USE OF NON-PEPTIDIC NK1 ANTAGONISTS IN A PREDEFINED DOSE FOR THE TREATMENT OF CANCER

Description

Field of the invention

[0001] The present invention relates to compositions and combined preparations comprising the non-peptide NK1 receptor antagonist Aprepitant, in doses between 5 and 10 mg / kg of weight per day, and Carboplatin, Cisplatin or Oxaliplatin, for use in the treatment of cancer in mammals and, more preferably, in humans.Backgrounds of the invention

[0002] NK1 receptors (neuropeptide receptors of Substance P and tachykinins), are widely distributed in the organism's cells. Their presence has been verified in the central and peripheral nervous system of mammals, in the digestive apparatus, in the circulatory system, in haematopoietic and inflammatory and / or immune response cell lines cells, as well as in soft tissues and especially in vascular endothelium. Numerous biological processes are currently known in which regulation NK1 receptors are involved.

[0003] Substance P (SP), is the preferred agonist of the NK1 receptor, it is an undecapeptide produced naturally in mammals, it belongs to the tachykinin family and its sequence was described by Veber et al. (US 4,680,283). The tachykinin family also includes other peptides such as Neurokinin A, Neurokinin B, Neuropeptide K, Neuropeptide Gamma and Hemokinin I, among others.

[0004] The scientific bibliography has widely referred to the involvement of SP and other tachykinins in the aetiopathogenesis of various diseases of the human nervous system such as Alzheimer's Disease, Multiple Sclerosis, Parkinson's Disease, anxiety and depression (Barker et al., 1996. Neurosci. Res. 7, 187-214; Kramer et al., 1998. Science 11;281(5383),1640-5). The involvement of tachykinins has also been verified in the etiopathogenesis of various diseases such as rheumatoid arthritis, asthma, allergic rhinitis, inflammatory intestinal diseases such as ulcerative colitis and Crohn's disease (Maggi et al., 1993. Journal of Autonomic Pharmacology 13, 23-93).

[0005] In this sense, non-peptide NK1 receptor antagonists have been developed as medicaments for the treatment of various central nervous system disorders such as depression, psychosis and anxiety (WO 95 / 16679, WO 95 / 18124, WO 95 / 23798 and WO 01 / 77100). It has been disclosed that the use of selective NK1 receptor antagonists is useful in the treatment of nauseas and vomiting induced by antineoplastic chemotherapies and in the treatment of certain forms of urinary incontinence (Quartara et al., 1998. Neuropeptides 32(1), 1-49; Doi et al., 1999. Eur. J. Pharmacol. 383(3), 297-303).

[0006] In a work published in 2003 (Giardina et al., 2003. IDrugs 6(8), 758-72.), a review was made of the more recent patents on NK1 receptor antagonists. The molecules of the most important global manufacturers are described with indication of their possible applications, among which we can highlight: anti-depressive, anti-inflammatory, anxiolytic, antiemetic, treatment of ulcerative colitis and others.

[0007] It has been demonstrated that NK1 and SP receptor antagonists may inhibit the proliferation of lung cancer cells (Orosz et al., 1995. Int. J. Cancer 60(1), 82-7, Bunn et al., 1994. Cancer Res. 54(13), 3602-10), brain tumours (Palma et al., 2000. Life Sci. 67(9), 985-1001), APUDOMAS (enterochromaffin cell tumours; patent EP 773026), prostate cancers (patent WO 2001001922), stomach and colon cancers (Rosso et al., 2008. Tumour Biol. 29(4), 245-54), and melanoma (Muñoz et al., 2010. Lab. Invest. 90(8), 1259-69).

[0008] Various studies with specific antagonists of neurokinin NK receptors such as CP-96341-1 (Pfizer), MEN 11467, SR 48968 (Sanofi) and MEN 11420 (Nepadutant) have demonstrated the efficacy thereof in blocking cell proliferation (Singh et al., 2000. Proc. Natl. Acad. Sci. 97(1), 388-93; and Bigioni et al., 2005. Anticancer Drugs 16(10), 1083-9.).

[0009] Patent ES 2246687 claims the use of non-peptide NK1 and SP receptor antagonists in the preparation of a pharmaceutical composition for the production of apoptosis in tumour cells of mammals.

[0010] In the genesis and development of cancer there is not just the intervention of molecular mechanisms typical of tumour cells, but the cells surrounding the tumour have great importance (specifically stroma cells and inflammatory cells), as well as the interactions that take place between the tumour cells and these cells surrounding the tumour (McAllister et al., 2010. J. Clin. Oncol. 28(26),4022-8; Ikushima et al., 2010. Nat. Rev. Cancer 10(6), 415-24). In this sense, it has been published that some substances, e.g. nuclear factor NF-KB (nuclear factor kappa B), SPARC (secreted protein acidic, cysteine-rich), TGF-α and TGFβ (transforming growth factors α and β, respectively) or Metalloproteinase (MMPs), are present in the tumour microenvironment and are of great importance in the genesis and progression of tumours (Coussens et al., 2002. Nature 19-26; 420(6917), 860-7; Berzofsky et al., 2004. J. Clin. Invest. 113,1515-1525; Carmeliet et al., 2000. Nature Sep 14;407(6801), 249-57.; Hanahan et al., 2000. Cell Jan 7;100(1), 57-70).

[0011] It is known that the cells surrounding the tumour (specifically the stroma cells and inflammatory cells) express a large amount of the NK1 receptor and that NK1 receptor antagonists modulate the production of these substances by the cells surrounding the cancerous tumours, preventing the survival and progression of these tumours (patent PCT / ES2012 / 070865).

[0012] Therefore, and in conclusion, nowadays the following facts are known in the state of the art: 1. That NK1 receptors are widely disseminated in the human organism. 2. That tachykinins and, in particular, SP act on the NK1 receptors. 3. That the use of non-peptide NK1 receptor antagonists is possible for the preparation of a medicament for the treatment of various central nervous system disorders such as depression, psychosis and anxiety which have been object of claim in various patent applications (WO 95 / 16679, WO 95 / 18124, WO 95 / 23798 and WO 01 / 77100). 4. That the use of non-peptide NK1 receptor antagonists has demonstrated effects on tumour cells, which results in their cell death by apoptosis (ES 2246687) in in vitro tumour cell cultures. 5. That, as it has been mentioned, patent ES 2 246 687 claims the use of non-peptide NK1 receptor antagonists to induce death and apoptosis in tumour cells (and it lists specifically a number thereof). Therefore, it does not include the effects that non-peptide NK1 receptor antagonists may perform at a level of substances and cells that compose the tumour microenvironment, which are of vital importance for the genesis, development and progression of tumours. 6. The presence of NK1 receptors has been demonstrated in blood cells involved in the inflammatory and / or immune response, in cells of the stromal matrix and in the vascularization cells that surround tumour cells. It is known that stromal cells, blood cells involved in the inflammatory and / or immune response and the vascularization cells, influence the evolution of malignant tumours. 7. It has been demonstrated that NK1 receptor antagonists may prevent the survival and progression of tumours by means of modulating the functioning of the microenvironment cells.

[0013] However, the known precedents, which include the use of non-peptide NK1 receptor antagonists to cause death (apoptosis) in tumour cells and the modification of the peritumoral environment by means of the induction of changes in the cells forming said environment and in the substances secreted by them, with the aim of preventing or hindering the genesis, development or progression of tumours, at present, there is controversy about the effect of the in vivo use of NK1 receptor antagonists for the treatment of cancerous tumour disease (Harford-Wrigth et al., Drug Discovery, 2013, 8, 13-23). In this sense, the data published in vivo are contradictory (Palma C, et al., Br J Cancer 2000; 82: 480-7; Bigioni M, et al. Anticancer Drugs 2005, 16, 1083-9), so that in some cases the use of NK1 receptor antagonists (such as Aprepitant) cause reduction in the tumour size in experimental animal models (in vivo) and in other cases does not produce them. In particular, in a recently published work, the use of Aprepitant at doses of 3 mg per kilogram of weight and day, does not cause a reduction in brain tumour sizes in animal experimentation models in mice (Lewis KM, et al., Anti-Cancer Drugs 2013, 24, 344-354).

[0014] Therefore, the efficacy of Aprepitant as treatment of cancerous tumours in animals (including human beings) is not a "universal" effect but dependent on dose and tumour type.

[0015] Thus, the object of the present invention and the technical advantage it provides, is the use of non-peptide NK1 receptor antagonists for the treatment of cancer, in a predetermined dose range, for the manufacturing of a medicament or pharmaceutical composition, by suitable administration route and at suitable doses, of use in the therapeutic treatment of cancer by direct administration to a mammal, including humans.

[0016] The fact that the invention influences cancer treatment through the use of suitable doses to reduce tumour sizes, prevent their development and, possibly, induce their disappearance, makes it possible to adjust the effective doses of anti-tumour agents both based on chemotherapy and radiotherapy, and the nature of the combinations to be performed therewith. This entails a more effective treatment, with a broader spectrum in treatable tumours, at possibly more adjusted doses, which involves less associated secondary effects and better quality of life for the patients during and after treatment.Summary of the invention

[0017] The present invention is defined in the claims.

[0018] In particular, the present invention provides a composition comprising: (a) Aprepitant, (b) Carboplatin, Cisplatin or Oxaliplatin, and (c) a pharmaceutically acceptable carrier, for use in the treatment of cancer in a mammal, wherein said treatment comprises administration of Aprepitant at a dose between 5 and 10 mg / kg of weight per day.

[0019] The present invention also provides a combined preparation comprising: a) Aprepitant, and b) Carboplatin, Cisplatin or Oxaliplatin, for simultaneous, combined or sequential use in treatment of cancer as defined in a mammal, wherein said treatment comprises administration of Aprepitant at a dose between 5 and 10 mg / kg of weight per day.Description of the figures

[0020] Figure 1. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of human colon adenocarcinoma tumour cells. Figure 2. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of human breast cancer tumour cells. Figure 3. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of human lung cancer tumour cells. Figure 4. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of tumour cells of the sarcomas (human fibrosarcoma). Figure 5. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of human glioma tumour cells. Figure 6. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of lymphoma tumour cells (human B-cell lymphoma). Figure 7. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of human melanoma tumour cells. Figure 8. NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of the embryonal tumour cells (human neuroblastoma). Detailed description of the invention

[0021] The examples of the present invention demonstrate that the non-peptide NK1 receptor antagonist Aprepitant, used in suitable doses, in combination with other anti-tumour drugs Carboplatin, Cisplatin or Oxaliplatin, may inhibit the growth of cancerous tumours.

[0022] There was previously a dispute in terms of the effects of these antagonists, since, for example, in Mayordomo et al.,(2012. Journal of Cellular Physiology, 227(4), 1358-1366) it is indicated that none of the NK1 receptor antagonists used in clinical trials has shown good anti-tumour activity. In Lewis et al., (2013. Anti-Cancer Drugs, 24(4), 344-354), it shows that the use of Aprepitant at doses of 3 mg per kilogram of weight and day, does not produce reduction in the size of brain tumours in animal experimentation models.

[0023] The modifications produced in the microperitumoral environment in mammals, including humans, which are produced by means of treatment with at least one non-peptide NK1 receptor antagonist, in suitable doses, may be summarized in the modification of the immunophenotype of the cells that form said microenvironment, preferably, fibroblasts, inflammatory cells and vascular endothelial cells, preferably related to the synthesis of key molecules in tumour progression, such as, for example, MMPs, NF-KB, TGFβ and SPARC.

[0024] Another of the modifications of said microperitumoral environment, via treatment with non-peptide NK1 antagonists, used at suitable doses, relates to the inhibition of neoangiogenesis by means of inhibition of the proliferation of vascular endothelial cells, a determining factor for tumour progression. Therefore, the use of non-peptide NK1 receptor antagonists gives rise to modification in the cells forming the tumour microenvironment, cells of fibroblastic cell line (stroma), vascular endothelial cells (vessels) and cells involved in the inflammatory and immune response (which promote the growth and perpetuation of the tumours by means of the interaction between the stroma and cancer cells) said modifications being beneficial for cancer treatment. These changes in the tumour microenvironment are aimed at reducing tumour size or its complete elimination, as well as preventing the development and the progression thereof.

[0025] Therefore, for the purposes of the present invention the NK1 receptor antagonist Aprepitant used at a dose between 5 and 10 mg / kg of weight per day, in combination with Carboplatin, Cisplatin or Oxaliplatin, has the capacity of modifying the peritumoral environment, as previously defined. Nevertheless, it is necessary to administer the antagonists at suitable doses, since even, as shown in Reference Example 7 of this specification, at predetermined doses (concentrations of the nanomolar range) the NK1 receptor antagonists, in certain tumour cell lines, induce an increase in proliferation of said cells.

[0026] Therefore, a first aspect of the present invention relates to a composition comprising: (a) Aprepitant, (b) Carboplatin, Cisplatin or Oxaliplatin, and (c) a pharmaceutically acceptable carrier, for use in the treatment of cancer in a mammal, wherein said treatment comprises administration of Aprepitant at a dose between 5 and 10 mg / kg of weight per day.

[0027] As used here "non-peptide NK1 receptor antagonist" means any substance of non-peptide nature with sufficient size and suitable formation to bond to the NK1 receptor and thus inhibit its normal functioning, including the fact of avoiding that the SP or other agonists of these receptors bond to said receptors.

[0028] In a preferred embodiment of this aspect of the invention, the cancer is selected from the list comprising: gastric cancer, colon cancer, pancreatic cancer, breast cancer, ovarian cancer, endometrial cancer, choriocarcinoma, uterine cervical cancer, lung cancer, thyroid cancer, bladder cancer, prostate cancer, glial tumours of the central nervous system, sarcomas, melanomas, embryonal carcinoma and haematological malignancies. In another more preferred embodiment, the cancer presents with alteration of the peritumoral environment. In another more preferred embodiment, the cancer that presents with alteration of the peritumoral environment shows an increased synthesis of the markers selected from the list consisting of: NF-kB, EGF, VEGF, TNF-α, TGF-α, TGF-β 1, TGF-β 2, TGF-β 3, SPARC, MMP-3; MMP-7, MMP-9, MMP-11, MMP-13, MMP-14 and / or combinations thereof.

[0029] In another preferred embodiment, the mammal is human. Even more preferably, the tumour cells treated with the object of the invention overexpress the markers NF-kB, EGF, VEGF, TNF-α, TGF-α, TGF-β 1, TGF-β 2, TGF-β 3, SPARC, MMP-3; MMP-7, MMP-9, MMP-11, MMP-13, MMP-14 and / or any of the combinations thereof.

[0030] A second aspect of the invention relates to a combined preparation comprising: a) Aprepitant, and b) Carboplatin, Cisplatin or Oxaliplatin, for simultaneous, combined or sequential use in treatment of cancer in a mammal, wherein said treatment comprises administration of Aprepitant at a dose between 5 and 10 mg / kg of weight per day.

[0031] In another preferred embodiment of this aspect of the invention, the a) and b) are administered separately, jointly or sequentially, and may additionally be combined with at least one other anti-cancer agent selected from a chemotherapy agent or a radiotherapy agent.

[0032] In another preferred embodiment of this aspect of the invention, the cancer is selected from the list comprising: gastric cancer, colon cancer, pancreatic cancer, breast cancer, ovarian cancer, endometrial cancer, choriocarcinoma, uterine cervical cancer, lung cancer, thyroid cancer, bladder cancer, prostate cancer, glial tumours of the central nervous system, sarcomas, melanomas, embryonal carcinoma and haematological malignancies. In another more preferred embodiment, the cancer presents with alteration of the peritumoral environment. In another more preferred embodiment, the cancer that presents with alteration of the peritumoral environment shows an increased synthesis of the following markers selected from the list comprising: NF-kB, EGF, VEGF, TNF-α, TGF-α, TGF-β 1, TGF-β 2, TGF-β 3, SPARC, MMP-3; MMP-7, MMP-9, MMP-11, MMP-13, MMP-14 and / or combinations thereof.

[0033] In another preferred embodiment, the mammal is human. Even more preferably, the tumour cells treated with the object of the invention overexpress the markers NF-kB, EGF, VEGF, TNF-α, TGF-α, TGF-β 1, TGF-β 2, TGF-β 3, SPARC, MMP-3; MMP-7, MMP-9, MMP-11, MMP-13, MMP-14 and / or any of the combinations thereof.

[0034] It should be understood that the composition (or pharmaceutical composition) or combined preparation is presented in a pharmaceutically acceptable form to be administered to an individual directly, preferably by means of intravenous, oral, parenteral route, or by any other route. Intravenous administration relates directly to the application of the antagonist or of a pharmaceutical composition comprising it, directly in the patient's bloodstream. Oral administration may involve the swallowing, so that the antagonist, as well as a pharmaceutical composition comprising it, enters in the gastrointestinal tract, or buccal or sublingual administration can be used by means of which the compound enters the bloodstream directly from the mouth. Parenteral administration relates to administration routes other than enteric, transdermal or by inhalation and is typically by injection or infusion. Parenteral administration includes injection or intravenous, intramuscular or subcutaneous infusion.

[0035] The term "medicament" or "pharmaceutical composition", as used in this specification, makes reference to any substance used to prevent, diagnose, relieve, treat or cure diseases in humans and animals. In the context of the present invention, the disease is cancer, preferably of epithelial cell line (cancers), glial cell line of the central nervous system, mesenchymal cell line (sarcomas), of melatonic cell line (melanoma), of embryonic origin (e.g. neuroblastoma) or of haemato-lymphoid cell line (lymphomas and leukaemias).

[0036] It should be emphasized that the term "combined preparation" or also called "juxtaposition", in this specification, means that the components of the combined preparation do not need to be present as a bond, e.g. in a composition, to be able to be found available for their separate or sequential application. In this way, the expression "juxtaposed" means that a true combination is not necessary, in light of the physical separation of the components.

[0037] The treatment described in the present invention is useful for patients affected by cancer, in asymptomatic or symptomatic condition, in neoadjuvant therapy (treatment before surgery), in adjuvant therapy (complementary treatment after surgery, where there is no detectable macroscopic tumour) and in treatment of the disease in metastatic stage.

[0038] A person skilled in the art shall adapt the composition depending on the particular administration route. The compositions for parenteral administration preferably include aqueous solutions or sterile non aqueous solutions, suspensions or emulsions, among others.

[0039] The term "pharmaceutically acceptable carrier" relates to a carrier that must be approved by a regulatory agency of the federal government or state government or listed in the United States Pharmacopoeia or the European Pharmacopoeia, or another pharmacopeia generally recognised for its use in animals, and more specifically in humans. Likewise, the suitable pharmaceutically acceptable excipients shall vary depending on the particular dosing form selected. Furthermore, the suitable pharmaceutically acceptable excipients may be selected for a particular function which they may have in the composition. For example, certain pharmaceutically acceptable excipients may be selected for their capacity to facilitate the production of uniform dosing forms. Certain pharmaceutically acceptable excipients may be selected for their capacity to facilitate the production of stable dosing forms. Certain pharmaceutically acceptable excipients may be selected for their capacity to facilitate the transport of the compound or compounds of the invention once administered to the patient from an organ or part of the body to another organ or part of the body. Certain pharmaceutically acceptable excipients may be selected for their capacity to improve acceptance by the patient. The suitable pharmaceutically acceptable excipients include the following types of excipients, without excluding others known in the state of the art: diluents, fillers, binding agents, disintegrants, lubricants, slip agents, granulation agents, coating agents, hydrating agents, solvents, co-solvents, suspension agents, emulsifiers, sweeteners, flavourings, flavour-masking agents, colouring agents, anti-caking agents, wetting agents, chelating agents, agents to increase viscosity, antioxidants, preservatives, stabilizers, surfactants and buffering agents. Persons skilled in the art will appreciate that certain pharmaceutically acceptable excipients may perform more than one function and may perform alternative functions depending on the amount of excipient and on the other ingredients present in the formulation. Specialists have the knowledge and ability in the technique that allows them to select suitable pharmaceutically acceptable excipients in the appropriate amounts for use in the invention. There are also several available resources for persons skilled in the art that describe pharmaceutically acceptable excipients and may be useful in the selection of suitable pharmaceutically acceptable excipients. The examples include Remington's Pharmaceutical Sciences (Mack Publishing Company), The Handbook of Pharmaceutical Additives (Gower Publishing Limited), and The Handbook of Pharmaceutical Excipients (the American Pharmaceutical Association and the Pharmaceutical Press).

[0040] The dosing of the Aprepitant, Carboplatin, Cisplatin and Oxaliplatin shall be selected depending on the desired therapeutic effect, the administration route and treatment duration. The administration does and the frequency shall depend on the size, age and conditions of general health of the individual, bearing in mind the possibility of secondary effects. The administration shall also depend on the simultaneous treatment with other drugs and the tolerance of each individual to the drug administered. Persons skilled in the art can establish the appropriate dose using standard procedures.

[0041] "Cancer" is understood as a malignant tumour of potential unlimited growth which locally expands due to invasion and systemically by metastasis. In the present invention, the compositions and combined preparations are administered to individuals with a cancer.Examples Example 1. Treatment with non-peptide NK1 receptor antagonists at doses between 1 and 10 mg per kilogram of weight and day, in combination with another anti-tumour drug, reduces the size of cancerous tumours of epithelial cell line (cancers) in mammals.

[0042] To verify that the administration of the antagonists not of the NK1 receptors, at doses between 1 and 10 mg per kilogram of weight and day, in combination with other anti-tumour agents, reduces the sizes of epithelial cell line tumours (cancers) in mammals, tumour cells were implanted in mice and were later treated with chemotherapeutic agents, alone and in combination with non-peptide NK1 receptor antagonists.

[0043] Immunocompromised female mice, 5-6 weeks of age were used, in the same conditions as explained in example 1. They were injected with 2 x 10 7< tumour cells, corresponding to an epithelial cell line tumour (human lung cancer; reference HCC-44; supplied by DSMZ) in 200 µl of PBS by subcutaneous route. The tumour size was measured and the mice were evaluated for their state of health and weight daily. The mice were randomized in nine groups when the tumours reached a volume of 75 mm 3< . One of the groups was treated with Cisplatin at 8 mg per kilogram of weight at single doses on days 1 and 7 of the experiment (control group) and the eight remaining groups with the same treatment as the control group and the doses of 1 (group 1), 3 (group 2), 5 (group 3), 6 (group 4), 7 (group 5), 8 (group 6), 9 (group 7) and 10 (group 8) mg per kilogram of weight and day, of the NK1 receptor antagonist Aprepitant. 3 animals were treated per group, during 14 days. All the mice were sacrificed at the end of the experiment. Table 7 shows the tumour size (in cubic millimetres ± standard deviation) after 7 and 14 days of treatment, with each one of the doses used. Table 1. Tumour size of the tumours provoked in an in vivo mouse model. Mean volume of the tumour in the control mice (untreated) or in the mice after treatment with the non-peptide NK1 receptor antagonist (Aprepitant).Human lung cancer cell line, reference HCC-44. 7 days 14 days Control. Cisplatin alone.*105±470±7Group 1. Cisplatin + Aprepitant 1 mg / kg / day*85±655±6Group 2. Cisplatin + Aprepitant 3 mg / kg / day*70±745±7Group 3. Cisplatin + Aprepitant 5 mg / kg / day60±830±4Group 4. Cisplatin + Aprepitant 6 mg / kg / day55±425±6Group 5. Cisplatin + Aprepitant 7 mg / kg / day40±310±3Group 6. Cisplatin + Aprepitant 8 mg / kg / day35±75±2Group 7. Cisplatin + Aprepitant 9 mg / kg / day20±60±0Group 8. Cisplatin + Aprepitant 10 mg / kg / day10±80±0* = for reference Example 2. Treatment with non-peptide NK1 receptor antagonists at doses between 1 and 10 mg per kilogram of weight and day, in combination with another anti-tumour drug, reduces the size of cancerous tumours of glial cell line of the nervous system (gliomas) in mammals.

[0044] To verify that the administration of the antagonists not of the NK1 receptors, at doses between 1 and 10 mg per kilogram of weight and day, in combination with other anti-tumour agents, reduces the sizes of glial cell line tumours (gliomas) of the nervous system in mammals, tumour cells were implanted in mice and were later treated with chemotherapeutic agents, alone and in combination with non-peptide NK1 receptor antagonists.

[0045] Immunocompromised female mice, 5-6 weeks of age were used, in the same conditions as explained in example 1. They were injected with 2 x 10 7< tumour cells, corresponding to a glial cell line tumour of the nervous system (human glioma; reference GAMG; supplied by DSMZ) in 200 µl of PBS by subcutaneous route. The tumour size was measured and the mice were evaluated for their state of health and weight daily. The mice were randomized in nine groups when the tumours reached a volume of 75 mm 3< . One of the groups was treated with two single doses of Cisplatin, of 8 mg per kilogram of weight, on days 1 and 7 of the experiment (control group). The eight remaining groups were treated with the same treatment as the control group and the doses of 1 (group 1), 3 (group 2), 5 (group 3), 6 (group 4), 7 (group 5), 8 (group 6), 9 (group 7) and 10 (group 8) mg per kilogram of weight and day, of the NK1 receptor antagonist Aprepitant. 3 animals were treated per group, during 14 days. All the mice were sacrificed at the end of the experiment. Table 8 shows the tumour size (in cubic millimetres ± standard deviation) after 7 and 14 days of treatment, with each one of the doses used. Table 2. Tumour size of the tumours provoked in an in vivo mouse model. Mean volume of the tumour in the control mice (untreated) or in the mice after treatment with the non peptide NK1 receptor antagonist (Aprepitant).Human glioma cell line, reference GAMG 7 days 14 days Control. Cisplatin alone.*115±785±6Group 1. Cisplatin + Aprepitant 1 mg / kg / day*90±560±5Group 2. Cisplatin + Aprepitant 3 mg / kg / day*80±355±4Group 3. Cisplatin + Aprepitant 5 mg / kg / day65±240±4Group 4. Cisplatin + Aprepitant 6 mg / kg / day60±235±3Group 5. Cisplatin + Aprepitant 7 mg / kg / day45±420±4Group 6. Cisplatin + Aprepitant 8 mg / kg / day30±315±3Group 7. Cisplatin + Aprepitant 9 mg / kg / day25±210±2Group 8. Cisplatin + Aprepitant 10 mg / kg / day5±10±0* = for reference Example 3. Treatment with non-peptide NK1 receptor antagonists at doses between 1 and 10 mg per kilogram of weight and day, in combination with another anti-tumour drug, reduces the size of cancerous tumours of mesenchymal cell line (sarcomas) in mammals.

[0046] To verify that the administration of the antagonists not of the NK1 receptors, at doses between 1 and 10 mg per kilogram of weight and day, in combination with other anti-tumour agents, reduces the sizes of mesenchymal cell line tumours (sarcomas) in mammals, tumour cells were implanted in mice and were later treated with chemotherapeutic agents, alone and in combination with non-peptide NK1 receptor antagonists.

[0047] Immunocompromised female mice, 5-6 weeks of age were used, in the same conditions as explained in example 1. They were injected with 2 x 10 7< tumour cells, corresponding to a mesenchymal cell line tumour (human fibrosarcoma; reference HT-1080; supplied by DSMZ) in 200 µl of PBS by subcutaneous route. The tumour size was measured and the mice were evaluated for their state of health and weight daily. The mice were randomized in nine groups when the tumours reached a volume of 75 mm 3< . One of the groups was treated with two single doses of Cisplatin, of 8 mg per kilogram of weight, on days 1 and 7 of the experiment (control group). The eight remaining groups were treated with the same treatment as the control group and the doses of 1 (group 1), 3 (group 2), 5 (group 3), 6 (group 4), 7 (group 5), 8 (group 6), 9 (group 7) and 10 (group 8) mg per kilogram of weight and day, of the NK1 receptor antagonist Aprepitant. 3 animals were treated per group, during 14 days. All the mice were sacrificed at the end of the experiment. Table 9 shows the tumour size (in cubic millimetres ± standard deviation) after 7 and 14 days of treatment, with each one of the doses used. Table 3. Tumour size of the tumours provoked in an in vivo mouse model. Mean volume of the tumour in the control mice (untreated) or in the mice after treatment with the non-peptide NK1 receptor antagonist (Aprepitant).Human fibrosarcoma cell line, reference HT-1080. 7 days 14 days Control. Cisplatin alone.*95±565±5Group 1. Cisplatin + Aprepitant 1 mg / kg / day*80±650±7Group 2. Cisplatin + Aprepitant 3 mg / kg / day*70±735±4Group 3. Cisplatin + Aprepitant 5 mg / kg / day55±320±3Group 4. Cisplatin + Aprepitant 6 mg / kg / day40±315±4Group 5. Cisplatin + Aprepitant 7 mg / kg / day25±510±5Group 6. Cisplatin + Aprepitant 8 mg / kg / day15±25±2Group 7. Cisplatin + Aprepitant 9 mg / kg / day10±10±0Group 8. Cisplatin + Aprepitant 10 mg / kg / day5±20±0* = for reference Example 4. Treatment with non-peptide NK1 receptor antagonists at doses between 1 and 10 mg per kilogram of weight and day, in combination with another anti-tumour drug, reduces the size of cancerous tumours of melanoma cell line (melanomas) in mammals.

[0048] To verify that the administration of the antagonists not of the NK1 receptors, at doses between 1 and 10 mg per kilogram of weight and day, in combination with other anti-tumour agents, reduces the sizes of melanoma cell line tumours (melanomas) in mammals, tumour cells were implanted in mice and were later treated with chemotherapeutic agents, alone and in combination with non-peptide NK1 receptor antagonists.

[0049] Immunocompromised female mice, 5-6 weeks of age were used, in the same conditions as explained in example 1. They were injected with 2 x 10 7< tumour cells, corresponding to a melanoma cell line tumour (human melanoma; reference MEL-HO; supplied by DSMZ) in 200 µl of PBS by subcutaneous route. The tumour size was measured and the mice were evaluated for their state of health and weight daily. The mice were randomized in nine groups when the tumours reached a volume of 75 mm 3< . One of the groups was treated with two single doses of Cisplatin, of 8 mg per kilogram of weight, on days 1 and 7 of the experiment (control group). The eight remaining groups were treated with the same treatment as the control group and the doses of 1 (group 1), 3 (group 2), 5 (group 3), 6 (group 4), 7 (group 5), 8 (group 6), 9 (group 7) and 10 (group 8) mg per kilogram of weight and day, of the NK1 receptor antagonist Aprepitant. 3 animals were treated per group, during 14 days. All the mice were sacrificed at the end of the experiment. Table 10 shows the tumour size (in cubic millimetres ± standard deviation) after 7 and 14 days of treatment, with each one of the doses used. Table 4. Tumour size of the tumours provoked in an in vivo mouse model. Mean volume of the tumour in the control mice (untreated) or in the mice after treatment with the non-peptide NK1 receptor antagonist (Aprepitant).Human melanoma cell line, reference MEL-HO. 7 days 14 days Control. Cisplatin alone.*105±675±6Group 1. Cisplatin + Aprepitant 1 mg / kg / day*100±755±8Group 2. Cisplatin + Aprepitant 3 mg / kg / day*95±830±8Group 3. Cisplatin + Aprepitant 5 mg / kg / day80±525±6Group 4. Cisplatin + Aprepitant 6 mg / kg / day65±410±7Group 5. Cisplatin + Aprepitant 7 mg / kg / day55±315±4Group 6. Cisplatin + Aprepitant 8 mg / kg / day40±35±3Group 7. Cisplatin + Aprepitant 9 mg / kg / day30±20±0Group 8. Cisplatin + Aprepitant 10 mg / kg / day25±20±0* = for reference Example 5. Treatment with non-peptide NK1 receptor antagonists at doses between 1 and 10 mg per kilogram of weight and day, in combination with another anti-tumour drug, reduces the size of cancerous tumours of embryonic character (e.g. neuroblastoma) in mammals.

[0050] To verify that the administration of the antagonists not of the NK1 receptors, at doses between 1 and 10 mg per kilogram of weight and day, in combination with other anti-tumour agents, reduces the sizes of tumours of embryonic character (e.g. neuroblastoma) in mammals, tumour cells were implanted in mice and were later treated with chemotherapeutic agents, alone and in combination with non-peptide NK1 receptor antagonists.

[0051] Immunocompromised female mice, 5-6 weeks of age were used, in the same conditions as explained in example 1. They were injected with 2 x 10 7< tumour cells, corresponding to an embryonic tumour (human neuroblastoma; reference KELLY; supplied by DSMZ) in 200 µl of PBS by subcutaneous route. The tumour size was measured and the mice were evaluated for their state of health and weight daily. The mice were randomized in nine groups when the tumours reached a volume of 75 mm 3< . One of the groups was treated with two single doses of Cisplatin, of 8 mg per kilogram of weight, on days 1 and 7 of the experiment (control group). The eight remaining groups were treated with the same treatment as the control group and the doses of 1 (group 1), 3 (group 2), 5 (group 3), 6 (group 4), 7 (group 5), 8 (group 6), 9 (group 7) and 10 (group 8) mg per kilogram of weight and day, of the NK1 receptor antagonist Aprepitant. 3 animals were treated per group, during 14 days. All the mice were sacrificed at the end of the experiment. Table 11 shows the tumour size (in cubic millimetres ± standard deviation) after 7 and 14 days of treatment, with each one of the doses used. Table 5. Tumour size of the tumours provoked in an in vivo mouse model. Mean volume of the tumour in the control mice (untreated) or in the mice after treatment with the non-peptide NK1 receptor antagonist (Aprepitant).Human neuroblastoma cell line, reference KELLY. 7 days 14 days Control. Cisplatin alone.*95±860±8Group 1. Cisplatin + Aprepitant 1 mg / kg / day*80±850±6Group 2. Cisplatin + Aprepitant 3 mg / kg / day*75±535±4Group 3. Cisplatin + Aprepitant 5 mg / kg / day60±620±4Group 4. Cisplatin + Aprepitant 6 mg / kg / day55±610±3Group 5. Cisplatin + Aprepitant 7 mg / kg / day40±75±2Group 6. Cisplatin + Aprepitant 8 mg / kg / day25±40±0Group 7. Cisplatin + Aprepitant 9 mg / kg / day10±30±0Group 8. Cisplatin + Aprepitant 10 mg / kg / day5±10±0* = for reference Example 6. Treatment with non-peptide NK1 receptor antagonists at doses between 1 and 10 mg per kilogram of weight and day, in combination with another anti-tumour drug, reduces the size of cancerous tumours of haemato-lymphoid cell line (leukaemias and lymphomas) in mammals.

[0052] To verify that the administration of the antagonists not of the NK1 receptors, at doses between 1 and 10 mg per kilogram of weight and day, in combination with other anti-tumour agents, reduces the sizes of haemato-lymphoid cell line tumours (leukaemias and lymphomas) in mammals, tumour cells were implanted in mice and were later treated with chemotherapeutic agents, alone and in combination with non-peptide NK1 receptor antagonists.

[0053] Immunocompromised female mice, 5-6 weeks of age were used, in the same conditions as explained in example 1. They were injected with 2 x 10 7< tumour cells, corresponding to a haemato-lymphoid cell line tumour (human lymphoma; reference BC-1; supplied by DSMZ) in 200 µl of PBS by subcutaneous route. The tumour size was measured and the mice were evaluated for their state of health and weight daily. The mice were randomized in nine groups when the tumours reached a volume of 75 mm 3< . One of the groups was treated with two single doses of Cisplatin, of 8 mg per kilogram of weight, on days 1 and 7 of the experiment (control group). The eight remaining groups were treated with the same treatment as the control group and the doses of 1 (group 1), 3 (group 2), 5 (group 3), 6 (group 4), 7 (group 5), 8 (group 6), 9 (group 7) and 10 (group 8) mg per kilogram of weight and day, of the NK1 receptor antagonist Aprepitant. 3 animals were treated per group, during 14 days. All the mice were sacrificed at the end of the experiment. Table 12 shows the tumour size (in cubic millimetres ± standard deviation) after 7 and 14 days of treatment, with each one of the doses used. Table 6. Tumour size of the tumours provoked in an in vivo mouse model. Mean volume of the tumour in the control mice (untreated) or in the mice after treatment with the non-peptide NK1 receptor antagonist (Aprepitant).Human lymphoma cell line, reference BC-1. 7 days 14 days Control. Cisplatin alone.*85±650±3Group 1. Cisplatin + Aprepitant 1 mg / kg / day*75±340±2Group 2. Cisplatin + Aprepitant 3 mg / kg / day*60±525±2Group 3. Cisplatin + Aprepitant 5 mg / kg / day50±510±4Group 4. Cisplatin + Aprepitant 6 mg / kg / day45±35±2Group 5. Cisplatin + Aprepitant 7 mg / kg / day30±20±0Group 6. Cisplatin + Aprepitant 8 mg / kg / day20±10±0Group 7. Cisplatin + Aprepitant 9 mg / kg / day15±10±0Group 8. Cisplatin + Aprepitant 10 mg / kg / day10±20±0* = for reference Reference Example 7. The NK1 receptor antagonists at low doses (nanomolar concentration range) increase the proliferation of the tumour cells.

[0054] Cell cultures of various commercial tumour cell lines stated in table 13 were used. Table 7. Human tumour cell lines used to demonstrate the action of the NK1 receptor antagonist at doses in nanomolar range.Type of tumour Cell line Selling company Human adenocolon cancerSW-403DSMZHuman breast cancerMT-3DSMZHuman lung cancerA-427DSMZHuman fibrosarcomaHT-1080DSMZHuman gliomaGAMGDSMZHuman B cell lymphomaBC-1DSMZHuman melanomaMEL HODSMZHuman neuroblastomaKELLYDSMZDSMZ: Deutsche Sammlung von Mikrorganismen und Zellkulturen.

[0055] The cell proliferation was evaluated by the compound tetrazolium 3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl) 2-(4-sulfophenyl)-2H-tetrazolium (MTS) in accordance with the instructions provided by the manufacturer (Kit: "CellTiter 96 Aqueous One-Solution Cell Proliferation Assay" Promega, USA; complete protocol of use available at url: http: / / www.promega.com / resources / protocols / technical-bulletins / 0 / celltiter-96-aqueous-one-solution-cell-proliferation-assay-system-protocol / ).

[0056] The number of cells was quantified using a Coulter counter. A blank sample (without cells) and a control sample (containing 10 4< cell / ml) were included in the tumour cell culture plates. The culture plates were grown in the presence of increasing concentrations of non-peptide NK1 receptor antagonists. To obtain the staining in the proliferation assays, 20 µl of MTS was added to each one of the wells of the cell culture plates 90 minutes before reading the samples in a multiscan spectrophotometer (TECAN Spectra classic, Barcelona, Spain) at 492 nm (assay wavelength) and 690 nm (reference wavelength). The different doses were tested in duplicate and each experiment was performed in triplicate.

[0057] The antagonist Aprepitant was used at the following concentrations: 1 nanomolar -nM-, 5 nanomolar -nM- and 7 nanomolar -nM-.

[0058] In all cases, an increase was observed of proliferation in the tumour cell line which was time dependent: greater inhibition in relation to longer antagonist exposure time. As proliferation control, the cells were grown in the absence of said antagonist. This is expressed in figures 1 to 10.

Claims

1. A composition comprising: (a) Aprepitant, (b) Carboplatin, Cisplatin or Oxaliplatin, and (c) a pharmaceutically acceptable carrier, for use in the treatment of cancer in a mammal, wherein said treatment comprises administration of Aprepitant at a dose between 5 and 10 mg / kg of weight per day.

2. The composition for use according to claim 1, wherein (b) is Cisplatin3. The composition for use according to claims 1 or 2, wherein the cancer is gastric cancer, colon cancer, pancreatic cancer, breast cancer, ovarian cancer, endometrial cancer, choriocarcinoma, uterine cervical cancer, lung cancer, thyroid cancer, bladder cancer, prostate cancer, glial tumours of the central nervous system, sarcomas, melanomas, embryonal carcinoma or haematological malignancies.

4. The composition for use according to any one of the preceding claims, wherein the cancer presents with alteration of the peritumoral environment.

5. The composition for use according to claim 4, wherein the cancer that presents with peritumoral alteration shows an increased synthesis of the markers selected from the list consisting of: NF-kB, EGF, VEGF, TNF-α, TGF-α, TGF-β 1, TGF-β 2, TGF-β 3, SPARC, MMP-3; MMP-7, MMP-9, MMP-11, MMP-13, MMP-14 and / or combinations thereof.

6. A combined preparation comprising: a) Aprepitant, and b) Carboplatin, Cisplatin or Oxaliplatin, for simultaneous, combined or sequential use in treatment of cancer in a mammal, wherein said treatment comprises administration of Aprepitant at a dose between 5 and 10 mg / kg of weight per day.

7. The combined preparation for use according to claim 6, wherein (b) is Cisplatin.

8. The combined preparation for use according to claim 6 or 7, wherein the cancer is gastric cancer, colon cancer, pancreatic cancer, breast cancer, ovarian cancer, endometrial cancer, choriocarcinoma, uterine cervical cancer, lung cancer, thyroid cancer, bladder cancer, prostate cancer, glial tumours of the central nervous system, sarcomas, melanomas, embryonal carcinoma or haematological malignancies.

9. The combined preparation for use according to any one of claims 6 to 8, wherein the cancer presents with alteration of the peritumoral environment.

10. The combined preparation for use according to claim 9, wherein the cancer that presents with peritumoral alteration shows an increased synthesis of the markers selected from the list consisting of: NF-kB, EGF, VEGF, TNF-α, TGF-α, TGF-β 1, TGF-β 2, TGF-β 3, SPARC, MMP-3; MMP-7, MMP-9, MMP-11, MMP-13, MMP-14 and / or combinations thereof