Compounds and compositions for treating conditions associated with sting activity
Chemical entities that inhibit STING activity address the challenge of excessive STING activation in treating conditions like cancer and inflammatory disorders by reducing STING signaling, offering therapeutic benefits for these diseases.
Patent Information
- Application Number
- PCT/US2024/034937
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2023-06-22
- Filing Date
- 2024-06-21
- Publication Date
- 2024-12-26
AI Technical Summary
Current treatments lack effective solutions for conditions associated with excessive STING activation, which contributes to various diseases such as cancer, type I interferonopathies, and inflammatory disorders, as existing therapies do not adequately address the pathological role of STING signaling.
Development of chemical entities that inhibit STING activity by directly binding or modifying the STING protein, thereby reducing its activity, blocking agonist-mediated responses, or altering its distribution, which are administered as pharmaceutical compositions to treat conditions where excessive STING activation is a contributing factor.
The STING inhibitors effectively reduce STING signaling, providing therapeutic benefits in treating conditions like cancer, type I interferonopathies, and inflammatory disorders by modulating STING activity, thereby alleviating symptoms and slowing disease progression.
Smart Images

Figure IMGF000004_0001 
Figure IMGF000004_0002 
Figure IMGF000018_0001
Abstract
Description
[0001] Compounds and Compositions for Treating Conditions Associated with STING Activity
[0002] CROSS REFERENCE TO RELATED APPLICATIONS
[0003] This application claims the benefit of U.S. Provisional Application Serial No. 63 / 522,664, filed on June 22, 2023, which is incorporated herein by reference in its entirety.
[0004] TECHNICAL FIELD
[0005] This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and / or hydrate, and / or cocrystal, and / or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING). Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). This disclosure also features compositions containing the same as well as methods of using and making the same.
[0006] BACKGROUND
[0007] STING, also known as transmembrane protein 173 (TMEM173) and MPYS / MITA / ERIS, is a protein that in humans is encoded by the TMEM173 gene. STING has been shown to play a role in innate immunity. STING induces type I interferon production when cells are infected with intracellular pathogens, such as viruses, mycobacteria and intracellular parasites. Type I interferon, mediated by STING, protects infected cells and nearby cells from local infection in an autocrine and paracrine manner.
[0008] The STING pathway is pivotal in mediating the recognition of cytosolic DNA. In this context, STING, a transmembrane protein localized to the endoplasmic reticulum (ER), acts as a second messenger receptor for 2', 3' cyclic GMP-AMP (hereafter cGAMP), which is produced by cGAS after dsDNA binding. In addition, STING can also function as a primary pattern recognition receptor for bacterial cyclic dinucleotides (CDNs) and small molecule agonists. The recognition of endogenous or prokaryotic CDNs proceeds through the carboxy-terminal domain of STING, which faces into the cytosol and creates a V-shaped binding pocket formed by a STING homodimer. Ligand-induced activation of STING triggers its re-localization to the Golgi, a process essential to promote the interaction of STING with TBK1. This protein complex, in turn, signals through the transcription factors IRF-3 to induce type I interferons (IFNs) and other co-regulated antiviral factors. In addition, STING was shown to trigger NF-KB and MAP kinase activation. Following the initiation of signal transduction, STING is rapidly degraded, a step considered important in terminating the inflammatory response.
[0009] Excessive activation of STING is associated with a subset of monogenic autoinflammatory conditions, the so-called type I interferonopathies. Examples of these diseases include a clinical syndrome referred to as STING-associated vasculopathy with onset in infancy (SAVI), which is caused by gain-of-function mutations in TMEM173 (the gene name of STING). Moreover, STING is implicated in the pathogenesis of Aicardi- Goutieres Syndrome (AGS) and genetic forms of lupus. As opposed to SAVI, it is the dysregulation of nucleic acid metabolism that underlies continuous innate immune activation in AGS. Apart from these genetic disorders, emerging evidence points to a more general pathogenic role for STING in a range of inflammation-associated disorders such as systemic lupus erythematosus, rheumatoid arthritis and cancer. Thus, small moleculebased pharmacological interventions into the STING signaling pathway hold significant potential for the treatment of a wide spectrum of diseases
[0010] SUMMARY
[0011] This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and / or hydrate, and / or cocrystal, and / or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING). Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). This disclosure also features compositions containing the same as well as methods of using and making the same. An "antagonist" of STING includes compounds that, at the protein level, directly bind or modify STING such that an activity of STING is decreased, e.g., by inhibition, blocking or dampening agonist-mediated responses, altered distribution, or otherwise. STING antagonists include chemical entities, which interfere or inhibit STING signaling.
[0012] In one aspect, compounds of Formula (I), or a pharmaceutically acceptable salt thereof, are featured: in which X1, X2, X3, Y1, Y2, Y3, R3, R4, R5, R6, and m can be as defined anywhere herein.
[0013] In one aspect, compounds of Formula (II), or a pharmaceutically acceptable salt thereof, are featured: in which X1, X2, X3, Y1, Y2, Y3, R3, R4, R5, R6, ring A, and m can be as defined anywhere herein.
[0014] In one aspect, pharmaceutical compositions are featured that include a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same) and one or more pharmaceutically acceptable excipients.
[0015] In one aspect, methods for inhibiting (e.g., antagonizing) STING activity are featured that include contacting STING with a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same). Methods include in vitro methods, e.g., contacting a sample that includes one or more cells comprising STING (e.g., innate immune cells, e.g., mast cells, macrophages, dendritic cells (DCs), and natural killer cells) with the chemical entity. Methods can also include in vivo methods; e.g., administering the chemical entity to a subject (e.g., a human) having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease.
[0016] In one aspect, methods of treating a condition, disease or disorder ameliorated by antagonizing STING are featured, e.g., treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). The methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
[0017] In another aspect, methods of treating cancer are featured that include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
[0018] In a further aspect, methods of treating other STING-associated conditions are featured, e.g., type I interferonopathies (e.g., STING-associated vasculopathy with onset in infancy (SAVI)), Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis. The methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
[0019] In another aspect, methods of suppressing STING-dependent type I interferon production in a subject in need thereof are featured that include administering to the subject an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same). In a further aspect, methods of treating a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the disease are featured. The methods include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).
[0020] In another aspect, methods of treatment are featured that include administering an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same) to a subject; wherein the subject has (or is predisposed to have) a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the disease.
[0021] In a further aspect, methods of treatment that include administering to a subject a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same), wherein the chemical entity is administered in an amount effective to treat a disease in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the disease, thereby treating the disease.
[0022] In another aspect, is a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein, for use in the treatment of a disease, condition or disorder modulated by STING inhibition.
[0023] In another aspect, is a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the treatment of a condition, disease or disorder associated with increased (e.g., excessive) STING activation.
[0024] In another aspect, is a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the treatment of cancer.
[0025] In another aspect, is a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the treatment of cancer selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
[0026] In another aspect, is a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the treatment of type I interferonopathies.
[0027] In another aspect, is a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the treatment of type I interferonopathies selected from STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
[0028] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the manufacture of a medicament for the treatment of a condition, disease or disorder associated with increased (e.g., excessive) STING activation.
[0029] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the manufacture of a medicament for the treatment of cancer.
[0030] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the manufacture of a medicament for the treatment of cancer selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma. In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the manufacture of a medicament for the treatment of type I interferonopathies.
[0031] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for use in the manufacture of a medicament for the treatment of type I interferonopathies selected from STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
[0032] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein, for the treatment of a disease, condition or disorder modulated by STING inhibition.
[0033] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for the treatment of a condition, disease or disorder associated with increased (e.g., excessive) STING activation.
[0034] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for the treatment of cancer.
[0035] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for the treatment of cancer selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
[0036] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for the treatment of type I interferonopathies.
[0037] In another aspect, is the use of a compound, or a pharmaceutically acceptable salt or tautomer thereof, described herein for the treatment of type I interferonopathies selected from STING-associated vasculopathy with onset in infancy (SAVI)), Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
[0038] Embodiments can include one or more of the following features.
[0039] The chemical entity can be administered in combination with one or more additional therapeutic agents and / or regimens. For examples, methods can further include administering one or more (e.g., two, three, four, five, six, or more) additional agents.
[0040] The chemical entity can be administered in combination with one or more additional therapeutic agents and / or regimens that are useful for treating other STING- associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis.
[0041] The chemical entity can be administered in combination with one or more additional cancer therapies (e.g., surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof; e.g., chemotherapy that includes administering one or more (e.g., two, three, four, five, six, or more) additional chemotherapeutic agents. Non-limiting examples of additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti -metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD- 1 - PD-L2, interleukin-2 (IL-2), indoleamine 2,3-dioxygenase (IDO), IL- 10, transforming growth factor-0 (TGF0), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidylserine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- IBB-4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM
[0042] - LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48
[0043] - CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
[0044] The subject can have cancer; e.g., the subject has undergone and / or is undergoing and / or will undergo one or more cancer therapies.
[0045] Non-limiting examples of cancer include melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma. In certain embodiments, the cancer can be a refractory cancer.
[0046] The chemical entity can be administered intratumorally. The methods can further include identifying the subject.
[0047] Other embodiments include those described in the Detailed Description and / or in the claims.
[0048] Additional Definitions
[0049] To facilitate understanding of the disclosure set forth herein, a number of additional terms are defined below. Generally, the nomenclature used herein and the laboratory procedures in organic chemistry, medicinal chemistry, and pharmacology described herein are those well-known and commonly employed in the art. Unless defined otherwise, all technical and scientific terms used herein generally have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. Each of the patents, applications, published applications, and other publications that are mentioned throughout the specification and the attached appendices are incorporated herein by reference in their entireties.
[0050] As used herein, the term “STING” is meant to include, without limitation, nucleic acids, polynucleotides, oligonucleotides, sense and antisense polynucleotide strands, complementary sequences, peptides, polypeptides, proteins, homologous and / or orthologous STING molecules, isoforms, precursors, mutants, variants, derivatives, splice variants, alleles, different species, and active fragments thereof.
[0051] The term “acceptable” with respect to a formulation, composition or ingredient, as used herein, means having no persistent detrimental effect on the general health of the subject being treated.
[0052] “API” refers to an active pharmaceutical ingredient.
[0053] The terms “effective amount” or “therapeutically effective amount,” as used herein, refer to a sufficient amount of a chemical entity being administered which will relieve to some extent one or more of the symptoms of the disease or condition being treated. The result includes reduction and / or alleviation of the signs, symptoms, or causes of a disease, or any other desired alteration of a biological system. For example, an “effective amount” for therapeutic uses is the amount of the composition comprising a compound as disclosed herein required to provide a clinically significant decrease in disease symptoms. An appropriate “effective” amount in any individual case is determined using any suitable technique, such as a dose escalation study.
[0054] The term “excipient” or “pharmaceutically acceptable excipient” means a pharmaceutically-acceptable material, composition, or vehicle, such as a liquid or solid fdler, diluent, carrier, solvent, or encapsulating material. In one embodiment, each component is “pharmaceutically acceptable” in the sense of being compatible with the other ingredients of a pharmaceutical formulation, and suitable for use in contact with the tissue or organ of humans and animals without excessive toxicity, irritation, allergic response, immunogenicity, or other problems or complications, commensurate with a reasonable benefit / risk ratio. See, e.g., Remington: The Science and Practice of Pharmacy, 21st ed:, Lippincott Williams & Wilkins: Philadelphia, PA, 2005; Handbook of Pharmaceutical Excipients, 6th ed. \ Rowe et al., Eds.; The Pharmaceutical Press and the American Pharmaceutical Association: 2009; Handbook of Pharmaceutical Additives, 3rd ed; Ash and Ash Eds.; Gower Publishing Company: 2007; Pharmaceutical Preformulation and Formulation, 2nd ed.. Gibson Ed.; CRC Press LLC: Boca Raton, FL, 2009.
[0055] The term “pharmaceutically acceptable salt” refers to a formulation of a compound that does not cause significant irritation to an organism to which it is administered and does not abrogate the biological activity and properties of the compound. In certain instances, pharmaceutically acceptable salts are obtained by reacting a compound described herein, with acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like. In some instances, pharmaceutically acceptable salts are obtained by reacting a compound having acidic group described herein with a base to form a salt such as an ammonium salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as dicyclohexylamine, A-methyl-D-glucamine, tris(hydroxymethyl)methylamine, and salts with amino acids such as arginine, lysine, and the like, or by other methods previously determined. The pharmacologically acceptable salt s not specifically limited as far as it can be used in medicaments. Examples of a salt that the compounds described hereinform with a base include the following: salts thereof with inorganic bases such as sodium, potassium, magnesium, calcium, and aluminum; salts thereof with organic bases such as methylamine, ethylamine and ethanolamine; salts thereof with basic amino acids such as lysine and ornithine; and ammonium salt. The salts may be acid addition salts, which are specifically exemplified by acid addition salts with the following: mineral acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, and phosphoric acid:organic acids such as formic acid, acetic acid, propionic acid, oxalic acid, malonic acid, succinic acid, fumaric acid, maleic acid, lactic acid, malic acid, tartaric acid, citric acid, methanesulfonic acid, and ethanesulfonic acid; acidic amino acids such as aspartic acid and glutamic acid.
[0056] The term “pharmaceutical composition” refers to a mixture of a compound described herein with other chemical components (referred to collectively herein as “excipients”), such as carriers, stabilizers, diluents, dispersing agents, suspending agents, and / or thickening agents. The pharmaceutical composition facilitates administration of the compound to an organism. Multiple techniques of administering a compound exist in the art including, but not limited to: rectal, oral, intravenous, aerosol, parenteral, ophthalmic, pulmonary, and topical administration.
[0057] The term “subject” refers to an animal, including, but not limited to, a primate (e.g., human), monkey, cow, pig, sheep, goat, horse, dog, cat, rabbit, rat, or mouse. The terms “subject” and “patient” are used interchangeably herein in reference, for example, to a mammalian subject, such as a human.
[0058] The terms “treat,” “treating,” and “treatment,” in the context of treating a disease or disorder, are meant to include alleviating or abrogating a disorder, disease, or condition, or one or more of the symptoms associated with the disorder, disease, or condition; or to slowing the progression, spread or worsening of a disease, disorder or condition or of one or more symptoms thereof. The “treatment of cancer”, refers to one or more of the following effects: (1) inhibition, to some extent, of tumor growth, including, (i) slowing down and (ii) complete growth arrest; (2) reduction in the number of tumor cells; (3) maintaining tumor size; (4) reduction in tumor size; (5) inhibition, including (i) reduction, (ii) slowing down or (iii) complete prevention, of tumor cell infiltration into peripheral organs; (6) inhibition, including (i) reduction, (ii) slowing down or (iii) complete prevention, of metastasis; (7) enhancement of anti-tumor immune response, which may result in (i) maintaining tumor size, (ii) reducing tumor size, (iii) slowing the growth of a tumor, (iv) reducing, slowing or preventing invasion and / or (8) relief, to some extent, of the severity or number of one or more symptoms associated with the disorder.
[0059] The term "halo" refers to fluoro (F), chloro (Cl), bromo (Br), or iodo (I).
[0060] The term "alkyl" refers to a saturated acyclic hydrocarbon radical that may be a straight chain or branched chain, containing the indicated number of carbon atoms. For example, Ci-io indicates that the group may have from 1 to 10 (inclusive) carbon atoms in it. Alkyl groups can either be unsubstituted or substituted with one or more substituents. Non-limiting examples include methyl, ethyl, z.so-propyl, tert-butyl, n-hexyl. The term “saturated” as used in this context means only single bonds present between constituent carbon atoms and other available valences occupied by hydrogen and / or other substituents as defined herein.
[0061] The term "haloalkyl" refers to an alkyl, in which one or more hydrogen atoms is / are replaced with an independently selected halo.
[0062] The term "alkoxy" refers to an -O-alkyl radical (e.g., -OCH3).
[0063] The term "alkylene" refers to a divalent alkyl (e.g., -CH2-).
[0064] The term "alkenyl" refers to an acyclic hydrocarbon chain that may be a straight chain or branched chain having one or more carbon-carbon double bonds. The alkenyl moiety contains the indicated number of carbon atoms. For example, C2-6 indicates that the group may have from 2 to 6 (inclusive) carbon atoms in it. Alkenyl groups can either be unsubstituted or substituted with one or more substituents.
[0065] The term "alkynyl" refers to an acyclic hydrocarbon chain that may be a straight chain or branched chain having one or more carbon-carbon triple bonds. The alkynyl moiety contains the indicated number of carbon atoms. For example, C2-6 indicates that the group may have from 2 to 6 (inclusive) carbon atoms in it. Alkynyl groups can either be unsubstituted or substituted with one or more substituents.
[0066] The term "aryl" refers to a 6-20 carbon mono-, bi-, tri- or polycyclic group wherein at least one ring in the system is aromatic (e.g., 6-carbon monocyclic, 10-carbon bicyclic, or 14-carbon tricyclic aromatic ring system); and wherein 0, 1, 2, 3, or 4 atoms of each ring may be substituted by a substituent. Examples of aryl groups include phenyl, naphthyl, tetrahydronaphthyl, dihydro- IH-indenyl and the like. The term "cycloalkyl" as used herein refers to cyclic saturated hydrocarbon groups having, e.g., 3 to 20 ring carbons, preferably 3 to 16 ring carbons, and more preferably 3 to 12 ring carbons or 3-10 ring carbons or 3-6 ring carbons, wherein the cycloalkyl group may be optionally substituted. Examples of cycloalkyl groups include, without limitation, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and cyclooctyl. Cycloalkyl may include multiple fused and / or bridged rings. Non-limiting examples of fused / bridged cycloalkyl includes: bicyclo[1.1.0]butanyl, bicyclo[2.1.0]pentanyl, bicyclofl. l.l]pentanyl, bicyclo[3.1.0]hexanyl, bicyclo[2.1.1 ]hexanyl, bicyclo[3 ,2.0]heptanyl, bicyclo[4.1 ,0]heptanyl, bicyclo[2.2. l]heptanyl, bicyclo[3.1. l]heptanyl, bicyclo[4.2.0]octanyl, bicyclo[3.2.1]octanyl, bicyclo[2.2.2]octanyl, and the like. Cycloalkyl also includes spirocyclic rings (e.g., spirocyclic bicycle wherein two rings are connected through just one atom). Non-limiting examples of spirocyclic cycloalkyls include spiro[2.2]pentanyl, spiro[2.5]octanyl, spiro[3.5]nonanyl, spiro[3.5]nonanyl, spiro[3.5]nonanyl, spiro[4.4]nonanyl, spiro[2.6]nonanyl, spiro[4.5]decanyl, spiro[3.6]decanyl, spiro[5.5]undecanyl, and the like. The term “saturated” as used in this context means only single bonds present between constituent carbon atoms.
[0067] The term "cycloalkenyl" as used herein means partially unsaturated cyclic hydrocarbon groups having 3 to 20 ring carbons, preferably 3 to 16 ring carbons, and more preferably 3 to 12 ring carbons or 3-10 ring carbons or 3-6 ring carbons, wherein the cycloalkenyl group may be optionally substituted. Examples of cycloalkenyl groups include, without limitation, cyclopentenyl, cyclohexenyl, cycloheptenyl, and cyclooctenyl. As partially unsaturated cyclic hydrocarbon groups, cycloalkenyl groups may have any degree of unsaturation provided that one or more double bonds is present in the ring, none of the rings in the ring system are aromatic, and the cycloalkenyl group is not fully saturated overall. Cycloalkenyl may include multiple fused and / or bridged and / or spirocyclic rings.
[0068] The term “heteroaryl”, as used herein, means a mono-, bi-, tri- or polycyclic group having 5 to 20 ring atoms, alternatively 5, 6, 9, 10, or 14 ring atoms; and having 6, 10, or 14 pi electrons shared in a cyclic array; wherein at least one ring in the system is aromatic, and at least one ring in the system contains one or more heteroatoms independently selected from the group consisting of N, O, and S (but does not have to be a ring which contains a heteroatom, e.g. tetrahydroisoquinolinyl, e.g., tetrahydroquinolinyl). Heteroaryl groups can either be unsubstituted or substituted with one or more substituents. Examples of heteroaryl include thienyl, pyridinyl, furyl, oxazolyl, oxadiazolyl, pyrrolyl, imidazolyl, triazolyl, thiodiazolyl, pyrazolyl, isoxazolyl, thiadiazolyl, pyranyl, pyrazinyl, pyrimidinyl, pyridazinyl, triazinyl, thiazolyl benzothienyl, benzoxadiazolyl, benzofuranyl, benzimidazolyl, benzotri azolyl, cinnolinyl, indazolyl, indolyl, isoquinolinyl, isothiazolyl, naphthyridinyl, purinyl, thienopyridinyl, pyrido[2,3-t / ]pyrimidinyl, pyrrolo[2,3- 6]pyridinyl, quinazolinyl, quinolinyl, thieno[2,3-c]pyridinyl, pyrazolo[3,4- / >]pyridinyl, pyrazolo[3,4-c]pyridinyl, pyrazolo[4,3-c]pyridinyl, pyrazolo[4,3- / >]pyridinyl, tetrazolyl, chromanyl, 2,3-dihydrobenzo[Z>][l,4]dioxinyl, benzo[t / ][l,3]dioxolyl, benzo[d]thiazolyl, 2,3-dihydrobenzofuran, tetrahydroquinolinyl, 2,3-dihydrobenzo[ / >][l,4]oxathiinyl, indolinyl, isoindolinyl, and others. In some embodiments, the heteroaryl is selected from thienyl, pyridinyl, furyl, pyrazolyl, imidazolyl, isoindolinyl, pyranyl, pyrazinyl, and pyrimidinyl.
[0069] The term "heterocyclyl" refers to a mon-, bi-, tri-, or polycyclic saturated ring system with 3-16 ring atoms (e.g., 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system) having 1-3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic or polycyclic, said heteroatoms selected from O, N, or S (e.g., carbon atoms and 1-3, 1-6, or 1-9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1, 2 or 3 atoms of each ring may be substituted by a substituent. Examples of heterocyclyl groups include piperazinyl, pyrrolidinyl, dioxanyl, morpholinyl, tetrahydrofuranyl, and the like. Heterocyclyl may include multiple fused and bridged rings. Non-limiting examples of fused / bridged heteorocyclyl includes: 2-azabicyclo[1.1.0]butanyl, 2-azabicyclo[2.1.0]pentanyl, 2- azabicyclo[l. l.l]pentanyl, 3-azabicyclo[3.1.0]hexanyl, 5-azabicyclo[2.1.1]hexanyl, 3- azabicyclo[3.2.0]heptanyl, octahydrocyclopenta[c]pyrrolyl, 3-azabicyclo[4. 1 ,0]heptanyl, 7-azabicyclo[2.2.1]heptanyl, 6-azabicyclo[3.1.1]heptanyl, 7-azabicyclo[4.2.0]octanyl, 2- azabicyclo[2.2.2]octanyl, 3-azabicyclo[3.2.1]octanyl, 2-oxabicyclo[1.1.0]butanyl, 2- oxabicyclo[2.1.0]pentanyl, 2-oxabicyclo[l. l.l]pentanyl, 3-oxabicyclo[3.1.0]hexanyl, 5- oxabicyclo[2.1.1]hexanyl, 3-oxabicyclo[3.2.0]heptanyl, 3-oxabicyclo[4.1.0]heptanyl, 7- oxabicyclo[2.2.1]heptanyl, 6-oxabicyclo[3.1.1]heptanyl, 7-oxabicyclo[4.2.0]octanyl, 2- oxabicyclo[2.2.2]octanyl, 3-oxabicyclo[3.2.1]octanyl, and the like. Heterocyclyl also includes spirocyclic rings (e.g., spirocyclic bicycle wherein two rings are connected through just one atom). Non-limiting examples of spirocyclic heterocyclyls include 2- azaspiro[2.2]pentanyl, 4-azaspiro[2.5]octanyl, 1-azaspiro[3.5]nonanyl, 2 azaspiro[3.5]nonanyl, 7-azaspiro[3.5]nonanyl, 2-azaspiro[4.4]nonanyl, 6 azaspiro[2.6]nonanyl, 1 , 7-diazaspiro[4.5 ] decanyl, 7-azaspiro[4.5]decanyl, 2,5 diazaspiro[3.6]decanyl, 3 -azaspiro[5.5]undecanyl, 2-oxaspiro[2.2]pentanyl, 4 oxaspiro [2.5 ] octanyl , 1-oxaspiro[3.5]nonanyl, 2-oxaspiro[3.5]nonanyl, 7 oxaspiro[3 ,5]nonanyl, 2-oxaspiro[4.4]nonanyl, 6-oxaspiro[2.6]nonanyl, 1,7 di oxaspiro[4.5 ] decany 1, 2,5-dioxaspiro[3.6]decanyl, l-oxaspiro[5.5]undecanyl, 3 oxaspiro[5.5]undecanyl, 3-oxa-9-azaspiro[5.5]undecanyl and the like. The term
[0070] “saturated” as used in this context means only single bonds present between constituent ring atoms and other available valences occupied by hydrogen and / or other substituents as defined herein.
[0071] The term "heterocycloalkenyl" as used herein means partially unsaturated cyclic ring system with 3-16 ring atoms (e.g., 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system) having 1-3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic or polycyclic, said heteroatoms selected from O, N, or S (e.g., carbon atoms and 1-3, 1-6, or 1-9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1, 2 or 3 atoms of each ring may be substituted by a substituent. Examples of heterocycloalkenyl groups include, without limitation, tetrahydropyridyl, dihydropyrazinyl, dihydropyridyl, dihydropyrrolyl, dihydrofuranyl, dihydrothiophenyl. As partially unsaturated cyclic groups, heterocycloalkenyl groups may have any degree of unsaturation provided that one or more double bonds is present in the ring, none of the rings in the ring system are aromatic, and the heterocycloalkenyl group is not fully saturated overall. Heterocycloalkenyl may include multiple fused and / or bridged and / or spirocyclic rings.
[0072] As used herein, when a ring is described as being “aromatic”, it means said ring has a continuous, delocalized 7t-electron system. Typically, the number of out of plane n- electrons corresponds to the Hiickel rule (4n+2). Examples of such rings include: benzene, pyridine, pyrimidine, pyrazine, pyridazine, pyridone, pyrrole, pyrazole, oxazole, thioazole, isoxazole, isothiazole, and the like. As used herein, when a ring is described as being “partially unsaturated”, it means said ring has one or more additional degrees of unsaturation (in addition to the degree of unsaturation attributed to the ring itself; e.g., one or more double or tirple bonds between constituent ring atoms), provided that the ring is not aromatic. Examples of such rings include: cyclopentene, cyclohexene, cycloheptene, dihydropyridine, tetrahydropyridine, dihydropyrrole, dihydrofuran, dihydrothiophene, and the like.
[0073] For the avoidance of doubt, and unless otherwise specified, for rings and cyclic groups (e.g., aryl, heteroaryl, heterocyclyl, heterocycloalkenyl, cycloalkenyl, cycloalkyl, and the like described herein) containing a sufficient number of ring atoms to form bicyclic or higher order ring systems (e.g., tricyclic, polycyclic ring systems), it is understood that such rings and cyclic groups encompass those having fused rings, including those in which the points of fusion are located (i) on adjacent ring atoms (e.g., [x.x.O] ring systems, in which 0 represents a zero atom bridge (e.g., )); (ii) a single ring atom (spiro- fused ring systems) (e.g., (iii) a contiguous array of ring atoms (bridged ring systems having all bridge lengths > 0) (e.g.,
[0074] In addition, atoms making up the compounds of the present embodiments are intended to include all isotopic forms of such atoms. Isotopes, as used herein, include those atoms having the same atomic number but different mass numbers. By way of general example and without limitation, isotopes of hydrogen include tritium and deuterium, and isotopes of carbon include13C and14C.
[0075] In addition, the compounds generically or specifically disclosed herein are intended to include all tautomeric forms. Thus, by way of example, a compound containing the encompasses the tautomeric form containing the moiety: . y, a pyridinyl or pyrimidinyl moiety that is described to be optionally substituted with hydroxyl encompasses pyridone or pyrimidone tautomeric forms.
[0076] The details of one or more embodiments of the invention are set forth in the accompanying drawings and the description below. Other features and advantages of the invention will be apparent from the description and drawings, and from the claims.
[0077] DETAILED DESCRIPTION
[0078] This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt, and / or hydrate, and / or cocrystal, and / or drug combination of the compound) that inhibit (e.g., antagonize) Stimulator of Interferon Genes (STING). Said chemical entities are useful, e.g., for treating a condition, disease or disorder in which increased (e.g., excessive) STING activation (e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the condition, disease or disorder (e.g., cancer) in a subject (e.g., a human). This disclosure also features compositions containing the same as well as methods of using and making the same.
[0079] Formula (I) Compounds
[0080] In one aspect, provided herein is a compound of Formula I: or a pharmaceutically acceptable salt thereof, wherein:
[0081] R4and R5taken together with the nitrogen atom to which each is attached forms a saturated or partially unsaturated ring of 4-12 ring atoms, wherein 0-2 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring is optionally further substituted with 1 -4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb; m is 0, 1, 2, or 3; each occurrence of R6is independently selected from the group consisting of: Rc, Rb, and -Lb-Rb;
[0082] R3is selected from the group consisting of: H and Rd;
[0083] Y1is selected from the group consisting of: CRlaand N;
[0084] Y2is selected from the group consisting of: CRlband N;
[0085] Y3is selected from the group consisting of: CRlcand N;
[0086] X1is selected from the group consisting of: CRld, N, N(R2), O, and S;
[0087] X2is selected from the group consisting of: CRle, N, N(R2), O, and S;
[0088] X3is selected from the group consisting of: CRlf, N, N(R2), O, and S, provided that 1-3 of X1, X2, and X3is independently selected from the group consisting of: N, N(R2), O, and S; each == is independently a single bond or a double bond, provided that the five membered ring comprising X1, X2, and X3is aromatic; and the six membered ring comprising Y1, Y2, and Y3is aromatic; each of Rla, Rlb, and R1cis independently selected from the group consisting of: H, -(Lb)b-Rb, Rb, and Rc; each of Rld, Rle, and Rlfis independently selected from the group consisting of: H, -Lb-Rb, Rb, and Rc; each occurrence of R2is independently selected from the group consisting of: H, Rd, -(Lb)b-Rb, and Rb; each occurrence of Rais independently selected from the group consisting of: – OH; -halo; –NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1-4 alkyl); -C(=O)OH; -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); and cyano; each occurrence of Rbis independently selected from the group consisting of: • C3-10 cycloalkyl or C3-10 cycloalkenyl, each of which is optionally substituted with 1-4 Rc; • heterocyclyl or heterocycloalkenyl of 3-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl or heterocycloalkenyl is optionally substituted with 1-4 Rc; • heteroaryl of 5-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; and • C6-10 aryl optionally substituted with 1-4 Rc; each occurrence of Lbis independently selected from the group consisting of: -O-, -NH-, -NRd,-S(O)0-2, C(O), alkylene, and Lb1-C1-3 alkylene optionally substituted with 1- 3 Ra; wherein Lb1is -O-, -NH-, -NRd,or -S(O)0-2, each occurrence of Rcis independently selected from the group consisting of: halo; cyano; C1-10 alkyl which is optionally substituted with 1-6 independently selected Ra; C2-6 alkenyl; C2-6 alkynyl; C1-4 alkoxy optionally substituted with –OH, NR’R”, C1-4 alkoxy, or C1-4 haloalkoxy; C1-4 haloalkoxy; -S(O)1-2(C1-4 alkyl); -S(O)(=NH)(C1-4 alkyl); -NReRf; – OH; -S(O)1-2NR’R’’; -C1-4 thioalkoxy; -C1-4 thiohaloalkoxy; -NO2; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)NR’R’’; and –SF5; each occurrence of Rdis independently selected from the group consisting of: C1-6 alkyl optionally substituted with 1-3 independently selected Ra; -C(O)(C1-4 alkyl); - C(O)O(C1-4 alkyl); -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; each occurrence of Reand Rfis independently selected from the group consisting of: H; C1-6 alkyl optionally substituted with 1-3 substituents each independently selected from the group consisting of NR’R’’, -OH, halo, C1-4 alkoxy, and C1-4 haloalkoxy; - C(O)R’’’; -C(O)OR’’’; -CONR’R’’; -C(=O)C(=O)R’’’; -S(O)1-2NR’R’’; -S(O)1-2R’’’; - OH; C1-4 alkoxy; and phenyl optionally substituted with from 1-6 Rc; each occurrence of R’ and R’’ is independently selected from the group consisting of: H; -OH; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; and R’’’ is selected from the group consisting of H; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; In some embodiments, it is provided that one, two or three of the following apply: (i) when the compound is a compound having formula , then R1fis other than , wherein Rd2is H or Rd; (ii) when the ring containing X1-X3and Y1-Y3is unsubstituted indolyl or 4- chloro-indolyl, m is 1, R6is CN and is ortho to the pyridyl N, then NR4R5cannot form (i) a piperidinyl ring that is substituted at the 4-position with OMe, F2, CF3, OPh, benzyl, p- F-benzyl, and Me2; (ii) piperazinyl ring that is substituted at the 4-position with iso-butyl, CH2CF3, and Me; or (iii) an N-linked morpholine ring; and (iii) the compound is other than: or . In certain embodiments of Formula (I), (i) applies. In certain embodiments of Formula (I), (ii) applies. In certain embodiments of Formula (I), (iii) applies. In certain embodiments of Formula (I), (i) and (ii) apply. In certain embodiments of Formula (I), (i) and (iii) apply. In some embodiments, the compound is other than a chemical entity disclosed in PCT / US2021 / 063732, filed on December 16, 2021 and published as WO 2022 / 133046 on Junes 23, 2022, which is incorporated herein by reference in its entirety. In some embodiments, the compound is other than a compound delineated in Table C1 of PCT / US2021 / 063732, filed on December 16, 2021 and published as WO 2022 / 133046 on Junes 23, 2022, which is incorporated herein by reference in its entirety. In some embodiments, the compound is a compound of Formula (I-a): Formula (I-a) or a pharmaceutically acceptable salt thereof. In certain embodiments of Formula (I-a), m is 1 or 2. In certain embodiments of Formula (I-a), m is 1. In some embodiments, the compound is a compound of Formula (I-a1), Formula (I-a2), Formula (I-a3), or Formula (I-a4):
[0089] Formula (I-a3) Formula (I-a4) or a pharmaceutically acceptable salt thereof. In certain embodiments, the compound is a compound of Formula (I-a1). In certain embodiments, the compound is a compound of Formula (I-a2). In certain embodiments, the compound is a compound of Formula (I-a3). In certain embodiments, the compound is a compound of Formula (I-a4). In certain embodiments of Formula (I-a1), Formula (I-a2), Formula (I-a3), or Formula (I-a4), m is 1 or 2. In certain embodiments of Formula (I-a1), Formula (I-a2), Formula (I-a3), or Formula (I-a4), m is 1. In some embodiments, the compound is a compound of Formula (I-a1-a), Formula (I-a2-a), or Formula (I-a3-a).
[0090] or a pharmaceutically acceptable salt thereof, wherein m1 is 0 or 1. In certain embodiments, the compound is a compound of Formula (I-a1-a). In certain embodiments, the compound is a compound of Formula (I-a2-a). In certain embodiments, the compound is a compound of Formula (I-a3-a). In certain embodiments of Formula (I-a1-a), Formula (I-a2-a), or Formula (I-a3- a), m is 0. In some embodiments, the compound is a compound of Formula (I-a1-ab), Formula (I-a2-ab), or Formula (I-a3-ab):
[0091] or a pharmaceutically acceptable salt thereof, wherein m1 is 0 or 1. In certain embodiments, the compound is a compound of Formula (I-a1-ab). In certain embodiments, the compound is a compound of Formula (I-a2-ab). In certain embodiments, the compound is a compound of Formula (I-a3-ab). In certain embodiments of Formula (I-a1-ab), Formula (I-a2-ab), or Formula (I- a3-ab), m is 0. In some embodiments, the compound is a compound of Formula (I-a1-ac) or Formula (I-a2-ac): Formula (I-a1-ac). Formula (I-a2- ac) or a pharmaceutically acceptable salt thereof. In certain embodiments, the compound is a compound of Formula (I-a1-ac). In certain embodiments, the compound is a compound of Formula (I-a2-ac). Formula (II) Compounds In one aspect, provided herein is a compound of Formula II: Formula (II) or a pharmaceutically acceptable salt thereof, wherein: Ring A is selected from the group consisting of: • pyridazinyl optionally further substituted with 1-2 independently selected Rc; • pyrimidinyl optionally further substituted with 1-2 independently selected Rc; • pyrazinyl optionally further substituted with 1-2 independently selected Rc; • triazinyl optionally further substituted with 1-2 independently selected Rc; and • heteroaryl of 10 ring atoms, wherein 1-4 ring atoms are N optionally further substituted with 1-2 independently selected Rc; R4and R5taken together with the nitrogen atom to which each is attached forms a saturated or partially unsaturated ring of 4-12 ring atoms, wherein 0-2 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(O)0-2, wherein the ring is optionally further substituted with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and –Lb-Rb; m is 0, 1, 2, or 3; each occurrence of R6is independently selected from the group consisting of: Rc, Rb, and –Lb-Rb; R3is selected from the group consisting of: H and Rd; Y1is selected from the group consisting of: CR1aand N; Y2is selected from the group consisting of: CR1band N; Y3is selected from the group consisting of: CR1cand N; X1is selected from the group consisting of: CR1d, N, N(R2), O, and S; X2is selected from the group consisting of: CR1e, N, N(R2), O, and S; X3is selected from the group consisting of: CR1f, N, N(R2), O, and S, provided that 1-3 of X1, X2, and X3is independently selected from the group each is independently a single bond or a double bond, provided that the five membered ring comprising X1, X2, and X3is aromatic; and the six membered ring comprising Y1, Y2, and Y3is aromatic; each of R1a, R1b, and R1cis independently selected from the group consisting of: H, -(Lb)b-Rb, Rb, and Rc; each of R1d, R1e, and R1fis independently selected from the group consisting of: H, -Lb-Rb, Rb, and Rc; each occurrence of R2is independently selected from the group consisting of: H, Rd, -(Lb)b-Rb, and Rb; each occurrence of Rais independently selected from the group consisting of: – OH; -halo; –NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1-4 alkyl); -C(=O)OH; -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); and cyano; each occurrence of Rbis independently selected from the group consisting of: • C3-10 cycloalkyl or C3-10 cycloalkenyl, each of which is optionally substituted with 1-4 Rc; • heterocyclyl or heterocycloalkenyl of 3-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl or heterocycloalkenyl is optionally substituted with 1-4 Rc; • heteroaryl of 5-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; and • C6-10 aryl optionally substituted with 1-4 Rc; each occurrence of Lbis independently selected from the group consisting of: -O-, -NH-, -NRd, -S(O)0-2, C(O), alkylene, and Lb1-C1-3 alkylene optionally substituted with 1- 3 Ra; wherein Lb1is -O-, -NH-, -NRd, or -S(O)0-2, each occurrence of Rcis independently selected from the group consisting of: halo; cyano; C1-10 alkyl which is optionally substituted with 1-6 independently selected Ra; C2-6 alkenyl; C2-6 alkynyl; C1-4 alkoxy optionally substituted with –OH, NR’R”, C1-4 alkoxy, or C1-4 haloalkoxy; C1-4 haloalkoxy; -S(O)1-2(C1-4 alkyl); -S(O)(=NH)(C1-4 alkyl); -NReRf; – OH; -S(O)1-2NR’R’’; -C1-4 thioalkoxy; -C1-4 thiohaloalkoxy; -NO2; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)NR’R’’; and –SF5; each occurrence of Rdis independently selected from the group consisting of: C1-6 alkyl optionally substituted with 1-3 independently selected Ra; -C(O)(C1-4 alkyl); - C(O)O(C1-4 alkyl); -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; each occurrence of Reand Rfis independently selected from the group consisting of: H; C1-6 alkyl optionally substituted with 1-3 substituents each independently selected from the group consisting of NR’R’’, -OH, halo, C1-4 alkoxy, and C1-4 haloalkoxy; - C(O)R’’’; -C(O)OR’’’; -CONR’R’’; -C(=O)C(=O)R’’’; -S(O)1-2NR’R’’; -S(O)1-2R’’’; - OH; and C1-4 alkoxy; each occurrence of R’ and R’’ is independently selected from the group consisting of: H; -OH; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; and R’’’ is selected from the group consisting of H; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH. In some embodiments of Formula (II), ring A is pyridazinyl optionally further substituted with 1-2 independently selected Rc. In certain of these embodiments, ring A has the formula: , wherein * represents the point of attachment to the bicycylic ring containing X1-X3and Y1-Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc. In some embodiments of Formula (II), ring A is pyrimidinyl, optionally further substituted with 1-2 independently selected Rc. In certain of these embodiments, ring A has the formula: , wherein * represents the point of attachment to the bicycylic ring containing X1-X3and Y1-Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc. In some embodiments of Formula (II), ring A is pyrazinyl optionally further substituted with 1-2 independently selected Rc. In certain of these embodiments, ring A has the formula: , wherein * represents the point of attachment to the bicycylic ring containing X1-X3and Y1-Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc. In some embodiments of Formula (II), ring A is triazinyl optionally further substituted with 1-2 independently selected Rc. In certain of these embodiments, ring A has the formula: , wherein * represents the point of attachment to the bicycylic ring containing X1-X3and Y1- Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc. In some embodiments of Formula (II), ring A is heteroaryl of 10 ring atoms, wherein 1-4 ring atoms are N optionally further substituted with 1-2 independently selected Rc. In certain of these embodiments, ring A has the formula: ts the point of attachment to the bicycylic ring containing X1-X3and Y1-Y3, and ** represents the point of attachment to NR4R5; and wherein ring B is aromatic 6-member ring containing 0-2 N atoms; and is optionally further substituted with 1-2 independently selected Rc. Embodiments can include any one or more of the following features. For ease of exposition, and unless otherwise indicated, the phrasing “in some / certain embodiments of any of the foregoing compound formulas” is intended to mean “in some / certain embodiments of Formula (I), Formula (I-a), Formula (I-a1), Formula (I-a2), Formula (I-a3), or Formula (I-a4), Formula (I-a1-a), Formula (I-a2-a), Formula (I-a3-a), Formula (I-a1-ab), Formula (I-a2-ab), Formula (I-a3-ab), Formula (I- a1-ac), Formula (I-a2-ac), or Formula (II).” Variables Y1, Y2, Y3, X1, X2, and X3In some embodiments of any of the foregoing compound formulas, Y1is CR1a. In certain of these embodiments, R1ais H. In certain embodiments (when Y1is CR1a), R1ais selected from the group consisting of: -(Lb)b-Rb, Rb, and Rc. In certain of these embodiments, R1ais Rc. For example, R1acan be halo (e.g., -Cl). In certain embodiments (when Y1is CR1a), R1ais Rb. In certain embodiments (when Y1is CR1a), R1ais -(Lb)b-Rb. In some embodiments of any of the foregoing compound formulas, Y2is CR1b. In certain of these embodiments, Y2is CH. In some embodiments of any of the foregoing compound formulas, Y3is CR1c. In certain of these embodiments, Y3is CH. In certain embodiments of any of the foregoing compound formulas, Y1is CH; Y2is CH; and Y3is CH. In some embodiments of any of the foregoing compound formulas, Y1is CR1a, wherein R1ais selected from the group consisting of: -(Lb)b-Rb, Rb, and Rc; Y2is CH; and Y3is CH. In certain of these embodiments, R1ais Rc. For example, R1acan be halo (e.g., -Cl). In certain embodiments, R1ais -(Lb)b-Rbor Rb. In some embodiments of any of the foregoing compound formulas, X1is N(R2). In certain of these embodiments, X1is N(H). In some embodiments of any of the foregoing compound formulas, X2is CR1e. In certain of these embodiments, X2is CH. In some embodiments of any of the foregoing compound formulas, X3is CR1f. In certain of these embodiments, X3is CH. In certain embodiments, R1fis selected from the group consisting of: -Lb-Rb, Rb, and Rc. In certain of these embodiments, R1fis Rc. In certain embodiments, R1fis –Lb-Rbor –Rb. In certain embodiments of any of the foregoing compound formulas, X1is N(H); X2is CH; and X3is CH. In certain embodiments of any of the foregoing compound formulas, X1is N(H); X2is CH; and X3is CR1f, wherein R1fis selected from the group consisting of: -Lb-Rb, Rb, and Rc. In certain of these embodiments, R1fis Rc. In certain embodiments, R1fis –Lb-Rbor Rb. In certain embodiments of any of the foregoing compound formulas, the moiety is . In certain of these embodiments, R2is H. In certain embodiments of , R1ais H; and R1fis H. In certain of these embodiments, R2is H. In certain embodiments of , R1ais halo (e.g., -Cl).; and R1fis halo (e.g., -F) or H. In certain of these embodiments, R2is H. For example, R1acan be -Cl; R1fis H; and R2is H. As another example, R1acan be -Cl; and R1fcan be F, and R2can be H. As another example, R1acan be H; and R1fcan be F, and R2can be H. As a further example, R1acan be H; and R1fcan be H, and R2can be H. In some embodiments of any of the foregoing compound formulas, R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 4-8 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(O)0-2, wherein the ring of 4-8 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and –Lb-Rb. In certain embodiments, R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 5-7 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(O)0-2, wherein the ring of 5-7 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and –Lb-Rb. In certain embodiments, R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 6 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(O)0-2, wherein the ring of 4-8 ring atoms is optionally further substituted with with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and –Lb- Rb. In some embodiments, R4and R5taken together with the nitrogen atom to which each is attached forms: , wherein Z1is selected from the group consisting of: N(RY); -O-; and C(RZ)2, wherein each RZis independently selected from the group consisting of: H, Rc, Rb, and –Lb-Rb; and RYis H, Rb, or –Lb-Rb; and wherein the ring is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and –Lb-Rb. In certain embodiments, Z1is C(RZ)2. In certain embodiments, R4and R5taken together with the nitrogen atom to which each is attached forms: . In certain embodiments, RZis Rc, Rb, or –Lb-Rb. For example, RZcan be –Lb- Rb. In certain embodiments, Lbis O. In certain embodiments, Rbis C6-10 aryl optionally substituted with 1-4 Rc. In certain embodiments, Lbis O, and Rbis C6-10 aryl optionally substituted with 1- 4 Rc. In certain of these embodiments, Rbis phenyl optionally substituted with 1-4 Rc. In certain of these embodiments, each occurrence of Rcis independently selected from CF3, chloro, and fluoro. For example, Rbcan be p-CF3-phenyl, m-CF3-phenyl, p-F-phenyl, p-Cl-phenyl, m- F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl. In embodiments RZis –O-(p-CF3-phenyl), –O-(m-CF3-phenyl), –O-(p-F-phenyl), – O-(m-F-phenyl), –O-(p-Cl-phenyl), –O-(m-Cl-phenyl), or O-(3,4-difluorophenyl). In other embodiments, Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms. For example, Rbcan be unsubstituted or substituted pyridyl. In certain embodiments, Lbis OCH2 or CH2. In certain embodiments, Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc. In certain embodiments, Lbis OCH2 or CH2, and Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc. In certain of these embodiments, Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc. For example, Rbcan be cyclopropyl, which is optionally substituted with 1-2 Rc. In other embodiments, Rbis phenyl optionally substituted with 1-4 Rc. In certain embodiments, RZis Rc. In certain of these embodiments, RZis C1-6 alkoxy or C1-6 haloalkoxy. For example, the C1-6 haloalkoxy can be C1-6 fluoroalkoxy. In certain embodiments, Z1is N(RY). In certain embodiments, the compound has the formula: , wherein RY1is absent, oxo or Rb. In certain of these embodiments, RYis Rb. In certain of these embodiments, Rbis C6-10 aryl optionally substituted with 1-4 Rc. For example, Rbcan be phenyl optionally substituted with 1-4 Rc. In certain of these embodiments, each occurrence of Rcis independently selected from CF3, chloro, and fluoro. For example, Rbcan be p-CF3-phenyl, m-CF3-phenyl, p-F-phenyl, p-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl. In other embodiments, Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; for example, Rbcan be substituted or unsubstitutedpyridyl. In some embodiments, R4and R5taken together with the nitrogen atom to which each is attached forms: . In certain embodiments, RZis other than H and independently selected from the group consisting of: OH, C1-6 alkyl optionally substituted with 1-6 independently selected halo, and Rb.. In some embodiments, R4and R5taken together with the nitrogen atom to which each is attached forms: . In certain embodiments, RZis Rc, Rb, or –Lb-Rb. For example, RZcan be –Lb-Rb. In certain embodiments, Lbis O. In certain embodiments, Rbis C6-10 aryl optionally substituted with 1-4 Rc. In certain embodiments, Lbis O, and Rbis C6-10 aryl optionally substituted with 1- 4 Rc. In certain of these embodiments, Rbis phenyl optionally substituted with 1-4 Rc. In certain of these embodiments, each occurrence of Rcis independently selected from CF3, chloro, and fluoro. For example, Rbcan be p-CF3-phenyl, m-CF3-phenyl, p-F-phenyl, p-Cl-phenyl, m- F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl. In embodiments RZis –O-(p-CF3-phenyl), –O-(m-CF3-phenyl), –O-(p-F-phenyl), – yl). In other embodiments, Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms. For example, Rbcan be unsubstituted or substituted pyridyl. In certain embodiments, Lbis OCH2 or CH2. In certain embodiments, Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc. In certain embodiments, Lbis OCH2 or CH2, and Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc. In certain of these embodiments, Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc. For example, Rbcan be cyclopropyl, which is optionally substituted with 1-2 Rc. In other embodiments, Rbis phenyl optionally substituted with 1-4 Rc. In certain embodiments, RZis Rc. In certain of these embodiments, RZis C1-6 alkoxy or C1-6 haloalkoxy. For example, the C1-6 haloalkoxy can be C1-6 fluoroalkoxy. In some embodiments, each occurrence of R6is an independently selected Rc. In certain embodiments, one occurrence of R6is cyano. In certain embodiments, one occurrence of R6is C1-10 alkyl which is optionally substituted with 1-6 independently selected Ra. In certain embodiments, one occurrence of R6is unsubstituted C1-6 alkyl. In certain embodiments, one occurrence of R6is unsubstituted C1-3 alkyl. For example, R6can be CH3. In certain embodiments, one occurrence of R6is CH3, and one occurrence of R6is CN. In some embodiments, R3is H. Non-Limiting Exemplary Compounds In some embodiments, the compound is selected from the group consisting of the compounds delineated in Table C1 or a pharmaceutically acceptable salt thereof. Table C1 Compound Structure #
[0092] Other Embodiments
[0093] In other embodiments, the compound can selected from the following:
[0094] Pharmaceutical Compositions and Administration
[0095] General
[0096] In some embodiments, a chemical entity (e.g., a compound that inhibits (e.g., antagonizes) STING, or a pharmaceutically acceptable salt, and / or hydrate, and / or cocrystal, and / or drug combination thereof) is administered as a pharmaceutical composition that includes the chemical entity and one or more pharmaceutically acceptable excipients, and optionally one or more additional therapeutic agents as described herein.
[0097] In some embodiments, the chemical entities can be administered in combination with one or more conventional pharmaceutical excipients. Pharmaceutically acceptable excipients include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, self-emulsifying drug delivery systems (SEDDS) such as d-a-tocopherol polyethylene glycol 1000 succinate, surfactants used in pharmaceutical dosage forms such as Tweens, poloxamers or other similar polymeric delivery matrices, serum proteins, such as human serum albumin, buffer substances such as phosphates, tris, 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 glycol, sodium carboxymethyl cellulose, polyacrylates, waxes, polyethylene-polyoxypropylene-block polymers, and wool fat. Cyclodextrins such as a-, 0, and y-cyclodextrin, or chemically modified derivatives such as hydroxyalkylcyclodextrins, including 2- and 3- hydroxypropyl-P-cyclodextrins, or other solubilized derivatives can also be used to enhance delivery of compounds described herein. Dosage forms or compositions containing a chemical entity as described herein in the range of 0.005% to 100% with the balance made up from non-toxic excipient may be prepared. The contemplated compositions may contain 0.001%-100% of a chemical entity provided herein, in one embodiment 0.1-95%, in another embodiment 75-85%, in a further embodiment 20-80%. Actual methods of preparing such dosage forms are known, or will be apparent, to those skilled in this art; for example, see Remington: The Science and Practice of Pharmacy, 22ndEdition (Pharmaceutical Press, London, UK. 2012). Routes of Administration and Composition Components
[0098] In some embodiments, the chemical entities described herein or a pharmaceutical composition thereof can be administered to subject in need thereof by any accepted route of administration. Acceptable routes of administration include, but are not limited to, buccal, cutaneous, endocervical, endosinusial, endotracheal, enteral, epidural, interstitial, intra-abdominal, intra-arterial, intrabronchial, intrabursal, intracerebral, intracistemal, intracoronary, intradermal, intraductal, intraduodenal, intradural, intraepidermal, intraesophageal, intragastric, intragingival, intraileal, intralymphatic, intramedullary, intrameningeal, intramuscular, intraovarian, intraperitoneal, intraprostatic, intrapulmonary, intrasinal, intraspinal, intrasynovial, intratesticular, intrathecal, intratubular, intratumoral, intrauterine, intravascular, intravenous, nasal, nasogastric, oral, parenteral, percutaneous, peridural, rectal, respiratory (inhalation), subcutaneous, sublingual, submucosal, topical, transdermal, transmucosal, transtracheal, ureteral, urethral and vaginal. In certain embodiments, a preferred route of administration is parenteral (e.g., intratumoral).
[0099] Compositions can be formulated for parenteral administration, e.g., formulated for injection via the intravenous, intramuscular, sub-cutaneous, or even intraperitoneal routes. Typically, such compositions can be prepared as injectables, either as liquid solutions or suspensions; solid forms suitable for use to prepare solutions or suspensions upon the addition of a liquid prior to injection can also be prepared; and the preparations can also be emulsified. The preparation of such formulations will be known to those of skill in the art in light of the present disclosure.
[0100] The pharmaceutical forms suitable for injectable use include sterile aqueous solutions or dispersions; formulations including sesame oil, peanut oil, or aqueous propylene glycol; and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. In all cases the form must be sterile and must be fluid to the extent that it may be easily injected. It also should be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms, such as bacteria and fungi.
[0101] The carrier also can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils. The proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of dispersion, and by the use of surfactants. The prevention of the action of microorganisms can be brought about by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars or sodium chloride. Prolonged absorption of the injectable compositions can be brought about by the use in the compositions of agents delaying absorption, for example, aluminum monostearate and gelatin.
[0102] Sterile injectable solutions are prepared by incorporating the active compounds in the required amount in the appropriate solvent with various of the other ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation are vacuum-drying and freeze-drying techniques, which yield a powder of the active ingredient, plus any additional desired ingredient from a previously sterile-filtered solution thereof.
[0103] Intratumoral injections are discussed, e.g., in Lammers, et al., “Effect of Intratumoral Injection on the Biodistribution and the Therapeutic Potential of HPMA Copolymer-Based Drug Delivery Systems” Neoplasia. 2006, 10, 788-795.
[0104] Pharmacologically acceptable excipients usable in the rectal composition as a gel, cream, enema, or rectal suppository, include, without limitation, any one or more of cocoa butter glycerides, synthetic polymers such as polyvinylpyrrolidone, PEG (like PEG ointments), glycerine, glycerinated gelatin, hydrogenated vegetable oils, poloxamers, mixtures of polyethylene glycols of various molecular weights and fatty acid esters of polyethylene glycol Vaseline, anhydrous lanolin, shark liver oil, sodium saccharinate, menthol, sweet almond oil, sorbitol, sodium benzoate, anoxid SBN, vanilla essential oil, aerosol, parabens in phenoxyethanol, sodium methyl p-oxybenzoate, sodium propyl p- oxybenzoate, diethylamine, carbomers, carbopol, methyloxybenzoate, macrogol cetostearyl ether, cocoyl caprylocaprate, isopropyl alcohol, propylene glycol, liquid paraffin, xanthan gum, carboxy-metabisulfite, sodium edetate, sodium benzoate, potassium metabisulfite, grapefruit seed extract, methyl sulfonyl methane (MSM) , lactic acid, glycine, vitamins, such as vitamin A and E and potassium acetate.
[0105] In certain embodiments, suppositories can be prepared by mixing the chemical entities described herein with suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum and release the active compound. In other embodiments, compositions for rectal administration are in the form of an enema.
[0106] In other embodiments, the compounds described herein or a pharmaceutical composition thereof are suitable for local delivery to the digestive or GI tract by way of oral administration (e.g., solid or liquid dosage forms.).
[0107] Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules. In such solid dosage forms, the chemical entity is mixed with one or more pharmaceutically acceptable excipients, such as sodium citrate or dicalcium phosphate and / or: a) fdlers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol monostearate, h) absorbents such as kaolin and bentonite clay, and i) lubricants such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof. In the case of capsules, tablets and pills, the dosage form may also comprise buffering agents. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.
[0108] In one embodiment, the compositions will take the form of a unit dosage form such as a pill or tablet and thus the composition may contain, along with a chemical entity provided herein, a diluent such as lactose, sucrose, dicalcium phosphate, or the like; a lubricant such as magnesium stearate or the like; and a binder such as starch, gum acacia, polyvinylpyrrolidine, gelatin, cellulose, cellulose derivatives or the like. In another solid dosage form, a powder, marume, solution or suspension (e.g., in propylene carbonate, vegetable oils, PEG’s, poloxamer 124 or triglycerides) is encapsulated in a capsule (gelatin or cellulose base capsule). Unit dosage forms in which one or more chemical entities provided herein or additional active agents are physically separated are also contemplated; e.g., capsules with granules (or tablets in a capsule) of each drug; two-layer tablets; two- compartment gel caps, etc. Enteric coated or delayed release oral dosage forms are also contemplated.
[0109] Other physiologically acceptable compounds include wetting agents, emulsifying agents, dispersing agents or preservatives that are particularly useful for preventing the growth or action of microorganisms. Various preservatives are well known and include, for example, phenol and ascorbic acid.
[0110] In certain embodiments the excipients are sterile and generally free of undesirable matter. These compositions can be sterilized by conventional, well-known sterilization techniques. For various oral dosage form excipients such as tablets and capsules sterility is not required. The USP / NF standard is usually sufficient.
[0111] In certain embodiments, solid oral dosage forms can further include one or more components that chemically and / or structurally predispose the composition for delivery of the chemical entity to the stomach or the lower GI; e g., the ascending colon and / or transverse colon and / or distal colon and / or small bowel. Exemplary formulation techniques are described in, e.g., Filipski, K.J., et al., Current Topics in Medicinal Chemistry, 2013, 13, 776-802, which is incorporated herein by reference in its entirety.
[0112] Examples include upper-GI targeting techniques, e.g., Accordion Pill (Intec Pharma), floating capsules, and materials capable of adhering to mucosal walls.
[0113] Other examples include lower-GI targeting techniques. For targeting various regions in the intestinal tract, several enteric / pH-responsive coatings and excipients are available. These materials are typically polymers that are designed to dissolve or erode at specific pH ranges, selected based upon the GI region of desired drug release. These materials also function to protect acid labile drugs from gastric fluid or limit exposure in cases where the active ingredient may be irritating to the upper GI (e.g., hydroxypropyl methyl cellulose phthalate series, Coateric (polyvinyl acetate phthalate), cellulose acetate phthalate, hydroxypropyl methylcellulose acetate succinate, Eudragit series (methacrylic acid-methyl methacrylate copolymers), and Marcoat). Other techniques include dosage forms that respond to local flora in the GI tract, Pressure-controlled colon delivery capsule, and Pulsincap.
[0114] Ocular compositions can include, without limitation, one or more of any of the following: viscogens (e.g., Carboxymethylcellulose, Glycerin, Polyvinylpyrrolidone, Polyethylene glycol); Stabilizers (e.g., Pluronic (triblock copolymers), Cyclodextrins); Preservatives (e.g., Benzalkonium chloride, ETDA, SofZia (boric acid, propylene glycol, sorbitol, and zinc chloride; Alcon Laboratories, Inc.), Purite (stabilized oxychloro complex; Allergan, Inc.)).
[0115] Topical compositions can include ointments and creams. Ointments are semisolid preparations that are typically based on petrolatum or other petroleum derivatives. Creams containing the selected active agent are typically viscous liquid or semisolid emulsions, often either oil-in-water or water-in-oil. Cream bases are typically water-washable, and contain an oil phase, an emulsifier and an aqueous phase. The oil phase, also sometimes called the “internal” phase, is generally comprised of petrolatum and a fatty alcohol such as cetyl or stearyl alcohol; the aqueous phase usually, although not necessarily, exceeds the oil phase in volume, and generally contains a humectant. The emulsifier in a cream formulation is generally a nonionic, anionic, cationic or amphoteric surfactant. As with other carriers or vehicles, an ointment base should be inert, stable, nonirritating and nonsensitizing.
[0116] In any of the foregoing embodiments, pharmaceutical compositions described herein can include one or more one or more of the following: lipids, interbilayer crosslinked multilamellar vesicles, biodegradeable poly(D,L-lactic-co-glycolic acid) [PLGA]-based or poly anhydride-based nanoparticles or microparticles, and nanoporous particle-supported lipid bilayers.
[0117] Dosages
[0118] The dosages may be varied depending on the requirement of the patient, the severity of the condition being treating and the particular compound being employed. Determination of the proper dosage for a particular situation can be determined by one skilled in the medical arts. The total daily dosage may be divided and administered in portions throughout the day or by means providing continuous delivery.
[0119] In some embodiments, the compounds described herein are administered at a dosage of from about 0.001 mg / Kg to about 500 mg / Kg (e.g., from about 0.01 mg / Kg to about 100 mg / Kg; from about 0.01 mg / Kg to about 10 mg / Kg; from about 0.01 mg / Kg to about 1 mg / Kg; from from about 0.01 mg / Kg to about 0.1 mg / Kg; from about 0. 1 mg / Kg to about 100 mg / Kg; from about 0. 1 mg / Kg to about 10 mg / Kg).
[0120] Regimens
[0121] The foregoing dosages can be administered on a daily basis (e.g., as a single dose or as two or more divided doses) or non-daily basis (e.g., every other day, every two days, every three days, once weekly, twice weeks, once every two weeks, once a month).
[0122] In some embodiments, the period of administration of a compound described herein is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 1 1 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 1 1 months, 12 months, or more. In a further embodiment, a period of during which administration is stopped is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 1 1 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 1 1 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 1 1 months, 12 months, or more. In an embodiment, a therapeutic compound is administered to an individual for a period of time followed by a separate period of time. In another embodiment, a therapeutic compound is administered for a first period and a second period following the first period, with administration stopped during the second period, followed by a third period where administration of the therapeutic compound is started and then a fourth period following the third period where administration is stopped. In an aspect of this embodiment, the period of administration of a therapeutic compound followed by a period where administration is stopped is repeated for a determined or undetermined period of time. In a further embodiment, a period of administration is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more. In a further embodiment, a period of during which administration is stopped is for 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 8 days, 9 days, 10 days, 11 days, 12 days, 13 days, 14 days, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or more.
[0123] Methods of Treatment
[0124] In some embodiments, methods for treating a subject having condition, disease or disorder in which increased (e.g., excessive)STING activity (e.g., , e.g., STING signaling) contributes to the pathology and / or symptoms and / or progression of the condition, disease or disorder (e.g., immune disorders, cancer) are provided.
[0125] Indications
[0126] In some embodiments, the condition, disease or disorder is cancer. Non-limiting examples of cancer include melanoma, carcinoma, lymphoma, blastoma, sarcoma, and leukemia or lymphoid malignancies. More particular examples of such cancers include breast cancer, colon cancer, rectal cancer, colorectal cancer, kidney or renal cancer, clear cell cancer lung cancer including small-cell lung cancer, non- small cell lung cancer, adenocarcinoma of the lung and squamous carcinoma of the lung, squamous cell cancer (e.g. epithelial squamous cell cancer), cervical cancer, ovarian cancer, prostate cancer, prostatic neoplasms, liver cancer, bladder cancer, cancer of the peritoneum, hepatocellular cancer, gastric or stomach cancer including gastrointestinal cancer, gastrointestinal stromal tumor, pancreatic cancer, head and neck cancer, glioblastoma, retinoblastoma, astrocytoma, thecomas, arrhenoblastomas, hepatoma, hematologic malignancies including non-Hodgkins lymphoma (NHL), multiple myeloma, myelodysplasia disorders, myeloproliferative disorders, chronic myelogenous leukemia, and acute hematologic malignancies, endometrial or uterine carcinoma, endometriosis, endometrial stromal sarcoma, fibrosarcomas, choriocarcinoma, salivary gland carcinoma, vulval cancer, thyroid cancer, esophageal carcinomas, hepatic carcinoma, anal carcinoma, penile carcinoma, nasopharyngeal carcinoma, laryngeal carcinomas, Kaposi's sarcoma, mast cell sarcoma, ovarian sarcoma, uterine sarcoma, melanoma, malignant mesothelioma, skin carcinomas, Schwannoma, oligodendroglioma, neuroblastomas, neuroectodermal tumor, rhabdomyosarcoma, osteogenic sarcoma, leiomyosarcomas, Ewing Sarcoma, peripheral primitive neuroectodermal tumor, urinary tract carcinomas, thyroid carcinomas, Wilm's tumor, as well as abnormal vascular proliferation associated with phakomatoses, edema (such as that associated with brain tumors), and Meigs' syndrome. In some cases, the cancer is melanoma.
[0127] In some embodiments, the condition, disease or disorder is a neurological disorder, which includes disorders that involve the central nervous system (brain, brainstem and cerebellum), the peripheral nervous system (including cranial nerves), and the autonomic nervous system (parts of which are located in both central and peripheral nervous system). Non-limiting examples of such neurological disorders include acquired epileptiform aphasia; acute disseminated encephalomyelitis; adrenoleukodystrophy; age-related macular degeneration; agenesis of the corpus callosum; agnosia; Aicardi syndrome; Alexander disease; Alpers' disease; alternating hemiplegia; Alzheimer's disease; Vascular dementia; amyotrophic lateral sclerosis; anencephaly; Angelman syndrome; angiomatosis; anoxia; aphasia; apraxia; arachnoid cysts; arachnoiditis; Anronl-Chiari malformation; arteriovenous malformation; Asperger syndrome; ataxia telegiectasia; attention deficit hyperactivity disorder; autism; autonomic dysfunction; back pain; Batten disease; Behcet's disease; Bell's palsy; benign essential blepharospasm; benign focal; amyotrophy; benign intracranial hypertension; Binswanger's disease; blepharospasm; Bloch Sulzberger syndrome; brachial plexus injury; brain abscess; brain injury; brain tumors (including glioblastoma multiforme); spinal tumor; Brown-Sequard syndrome; Canavan disease; carpal tunnel syndrome; causalgia; central pain syndrome; central pontine myelinolysis; cephalic disorder; cerebral aneurysm; cerebral arteriosclerosis; cerebral atrophy; cerebral gigantism; cerebral palsy; Charcot-Marie-Tooth disease; chemotherapy-induced neuropathy and neuropathic pain; Chiari malformation; chorea; chronic inflammatory demyelinating polyneuropathy; chronic pain; chronic regional pain syndrome; Coffin Lowry syndrome; coma, including persistent vegetative state; congenital facial diplegia; corticobasal degeneration; cranial arteritis; craniosynostosis; Creutzfeldt-Jakob disease; cumulative trauma disorders; Cushing's syndrome; cytomegalic inclusion body disease; cytomegalovirus infection; dancing eyes-dancing feet syndrome; Dandy-Walker syndrome; Dawson disease; De Morsier's syndrome; Dejerine-Klumke palsy; dementia; dermatomyositis; diabetic neuropathy; diffuse sclerosis; dysautonomia; dysgraphia; dyslexia; dystonias; early infantile epileptic encephalopathy; empty sella syndrome; encephalitis; encephaloceles; encephalotrigeminal angiomatosis; epilepsy; Erb's palsy; essential tremor; Fabry's disease; Fahr's syndrome; fainting; familial spastic paralysis; febrile seizures; Fisher syndrome; Friedreich's ataxia; fronto-temporal dementia and other “tauopathies”; Gaucher's disease; Gerstmann's syndrome; giant cell arteritis; giant cell inclusion disease; globoid cell leukodystrophy; Guillain-Barre syndrome; HTLV-1- associated myelopathy; Hallervorden- Spatz disease; head injury; headache; hemifacial spasm; hereditary spastic paraplegia; heredopathia atactica polyneuritiformis; herpes zoster oticus; herpes zoster; Hirayama syndrome; HIV-associated dementia and neuropathy (also neurological manifestations of AIDS); holoprosencephaly; Huntington's disease and other polyglutamine repeat diseases; hydranencephaly; hydrocephalus; hypercortisolism; hypoxia; immune-mediated encephalomyelitis; inclusion body myositis; incontinentia pigmenti; infantile phytanic acid storage disease; infantile refsum disease; infantile spasms; inflammatory myopathy; intracranial cyst; intracranial hypertension; Joubert syndrome; Kearns-Sayre syndrome; Kennedy disease Kinsboume syndrome; Klippel Feil syndrome; Krabbe disease; Kugelberg- Welander disease; kuru; Lafora disease; Lambert-Eaton myasthenic syndrome; Landau-Kleffner syndrome; lateral medullary (Wallenberg) syndrome; learning disabilities; Leigh's disease; Lennox-Gustaut syndrome; Lesch-Nyhan syndrome; leukodystrophy; Lewy body dementia; Lissencephaly; locked-in syndrome; Lou Gehrig's disease (i.e., motor neuron disease or amyotrophic lateral sclerosis); lumbar disc disease; Lyme disease — neurological sequelae; Machado-Joseph disease; macrencephaly; megalencephaly; Melkersson-Rosenthal syndrome; Menieres disease; meningitis; Menkes disease; metachromatic leukodystrophy; microcephaly; migraine; Miller Fisher syndrome; mini-strokes; mitochondrial myopathies; Mobius syndrome; monomelic amyotrophy; motor neuron disease; Moyamoya disease; mucopolysaccharidoses; milti-infarct dementia; multifocal motor neuropathy; multiple sclerosis and other demyelinating disorders; multiple system atrophy with postural hypotension; p muscular dystrophy; myasthenia gravis; myelinoclastic diffuse sclerosis; myoclonic encephalopathy of infants; myoclonus; myopathy; myotonia congenital; narcolepsy; neurofibromatosis; neuroleptic malignant syndrome; neurological manifestations of AIDS; neurological sequelae of lupus; neuromyotonia; neuronal ceroid lipofuscinosis; neuronal migration disorders; Niemann-Pick disease; O'Sullivan-McLeod syndrome; occipital neuralgia; occult spinal dysraphism sequence; Ohtahara syndrome; olivopontocerebellar atrophy; opsoclonus myoclonus; optic neuritis; orthostatic hypotension; overuse syndrome; paresthesia; Parkinson's disease; paramyotonia congenital; paraneoplastic diseases; paroxysmal attacks; Parry Romberg syndrome; Pelizaeus-Merzbacher disease; periodic paralyses; peripheral neuropathy; painful neuropathy and neuropathic pain; persistent vegetative state; pervasive developmental disorders; photic sneeze reflex; phytanic acid storage disease; Pick's disease; pinched nerve; pituitary tumors; polymyositis; porencephaly; post-polio syndrome; postherpetic neuralgia; postinfectious encephalomyelitis; postural hypotension; Prader-Willi syndrome; primary lateral sclerosis; prion diseases; progressive hemifacial atrophy; progressive multifocal leukoencephalopathy; progressive sclerosing poliodystrophy; progressive supranuclear palsy; pseudotumor cerebri; Ramsay-Hunt syndrome (types I and II); Rasmussen's encephalitis; reflex sympathetic dystrophy syndrome; Refsum disease; repetitive motion disorders; repetitive stress injuries; restless legs syndrome; retrovirus- associated myelopathy; Rett syndrome; Reye's syndrome; Saint Vitus dance; Sandhoff disease; Schilder's disease; schizencephaly; septo-optic dysplasia; shaken baby syndrome; shingles; Shy -Drager syndrome; Sjogren's syndrome; sleep apnea; Soto's syndrome; spasticity; spina bifida; spinal cord injury; spinal cord tumors; spinal muscular atrophy; Stiff-Person syndrome; stroke; Sturge-Weber syndrome; subacute sclerosing panencephalitis; subcortical arteriosclerotic encephalopathy; Sydenham chorea; syncope; syringomyelia; tardive dyskinesia; Tay-Sachs disease; temporal arteritis; tethered spinal cord syndrome; Thomsen disease; thoracic outlet syndrome; Tic Douloureux; Todd's paralysis; Tourette syndrome; transient ischemic attack; transmissible spongiform encephalopathies; transverse myelitis; traumatic brain injury; tremor; trigeminal neuralgia; tropical spastic paraparesis; tuberous sclerosis; vascular dementia (multi -infarct dementia); vasculitis including temporal arteritis; Von Hippel-Lindau disease; Wallenberg's syndrome; Werdnig-Hoffman disease; West syndrome; whiplash; Williams syndrome; Wildon's disease; amyotrophe lateral sclerosis and Zellweger syndrome.
[0128] In some embodiments, the condition, disease or disorder is STING-associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis. In certain embodiments, the condition, disease or disorder is an autoimmune disease (e.g., a cytosolic DNA-triggered autoinfl ammatory disease). Non-limiting examples include rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, inflammatory bowel diseases (IBDs) comprising Crohn disease (CD) and ulcerative colitis (UC), which are chronic inflammatory conditions with polygenic susceptibility. In certain embodiments, the condition is an inflammatory bowel disease. In certain embodiments, the condition is Crohn’s disease, autoimmune colitis, iatrogenic autoimmune colitis, ulcerative colitis, colitis induced by one or more chemotherapeutic agents, colitis induced by treatment with adoptive cell therapy, colitis associated by one or more alloimmune diseases (such as graft-vs-host disease, e.g., acute graft vs. host disease and chronic graft vs. host disease), radiation enteritis, collagenous colitis, lymphocytic colitis, microscopic colitis, and radiation enteritis. In certain of these embodiments, the condition is alloimmune disease (such as graft-vs-host disease, e.g., acute graft vs. host disease and chronic graft vs. host disease), celiac disease, irritable bowel syndrome, rheumatoid arthritis, lupus, scleroderma, psoriasis, cutaneous T-cell lymphoma, uveitis, and mucositis (e.g., oral mucositis, esophageal mucositis or intestinal mucositis).
[0129] In some embodiments, modulation of the immune system by STING provides for the treatment of diseases, including diseases caused by foreign agents. Exemplary infections by foreign agents which may be treated and / or prevented by the method of the present invention include an infection by a bacterium (e.g., a Gram-positive or Gramnegative bacterium), an infection by a fungus, an infection by a parasite, and an infection by a virus. In one embodiment of the present invention, the infection is a bacterial infection (e.g., infection by E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella spp., Staphylococcus aureus, Streptococcus spp., or vancomycin-resistant enterococcus), or sepsis. In another embodiment, the infection is a fungal infection (e.g. infection by a mould, a yeast, or a higher fungus). In still another embodiment, the infection is a parasitic infection (e.g., infection by a single-celled or multicellular parasite, including Giardia duodenalis, Cryptosporidium parvum, Cyclospora cayetanensis, and Toxoplasma gondiz). In yet another embodiment, the infection is a viral infection (e.g., infection by a virus associated with AIDS, avian flu, chickenpox, cold sores, common cold, gastroenteritis, glandular fever, influenza, measles, mumps, pharyngitis, pneumonia, rubella, SARS, and lower or upper respiratory tract infection (e.g., respiratory syncytial virus)).
[0130] In some embodiments, the condition, disease or disorder is hepatits B (see, e.g., WO 2015 / 061294).
[0131] In some embodiments, the condition, disease or disorder is selected from cardiovascular diseases (including e.g., myocardial infarction).
[0132] In some embodiemnts, the condition, disease or disorder is age-related macular degeneration.
[0133] In some embodiments, the condition, disease or disorder is mucositis, also known as stomatitits, which can occur as a result of chemotherapy or radiation therapy, either alone or in combination as well as damage caused by exposure to radiation outside of the context of radiation therapy.
[0134] In some embodiments, the condition, disease or disorder is uveitis, which is inflammation of the uvea (e.g., anterior uveitis, e.g., iridocyclitis or iritis; intermediate uveitis (also known as pars planitis); posterior uveitis; or chorioretinitis, e.g., pan-uveitis).
[0135] In some embodiments, the condition, disease or disorder is selected from the group consisting of a cancer, a neurological disorder, an autoimmune disease, hepatitis B, uvetitis, a cardiovascular disease, age-related macular degeneration, and mucositis.
[0136] Still other examples can include those indications discussed herein and below in contemplated combination therapy regimens.
[0137] Combination therapy
[0138] This disclosure contemplates both monotherapy regimens as well as combination therapy regimens. In some embodiments, the methods described herein can further include administering one or more additional therapies (e.g., one or more additional therapeutic agents and / or one or more therapeutic regimens) in combination with administration of the compounds described herein.
[0139] In certain embodiments, the methods described herein can further include administering one or more additional cancer therapies.
[0140] The one or more additional cancer therapies can include, without limitation, surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy, cancer vaccines (e.g., HPV vaccine, hepatitis B vaccine, Oncophage, Provenge) and gene therapy, as well as combinations thereof. Immunotherapy, including, without limitation, adoptive cell therapy, the derivation of stem cells and / or dendritic cells, blood transfusions, lavages, and / or other treatments, including, without limitation, freezing a tumor.
[0141] In some embodiments, the one or more additional cancer therapies is chemotherapy, which can include administering one or more additional chemotherapeutic agents.
[0142] In certain embodiments, the additional chemotherapeutic agent is an immunomodulatory moiety, e.g., an immune checkpoint inhibitor. In certain of these embodiments, the immune checkpoint inhibitor targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD-1 - PD- L2, interleukin-2 (IL-2), indoleamine 2,3 -dioxygenase (IDO), IL- 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidylserine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- 1BB-4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40-CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM - LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48 - CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2- TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39-CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155; e.g., CTLA-4 orPDl or PD-L1). See, e.g., Postow, M. J. Clin. Oncol. 2015, 33, 1.
[0143] In certain of these embodiments, the immune checkpoint inhibitor is selected from the group consisting of: Urelumab, PF-05082566, MEDI6469, TRX518, Varlilumab, CP-870893, Pembrolizumab (PD1), Nivolumab (PD1), Atezolizumab (formerly MPDL3280A) (PDL1), MEDI4736 (PD-L1), Avelumab (PD-L1), PDR001 (PD1), BMS-986016, MGA271, Lirilumab, IPH2201, Emactuzumab, INCB024360, Galunisertib, Ulocuplumab, BKT140, Bavituximab, CC-90002, Bevacizumab, and MNRP1685A, and MGA271.
[0144] In certain embodiments, the additional chemotherapeutic agent is an alkylating agent. Alkylating agents are so named because of their ability to alkylate many nucleophilic functional groups under conditions present in cells, including, but not limited to cancer cells. In a further embodiment, an alkylating agent includes, but is not limited to, Cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin. In an embodiment, alkylating agents can function by impairing cell function by forming covalent bonds with the amino, carboxyl, sulfhydryl, and phosphate groups in biologically important molecules or they can work by modifying a cell's DNA. In a further embodiment an alkylating agent is a synthetic, semisynthetic or derivative.
[0145] In certain embodiments, the additional chemotherapeutic agent is an antimetabolite. Anti-metabolites masquerade as purines or pyrimidines, the building-blocks of DNA and in general, prevent these substances from becoming incorporated in to DNA during the "S" phase (of the cell cycle), stopping normal development and division. Antimetabolites can also affect RNA synthesis. In an embodiment, an antimetabolite includes, but is not limited to azathioprine and / or mercaptopurine. In a further embodiment an antimetabolite is a synthetic, semisynthetic or derivative.
[0146] In certain embodiments, the additional chemotherapeutic agent is a plant alkaloid and / or terpenoid. These alkaloids are derived from plants and block cell division by, in general, preventing microtubule function. In an embodiment, a plant alkaloid and / or terpenoid is a vinca alkaloid, a podophyllotoxin and / or a taxane. Vinca alkaloids, in general, bind to specific sites on tubulin, inhibiting the assembly of tubulin into microtubules, generally during the M phase of the cell cycle. In an embodiment, a vinca alkaloid is derived, without limitation, from the Madagascar periwinkle, Catharanthus roseus (formerly known as Vinca rosea). In an embodiment, a vinca alkaloid includes, without limitation, Vincristine, Vinblastine, Vinorelbine and / or Vindesine. In an embodiment, a taxane includes, but is not limited, to Taxol, Paclitaxel and / or Docetaxel. In a further embodiment a plant alkaloid or terpernoid is a synthetic, semisynthetic or derivative. In a further embodiment, a podophyllotoxin is, without limitation, an etoposide and / or teniposide. In an embodiment, a taxane is, without limitation, docetaxel and / or ortataxel.
[0021] In an embodiment, a cancer therapeutic is a topoisomerase. Topoisomerases are essential enzymes that maintain the topology of DNA. Inhibition of type I or type II topoisomerases interferes with both transcription and replication of DNA by upsetting proper DNA supercoiling. In a further embodiment, a topoisomerase is, without limitation, a type I topoisomerase inhibitor or a type II topoisomerase inhibitor. In an embodiment a type I topoisomerase inhibitor is, without limitation, a camptothecin. In another embodiment, a camptothecin is, without limitation, exatecan, irinotecan, lurtotecan, topotecan, BNP 1350, CKD 602, DB 67 (AR67) and / or ST 1481. In an embodiment, a type II topoisomerase inhibitor is, without limitation, epipodophyllotoxin. In a further embodiment an epipodophyllotoxin is, without limitation, an amsacrine, etoposid, etoposide phosphate and / or teniposide. In a further embodiment a topoisomerase is a synthetic, semisynthetic or derivative, including those found in nature such as, without limitation, epipodophyllotoxins, substances naturally occurring in the root of American Mayapple (Podophyllum peltatum).
[0147] In certain embodiments, the additional chemotherapeutic agent is a stilbenoid. In a further embodiment, a stilbenoid includes, but is not limited to, Resveratrol, Piceatannol, Pinosylvin, Pterostilbene, Alpha-Viniferin, Ampelopsin A, Ampelopsin E, Diptoindonesin C, Diptoindonesin F, Epsilon- Vinferin, Flexuosol A, Gnetin H, Hemsleyanol D, Hopeaphenol, Trans-Diptoindonesin B, Astringin, Piceid and Diptoindonesin A. In a further embodiment a stilbenoid is a synthetic, semisynthetic or derivative.
[0148] In certain embodiments, the additional chemotherapeutic agent is a cytotoxic antibiotic. In an embodiment, a cytotoxic antibiotic is, without limitation, an actinomycin, an anthracenedione, an anthracycline, thalidomide, dichloroacetic acid, nicotinic acid, 2- deoxyglucose and / or chlofazimine. In an embodiment, an actinomycin is, without limitation, actinomycin D, bacitracin, colistin (polymyxin E) and / or polymyxin B. In another embodiment, an antracenedione is, without limitation, mitoxantrone and / or pixantrone. In a further embodiment, an anthracycline is, without limitation, bleomycin, doxorubicin (Adriamycin), daunorubicin (daunomycin), epirubicin, idarubicin, mitomycin, plicamycin and / or valrubicin. In a further embodiment a cytotoxic antibiotic is a synthetic, semisynthetic or derivative.
[0149] In certain embodiments, the additional chemotherapeutic agent is selected from endostatin, angiogenin, angiostatin, chemokines, angioarrestin, angiostatin (plasminogen fragment), basement-membrane collagen-derived anti-angiogenic factors (tumstatin, canstatin, or arrestin), anti-angiogenic antithrombin III, signal transduction inhibitors, cartilage-derived inhibitor (CDI), CD59 complement fragment, fibronectin fragment, gro- beta, heparinases, heparin hexasaccharide fragment, human chorionic gonadotropin (hCG), interferon alpha / beta / gamma, interferon inducible protein (IP- 10), interleukin- 12, kringle 5 (plasminogen fragment), metalloproteinase inhibitors (TIMPs), 2-methoxyestradiol, placental ribonuclease inhibitor, plasminogen activator inhibitor, platelet factor-4 (PF4), prolactin 16 kD fragment, proliferin-related protein (PRP), various retinoids, tetrahydrocortisol-S, thrombospondin- 1 (TSP-1), transforming growth factor-beta (TGF- P), vasculostatin, vasostatin (calreticulin fragment) and the like.
[0150] In certain embodiments, the additional chemotherapeutic agent is selected from abiraterone acetate, altretamine, anhydrovinblastine, auri statin, bexarotene, bicalutamide, BMS 184476, 2,3,4,5,6-pentafluoro-N-(3-fluoro-4-methoxyphenyl)benzene sulfonamide, bleomycin, N,N-dimethyl-L-valyl-L-valyl-N-methyl-L-valyl-L-proly-l-Lproline-t- butylamide, cachectin, cemadotin, chlorambucil, cyclophosphamide, 3',4'-didehydro-4'- deoxy-8'-norvin-caleukoblastine, docetaxol, doxetaxel, cyclophosphamide, carboplatin, carmustine, cisplatin, cryptophycin, cyclophosphamide, cytarabine, dacarbazine (DTIC), dactinomycin, daunorubicin, decitabine dolastatin, doxorubicin (adriamycin), etoposide, 5- fluorouracil, finasteride, flutamide, hydroxyurea and hydroxyureataxanes, ifosfamide, liarozole, lonidamine, lomustine (CCNU), MDV3100, mechlorethamine (nitrogen mustard), melphalan, mivobulin isethionate, rhizoxin, sertenef, streptozocin, mitomycin, methotrexate, taxanes, nilutamide, onapristone, paclitaxel, prednimustine, procarbazine, RPR109881 , stramustine phosphate, tamoxifen, tasonermin, taxol, tretinoin, vinblastine, vincristine, vindesine sulfate, and vinflunine.
[0151] In certain embodiments, the additional chemotherapeutic agent is platinum, cisplatin, carboplatin, oxaliplatin, mechlorethamine, cyclophosphamide, chlorambucil, azathioprine, mercaptopurine, vincristine, vinblastine, vinorelbine, vindesine, etoposide and teniposide, paclitaxel, docetaxel, irinotecan, topotecan, amsacrine, etoposide, etoposide phosphate, teniposide, 5-fluorouracil, leucovorin, methotrexate, gemcitabine, taxane, leucovorin, mitomycin C, tegafur-uracil, idarubicin, fludarabine, mitoxantrone, ifosfamide and doxorubicin. Additional agents include inhibitors of mTOR (mammalian target of rapamycin), including but not limited to rapamycin, everolimus, temsirolimus and deforolimus.
[0152] In still other embodiments, the additional chemotherapeutic agent can be selected from those delineated in U.S. Patent 7,927,613, which is incorporated herein by reference in its entirety.
[0153] In some embodiments, the additional therapeutic agent and / or regimen are those that can be used for treating other STING-associated conditions, e.g., type I interferonopathies (e.g., STING-associated vasculopathywith onset in infancy (SAVI)), Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, and inflammation-associated disorders such as systemic lupus erythematosus, and rheumatoid arthritis and the like.
[0154] Non-limiting examples of additional therapeutic agents and / or regimens for treating rheumatoid arthritis include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), disease-modifying antirheumatic drugs (DMARDs; e.g., methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), leflunomide (Arava®), hydroxychloroquine (Plaquenil), PF-06650833, iguratimod, tofacitinib (Xeljanz®), ABBV-599, evobrutinib, and sulfasalazine (Azulfidine®)), and biologies (e.g., abatacept (Orencia®), adalimumab (Humira®), anakinra (Kineret®), certolizumab (Cimzia®), etanercept (Enbrel®), golimumab (Simponi®), infliximab (Remicade®), rituximab (Rituxan®), tocilizumab (Actemra®), vobarilizumab, sarilumab (Kevzara®), secukinumab, ABP 501, CHS-0214, ABC-3373, and tocilizumab (ACTEMRA®)). Non-limiting examples of additional therapeutic agents and / or regimens for treating lupus include steroids, topical immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), thalidomide (Thalomid®), non-steroidal antiinflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., evobrutinib, iberdomide, voclosporin, cenerimod, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and mycophenolate mofetil) baricitinb, iguratimod, filogotinib, GS-9876, rapamycin, and PF-06650833), and biologies (e.g., belimumab (Benlysta®), anifrolumab, prezalumab, MEDI0700, obinutuzumab, vobarilizumab, lulizumab, atacicept, PF-06823859, and lupizor, rituximab, BT063, BI655064, BIIB059, aldesleukin (Proleukin®), dapirolizumab, edratide, IFN-a-kinoid, OMS721, RC18, RSLV- 132, theralizumab, XmAb5871, and ustekinumab (Stelara®)). For example, non-limiting treatments for systemic lupus erythematosus include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., iberdomide, voclosporin, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and mycophenolate mofetil, baricitinb, filogotinib, and PF-06650833), and biologies (e.g., belimumab (Benlysta®), anifrolumab, prezalumab, MEDI0700, vobarilizumab, lulizumab, atacicept, PF-06823859, lupizor, rituximab, BT063, BI655064, BIIB059, aldesleukin (Proleukin®), dapirolizumab, edratide, IFN-a-kinoid, RC18, RSLV-132, theralizumab, XmAb5871, and ustekinumab (Stelara®)). As another example, non-limiting examples of treatments for cutaneous lupus include steroids, immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), GS-9876, filogotinib, and thalidomide (Thalomid®). Agents and regimens for treating drug-induced and / or neonatal lupus can also be administered.
[0155] Non-limiting examples of additional therapeutic agents and / or regimens for treating STING-associated vasculopathy with onset in infancy (SAVI) include JAK inhibitors (e.g., tofacitinib, ruxolitinib, filgotinib, and baricitinib). Non-limiting examples of additional therapeutic agents and / or regimens for treating Aicardi-Goutieres Syndrome (AGS) include physiotherapy, treatment for respiratory complications, anticonvulsant therapies for seizures, tube-feeding, nucleoside reverse transcriptase inhibitors (e.g., emtricitabine (e.g., Emtriva®), tenofovir (e.g., Viread®), emtricitabine / tenofovir (e.g., Truvada®), zidovudine, lamivudine, and abacavir), and JAK inhibitors (e.g., tofacitinib, ruxolitinib, fdgotinib, and baricitinib).
[0156] Non-limiting examples of additional therapeutic agents and / or regimens for treating IBDs include 6-mercaptopurine, AbGn-168H, ABX464, ABT-494, adalimumab, AJM300, alicaforsen, AMG139, anrukinzumab, apremilast, ATR-107 (PF0530900), autologous CD34-selected peripheral blood stem cells transplant, azathioprine, bertilimumab, BI 655066, BMS-936557, certolizumab pegol (Cimzia®), cobitolimod, corticosteroids (e.g., prednisone, Methylprednisolone, prednisone), CP-690,550, CT-P13, cyclosporine, DIMS0150, E6007, E6011, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, fingolimod, firategrast (SB-683699) (formerly T-0047), GED0301, GLPG0634, GLPG0974, guselkumab, golimumab, GSK 1399686, HMPL-004 (Andrographis paniculata extract), IMU-838, infliximab, Interleukin 2 (IL-2), Janus kinase (JAK) inhibitors, laquinimod, masitinib (AB 1010), matrix metalloproteinase 9 (MMP 9) inhibitors (e.g., GS-5745), MEDI2070, mesalamine, methotrexate, mirikizumab (LY3074828), natalizumab, NNC 0142-0000-0002, NNC0114-0006, ozanimod, peficitinib (JNJ-54781532), PF-00547659, PF-04236921, PF-06687234, QAX576, RHB- 104, rifaximin, risankizumab, RPC1063, SB012, SHP647, sulfasalazine, TD-1473, thalidomide, tildrakizumab (MK 3222), TJ301, TNF-Kinoid®, tofacitinib, tralokinumab, TRK-170, upadacitinib, ustekinumab, UTTR1147A, V565, vatelizumab, VB-201, vedolizumab, and vidofludimus.
[0157] Non-limiting examples of additional therapeutic agents and / or regimens for treating irritable bowel syndrome include alosetron, bile acid sequesterants (e.g., cholestyramine, colestipol, colesevelam), chloride channel activators (e.g., lubiprostone), coated peppermint oil capsules, desipramine, dicyclomine, ebastine, eluxadoline, farnesoid X receptor agonist (e.g., obeticholic acid), fecal microbiota transplantation, fluoxetine, gabapentin, guanylate cyclase-C agonists (e.g., linaclotide, plecanatide), ibodutant, imipramine, JCM- 16021, loperamide, lubiprostone, nortriptyline, ondansetron, opioids, paroxetine, pinaverium, polyethylene glycol, pregabalin, probiotics, ramosetron, rifaximin, and tanpanor.
[0158] Non-limiting examples of additional therapeutic agents and / or regimens for treating scleroderma include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), immunomodulators (e.g., azathioprine, methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), antithymocyte globulin, mycophenolate mofetil, intravenous immunoglobulin, rituximab, sirolimus, and alefacept), calcium channel blockers (e.g., nifedipine), alpha blockers, serotonin receptor antagonists, angiotensin II receptor inhibitors, statins, local nitrates, iloprost, phosphodiesterase 5 inhibitors (e.g., sildenafil), bosentan, tetracycline antibiotics, endothelin receptor antagonists, prostanoids, and tyrosine kinase inhibitors (e g., imatinib, nilotinib and dasatinib).
[0159] Non-limiting examples of additional therapeutic agents and / or regimens for treating Crohn’s Disease (CD) include adalimumab, autologous CD34-selected peripheral blood stem cells transplant, 6-mercaptopurine, azathioprine, certolizumab pegol (Cimzia®), corticosteroids (e.g., prednisone), etrolizumab, E6011, fecal microbial transplantation, figlotinib, guselkumab, infliximab, IL-2, JAK inhibitors, matrix metalloproteinase 9 (MMP 9) inhibitors (e.g., GS-5745), MEDI2070, mesalamine, methotrexate, natalizumab, ozanimod, RHB-104, rifaximin, risankizumab, SHP647, sulfasalazine, thalidomide, upadacitinib, V565, and vedolizumab.
[0160] Non-limiting examples of additional therapeutic agents and / or regimens for treating UC include AbGn-168H, ABT-494, ABX464, apremilast, PF-00547659, PF-06687234, 6- mercaptopurine, adalimumab, azathioprine, bertilimumab, brazikumab (MEDI2070), cobitolimod, certolizumab pegol (Cimzia®), CP-690,550, corticosteroids (e.g., multimax budesonide, Methylprednisolone), cyclosporine, E6007, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, guselkumab, golimumab, IL-2, IMU-838, infliximab, matrix metalloproteinase 9 (MMP9) inhibitors (e.g., GS-5745), mesalamine, mesalamine, mirikizumab (LY3074828), RPC 1063, risankizumab (BI 6555066), SHP647, sulfasalazine, TD-1473, TJ301, tildrakizumab (MK 3222), tofacitinib, tofacitinib, ustekinumab, UTTR1147A, and vedolizumab. Non-limiting examples of additional therapeutic agents and / or regimens for treating autoimmune colitis include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate / atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012 / 0202848), and vedolizumab.
[0161] Non-limiting examples of additional therapeutic agents and / or regimens for treating iatrogenic autoimmune colitis include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate / atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012 / 0202848), and vedolizumab.
[0162] Non-limiting examples of additional therapeutic agents and / or regimens for treating colitis induced by one or more chemotherapeutics agents include corticosteroids (e g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate / atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012 / 0202848), and vedolizumab.
[0163] Non-limiting examples of additional therapeutic agents and / or regimens for treating colitis induced by treatment with adoptive cell therapy include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate / atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012 / 0202848), and vedolizumab.
[0164] Non-limiting examples of additional therapeutic agents and / or regimens for treating colitis associated with one or more alloimmune diseases include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), sulfasalazine, and eicopentaenoic acid.
[0165] Non-limiting examples of additional therapeutic agents and / or regimens for treating radaiation enteritis include teduglutide, amifostine, angiotensin-converting enzyme (ACE) inhibitors (e.g., benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril), probiotics, selenium supplementation, statins (e.g., atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin), sucralfate, and vitamin E. Non-limiting examples of additional therapeutic agents and / or regimens for treating collagenous colitis include 6-mercaptopurine, azathaioprine, bismuth subsalicate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
[0166] Non-limiting examples of additional therapeutic agents and / or regimens for treating lyphocytic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, and sulfasalazine.
[0167] Non-limiting examples of additional therapeutic agents and / or regimens for treating microscopic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e g., budesonide, prednisone, prednisolone, beclometasone dipropionate), fecal microbial transplantation, loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
[0168] Non-limiting examples of additional therapeutic agents and / or regimens for treating alloimmune disease include intrauterine platelet transfusions, intravenous immunoglobin, maternal steroids, abatacept, alemtuzumab, alphal -antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, pevonedistat, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib.
[0169] Non-limiting examples of additional therapeutic agents and / or regimens for treating multiple sclerosis (MS) include alemtuzumab (Lemtrada®), ALKS 8700, amiloride, ATX- MS-1467, azathioprine, baclofen (Lioresal®), beta interferons (e.g., IFN-P-la, IFN-P-lb), cladribine, corticosteroids (e.g., methylprednisolone), daclizumab, dimethyl fumarate (Tecfidera®), fingolimod (Gilenya®), fluoxetine, glatiramer acetate (Copaxone®), hydroxychloroquine, ibudilast, idebenone, laquinimod, lipoic acid, losartan, masitinib, MD1003 (biotin), mitoxantrone, montel ukast, natalizumab (Tysabri®), NeuroVax™, ocrelizumab, ofatumumab, pioglitazone, and RPC1063. Non-limiting examples of additional therapeutic agents and / or regimens for treating graft-vs-host disease include abatacept, alemtuzumab, alphal-antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, pevonedistat, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib.
[0170] Non-limiting examples of additional therapeutic agents and / or regimens for treating acute graft-vs-host disease include alemtuzumab, alpha-1 antitrypsin, antithymocyte globulin, basiliximab, brentuximab, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, ibrutinib, infliximab, itacitinib, LBH589, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, photopheresis, ruxolitinib, sirolimus, tacrolimus, and tocilizumab.
[0171] Non-limiting examples of additional therapeutic agents and / or regimens for treating chronic graft vs. host disease include abatacept, alemtuzumab, AMG592, antithymocyte globulin, basiliximab, bortezomib, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, mycophenolate mofetil, pentostatin, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib.
[0172] Non-limiting examples of additional therapeutic agents and / or regimens for treating celiac disease include AMG 714, AMY01, Aspergillus niger prolyl endoprotease, BL- 7010, CALY-002, GBR 830, Hu-Mik-Beta-1, IMGX003, KumaMax, Larazotide Acetate, Nexvan2®, pancrelipase, TIMP-GLIA, vedolizumab, and ZED1227.
[0173] Non-limiting examples of additional therapeutic agents and / or regimens for treating psoriasis include topical corticosteroids, topical crisaborole / AN2728, topical SNA-120, topical SAN021, topical tapinarof, topical tocafinib, topical IDP-118, topical M518101, topical calcipotriene and betamethasone dipropionate (e.g., MC2-01 cream and Taclonex®), topical P-3073, topical LEO 90100 (Enstilar®), topical betamethasone dipropriate (Sernivo®), halobetasol propionate (Ultravate®), vitamin D analogues (e.g., calcipotriene (Dovonex®) and calcitriol (Vertical®)), anthralin (e.g., Dritho-scalp® and Dritho-creme®), topical retinoids (e.g., tazarotene (e.g., Tazorac® and Avage®)), calcineurin inhibitors (e.g., tacrolimus (Prograf®) and pimecrolimus (Elidel®)), salicylic acid, coal tar, moisturizers, phototherapy (e.g., exposure to sunlight, UVB phototherapy, narrow band UVB phototherapy, Goeckerman therapy, psoralen plus ultraviolet A (PUVA) therapy, and excimer laser), retinoids (e g., acitretin (Soriatane®)), methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), Apo805Kl, baricitinib, FP187, KD025, prurisol, VTP-43742, XP23829, ZPL-389, CF101 (piclidenoson), LAS41008, VPD-737 (serlopitant), upadacitinib (ABT-494), aprmilast, tofacitibin, cyclosporine (Neoral®, Sandimmune®, Gengraf®), biologies (e.g., etanercept (Enbrel®), entanercept-szzs (Elrezi®), infliximab (Remicade®), adalimumab (Humira®), adalimumab-adbm (Cyltezo®), ustekinumab (Stelara®), golimumab (Simponi®), apremilast (Otezla®), secukinumab (Cosentyx®), certolixumab pegol, secukinumab, tildrakizumab-asmn, infliximab-dyyb, abatacept, ixekizumab (Taltz®), ABP 710, BCD-057, BI695501, bimekizumab (UCB4940), CHS-1420, GP2017, guselkumab (CNTO 1959), HD203, M923, MSB11022, Mirikizumab (LY3074828), PF-06410293, PF-06438179, risankizumab (BI655066), SB2, SB4, SB5, siliq (brodalumab), namilumab (MT203, tildrakizumab (MK-3222), and ixekizumab (Taltz®)), thioguanine, and hydroxyurea (e.g., Droxia® and Hydrea®).
[0174] Non-limiting examples of additional therapeutic agents and / or regimens for treating cutaneous T-cell lymphoma include phototherapy (e.g., exposure to sunlight, UVB phototherapy, narrow band UVB phototherapy, Goeckerman therapy, psoralen plus ultraviolet A (PUVA) therapy, and excimer laser), extracorporeal photopheresis, radiation therapy (e.g., spot radiation and total skin body electron beam therapy), stem cell transplant, corticosteroids, imiquimod, bexarotene gel, topical bis-chloroethyl-nitrourea, mechl or ethamine gel, vorinostat (Zolinza®), romidepsin (Istodax®), pralatrexate (Folotyn®) biologies (e.g., alemtuzumab (Campath®), brentuximab vedotin (SGN-35), mogamulizumab, and IPH4102).
[0175] Non-limiting examples of additional therapeutic agents and / or regimens for treating uveitis include corticosteroids (e.g., intravitreal triamcinolone acetonide injectable suspensions), antibiotics, antivirals (e.g., acyclovir), dexamethasone, immunomodulators (e.g., tacrolimus, leflunomide, cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), chlorambucil, azathioprine, methotrexate, and mycophenolate mofetil), biologies (e.g., infliximab (Remicade®), adalimumab (Humira®), etanercept (Enbrel®), golimumab (Simponi®), certolizumab (Cimzia®), rituximab (Rituxan®), abatacept (Orencia®), basiliximab (Simulect®), anakinra (Kineret®), canakinumab (Haris®), gevokixumab (XOMA052), tocilizumab (Actemra®), alemtuzumab (Campath®), efalizumab (Raptiva®), LFG316, sirolimus (Santen®), abatacept, sarilumab (Kevzara®), and daclizumab (Zenapax®)), cytotoxic drugs, surgical implant (e g., fluocinolone insert), and vitrectomy. on-limiting examples of additional therapeutic agents and / or regimens for treating mucositis include AG013, SGX942 (dusquetide), amifostine (Ethyol®), cryotherapy, cepacol lonzenges, capsaicin lozenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e.g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone- sodium hyaluronate gel (Gelclair®)), oral lubricants (e.g., Oral Balance®), caphosol, chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g., lidocaine, benzocaine, dyclonine hydrochloride, xylocaine (e.g., viscous xylocaine 2%), and Ulcerease® (0.6% phenol)), corticosteroids (e.g., prednisone), pain killers (e.g., ibuprofen, naproxen, acetaminophen, and opioids), GC4419, palifermin (keratinocyte growth factor; Kepivance®), ATL-104, clonidine lauriad, IZN-6N4, SGX942, rebamipide, nepidermin, soluble p-1,3 / 1,6 glucan, P276, LP-0004-09, CR-3294, ALD-518, IZN-6N4, quercetin, granules comprising vaccinium myrtillus extract, macleaya cordata alkaloids and echinacea angustifolia extract (e.g., SAMITAL®), and gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)). For example, nonlimiting examples of treatments for oral mucositis include AG013, amifostine (Ethyol®), cryotherapy, cepacol lonzenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair®)), oral lubricants (e.g., Oral Balance®), caphosol, chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g., lidocaine, benzocaine, dyclonine hydrochloride, xylocaine (e.g., viscous xylocaine 2%), and Ulcerease® (0.6% phenol)), corticosteroids (e.g., prednisone), pain killers (e.g., ibuprofen, naproxen, acetaminophen, and opioids), GC4419, palifermin (keratinocyte growth factor; Kepivance®), ATL-104, clonidine lauriad, IZN-6N4, SGX942, rebamipide, nepidermin, soluble P-1,3 / 1,6 glucan, P276, LP-0004-09, CR-3294, ALD-518, IZN-6N4, quercetin, and gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)). As another example, non-limiting examples of treatments for esophageal mucositis include xylocaine (e.g., gel viscous Xylocaine 2%). As another example, treatments for intestinal mucositis, treatments to modify intestinal mucositis, and treatments for intestinal mucositis signs and symptoms include gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)).
[0176] In certain embodiments, the second therapeutic agent or regimen is administered to the subject prior to contacting with or administering the chemical entity (e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior).
[0177] In other embodiments, the second therapeutic agent or regimen is administered to the subject at about the same time as contacting with or administering the chemical entity. By way of example, the second therapeutic agent or regimen and the chemical entity are provided to the subject simultaneously in the same dosage form. As another example, the second therapeutic agent or regimen and the chemical entity are provided to the subject concurrently in separate dosage forms.
[0178] In still other embodiments, the second therapeutic agent or regimen is administered to the subject after contacting with or administering the chemical entity (e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after).
[0179] Patient Selection
[0180] In some embodiments, the methods described herein further include the step of identifying a subject (e.g., a patient) in need of such treatment (e.g., by way of biopsy, endoscopy, or other conventional method known in the art). In certain embodiments, the STING protein can serve as a biomarker for certain types of cancer, e.g., colon cancer and prostate cancer. In other embodiments, identifying a subject can include assaying the patient’s tumor microenvironment for the absence of T-cells and / or presence of exhausted T-cells, e.g., patients having one or more cold tumors. Such patients can include those that are resistant to treatment with checkpoint inhibitors. In certain embodiments, such patients can be treated with a chemical entity herein, e.g., to recruit T-cells into the tumor, and in some cases, further treated with one or more checkpoint inhibitors, e.g., once the T-cells become exhausted.
[0181] In some embodiments, the chemical entities, methods, and compositions described herein can be administered to certain treatment-resistant patient populations (e.g., patients resistant to checkpoint inhibitors; e.g., patients having one or more cold tumors, e.g., tumors lacking T-cells or exhausted T-cells).
[0182] Compound Preparation
[0183] As can be appreciated by the skilled artisan, methods of synthesizing the compounds of the formulae herein will be evident to those of ordinary skill in the art. Synthetic chemistry transformations and protecting group methodologies (protection and deprotection) useful in synthesizing the compounds described herein are known in the art and include, for example, those such as described in R. Larock, Comprehensive Organic Transformations, VCH Publishers (1989); T. W. Greene and RGM. Wuts, Protective Groups in Organic Synthesis, 2d. Ed., John Wiley and Sons (1991); L. Fieser and M. Fieser, Fieser and Fieser's Reagents for Organic Synthesis, John Wiley and Sons (1994); and L. Paquette, ed., Encyclopedia of Reagents for Organic Synthesis, John Wiley and Sons (1995), and subsequent editions thereof. The starting materials used in preparing the compounds of the invention are known, made by known methods, or are commercially available. The skilled artisan will also recognize that conditions and reagents described herein that can be interchanged with alternative art-recognized equivalents. For example, in many reactions, triethylamine can be interchanged with other bases, such as non- nucleophilic bases (e.g. diisopropylamine, l,8-diazabicycloundec-7-ene, 2,6-di-tert- butylpyridine, or tetrabutylphosphazene).
[0184] The skilled artisan will recognize a variety of analytical methods that can be used to characterize the compounds described herein, including, for example, 'H NMR, heteronuclear NMR, mass spectrometry, liquid chromatography, and infrared spectroscopy. The foregoing list is a subset of characterization methods available to a skilled artisan and is not intended to be limiting.
[0185] To further illustrate the foregoing, the following non-limiting, exemplary synthetic schemes are included. Variations of these examples within the scope of the claims are within the purview of one skilled in the art and are considered to fall within the scope of the invention as described, and claimed herein. The reader will recognize that the skilled artisan, provided with the present disclosure, and skill in the art is able to prepare and use the invention without exhaustive examples.
[0186] The following abbreviations have the indicated meanings:
[0187] ACN = acetonitrile
[0188] DCM = Methylene chloride t-AmOH = tert-amyl alcohol
[0189] THF = tetrahydrofuran
[0190] TEA = Triethylamine
[0191] TMSCN = Trimethylsilyl cyanide
[0192] Sphos Pd G3 = (2-dicyclohexylphosphino-2',6'-dimethoxybiphenyl) [2-(2'-amino-l.T- biphenyl)]palladium (II) methanesulfonate
[0193] Brettphos Pd G3 = Methanesulfonato(2-dicyclohexylphosphino-3,6-dimethoxy-2’.4',6’-tri-i- propyl- 1,1’ -biphenyl)(2 ’-amino- 1,1’ -biphenyl-2-yl)palladium(II)
[0194] Ruphos Pd G3 = Methanesulfonato (2-dicyclohexylphosphino-2.6-di-i-propoxy-l,l-biphenyl)(2- amino- 1 , 1 -biphenyl-2-yl)palladium (II)
[0195] PEPSSI Pd TPcntCl = [l,3-bis[2,6-bis(l-propylbutyl)phcnyl]-4,5-dichloro-imidazol-2-ylidcnc]- dichloro-( 3 -chloropyridin- 1 -ium- 1 -yl)palladium
[0196] Xantphos = 4,5-bis(diphenylphosphino)-9,9-dimethylxanthene
[0197] Pd2(dba)s = Tris(dibenzylidene-acetone)dipalladium(0)
[0198] DMAP = 4-dimethylaminopyridine m-CPBA = 3 -Chloroperoxybenzoic acid
[0199] K3PO4= Potassium phosphate
[0200] CS2CO3 = Cesium carbonate
[0201] NaHCOj = Sodium bicarbonate
[0202] Na2SO;= Sodium sulfite
[0203] Na2SC>4 = Sodium sulfate
[0204] HPLC = high-performance liquid chromatography
[0205] LCMS = liquid chromatography - mass spectrometry
[0206] MeOH = methanol
[0207] H2O = water
[0208] NMR = nuclear magnetic resonance
[0209] EA = EtOAc = Ethyl acetate
[0210] FA = formic acid
[0211] SpeedVac = Savant SC250EXP SpeedVac Concentrator
[0212] DMF = Dimethyl Formamide
[0213] DMF-DMA = 1,1 -dimethoxy -N,N-dimethylmethanamine
[0214] HOAc= Acetic acid
[0215] Fe = iron
[0216] EtOH = Ethyl alcohol
[0217] HC1 = Hydrochloric acid
[0218] K2CO3 = Potassium carbonate t-BuONa = Sodium tert-butanol
[0219] TLC = Thin layer chromatography
[0220] PE = Petroleum ether
[0221] Ac = acetyl
[0222] ACN = acetonitrile
[0223] BINAP = 1. T-binaphthyl-2.2'-diphemyl phosphine
[0224] Boc2O = di-tert-butyl pyrocarbomate
[0225] BrettPhos = 2-Dicyclohexylphosphino-2',4',6'-tri-i-propyl-3,6-diMethoxy- 1.1 '-biphenyl
[0226] Bu = butyl
[0227] DCE = dichloroethane
[0228] DIAD = diisopropyl azodicarboxylate
[0229] DIEA = X.A'-diisopropylcthylaminc
[0230] DMSO = dimethyl sulfoxide
[0231] Dppf = bis(diphenylphosphino)ferrocene EPhos = Methane sulfonato { Dicyclohexyl [3 -( 1 -methylethoxy)-2',4',6'-tris( 1 -methylethyl)- 1,1'- biphcnyl-2-yl]phosphinc}(2'-mcthylamino-l,r-biphcnyl-2-yl)
[0232] EPhos Pd G4 = Methanesulfonato{Dicyclohexyl[3-(l-methylethoxy)-2'.4'.6'-tris(l-methylethyl)-
[0233] 1 , l'-biphenyl-2-yl]phosphine } (2'-methylamino- 1 , 1 '-biphenyl-2-yl)palladium(II)
[0234] Et = ethyl
[0235] HATU = 2-(7-Azabenzotnazol-l -yl)- / V ,VA'",A''-tctramcthykironium hexafluorophosphate
[0236] PPh;, = triphenylphosphine
[0237] Py = pyridine
[0238] Room temperature = RT
[0239] Ru(bpy)?CI? = Tris(2,2’-bipyridine)dichlororuthenium(II) hexahydrate
[0240] RuPhos Pd G2 = Chloro(2-dicyclohcxylphosphino-2',6'-diisopropoxy-l,l'-biphcnyl)(2'-amino-
[0241] 1.1 '-biphenyl-2-yl)palladium(H)
[0242] Select-F = l-Chloromethyl-4-fluoro-l,4-diazoniabicyclo[2.2.2]octane bis(tetrafluoroborate)
[0243] SEM = 2-(Trimethylsilyl)ethoxymethyl
[0244] TEA = trimethylamine
[0245] TFA = trifluoroacetic acid
[0246] TFAA = Trifluoroacetic anhydride
[0247] T P = 2,4,6-tripropyl-2,4,6-trioxo-1.3,5,2,4,6-trioxatriphosphorinane
[0248] Ts = tosyl
[0249] XPhos = 2-Dicyclohexylphosphino-2',4',6'-triisopropylbiphenyl
[0250] XPhos Pd G3 = (2-Dicvclohexylphosphino-2'.4',6'-triisopropyl- 1 , 1 '-biphenyl) 12-(2'-amino- 1 , T- biphenyl)lpalladium(II) methane sulfonate
[0251] Examples
[0252] LCMS analysis condition
[0253] Method A
[0254] Instrument: Agilent LCMS system equipped with DAD and ELSD detector
[0255] Ion mode: Positive
[0256] Column: Waters X-Bridge Cl 8, 50*2.1 mm*5 pm or equivalent
[0257] Mobile Phase: A: H2O (0.04% TFA); B: CH3CN (0.02% TFA)
[0258] Gradient: 4.5 min gradient method, actual method would depend on clogP of compound.
[0259] Flow Rate: 0.6 mL / min or 0.8 mL / min
[0260] Column Temp: 40 °C or 50 °C
[0261] UV: 220 nm
[0262] Method B
[0263] Instrument: Agilent LCMS system equipped with DAD and ELSD detector
[0264] Ion mode: Positive
[0265] Column: Waters X-Bridge ShieldRP18, 50*2.1 mm*5 pm or equivalent
[0266] Mobile Phase:A: FEO (0.05% NH3 H2O) or 10 mM ammonia bicarbonate; B: CH3CN Gradient: 4.5 min gradient method; actual method would depend on the clogP of the compound. Flow Rate: 0.6 mL / min or 0.8 mL / min
[0267] Column Temp: 40 °C
[0268] UV: 220 nm
[0269] LCMS Method C: Kinetex EVO C18 100A, 30*3mm, 0.5 pL injection, 1.2 mL / min flowrate, 90-900 amu scan range, 254 nm UV detection. Mobile Phase A (MPA): Water / 5mM NH4HCO3 and Mobile Phase B (MPB): Acetonitrile. Elution 10% MPB to 95% in 2.00 min, hold at 95% MPB for 0.30 min, 95% MPB to 10% in 0.10 min.
[0270] LCMS Method D: Xselect CSH C18, 50*3mm, 1.0 pL injection, 1.2 mL / min flowrate, 90- 900 amu scan range, 254 nm UV detection. Mobile Phase A (MPA): Water / 0.1% FA and Mobile Phase B (MPB): Acetonitrile / 0.1% FA. Elution 5% MPB to 100% in 2.00 min, hold at 100% MPB for 0.70 min, 100% MPB to 5% in 0.05 min, then equilibration to 5% MPB for 0.15 min.
[0271] LCMS Method E: HALOC18, 3O*3mm, 0.5 pL injection, 1.5 mL / min flowrate, 30-2000 amu scan range, 254 nm UV detection. Mobile Phase A (MPA): Water / 0.05% TFA and Mobile Phase B (MPB): Acetonitrile / 0.05% TFA. Elution 5% MPB to 100% in 1.20 min, hold at 100% MPB for 0.60 min, 100% MPB to 5% in 0.02 min, then equilibration to 5%
[0272] MPB for 0.18 min.
[0273] LCMS Method F: Shim-pack Scepter C18-120, 33*3mm, 0.5 pL injection, 1.5 mL / min flowrate, 30-2000 amu scan range, 254 nm UV detection. Mobile Phase A (MPA): Water / 5 mM NH4HCO3 and Mobile Phase B (MPB): Acetonitrile. Elution 50% MPB to 95% in 2.00 min, hold at 95% MPB for 0.60 min, 95% MPB to 10% in 0.05 min, then equilibration to 10% MPB for 0.25 min.
[0274] LCMS Method G: Luna Omega PS C18, 33*3mm, 0.5 pL injection, 1.5 mL / min flowrate, 30-2000 amu scan range, 254 nm UV detection. Mobile Phase A (MPA): Water / 0.1% FA and Mobile Phase B (MPB): Acetonitrile / 0.1% FA. Elution 5% MPB to 100% in 1.20 min, hold at 100% MPB for 0.60 min, 100% MPB to 5% in 0.02 min, then equilibration to 5% MPB for 0.25 min.
[0275] LCMS Method H: HALOCI 8, 3O*3mm, 0.5 pL injection, 1.5 mL / min flowrate, 30-2000 amu scan range, 254 nm UV detection. Mobile Phase A (MPA): Water / 0.1% FA and Mobile Phase B (MPB): Acetonitrile / 0.1% FA. Elution 5% MPB to 100% in 2.00 min, hold at 100% MPB for 0.70 min, 100% MPB to 5% in 0.05 min, then equilibration to 5% MPB for 0.25 min.
[0276] NMR was recorded on BRUKER NMR 300.03 Mz, DUL-C-H, ULTRASHIELD™ 300, AVANCE II 300 B-ACS™ 120 or BRUKER NMR 400.13 Mz, BBFO, ULTRASHIELD™ 400, AVANCE III 400, B-ACS™ 120.
[0277] Prep. HPLC condition
[0278] Instrument:
[0279] 1. GILSON 281 and Shimadzu LCMS 2010A
[0280] 2. GILSON 215 and Shimadzu LC-20AP
[0281] 3. GILSON 215
[0282] Mobile phase: A: NH4OH / H2O = 0.05% v / v; B: ACN
[0283] A: FA / H2O = 0.225% v / v; B: ACN
[0284] Column
[0285] Xtimate C18 150*25mm*5pm
[0286] Flow rate: 25 mL / min or 30 mL / min Monitor wavelength: 220&254 nm Gradient: actual method would depend on clog P of compound Detector: MS Trigger or UV
[0287] Intermediate Preparation
[0288] Synthesis of N-(6-(pyrrolidin-l-yl)pyridin-2-yl)-lH-indol-6-amine lH-indol-6-amine (52.8 mg, 0.4 mmol, 1.0 equiv.) and 2-bromo-6-(pyrrolidin-l- yl)pyridine (90.4 mg, 0.4 mmol, 1.00 equiv.) were dissolved in t-AmOH (4.0 mL), then CS2CO3 (390 mg, 1.20 mmol, 3.0 equiv.) and Brettphos Pd G3 (0.05 equiv.) were added under an atmosphere of nitrogen. The mixture was heated at 100 °C for 2 hours. Spot check by LC-MS. 2.0 mL water was added to the reaction mixture and was extracted with EtOAc. The organic layer was collected and concentrated solvent by Speedvac. The residue was purified by prep HPLC to give N-(6-(pyrrolidin-l-yl)pyridin-2-yl)-lH-indol-6-amine (44.04 mg, 0.16 mmol). MS-ESI, 279.1 [M+H+],
[0289] Synthesis of 4-chloro-lH-indoI-6-amine l-chloro-2-methyl-3, 5-dinitrobenzene (25.00 g, 115.00 mmol, 1.00 equiv.) was dissolved in DMF (250.00 mL). Then DMF-DMA (15.10 g, 16.90 mL, 127.00 mmol, 1.10 equiv.) was added. Then the mixture was heated at 100 °C for 30 mins. The mixture was brown transparent. TLC (PE: EA=3:1, Rf =0.6) indicated starting material was consumed completely and one new spot formed. The reaction mixture was poured into ice water 2000.00 mL at 0 °C, and stirred at 0 °C for 1 h and the precipitate was filtered, the cake was washed with H2O (200.00 mL) and dried to give (E)-2-(2-chloro-4,6-dinitrophenyl)- N,N-dimethylethen-l -amine (56.00 g, 115.00 mmol, 56.00% purity) as a brown solid.
[0290] Step 2: Synthesis of 4-chloro-lH-indol-6-amine
[0291] The reaction was carried out in 2 batches in parallels :
[0292] (E)-2-(2-chloro-4, 6-dinitrophenyl)-N, N-dimethylethen-1 -amine (11.00 g, 22.70 mmol, 56.00% purity, 1.00 equiv.) was dissolved in HO Ac (100.00 mL). Then Fe (6.33 g, 113.00 mmol, 5.00 equiv.) was added. The mixture was heated at 80 °C for 1 hr. LC-MS showed starting material was consumed completely and -69% of desired compound was detected, -9% of byproduct was detected. The reaction mixture was filtered and washed with EtOAc 500.00 mL. Then to the heated filter liquor was added 4 M K2CO3 (550.00 mL) dropwise at -10 - -5 °C over 1 hr and adjust pH to 7-8. Some solid was formed, the mixture was filtered and washed with EtOAc 500.00 mL, then extracted with EtOAc (300.00 mL*2). The combined organic layers were dried over [Na2SO4], filtered and concentrated under reduced pressure to give a residue. The residue was purified by flash silica gel chromatography (ISCO®; 80 g SepaFlash® Silica Flash Column, Eluent of 0~30%THF / Petroleum ether gradient). Byproduct (0.40 g) to 4-chloro-lH-indol-6-amine by step 3. 4-chloro-lH-indol-6-amine (4.20 g, 25.20 mmol, 55.60% yield) was obtained as a brown solid.
[0293] Synthesis of 4-chloro-lH-indol-6-amine N-(4-chloro-lH-indol-6-yl) acetamide (0.40 g, 1 .92 mmol, 1 .00 equiv.) was dissolved in EtOH (6.00 mL) was added HC1 (13 M, 3.00 mL, 20.30 equiv.), and then the mixture was heated at 90 °C for 16 hrs. The mixture was brown suspension. LC-MS showed starting material was consumed completely and one main peak with desired mass was detected. The reaction mixture was concentrated under reduced pressure to give 4-chloro- lH-indol-6-amine (0.39 g, 1.92 mmol, 99.90% yield, HC1) was obtained as a brown solid. Synthesis of tert-butyl 6-((4-chloro-6-cyanopyridin-2-yl)amino)-lH-indole-l- carboxylate oc
[0294] Step 1: Synthesis of 2-amino-4-chloropyridine 1 -oxide
[0295] 4-chloropyridin-2-amine (20 g, 155.57 mmol, 1 equiv.) was dissolved in DCM (500 mL). Then m-CPBA (36.91 g, 171.13 mmol, 80% purity, 1.1 equiv.) was added under 0 °C. The reaction mixture was stirred at 0-30 °C for 4 hours. Then the reaction mixture was filtered to get residue. The residue were washed with 2 M aqueous Na2SOs solution and 2 M aqueous NaHCCh solution to give 4-chloro-l-oxido-pyridin-l-ium-2-amine (35 g, 121 .06 mmol, 77.82% yield, 50% purity) as a white solid.
[0296] Step 2: Synthesis of 6-amino-4-chloropicolinonitrile
[0297] 4-chloro-l-oxido-pyridin-l-ium-2-amine (35 g, 121.06 mmol, 50% purity, 1 equiv.) was dissolved in ACN (500 mL). Then TEA (1.94 mol, 269.60 mL, 16 equiv.) and TMSCN (192.16 g, 1.94 mol, 242.32 mL, 16 equiv.) were added. The mixture was heated at 90 °C for 16 hours and then concentrated under reduced pressure to remove ACN. The mixture was adjusted to pH 8 by the drop-wise addition of 2 M aqueous NaHCOa solution. The residue was added 300 mL H2O and extracted with DCM. The combined organic layers were washed with 300 mL H2O, dried over anhydrous Na2SO4, fdtered and concentrated under reduced pressure to give a residue. The residue was purified by flash silica gel chromatography (ISCO®; 220 g SepaFlash® Silica Flash Column, Eluent of 0~28% Ethyl acetate / Petroleum ethergradient @ 80 mL / min) to give 6-amino-4-chloro- pyridine-2-carbonitrile (8 g, 49.49 mmol, 40.88% yield, 95% purity) as a yellow solid.
[0298] Step 3: Synthesis of tert-butyl 6-bromo-lH-indole-l-carboxylate
[0299] 6-bromo-lH-indole (25 g, 127.52 mmol, 1 equiv.) was dissolved in THF (300 mL). Then di-tert-butyl dicarbonate (41.75 g, 191.28 mmol, 43.94 mL, 1.5 equiv.) and DMAP (31.16 g, 255.05 mmol, 2 equiv.) was added. The reaction mixture was stirred at 20 °C for 4 hours. The reaction mixture was concentrated under reduced pressure to remove THF. The crude product was triturated with MeOH (50 mL) and H2O (lOOmL) at 30 °C for 30 minutes. The solid was collected to give tert-butyl 6-bromoindole-l -carboxylate (32 g, 92.92 mmol, 72.87% yield, 86% purity).
[0300] Step 4: Synthesis of tert-butyl 6-((4-chloro-6-cyanopyridin-2-yl)amino)-lH-indole-l- carboxylate
[0301] 6-amino-4-chloro-pyridine-2-carbonitrile (8 g, 49.49 mmol, 95% purity, 1 equiv.) and tert-butyl 6-bromoindole-l -carboxylate (20.45 g, 59.39 mmol, 86% purity, 1.2 equiv.) were dissolved in dioxane (400 mL). Then CS2CO3 (32.25 g, 98.98 mmol, 2 equiv.), Xantphos (2.86 g, 4.95 mmol, 0.1 equiv.) and Pd2(dba)3 (2.27 g, 2.47 mmol, 0.05 equiv.) were added under an atmosphere of nitrogen. The reaction mixture was heated at 100 °C for 16 hours and then concentrated under reduced pressure to remove dioxane. The residue was added 200 mL H2O and extracted with 300 mL DCM. The combined organic layers were washed with 90 mL H2O, dried over anhydrous Na2SC>4, filtered and concentrated under reduced pressure to give a residue. The residue was purified by flash silica gel chromatography (ISCO®; 240 g SepaFlash® Silica Flash Column, Eluent of 0-15% Ethyl acetate / Petroleum ethergradient @ 80 mL / min) to give tert-butyl 6-[(4- chloro-6-cyano-2-pyridyl)amino]indole-l-carboxylate (10.5 g, 25.62 mmol, 51.77% yield, 90% purity) as a yellow oil.
[0302] Synthesis of tert-butyl 4-chloro-6-[(4-chloro-6-cyano-2-pyridyl)amino]indole-l- carboxylate
[0303] Step 1: Synthesis of 2-amino-4-chloropyridine 1-oxide
[0304] 4-chloropyridin-2-amine (20 g, 155.57 mmol, 1.00 equiv.) was dissolved in DCM (500 mL). Then m-CPBA (36.91 g, 171.13 mmol, 80% purity, 1.1 equiv.) was added under 0 °C. The reaction mixture was stirred at 30 °C for 16 hours. Then the reaction mixture was fdtered to get residue. The residue was washed with 2 M aqueous Na2SO3 solution and 2 M aqueous NaHCCh solution to give 2-amino-4-chloropyridine 1-oxide (35 g, 121.06 mmol, 77.82% yield, 50% purity) as a white solid.
[0305] Step 2: Synthesis of 6-amino-4-chloropicolinonitrile 4-chloro-l-oxido-pyridin-l-ium-2-amine (35 g, 121.06 mmol, 50% purity, 1.00 equiv.) was dissolved in ACN (500 mL). Then TEA (269.60 mL, 1.94 mol, 16 equiv.) and TMSCN (192.16 g, 242.32 mL, 1.94 mol, 16 equiv.) were added. The mixture was heated at 90 °C for 16 hours and then concentrated under reduced pressure to remove ACN. The mixture was adjusted to pH = 8 by the drop-wise addition of 2 M aqueous NaHCOa solution. The residue was added 300 mL H2O and extracted with DCM. The combined organic layers were washed with 300 mL H2O, dried over anhydrous Na2SO4, fdtered and concentrated under reduced pressure to give a residue. The residue was purified by flash silica gel chromatography (ISCO®; 220 g SepaFlash® Silica Flash Column, Eluent of 0-28% Ethyl acetate / Petroleum ethergradient @ 80 mL / min) to give 6-amino-4- chloropicolinonitrile (8 g, 49.49 mmol, 40.88% yield, 95% purity) as a yellow solid.
[0306] Step 3: Synthesis of tert-butyl 6-bromo-4-chloro-indole-l-carboxylate
[0307] 6-bromo-4-chloro-lH-indole (10 g, 43.39 mmol, 1.0 equiv.) in THF (300 mL) was added di-tert-butyl dicarbonate (14.20 g, 14.95 mL, 65.08 mmol, 1.5 equiv.) and DMAP (10.60 g, 86.77 mmol, 2.0 equiv.). The mixture was stirred at 20 °C for 4 hours. The reaction mixture was concentrated under reduced pressure to remove THF. The crude product was triturated with MeOH (50 mL) and H2O (lOOmL) at 20 °C for 30 minutes. The solid was collected to give tert-butyl 6-bromo-4-chloro-indole-l -carboxylate (15 g, 36.30 mmol, 83.66% yield, 80% purity) as a white solid.
[0308] Step 4: Synthesis of tert-butyl 4-chloro-6-[(4-chloro-6-cyano-2-pyridyl)amino]indole- 1-carboxylate tert-butyl 6-bromo-4-chloro-indole-l -carboxylate (6 g, 14.52 mmol, 80% purity, 1 equiv.) and 6-amino-4-chloropicolinonitrile (2.35 g, 14.52 mmol, 95% purity, 1 equiv.) dissolved in dioxane (300 mL) was added Cs2CO3 (14.19 g, 43.56 mmol, 3 equiv.) and Xantphos (840.09 mg, 1.45 mmol, 0.1 equiv.) and Pd2(dba)3 (664.76 mg, 725.94 umol, 0.05 equiv.). The mixture was heated at 100 °C for 16 hours and then concentrated under reduced pressure to remove dioxane. The residue was added 200 mL H2O and extracted with 300 mL DCM. The combined organic layers were washed with 90 mL H2O, dried over anhydrous Na2SO4, filtered and concentrated under reduced pressure to give a residue. The residue was purified by flash silica gel chromatography (ISCO®; 240 g SepaFlash® Silica Flash Column, Eluent of 0~15% Ethyl acetate / Petroleum ethergradient @ 80 mL / min) to give tert-butyl 4-chloro-6-[(4-chloro-6-cyano-2-pyridyl)amino]indole-1-carboxylate (2 g, 4.46 mmol, 30.74% yield, 90% purity) was obtained as a yellow solid. Synthesis of 3-fluoro-1H-indol-6-amine hydrochloride 6-Nitro-1H-indole (660.0 g, 4.0 mol, 1.0 equiv.) was dissolved in DMF (19.8 L), then TFAA (1711.1 g, 8.1 mol, 2.0 equiv.) was added dropwise at 5-10 ℃ under N2 atmosphere. The resulting mixture was stirred for 15 hours at 80 °C under N2 atmosphere. The mixture was allowed to cool down to RT. The resulting mixture was diluted with water (13.2 L). After filtration, filter cake was washed with water (13.2 L) and then dried under vacuum for 24 hours at 40 ℃. This resulted in 2,2,2-trifluoro-1-(6-nitro-1H-indol-3-yl) ethanone (1089.5 g) as a light-yellow solid. LCMS Method C: [M+H]+= 259.0. Step 2: 6-nitro-1H-indole-3-carboxylic acid 2,2,2-Trifluoro-1-(6-nitro-1H-indol-3-yl)ethanone (1089.5 g, 3.7 mol, 1.0 equiv.) was dissolved in 4 M aq. NaOH (18.5 L) at RT. The resulting mixture was stirred for 15 hours at 60 °C under N2 atmosphere. The mixture was allowed to cool down to RT. The resulting mixture was diluted with water (17.0 L). The aqueous layer was adjusted to pH 1 with conc. HCl at 5 °C. The precipitated solids were collected by filtration and washed with water and then dried under vacuum for 24 hours at 40 ℃. This resulted in 6-nitro-1H- indole-3-carboxylic acid (573.5 g) as a light brown solid. LCMS Method C: [M-H]- = 205.0. Step 3: 3-fluoro-6-nitro-1H-indole 6-Nitro-1H-indole-3-carboxylic acid (573.5 g, 2.7 mol, 1 equiv.) and Selectfluor (1911.6 g, 5.4 mol, 2.0 equiv.) were dissolved in DCE (17.2 L) and H2O (8.6 L), then Li2CO3 (797.4 g, 10.8 mol, 4.0 equiv.) was added in five portions over 1 hour at 5-10 °C under N2 atmosphere. The resulting mixture was stirred for 4 h at 25 °C under N2 atmosphere. The resulting mixture was diluted with water (10.0 L). The resulting mixture was extracted with DCM, washed with brine, dried over anhydrous Na2SO4. After filtration, the filtrate was concentrated under vacuum. Crude product (423.1 g) was slurried with petroleum ether / EtOAc (3:1, 2.8 L) for 2 hours. After filtration, filter cake was washed with petroleum ether and then dried under vacuum for 2 hours at 40 ℃. This resulted in 3- fluoro-6-nitro-1H-indole (297.3 g) as a yellow solid. LCMS Method C: [M+H]+= 181.0. Step 4: 3-fluoro-1H-indol-6-amine hydrochloride 3-Fluoro-6-nitro-1H-indole (297.3 g, 1.3 mol, 1.0 equiv.) was dissolved in EtOAc (11.8 L), 10% wet Pd / C (20% w / w, 59.4 g) was added under N2 atmosphere. The resulting mixture was degassed and back filled with hydrogen. The mixture was hydrogenated at 25 °C for 15 hours under hydrogen atmosphere, filtered through a celite pad. To above filtrate was added 4 M hydrochloric acid solution in EtOAc (5.2 L) dropwise over 30 min at 25 °C. The resulting mixture was stirred for 3 hours at 25 °C. After filtration, filter cake was washed with EtOAc and then dried under vacuum for 16 hours at 40 ℃. This resulted in 3-fluoro-1H-indol-6-amine hydrochloride (151.0 g) as a black solid. LCMS Method C: [M+H]+= 151.1. Synthesis of 4-chloro-1H-indol-6-amine ep : [( )- -( -c oro- , - n rop eny )e eny ] me y am ne 1-Chloro-2-methyl-3,5-dinitrobenzene (2.0 g, 9.2 mmol, 1.0 equiv.) was dissolved in DMF (30 mL), then DMF-DMA (4.4 g, 36.9 mmol, 4.0 equiv.) was added. The reaction mixture was stirred for 4 hours at 80 °C, then cooled to RT and concentrated under vacuum. The residue was diluted with water, extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. This resulted in [(E)-2-(2-chloro-4,6- dinitrophenyl)ethenyl]dimethylamine (1.8 g) as a white solid. LCMS Method C: [M+H]+= 272.0. Step 2: 4-chloro-1H-indol-6-amine [(E)-2-(2-chloro-4,6-dinitrophenyl)ethenyl]dimethylamine (1.8 g, 6.6 mmol, 1.0 equiv.) was dissolved in ACN (20 mL), then Pt / C (2.6 g, 13.3 mmol, 2.0 equiv.) was added under an atmosphere of N2. The resulting solution was degassed and back filled with hydrogen for three times. The reaction mixture was stirred overnight at RT under hydrogen. The reaction mixture was filtered through Celite and the collected filtrate was concentrated under vacuum. This resulted in 4-chloro-1H-indol-6-amine (700.0 mg) as a white solid. LCMS Method C: [M+H]+= 167.0. Synthesis of 4-chloro-3-fluoro-1H-indol-6-amine hydrochloride 4-Chloro-1H-indole (500.0 g, 3.3 mol, 1.0 equiv.) was dissolved in DMF (3.5 L), then TFAA (831.3 g, 3.9 mol, 1.2 equiv.) was added dropwise at 10 °C over 30 min under N2 atmosphere. The resulting mixture was stirred overnight at RT under N2 atmosphere and then quenched by the addition of water. The precipitated solids were collected by filtration and washed with water, then dried under oven vacuum at 45 °C for 24 hours. This resulted in 1-(4-chloro-1H-indol-3-yl)-2,2,2-trifluoroethanone (683.0 g) as a light yellow solid. LCMS Method C: [M+H]+= 248.0. Step 2: 1-(4-chloro-6-nitro-1H-indol-3-yl)-2,2,2-trifluoroethanone 1-(4-Chloro-1H-indol-3-yl)-2,2,2-trifluoroethanone (683.0 g, 2.7 mol, 1.0 equiv.) was dissolved in AcOH (10.2 L), H2SO4 (68.3 mL, 1.3 mol, 0.46 equiv.) was added dropwise at 15 °C under N2 atmosphere. This was followed by the addition of a solution of HNO3 (869.0 g, 13.8 mol, 5.0 equiv.) in AcOH (3.41 L) dropwise over 1 hour at 15 °C. The resulting mixture was stirred overnight at RT and then quenched by the addition of 10% aq. NaCl (13.7 L) at RT. The resulting mixture was extracted with EtOAc, washed aq. NaHCO3 and brine, then dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (10:1) to afford 1-(4-chloro-6-nitro-1H-indol-3-yl)-2,2,2-trifluoroethanone (220.0 g) as a yellow solid. LCMS Method C: [M+H]+= 293.0. Step 3: 4-chloro-6-nitro-1H-indole-3-carboxylic acid 1-(4-Chloro-6-nitro-1H-indol-3-yl)-2,2,2-trifluoroethanone (220.0 g, 751.8 mmol, 1.0 equiv.) was dissolved in 4 M aq. NaOH (601.4 g, 15.0 mol, 20.0 equiv.). The resulting mixture was stirred overnight at 65 °C under N2 atmosphere. The mixture was allowed to cool down to RT and washed with MeTHF. The water phase was adjusted to pH 1-2 with conc. HCl at 0 °C. The precipitated solids were collected by filtration, washed with water and dried under vacuum at 45 °C for 6 hours to afford 4-chloro-6-nitro-1H-indole-3- carboxylic acid (157.0 g) as a brown solid. LCMS Method C: [M-H]- = 238.9. Step 4: 4-chloro-3-fluoro-6-nitro-1H-indole 4-Chloro-6-nitro-1H-indole-3-carboxylic acid (157.0 g, 652.5 mmol, 1.0 equiv.) was dissolved in THF (4.7 L) and water (2.4 L), then selectfluor (462.3 g, 1.3 mol, 2.0 equiv.) was added. This was followed by the addition of Li2CO3 (192.8 g, 2.6 mol, 4.0 equiv.) in five portions over 30 min at 10oC under N2 atmosphere. The resulting mixture was stirred overnight at room temperature under N2 atmosphere. The resulting mixture was filtered and the filter cake was washed with THF. The resulting solution was diluted with water, extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (12:1) to afford 4-chloro-3-fluoro-6-nitro-1H-indole (76.9 g) as a yellow solid. LCMS Method C: [M-H]- = 213.0. Step 5: 4-chloro-3-fluoro-1H-indol-6-amine hydrochloride 4-Chloro-3-fluoro-6-nitro-1H-indole (76.9 g, 358.3 mmol, 1.0 equiv.) was dissolved in EtOH (1.2 L) and water (0.3 L), then NH4Cl (95.8 g, 1.8 mol, 5.0 equiv.) was added. After stirred for 10 min at 50 °C under N2 atmosphere, Fe powder (100.0 g, 1.8 mol, 5.0 equiv.) was added in five portions over 1 hour at 50 °C. The resulting mixture was stirred for additional 3 hours at 50 °C under N2 atmosphere. The mixture was allowed to cool down to room temperature. The resulting mixture was filtered and the filter cake was washed with EtOH. The filtrate was concentrated under vacuum. The residue was dilute with water, extracted with EtOAc, washed with 10% aq. NaCl, dried over anhydrous Na2SO4. To the organic layers was added 4 M HCl in EtOAc (769 mL) dropwise over 30 min at 10 °C under N2 atmosphere. The resulting mixture was stirred for 1 hour at RT under N2 atmosphere and then concentrated to about 600 mL (8 V) under vacuum. The precipitated solids were collected by filtration to afford 4-chloro-3-fluoro-1H-indol-6-amine hydrochloride (63.5 g) as a brown solid. LCMS Method C: [M+H]+= 185.0.1H NMR (300 MHz, DMSO-d6) δ 11.66 (s, 1H), 10.44 (s, 2H), 7.54 (dt, J = 15.0, 2.3 Hz, 2H), 7.13 (d, J = 1.6 Hz, 1H). Synthesis of ([(3-fluoro-1H-indol-6-yl)sulfanyl]formonitrile) - - - - - y 19.0 g, 638.0 mmol, 1.0 equiv.) was dissolved in DCM (2.4 L), then TEA (96.8 g, 957.0 mmol, 1.5 equiv.) and 1-(2- oxopyridine-1-carbothioyl)pyridin-2-one (148.1 g, 638.0 mmol, 1.0 equiv.) were added. The reaction mixture was stirred for 1.5 hours at RT and then concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (10:1) to afford [(3-fluoro-1H-indol-6-yl)sulfanyl]formonitrile (72.0 g) as a brown solid.1H NMR (400 MHz, DMSO-d6) δ 6.66–6.62 (m, 1H), 6.43–6.41 (m, 1H), 6.37–6.36 (m, 1H), 6.28–6.25 (m, 1H). Synthesis of N-(4-bromo-6-chloropyridin-2-yl)acetamide .0 mg, 2.4 mmol, 1.0 equiv.) and TEA (365.8 mg, 3.6 mmol, 1.5 equiv.) were dissolved in THF (5 mL) and cooled to 0 °C, then acetyl chloride (378.4 mg, 4.8 mmol, 2.0 equiv.) was added. The reaction mixture was stirred for 4 hours at 60 °C, then cooled to RT and quenched by the addition of water. The resulting solution was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (3:1) to afford N-(4-bromo-6- chloropyridin-2-yl)acetamide (268.0 mg) as a white solid. LCMS Method C: [M+H]+= 249.1. Synthesis of 4,6-dichloro-N-methylpyrimidine-2-carboxamide , (1.0 g, 5.2 mmol, 1.0 equiv.) and methanamine hydrochloride (521.7 mg, 7.8 mmol, 1.5 equiv.) were dissolved in THF (10 mL), then TEA (2.1 g, 20.7 mmol, 4.0 equiv.) and T3P (2.8 g, 7.8 mmol, 1.5 equiv.) were added. The reaction mixture was stirred for 1 hour at RT and then quenched by the addition of water. The resulting solution was extracted with EtOAc, dried over anhydrous sodium sulfate and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with dichloromethane / MeOH (10:1) to afford 4,6-dichloro-N- methylpyrimidine-2-carboxamide (800.0 mg) as a white solid. LCMS Method C: [M+H]+= 205.0. Synthesis of 4-bromo-6-chloro-N-methylpicolinamide 0 equiv.) and DIEA (2.6 g, 20.5 mmol, 5.0 equiv.) were dissolved in DCM (10 mL), then HATU (2.3 g, 6.1 mmol, 1.5 equiv.) and methanamine hydrochloride (330.2 mg, 4.9 mmol, 1.2 equiv.) were added. The reaction mixture was stirred for 1 hour at room temperature and quenched by the addition of water. The resulting solution was extracted with DCM, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (2:1) to afford 4-bromo-6-chloro-N- methylpicolinamide (600.0 mg) as a white solid. LCMS Method C: [M+H]+= 249.0. Synthesis of 4-(2,2,2-trifluoroethyl)piperidine hydrochloride tert-Butyl 4-methylidenepiperidine-1-carboxylate (500.0 mg, 2.5 mmol, 1.0 equiv.) was dissolved in MeOH (5 mL), then 5-(trifluoromethyl)-5H-dibenzo[b,d]thiophen-5-ium trifluoromethanesulfonate (1.0 g, 2.5 mmol, 1.0 equiv.), Tris(2,2'-bipyridine)ruthenium dichloride (162.3 mg, 0.2 mmol, 0.1 equiv.) and Pyridine (200.4 mg, 2.5 mmol, 1.0 equiv.) were added. The resulting mixture was stirred overnight at RT under blue light and then concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (10:1) to afford tert-butyl 4-(2,2,2- trifluoroethyl)piperidine-1-carboxylate (370.0 mg) as a colorless liquid. LCMS Method C: [M+H]+= 268.2. Step 2: 4-(2,2,2-trifluoroethyl)piperidine hydrochloride tert-Butyl 4-(2,2,2-trifluoroethyl)piperidine-1-carboxylate (320.0 mg, 1.2 mmol, 1.0 equiv.) was dissolved in EtOAc (5 mL), then HCl / 1,4-dioxane (4N, 3 mL) was added. The reaction mixture was stirred for 1 hour at RT. The precipitated solids were collected by filtration and washed with EtOAc to afford 4-(2,2,2-trifluoroethyl)piperidine hydrochloride (190.0 mg) as a white solid. LCMS Method C: [M+H]+=168.1. Synthesis of 4-(2,2,2-trifluoroethoxy)piperidine 2,2,2-Trifluoroethan-1-ol (2.4 g, 24.7 mmol, 1.2 equiv.) was dissolved in DMF (25 mL) and cooled to 0 °C, then NaH (1.2 g, 60%wt., 30.0 mmol, 1.5 equiv.) was added. After stirred for 10 min, 4-fluoropyridine (2.0 g, 20.5 mmol, 1.0 equiv.) was added under N2 atmosphere. The reaction mixture was stirred for 1 hour at 90 °C, then cooled to RT and quenched by the addition ice-water. The resulting solution was extracted with EtOAc, dried over anhydrous sodium sulfate and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (5:1) to afford 4-(2,2,2-trifluoroethoxy)pyridine (790.0 mg) as a yellow liquid. LCMS Method C: [M+H]+= 178.0. Step 2: 4-(2,2,2-trifluoroethoxy)piperidine 4-(2,2,2-Trifluoroethoxy)pyridine (750.0 mg, 4.2 mmol, 1.0 equiv.) was dissolved in EtOH (5 mL) and AcOH (5 mL), then PtO2 (750.0 mg, 3.3 mmol, 0.7 equiv.) was added. The resulting solution was degassed and back filled with hydrogen for three times. The reaction mixture was stirred overnight at RT under hydrogen. The reaction mixture was filtered through Celite and the collected filtrate was concentrated under vacuum to afford crude 4-(2,2,2-trifluoroethoxy)piperidine (900.0 mg) as a brown oil. LCMS Method C: [M+H]+= 184.1. Synthesis of 3-(3,4-difluorophenoxy)azetidine hydrochloride Step 1: tert-butyl 3-(3,4-difluorophenoxy)azetidine-1-carboxylate tert-Butyl 3-hydroxyazetidine-1-carboxylate (400.0 mg, 2.3 mmol, 1.0 equiv.), 3,4- difluorophenol (330.5 mg, 2.5 mmol, 1.1 equiv.) and PPh3 (1211.4 mg, 4.6 mmol, 2.0 equiv.) were dissolved in THF (4 mL), then DIAD (933.9 mg, 4.6 mmol, 2.0 equiv.) was added dropwise at 0 °C under nitrogen atmosphere. The reaction mixture was stirred overnight at 60 °C under nitrogen atmosphere, then cooled to room temperature and concentrated under vacuum. The resulting mixture was diluted with water (150 mL). The resulting solution was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (2:1) to afford tert-butyl 3-(3,4- difluorophenoxy)azetidine-1-carboxylate (595.0 mg) as a white oil. LCMS Method C: [M+H]+= 286.1. Step 2: 3-(3,4-difluorophenoxy)azetidine hydrochloride tert-Butyl 3-(3,4-difluorophenoxy)azetidine-1-carboxylate (500.0 mg, 1.8 mmol, 1.0 equiv.) was dissolved in HCl(gas) / 1,4-dioxane (4M, 5 mL). The reaction mixture was stirred 3 hours at room temperature under nitrogen atmosphere and then concentrated under vacuum to afford crude 3-(3,4-difluorophenoxy)azetidine hydrochloride, which was used in the next step directly without further purification. LCMS Method C: [M+H]+= 186.2. Table Y. The compounds in Table Y were prepared using an analogous procedure as the synthesis of 3-(3,4-difluorophenoxy)azetidine hydrochloride. Structure LCMS data +++ Method C: MS-ESI: 246.1 [M+H]++ rochloride {[1-(tert-butoxycarbonyl)piperidin-4-yl]oxy}acetic acid (1.0 g, 3.9 mmol, 1.0 equiv.) and methylamine hydrochloride (239.6 mg, 7.7 mmol, 2.0 equiv.) were dissolved in DCM (15 mL), then HATU (2.9 g, 7.7 mmol, 2.0 equiv.) and DIEA (996.9 mg, 7.7 mmol, 2.0 equiv.) were added. The resulting mixture was stirred for 5 hours at room temperature and then concentrated under vacuum. The resulting mixture was diluted with water (20 mL). The resulting mixture was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (20:1) to afford tert-butyl 4- [(methylcarbamoyl)methoxy]piperidine-1-carboxylate (996.0 mg) as a colorless oil. LCMS Method C: [M+H]+= 273.2. Step 2: N-methyl-2-(piperidin-4-yloxy)acetamide hydrochloride tert-Butyl 4-[(methylcarbamoyl)methoxy]piperidine-1-carboxylate (960.0 mg, 3.5 mmol, 1.0 equiv.) was dissolved in HCl(gas) in 1,4-dioxane (10 mL). The resulting mixture was stirred for 2 hours at room temperature and then concentrated under vacuum to afford crude N-methyl-2-(piperidin-4-yloxy)acetamide hydrochloride (585.0 mg). LCMS Method C: [M+H]+= 173.1. Synthesis of 2-(azetidin-3-yloxy)-5-(trifluoromethyl)pyridine hydrochloride tert-Butyl 3-hydroxyazetidine-1-carboxylate (2.2 g, 13.1 mmol, 1.1 equiv.) and Cs2CO3 (7.2 g, 22.1 mmol, 2.0 equiv.) was dissolved in DMF (20 mL), then (5- (trifluoromethyl)pyridin-2-yl)boronic acid (2.0 g, 11.0 mmol, 1.0 equiv.) was added. The resulting mixture was stirred for 3 hours at 80 °C under nitrogen atmosphere, then cooled to room temperature and quenched by the addition of water (100 mL). The resulting solution was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under reduced pressure. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (9:1) to afford tert-butyl 3-((5- (trifluoromethyl)pyridin-2-yl)oxy)azetidine-1-carboxylate (3.3 g) as a light yellow solid. LCMS Method C: [M+H]+= 319.2. Step 2: 2-(azetidin-3-yloxy)-5-(trifluoromethyl)pyridine hydrochloride tert-Butyl 3-((5-(trifluoromethyl)pyridin-2-yl)oxy)azetidine-1-carboxylate (2.1 g, 6.5 mmol, 1.0 equiv.) was dissolved in HCl(gas) in 1,4-dioxane (20 mL) at room temperature under nitrogen atmosphere. The resulting mixture was stirred for 1 hour at room temperature and then concentrated under vacuum. This resulted in crude 2-(azetidin- 3-yloxy)-5-(trifluoromethyl)pyridine (2.0 g) as a white solid. LCMS Method C: [M+H]+= 219.1. Synthesis of 3-[(3,3-difluorocyclobutyl)methoxy]azetidine , y y y y y A mixture of (3,3-difluorocyclobutyl)methanol (3.0 mL, 16.4 mmol) and 1- (diphenylmethyl) -3-methanesulfonylazetidine (2.0 g, 6.6 mmol, 1.0 equiv.) was stirred for 0.5 hour at 120 °C. Then the mixture was cooled to room temperature and diluted with DCM (2 mL). The crude product was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (8:1) to afford 3-[(3,3-difluorocyclobutyl)methoxy]- 1-(diphenylmethyl)azetidine (1.1 g) as a white solid. LCMS Method C: [M+H]+= 344.1. Step 2: 3-[(3,3-difluorocyclobutyl)methoxy]azetidine 3-[(3,3-difluorocyclobutyl)methoxy]-1-(diphenylmethyl)azetidine (1.0 g, 2.9 mmol, 1.0 equiv.) was dissolved in EtOH (10 mL), Pd(OH)2 / C (10%, 100 mg) was added under nitrogen atmosphere. The mixture was hydrogenated at room temperature for overnight under hydrogen atmosphere using a hydrogen balloon. The mixture was filtered through a Celite pad and the concentrated under vacuum. This resulted in 3-[(3,3- difluorocyclobutyl)methoxy]azetidine (500 mg) as a white oil. The crude product was used in the next step directly without further purification. LCMS Method C: [M+H]+= 178.1. Table Y2. The compounds in Table Y2 were prepared using an analogous procedure as the synthesis of 3-[(3,3-difluorocyclobutyl)methoxy]azetidine Structure LCMS data I: Synthesis of 3 -( , , -tr uoroet oxy)azetd ne ydroc or de , , 2,2,2-trifluoroethyl trifluoromethanesulfonate (10.0 g, 43.1 mmol, 1.0 equiv.) and tert-butyl 3-hydroxyazetidine-1-carboxylate (11.2 g, 64.6 mmol, 1.5 equiv.) were dissolved in DMF (100 ml), Cs2CO3 (42.2 g, 129.3 mmol, 3.0 equiv.) was added. The resulting mixture was stirred for 16 hours at room temperature under nitrogen atmosphere and then quenched by the addition of water (50mL). The resulting mixture was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by reversed-phase flash chromatography with the following conditions: column, C18 silica gel; mobile phase, MeCN in Water (0.1% NH3.H2O+10mmol / L NH4HCO3), 30% to 70% gradient in 30 min; detector, UV 254 nm. This resulted in tert-butyl 3-(2,2,2-trifluoroethoxy)azetidine-1-carboxylate (2.13 g) as a white solid. LCMS Method C: [M+H]+= 256.2. Step 2: 3-(2,2,2-trifluoroethoxy)azetidine hydrochloride tert-Butyl 3-(2,2,2-trifluoroethoxy)azetidine-1-carboxylate (2.1 g, 8.3 mmol, 1.0 equiv.) was dissolved in HCl(gas) in 1,4-dioxane (4M, 20 mL). The reaction mixture was stirred for 2 hours at room temperature and then concentrated under vacuum. This resulted in 3- (2,2,2-trifluoroethoxy)azetidine (1.5 g) as a brown oil. LCMS Method C: [M+H]+= 156.1. Synthesis of 3-[4-(trifluoromethyl)phenoxy]azetidine hydrochloride 4-(Trifluoromethyl)phenol (5.0 g, 30.8 mmol, 1.0 equiv.) and tert-butyl 3- iodoazetidine-1-carboxylate (10.5 g, 37.0 mmol, 1.2 equiv.) were dissolved in DMF (50 mL), then Cs2CO3 (20.1 g, 61.7 mmol, 2.0 equiv.) was added. The resulting mixture was stirred for 16 hours at 80 °C under nitrogen atmosphere, then cooled to room temperature and quenched by the addition of water (200 mL). The resulting mixture was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (1:1) to afford tert-butyl 3-[4-(trifluoromethyl)phenoxy]azetidine-1- carboxylate (6.4 g) as a yellow solid. LCMS Method C: [M+H]+= 318.1. Step 2: 3-[4-(trifluoromethyl)phenoxy]azetidine hydrochloride tert-Butyl 3-[4-(trifluoromethyl)phenoxy]azetidine-1-carboxylate (6.4 g, 20.2 mmol, 1.0 equiv.) was dissolved in HCl(gas) in 1,4-dioxane (65 mL). The resulting mixture was stirred for 3 hours at room temperature under nitrogen atmosphere and then concentrated under reduced pressure. The resulted in crude 3-[4- (trifluoromethyl)phenoxy]azetidine hydrochloride ( 4.3 g) as a yellow solid, that was used in the next step directly without further purification. LCMS Method C: [M+H]+= 217.1. Synthesis of 6-chloro-4-(4-phenoxypiperidin-1-yl)picolinonitrile mol, 1.0 equiv.) was dissolved in DMF (20 mL), then K2CO3 (1.2 g, 9.1 mmol, 2.0 equiv.) and 4- phenoxypiperidine (0.8 g, 4.5 mmol, 1.0 equiv.) were added. The reaction mixture was stirred for 3 hours at 80 °C, then cooled to RT and quenched by the addition of water. The resulting solution was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (1:1) to afford 6-chloro-4-(4- phenoxypiperidin-1-yl)pyridine-2-carbonitrile (860.0 mg) as a light yellow solid. LCMS Method C: [M+H]+= 314.1. Table Y3. The compounds in Table Y3 were prepared using an analogous procedure as the synthesis of 6-chloro-4-(4-phenoxypiperidin-1-yl)picolinonitrile Structure LCMS data Synthesis of 4-bromo-3-methyl-2-{4-[3-(trifluoromethyl)phenoxy]piperidin-1- yl}pyridine Piperidin-4-ol (2.0 g, 19.8 mmol, 1.0 equiv.) and 4-bromo-2-chloro-3-methylpyridine (4.9 g, 23.7 mmol, 1.2 equiv.) were dissolved in DMSO (20 mL), then DBU (6.0 g, 39.5 mmol, 2.0 equiv.) was added. The reaction mixture was stirred overnight at 80 °C, then cooled to room temperature and concentrated under vacuum. The residue was purified by reversed-phase flash chromatography with the following conditions: column, C18 silica gel; mobile phase, MeCN in Water (10mmol / L NH4HCO3), 20% to 50% gradient in 30 min; detector, UV 254 nm. This resulted in 1-(4-bromo-3-methylpyridin-2-yl)piperidin-4- ol (550.0 mg) as a yellow oil. LCMS Method C: [M+H]+= 271.2. Step 2: 4-bromo-3-methyl-2-{4-[3-(trifluoromethyl)phenoxy]piperidin-1- yl}pyridine 1-(4-bromo-3-methylpyridin-2-yl)piperidin-4-ol (480.0 mg, 1.8 mmol, 1.0 equiv.) and M- trifluoromethylphenol (344.0 mg, 2.1 mmol, 1.2 equiv.) were dissolved in THF (5 mL), then PPh3 (696.0 mg, 2.7 mmol, 1.5 equiv.) was added. This was followed by the addition of DEAD (462.0 mg, 2.7 mmol, 1.5 equiv.) dropwist at 0°C under nitrogen atmosphere. The reaction mixture was stirred overnight at 70 °C under nitrogen atmosphere, then cooled to room temperature and concentrated under vacuum. The residue was diluted with water, then extracted with EtOAc, washed with brine and dried over anhydrous Na2SO4. After filtration, the filtrate was concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / ethyl acetate (15:1) to afford 4- bromo-3-methyl-2-{4-[3-(trifluoromethyl)phenoxy]piperidin-1-yl}pyridine (430.0 mg) as a yellow solid. LCMS Method C: [M+H]+= 415.1. Attorney Docket No.47110-0083WO1 Table Y4. The compounds in Table Y4 were prepared using an analogous procedure as the synthesis of 4-bromo-3-methyl-2-{4-[3-(trifluoromethyl)phenoxy]piperidin-1- yl}pyridine Structure LCMS data I: Synthesis - - - y - - - - y p enoxy]azetidin-1- yl}pyridazine 4,5-Dibromo-2H-pyridazin-3-one (10.0 g, 39.4 mmol, 1.0 equiv.) was dissolved in DMF (100 mL) and cooled to 0 °C, then NaH (3.15 g, 78.8 mmol, 2.0 equiv., 60%) was added in portions at 0 °C under nitrogen atmosphere. The resulting mixture was stirred for 15 min at 0 °C, and then SEMCl (9.85 g, 59.1 mmol, 1.5 equiv.) was added dropwise over 3 min at 0 °C. The resulting mixture was stirred for additional 16 hours at room temperature under nitrogen atmosphere and quenched by the addition of ice-water (300 mL) at 0 °C. The resulting mixture was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (12:1) to afford 4,5-dibromo-2-{[2- (trimethylsilyl)ethoxy]methyl}pyridazin-3-one (11.0 g) as a yellow oil. LCMS Method C: [M+H-28]+= 357.0. Step 2: 4-bromo-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2-{[2- (trimethylsilyl)ethoxy]methyl}pyridazin-3-one 4,5-Dibromo-2-{[2-(trimethylsilyl)ethoxy]methyl}pyridazin-3-one (11.0 g, 28.6 mmol, 1.0 equiv.) and 3-[4-(trifluoromethyl)phenoxy]azetidine (7.2 g, 28.6 mmol, 1.0 equiv.) were dissolved in MeCN (110 mL), then Cs2CO3 (18.7 g, 57.3 mmol, 2.0 equiv.) was added. The reaction mixture was stirred for 16 hours at 60 °C, then cooled to room temperature and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ehter / EtOAc (1:1) to afford 4-bromo-5-{3-[4- (trifluoromethyl)phenoxy]azetidin-1-yl}-2-{[2-(trimethylsilyl)ethoxy]methyl}pyridazin- 3-one (11.1 g) as a yellow oil. LCMS Method C: [M+H]+= 520.1. Step 3: 4-methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2-{[2- (trimethylsilyl)ethoxy]methyl}pyridazin-3-one 4-Bromo-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2-{[2- (trimethylsilyl)ethoxy]methyl}pyridazin-3-one (11.8 g, 22.7 mmol, 1.0 equiv.) and trimethyl-1,3,5,2,4,6-trioxatriborinane (28.5 g, 226.7 mmol, 10.0 equiv) were dissolved in 1,4-dioxane (110 mL) and water (11 mL), then Pd(dppf)Cl2 (3.3 g, 4.5 mmol, 0.2 equiv.) and Cs2CO3 (14.8 g, 45.3 mmol, 2.0 equiv.) were added at room temperature under nitrogen atmosphere. The resulting mixture was stirred for 16 hours at 85 °C under nitrogen atmosphere, then cooled to room temperature and concentrated under vacuum. The residue was diluted with water (200 mL). The resulting solution was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ehter / EtOAc (1:1) to afford 4-methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2-{[2- (trimethylsilyl)ethoxy]methyl}pyridazin-3-one (11.3 g) as a brown yellow solid. LCMS Method C: [M+H]+= 456.1. Step 4: 4-methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2H-pyridazin-3- one 4-Methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2-{[2- (trimethylsilyl)ethoxy]methyl}pyridazin-3-one (11.3 g, 24.8 mmol, 1.0 equiv.) was dissolved in HCl (gas) in 1,4-dioxane (4M, 110 mL) at room temperature .The resulting mixture was stirred for 3 hours at room temperature under nitrogen atmosphere. The resulting mixture was concentrated under reduced pressure. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (1:1) to afford 4- methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2H-pyridazin-3-one (2.3 g) as a yellow solid. LCMS Method C: [M+H]+= 326.1. Step 5: 3-chloro-4-methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1- yl}pyridazine 4-Methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}-2H-pyridazin-3-one (2.3 g, 7.2 mmol, 1.0 equiv.) was dissolved in MeCN (11 mL) and cooled to 0 °C, then POCl3 (11 mL) was added dropwise at 0 °C. The reaction mixture was stirred for 16 hours at 100 °C under nitrogen atmosphere, then cooled to room temperature and concentrated under vacuum. The residue was diluted with ice-water (100 mL). The resulting mixture was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by reversed-phase flash chromatography with the following conditions: column, C18 silica gel; mobile phase, MeCN in Water (10mmol / L NH4HCO3), 10% to 50% gradient in 10 min; detector, UV 254 nm. This resulted in 3- chloro-4-methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1-yl}pyridazine (420.0 mg) as a brown solid. LCMS Method C: [M+H]+= 344.1. Table Y5. The compounds in Table Y5 were prepared using an analogous procedure as the synthesis of 3-chloro-4-methyl-5-{3-[4-(trifluoromethyl)phenoxy]azetidin-1- yl}pyridazine Structure LCMS data .1 .1 Synthesis of 2-chloro-4-(4-(pyridin-2-yloxy)piperidin-1-yl)-6- (trifluoromethyl)pyridine 2-chloro-4- iodo-6-(trifluoromethyl)pyridine (690.0 mg, 2.2 mmol, 1.0 equiv.) were dissolved in DMSO (5 mL), then K3PO4 (952.7 mg, 4.5 mmol, 2.0 equiv.), CuI (42.7 mg, 0.2 mmol, 0.1 equiv.) and (1R,2R)-N,N'-Dimethyl-1,2-cyclohexanediamine (31.9 mg, 0.2 mmol, 0.1 equiv.) were added in portions at room temperature under nitrogen atmosphere. The resulting mixture was stirred for 2 hours at 100 °C under nitrogen atmosphere, then cooled to room temperature and quenched by the addition of water. The resulting mixture was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by Prep-TLC (petroleum ether / EtOAc = 2:1) to afford 2-chloro-4-(4-(pyridin-2-yloxy)piperidin-1-yl)-6-(trifluoromethyl)pyridine(310.0 mg, 38.6%) as a brown oil. LCMS Method C: [M+H]+= 358.1. Synthesis of 4-bromo-3-methyl-7-(trifluoromethyl)quinolone Step 1: ethyl 2-methyl-3-oxopropanoate Ethyl (2Z)-3-ethoxy-2-methylprop-2-enoate (10.0 g, 63.2 mmol, 1.0 equiv.) was dissolved in aqueous HCl (6N, 200 mL). The reaction mixture was stirred for 4 hours at RT. The resulting solution was extracted with EtOAc, washed with water, dried over anhydrous Na2SO4 and concentrated under vacuum to give ethyl 2-methyl-3- oxopropanoate (7.0 g) as a white solid. The crude product was used in the next step directly without further purification. Step 2: ethyl (2E)-2-methyl-3-{[3-(trifluoromethyl)phenyl]amino}prop-2-enoate Ethyl 2-methyl-3-oxopropanoate (7.0 g, 53.7 mmol, 1.0 equiv.) was dissolved in EtOAc (100 mL), then 3-(trifluoromethyl)aniline (6.9 g, 43.0 mmol, 0.8 equiv.) was added at RT. The reaction mixture was stirred for 12 hours at 60 °C, then cooled to RT and concentrated under vacuum. The residue was purified by reversed-phase flash chromatography with the following conditions: column, C18; mobile phase, ACN in Water (10mmol / L NH4HCO3), 0% to 100% gradient in 15 min; detector, UV 254 nm. This give ethyl (2E)-2-methyl-3-{[3-(trifluoromethyl)phenyl]amino}prop-2-enoate (5.7 g) as a white solid. LCMS Method C: [M+H]+= 274.1. Step 3: 3-methyl-7-(trifluoromethyl)quinolin-4-ol Ethyl (2E)-2-methyl-3-{[3-(trifluoromethyl)phenyl]amino}prop-2-enoate (2.7 g, 9.8 mmol, 1.0 equiv.) was dissolved in diphenyl-ether (50 mL). The reaction mixture was stirred for 4 hours at 250 °C, then cooled to 100 °C and diluted with hexane. The precipitated solids were collected by filtration, washed with hexane and dried under vacuum. This gave 3-methyl-7-(trifluoromethyl)quinolin-4-ol (1.6 g) as a white solid. LCMS Method C: [M+H]+= 228.1. Step 4: 4-bromo-3-methyl-7-(trifluoromethyl)quinoline 3-Methyl-7-(trifluoromethyl)quinolin-4-ol (700.0 mg, 3.0 mmol, 1.0 equiv.) was dissolved in DMF (15 mL), then POBr3 (1.2 g, 4.3 mmol, 1.4 equiv.) was added at room temperature. The reaction mixture was stirred for 3 hours at 80 °C, then cooled to room temperature and quenched by the addition of water. The resulting solution was adjusted to 8 with saturated aq. Na2CO3, then extracted with EtOAc, washed with water, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by reverse flash chromatography with the following conditions: column, C18; mobile phase, MeCN in Water (10mmol / L NH4HCO3), 0% to 100% gradient in 15 min; detector, UV 254 nm. This resulted in 4- bromo-3-methyl-7-(trifluoromethyl)quinoline (610.0 mg) as a white solid. LCMS Method C: [M+H]+= 290.0. Table Y6. The compounds in Table Y6 were prepared using an analogous procedure as the synthesis of 4-bromo-3-methyl-7-(trifluoromethyl)quinolone Structure LCMS data I: Example Co mpoun repara ons Example 1: Synthesis of 1-(2-((4-chloro-1H-indol-6-yl) amino)-3-methylpyridin-4-yl)- 3-(4-(trifluoromethyl) phenyl) azetidin-3-ol (Compound 12) 2-chloro-4-iodo-3-methylpyridine (88.52 mg, 0.35 mmol, 1.00 equiv.) and 3-(4- (trifluoromethyl) phenyl) azetidin-3-ol (91.17 mg, 0.42 mmol, 1.20 equiv.) were dissolved in Dioxane (4.00 mL). Then t-BuONa (100.91 mg, 1.05 mmol, 3.00 equiv), Pd2(dba)3 (16.03 mg, 0.02 mmol, 0.05 equiv.) and Xantphos (10.13 mg, 0.02 mmol, 0.05 equiv.) were added under an atmosphere of nitrogen. The reaction mixture was heated at 60 °C for 16 hrs. Spot check by LC-MS. 5 mL H2O was added to the reaction mixture and then extracted with EtOAc. The combined organic layers were collected, dried over anhydrous Na2SO4, filtered and concentrated under reduced pressure to give 1-(2-chloro-3- methylpyridin-4-yl)-3-(4-(trifluoromethyl)phenyl)azetidin-3-ol. The crude product was used into next step without further purification. Step 2: Synthesis of 1-(2-((4-chloro-1H-indol-6-yl) amino)-3-methylpyridin-4-yl)-3-(4- (trifluoromethyl) phenyl) azetidin-3-ol 1-(2-chloro-3-methylpyridin-4-yl)-3-(4-(trifluoromethyl)phenyl)azetidin-3-ol (crude, 0.35 mmol, 1.00 equiv.) and 4-chloro-1H-indol-6-amine (52.29 mg, 0.32 mmol, 0.90 equiv.) were dissolved in Dioxane (4.00 mL), then Cs2CO3 (342.11 mg, 1.05 mmol, 3.00 equiv.) and Brettphos Pd G3 (15.86 mg, 0.02 mmol, 0.05 equiv.) were added under an atmosphere of nitrogen. The reaction mixture was heated at 100 °C for 16 hrs. Spot check by LC-MS. 5 mL H2O was added to the reaction mixture and then extracted with EtOAc. The combined organic layers were collected, dried over anhydrous Na2SO4, filtered and concentrated under reduced pressure. The residue was purified by prep-HPLC to give final compound 1-(2-((4-chloro-1H-indol-6-yl) amino)-3-methylpyridin-4-yl)-3- (4-(trifluoromethyl) phenyl) azetidin-3-ol (20.83 mg, 44.11µmol). MS-ESI, 473.1 [M+H+].1H NMR (400 MHz, DMSO-d6) δ ppm 11.13 (br s, 1 H), 7.88 (d, 2 H), 7.79 (s, 5 H), 7.29 –7.25 (m, 2 H), 6.52 (s, 1 H), 6.33 (br s, 1 H), 6.17 (d, 1 H), 4.29 (d, 2 H), 4.19 (d, 2 H), 2.09 (s, 3 H). Table X. The compounds in Table X were prepared using an analogous procedure as Example 1. Comp LC-MS, - .
[0309] Example 2: Synthesis of 6-((lH-indol-6-yl)amino)-4-(4-methylpiperazin-l- yl)picolinonitrile (Compound 110) Step 1: Synthesis of tert-butyl 6-((6-cyano-4-(4-methylpiperazin-1-yl)pyridin-2- yl)amino)-1H-indole-1-carboxylate tert-butyl 6-((4-chloro-6-cyanopyridin-2-yl)amino)-1H-indole-1-carboxylate (110.4 mg, 0.3 mmol, 1.0 equiv.) and 1-methylpiperazine (60 mg, 0.6 mmol, 2.0 equiv.) were dissolved in t-AmOH (3.0 mL). Then K3PO4 (190.8 mg, 0.9 mmol, 3.0 equiv.) and RuPhos Pd G3 (12.54 mg, 0.015 mmol, 0.05 equiv.) were added under an atmosphere of nitrogen. The mixture was heated at 100 °C for 3 hours. Spot check by LC-MS. 10 mL H2O was added to the reaction mixture and then extracted with EtOAc. The combined organic layers were collected, dried over anhydrous Na2SO4, filtered and concentrated under reduced pressure to give crude tert-butyl 6-((6-cyano-4-(4-methylpiperazin-1-yl)pyridin-2- yl)amino)-1H-indole-1-carboxylate (129.6 mg, 70% purity) which was used in next step without further purification. Step 2: Synthesis of 6-((1H-indol-6-yl)amino)-4-(4-methylpiperazin-1- yl)picolinonitrile tert-butyl 6-((6-cyano-4-(4-methylpiperazin-1-yl)pyridin-2-yl)amino)-1H-indole-1- carboxylate (129.6 mg, 70% purity) was dissolved in 1.5 mL Dioxane. Then 1.5 mL H2O was added. The reaction mixture was heated at 100oC for 16 hours. Spot check by LC- MS. The reaction mixture was concentrated under vacuum and purified by prep HPLC to give 6-((1H-indol-6-yl)amino)-4-(4-methylpiperazin-1-yl)picolinonitrile (10.31 mg, 0.03 mmol). MS-ESI, 333.2 [M+H+].1H NMR (400 MHz, DMSO-d6) δ ppm 10.95 (br s, 1 H), 8.90 (s, 1 H), 7.88 (s, 1 H), 7.40 (d, 1 H), 7.23–7.16 (m, 1 H), 7.04 (d, 1 H), 6.94 (dd, 1 H), 6.37–6.28 (m, 2 H), 3.34 (br s, 4 H), 2.44–2.36 (m, 4 H), 2.21 (s, 3 H). Table X2. The compounds in Table X2 were prepared using an analogous procedure as Example 2. 4-(4,4- difluoropiperidin-1-yl)- Example 3: Synthesis of 6-((4-chloro-1H-indol-6-yl)amino)-4-(4-methylpiperazin-1- yl)picolinonitrile (Compound 97) p y y y y p p yl)pyridin-2-yl)amino)-1H-indole-1-carboxylate tert-butyl 4-chloro-6-((4-chloro-6-cyanopyridin-2-yl)amino)-1H-indole-1- carboxylate (120.6 mg, 0.3 mmol, 1.0 equiv.) and 1-methylpiperazine (45.0 mg, 0.45 mmol, 1.5 equiv.) were dissolved in t-AmOH (3.0 mL). Then K3PO4 (190.8 mg, 0.9 mmol, 3.0 equiv.) and BrettPhos Pd G3 (13.4 mg, 0.015 mmol, 0.05 equiv.) were added under an atmosphere of nitrogen. The mixture was heated at 80 °C for 16 hours. Spot check by LC- MS. 10 mL H2O was added to the reaction mixture and then extracted with EtOAc. The combined organic layers were collected, dried over anhydrous Na2SO4, filtered and concentrated under reduced pressure to give crude tert-butyl 4-chloro-6-((6-cyano-4-(4- methylpiperazin-1-yl)pyridin-2-yl)amino)-1H-indole-1-carboxylate which was used in next step without further purification. Step 2: Synthesis of 6-((4-chloro-1H-indol-6-yl)amino)-4-(4-methylpiperazin-1- yl)picolinonitrile tert-butyl 4-chloro-6-((6-cyano-4-(4-methylpiperazin-1-yl)pyridin-2-yl)amino)-1H- indole-1-carboxylate (curde) was dissolved in 1.5 mL Dioxane. Then 1.5 mL H2O was added. The reaction mixture was heated at 100oC for 16 hours. Spot check by LC-MS. The reaction mixture was concentrated under vacuum and purified by prep HPLC to give 6-((4-chloro-1H-indol-6-yl)amino)-4-(4-methylpiperazin-1-yl)picolinonitrile (2.28 mg, 0.006 mmol). MS-ESI, 367.1 [M+H+]. Example 4: Synthesis of 6-((4-chloro-1H-indol-6-yl)amino)-4-(4-(2,2,2- trifluoroethyl)piperazin-1-yl)picolinonitrile (Compound 94) p y y y , , trifluoroethyl)piperazin-1-yl)pyridin-2-yl)amino)-1H-indole-1-carboxylate tert-butyl 4-chloro-6-((4-chloro-6-cyanopyridin-2-yl)amino)-1H-indole-1- carboxylate (120.6 mg, 0.3 mmol, 1.0 equiv.) and 1-(2,2,2-trifluoroethyl)piperazine (75.6 mg, 0.45 mmol, 1.5 equiv.) were dissolved in t-AmOH (3.0 mL). Then K3PO4 (190.8 mg, 0.9 mmol, 3.0 equiv.) and PEPSSI Pd TPentCl (14.6 mg, 0.015 mmol, 0.05 equiv.) were added under an atmosphere of nitrogen. The mixture was heated at 80 °C for 16 hours. Spot check by LC-MS. 10 mL H2O was added to the reaction mixture and then extracted with EtOAc. The combined organic layers were collected, dried over anhydrous Na2SO4, filtered and concentrated under reduced pressure to give crude tert-butyl 4-chloro-6-((6- cyano-4-(4-(2,2,2-trifluoroethyl)piperazin-1-yl)pyridin-2-yl)amino)-1H-indole-1- carboxylate which was used in next step without further purification. Step 2: Synthesis of 6-((4-chloro-1H-indol-6-yl)amino)-4-(4-(2,2,2- trifluoroethyl)piperazin-1-yl)picolinonitrile tert-butyl 4-chloro-6-((6-cyano-4-(4-(2,2,2-trifluoroethyl)piperazin-1-yl)pyridin-2- yl)amino)-1H-indole-1-carboxylate (crude) was dissolved in 1.5 mL Dioxane. Then 1.5 mL H2O was added. The reaction mixture was heated at 100oC for 16 hours. Spot check by LC-MS. The reaction mixture was concentrated under vacuum and purified by prep HPLC to give 6-((4-chloro-1H-indol-6-yl)amino)-4-(4-(2,2,2-trifluoroethyl)piperazin-1- yl)picolinonitrile (17.36 mg, 0.04 mmol). MS-ESI, 435.2 [M+H+].1H NMR (400 MHz, DMSO-d6) δ ppm 11.28 (br s, 1 H), 9.09 (s, 1 H), 7.88 (s, 1 H), 7.31–7.28 (m, 1 H), 7.12 (dd, 2 H), 6.38–6.29 (m, 2 H), 3.25 (q, 4 H), 2.76–2.68 (m, 4 H), 1.29–1.10 (m, 1 H), 0.88– 0.75 (m, 1 H). Table X3. The compounds in Table X3 were prepared using an analogous procedure as Examples 3 and 4. Compound Final compound IUPAC Name LC-MS, MS- ]. 96 4-(4-benzylpiperidin-1- 442.2 yl)-6-[(4-chloro-1H-indol- Example 5: Synthesis of 6-((3-fluoro-1H-indol-6-yl)amino)-4-(4-phenoxypiperidin-1- yl)picolinonitrile (Compound 92) 6-Chloro-4-(4-phenoxypiperidin-1-yl)pyridine-2-carbonitrile (200.0 mg, 0.6 mmol, 1.0 equiv.) and 3-fluoro-1H-indol-6-amine (143.6 mg, 1.0 mmol, 1.5 equiv.) were dissolved in 1,4-dioxane (5 mL), then Cs2CO3 (415.3 mg, 1.3 mmol, 2 equiv), Brettphos (68.4 mg, 0.1 mmol, 0.2 equiv.), Brettphos Pd G3 (57.8 mg, 0.1 mmol, 0.1 equiv.) were added at room temperature under nitrogen atmosphere. The reaction mixture was stirred for 16 hours at 100 °C under nitrogen atmosphere, then cooled to room temperature and quenched by the addition of water (80 mL). The resulting mixture was extracted with EtOAc, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by reversed-phase flash chromatography with the following conditions: column, C18 silica gel; mobile phase, MeCN in Water (0.1% FA), 10% to 100% gradient in 30 min; detector, UV 254 nm. The resulting crude product was further purified by Prep-HPLC with the following conditions (Column: SunFire C18 OBD Prep Column, 19*250 mm, 5μm; Mobile Phase A: Water(0.1%FA), Mobile Phase B: ACN; Flow rate: 30 mL / min; Gradient: 70% B to 90% B in 6 min, 90% B; Wave Length: 254 / 210 nm; RT1(min): 6) to afford 6-[(3-fluoro-1H-indol-6-yl)amino]-4-(4-phenoxypiperidin-1- yl)pyridine-2-carbonitrile (50.1 mg) as a grey solid. LCMS Method G: [M+H]+= 428.3.1H NMR (400 MHz, DMSO-d6): δ 10.68 (s, 1H), 9.00 (s, 1H), 7.96 (s, 1H), 7.39 (d, J = 8.4 Hz, 1H), 7.32–7.28 (m, 2H), 7.14 – 7.11 (m, 2H), 7.02 – 6.99 (m, 3H), 6.96 – 6.93 (m, 1H), 6.40 (s, 1H), 4.68 – 4.64 (m, 1H), 3.70 – 3.64 (m, 2H), 3.30 – 3.25 (m, 2H), 2.04 – 1.99 (m, 2H), 1.70 – 1.64 (m, 2H). Table X4. The compounds in Table X4 were prepared using an analogous procedure as Example 5. Compound # Structure LCMS data
[0310] Example 6: Synthesis of N-(3-fluoro-lH-indol-6-yl)-4-(4-phenoxypiperidin-l-yl)-7- (trifluoromethyl)quinolin-2-amine (Compound 90) Step 1: 4-bromo-7-(trifluoromethyl)quinoline 1-oxide 4-Bromo-7-(trifluoromethyl)quinoline (500.0 mg, 1.8 mmol, 1.0 equiv.) was dissolved in DCM (10 mL), then m-CPBA (892.9 mg, 3.6 mmol, 2.0 equiv, 70.0%) was added. The reaction mixture was stirred for 3 hours at RT and then quenched by the addition of water. The solution was adjusted to pH 8 with aq. NaOH(1 N). The resulting mixture was extracted with DCM, washed with brine, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with DCM / MeOH (10:1) to afford 4-bromo-7- (trifluoromethyl)quinoline 1-oxide (420.0 mg) as a white solid. LCMS Method D: [M+H]+= 292.0. Step 2: 4-bromo-N-(3-fluoro-1H-indol-6-yl)-7-(trifluoromethyl)quinolin-2-amine 4-Bromo-7-(trifluoromethyl)quinoline 1-oxide (400.0 mg, 1.3 mmol, 1.0 equiv.) was dissolved in DMF (5 mL), then 3-fluoro-6-isothiocyanato-1H-indole (263.2 mg, 1.3 mmol, 1.0 equiv.) and AgBF4 (266.6 mg, 1.3 mmol, 1.0 equiv.) were added. The reaction mixture was stirred for 3 hours at RT and then quenched by the addition of water. The resulting solution was extracted with EtOAc, washed with water, dried over anhydrous Na2SO4 and concentrated under vacuum. The residue was purified by reverse flash chromatography with the following conditions: column, C18; mobile phase, MeCN in Water (0.1% FA), 10% to 80% gradient in 30 min; detector, UV 254 nm. This resulted in 4-bromo-N-(3- fluoro-1H-indol-6-yl)-7-(trifluoromethyl)quinolin-2-amine (560.0 mg) as a yellow solid. LCMS Method C: [M+H]+= 424.0. Step 3: N-(3-fluoro-1H-indol-6-yl)-4-(4-phenoxypiperidin-1-yl)-7- (trifluoromethyl)quinolin-2-amine 4-Bromo-N-(3-fluoro-1H-indol-6-yl)-7-(trifluoromethyl)quinolin-2-amine (150.0 mg, 0.4 mmol, 1.0 equiv.) and 4-phenoxypiperidine (125.4 mg, 0.7 mmol, 2.0 equiv.) were dissolved in 1,4-dioxane (2 mL), then Cs2CO3 (230.4 mg, 0.7 mmol, 2.0 equiv.) and RuPhos-PdCl-2nd G (55.0 mg, 0.1 mmol, 0.2 equiv.) were added under an atmosphere of N2. The reaction mixture was stirred overnight at 120 °C, then cooled to RT and concentrated under vacuum. The residue was purified by silica gel column chromatography, eluting with petroleum ether / EtOAc (1:1) to afford the crude product, that was further purified by Prep-HPLC with the following conditions: Column: Sunfire prep C18 column, 30*150, 5µm; Mobile Phase A: Water (0.1% FA), Mobile Phase B: ACN; Flow rate: 60 mL / min; Gradient: 45 B to 75 B in 7 min; 254 / 210 nm. This resulted in N-(3-fluoro-1H-indol-6-yl)-4-(4-phenoxypiperidin-1-yl)-7-(trifluoromethyl)quinolin-2- amine (18.2 mg) as a yellow solid. LCMS Method E: [M+H]+= 521.2.1H NMR (400 MHz, DMSO-d6): δ 10.68 (s, 1H), 9.48 (s, 1H), 8.64 (s, 1H), 8.16 (s, 1H), 8.04–8.01 (m, 1H), 7.92 (s, 1H), 7.52–7.50 (m, 1H), 7.45–7.43 (m, 1H), 7.35–7.31 (m, 2H), 7.20–7.19 (m, 2H), 7.06 (d, J = 8.4 Hz, 2H), 6.96 (t, J = 7.6 Hz, 2H), 6.74 (s, 2H), 4.72–4.71 (m, 1H), 3.41– 3.39 (m, 2H), 3.12–3.08 (m, 2H), 2.24–2.21 (m, 2H), 1.98–1.94 (m, 2H). Table X5. The compounds in Table X5 were prepared using an analogous procedure as Example 6. Compound Structure LCMS data - - 83 Method G: MS- ESI: 535.3 [M+H]+- Biological Assays STING pathway activation by the compounds described herein was measured using THP1- Dual™ cells (KO-IFNAR2). THP1-Dual™ KO-IFNAR2 Cells (obtained from invivogen) were maintained in RPMI, 10% FCS, 5 ml P / S, 2mM L-glut, 10mM Hepes, and 1 mM sodium pyruvate. Compounds were spotted in empty 384 well tissue culture plates (Greiner 781182) by Echo for a final concentration of 0.0017 - 100 µM. Cells were plated into the TC plates at 40 μL per well, 2×10E6 cells / mL. For activation with STING ligand, 2'3'cGAMP (MW 718.38, obtained from Invivogen), was prepared in Optimem media. The following solutions were prepared for each 1×384 plate: o Solution A: 2 mL Optimem with one of the following stimuli: ▪ 60 µL of 10 mM 2'3'cGAMP → 150 μM stock o Solution B: 2 mL Optimem with 60 μL Lipofectamine 2000 → Incubate 5 min at RT 2 mL of solution A and 2 ml Solution B was mixed and incubated for 20 min at room temperature (RT).20 µL of transfection solution (A+B) was added on top of the plated cells, with a final 2’3’cGAMP concentration of 15 μM. The plates were then centrifuged immediately at 340 g for 1 minute, after which they were incubated at 37oC, 5% CO2, >98% humidity for 24h. Luciferase reporter activity was then measured. EC50 values were calculated by using standard methods known in the art. Luciferase reporter assay: 10 µL of supernatant from the assay was transferred to white 384-plate with flat bottom and squared wells. One pouch of QUANTI-Luc™ Plus was dissolved in 25 mL of water.100 µL of QLC Stabilizer per 25 mL of QUANTI-Luc™ Plus solution was added.50 µL of QUANTI-Luc™ Plus / QLC solution per well was then added. Luminescence was measured on a Platereader (e.g., Spectramax I3X (Molecular Devices GF3637001)). Luciferase reporter activity was then measured. EC50 values were calculated by using standard methods known in the art. Table BA shows the activity of compounds in STING reporter assay: <0.008 µM = “++++++”; ≥0.008 and <0.04 µM = “+++++”; ≥0.04 and <0.2 µM = “++++”; ≥0.2 and <1 µM = “+++”; ≥1 and <5 µM = “++”; ≥5 and <100 µM = “+”. Table BA Pharmaron, Pharmaron, 2
[0311] Numbered Clauses
[0312] The compounds, compositions, methods, and other subject matter described herein are further described in the following numbered clauses:
[0313] 1. A compound of Formula (I):
[0314] Formula (I) or a pharmaceutically acceptable salt thereof, wherein:
[0315] R4and R=taken together with the nitrogen atom to which each is attached forms a saturated or partially unsaturated ring of 4-12 ring atoms, wherein 0-2 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring is optionally further substituted with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb; m is 0, 1, 2, or 3; each occurrence of R6is independently selected from the group consisting of: Rc, Rb, and -Lb-Rb;
[0316] R3is selected from the group consisting of: H and Rd;
[0317] Y1is selected from the group consisting of: CRlaand N;
[0318] Y2is selected from the group consisting of: CRlband N;
[0319] Y3is selected from the group consisting of: CRlcand N;
[0320] X1is selected from the group consisting of: CRld, N, N(R2), O, and S;
[0321] X2is selected from the group consisting of: CRle, N, N(R2), O, and S;
[0322] X3is selected from the group consisting of: CRlf, N, N(R2), O, and S, provided that 1-3 of X1, X2, and X3is independently selected from the group consisting of: N, N(R2), O, and S; each is independently a single bond or a double bond, provided that the five membered ring comprising X1, X2, and X3is aromatic; and the six membered ring comprising Y1, Y2, and Y3is aromatic; each of R1a, R1b, and R1cis independently selected from the group consisting of: H, -(Lb)b-Rb, Rb, and Rc; each of R1d, R1e, and R1fis independently selected from the group consisting of: H, -Lb-Rb, Rb, and Rc; each occurrence of R2is independently selected from the group consisting of: H, Rd, -(Lb)b-Rb, and Rb; each occurrence of Rais independently selected from the group consisting of: – OH; -halo; –NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1-4 alkyl); -C(=O)OH; -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); and cyano; each occurrence of Rbis independently selected from the group consisting of: • C3-10 cycloalkyl or C3-10 cycloalkenyl, each of which is optionally substituted with 1-4 Rc; • heterocyclyl or heterocycloalkenyl of 3-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl or heterocycloalkenyl is optionally substituted with 1-4 Rc; • heteroaryl of 5-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; and • C6-10aryl optionally substituted with 1-4 Rc; each occurrence of Lbis independently selected from the group consisting of: -O-, -NH-, -NRd, -S(O)0-2, C(O), alkylene, and Lb1-C1-3 alkylene optionally substituted with 1- 3 Ra; wherein Lb1is -O-, -NH-, -NRd, or -S(O)0-2, each occurrence of Rcis independently selected from the group consisting of: halo; cyano; C1-10 alkyl which is optionally substituted with 1-6 independently selected Ra; C2-6 alkenyl; C2-6 alkynyl; C1-4 alkoxy optionally substituted with –OH, NR’R”, C1-4 alkoxy, or C1-4 haloalkoxy; C1-4 haloalkoxy; -S(O)1-2(C1-4 alkyl); -S(O)(=NH)(C1-4 alkyl); -NReRf; – OH; -S(O)1-2NR’R’’; -C1-4 thioalkoxy; -C1-4 thiohaloalkoxy; -NO2; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)NR’R’’; and –SF5; each occurrence of Rdis independently selected from the group consisting of: C1-6 alkyl optionally substituted with 1-3 independently selected Ra; -C(O)(C1-4 alkyl); - C(O)O(C1-4 alkyl); -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; each occurrence of Reand Rfis independently selected from the group consisting of: H; C1-6 alkyl optionally substituted with 1-3 substituents each independently selected from the group consisting of NR’R’’, -OH, halo, C1-4 alkoxy, and C1-4 haloalkoxy; - C(O)R’’’; -C(O)OR’’’; -CONR’R’’; -C(=O)C(=O)R’’’; -S(O)1-2NR’R’’; -S(O)1-2R’’’; - OH; C1-4 alkoxy; and phenyl optionally substituted with from 1-6 Rc; each occurrence of R’ and R’’ is independently selected from the group consisting of: H; -OH; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; and R’’’ is selected from the group consisting of H; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; provided that: (iv) when the compound is a compound having formula , wherein Rd2is H or (v) when the ring containing X1-X3and Y1-Y3is unsubstituted indolyl or 4- chloro-indolyl, m is 1, R6is CN and is ortho to the pyridyl N, then NR4R5cannot form (i) a piperidinyl ring that is substituted at the 4-position with OMe, F2, CF3, OPh, benzyl, p- F-benzyl, and Me2; (ii) piperazinyl ring that is substituted at the 4-position with iso-butyl, CH2CF3, and Me; or (iii) an N-linked morpholine ring; and (vi) the compound is other than: or . 2. The compound of clause 1, wherein the compound is a compound of Formula (I-a): or a pharmaceutically acceptable salt thereof. 3. The compound of clause 1 or 2, wherein the compound is a compound of Formula (I-a1), Formula (I-a2), Formula (I-a3), or Formula (I-a4):
[0323] or a pharmaceutically acceptable salt thereof.
[0324] 4. The compound of any one of clauses 1-3, wherein m is 1 or 2.
[0325] 5. The compound of any one of clauses 1-4, wherein m is 1.
[0326] 6. The compound of any one of clauses 1-3, wherein the compound is a compound of Formula (I-al-a), Formula (I-a2-a), or Formula (I-a3-a): or a pharmaceutically acceptable salt thereof, wherein ml is 0 or 1. 7. The compound of any one of clauses 1-3, wherein the compound is a compound of Formula (I-al-ab), Formula (I-a2-ab), or Formula (I-a3-ab):
[0327] (Formula l-a3-ab) or a pharmaceutically acceptable salt thereof, wherein ml is 0 or 1.
[0328] 8. The compound of clause 6 or 7, wherein ml is 0.
[0329] 9. The compound of clause 6 or 7, wherein the compound is a compound of
[0330] Formula (I-al-ac) or Formula (I-a2-ac):
[0331] 10. The compound of any one of clauses 1-9, wherein Y1is CRla.
[0332] 11. The compound of any one of clauses 1-10, wherein Rlais H.
[0333] 12. The compound of any one of clauses 1-10, wherein Rlais selected from the group consisting of: -Lb-Rb, Rb, and Rc. 13. The compound of any one of clauses 1-10 and 12, wherein Rlais Rc.
[0334] 14. The compound of any one of clauses 1-9 and 12-13, wherein Rlais halo.
[0335] 15. The compound of any one of clauses 1-9 and 12-13, wherein Rlais Cl.
[0336] 16. The compound of any one of clauses 1-15, wherein Y2is CRlb.
[0337] 17. The compound of any one of clauses 1-16, wherein Y2is CH.
[0338] 18. The compound of any one of clauses 1-17, wherein Y3is CRlc.
[0339] 19. The compound of any one of clauses 1-18, wherein Y3is CH.
[0340] 20. The compound of any one of clauses 1-11 and 16-19, wherein Y1is CH; Y2is CH; and Y3is CH.
[0341] 21. The compound of any one of clauses 1-10 and 12-20, wherein Y1is CRla, wherein Rlais Rc; Y2is CH; and Y3is CH.
[0342] 22. The compound of clause 21, wherein Rlais Cl.
[0343] 23. The compound of any one of clauses 1-22, wherein X1is N(R2), optionally wherein X1is N(H); and X2is CRle, optionally wherein X2is CH.
[0344] 24. The compound of any one of clauses 1-23, wherein X3is CRlf, optionally wherein X3is CH or CF.
[0345] 25. The compound of any one of clauses 1-24, wherein the , wherein R2is H, Rlfis H or F; and Rlais H or Cl; optionally wherein R2is H, Rlfis H; and Rlais H.
[0346] 26. The compound of any one of clauses 1-25, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 4-8 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0347] 27. The compound of any one of clauses 1 -26, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 5-7 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 5-7 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0348] 28. The compound of any one of clauses 1 -27, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 6 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0349] 29. The compound of any one of clauses 1-28, wherein R4and R5taken together with the nitrogen atom to which each is attached forms: wherein Z1is selected from the group consisting of: N(RY); -0-; and C(RZ)2, wherein each Rzis independently selected from the group consisting of: H, Rc, Rb, and -Lb-Rb; and RYis H, Rb, or -Lb-Rb; and wherein the ring is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0350] 30. The compound of clause 29, wherein Z1is C(RZ)2. 31. The compound of clause 30, wherein R4and R=taken together with the nitrogen atom to which each is attached forms: — 1— .
[0351] 32. The compound of clause 30 or 31, wherein Rzis Rc, Rb, or -Lb-Rb.
[0352] 33. The compound of any one of clauses 30-32, wherein Rzis -Lb-Rb.
[0353] 34. The compound of clause 33, wherein Lbis O.
[0354] 35. The compound of clause 33 or 34, wherein Rbis Ce-io aryl optionally substituted with 1-4 Rc.
[0355] 36. The compound of any one of clauses 33-35, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0356] 37. The compound of clause 35 or 36, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
[0357] 38. The compound of clause 37, wherein Rbis / ?-CF3-phenyl, / rz-CFi-phenyl, / ?- F-phenyl, j>-Cl-phenyl, m-F-phenyl, zw-Cl-phenyl, or 3,4-difluorophenyl; optionally wherein Rzis -O-( / ?-CF3-phenyl), -O-(m-CF3-phenyl), -O-( / ?-F-phenyl), -O-(m-F- phenyl), -O-( / ?-Cl-phenyl), -O-fm-CI -phenyl), or O-(3,4-difluorophenyl).
[0358] 39. The compound of clause 33 or 34, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl.
[0359] 40. The compound of clause 33, wherein Lbis OCH2 or CH2.
[0360] 41. The compound of clause 40, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc;
[0361] 42. The compound of clause 40 or 41, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
[0362] 43. The compound of any one of clauses 40-42, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc. 44. The compound of clause 40, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0363] 45. The compound of any one of clauses 30-32, wherein Rzis Rc.
[0364] 46. The compound of clause 45, , wherein Rzis Ci-6 alkoxy or Ci-6 haloalkoxy.
[0365] 47. The compound of clause 46, wherein the Ci-6 haloalkoxy is Ci-6 fluoroalkoxy.
[0366] 48. The compound of clause 29, wherein Z1is N(R¥).
[0367] 49. The compound of clause 48, wherein wherein the compound has the formula: , wherein RY1is absent, oxo or Rb.
[0368] 50. The compound of clause 48 or 49, wherein RYis Rb.
[0369] 51. The compound of clause 49 or 50, wherein Rbis Ce-io aryl optionally substituted with 1-4 Rc.
[0370] 52. The compound of any one of clauses 48-51, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0371] 53. The compound of clause 51 or 52, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
[0372] 54. The compound of clause 53, wherein Rbis / J-CFS -phenyl, zw-CFa-phenyl, p- F-phenyl, / >-Cl-phenyl, / w-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl.
[0373] 55. The compound of clause 49 or 50, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1 -4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl. 56. The compound of clause 29, wherein R4and R=taken together with the nitrogen atom to which each is attached forms: wherein each Rzis other than H and independently selected from the group consisting of: OH, Ci-6 alkyl optionally substituted with 1-6 independently selected halo, and Rb..
[0374] 57. The compound of any one of clauses 1 -26, wherein R4and R5taken together
[0375] Rzwith the nitrogen atom to which each is attached forms:
[0376] 58. The compound of clause 57, wherein Rzis Rc, Rb, or -Lb-Rb.
[0377] 59. The compound of any one of clauses 57 or 58, wherein Rzis -Lb-Rb.
[0378] 60. The compound of clause 59, wherein Lbis O.
[0379] 61. The compound of clause 59 or 60, wherein Rbis Ce-io aryl optionally substituted with 1-4 Rc.
[0380] 62. The compound of any one of clauses 59-61, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0381] 63. The compound of clause 61 or 62, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
[0382] 64. The compound of clause 63, wherein Rbis / ?-CF3 -phenyl, / w-CFi-phenyl, p- F -phenyl, / ?-Cl -phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl.
[0383] 65. The compound of clause 59 or 60, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis pyridyl.
[0384] 66. The compound of clause 59, wherein Lbis OCH2 or CH2. 67. The compound of clause 66, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc;
[0385] 68. The compound of clause 66 or 67, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
[0386] 69. The compound of any one of clauses 66-68, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc.
[0387] 70. The compound of clause 66, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0388] 71. The compound of clause 57 or 58, wherein Rzis Rc.
[0389] 72. The compound of clause 71, wherein Rzis C1-6 alkoxy or C1-6 haloalkoxy.
[0390] 73. The compound of clause 72, wherein the C1-6 haloalkoxy is C1-6 fluoroalkoxy.
[0391] 74. The compound of any one of clauses 1-38, wherein each occurrence of R6is an independently selected Rc.
[0392] 75. The compound of any one of clauses 1-74, wherein one occurrence of R6is cyano.
[0393] 76. The compound of any one of clauses 1-75, wherein one occurrence of R6is Ci-10 alkyl which is optionally substituted with 1-6 independently selected Ra.
[0394] 77. The compound of any one of clauses 1-76, wherein one occurrence of R6is unsubstituted C1-6 alkyl.
[0395] 78. The compound of any one of clauses 1-77, wherein one occurrence of R6is unsubstituted C1-3 alkyl.
[0396] 79. The compound of any one of clauses 1-78, wherein R6is CH3.
[0397] 80. The compound of any one of clauses 1-78, wherein one occurrence of R6is CH3, and one occurrence of R6is CN. 81. The compound of any one of clauses 1-79, wherein R3is H.
[0398] 82. A compound of Formula (II):
[0399] Formula (II) or a pharmaceutically acceptable salt thereof, wherein:
[0400] Ring A is selected from the group consisting of:
[0401] • pyridazinyl optionally further substituted with 1-2 independently selected Rc;
[0402] • pyrimidinyl optionally further substituted with 1-2 independently selected Rc;
[0403] • pyrazinyl optionally further substituted with 1-2 independently selected Rc;
[0404] • triazinyl optionally further substituted with 1-2 independently selected Rc; and
[0405] • heteroaryl of 10 ring atoms, wherein 1-4 ring atoms are N optionally further substituted with 1-2 independently selected Rc;
[0406] R4and R5taken together with the nitrogen atom to which each is attached forms a saturated or partially unsaturated ring of 4-12 ring atoms, wherein 0-2 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring is optionally further substituted with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb; m is 0, 1, 2, or 3; each occurrence of R6is independently selected from the group consisting of: Rc, Rb, and -Lb-Rb; R3is selected from the group consisting of: H and Rd;
[0407] Y1is selected from the group consisting of: CRlaand N;
[0408] Y2is selected from the group consisting of: CRlband N;
[0409] Y3is selected from the group consisting of: CRlcand N;
[0410] X1is selected from the group consisting of: CRld, N, N(R2), O, and S;
[0411] X2is selected from the group consisting of: CRle, N, N(R2), O, and S;
[0412] X3is selected from the group consisting of: CRlf, N, N(R2), O, and S, provided that 1-3 of X1, X2, and X3is independently selected from the group consisting of: N, N(R2), O, and S; each == is independently a single bond or a double bond, provided that the five membered ring comprising X1, X2, and X3is aromatic; and the six membered ring comprising Y1, Y2, and Y3is aromatic; each of Rla, Rlb, and Rlcis independently selected from the group consisting of: H, -(Lb)b-Rb, Rb, and Rc; each of Rld, Rle, and Rlfis independently selected from the group consisting of: H, -Lb-Rb, Rb, and Rc; each occurrence of R2is independently selected from the group consisting of: H, Rd, -(Lb)b-Rb, and Rb; each occurrence of Rais independently selected from the group consisting of: - OH; -halo; -NReRf; Ci-4 alkoxy; Ci-4 haloalkoxy; -C(=O)O(Ci-4 alkyl); -C(=O)(Ci-4 alkyl); -C(=O)OH; -CONR’R”; -S(O)i-2NR’R”; -S(O)i-2(Ci-4 alkyl); and cyano; each occurrence of Rbis independently selected from the group consisting of: • C.3-10 cycloalkyl or C3-10 cycloalkenyl, each of which is optionally substituted with 1-4 Rc;
[0413] • heterocyclyl or heterocycloalkenyl of 3-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heterocyclyl or heterocycloalkenyl is optionally substituted with 1-4 Rc;
[0414] • heteroaryl of 5-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; and
[0415] • Ce-io aryl optionally substituted with 1-4 Rc; each occurrence of Lbis independently selected from the group consisting of: -O-, -NH-, -NRd, -S(0)o-2, C(O), alkylene, and Lbl-Ci-3 alkylene optionally substituted with 1- 3 Ra; wherein Lblis -O-, -NH-, -NRd, or -S(0)o-2, each occurrence of Rcis independently selected from the group consisting of: halo; cyano; C1-10 alkyl which is optionally substituted with 1-6 independently selected Ra; C2-6 alkenyl; C2-6 alkynyl; Ci-4 alkoxy optionally substituted with -OH, NR’R”, Ci-4 alkoxy, or C1-4 haloalkoxy; Ci-4 haloalkoxy; -S(O)i-2(Ci-4 alkyl); -S(O)(=NH)(CI-4 alkyl); -NReRf; - OH; -S(O)I-2NR’R”; -C1-4 thioalkoxy; -C1-4 thiohaloalkoxy; -NO2; -C(=0)(Ci-io alkyl); - C(=O)O(Ci-4 alkyl); -C(=O)OH; -C(=O)NR’R”; and -SFs; each occurrence of Rdis independently selected from the group consisting of: C1-6 alkyl optionally substituted with 1-3 independently selected Ra; -C(O)(Ci-4 alkyl); - C(O)O(Ci-4 alkyl); -CONR’R”; -S(O)I-2NR’R”; -S(O)i-2(Ci-4 alkyl); -OH; and Ci-4 alkoxy; each occurrence of Reand Rfis independently selected from the group consisting of: H; C1-6 alkyl optionally substituted with 1-3 substituents each independently selected from the group consisting of NR’R”, -OH, halo, Ci-4 alkoxy, and Ci-4 haloalkoxy; - C(O)R”’; -C(O)OR”’; -CONR’R”; -C(=O)C(=O)R”’; -S(O)I-2NR’R”; -S(O)I-2R’”; - OH; and C1-4 alkoxy; each occurrence of R’ and R” is independently selected from the group consisting of: H; -OH; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, Ci-4 alkoxy, Ci-4 haloalkoxy, and -OH; and
[0416] R’” is selected from the group consisting of H; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and -OH.
[0417] 83. The compound of claim 82, wherein ring A is pyridazinyl optionally further substituted with 1-2 independently selected Rc.
[0418] 84. The compound of claim 82 or 83, wherein ring A has the formula:
[0419] , wherein * represents the point of attachment to the bicycylic ring containing X3-X3and Y^Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc.
[0420] 85. The compound of claim 82, wherein ring A is pyrimidinyl, optionally further substituted with 1-2 independently selected Rc.
[0421] 86. The compound of claim 82 or 85, wherein ring A has the formula: represents the point of attachment to the bicycylic ring containing X^X3and Y^Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with
[0422] 1-2 independently selected Rc.
[0423] 87. The compound of claim 82, wherein ring A is pyrazinyl optionally further substituted with 1-2 independently selected Rc.
[0424] 88. The compound of claim 82 or 87, wherein ring A has the formula:
[0425] , wherein * represents the point of attachment to the bicycylic ring containing X3-X3and Y^Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc.
[0426] 89. The compound of claim 82, wherein ring A is triazinyl optionally further substituted with 1-2 independently selected Rc.
[0427] 90. The compound of claim 82 or 89, wherein ring A has the formula:
[0428] , wherein * represents the point of attachment to the bicycylic ring containing X^X3and YJ-Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc.
[0429] 91. The compound of claim 82, wherein ring A is heteroaryl of 10 ring atoms, wherein 1-4 ring atoms are N optionally further substituted with 1-2 independently selected Rc 92. The compound of claim 82 or 91, wherein ring A has the formula: of attachment to the bicycylic ring containing X’-X3and Y’-Y3, and ** represents the point of attachment to NR4R5; and wherein ring B is aromatic 6-member ring containing 0-2 N atoms; and is optionally further substituted with 1-2 independently selected Rc.
[0430] 93. The compound of any one of clauses 82-92, wherein Y1is CRla.
[0431] 94. The compound of any one of clauses 82-93, wherein Rlais H.
[0432] 95. The compound of any one of clauses 82-92, wherein Rlais selected from the group consisting of -Lb-Rb, Rb, and Rc.
[0433] 96. The compound of any one of clauses 82-92 and 95, wherein Rlais Rc.
[0434] 97. The compound of any one of clauses 82-92 and 95-96, wherein Rlais halo.
[0435] 98. The compound of any one of clauses 82-92 and 96-97, wherein Rlais Cl.
[0436] 99. The compound of any one of clauses 82-98, wherein Y2is CRlb.
[0437] 100. The compound of any one of clauses 82-99, wherein Y2is CH.
[0438] 101. The compound of any one of clauses 82-100, wherein Y3is CRlc.
[0439] 102. The compound of any one of clauses 82-101, wherein Y3is CH.
[0440] 103. The compound of any one of clauses 82-94 and 99-102, wherein Y1is CH; Y2is CH; and Y3is CH.
[0441] 104. The compound of any one of clauses 82-93 and 95-102, wherein Y1is CRla, wherein Rlais Rc; Y2is CH; and Y3is CH. 105. The compound of clause 104, wherein Rlais Cl.
[0442] 106. The compound of any one of clauses 82-105, wherein X1is N(R2), optionally wherein X1is N(H); and X2is CRle, optionally wherein X2is CH.
[0443] 107. The compound of any one of clauses 82-106, wherein X3is CRlf, optionally wherein X3is CH or CF.
[0444] 108. The compound of any one of clauses 82-107, wherein the is H or Cl; optionally wherein R2is H, Rlfis H; and Rlais H.
[0445] 109. The compound of any one of clauses 82-108, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 4-8 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R3) is a ring heteroatom independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0446] 110. The compound of any one of clauses 82-109, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 5-7 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 5-7 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0447] 111. The compound of any one of clauses 82-110, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 6 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R3) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with with 1 -4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0448] 112. The compound of any one of clauses 82-111, wherein R4and R5taken together with the nitrogen atom to which each is attached forms: wherein Z1is selected from the group consisting of: N(RY); -O-; and C(RZ)2, wherein each Rzis independently selected from the group consisting of: H, Rc, Rb, and -Lb-Rb; and RYis H, Rb, or -Lb-Rb; and wherein the ring is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
[0449] 113. The compound of clause 112, wherein Z1is C(RZ)2.
[0450] 114. The compound of clause 113, wherein R4and R5taken together with the nitrogen atom to which each is attached forms:
[0451] 115. The compound of clause 112 or 113, wherein Rzis Rc, Rb, or-Lb-Rb.
[0452] 116. The compound of any one of clauses 113-115, wherein Rzis -Lb-Rb.
[0453] 117. The compound of clause 116, wherein Lbis O.
[0454] 118. The compound of clause 116 or 117, wherein Rbis Ce-io aryl optionally substituted with 1-4 Rc.
[0455] 119. The compound of any one of clauses 116-118, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0456] 120. The compound of clause 118 or 119, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
[0457] 121. The compound of clause 120, wherein Rbis / 2-CF3 -phenyl, m-CF3-phenyl, / 2-F-phenyl, / ?-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl; optionally wherein Rzis -O-( / ?-CF3-phenyl), -O-(w-CF3-phenyl), -O-(p-F-phenyl), -O-( / M-F- phenyl), -O-( / ?-Cl-phenyl), -O-( / w-Cl-phenyl), or O-(3,4-difluorophenyl). 122. The compound of clause 1 16 or 1 17, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl.
[0458] 123. The compound of clause 116, wherein Lbis OCH2 or CH2.
[0459] 124. The compound of clause 123, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc;
[0460] 125. The compound of clause 123 or 124, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
[0461] 126. The compound of any one of clauses 123-125, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc.
[0462] 127. The compound of clause 126, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0463] 128. The compound of any one of clauses 113-115, wherein Rzis Rc.
[0464] 129. The compound of clause 128, wherein Rzis C1-6 alkoxy or C1-6 haloalkoxy.
[0465] 130. The compound of clause 129, wherein the C1-6 haloalkoxy is C1-6 fluoroalkoxy.
[0466] 131. The compound of clause 112, wherein Z1is N(RY).
[0467] 132. The compound of clause 131, wherein wherein the compound has the formula: , wherein R¥1is absent, oxo or Rb.
[0468] 133. The compound of clause 131 or 132, wherein RYis Rb.
[0469] 134. The compound of clause 132 or 133, wherein Rbis Ce-io aryl optionally substituted with 1-4 Rc.
[0470] 135. The compound of any one of clauses 132-134, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0471] 136. The compound of clause 134 or 135, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro. 137. The compound of clause 136, wherein Rbis / ?-CF3-phenyl, w-CFs-phenyl, / 2-F-phenyl, / 2-Cl-phenyl, m-F-phenyl, w-Cl-phenyl, or 3,4-difluorophenyl; optionally wherein Rzis -O-( / ?-CF3-phenyl), -O-(m-CF3-phenyl), -O-(p-F-phenyl), phenyl), -O-( / ?-Cl-phenyl), -O-( / w-Cl-phenyl), or O-(3,4-difluorophenyl).
[0472] 138. The compound of clause 132 or 133, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl.
[0473] 139. The compound of clause 112, wherein R4and R5taken together with the nitrogen atom to which each is attached forms: wherein each Rzis other than H and independently selected from the group consisting of OH, Ci-6 alkyl optionally substituted with 1-6 independently selected halo, and Rb..
[0474] 140. The compound of any one of clauses 82-109, wherein R4and R5taken
[0475] Rztogether with the nitrogen atom to which each is attached forms:
[0476] 141. The compound of clause 140, wherein Rzis Rc, Rb, or -Lb-Rb.
[0477] 142. The compound of any one of clauses 140 or 141, wherein Rzis -Lb-Rb.
[0478] 143. The compound of clause 142, wherein Lbis O
[0479] 144. The compound of clause 142 or 143, wherein Rbis Ce-io aryl optionally substituted with 1-4 Rc.
[0480] 145. The compound of any one of clauses 142-144, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0481] 146. The compound of clause 144 or 145, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro. 147. The compound of clause 63, wherein Rbis y?-CF3-phenyl, / M-CFa-phenyl, / ?- F-phenyl, / ?-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl; optionally wherein Rzis -O-( / ?-CF3-phenyl), -O-(m-CF3-phenyl), -O-(p-F-phenyl), phenyl), -O-( / ?-Cl-phenyl), -O-( / w-Cl-phenyl), or O-(3,4-difluorophenyl).
[0482] 148. The compound of clause 59 or 60, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis pyridyl.
[0483] 149. The compound of clause 142, wherein Lbis OCH2 or CH2.
[0484] 150. The compound of clause 149, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc;
[0485] 151. The compound of clause 149 or 150, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
[0486] 152. The compound of any one of clauses 149-151, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc.
[0487] 153. The compound of clause 149, wherein Rbis phenyl optionally substituted with 1-4 Rc.
[0488] 154. The compound of clause 140 or 141, wherein Rzis Rc.
[0489] 155. The compound of clause 154, wherein Rzis C1-6 alkoxy or C1-6 haloalkoxy.
[0490] 156. The compound of clause 155, wherein the C1-6 haloalkoxy is C1-6 fluoroalkoxy.
[0491] 157. The compound of any one of clauses 82-156, wherein each occurrence of R6is an independently selected Rc.
[0492] 158. The compound of any one of clauses 82-157, wherein one occurrence of R6is cyano.
[0493] 159. The compound of any one of clauses 82-157, wherein one occurrence of R6is Ci-10 alkyl which is optionally substituted with 1-6 independently selected Ra. 160. The compound of any one of clauses 82-157 and 159, wherein one occurrence of R6is unsubstituted Ci-6 alkyl.
[0494] 161. The compound of any one of clauses 82-157 and 159-160, wherein one occurrence of R6is unsubstituted C1-3 alkyl.
[0495] 162. The compound of any one of clauses 82-157 and 159-161, wherein R6is CH3.
[0496] 163. The compound of any one of clauses 82-162, wherein one occurrence of R6is CH3, and one occurrence of R6is CN.
[0497] 164. The compound of any one of clauses 82-163, wherein R3is H.
[0498] 165. The compound of clause 1, wherein the compound is selected from the group consisting of the compounds delineated in Table Cl, or a pharmaceutically acceptable salt thereof.
[0499] 166. A pharmaceutical composition comprising a compound of clauses 1-165 and one or more pharmaceutically acceptable excipients.
[0500] 167. A method for inhibiting STING activity, the method comprising contacting STING with a compound or a pharmaceutically acceptable salt thereof as defined in any one of clauses 1-115; or a pharmaceutical composition as defined in clause 166.
[0501] 168. The method of clause 167, wherein the inhibiting comprises antagonizing STING.
[0502] 169. The method of any one of clauses 167-168, which is carried out in vitro.
[0503] 170. The method of clause 169, wherein the method comprises contacting a sample comprising one or more cells comprising STING with the compound.
[0504] 171. The method of clause 169 or 170, wherein the one or more cells are one or more cancer cells. 172. The method of clause 170 or 171 wherein the sample further comprises one or more cancer cells, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
[0505] 173. The method of clause 171 or 172, which is carried out in vivo.
[0506] 174. The method of clause 173, wherein the method comprises administering the compound to a subject having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease.
[0507] 175. The method of clause 174, wherein the subject is a human.
[0508] 176. The method of clause 174, wherein the disease is cancer.
[0509] 177. The method of clause 176, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
[0510] 178. The method of clause 126 or 127, wherein the cancer is a refractory cancer.
[0511] 179. The method of clause 174, wherein the compound is administered in combination with one or more additional cancer therapies. 180. The method of clause 179, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
[0512] 181. The method of clause 180, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
[0513] 182. The method of clause 181, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD- 1 -PD-L2, interleukin-2 (IL-2), indol eamine 2,3-dioxygenase (IDO), IL - 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidyl serine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- 1BB-4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1 A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM
[0514] - LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48
[0515] - CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidyl serine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
[0516] 183. The method of any one of clauses 174-182, wherein the compound is administered intratumorally.
[0517] 184. A method of treating cancer, comprising administering to a subject in need of such treatment an effective amount of a compound as defined in any one of clauses 1 - 165, or a pharmaceutical composition as defined in clause 166.
[0518] 185. The method of clause 184, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
[0519] 186. The method of clause 184 or 185, wherein the cancer is a refractory cancer.
[0520] 187. The method of clause 184, wherein the compound is administered in combination with one or more additional cancer therapies. 188. The method of clause 187, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
[0521] 189. The method of clause 188, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
[0522] 190. The method of clause 189, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1 , PD-L1 , PD-1 - PD-L1 , PD- 1 - PD-L2, interleukin-2 (IL 2), indoleamine 2,3-dioxygenase (IDO), IL- 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidylserine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- 1BB-4- IBB ligand, 0X40-0X40 ligand, G1TR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1 A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM
[0523] - LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48
[0524] - CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidyl serine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
[0525] 191. The method of any one of clauses 174-190, wherein the compound is administered intratumorally.
[0526] 192. A method of inducing an immune response in a subject in need thereof, the method comprising administering to the subject an effective amount of a compound as defined in any one of clauses 1-165, or a pharmaceutical composition as defined in clause 166.
[0527] 193. The method of clause 192, wherein the subject has cancer.
[0528] 194. The method of clause 193, wherein the subject has undergone and / or is undergoing and / or will undergo one or more cancer therapies.
[0529] 195. The method of clause 193, wherein the cancer selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma. 196. The method of clause any one of clauses 193-195, wherein the cancer is a refractory cancer.
[0530] 197. The method of clause 192, wherein the immune response is an innate immune response.
[0531] 198. The method of clause 197, wherein the at least one or more cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
[0532] 199. The method of clause 198, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
[0533] 200. The method of clause 199, wherein the one or more additional chemotherapeutic agents is selected from alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1 , PD-L1 , PD-1 - PD-L1 , PD- 1 - PD-L2, interleukin-2 (IL 2), indoleamine 2,3-dioxygenase (IDO), IL- 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidylserine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- 1BB-4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM
[0534] - LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48
[0535] - CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
[0536] 201. A method of treatment of a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease, comprising administering to a subject in need of such treatment an effective amount of a compound as defined in any one of clauses 1-165, or a pharmaceutical composition as defined in clause 166.
[0537] 202. A method of treatment comprising administering to a subject having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease an effective amount of a compound as defined in any one of clauses 1-165, or a pharmaceutical composition as defined in clause 166.
[0538] 203. A method of treatment comprising administering to a subject a compound as defined in any one of clauses 1-165, or a pharmaceutical composition as defined in clause 166, wherein the compound or composition is administered in an amount effective to treat a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease, thereby treating the disease.
[0539] 204. The method of any one of clauses 201-203, wherein the disease is cancer.
[0540] 205. The method of clause 204, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
[0541] 206. The method of clause 204 or 205, wherein the cancer is a refractory cancer.
[0542] 207. The method of any one of clauses 204-206, wherein the compound is administered in combination with one or more additional cancer therapies.
[0543] 208. The method of clause 207, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
[0544] 209. The method of clause 208, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
[0545] 210. The method of clause 209, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD- 1 -PD-L2, interleukin-2 (IL-2), indoleamine 2,3-dioxygenase (IDO), IL- 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidylserine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II LAG3, 4- IBB 4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM
[0546] - LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48
[0547] - CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
[0548] 211. The method of any one of clauses 201-210, wherein the compound is administered intratumorally. 212. A method of treatment of a disease, disorder, or condition associated with STING, comprising administering to a subject in need of such treatment an effective amount of a compound as defined in any one of clauses 1-165, or a pharmaceutical composition as defined in clause 166.
[0549] 213. The method of clause 212, wherein the disease, disorder, or condition is selected from type I interferonopathies, Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, inflammation-associated disorders, and rheumatoid arthritis.
[0550] 214. The method of clause 213, wherein the disease, disorder, or condition is a type I interferonopathy (e.g., STING-associated vasculopathywith onset in infancy (SAVI)).
[0551] 215. The method of clause 214, wherein the type I interferonopathy is STING- associated vasculopathy with onset in infancy (SAVI)).
[0552] 216. The method of clause 213, wherein the disease, disorder, or condition is Aicardi-Goutieres Syndrome (AGS).
[0553] 217. The method of clause 213, wherein the disease, disorder, or condition is a genetic form of lupus.
[0554] 218. The method of clause 213, wherein the disease, disorder, or condition is inflammation-associated disorder.
[0555] 219. The method of clause 218, wherein the inflammation-associated disorder is systemic lupus erythematosus.
[0556] 220. A combination comprising a compounds defined in any one of clauses 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, and one or more therapeutically active agents. 221. A compound defined in any one of clauses 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or a pharmaceutical composition defined in clause 166, for use as a medicament. 222. A compound defined in any one of clauses 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or a pharmaceutical composition defined in clause 166, for use in the treatment of a disease, condition or disorder modulated by STING inhibition.
[0557] 223. A compound defined in any one of clauses 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or the pharmaceutical composition defined in clause
[0558] 166, for use in the treatment of a disease mentioned in any one of clauses 167-219.
[0559] 224. Use of a compound defined in any one of clauses 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or a pharmaceutical composition defined in clause 166, in the manufacture of a medicament for the treatment of a disease mentioned in any one of clauses 167-219.
Claims
WHAT IS CLAIMED IS:
1. A compound of Formula (I):Formula (I) or a pharmaceutically acceptable salt thereof, wherein:R4and R3taken together with the nitrogen atom to which each is attached forms a saturated or partially unsaturated ring of 4-12 ring atoms, wherein 0-2 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring is optionally further substituted with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb; m is 0, 1, 2, or 3; each occurrence of R6is independently selected from the group consisting of: Rc, Rb, and -Lb-Rb;R3is selected from the group consisting of: H and Rd;Y1is selected from the group consisting of: CRlaand N;Y2is selected from the group consisting of: CRlband N;Y3is selected from the group consisting of: CRlcand N;X1is selected from the group consisting of: CRld, N, N(R2), O, and S;X2is selected from the group consisting of: CRle, N, N(R2), O, and S;X3is selected from the group consisting of: CRlf, N, N(R2), O, and S, provided that 1-3 of X1, X2, and X3is independently selected from the group consisting of: N, N(R2), O, and S;each is independently a single bond or a double bond, provided that the five membered ring comprising X1, X2, and X3is aromatic; and the six membered ring comprising Y1, Y2, and Y3is aromatic; each of R1a, R1b, and R1cis independently selected from the group consisting of: H, -(Lb)b-Rb, Rb, and Rc; each of R1d, R1e, and R1fis independently selected from the group consisting of: H, -Lb-Rb, Rb, and Rc; each occurrence of R2is independently selected from the group consisting of: H, Rd, -(Lb)b-Rb, and Rb; each occurrence of Rais independently selected from the group consisting of: – OH; -halo; –NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1-4 alkyl); -C(=O)OH; -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); and cyano; each occurrence of Rbis independently selected from the group consisting of: • C3-10 cycloalkyl or C3-10 cycloalkenyl, each of which is optionally substituted with 1-4 Rc; • heterocyclyl or heterocycloalkenyl of 3-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl or heterocycloalkenyl is optionally substituted with 1-4 Rc; • heteroaryl of 5-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; and • C6-10aryl optionally substituted with 1-4 Rc;each occurrence of Lbis independently selected from the group consisting of: -O-, -NH-, -NRd, -S(O)0-2, C(O), alkylene, and Lb1-C1-3 alkylene optionally substituted with 1- 3 Ra; wherein Lb1is -O-, -NH-, -NRd, or -S(O)0-2, each occurrence of Rcis independently selected from the group consisting of: halo; cyano; C1-10 alkyl which is optionally substituted with 1-6 independently selected Ra; C2-6 alkenyl; C2-6 alkynyl; C1-4 alkoxy optionally substituted with –OH, NR’R”, C1-4 alkoxy, or C1-4 haloalkoxy; C1-4 haloalkoxy; -S(O)1-2(C1-4 alkyl); -S(O)(=NH)(C1-4 alkyl); -NReRf; – OH; -S(O)1-2NR’R’’; -C1-4 thioalkoxy; -C1-4 thiohaloalkoxy; -NO2; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)NR’R’’; and –SF5; each occurrence of Rdis independently selected from the group consisting of: C1-6 alkyl optionally substituted with 1-3 independently selected Ra; -C(O)(C1-4 alkyl); - C(O)O(C1-4 alkyl); -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; each occurrence of Reand Rfis independently selected from the group consisting of: H; C1-6 alkyl optionally substituted with 1-3 substituents each independently selected from the group consisting of NR’R’’, -OH, halo, C1-4 alkoxy, and C1-4 haloalkoxy; - C(O)R’’’; -C(O)OR’’’; -CONR’R’’; -C(=O)C(=O)R’’’; -S(O)1-2NR’R’’; -S(O)1-2R’’’; - OH; C1-4 alkoxy; and phenyl optionally substituted with from 1-6 Rc; each occurrence of R’ and R’’ is independently selected from the group consisting of: H; -OH; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; and R’’’ is selected from the group consisting of H; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; provided that:(i) when the compound is a compound having formula ,(ii) when the ring containing X1-X3and Y1-Y3is unsubstituted indolyl or 4- chloro-indolyl, m is 1, R6is CN and is ortho to the pyridyl N, then NR4R5cannot form (i) a piperidinyl ring that is substituted at the 4-position with OMe, F2, CF3, OPh, benzyl, p- F-benzyl, and Me2; (ii) piperazinyl ring that is substituted at the 4-position with iso-butyl, CH2CF3, and Me; or (iii) an N-linked morpholine ring; and (iii) the compound is other than: or.
2. The compound of claim 1, wherein the compound is a compound of Formula (I-a):or a pharmaceutically acceptable salt thereof.
3. The compound of claim 1 or 2, wherein the compound is a compound of Formula (I-a1), Formula (I-a2), Formula (I-a3), or Formula (I-a4):or a pharmaceutically acceptable salt thereof.
4. The compound of any one of claims 1-3, wherein m is 1 or 2.
5. The compound of any one of claims 1-4, wherein m is 1.
6. The compound of any one of claims 1-3, wherein the compound is a compound of Formula (I-al-a), Formula (I-a2-a), or Formula (I-a3-a):or a pharmaceutically acceptable salt thereof, wherein ml is 0 or 1.
7. The compound of any one of claims 1 -3, wherein the compound is a compound of Formula (I-al-ab), Formula (I-a2-ab), or Formula (I-a3-ab):(Formula l-a3-ab) or a pharmaceutically acceptable salt thereof, wherein ml is 0 or 1.
8. The compound of claim 6 or 7, wherein ml is 0.
9. The compound of claim 6 or 7, wherein the compound is a compound ofFormula (I-al-ac) or Formula (I-a2-ac):
10. The compound of any one of claims 1 -9, wherein Y1is CRla11. The compound of any one of claims 1-10, wherein Rlais H.
12. The compound of any one of claims 1-10, wherein Rlais selected from the group consisting of: -Lb-Rb, Rb, and Rc.
13. The compound of any one of claims 1 -10 and 12, wherein Rlais Rc.
14. The compound of any one of claims 1-9 and 12-13, wherein Rlais halo.
15. The compound of any one of claims 1-9 and 12-13, wherein Rlais Cl.
16. The compound of any one of claims 1-15, wherein Y2is CRlb.
17. The compound of any one of claims 1-16, wherein Y2is CH.
18. The compound of any one of claims 1-17, wherein Y3is CRlc.
19. The compound of any one of claims 1-18, wherein Y3is CH.
20. The compound of any one of claims 1-11 and 16-19, wherein Y1is CH; Y2is CH; and Y3is CH.
21. The compound of any one of claims 1-10 and 12-20, wherein Y1is CRla, wherein Rlais Rc; Y2is CH; and Y3is CH.
22. The compound of claim 21, wherein Rlais Cl.
23. The compound of any one of claims 1-22, wherein X1is N(R2), optionally wherein X1is N(H); and X2is CRle, optionally wherein X2is CH.
24. The compound of any one of claims 1-23, wherein X3is CRlf, optionally wherein X3is CH or CF.
25. The compound of any one of claims 1-24, wherein theis H or Cl; optionally wherein R2is H, Rlfis H; and Rlais H.
26. The compound of any one of claims 1 -25, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 4-8 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
27. The compound of any one of claims 1-26, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 5-7 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 5-7 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
28. The compound of any one of claims 1 -27, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 6 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
29. The compound of any one of claims 1 -28, wherein R4and R5taken together with the nitrogen atom to which each is attached forms:wherein Z1is selected from the group consisting of: N(Ry); -0-; and C(RZ)2, wherein each Rzis independently selected from the group consisting of: H, Rc, Rb, and -Lb-Rb; and Ryis H, Rb, or -Lb-Rb; and wherein the ring is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
30. The compound of claim 29, wherein Z1is C(RZ)2.
31. The compound of claim 30, wherein R4and R5taken together with the nitrogen atom to which each is attached forms:.
32. The compound of claim 30 or 31, wherein Rzis Rc, Rb, or -Lb-Rb.
33. The compound of any one of claims 30-32, wherein Rzis -Lb-Rb.
34. The compound of claim 33, wherein Lbis O.
35. The compound of claim 33 or 34, wherein Rbis Ce-io aryl optionally substituted with 1-4 Rc.
36. The compound of any one of claims 33-35, wherein Rbis phenyl optionally substituted with 1-4 Rc.
37. The compound of claim 35 or 36, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
38. The compound of claim 37, wherein Rbis j>-CF3-phenyl, wz-CFi-phenyl, / ?- F-phenyl, j>-Cl-phenyl, m-F-phenyl, zw-Cl-phenyl, or 3,4-difluorophenyl; optionally wherein Rzis -O-( / ?-CF3-phenyl), -O-(m-CF3-phenyl), -O-( / ?-F-phenyl), -O-(m-F- phenyl), -O-( / ?-Cl-phenyl), -O-f / w-CI -phenyl), or O-(3,4-difluorophenyl).
39. The compound of claim 33 or 34, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(0)o-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl.
40. The compound of claim 33, wherein Lbis OCH2 or CH2.
41. The compound of claim 40, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc.
42. The compound of claim 40 or 41, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
43. The compound of any one of claims 40-42, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc.
44. The compound of claim 40, wherein Rbis phenyl optionally substituted with 1-4 Rc.
45. The compound of any one of claims 30-32, wherein RZis Rc.
46. The compound of claim 45, , wherein RZis C1-6 alkoxy or C1-6 haloalkoxy.
47. The compound of claim 46, wherein the C1-6 haloalkoxy is C1-6 fluoroalkoxy.
48. The compound of claim 29, wherein Z1is N(RY).
49. The compound of claim 48, wherein wherein the compound has the formula: , wherein RY1is absent, oxo or Rb.
50. The compound of claim 48 or 49, wherein RYis Rb.
51. The compound of claim 49 or 50, wherein Rbis C6-10 aryl optionally substituted with 1-4 Rc.
52. The compound of any one of claims 48-51, wherein Rbis phenyl optionally substituted with 1-4 Rc.
53. The compound of claim 51 or 52, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
54. The compound of claim 53, wherein Rbis p-CF3-phenyl, m-CF3-phenyl, p- F-phenyl, p-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl.
55. The compound of claim 49 or 50, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl.
56. The compound of claim 29, wherein R4and R5taken together with the nitrogen atom to which each is attached forms , wherein each RZis other than H and independently selected from the groupsting of: OH, C1-6 alkyl optionally substituted with 1-6 independently selected halo, and Rb..
57. The compound of any one of claims 1-26, wherein R4and R5taken together with the nitrogen atom to which each is attached forms: .
58. The compound of claim 57, wherein RZis Rc, Rb, or –Lb-Rb.
59. The compound of any one of claims 57 or 58, wherein RZis –Lb-Rb.
60. The compound of claim 59, wherein Lbis O.
61. The compound of claim 59 or 60, wherein Rbis C6-10 aryl optionally substituted with 1-4 Rc.
62. The compound of any one of claims 59-61, wherein Rbis phenyl optionally substituted with 1-4 Rc.
63. The compound of claim 61 or 62, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
64. The compound of claim 63, wherein Rbis p-CF3-phenyl, m-CF3-phenyl, p- F-phenyl, p-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl.
65. The compound of claim 59 or 60, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis pyridyl.
66. The compound of claim 59, wherein Lbis OCH2 or CH2.
67. The compound of claim 66, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc.
68. The compound of claim 66 or 67, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
69. The compound of any one of claims 66-68, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc.
70. The compound of claim 66, wherein Rbis phenyl optionally substituted with 1-4 Rc.
71. The compound of claim 57 or 58, wherein RZis Rc.
72. The compound of claim 71, wherein RZis C1-6 alkoxy or C1-6 haloalkoxy.
73. The compound of claim 72, wherein the Ci-6 haloalkoxy is Ci-6 fluoroalkoxy.
74. The compound of any one of claims 1-38, wherein each occurrence of R6is an independently selected Rc.
75. The compound of any one of claims 1-74, wherein one occurrence of R6is cyano.
76. The compound of any one of claims 1-75, wherein one occurrence of R6isCi-io alkyl which is optionally substituted with 1-6 independently selected Ra.
77. The compound of any one of claims 1-76, wherein one occurrence of R6is unsubstituted Ci-6 alkyl.
78. The compound of any one of claims 1-77, wherein one occurrence of R6is unsubstituted Ci-3 alkyl.
79. The compound of any one of claims 1-78, wherein R6is CH3.
80. The compound of any one of claims 1-78, wherein one occurrence of R6is CH3, and one occurrence of R6is CN.
81. The compound of any one of claims 1-79, wherein R3is H.
82. A compound of Formula (II):Formula (II) or a pharmaceutically acceptable salt thereof, wherein:Ring A is selected from the group consisting of:• pyridazinyl optionally further substituted with 1-2 independently selected Rc;• pyrimidinyl optionally further substituted with 1-2 independently selected Rc;• pyrazinyl optionally further substituted with 1-2 independently selected Rc;• triazinyl optionally further substituted with 1-2 independently selected Rc; and• heteroaryl of 10 ring atoms, wherein 1-4 ring atoms are N optionally further substituted with 1-2 independently selected Rc;R4and R5taken together with the nitrogen atom to which each is attached forms a saturated or partially unsaturated ring of 4-12 ring atoms, wherein 0-2 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring is optionally further substituted with 1 -4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb; m is 0, 1, 2, or 3; each occurrence of R6is independently selected from the group consisting of: Rc, Rb, and -Lb-Rb;R3is selected from the group consisting of: H and Rd;Y1is selected from the group consisting of: CRlaand N;Y2is selected from the group consisting of: CRlband N;Y3is selected from the group consisting of: CRlcand N;X1is selected from the group consisting of: CRld, N, N(R2), O, and S;X2is selected from the group consisting of: CRle, N, N(R2), O, and S;X3is selected from the group consisting of: CRlf, N, N(R2), O, and S,provided that 1-3 of X1, X2, and X3is independently selected from the group consisting of: N, N(R2), O, and S; each is independently a single bond or a double bond, provided that the five membered ring comprising X1, X2, and X3is aromatic; and the six membered ring comprising Y1, Y2, and Y3is aromatic; each of R1a, R1b, and R1cis independently selected from the group consisting of: H, -(Lb)b-Rb, Rb, and Rc; each of R1d, R1e, and R1fis independently selected from the group consisting of: H, -Lb-Rb, Rb, and Rc; each occurrence of R2is independently selected from the group consisting of: H, Rd, -(Lb)b-Rb, and Rb; each occurrence of Rais independently selected from the group consisting of: – OH; -halo; –NReRf; C1-4 alkoxy; C1-4 haloalkoxy; -C(=O)O(C1-4 alkyl); -C(=O)(C1-4 alkyl); -C(=O)OH; -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); and cyano; each occurrence of Rbis independently selected from the group consisting of: • C3-10 cycloalkyl or C3-10 cycloalkenyl, each of which is optionally substituted with 1-4 Rc; • heterocyclyl or heterocycloalkenyl of 3-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heterocyclyl or heterocycloalkenyl is optionally substituted with 1-4 Rc; • heteroaryl of 5-10 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; and • C6-10 aryl optionally substituted with 1-4 Rc;each occurrence of Lbis independently selected from the group consisting of: -O-, -NH-, -NRd, -S(O)0-2, C(O), alkylene, and Lb1-C1-3 alkylene optionally substituted with 1- 3 Ra; wherein Lb1is -O-, -NH-, -NRd,or -S(O)0-2, each occurrence of Rcis independently selected from the group consisting of: halo; cyano; C1-10 alkyl which is optionally substituted with 1-6 independently selected Ra; C2-6 alkenyl; C2-6 alkynyl; C1-4 alkoxy optionally substituted with –OH, NR’R”, C1-4 alkoxy, or C1-4 haloalkoxy; C1-4 haloalkoxy; -S(O)1-2(C1-4 alkyl); -S(O)(=NH)(C1-4 alkyl); -NReRf; – OH; -S(O)1-2NR’R’’; -C1-4 thioalkoxy; -C1-4 thiohaloalkoxy; -NO2; -C(=O)(C1-10 alkyl); - C(=O)O(C1-4 alkyl); -C(=O)OH; -C(=O)NR’R’’; and –SF5; each occurrence of Rdis independently selected from the group consisting of: C1-6 alkyl optionally substituted with 1-3 independently selected Ra; -C(O)(C1-4 alkyl); - C(O)O(C1-4 alkyl); -CONR’R’’; -S(O)1-2NR’R’’; -S(O)1-2(C1-4 alkyl); -OH; and C1-4 alkoxy; each occurrence of Reand Rfis independently selected from the group consisting of: H; C1-6 alkyl optionally substituted with 1-3 substituents each independently selected from the group consisting of NR’R’’, -OH, halo, C1-4alkoxy, and C1-4haloalkoxy; - C(O)R’’’; -C(O)OR’’’; -CONR’R’’; -C(=O)C(=O)R’’’; -S(O)1-2NR’R’’; -S(O)1-2R’’’; - OH; and C1-4 alkoxy; each occurrence of R’ and R’’ is independently selected from the group consisting of: H; -OH; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4 alkoxy, C1-4 haloalkoxy, and –OH; and R’’’ is selected from the group consisting of H; and C1-4 alkyl which is optionally substituted with 1-3 substituents each independently selected from the group consisting of: halo, cyano, C1-4alkoxy, C1-4haloalkoxy, and –OH.
83. The compound of claim 82, wherein ring A is pyridazinyl optionally further substituted with 1-2 independently selected Rc.
84. The compound of claim 82 or 83, wherein ring A has the formula:5, wherein * represents the point of attachment tod Y1-Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc.
85. The compound of claim 82, wherein ring A is pyrimidinyl, optionally further substituted with 1-2 independently selected Rc.
86. The compound of claim 82 or 85, wherein ring A has the formula: n *and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc.
87. The compound of claim 82, wherein ring A is pyrazinyl optionally further substituted with 1-2 independently selected Rc.
88. The compound of claim 82 or 87, wherein ring A has the formula:, wherein * represents the point of attachment to the bicycylic ring containing XJ-X3and YJ-Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc.
89. The compound of claim 82, wherein ring A is triazinyl optionally further substituted with 1-2 independently selected Rc.
90. The compound of claim 82 or 89, wherein ring A has the formula:, wherein * represents the point of attachment to the bicycylic ring containing X^X3and Yx-Y3, and ** represents the point of attachment to NR4R5; and is optionally further substituted with 1-2 independently selected Rc.
91. The compound of claim 82, wherein ring A is heteroaryl of 10 ring atoms, wherein 1-4 ring atoms are N optionally further substituted with 1-2 independently selected Rc.
92. The compound of claim 82 or 91, wherein ring A has the formula:of attachment to the bicycylic ring containing X’-X3and Y’-Y3, and ** represents the point of attachment to NR4R5; and wherein ring B is aromatic 6-member ring containing 0-2 N atoms; and is optionally further substituted with 1-2 independently selected Rc.
93. The compound of any one of claims 82-92, wherein Y1is CRla.
94. The compound of any one of claims 82-93, wherein Rlais H.
95. The compound of any one of claims 82-92, wherein Rlais selected from the group consisting of: -Lb-Rb, Rb, and Rc.
96. The compound of any one of claims 82-92 and 95, wherein Rlais Rc.
97. The compound of any one of claims 82-92 and 95-96, wherein Rlais halo.
98. The compound of any one of claims 82-92 and 96-97, wherein Rlais Cl.
99. The compound of any one of claims 82-98, wherein Y2is CRlb.
100. The compound of any one of claims 82-99, wherein Y2is CH.
101. The compound of any one of claims 82-100, wherein Y3is CRlc.
102. The compound of any one of claims 82-101, wherein Y3is CH.
103. The compound of any one of claims 82-94 and 99-102, wherein Y1is CH; Y2is CH; and Y3is CH.
104. The compound of any one of claims 82-93 and 95-102, wherein Y1is CRla, wherein Rlais Rc; Y2is CH; and Y3is CH.
105. The compound of claim 104, wherein Rlais Cl.
106. The compound of any one of claims 82-105, wherein X1is N(R2), optionally wherein X1is N(H); and X2is CRle, optionally wherein X2is CH.
107. The compound of any one of claims 82-106, wherein X3is CRlf, optionally wherein X3is CH or CF.
108. The compound of any one of claims 82-107, wherein the, wherein R2is H, Rlfis H or F; and Rlais H or Cl; optionally wherein R2is H, Rlfis H; and Rlais H.
109. The compound of any one of claims 82-108, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 4-8 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
110. The compound of any one of claims 82-109, wherein R4and R=taken together with the nitrogen atom to which each is attached forms a saturated ring of 5-7 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R5) is a ring heteroatom independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 5-7 ring atoms is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
111. The compound of any one of claims 82-110, wherein R4and R5taken together with the nitrogen atom to which each is attached forms a saturated ring of 6 ring atoms, wherein 0-1 ring atoms (in addition to the nitrogen atom attached to R4and R=) is a ring heteroatom each independently selected from the group consisting of: N, N(H), N(Rd), N(Rb), N(Lb-Rb), O, and S(0)o-2, wherein the ring of 4-8 ring atoms is optionally further substituted with with 1-4 substituents independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
112. The compound of any one of claims 82-111, wherein R4and R5taken together with the nitrogen atom to which each is attached forms:wherein Z1is selected from the group consisting of: N(RY); -O-; and C(RZ)2, wherein each Rzis independently selected from the group consisting of: H, Rc, Rb, and -Lb-Rb; and RYis H, Rb, or -Lb-Rb; and wherein the ring is optionally further substituted with 1-4 substituents each independently selected from the group consisting of: oxo, Rc, Rb, and -Lb-Rb.
113. The compound of claim 112, wherein Z1is C(RZ)2.
114. The compound of claim 113, wherein R4and R5taken together with theRz0 nitrogen atom to which each is attached forms: — .
115. The compound of claim 112 or 113, wherein Rzis Rc, Rb, or -Lb-Rb.
116. The compound of any one of claims 113-115, wherein Rzis -Lb-Rb.
117. The compound of claim 116, wherein Lbis O.
118. The compound of claim 116 or 117, wherein Rbis C6-10 aryl optionally substituted with 1-4 Rc.
119. The compound of any one of claims 116-118, wherein Rbis phenyl optionally substituted with 1-4 Rc.
120. The compound of claim 118 or 119, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
121. The compound of claim 120, wherein Rbis p-CF3-phenyl, m-CF3-phenyl, p-F-phenyl, p-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl; optionally wherein RZis –O-(p-CF3-phenyl), –O-(m-CF3-phenyl), –O-(p-F-phenyl), –O-(m-F- phenyl), –O-(p-Cl-phenyl), –O-(m-Cl-phenyl), or O-(3,4-difluorophenyl).
122. The compound of claim 116 or 117, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl.
123. The compound of claim 116, wherein Lbis OCH2 or CH2.
124. The compound of claim 123, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc; 125. The compound of claim 123 or 124, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
126. The compound of any one of claims 123-125, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc.
127. The compound of claim 126, wherein Rbis phenyl optionally substituted with 1-4 Rc.
128. The compound of any one of claims 113-115, wherein RZis Rc.
129. The compound of claim 128, wherein RZis C1-6 alkoxy or C1-6 haloalkoxy.
130. The compound of claim 129, wherein the C1-6 haloalkoxy is C1-6 fluoroalkoxy.
131. The compound of claim 112, wherein Z1is N(RY).
132. The compound of claim 131, wherein wherein the compound has the formula: , wherein RY1is absent, oxo or Rb.
133. The compound of claim 131 or 132, wherein RYis Rb.
134. The compound of claim 132 or 133, wherein Rbis C6-10 aryl optionally substituted with 1-4 Rc.
135. The compound of any one of claims 132-134, wherein Rbis phenyl optionally substituted with 1-4 Rc.
136. The compound of claim 134 or 135, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
137. The compound of claim 136, wherein Rbis p-CF3-phenyl, m-CF3-phenyl, p-F-phenyl, p-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl; optionally wherein RZis –O-(p-CF3-phenyl), –O-(m-CF3-phenyl), –O-(p-F-phenyl), –O-(m-F- phenyl), –O-(p-Cl-phenyl), –O-(m-Cl-phenyl), or O-(3,4-difluorophenyl).
138. The compound of claim 132 or 133, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl isoptionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis optionally substituted pyridyl.
139. The compound of claim 112, wherein R4and R5taken together with the nitrogen atom to which each is attached forms , wherein each RZis other than H and independently selected from the groupsting of: OH, C1-6 alkyl optionally substituted with 1-6 independently selected halo, and Rb..
140. The compound of any one of claims 82-109, wherein R4and R5taken together with the nitrogen atom to which each is attached form .
141. The compound of claim 140, wherein RZis Rc, Rb, or –Lb-Rb.
142. The compound of any one of claims 140 or 141, wherein RZis –Lb-Rb.
143. The compound of claim 142, wherein Lbis O.
144. The compound of claim 142 or 143, wherein Rbis C6-10 aryl optionally substituted with 1-4 Rc.
145. The compound of any one of claims 142-144, wherein Rbis phenyl optionally substituted with 1-4 Rc.
146. The compound of claim 144 or 145, wherein each occurrence of Rcis independently selected from CF3, chloro, and fluoro.
147. The compound of claim 63, wherein Rbis p-CF3-phenyl, m-CF3-phenyl, p- F-phenyl, p-Cl-phenyl, m-F-phenyl, m-Cl-phenyl, or 3,4-difluorophenyl; optionallywherein RZis –O-(p-CF3-phenyl), –O-(m-CF3-phenyl), –O-(p-F-phenyl), –O-(m-F- phenyl), –O-(p-Cl-phenyl), –O-(m-Cl-phenyl), or O-(3,4-difluorophenyl).
148. The compound of claim 59 or 60, wherein Rbis heteroaryl of 5-6 ring atoms, wherein 1-3 ring atoms are heteroatoms, each independently selected from the group consisting of N, N(H), N(Rd), O, and S(O)0-2, and wherein the heteroaryl is optionally substituted with 1-4 Rc; optionally wherein Rbis heteroaryl of 6 ring atoms; optionally wherein Rbis pyridyl.
149. The compound of claim 142, wherein Lbis OCH2 or CH2.
150. The compound of claim 149, wherein Rbis C3-10 cycloalkyl, which is optionally substituted with 1-4 Rc.
151. The compound of claim 149 or 150, wherein Rbis C3-6 cycloalkyl, which is optionally substituted with 1-4 Rc.
152. The compound of any one of claims 149-151, wherein Rbis cyclopropyl, which is optionally substituted with 1-2 Rc.
153. The compound of claim 149, wherein Rbis phenyl optionally substituted with 1-4 Rc.
154. The compound of claim 140 or 141, wherein RZis Rc.
155. The compound of claim 154, wherein RZis C1-6alkoxy or C1-6haloalkoxy.
156. The compound of claim 155, wherein the C1-6 haloalkoxy is C1-6 fluoroalkoxy.
157. The compound of any one of claims 82-156, wherein each occurrence of R6is an independently selected Rc.
158. The compound of any one of claims 82-157, wherein one occurrence of R6is cyano.
159. The compound of any one of claims 82-157, wherein one occurrence of R6is Ci-io alkyl which is optionally substituted with 1-6 independently selected Ra.
160. The compound of any one of claims 82-157 and 159, wherein one occurrence of R6is unsubstituted Ci-6 alkyl.
161. The compound of any one of claims 82-157 and 159-160, wherein one occurrence of R6is unsubstituted C1-3 alkyl.
162. The compound of any one of claims 82-157 and 159-161, wherein R6is CH3.
163. The compound of any one of claims 82-162, wherein one occurrence of R6is CH3, and one occurrence of R6is CN.
164. The compound of any one of claims 82-163, wherein R3is H.
165. The compound of claim 1 , wherein the compound is selected from the group consisting of the compounds delineated in Table Cl, or a pharmaceutically acceptable salt thereof.
166. A pharmaceutical composition comprising a compound of claims 1-165 and one or more pharmaceutically acceptable excipients.
167. A method for inhibiting STING activity, the method comprising contacting STING with a compound or a pharmaceutically acceptable salt thereof as defined in any one of claims 1-115; or a pharmaceutical composition as defined in claim 166.
168. The method of claim 167, wherein the inhibiting comprises antagonizing STING.
169. The method of any one of claims 167-168, which is carried out in vitro.
170. The method of claim 169, wherein the method comprises contacting a sample comprising one or more cells comprising STING with the compound.
171. The method of claim 169 or 170, wherein the one or more cells are one or more cancer cells.
172. The method of claim 170 or 171 wherein the sample further comprises one ormore cancer cells, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
173. The method of claim 171 or 172, which is carried out in vivo.
174. The method of claim 173, wherein the method comprises administering the compound to a subject having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease.
175. The method of claim 174, wherein the subject is a human.
176. The method of claim 174, wherein the disease is cancer.
177. The method of claim 176, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasiasyndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
178. The method of claim 126 or 127, wherein the cancer is a refractory cancer.
179. The method of claim 174, wherein the compound is administered in combination with one or more additional cancer therapies.
180. The method of claim 179, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
181. The method of claim 180, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
182. The method of claim 181, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an anti-helminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD- 1 -PD-L2, interleukin-2 (IL-2), indoleamine 2,3-dioxygenase (IDO), IL- 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidylserine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- 1BB-4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM- LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48- CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e g., CTLA-4 or PD1 or PD-L1).
183. The method of any one of claims 174-182, wherein the compound is administered intratumorally.
184. A method of treating cancer, comprising administering to a subject in need of such treatment an effective amount of a compound as defined in any one of claims 1- 165, or a pharmaceutical composition as defined in claim 166.
185. The method of claim 184, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
186. The method of claim 184 or 185, wherein the cancer is a refractory cancer.
187. The method of claim 184, wherein the compound is administered in combination with one or more additional cancer therapies.
188. The method of claim 187, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
189. The method of claim 188, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
190. The method of claim 189, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e.g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD-1 - PD-L2, interleukin-2 (IL-2), indoleamine 2,3-dioxygenase (IDO), IL- 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidyl serine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4 1BB-4 IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM- LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48- CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidyl serine - TIM3, SIRPA CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
191. The method of any one of claims 174-190, wherein the compound is administered intratum orally.
192. A method of inducing an immune response in a subject in need thereof, the method comprising administering to the subject an effective amount of a compound as defined in any one of claims 1-165, or a pharmaceutical composition as defined in claim 166.
193. The method of claim 192, wherein the subject has cancer.
194. The method of claim 193, wherein the subject has undergone and / or is undergoing and / or will undergo one or more cancer therapies.
195. The method of claim 193, wherein the cancer selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors,gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
196. The method of claim any one of claims 193-195, wherein the cancer is a refractory cancer.
197. The method of claim 192, wherein the immune response is an innate immune response.
198. The method of claim 197, wherein the at least one or more cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
199. The method of claim 198, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
200. The method of claim 199, wherein the one or more additional chemotherapeutic agents is selected from alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vinca alkaloid and / or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab,Muromonab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD- 1 -PD-L2, interleukin-2 (IL-2), indoleamine 2,3-dioxygenase (IDO), IL - 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidyl serine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- 1BB-4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40- CD40 ligand, HVEM-LIGHT-LTA, HVEM, HVEM - BTLA, HVEM - CD 160, HVEM- LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48- CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
201. A method of treatment of a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease, comprising administering to a subject in need of such treatment an effective amount of a compound as defined in any one of claims 1-165, or a pharmaceutical composition as defined in claim 166.
202. A method of treatment comprising administering to a subject having a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease an effective amount of a compound as defined in any one of claims 1-165, or a pharmaceutical composition as defined in claim 166.
203. A method of treatment comprising administering to a subject a compound as defined in any one of claims 1-165, or a pharmaceutical composition as defined in claim 166, wherein the compound or composition is administered in an amount effective to treat a disease in which increased (e.g., excessive) STING signaling contributes to the pathology and / or symptoms and / or progression of the disease, thereby treating the disease.
204. The method of any one of claims 201-203, wherein the disease is cancer.
205. The method of claim 204, wherein the cancer is selected from the group consisting of melanoma, cervical cancer, breast cancer, ovarian cancer, prostate cancer, testicular cancer, urothelial carcinoma, bladder cancer, non-small cell lung cancer, small cell lung cancer, sarcoma, colorectal adenocarcinoma, gastrointestinal stromal tumors, gastroesophageal carcinoma, colorectal cancer, pancreatic cancer, kidney cancer, hepatocellular cancer, malignant mesothelioma, leukemia, lymphoma, myelodysplasia syndrome, multiple myeloma, transitional cell carcinoma, neuroblastoma, plasma cell neoplasms, Wilm's tumor, or hepatocellular carcinoma.
206. The method of claim 204 or 205, wherein the cancer is a refractory cancer.
207. The method of any one of claims 204-206, wherein the compound is administered in combination with one or more additional cancer therapies.
208. The method of claim 207, wherein the one or more additional cancer therapies comprises surgery, radiotherapy, chemotherapy, toxin therapy, immunotherapy, cryotherapy or gene therapy, or a combination thereof.
209. The method of claim 208, wherein chemotherapy comprises administering one or more additional chemotherapeutic agents.
210. The method of claim 209, wherein the one or more additional chemotherapeutic agents is selected from an alkylating agent (e.g., cisplatin, carboplatin, mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide and / or oxaliplatin); an anti-metabolite (e.g., azathioprine and / or mercaptopurine); a terpenoid (e.g., a vincaalkaloid and / or a taxane; e.g., Vincristine, Vinblastine, Vinorelbine and / or Vindesine Taxol, Pacllitaxel and / or Docetaxel); a topoisomerase (e g., a type I topoisomerase and / or a type 2 topoisomerase; e.g., camptothecins, such as irinotecan and / or topotecan;. amsacrine, etoposide, etoposide phosphate and / or teniposide); a cytotoxic antibiotic (e.g., actinomycin, anthracyclines, doxorubicin, daunorubicin, valrubicin, idarubicin, epirubicin, bleomycin, plicamycin and / or mitomycin); a hormone (e.g., a lutenizing hormone releasing hormone agonist; e.g., leuprolidine, goserelin, triptorelin, histrelin, bicalutamide, flutamide and / or nilutamide); an antibody (e.g., Abciximab, Adalimumab, Alemtuzumab, Atlizumab, Basiliximab, Belimumab, Bevacizumab, Bretuximab vedotin, Canakinumab, Cetuximab, Ceertolizumab pegol, Daclizumab, Denosumab, Eculizumab, Efalizumab, Gemtuzumab, Golimumab, Golimumab, Ibritumomab tiuxetan, Infliximab, Ipilimumab, Murom onab-CD3, Natalizumab, Ofatumumab, Omalizumab, Palivizumab, Panitumuab, Ranibizumab, Rituximab, Tocilizumab, Tositumomab and / or Trastuzumab); an anti- angiogenic agent; a cytokine; a thrombotic agent; a growth inhibitory agent; an antihelminthic agent; and an immune checkpoint inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1 - PD-L1, PD- 1 -PD-L2, interleukin-2 (IL-2), indoleamine 2, 3 -di oxygenase (IDO), IL- 10, transforming growth factor-P (TGFP), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9 - TIM3, Phosphatidyl serine - TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II - LAG3, 4- 1BB-4- IBB ligand, 0X40-0X40 ligand, GITR, GITR ligand - GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40L, CD40- CD40 ligand, HVEM LIGHT LT A, HVEM, HVEM BTLA, HVEM CD 160, HVEM- LIGHT, HVEM-BTLA-CD160, CD80, CD80 - PDL-1, PDL2 - CD80, CD244, CD48- CD244, CD244, ICOS, ICOS-ICOS ligand, B7 H3, B7 H4, VISTA, TMIGD2, HHLA2-TMIGD2, Butyrophilins, including BTNL2, Siglec family, TIGIT and PVR family members, KIRs, ILTs and LIRs, NKG2D and NKG2A, MICA and MICB, CD244, CD28, CD86 - CD28, CD86 - CTLA, CD80 - CD28, CD39, CD73 Adenosine-CD39- CD73, CXCR4-CXCL12, Phosphatidylserine, TIM3, Phosphatidylserine - TIM3, SIRPA-CD47, VEGF, Neuropilin, CD160, CD30, and CD155 (e.g., CTLA-4 or PD1 or PD-L1).
211. The method of any one of claims 201 -210, wherein the compound is administered intratum orally.
212. A method of treatment of a disease, disorder, or condition associated with STING, comprising administering to a subject in need of such treatment an effective amount of a compound as defined in any one of claims 1-165, or a pharmaceutical composition as defined in claim 166.
213. The method of claim 212, wherein the disease, disorder, or condition is selected from type I interferonopathies, Aicardi-Goutieres Syndrome (AGS), genetic forms of lupus, inflammation-associated disorders, and rheumatoid arthritis.
214. The method of claim 213, wherein the disease, disorder, or condition is a type I interferonopathy (e g., STING-associated vasculopathywith onset in infancy (SAVI)).
215. The method of claim 214, wherein the type I interferonopathy is STING- associated vasculopathy with onset in infancy (SAVI)).
216. The method of claim 213, wherein the disease, disorder, or condition is Aicardi-Goutieres Syndrome (AGS).
217. The method of claim 213, wherein the disease, disorder, or condition is a genetic form of lupus.
218. The method of claim 213, wherein the disease, disorder, or condition is inflammation-associated disorder.
219. The method of claim 218, wherein the inflammation-associated disorder is systemic lupus erythematosus.
220. A combination comprising a compounds defined in any one of claims 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, and one or more therapeutically active agents.
221. A compound defined in any one of claims 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or a pharmaceutical composition defined in claim 166, for use as a medicament.
222. A compound defined in any one of claims 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or a pharmaceutical composition defined in claim 166, for use in the treatment of a disease, condition or disorder modulated by STING inhibition.
223. A compound defined in any one of claims 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or the pharmaceutical composition defined in claim 166, for use in the treatment of a disease mentioned in any one of claims 167-219.
224. Use of a compound defined in any one of claims 1 to 165 or a pharmaceutically acceptable salt or tautomer thereof, or a pharmaceutical composition defined in claim 166, in the manufacture of a medicament for the treatment of a disease mentioned in any one of claims 167-219.
Citation Information
Patent Citations
Therapy of autoimmune colitis using a tip60 inhibitor
US20120202848A1
Image processing apparatus, method for controlling the same, non-transitory computer-readable storage medium, and system
US20210063732A1
Pharmaceutical co-crystal compositions
US7927613B2
Use of sting agonists to treat chronic hepatitis b virus infection
WO2015061294A2
Heteroaryl compounds
WO2006053109A1
Cited By
Monoarylic heterocyclic compounds as sting antagonists and the use thereof as medicament
WO2025228889A1
Monoaryl and hetaryl substituted indazoles and benzimidazoles as sting antagonists and the use thereof as medicament
WO2025228892A1
Hetaryl substituted indazoles and benzimidazoles as sting antagonists and the use thereof as medicament
WO2025228895A1
Further heterocyclic compounds as sting antagonists and the use thereof as medicament
WO2025228899A1
Arylamide substituted indazoles and the use thereof as medicament
WO2025228900A1
