommended at this point.
If the bone marrow biopsy shows a reduced number of bone marrow cells and fewer than 10%
blasts, within a few weeks normal bone marrow cells return and start making new blood cells.
When the blood cell counts recover, a bone marrow sample is taken to see if the leukemia is in
remission. Remission induction usually does not destroy all the leukemia cells, and a small
number often t. Without consolidation treatment, the ia is likely to return within
several months.
Induction is considered successful if remission is achieved. Further ent,
consolidation, is then given to try to destroy any remaining leukemia cells and help prevent a
relapse. For r patients, the main options for AML consolidation therapy are l
cycles of high—dose cytarabine (ara—C) imes known as HiDAC), allogeneic (donor) stem
cell transplant, or an autologous (patient’s own) stem cell transplant. Prior to a stem cell
transplant, patients receive very high doses of chemotherapy to destroy all bone marrow cells,
followed by stem cell transplant to restore blood cell production. Stem cell transplants have been
found to reduce the risk of leukemia coming back more than standard chemotherapy, but they are
also more likely to have s complications, including an increased risk of death from
treatment.
Older ts or those in poor health may not be able to tolerate such intensive
consolidation treatment. Often, giving them more intensive therapy raises the risk of s side
effects (including treatment—related death) without providing much more of a benefit. These
patients may be treated with l or 2 cycles of higher dose cytarabine (usually not quite as high as
in younger patients), or intermediate—dose Ara—C (MEC‘, decitabine, 5—azacytidine, clofarabine,
l or 2 cycles of standard dose cytarabine, possibly along with icin or daunorubicin, or non—
myeloablative stem cell transplant (mini—transplant).
The ing criteria ed in Table 5 and Table 6 are used to assess response to
treatment.
WO 17821 2014/049469
Table 5: Proposed Modified International Working Group Response ia for
Altering Natural History of MDS
Category Response criteria (Responses must last at least 4 weeks)
Complete remission Bone marrow: 55% myeloblasts with normal maturation of all cell lines*
Persistent dysplasia is noted*’(
Peripheral bloodi
Hgb 211 g/dL
Platelets 2100 x 109/L
Neutrophils 21.0 x log/LT
Blasts = 0%
Partial remission All CR criteria if abnormal before treatment except:
Bone marrow blasts decreased by 250% over pretreatment but still >5%
Cellularity and morphology not relevant
Marrow CRT Bone marrow: 55% myeloblasts and decrease by 250% over
pretreatment‘f
Peripheral blood: if HI responses, they are noted in addition to marrow
Stable disease Failure to achieve at least PR, but no evidence of progression for >8 wks
Death during ent or disease ssion characterized by worsening
of cytopenias, increase in percentage of bone marrow blasts, or
progression to a more advanced MDS FAB subtype than pretreatment
Relapse after CR or At least 1 of the following:
PR Return to pretreatment bone marrow blast percentage
Decrement of 250% from maximum remission/response levels in
granulocytes or platelets
ion in Hgb tration by 21.5 g/dL or transfusion dependence
Cytogenetic Complete: Disappearance of the chromosomal abnormality without
response appearance of new ones
Partial: At least 50% reduction of the chromosomal abnormality
Disease progression For patients with:
Less than 5% blasts: 250% se in blasts to >5% blasts
%—10% : 250% increase to >10% blasts
%—20% : 250% increase to >20% blasts
%-30% blasts: 250% increase to >30% blasts
Any of the following:
At least 50% decrement from maximum remission/response in
granulocytes or platelets
WO 17821
Reduction in Hgb by 22 g/dL
Transfusion dependence
Survival Endpoints:
Overall: death from any cause
Event free: failure or death from any cause
PFS: e progression or death from MDS
DFS: time to relapse
Cause—specific death: death related to MDS
Source: Cheson, et al. Blood. 2006;108(2):4l9—25
Abbreviations: MDS = myelodysplastic mes; CR 2 complete remission; Hgb =
hemoglobin; HI = hematologic improvement; PR 2 l remission; FAB = French—American—
British; AML = acute myeloid leukemia; PFS = progression—free survival; DFS = disease—free
survival.
Note: Deletions to IWG response criteria are not shown.
Note: To convert hemoglobin from g/L to g/dL, divide g/L by 10.
*Dysplastic changes should consider the normal range of dysplastic changes (modification).
ication to IWG response criteria (Cheson, et al. J Clin Oncol. 2003;21(24):4642-9).
iln some circumstances, protocol y may require the tion of further treatment (e.g.,
consolidation, maintenance) before the 4—week period. Such subjects can be included in the
response category into which they fit at the time the therapy is started. Transient cytopenias
during ed chemotherapy courses should not be considered as interrupting durability of
response, as long as they recover to the improved counts of the previous course.
Table 6: Proposed Modified International Working Group Response Criteria for
Hematologic Improvement
Hematologic Response criteria (Responses must last at least 8 ?
improvement*
Erythroid response Hgb increase by 21.5 g/dL
(pretreatment, < 11 g/dL) Relevant ion of units of RBC transfusions by an te
number of at least 4 RBC transfusions/8 wk compared with the
pretreatment transfusion number in the previous 8 wk. Only RBC
transfusions given for a Hgb of 59.0 g/dL pretreatment counts in the
RBC transfusion response evaluation‘t
2014/049469
et response Absolute increase of 230 x 109/L for patients starting with >20 x
eatment, < 100 x 10 /L platelets
lOg/L) Increase from <20 x 109/L to >20 x 109/L and by at least 100%T
Neutrophil response At least 100% increase and an absolute increase >0.5 x lOg/LT
(pretreatment, < 1.0 x
109/L)
Progression or relapse At least 1 of the following:
after H13? At least 50% decrement from maximum response levels in
granulocytes or platelets
Reduction in Hgb by > 1.5 g/dL
Transfusion dependence
Source: , et al. Blood. 2006;108(2):4l9—25
Abbreviations: Hgb indicates hemoglobin; RBC: red blood cell; HI: hematologic improvement.
Note: Deletions to the IWG response criteria are not shown.
Note: To convert hemoglobin from g/L to g/dL, divide g/L by 10.
*Pretreatment counts es of at least 2 measurements (not influenced by transfusions) 21
week apart (modification).
ication to IWG response criteria n, et al. J Clin Oncol. 2003;2l(24):4642—9)
iln the absence of r explanation, such as acute infection, repeated courses of
chemotherapy (modification), gastrointestinal bleeding, hemolysis, and so forth. It is
recommended that the 2 kinds of erythroid and platelet responses be reported overall as well as
by the individual response pattern.
Table 8: Cytogenetic classification according to the IPSS and the new S-group
classification
Classification/ Abnormalities
prognostic group
Normal; —Y;
Good
del(5q); del(20q)
Intermediate
Very good —Y; del(l lq) — —
Normal; del(5q); del
Good Including del(5q). —
(20(1); del(12p)
d l 7( q) '
e ; +8; 1( 17q) ;
Intermediate Any other —
+19; an other
/t(3cc)/del(3)
n__>3T
Greenberg P, et al. International scoring system for evaluating prognosis in
myelodysplastic syndromes [erratum appears in Blood. 1998;91(3):1100]. Blood
l997;89(6):2079—2088.
Schanz J, et al. Coalesced multicentric analysis of 2351 patients with ysplastic
syndromes indicates an underestimation of poor—risk cytogenetics of ysplastic
syndromes in the international prognostic scoring system. J Clin Oncol 2011;29(15):1963—
1970.
— indicates not applicable
* Any chromosome 7 abnormality
T Number of clonal abnormalities
Table 7 illustrates clinical activity for 14 patients of a total 35 patients with an advanced
hematological malignancy terized by the presence of a mutant allele of IDH2 between the
ages of 48 and 81 (median age 68) with ECOG Performance status of grades 0, l, or 2 (5 with
stable disease, 6 with progressive disease, 10 not evaluable patients are not included in Table 7).
Neutrophil counts increase by cycle 1 day 15. White blood cell counts and neutrophil counts are
in normal range by cycle 2 day 15 in patients with a response.
Table 7: Clinical Activity
Cohort 1)?“th Tumor 3 Characteristics of Prior Response4
e cs
(dose1) Therapy (Cycle)5
(Cytogenetics)
1 AML R140Q, FLT3 Relapse 1 9 Re— CR
(30mg)1 (Normal) induction Failure (4)
Rl72K, Relapse (Post—allo—
AML CRp
DNMT3A, transplant) 9 Re—
(Normal) (5)
ASXLl, FLT3 induction e. . .
MDS,
N '
0 pnor therapy for CR
prior AML R140Q, FLT3
MDS (1)
(Normal)
AML,
prior MPD Rl40Q Primary Induction Failure
(Monosomy 7)
. Relapse l 9 Re—
(Trisomy 8, Rl40Q
induction Failure. . . (3)
t(l7;18))
AML CR
. Rl40Q Relapse l
(Trisomy 8) (2)
2 AML PR
Rl72K Primary Induction Failure_ _ _
(50mg) (Normal) (2)
AML Cfi
Rl40Q NPMl Re al se l
, p
(Normal) (2)
y Induction Failure
AML CR**
Rl40Q 9 Relapse allo
(t(1;13)) (1)
transplant)
3 CMML PR
1 Rl40Q Relapse l 9 Relapse 2
(75mg) (Normal) (2)
AML,
prior MDS/ Rl40Q, Primary ion Failure CR
CMML NPMl, FLT3 9 Re—induction Failure (1)
(100 mg)2
(Normal)
Rl40Q,
.MDS CRp
DNMT3A, Refractory l
(Trisomy ll) (2)
(100 mg)1 ASXLI
MDS Rl40Q Refractory 1 PR
(Normal) (2)
6 MDS No prior therapy for PR
RMOQ
(150 mg)2 (Normal) MDS (1)
T Compound 1 is provided as 30, 50, 75, 100 or 150 mg free—base equivalent strength doses (for
example, in Cohort Level 1, 36 mg of compound 1 is equivalent to 30 mg of free—base
compound 3)
* Bone
marrow blasts 7% at cycle 5 day 1. Dose escalated to 75 mg (free—base lent) as a
single agent dosed orally twice daily (approximately every 12 hours)
** Bone
marrow blast increase 11% at cycle 3 day 1. Dose escalated to 75 mg (free—base
equivalent) as a single agent dosed orally twice daily (approximately every 12 hours)
Compound 1 administered as a single agent dosed orally twice daily (approximately every 12
hours) on Days 1 to 28 of a 28—day cycle.
Compound 1 administered as a single agent dosed orally once daily on Days 1 to 28 of a 28—day
cycle.
Tumor genetics based on local assessment. R140Q on in IDH2, R172K on in
IDH2, FLT3—ITD: Fms—related tyrosine kinase 3 (FLT3) internal tandem duplication (ITD),
CEPBA: CCAAT/enhancer binding n alpha, NPMl: nucleophosmin (neucleolar
phosphoprotein B23), DNMT3A: DNA (cytosine—5—)methyltransferase 3 alpha, ASXLl:
additional sex combs like 1
Response Criteria evaluated as defined in Tables 5 and 6. CR : Complete Remission, CRp :
Complete Remission, Incomplete Platelet Recovery, CRi: Complete Remission, incomplete
hematologic recovery, PR: Partial Remission, PD: Disease Progression, NE: not ble.
Five patients with complete remission have a duration of greater than 2.5 months, with a range
of one to four months.
Statistical analysis
Statistical es is primarily descriptive in nature since the goal of the study is to
determine the MTD of compound 1. Tabulations are produced for riate disposition,
demographic, ne, safety, PK, PD, and al activity parameters and are presented by
dose level and overall. Categorical les are summarized by frequency distributions (number
and percentages of subjects) and continuous variables are summarized by descriptive statistics
(mean, standard ion, median, minimum, and maximum).
Adverse events are summarized by Medical Dictionary for tory Activities (MedDRA)
system organ class and preferred term. Separate tabulations are produced for all treatment—
emergent AEs (TEAEs), treatment—related AEs (those ered by the Investigator as at least
possibly drug related), SAEs, tinuations due to ABS, and AEs of at least Grade 3 severity.
By—subject listings are provided for deaths, SAEs, DLTs, and AEs leading to discontinuation of
treatment.
Descriptive statistics are provided for clinical laboratory, ECG interval, LVEF, and vital
signs data, presented as both actual values and changes from baseline relative to each on—study
evaluation and to the last evaluation on study. Shift analyses are conducted for laboratory
parameters and ECOG PS.
Descriptive statistics (i.e., number of ts, mean, standard deviation, geometric mean
and coefficient of ion, median, minimum, and maximum) are used to summarize PK
ters for each dose group and, Where appropriate, for the entire population. Such
ters include (but are not limited to) Cmax, time to maximum concentration (Tmax), AUC,
ation half—life, and the fraction of drug excreted ged in the urine. The relationships
between dose and both Cmax and AUC is explored graphically for roportionality.
Response to treatment as assessed by the site Investigators using modified IWG is
tabulated. Two—sided 90% confidence intervals on the response rates is calculated for each dose
level and overall. Data is summarized by type of malignancy for subjects in the cohort expansion
phase.
Example 6:
mg and 10 mg dose strength tablets (free—base equivalent) may be prepared using a dry
blend process described in Table A.
Table A
mg tablet*
mg tablet>l<
Weight Amount
Component Amount
Composition per tablet
per tablet m( g)
(mg)
Compound1"“
—-—n
l-{ypromeliose Acetate Suecinate
(Hydroxypropyl lvlethyleellulose 1% 1.0 2.0
Acetate ate)
TOTAL 100% 100.0 200.0
*Free—base equivalent
50 mg and 200 mg dose strength tablets (free—base equivalent) may be prepared using a
dry granulation s described in Table B
Table B
50 mg tablet* 200 mg tablet*
Weight
Component Amount per Amount
Composition
tablet (mg) per tablet (mg)
Compound1 —mm- 2400
Microcrystalline Cellulose 2100
Intragranule
Sodlum. Lauryl e ——m_
buttemate
Microcrystalline Cellulose 9.50% 14.25
Extragranule
_ TOTAL 100% 150.0 600.0
*Free—base equivalent
mg, 50 mg, 100 mg and 150 mg dose strength tablets (free—base equivalent) may be
prepared using a dry granulation common blend as described in Table C.
Table C
100 mg * 150 mg *
Weight
Component Amount per tablet Amount per tablet
Composition
(mg) (mg)
Compound 1 30%
Microcrystalline Cellulose 45%
Hydroxypropyl Cellulose
Sodium Starch Glycolate [0.4; O
Sodium Lauryl Sulfate
HVpromollose Acetate :h:'> 00
Succinate
Colloidal Silicon Dioxide l.50%
b.) . o U]
Microcrystalline Cellulose
950%
Sodium Starch ate
Colloidal Silicon Dioxide 0.50% .N o o: o
TOTAL 100% 400.0 600.0
*Free—base equivalent
While the foregoing invention has been described in some detail for purposes of clarity
and understanding, these particular embodiments are to be considered as illustrative and not
restrictive. It will be iated by one skilled in the art from a reading of this disclosure that
various changes in form and detail can be made t ing from the true scope of the
invention, which is to be defined by the ed claims rather than by the specific
embodiments.
The patent and scientific literature referred to herein establishes knowledge that is
available to those with skill in the art. Unless otherwise defined, all technical and scientific terms
used herein have the same meaning as commonly understood by one of ordinary skill in the art to
which this invention belongs. The issued patents, applications, and references that are cited
herein are hereby incorporated by reference to the same extent as if each was specifically and
individually ted to be incorporated by nce. In the case of inconsistencies, the present
disclosure, including definitions, will control.
Applications Claiming Priority (11)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201361861884P | 2013-08-02 | 2013-08-02 | |
| US61/861,884 | 2013-08-02 | ||
| CNPCT/CN2013/081170 | 2013-08-09 | ||
| PCT/CN2013/081170 WO2015018060A1 (en) | 2013-08-09 | 2013-08-09 | Crystalline forms of therapeutically active compounds and use thereof |
| US201461939098P | 2014-02-12 | 2014-02-12 | |
| US61/939,098 | 2014-02-12 | ||
| US201461975448P | 2014-04-04 | 2014-04-04 | |
| US61/975,448 | 2014-04-04 | ||
| US201462011948P | 2014-06-13 | 2014-06-13 | |
| US62/011,948 | 2014-06-13 | ||
| PCT/US2014/049469 WO2015017821A2 (en) | 2013-08-02 | 2014-08-01 | Therapeutically active compounds and their methods of use |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| NZ716226A NZ716226A (en) | 2021-08-27 |
| NZ716226B2 true NZ716226B2 (en) | 2021-11-30 |
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