Injection solution containing p-boronophenylalanine
The injection solution for BNCT, comprising P-boronphenylalanine with boron-10, sugar alcohol, and antioxidant, addresses solubility and concentration issues, ensuring stable and safe administration for enhanced treatment efficacy.
Patent Information
- Application Number
- JP2024200556
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2019-09-12
- Filing Date
- 2024-11-18
- Publication Date
- 2025-01-30
AI Technical Summary
Existing boron neutron capture therapy (BNCT) compounds, such as P-boronphenylalanine, face challenges with poor solubility and limited blood boron concentration, necessitating precise administration to enhance treatment efficacy while minimizing adverse effects.
An injection solution containing P-boronphenylalanine with a high ratio of boron-10, sugar alcohol, antioxidant, and specific pH and osmotic pressure ratios, ensuring stability and safety during infusion.
The solution provides a stable, safe, and effective infusion with balanced administration, achieving high boron concentration in tumor tissues and minimizing adverse events.
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Abstract
Description
[Technical field]
[0001] The present invention relates to an injectable solution containing p-boronophenylalanine. [Background technology]
[0002] In recent years, boron neutron capture therapy (BNCT) has been attracting attention as a cancer treatment method using radioisotopes. 10 This is a treatment method in which a boron compound containing boron-10 is taken up by cancer cells, and then low-energy neutrons (e.g. epithermal neutrons) are irradiated to destroy the cancer cells locally through a nuclear reaction that occurs within the cells. In this treatment method, it is important to selectively accumulate the boron compound containing boron-10 in the cells of the cancer tissue in order to enhance the therapeutic effect, so it is necessary to develop a boron compound that can be selectively and reliably taken up by cancer cells.
[0003] Boron-containing compounds that have boron atoms or boron groups introduced into their basic skeletons have been synthesized as drugs for use in BNCT. Drugs actually used in clinical practice include p-boronophenylalanine (BPA) and mercaptoundecahydrododecaborate (BSH).
[0004] p-Boronophenylalanine is extremely poorly soluble at physiological pH.
[0005] In order to improve the solubility of p-boronophenylalanine in water, methods have been attempted in which a fructose complex of p-boronophenylalanine is produced (e.g., Patent Document 1), or a monosaccharide or polyol is added to p-boronophenylalanine in an alkaline solution (e.g., an aqueous solution of sodium hydroxide), and inorganic salts are removed using an ion exchange resin before use (e.g., Patent Document 2).
[0006] Furthermore, other techniques for improving the solubility of p-boronophenylalanine have also been proposed (Patent Document 3). [Patent Document 1] U.S. Patent No. 5,492,900 [Patent Document 2] U.S. Patent No. 6,169,076 [Patent Document 3] Patent No. 5345771 Summary of the Invention [Problem to be solved by the invention]
[0007] However, the blood boron concentration required for boron neutron capture therapy to be effective is limited. Therefore, it is necessary to strictly regulate the blood boron concentration within a certain range and to strictly determine the administration rate. On the other hand, it is desirable to establish a well-balanced prescription that maximizes the effect on the subject while preventing adverse events during administration.
[0008] Therefore, an object of the present invention is to provide an injection solution containing p-boronophenylalanine which is highly stable, has guaranteed safety as an intravenous infusion solution, and imposes little burden on the subject to which it is administered. [Means for solving the problem]
[0009] As a result of intensive research into solving the above problems, the inventors have discovered that by controlling the proportion of boron-10 among the boron atoms in a compound, and further by adding a sugar alcohol or an antioxidant and adjusting the pH value and osmotic pressure ratio, it is possible to prepare a formulation that has excellent effects on subjects while improving the solubility of p-boronophenylalanine in an injection solution, its stability over a wide temperature range, and its safety, and thus have completed the present invention.
[0010] That is, the present invention provides the following injectable solutions. [1] p-Boronophenylalanine or a pharma- ceutically acceptable salt thereof, in which the proportion of boron-10 among the boron atoms in the compound is 75% or more; Sugar alcohols; Antioxidants; and 1. An injectable solution for boron neutron capture therapy, which contains water, has a pH of 6.5 to 7.8, and has an osmotic pressure ratio of 1.0 to 1.8, and is to be administered by intravenous drip injection. [2] Item 1. An injection solution for boron neutron capture therapy according to Item 1, which is administered at a rate of 150 to 250 mg / kg / hour as a p-boronophenylalanine concentration for 1.5 to 3 hours, and then at a rate of 80 to 120 mg / kg / hour for 0.5 to 1.5 hours while irradiating with epithermal neutron rays during said slow-dose administration. [3] Item 3. The injection solution for boron neutron capture therapy according to item 1 or 2, wherein the sugar alcohol is sorbitol or mannitol. [4] Item 4. The injection solution for boron neutron capture therapy according to any one of Items 1 to 3, wherein the concentration of the sugar alcohol is 2.6 to 6.5 w / v %. [5] Item 5. The injection solution for boron neutron capture therapy according to any one of items 1 to 4, wherein the content of the sugar alcohol is in the range of 0.9 to 3.0 in terms of molar ratio to the content of p-boronophenylalanine. [6] Item 6. The injection solution for boron neutron capture therapy according to any one of Items 1 to 5, wherein the antioxidant is a sulfite. [7] Item 7. The injection solution for boron neutron capture therapy according to Item 6, wherein the concentration of the antioxidant is 0.01 to 0.6 w / v %. [8] Item 8. The injection solution for boron neutron capture therapy according to Item 6 or 7, wherein the sulfite is sodium pyrosulfite, sodium sulfite, or sodium hydrogen sulfite. [9] Item 9. The injectable solution according to any one of Items 1 to 8, which is for treating a solid cancer. Effect of the Invention
[0011] The injectable solution of the present invention has excellent stability, ensures safety as an intravenous infusion solution, and has favorable properties when administered to humans and animals. [Brief description of the drawings]
[0012] [Figure 1] FIG. 1 is a graph showing the relationship between the time (horizontal axis (hr)) during which the composition of the example was infused into a subject and the blood concentration of 10B (vertical axis (μg / ml)). DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0013] In this specification, the unit "% by mass" is synonymous with "g / 100 g", and "w / v%" is synonymous with "g / 100 ml".
[0014] The injectable solution of the present invention comprises p-boronophenylalanine or a pharma- ceutically acceptable salt thereof, in which the proportion of boron-10 among the boron atoms in the compound is 75% or more; Sugar alcohols; Antioxidants; and The injectable solution for boron neutron capture therapy (BNCT) contains water, has a pH of 6.5 to 7.8, and has an osmotic pressure ratio of 1.0 to 1.8, and is to be administered by intravenous drip infusion.
[0015] [Injection solution for Boron Neutron Capture Therapy (BNCT)] (p-Boronophenylalanine or a pharma- ceutically acceptable salt thereof) The p-boronophenylalanine used in the present invention has a ratio of boron-10 to the total boron atoms in the compound of 75% or more, preferably 80% or more, more preferably 90% or more, even more preferably 95% or more, and particularly preferably 99% or more.
[0016] Natural boron (boron) contains isotopes of boron-10 and boron-11, with the ratio of boron-10 being 20% and boron-11 being 80%. Therefore, prior to the production of an injectable solution containing p-boronophenylalanine of the present invention, boron with a mass number of 10 (boron-10) is concentrated. For this purpose, boron-10 and boron-11 in natural boron compounds are separated to produce highly concentrated boron-10. The boron used in the present invention may be concentrated to increase its concentration as boron-10, or a commercially available product may be used. Examples of commercially available products include 10 B Concentrated boric acid (manufactured by Stella Chemifa Co., Ltd.) can be used as the starting material.
[0017] Here, the boron-10 measurement method can be performed by quadrupole ICP-MS (ICP-QMS) using a quadrupole mass analyzer, using an Agilent 7500 (manufactured by Agilent). The ICP-QMS used for the measurement is adjusted in accordance with JIS K0133.
[0018] The currently used form of p-boronophenylalanine is the L-form, and the present invention also preferably uses Lp-boronophenylalanine, but is not limited thereto. That is, the present invention also uses D-form or racemic p-boronophenylalanine containing both D-form and L-form.
[0019] Here, p-boronophenylalanine can be used by, for example, synthesizing it by a known method after obtaining boron having an increased ratio of boron-10, or after obtaining boric acid having an increased ratio of boron-10 (e.g., H. R. Synder, A. J. Reedy, W. M. J. Lennarz, J. Am. Chem. Soc., 1958, 80, 835; C. Malan, C. Morin, SYNLETT, 1996, 167; U.S. Patent No. 5,157,149; Japanese Patent Publication No. 2000-212185; and Japanese Patent No. 2,979,139).
[0020] Here, the salt is not particularly limited as long as it is pharmacologically acceptable. Examples of salts of p-boronophenylalanine include salts with organic acids, salts with inorganic acids, salts with organic bases, and salts with inorganic bases.
[0021] Examples of salts with organic acids include acetates, trifluoroacetates, fumarates, maleates, lactates, tartrates, citrates, and methanesulfonates. Examples of salts with inorganic acids include hydrochlorides, sulfates, nitrates, hydrobromides, and phosphates. Examples of salts with organic bases include salts with triethanolamine. Examples of salts with inorganic bases include ammonium salts, sodium salts, potassium salts, calcium salts, and magnesium salts.
[0022] In the injection solution of the present invention, the content of p-boronophenylalanine or a salt thereof relative to the total amount of the injection solution is appropriately set depending on the balance with other components. The total content of p-boronophenylalanine and / or a salt thereof relative to the total amount of the injection solution is not particularly limited, but is preferably 2.0 to 5.5 w / v%, more preferably 2.5 to 5.0 w / v%, and even more preferably 2.5 to 4.0 w / v%.
[0023] When the content of p-boronophenylalanine in the injectable solution of the present invention is within the above range, the amount of solution required for clinical application is adequate, the solution has good stability, and is highly effective when administered.
[0024] (Sugar alcohol) The sugar alcohol used in the present invention is not particularly limited as long as it is used as a component of injections in the pharmaceutical field. Although the sugar alcohol is not limited, it is preferably a monosaccharide sugar alcohol, and sorbitol and / or mannitol are particularly preferred.
[0025] As sorbitol, D-sorbitol, which is currently approved for use in pharmaceuticals and has been confirmed to be safe, may be preferably used, but is not limited thereto. That is, in the present invention, L-sorbitol or a mixture of L- and D-sorbitol may also be used.
[0026] As mannitol, D-mannitol, which is currently approved for use in pharmaceuticals and has been confirmed to be safe, may be preferably used, but is not limited thereto. That is, in the present invention, L-mannitol or a mixture of L-mannitol and D-mannitol may also be used.
[0027] The total content of sugar alcohols used in the injectable solution of the present invention varies depending on the amounts of other additives, but is preferably 2.0 to 7.0 w / v%, more preferably 2.6 to 6.5 w / v%, and even more preferably 2.6 to 4.2 w / v%, based on the total amount of the injectable solution.
[0028] The amount of sugar alcohol relative to the amount of p-boronophenylalanine is preferably in the range of 0.9 to 3.0, more preferably 0.9 to 2.0, and even more preferably 1.1 to 1.5, in terms of molar ratio. When the amount of sugar alcohol is in this range, precipitation of p-boronophenylalanine can be suppressed, and the osmotic pressure ratio can be appropriately adjusted.
[0029] (Antioxidant) The antioxidant used in the present invention is not particularly limited as long as it is used as a component of injections in the pharmaceutical field. The antioxidant is not limited, but is preferably one or more selected from the group consisting of sulfurous acid, hydrogen sulfite, pyrosulfite, nitrous acid, ascorbic acid, L-cysteine, thioglycolic acid, and salts thereof.
[0030] Here, examples of the salts of sulfurous acid, hydrogen sulfite, pyrosulfite, nitrous acid, ascorbic acid, L-cysteine, or thioglycolic acid include alkali metal salts such as sodium salts and potassium salts; alkaline earth metal salts such as calcium salts and magnesium salts; and inorganic bases such as aluminum salts and ammonium salts. Furthermore, salts with organic bases such as trimethylamine, triethylamine, pyridine, picoline, ethanolamine, diethanolamine, triethanolamine, dicyclohexylamine, and N,N'-dibenzylethylenediamine can also be used. Particularly preferred are sodium salts, potassium salts, and ammonium salts.
[0031] Particularly preferred antioxidants for use in the present invention are one or more selected from the group consisting of sodium sulfite, dry sodium sulfite, potassium sulfite, calcium sulfite, sodium hydrogen sulfite, potassium hydrogen sulfite, ammonium hydrogen sulfite, sodium pyrosulfite, and potassium pyrosulfite.
[0032] The total content of the antioxidants used in the injectable solution of the present invention varies depending on the amounts of other additives, but is preferably 0.005 to 2.0 w / v%, more preferably 0.005 to 1.5 w / v%, even more preferably 0.005 to 1.2 w / v%, even more preferably 0.01 to 0.6 w / v%, and most preferably 0.01 to 0.03 w / v%, based on the total amount of the injectable solution.
[0033] (water) The injection solution of the present invention further contains water. The water used in the present invention is not particularly limited as long as it is used as a component of injections in the pharmaceutical field.
[0034] The content of water used in the injection solution of the present invention varies depending on the amounts of other additives, but is preferably 80 w / v% or more, more preferably 85 w / v% or more, and is preferably 95 w / v% or less, and even more preferably 94 w / v% or less, based on the total amount of the injection solution.
[0035] (pH) The pH of the injection solution of the present invention is preferably neutral to weakly alkaline, taking into consideration the balance between administration to a living body and stability. More specifically, it is in the range of 6.5 to 7.8, more preferably 7.0 to 7.8, and particularly from the viewpoint of long-term stability in a low temperature range, it is preferably in the range of more than pH 7.4 to 7.8 or less, and particularly preferably around more than pH 7.5 to 7.8 or less. For adjusting the pH, a suitable pH regulator, buffer, etc. used in the art may be used as necessary.
[0036] (Osmolality ratio) The osmotic pressure ratio of the injection solution of the present invention is not particularly limited, but is preferably within the range of 1.0 to 1.8 relative to physiological saline, and more preferably within the range of 1.1 to 1.5. When it is within this range, in the case of a large amount of intravenous injection, it is possible to reduce pain, prevent the onset of phlebitis, and shorten the administration time.
[0037] In order to improve the stability in and out of the body, the injection solution of the present invention may contain various metal ions that may be contained in the body. Preferably, sodium ions are contained, and the concentration is not particularly limited, but is particularly preferably 130 mEq / L to 160 mEq / L. This numerical range close to the Na ion concentration range of body fluids is preferable so that the electrolyte balance between the intracellular fluid and the extracellular fluid is not significantly disrupted.
[0038] (pH adjuster) The injection solution of the present invention may contain, as necessary, an inorganic acid such as hydrochloric acid or phosphoric acid, or an alkaline component such as sodium hydroxide or potassium hydroxide, or other pH adjusters. Furthermore, it is also preferable to use an organic acid in addition to or instead of an inorganic acid. As the organic acid, it is preferable to use citric acid, acetic acid, trifluoroacetic acid, fumaric acid, maleic acid, lactic acid, tartaric acid, or methanesulfonic acid, and it is more preferable to use citric acid or lactic acid.
[0039] [Other ingredients] If necessary, the injection solution of the present invention may contain a buffer such as a phosphate buffer, a Tris-HCl buffer, an acetate buffer, a carbonate buffer, a citrate buffer, etc. These buffers may be useful for stabilizing the preparation or reducing irritation.
[0040] Furthermore, the composition of the present invention may contain other components that are generally used in the art, if necessary, as long as they are not contrary to the purpose of the present invention.Such components include additives that are generally used in liquid, particularly aqueous compositions, such as preservatives such as benzalkonium chloride, potassium sorbate, and chlorhexidine hydrochloride, stabilizers such as sodium edetate, thickeners such as hydroxyethyl cellulose and hydroxypropyl methylcellulose, isotonicity agents such as sodium chloride, potassium chloride, glycerin, sucrose, and glucose, surfactants such as polysorbate 80 and polyoxyethylene hydrogenated castor oil, isotonicity agents such as sodium chloride, potassium chloride, and glycerin, and pH adjusters such as sodium hydroxide.
[0041] When the injectable solution of the present invention is used as a pharmaceutical product, it may be in the form of an injection for intravenous administration, particularly an intravenous drip injection solution.
[0042] Injectable solutions are prepared by dissolving, suspending or emulsifying a certain amount of active ingredient together with a dispersant (e.g., polysorbate 80, polyoxyethylene hydrogenated castor oil 60, polyethylene glycol, carboxymethylcellulose, sodium alginate, etc.), a preservative (e.g., methylparaben, propylparaben, benzyl alcohol, chlorobutanol, phenol, etc.), an isotonic agent (e.g., sodium chloride, glycerin, D-mannitol, glucose, etc.) in an aqueous solvent (e.g., distilled water for injection, physiological saline, Ringer's solution, etc.) or an oily solvent (e.g., vegetable oil such as olive oil, sesame oil, cottonseed oil, corn oil, propylene glycol, etc.). In this case, additives such as solubilizing agents (e.g., sodium salicylate, sodium acetate, etc.), stabilizers (e.g., human serum albumin, etc.), and pain-relieving agents (e.g., benzyl alcohol, etc.) may be used as desired. Furthermore, antioxidants, colorants, and other additives may be added as necessary.
[0043] In addition, a "pharmaceutical acceptable carrier" can also be used. Examples of such substances include solvents, solubilizing agents, suspending agents, isotonicity agents, surfactants, soothing agents, etc. in liquid preparations. Furthermore, if necessary, preparation additives such as preservatives, colorants, etc. can also be used in the usual manner.
[0044] Suitable examples of the "solvent" include alcohol (such as ethanol), propylene glycol, macrogol, etc.
[0045] Examples of the solubilizing agent include polyethylene glycol, propylene glycol, benzyl benzoate, trisaminomethane, cholesterol, triethanolamine, sodium carbonate, and sodium citrate.
[0046] Suitable examples of the "suspending agent" include hydrophilic polymers such as polyvinyl alcohol, polyvinylpyrrolidone, sodium carboxymethylcellulose, methylcellulose, hydroxymethylcellulose, hydroxyethylcellulose, and hydroxypropylcellulose.
[0047] Suitable examples of the "isotonicity agent" include glucose, sodium chloride, glycerin, and the like. Examples of the "surfactant" include sodium lauryl sulfate, lauryl aminopropionic acid, lecithin, benzalkonium chloride, benzethonium chloride, glycerin monostearate, and the like. Suitable examples of "soothing agents" include benzyl alcohol and the like.
[0048] Suitable examples of the "preservative" include paraoxybenzoic acid esters, chlorobutanol, benzyl alcohol, phenethyl alcohol, dehydroacetic acid, sorbic acid and the like.
[0049] [Manufacturing method of injection solution] The method for producing the injection solution of the present invention is not particularly limited, but as an example, a pH adjuster such as sodium hydroxide, water, and p-boronophenylalanine can be mixed, and then a sugar alcohol can be added to prepare the injection solution. Here, in preparation, the order may be important for more efficient production. Particularly preferably, a mixture of water and an alkaline component pH adjuster such as sodium hydroxide is first prepared, and then p-boronophenylalanine is added and stirred. Then, a sugar alcohol is added and dissolved to prepare the injection solution. By following such a protocol, each component can be efficiently dissolved in a short time, and an excellent injection solution can be efficiently prepared. The amounts of water, p-boronophenylalanine, sugar alcohol, and pH adjuster used in this step should conform to those described in the injectable solution for boron neutron capture therapy.
[0050] [Neutron capture therapy] (Administration) The injection solution of the present invention is preferably used as an intravenous infusion, and particularly preferably as an intravenous infusion used in boron neutron capture therapy. Neutron capture therapy is a method of treatment using powerful particle beams (alpha beams, 7Li particles) generated by the nuclear reaction between boron 10 taken up by tumor cells and neutrons, and the injection solution of the present invention can be particularly advantageously used in this method.
[0051] Prior to irradiation, the injection solution of the present invention can be administered to a subject or animal in advance, adjusted so that boron-10 accumulates in the tumor, and then epithermal neutron radiation can be irradiated. Alternatively, prior to irradiation, the injection solution of the present invention can be administered to a subject or animal in advance, adjusted so that boron-10 accumulates in the tumor, and then epithermal neutron radiation can be irradiated while continuing the administration. The dosage of the injection solution of the present invention is not particularly limited, but can be controlled to achieve a preferred intracellular boron concentration. Such a dosage is set depending on the type and progression of the tumor to be applied, the age and weight of the subject, etc., but when the injection solution of the present invention is used for intravenous administration, it is administered by drip infusion into a vein at a rate of 200 to 500 ml per hour for 1.5 to 4.0 hours, preferably 2.0 to 3.6 hours. It is particularly preferable that the timing of administration is continuously performed from before the start of neutron irradiation until the start of irradiation.
[0052] For example, but not limited to, for a brain tumor patient or a head and neck cancer patient, the p-boronophenylalanine concentration is preferably adjusted to 150 to 250 mg / kg / hour, more preferably 200 mg / kg / hour, and after administration for preferably 1.5 to 3 hours, more preferably 2 hours, the p-boronophenylalanine concentration is then preferably slowed down to 80 to 120 mg / kg / hour, more preferably 100 mg / kg / hour, and such slowed down administration is performed for a maximum of 0.5 to 1.5 hours, preferably for a maximum of 1 hour, while irradiating with epithermal neutrons. If the injection solution of the present invention is used, there is no need to prepare it at the time of use, and it is also possible to perform a series of administrations from the start of administration to the end of slowed down administration with one injection solution.
[0053] For p-boronophenylalanine administered, the concentration of boron-10 in tumor tissue is desirably 20 ppm (109 boron-10 atoms per cell) or more and 60 ppm or less, preferably 20 ppm or more and 45 ppm or less. In practice, the blood concentration can be measured to predict the amount in the tumor tissue or cells.
[0054] (irradiation) It is preferable to control the nuclear reaction of epithermal neutrons efficiently in tumor cells so that the alpha rays and 7Li particles generated by the nuclear reaction can kill only tumor cells. The dose is calculated based on the boron concentration in the blood and the neutron fluence irradiated to the tissue, and the X-ray equivalent dose can be calculated by multiplying the dose by the effective relative biological effectiveness (RBE) of p-boronophenylalanine.
[0055] For example, but not limited to, for a brain tumor patient, the skin dose is preferably 6 to 12 Gy-Eq, more preferably about 8.5 Gy-Eq, and the irradiation time is about 60 minutes at most per session. Alternatively, but not limited to, for a head and neck cancer patient, the mucosal dose is preferably 10 to 15 Gy-Eq, more preferably about 12 Gy-Eq, and the irradiation time is about 60 minutes at most per session.
[0056] <Effects of the present invention> The antitumor agent of the present invention is highly safe to living organisms and can exert a strong antitumor effect.
[0057] Prior to administration of the injectable solution of the present invention, positron emission tomography (PET) can be used to measure the accumulation of p-boronophenylalanine. For example, in addition to p-boronophenylalanine, a method for measuring the accumulation of p-boronophenylalanine containing a radioactive nuclide can be used. 18It is also possible to estimate the accumulation of boron compounds by administering a radioactive compound labeled with F (18F-fluoro-borono-phenylalanine:FBPA) and imaging its whole-body distribution by PET examination. Although not limited thereto, it is particularly preferable to administer to a subject whose boron concentration ratio in cancer tissue / normal tissue is 2.5 or more, preferably 3 or more, in such a PET examination.
[0058] Thus, the injection liquid of the present invention is preferably used in neutron capture therapy. The target disease is not limited, but solid cancer is preferable, and cancer (epithelial tumor) developed from epithelial cells is particularly preferable. Representative examples include skin cancer including melanoma, lung cancer, breast cancer, stomach cancer, colon cancer, uterine cancer, ovarian cancer, and head and neck cancer (oral cancer, laryngeal cancer, pharyngeal cancer, tongue cancer, etc.). Alternatively, sarcoma developed from non-epithelial cells may be the target. Representative examples include osteosarcoma, chondrosarcoma, rhabdomyosarcoma, leiomyosarcoma, fibrosarcoma, liposarcoma, and angiosarcoma. In addition to these, brain tumors such as glioma, central nervous system primary malignant lymphoma, meningioma, pituitary adenoma, neurilemmoma, and craniopharyngioma may be the target diseases for treatment. Not only primary or single cancer, but also cancer that has spread to individual organs, metastatic cancer, and intractable cancer may be the target.
[0059] That is, the present invention includes each embodiment of the injection solution described below. (1) p-Boronophenylalanine or a pharma- ceutically acceptable salt thereof, in which the proportion of boron-10 among the boron atoms in the compound is 75% or more; Sugar alcohols; Antioxidants; and 1. An injectable solution for boron neutron capture therapy, which contains water, has a pH of 6.5 to 7.8, and has an osmotic pressure ratio of 1.0 to 1.8, and is to be administered by intravenous drip injection. (2) An injection solution for boron neutron capture therapy according to (1), which is administered at a rate of 150 to 250 mg / kg / hour as a p-boronophenylalanine concentration for 1.5 to 3 hours, and then at a rate of 80 to 120 mg / kg / hour for 0.5 to 1.5 hours, while irradiating with epithermal neutron rays during the slow-dose administration. (3) The injection solution for boron neutron capture therapy according to (1) or (2), wherein the sugar alcohol is sorbitol or mannitol. (4) The injection solution for boron neutron capture therapy according to any one of (1) to (3), wherein the concentration of the sugar alcohol is 2.6 to 6.5 w / v %. (5) The injection solution for boron neutron capture therapy according to any one of (1) to (4), wherein the content ratio of the sugar alcohol relative to the content of p-boronophenylalanine is in the range of 0.9 to 3.0 in terms of molar ratio. (6) The injectable solution for boron neutron capture therapy according to any one of (1) to (5), wherein the antioxidant is a sulfite. (7) The injection solution for boron neutron capture therapy according to (6), wherein the concentration of the antioxidant is 0.01 to 0.6 w / v %. (8) The injection solution for boron neutron capture therapy according to (6) or (7), wherein the sulfite is sodium pyrosulfite, sodium sulfite, or sodium hydrogen sulfite. (9) The injection solution for boron neutron capture therapy according to any one of (1) to (8), further comprising a pH adjuster. (10) The injection solution for boron neutron capture therapy according to (9), wherein the pH adjuster contains at least hydrochloric acid, and the amount of the hydrochloric acid is 0.001 to 0.5 w / v %. (11) The injection solution for boron neutron capture therapy according to any one of (1) to (10), having a pH of more than 7.5 to 7.8. (12) The injectable liquid preparation for boron neutron capture therapy according to any one of (1) to (11), which is for treating a solid cancer. (13) The injectable solution for boron neutron capture therapy according to any one of (1) to (12), wherein the solid cancer is head and neck cancer or brain tumor. (14) The injection solution for boron neutron capture therapy according to any one of (1) to (13), wherein the proportion of boron-10 among the boron atoms in the compound is 90% or more. (15) 15. The injection solution for boron neutron capture therapy according to any one of (1) to (14), wherein the proportion of boron-10 among at least the boron atoms in the compound is 90% or more. (16) The injectable solution for boron neutron capture therapy according to any one of (1) to (15), further comprising an organic acid. (17) The injectable solution for boron neutron capture therapy according to any one of (1) to (16), wherein the organic acid is citric acid and / or lactic acid. EXAMPLES
[0060] The present invention will be described in more detail below with reference to examples, but these are not intended to limit the scope of the present invention.
[0061] (Production example) Prior to the production of an injection solution containing p-boronophenylalanine (BPA; L-form was used here), 10B 96% concentrated boric acid (manufactured by Stella Chemifa Corporation), which is a concentrated form of boron with a mass number of 10 (boron-10), was used. Using the resulting highly concentrated boron-10, p-boronophenylalanine (BPA) was produced by a conventional method.
[0062] [Examples 1 to 68] (Preparation of BPA sorbitol aqueous solution) Aqueous solutions containing 2.5 w / v% to 5.0 w / v% BPA, D-sorbitol, sodium hydrogen sulfite, or sodium pyrosulfite were prepared as follows. That is, first, 5 g to 10 g of BPA was suspended in a solution in which 1.05 to 2.08 g of sodium hydroxide was dissolved in 175 ml of water. 5.25 to 13.0 g of D-sorbitol was added, stirred, and dissolved. 0.02 g of sodium hydrogen sulfite or sodium pyrosulfite was added and dissolved, and 1.22 ml (at pH 7.6) or an appropriate amount of 1 mol / l hydrochloric acid was added to adjust the pH, and water was added to make the total volume 200 ml. Then, the solution was filtered through a 0.2 μm filter. The composition, osmotic pressure ratio, and pH of each aqueous solution are as shown in Tables 1 and 2.
[0063] (Preparation of BPA-mannitol aqueous solution) Using mannitol instead of sorbitol, the aqueous solutions shown in Table 2 were prepared in the same manner as the BPA sorbitol aqueous solution. The composition, osmotic pressure ratio, and pH of each aqueous solution are shown in Table 2.
[0064] (Preparation of BPA sugar alcohol aqueous solution) In addition to sorbitol, mannitol was also added, and the aqueous solutions shown in Table 2 were prepared in the same manner as the BPA sorbitol aqueous solution. The composition, osmotic pressure ratio, and pH of each aqueous solution are shown in Table 2.
[0065] Comparative Example 1 (Preparation of L-BPA-fructose aqueous solution) L-BPA and fructose were added to water to prepare an L-BPA-fructose aqueous solution in the same manner.
[0066] <Stability test 1> Stability evaluation was mainly performed using the following equipment and conditions as standard conditions for severe pharmaceutical stability testing based on ICH guidelines.
[0067] First, a storage test at 40°C was conducted as stability test 1. In this storage test, the liquids were stored in a storage device: LH21-13M (Nagano Science) at 40°C ± 2°C, 75 ± 5% RH, and in a dark place for 2 weeks and 4 weeks, and samples were taken from each liquid to measure the BPA concentration, Tyr concentration, Phe concentration, and Ac-BPA concentration (High-performance liquid chromatograph NexeraX2 series, Shimadzu Corporation) and compared with the concentrations at the start of the test.
[0068] The HPLC measurement conditions are as follows: Column used: Mightysil RP-18GP (5 μm, 4.6 × 150 mm) manufactured by Kanto Chemical Mobile phase: 0.05 mol / L sodium dihydrogen phosphate test solution (pH 2.5) / methanol (95:5) Column temperature: constant temperature around 40℃ Flow rate: approx. 0.8ml / min Injection volume: 10μl Detection wavelength: 223 nm
[0069] The compositions of the examples and the results of stability evaluation 1 are shown in Tables 1 and 2. The remaining amount of BPA in the tables indicates the amount of BPA remaining after 4 weeks of storage, assuming that the amount of BPA used in production in stability test 1 is 100%. In addition, although not shown in the tables, the initial tyrosine amount was evaluated as an index showing the state of BPA decomposition in the early stage due to the coexistence of components other than BPA in the composition.
[0070] [Table 1] (The percentages of BPA and additives refer to w / v%.)
[0071] As shown in Table 1, all of the compositions of the examples showed good stability. When the BPA concentration was set at 2.5 w / v% and the sorbitol concentration was increased to 5.35 w / v% and 6.5 w / v%, and the type and concentration of the antioxidants were examined under similar conditions, compositions showing similarly good stability were obtained.
[0072] [Table 2] (The percentages of BPA and additives refer to w / v%.)
[0073] In the storage test of the compositions in Table 2, it was found that in the aqueous solutions of the Examples, p-boronophenylalanine was retained at approximately 99% or more even after 4 weeks or more. In the observation of the retention properties, no change in color or appearance of the components was observed. In Examples 50 to 55, an increase in the initial tyrosine content was observed. On the other hand, the fructose preparations showed significant decomposition and color change, and the BPA concentration decreased significantly, whereas the injection solutions of the Examples containing sorbitol or mannitol showed little change in concentration and were stable.
[0074] Comprehensively judging the results of the solubility and storage tests, it was found that the injection solutions containing sorbitol or mannitol of the examples had excellent stability when stored at 40°C at a pH of 7.4 to 7.8, and also had excellent liquid homogeneity.
[0075] [Examples 69 to 72] (Preparation of BPA sorbitol aqueous solution) An aqueous solution containing 3 w / v% BPA, D-sorbitol, and sodium bisulfite was prepared as follows. First, 0.62 g of sodium hydroxide was added to 87 ml of water and stirred. 3 g of L-BPA was suspended. 3.15 g of D-sorbitol was added and stirred at room temperature for 30 minutes to completely dissolve. 0.02 g of sodium bisulfite was added, and an appropriate amount of 1 mol / l hydrochloric acid or 1 mol / l citric acid was added at room temperature to adjust the pH, and water was added to make the total volume 100 ml.
[0076] <Stability test 2> The BPA sorbitol aqueous solution thus prepared was subjected to stability test 2. In this test, it was subjected to a storage test at 5°C. In this storage test, it was left to stand at 5°C ± 3°C / ambH / dark place, and the presence or absence of cloudiness and the time until cloudiness occurred were measured. The results are shown in Table 3.
[0077] [Table 3] Example 69: HCl 0.09 w / v% Examples 70, 71, and 72: Citric acid 0.15 w / v%
[0078] As a result, it was found that in Example 69, in which the pH was 7.0 and hydrochloric acid was used as an adjuster, cloudiness sometimes occurred after storage.
[0079] Next, an aqueous solution containing 3 w / v% BPA, D-sorbitol, and sodium hydrogen sulfite was prepared as follows: First, 0.32 g of sodium hydroxide was added to 43 ml of water and stirred. 1.50 g of L-BPA was suspended. 1.575 g of D-sorbitol was added and stirred at room temperature for 30 minutes to completely dissolve. 0.01 g of sodium hydrogen sulfite was added, and an appropriate amount of 1 mol / l hydrochloric acid was added at room temperature to adjust the pH, and water was added to make the total volume 50 ml. [Table 4]
[0080] As a result, when hydrochloric acid was used, cloudiness could occur during storage at 5°C, especially in the lower pH range. However, by using citric acid instead of hydrochloric acid, precipitation could be suppressed. The presence of insoluble fine particles (precipitation) is a problem with intravenous injections, but by being able to suppress precipitation even during storage at low temperatures, it is possible to prepare a stable and excellent formulation.
[0081] <Administration test on subjects with head and neck cancer> Neutron capture therapy was performed on 21 subjects with head and neck cancer, for whom standard treatment was ineffective, using the same aqueous solution as in Example 20 as the injection solution, except that sodium bisulfite was 0.02% and the osmotic pressure ratio was 1.3. Prior to administration of the injection solution, positron emission tomography (PET) was used to measure the accumulation of p-boronophenylalanine. A radioactive compound (18F-fluoro-borono-phenylalanine:FBPA) in which p-boronophenylalanine was labeled with the radionuclide 18F was administered, and the accumulation of the boron compound was estimated by imaging its distribution throughout the body using a PET examination. The solution was administered to subjects whose boron concentration ratio in cancer tissue / normal tissue was 3 or more in such a PET examination.
[0082] Prior to irradiation, the subjects were given an injection solution. The injection solution was administered intravenously for each patient, and the BPA concentration was adjusted to 200 mg / kg / hour so that boron-10 would accumulate in the tumor. After 2 hours of administration, the BPA concentration was reduced to 100 mg / kg / hour, and epithermal neutrons were irradiated during the reduced-rate administration.
[0083] It was confirmed that the blood concentration of boron-10 after administration of p-boronophenylalanine was between 20 ppm (109 boron-10 atoms per cell) and 45 ppm. Thus, the blood concentration was measured and the amount in the tumor tissue or cells was predicted.
[0084] (irradiation) For each head and neck cancer patient, the mucosal dose was about 12 Gy-Eq, and the irradiation time was about 60 minutes per session. The time that the injection solution used in this test was infused into the subject (horizontal axis (hr)) and 10 The relationship between the blood concentration of boron-10 and the vertical axis (μg / ml) is shown in Figure 1. It was confirmed that the blood concentration of boron-10 was between 20 ppm and 45 ppm after administration of p-boronophenylalanine, and it was shown that for subjects who showed a particularly good response, the values were in this range from 2 hours to more than 3 hours after the start of administration (Figure 1).
[0085] As a result, first of all, no adverse events were observed in any of the subjects when the injection solution was administered. In other words, none of the subjects experienced shock symptoms when the solution was administered. In addition, no phlebitis was observed after administration. After neutron irradiation, tumor shrinkage was observed in 15 cases over a period of 90 days. The 90-day response rate was 71.4%.
[0086] <Administration test on subjects with brain tumors> Neutron capture therapy was performed on subjects with brain tumors for which standard treatment was ineffective, using the same aqueous solution as in Example 20 as an injection solution, except that sodium bisulfite was 0.02% and the osmotic pressure ratio was 1.3. Prior to administration of the injection solution, positron emission tomography (PET) was used to measure the accumulation of p-boronophenylalanine. A radioactive compound (18F-fluoro-borono-phenylalanine:FBPA) in which p-boronophenylalanine was labeled with the radionuclide 18F was administered, and the accumulation of the boron compound was estimated by imaging its distribution throughout the body using a PET examination. The solution was administered to subjects whose boron concentration ratio in cancer tissue / normal tissue was 3 or more in such a PET examination.
[0087] Prior to irradiation, the subjects were given an injection solution. The injection solution was administered intravenously for each patient, and the BPA concentration was adjusted to 200 mg / kg / hour so that boron-10 would accumulate in the tumor. After 2 hours of administration, the BPA concentration was reduced to 100 mg / kg / hour, and epithermal neutrons were irradiated during the reduced-rate administration.
[0088] It was confirmed that the blood concentration of boron-10 after administration of p-boronophenylalanine was between 20 ppm (109 boron-10 atoms per cell) and 45 ppm. Thus, the blood concentration was measured and the amount in the tumor tissue or cells was predicted.
[0089] (irradiation) For each brain tumor patient, the skin dose was approximately 8.5 Gy-Eq, and irradiation was performed for a maximum of 60 minutes per session.
[0090] As a result, first of all, no adverse events were observed in any of the subjects when the injection solution was administered. In other words, none of the subjects experienced shock symptoms when the solution was administered. In addition, no phlebitis was observed after administration. After neutron irradiation, the one-year survival rate of the 27 cases was 81.5%.
Claims
1. p-boronophenylalanine or a pharma- ceutically acceptable salt thereof, in which the proportion of boron-10 among the boron atoms in the compound is 75% or more; Sugar alcohol; Antioxidants; Citric acid; and An injection solution for boron neutron capture therapy, which contains water, has a pH of 6.5 to 7.5, and an osmotic pressure ratio of 1.0 to 1.8, and is to be administered by intravenous drip injection.
2. 2. The injection solution for boron neutron capture therapy according to claim 1, which is administered at a rate of 150 to 250 mg / kg / hour as a p-boronophenylalanine concentration for 1.5 to 3 hours, and then at a rate of 80 to 120 mg / kg / hour for 0.5 to 1.5 hours in a slow-speed administration manner, while irradiating with epithermal neutron rays during said slow-speed administration.
3. 3. The injection solution for boron neutron capture therapy according to claim 1 or 2, wherein the sugar alcohol is sorbitol or mannitol.
4. 4. The injection solution for boron neutron capture therapy according to claim 1, wherein the concentration of the sugar alcohol is 2.6 to 6.5 w / v %.
5. 5. The injection solution for boron neutron capture therapy according to claim 1, wherein the content of the sugar alcohol is in the range of 0.9 to 3.0 in terms of molar ratio to the content of p-boronophenylalanine.
6. 6. The injection solution for boron neutron capture therapy according to claim 1, wherein the antioxidant is a sulfite.
7. 7. The injection solution for boron neutron capture therapy according to claim 6, wherein the concentration of the antioxidant is 0.01 to 0.6 w / v %.
8. 8. The injection solution for boron neutron capture therapy according to claim 6 or 7, wherein the sulfite is sodium pyrosulfite, sodium sulfite, or sodium hydrogen sulfite.
9. The injectable solution according to any one of claims 1 to 8, which is for treating solid cancer.