Reduction of tumor burden by administering a CCR1 antagonist in combination with a PD-1 or PD-L1 inhibitor

Abstract

Methods are provided for reducing tumor burden, tumor growth, tumor progression, and / or metastasis in a subject afflicted with a solid tumor, such as triple-negative breast cancer. The method includes administering to a subject in need thereof a therapeutically effective amount of a PD-L1 inhibitor or a PD-1 inhibitor in combination with a small molecule chemokine receptor antagonist that blocks CCR1.

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit under 35 USC § 119(e) of U.S. Provisional Application No. 62 / 319,689, filed April 7, 2016, which is incorporated by reference in its entirety.

[0002] STATEMENT REGARDING RIGHTS TO INVETIONS MADE UNDER FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT Not applicable

[0003] Reference to a "Sequence Listing," Table, or Computer Program Listing Attachment Submitted on a Compact Disc Not applicable [Background technology]

[0004] Cancerous tumors utilize numerous mechanisms to evade the body's innate cytotoxic immune response so that the tumor is tolerated by the immune system. These mechanisms include dysfunctional T cell signaling, suppressive regulatory cells, and immune checkpoints that normally function to downregulate the strength of the adaptive immune response and protect healthy tissues from collateral damage. For example, tumors develop immune tolerance, particularly to T cells specific for tumor antigens, by recruiting myeloid-derived suppressor cells (MDSCs) to the tumor and its surrounding microenvironment.

[0005] MDSCs express chemokine receptors, such as the chemokine receptor CCR1, and have immune suppressive functions. MDSCs play an important role in the ability of tumors to suppress immune responses. Another important factor for this suppression is the activation of immune checkpoints, which in turn limit the activation and infiltration of T cells into tumors. Immune checkpoints refer to inhibitory pathways of the immune system that are essential to maintain self-tolerance and control immune responses in peripheral tissues to minimize collateral tissue damage.

[0006] Programmed Death-1 (PD-1) is one of many immune checkpoint receptors expressed by activated T cells and mediates immune suppression. Ligands for PD-1 include Programmed Death Ligand-1 (PD-L1) and Programmed Death Ligand-2 (PD-L2), which are expressed on antigen-presenting cells and many human cancer cells. PD-L1 and PD-L2 can downregulate T cell activation and cytokine secretion upon binding to PD-1.

[0007] Inhibitors of PD-1 / PD-L1 interactions can mediate potent antitumor activity and have been shown to be effective in the treatment of several cancers. Inhibition of CCR1 is associated with reduced tumor burden in a mouse model of myeloma bone disease (Non-Patent Document 1). [Prior art documents] [Non-patent literature]

[0008] [Non-Patent Document 1] Dairaghi et al., Blood, 2012, 12(7):1449-1457 Summary of the Invention [Problem to be solved by the invention]

[0009] There remains a need for effective treatments for cancer, such as solid tumor cancer. [Means for solving the problem]

[0010] Summary of the Invention In one aspect, provided herein is a method of treating a subject having a solid tumor, comprising administering to a subject in need thereof a therapeutically effective amount of a CCR1 chemokine receptor antagonist and a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor.

[0011] In another aspect, provided herein is a composition for treating a subject having a solid tumor, the composition comprising a therapeutically effective amount of a CCR1 chemokine receptor antagonist, a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor, and a pharma- ceutically acceptable carrier or excipient.

[0012] In yet another aspect, provided herein is a kit for treating a subject having a solid tumor, the kit comprising a therapeutically effective amount of a CCR1 chemokine receptor antagonist and a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor, together with instructions for effective administration.

[0013] Other objects, features and advantages of the present invention will become apparent to those skilled in the art from the following detailed description and drawings. [Brief description of the drawings]

[0014] [Figure 1] Figures 1A-1E show expression levels of ligands for the chemokine receptor CCR1 (CCL3, CCL5, and CCL7), PD-L1, and CCR1 in samples from breast cancer patients. Significantly elevated expression of CCL5 (RANTES; Figure 1A), CCL7 (MCP-3; Figure 1B), and PD-L1 (Figure 1D) was found in triple-negative breast cancer patients. Expression levels of CCL3 (MIP-1α) are shown in Figure 1C. Figure 1E shows that expression of CCR1 and PD-L1 correlated well in human breast cancer patient samples. [Diagram 2] FIG. 2 shows the 4T1 breast cancer mouse model, which can be used as a mouse triple-negative breast cancer model. [Diagram 3]Figures 3A-3E show that combination therapy with a CCR1 antagonist and an anti-PD-L1 antibody reduces the progression of aggressive metastatic tumors (e.g., established 4T1 tumors). 4T1 breast cancer mice were administered vehicle (Figure 3A), CCR1 antagonist alone (Figure 3B), PD-L1 antibody alone (Figure 3C), or a combination of CCR1 antagonist and PD-L1 antibody (Figure 3D). Comparison of final tumor weights in Figure 3E shows that the combination therapy was effective in minimizing or reducing tumor progression. [Figure 4] Figures 4A and 4B show that CCR1 antagonists reduced lung metastasis in 4T1 tumor-bearing mice. Figure 4A shows that mice administered CCR1 antagonists had fewer metastatic nodes per lung compared to similar mice administered vehicle. Figure 4B provides images of metastatic nodes in the lungs. [Diagram 5] Figures 5A-5C show that granulocytic myeloid-derived suppressor cells (G-MDSCs) are present in 4T1 tumor-bearing mice. G-MDSCs are dramatically increased in the blood (Figure 5A) and spleen (Figure 5B) of these mice. A slight increase in monocytic myeloid-derived suppressor cells (M-MDSCs) was also seen in the blood and spleen. The majority of immune cells infiltrating 4T1 tumors are G-MDSCs (Figure 5C). [Figure 6] Figures 6A and 6B show that the majority of CCR1-expressing cells in the spleens of 4T1 tumor-bearing mice are G-MDSCs. Flow cytometry analysis is provided in Figure 6A. Figure 6B shows that the highest percentage of CCR1-expressing cells are G-MDSCs. [Figure 7] Figures 7A and 7B show the correlation between tumor weight and the percentage of G-MDSC and CD8 positive T cells. Figure 7A compares the percentage of G-MDSC among tumor-infiltrating immune cells with tumor weight. Figure 7B compares the percentage of CD8+ T cells among tumor-infiltrating immune cells with tumor weight. [Figure 8]Figures 8A and 8B show that combination therapy of CCR1 antagonist and PD-L1 mAb reduces G-MDSC levels (Figure 8A) but not M-MDSC levels (Figure 8B) in the blood of 4T1 tumor-bearing mice. [Figure 9] Figures 9A-9D show the levels of G-MDSC, M-MDSC, CD8 T cells, and B cells infiltrating 4T1 tumors after administration of vehicle, CCR1 antagonist, PD-L1 mAb, and combination therapy. Figure 9A shows that CCR1 antagonist reduces G-MDSC infiltration into 4T1 tumors. Figure 9B shows the levels of M-MDSC infiltration in 4T1 tumors in treated mice. Figure 9C shows increased CD8 T cell infiltration into 4T1 tumors in mice treated with CCR1 antagonist alone or in combination with PD-L1 mAb. Figure 9D shows the levels of B cell infiltration into 4T1 tumors in treated mice. [Figure 10] Figure 10 shows a schematic of CCR1-mediated G-MDSC recruitment to the tumor microenvironment and how this pathway may promote tumor progression. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] Detailed Description of the Invention I. Introduction Provided herein are methods, compositions, and kits for treating cancer, e.g., solid tumors, in a subject in need of such treatment by administering a combination therapy of a CCR1 antagonist and either a PD-1 inhibitor or a PD-L1 inhibitor. The present invention is based in part on the synergistic effect of a CCR1 antagonist in combination with either a PD-1 inhibitor or a PD-L1 inhibitor to reduce or decrease tumor burden, tumor progression, and / or metastasis. In some cases, a therapy comprising a CCR1 antagonist alone can reduce metastasis, e.g., lung metastasis.

[0016] II. Definition The terms "a," "an," or "the," as used herein, not only include embodiments having one member, but also include embodiments having two or more members. For example, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to "a cell" includes a plurality of such cells, reference to "the agent" includes reference to one or more agents known to those of skill in the art, and so forth.

[0017] The terms "about" and "approximately" are generally intended to mean an acceptable degree of error for the measured quantity, given the nature or precision of the measurement. An example of a typical degree of error is within 20 percent (%), preferably within 10%, and more preferably within 5% of a given value or range of values. Alternatively, particularly in biological systems, the terms "about" and "approximately" can mean values ​​within 10-fold, preferably within 5-fold, and more preferably within 2-fold of a given value. Numerical quantities described herein are approximate, unless otherwise stated, meaning that they can be inferred when the term "about" or "approximately" is not explicitly stated.

[0018] The term “alkyl,” by itself or as part of another substituent, means, unless otherwise stated, a straight or branched chain hydrocarbon radical having the specified number of carbon atoms (i.e., C 1-8means 1 to 8 carbons). Examples of alkyl groups include methyl, ethyl, n-propyl, isopropyl, n-butyl, t-butyl, isobutyl, sec-butyl, n-pentyl, n-hexyl, n-heptyl, n-octyl, and the like. The term "alkenyl" refers to unsaturated alkyl groups having one or more double bonds. Similarly, the term "alkynyl" refers to unsaturated alkyl groups having one or more triple bonds. Examples of such unsaturated alkyl groups include vinyl, 2-propenyl, crotyl, 2-isopentenyl, 2-(butadienyl), 2,4-pentadienyl, 3-(1,4-pentadienyl), ethynyl, 1- and 3-propynyl, 3-butynyl, and higher homologs and isomers. The term "cycloalkyl" refers to any alkyl group having the indicated number of ring atoms (e.g., C 3-6 "Cycloalkyl" refers to a hydrocarbon ring that is fully saturated or has no more than one double bond between the ring vertices. "Cycloalkyl" is also intended to refer to bicyclic and polycyclic hydrocarbon rings, such as, for example, bicyclo[2.2.1]heptane, bicyclo[2.2.2]octane, and the like. The term "heterocycloalkane" or "heterocycloalkyl" refers to a cycloalkyl group containing 1 to 5 heteroatoms selected from N, O, and S, wherein the nitrogen and sulfur atoms are optionally oxidized and the nitrogen atom(s) are optionally quaternized. Heterocycloalkanes may be monocyclic, bicyclic, or polycyclic ring systems. Non-limiting examples of heterocycloalkane groups include pyrrolidine, imidazolidine, pyrazolidine, butyrolactam, valerolactam, imidazolidinone, hydantoin, dioxolane, phthalimide, piperidine, 1,4-dioxane, morpholine, thiomorpholine, thiomorpholine-S-oxide, thiomorpholine-S,S-oxide, piperazine, pyran, pyridone, 3-pyrroline, thiopyran, pyrone, tetrahydrofuran, tetrahydrothiophene, quinuclidine, etc. Heterocycloalkane groups can be attached to the remainder of the molecule through a ring carbon or heteroatom.

[0019] The term "alkylene," by itself or as part of another substituent, means -CH 2 CH 2CH 2 CH 2 "Alkyl" refers to a divalent group derived from an alkane, such as exemplified by -. Typically, an alkyl (or alkylene) group will have from 1 to 24 carbon atoms, with groups having 10 or fewer carbon atoms being preferred in the present invention. A "lower alkyl" or "lower alkylene" is a shorter chain alkyl or alkylene group, generally having four or fewer carbon atoms. Similarly, "alkenylene" and "alkynylene" refer to the unsaturated forms of "alkylene" having a double or triple bond, respectively.

[0020] As used herein, a wavy line "" across a single bond, double bond, or triple bond in any chemical structure described herein is TIFF0007611189000001.tif68" represents the point of attachment of a single, double, or triple bond to the rest of the molecule.

[0021] The terms "alkoxy," "alkylamino," and "alkylthio" (or thioalkoxy) are used in their conventional sense to refer to an alkyl group attached to the remainder of the molecule via an oxygen atom, an amino group, or a sulfur atom, respectively. Additionally, for dialkylamino groups, the alkyl portions may be the same or different and may be combined to form a 3- to 7-membered ring with the nitrogen atom to which each is attached. Thus, dialkylamino or -NR a R b A group represented as: is intended to include piperidinyl, pyrrolidinyl, morpholinyl, azetidinyl, and the like.

[0022] The term "di-(C 1-4 Alkyl)amino-C 1-4 "Alkyl" means two C alkyl groups which may be the same or different. 1-4 having an alkyl group (e.g., methyl, ethyl, propyl, isopropyl, n-butyl, sec-butyl, isobutyl, and tert-butyl); 1-4 Refers to an amino group that is attached to the rest of the molecule through an alkyl group (a 1-4 carbon alkylene linking group). 1-4Alkyl)amino-C 1-4 Examples of alkyl groups include dimethylaminomethyl, 2-(ethyl(methyl)amino)ethyl, 3-(dimethylamino)butyl, and the like.

[0023] The terms "halo" or "halogen," by themselves or as part of another substituent, mean, unless otherwise stated, a fluorine, chlorine, bromine, or iodine atom. Additionally, terms such as "haloalkyl" are meant to include monohaloalkyl and polyhaloalkyl. For example, the term "C 1-4 "Haloalkyl" is meant to include trifluoromethyl, 2,2,2-trifluoroethyl, 4-chlorobutyl, 3-bromopropyl, and the like.

[0024] The term "aryl" means, unless otherwise stated, a polyunsaturated, typically aromatic, hydrocarbon group that may be a single ring or multiple rings (up to three rings) fused or covalently linked together. The term "heteroaryl" refers to an aryl group (or ring) containing 1 to 5 heteroatoms selected from N, O, and S, where the nitrogen and sulfur atoms are optionally oxidized and the nitrogen atom(s) are optionally quaternized. A heteroaryl group can be attached to the remainder of the molecule through a heteroatom. Non-limiting examples of aryl groups include phenyl, naphthyl, and biphenyl, while non-limiting examples of heteroaryl groups include pyridyl, pyridazinyl, pyrazinyl, pyrimidinyl, triazinyl, quinolinyl, quinoxalinyl, quinazolinyl, cinnolinyl, phthalazinyl, benzotriazinyl, purinyl, benzimidazolyl, benzopyrazolyl, benzotriazolyl, benzisoxazolyl, isobenzofuryl, isoindolyl. , indolizinyl, benzotriazinyl, thienopyridinyl, thienopyrimidinyl, pyrazolopyrimidinyl, imidazopyridine, benzothiazolyl, benzofuranyl, benzothienyl, indolyl, quinolyl, isoquinolyl, isothiazolyl, pyrazolyl, indazolyl, pteridinyl, imidazolyl, triazolyl, tetrazolyl, oxazolyl, isoxazolyl, thiadiazolyl, pyrrolyl, thiazolyl, furyl, thienyl, and the like. Substituents for each of the above noted aryl and heteroaryl ring systems are selected from the group of acceptable substituents described below.

[0025] The term "arylalkyl" is intended to include groups in which an aryl group is attached to an alkyl group (e.g., benzyl, phenethyl, etc.). Similarly, the term "heteroaryl-alkyl" is intended to include groups in which a heteroaryl group is attached to an alkyl group (e.g., pyridylmethyl, thiazolylethyl, etc.).

[0026] The above terms (e.g., "alkyl," "aryl," and "heteroaryl"), in some embodiments, refer to both substituted and unsubstituted forms of the indicated radical. Preferred substituents for each type of radical are provided below.

[0027] Substituents for alkyl groups (including groups often referred to as alkylene, alkenyl, alkynyl, and cycloalkyl) are selected from the group consisting of -halogen, -OR', -NR'R'', -SR', -SiR'R''R''', -OC(O)R', -C(O)R', -CO 2 R', -CONR'R'', -OC(O)NR'R'', -NR''C(O)R', -NR'-C(O)NR''R''', -NR''C(O) 2 R', -NH-C(NH 2 )=NH, -NR'C(NH 2 )=NH, -NH-C(NH 2 )=NR', -S(O)R', -S(O) 2 R', -S(O) 2 NR'R'', -NR'S(O) 2 R'', -CN, and -NO 2 R′, R″, and R′″ may each independently be selected from the group consisting of hydrogen; 1-8 Alkyl; unsubstituted aryl; 1-3 halogens, unsubstituted C 1-8 Alkyl, C 1-8 Alkoxy or C 1-8 aryl substituted with a thioalkoxy group; or unsubstituted aryl-C 1-4 represents an alkyl group. When R' and R" are attached to the same nitrogen atom, they can be combined with the nitrogen atom to form a 3-, 4-, 5-, 6-, or 7-membered ring. For example, -NR'R" is meant to include 1-pyrrolidinyl and 4-morpholinyl.

[0028] Similarly, substituents on the aryl and heteroaryl groups are varied and generally include -halogen, -OR', -OC(O)R', -NR'R'', -SR', -R', -CN, -NO in a number ranging from 0 to the total number of open valences on the aromatic ring system. 2 , -CO 2 R', -CONR'R'', -C(O)R', -OC(O)NR'R'', -NR''C(O)R', -NR''C(O) 2 R', -NR'-C(O)NR''R''', -NH-C(NH 2 )=NH, -NR'C(NH 2 )=NH, -NH-C(NH 2 )=NR', -S(O)R', -S(O) 2 R', -S(O) 2 NR'R'', -NR'S(O) 2 R'', -N 3 , perfluoro(C 1 -C 4 ) alkoxy, and perfluoro (C 1 -C 4 R', R'', and R''' are independently selected from hydrogen, C 1-8 Alkyl. C 1-8 Haloalkyl, C 3-6 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, unsubstituted aryl and heteroaryl, (unsubstituted aryl)-C 1-4 Alkyl and unsubstituted aryloxy-C 1-4 Other suitable substituents include each of the above aryl substituents attached to a ring atom by an alkylene tether of 1 to 4 carbon atoms.

[0029] Two of the substituents on adjacent atoms of an aryl or heteroaryl ring may optionally be of the formula -TC(O)-(CH 2 ) q and wherein T and U are independently -NH-, -O-, -CH 2-, or a single bond, and q is an integer from 0 to 2. Alternatively, two of the substituents on adjacent atoms of the aryl or heteroaryl ring are optionally represented by the formula -A-(CH 2 ) r A and B may be independently substituted with a -CH 2 -, -O-, -NH-, -S-, -S(O)-, -S(O) 2 -, -S(O) 2 NR'-, or a single bond, where r is an integer from 1 to 3. One of the single bonds of the new ring thus formed may optionally be replaced with a double bond. Alternatively, two of the substituents on adjacent atoms of the aryl or heteroaryl ring may optionally be replaced with a group of the formula -(CH 2 ) s -X-(CH 2 ) t In the formula, s and t are independently an integer of 0 to 3, and X is -O-, -NR'-, -S-, -S(O)-, -S(O) 2 - or -S(O) 2 -NR'- and -S(O) 2 The substituent R' in NR'- is hydrogen or an unsubstituted C 1-6 is selected from alkyl.

[0030] As used herein, the term "heteroatom" is meant to include oxygen (O), nitrogen (N), sulfur (S), and silicon (Si).

[0031] The term "pharmaceutical acceptable salts" is intended to include salts of active compounds prepared with relatively non-toxic acids or bases, depending on the particular substituents found on the compounds described herein. When the compounds of the present invention have relatively acidic functionalities, base addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of the desired base, either in pure form or in a suitable inert solvent. Examples of salts derived from pharmaceutical acceptable inorganic bases include aluminum, ammonium, calcium, copper, ferric, ferrous, lithium, magnesium, manganic, manganous, potassium, sodium, zinc, and the like. Salts derived from pharma- ceutically acceptable organic bases include salts of primary, secondary, and tertiary amines, including substituted amines, cyclic amines, naturally occurring amines, and the like, such as arginine, betaine, caffeine, choline, N,N'-dibenzylethylenediamine, diethylamine, 2-diethylaminoethanol, 2-dimethylaminoethanol, ethanolamine, ethylenediamine, N-ethylmorpholine, N-ethylpiperidine, glucamine, glucosamine, histidine, hydrabamine, isopropylamine, lysine, methylglucamine, morpholine, piperazine, piperidine, polyamine resins, procaine, purine, theobromine, triethylamine, trimethylamine, tripropylamine, tromethamine, and the like. In cases where a compound of the present invention possesses a relatively basic functionality, an acid addition salt can be obtained by contacting the neutral form of such a compound, either neat or in a suitable inert solvent, with a sufficient amount of the desired acid.Examples of pharma- ceutically acceptable acid addition salts include those derived from inorganic acids such as hydrochloric acid, hydrobromic acid, nitric acid, carbonic acid, monohydrogencarbonic acid, phosphoric acid, monohydrogenphosphoric acid, dihydrogenphosphoric acid, sulfuric acid, monohydrogensulfuric acid, hydroiodic acid, or phosphorous acid, as well as those derived from relatively non-toxic organic acids such as acetic acid, propionic acid, isobutyric acid, malonic acid, benzoic acid, succinic acid, suberic acid, fumaric acid, mandelic acid, phthalic acid, benzenesulfonic acid, p-tolylsulfonic acid, citric acid, tartaric acid, methanesulfonic acid, and the like. Also included are salts of amino acids, such as arginate, and salts of organic acids, such as glucuronic acid or galacturonic acid (see, e.g., Berge, SM, et al, "Pharmaceutical Salts", Journal of Pharmaceutical Science, 1977, 66, 1-19).Certain compounds of the present invention contain both basic and acidic functionalities that allow the compounds to be converted into either base or acid addition salts.

[0032] The neutral forms of the compounds can be regenerated by contacting the salt with a base or acid and isolating the parent compound in the conventional manner. The parent form of the compound differs from the various salt forms in certain physical properties, such as solubility in polar solvents, but otherwise the salts are equivalent to the parent form of the compound for purposes of the invention.

[0033] In addition to salt forms, the present invention provides compounds that are in prodrug form. Prodrugs of the compounds described herein are compounds that easily undergo chemical changes under physiological conditions to provide the compounds of the present invention. In addition, prodrugs can be converted to the compounds of the present invention by chemical or biochemical methods in an ex vivo environment. For example, prodrugs can be slowly converted to the compounds of the present invention when placed in a transdermal patch reservoir with a suitable enzyme or chemical reagent.

[0034] Certain compounds of the present invention can exist in unsolvated and solvated forms, such as hydrated forms. In general, solvated forms are equivalent to unsolvated forms and are intended to be included within the scope of the present invention. Certain compounds of the present invention can exist in multiple crystalline or amorphous forms. In general, all physical forms are equivalent for the uses contemplated by the present invention and are intended to be within the scope of the present invention.

[0035] Certain compounds of the present invention have asymmetric carbon atoms (optical centers) or double bonds; racemates, diastereomers, geometric isomers, positional isomers, and individual isomers (e.g., separated enantiomers) are all intended to be encompassed within the scope of the present invention. When a stereochemical depiction is shown, it is intended to refer to a compound in which one of the isomers is present and the other isomer is substantially absent. "Substantially absent" of another isomer refers to a ratio of at least 80 / 20, more preferably 90 / 10, or 95 / 5 or greater, of the two isomers. In some embodiments, one of the isomers is present in an amount of at least 99%.

[0036] The compounds of the present invention may also contain unnatural proportions of atomic isotopes at one or more of the atoms that constitute such compounds. Unnatural proportions of an isotope may be defined as a range from the amount found in nature to the amount at which the atom in question constitutes 100%. For example, the compounds may contain radioactive isotopes, such as tritium ( 3 H), iodine-125( 125 I), or carbon-14 ( 14 C), or non-radioactive isotopes such as deuterium ( 2 H) or carbon-13 ( 13C) may be incorporated. Such isotopic variations may provide additional utility to those described elsewhere in this application. For example, isotopic variants of the compounds of the present invention may find additional utility, including but not limited to, as diagnostic and / or imaging reagents or as cytotoxic / radiotoxic therapeutic agents. In addition, isotopic variants of the compounds of the present invention may have altered pharmacokinetic and pharmacodynamic properties that may contribute to enhanced safety, tolerability, or efficacy during treatment. All isotopic variations of the compounds of the present invention, whether radioactive or not, are intended to be encompassed within the scope of the present invention.

[0037] The compounds of the present invention having formulas I-V can exist in various isomeric forms. As used herein, the terms cis or trans are used in their conventional sense in the chemical art, i.e., referring to the position of the substituents relative to a reference plane (e.g., a double bond, or a ring system, such as a decalin-type ring system or a hydroquinolone ring system); in cis isomers, the substituents are on the same side of the reference plane, and in trans isomers, the substituents are on opposite sides. Additionally, different conformers and distinct rotamers are contemplated by the present invention. Conformers are structural isomers that can differ by rotation around one or more σ-bonds. Rotamers are conformers that differ by rotation around only a single σ-bond.

[0038] The term "cancer" refers to a disease characterized by uncontrolled proliferation of abnormal cells. Cancer cells can spread locally or through the bloodstream and lymphatic system to other parts of the body. Examples of various cancers are described herein and include, but are not limited to, breast cancer, prostate cancer, ovarian cancer, cervical cancer, skin cancer, pancreatic cancer, colon cancer, renal cancer, liver cancer, brain cancer, lymphoma, leukemia, lung cancer, etc. The terms "tumor" and "cancer" are used interchangeably herein, e.g., both terms encompass solid tumors and liquid tumors, e.g., diffuse tumors or circulating tumors. As used herein, the term "cancer" or "tumor" includes pre-malignant and malignant cancers and tumors.

[0039] The term "PD-1" or "PD-1 receptor" refers to the T cell co-inhibitor programmed death-1 protein (also known as CD279). The amino acid sequence of human full-length PD-1 protein is set forth, for example, in GenBank Accession No. NP_005009.2. PD-1 is a 288 amino acid protein with an extracellular N-terminal domain that is IgV-like, a transmembrane domain, and an intracellular domain that contains immunoreceptor tyrosine-based inhibitory (ITIM) motifs and immunoreceptor tyrosine-based switch (ITSM) motifs (Chattopadhyay et al., Immunol Rev, 2009, 229(1):356-386). The term "PD-1" includes recombinant PD-1 or fragments thereof, or variants thereof. The PD-1 receptor has two ligands, PD-ligand-1 (PD-L1) and PD-ligand-2 (PD-L2).

[0040] The term "PD-L1" or "programmed death ligand 1" refers to the ligand of the PD-1 receptor, also known as CD274 and B7H 1. The amino acid sequence of the human full-length PD-L1 protein is set forth, for example, in GenBank Accession No. NP_054862.1. PD-L1 is a 290 amino acid protein with an extracellular IgV-like domain, a transmembrane domain, and a highly conserved intracellular domain of approximately 30 amino acids. PD-L1 is constitutively expressed on many cells, including antigen-presenting cells (e.g., dendritic cells, macrophages, and B cells), and hematopoietic and non-hematopoietic cells (e.g., vascular endothelial cells, pancreatic islets, and immune privileged sites). PD-L1 is also expressed on a variety of tumors, virus-infected cells, and autoimmune tissues.

[0041] The programmed death 1 (PD-1 / PD-L1) pathway functions as a checkpoint that limits T cell-mediated immune responses. Both PD-1 ligands, PD-L1 and PD-L2, can engage the PD-1 receptor and induce PD-1 signaling and reversible inhibition of T cell activation and proliferation. When PD-1 ligands are present on the surface or on cancer cells or adjacent cells, these ligands bind to PD-1 receptor-positive immune effector cells and utilize the PD-1 pathway to evade the immune response.

[0042] The term "immune checkpoint inhibitor" or "immune checkpoint blockade" refers to any drug, molecule, compound, chemical, protein, polypeptide, macromolecule, etc. that blocks or inhibits an inhibitory pathway of the immune system in a statistically, clinically, or biologically significant manner. Such inhibitors may include small molecule inhibitors or may include antibodies or antigen-binding fragments thereof that bind to and block or inhibit immune checkpoint receptors or immune checkpoint receptor ligands. Examples of immune checkpoint molecules that can be targeted for blockade or inhibition include, but are not limited to, CTLA-4, 4-1BB (CD137), 4-1BBL (CD137L), PDL1, PDL2, PD-1, B7-H3, B7-H4, BTLA, HVEM, TIM3, GAL9, LAG3, TIM3, B7H3, B7H4, VISTA, KIR, 2B4 (belonging to the CD2 family of molecules and expressed on all NK, gamma delta, and memory CD8+ (alpha beta) T cells), CD160 (also called BY55), and CGEN-15049. Examples of immune checkpoint inhibitors include durvalumab (anti-PD-L1 antibody; MEDI4736), pembrolizumab (anti-PD-1 monoclonal antibody), nivolumab (anti-PD-1 antibody), pidilizumab (CT-011; humanized anti-PD-1 monoclonal antibody), AMP224 (recombinant B7-DC-Fc fusion protein), BMS-936559 (anti-PD-L1 antibody), atezolizumab (MPLDL3280A; human Fc-optimized anti-PD-L1 monoclonal antibody), avelumab (MSB0010718C; human anti-PD-L1 antibody), ipilimumab (anti-CTLA-4 checkpoint inhibitor), tremelimumab (CTLA-4 blocking antibody), and anti-OX40.

[0043] The terms "CCR1 antagonist" and "CCR1 chemokine receptor antagonist" are used interchangeably and refer to small molecules that antagonize the interaction of the chemokine receptor CCR1 with any one of its ligands. Such compounds can inhibit processes normally triggered by receptor-ligand interaction.

[0044] As used herein, "complete response" or "CR" refers to the disappearance of all target lesions; "partial response" or "PR" refers to at least a 30% reduction in the sum of the longest diameters (SLD) of the target lesions (based on baseline SLD); and "stable disease" or "SD" refers to neither sufficient shrinkage of target lesions to qualify as PR nor sufficient increase to qualify as PD (based on the smallest SLD since treatment initiation).

[0045] As used herein, "progressive disease" or "PD" refers to at least a 20% increase in the SLD of target lesions (based on the smallest SLD recorded since the start of treatment or the presence of one or more new lesions).

[0046] As used herein, "progression-free survival" (PFS) refers to the length of time during and after treatment during which the disease being treated (e.g., cancer) does not worsen. Progression-free survival can include the amount of time a patient experiences a complete response or a partial response, as well as the amount of time a patient experiences stable disease.

[0047] As used herein, "overall response rate" (ORR) refers to the sum of the complete response (CR) rate and the partial response (PR) rate.

[0048] As used herein, "overall survival" refers to the percentage of individuals in a group who are likely to be alive after a particular duration of time.

[0049] III. Detailed Description of the Preferred Embodiments In one aspect, the invention provides a method of treating a subject having a solid tumor, comprising administering to a subject in need thereof a therapeutically effective amount of a CCR1 chemokine receptor antagonist and a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor.

[0050] In some embodiments, the methods comprise administering to a subject in need thereof a therapeutically effective amount of a CCR1 chemokine receptor antagonist and a therapeutically effective amount of a PD-1 inhibitor.

[0051] In some embodiments, the methods comprise administering to a subject in need thereof a therapeutically effective amount of a CCR1 chemokine receptor antagonist and a therapeutically effective amount of a PD-L1 inhibitor.

[0052] In some embodiments, the CCR1 chemokine receptor antagonist is selected from compounds of formulas I-V below, more particularly from compounds 1.001, 3.002, 4.005, 5.005, and 3.001, or a pharma- ceutically acceptable salt thereof.

[0053] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of BL-5923, UCB-35625, BX-471, BI-638683, PS-031291, MLN-3701, AZD-4818, MLN-3897, CP-481715, F-18-CCR1, AOP-RANTES, PS-375179, and NSC-651016.

[0054] In some embodiments, the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, STI-1110, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0055] In some embodiments, the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, and STI-1110.

[0056] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0057] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0058] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-327, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0059] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, and KY-1003.

[0060] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from compounds disclosed in US2015291549, WO16039749, WO15034820, and US2014294898 (BRISTOL MYERS SQUIBB CO), which are incorporated herein by reference.

[0061] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from compounds disclosed in WO14151634, WO15160641, WO16039749, WO16077518, WO16100608, WO16149351, WO2016057624, WO2016100285, US2016194307, US2016222060, and US2014294898 (BRISTOL MYERS SQUIBB CO), which are incorporated by reference herein.

[0062] In some embodiments, the PD-1 or PD-L1 inhibitor is selected from the compounds disclosed in U.S. Provisional Patent Application No. 62 / 355,119 or 62 / 440,100, which are incorporated herein by reference.

[0063] In some embodiments, the PD-1 and / or PD-L1 inhibitor is one of the following: [ka] is selected from the group consisting of:

[0064] In some embodiments, the PD-1 and / or PD-L1 inhibitors are disclosed in WO16142886, WO16142894, WO16142852, WO16142833, WO15033301, WO15033299, WO11161699, WO12168944, WO13132317, WO13144704, WO15033303, WO15036927, WO15044900, WO16142835, US2015073024, US8907053, US9044442, US9096642, US9233940, and US2016194295 (Aurigene discovery tech The compound is selected from those disclosed in US Pat. No. 6,399,363, issued Dec. 23, 1997, and entitled "Compounds for the Preparation of Compounds of the Invention."

[0065] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, pembrolizumab, nivolumab, AP-106, AP-105, MSB-2311, CBT-501, avelumab, AK-105, IO-102, IO-103, PDR-001, CX-072, SHR-1316, JTX-4014, GNS-1480, recombinant humanized anti-PD1 mAb (Shanghai Junshi Biosciences), REGN-2810, pelareorep, SHR-1210, PD1 / PDL1 inhibitor vaccine (THERAVECTYS), BGB-A317, recombinant humanized anti-PD-1 mAb (Bio-Thera Solutions), Probody targeting PD-1 (CytomX), XmAb-20717, FS-118, PSI-001, SN-PDL01, SN-PD07, PD-1 modified TILs (Sangamo Therapeutics), PRS-332, FPT-155, jienuo mAb (Genor Biopharma), TSR-042, REGN-1979, REGN-2810, resminostat, FAZ-053, PD-1 / CTLA-4 bispecific antibody (MacroGenics), MGA-012, MGD-013, M-7824, PD-1 based bispecific antibody (Beijing Hanmi Pharmaceutical), AK-112, AK-106, AK-104, AK-103, BI-754091, ENUM-244C8, MCLA-145, MCLA-134, anti-PD1 oncolytic monoclonal antibody (Transgene SA), AGEN-2034, IBI-308, WBP-3155, JNJ-63723283, MEDI-0680, SSI-361, CBT-502, anti-PD-1 bispecific antibody, dual-targeted anti-PD-1 / LAG-3 mAbs (TESARO), dual-targeted anti-PD-1 / TIM-3mAbs (TESARO), PF-06801591, LY-3300054, BCD-100, STI-1110, pembrolizumab biosimilar, nivolumab biosimilar, PD-L1-TGF-beta therapy, KY-1003, STI-1014, GLS-010, AM-0001, GX-P2, KD-033, PD-L1 / BCMA bispecific antibody (Immune Pharmaceuticals), PD-1 / Ox40-targeted bispecific antibody (Immune Pharmaceuticals), BMS-936559, anti-PD-1 / VEGF-A DARPins (Molecular Partners), mDX-400, ALN-PDL, PD-1 inhibitor peptide (Aurigene), siRNA-loaded dendritic cell vaccine (Alnylam Pharmaceuticals), GB-226, PD-L1-targeted CAR-TNK-based immunotherapy (TNK Therapeutics / NantKwest), INSIX RA, INDUS-903, AMP-224, anti-CTLA-4 / anti-PD-1 bispecific humanized antibody (Akeso Biopharma), B7-H1 vaccine (State Key Laboratory of Cancer Biology / Fourth Military Medical University), and GX-D1.

[0066] The CCR1 chemokine receptor antagonist and the PD-1 inhibitor or PD-L1 inhibitor may be administered simultaneously. In some cases, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor are administered simultaneously. In some cases, the CCR1 chemokine receptor antagonist and the PD-L1 inhibitor are administered simultaneously. In some cases, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or PD-L1 inhibitor are administered in a combined formulation. The CCR1 chemokine receptor antagonist and the PD-1 inhibitor may be administered in a combined formulation. Optionally, the CCR1 chemokine receptor antagonist and the PD-L1 inhibitor are administered in a combined formulation.

[0067] In other embodiments, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or PD-L1 inhibitor are administered sequentially. In some cases, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor are administered sequentially. In some cases, the CCR1 chemokine receptor antagonist and the PD-L1 inhibitor are administered sequentially. The CCR1 chemokine receptor antagonist may be administered prior to administration of the PD-1 inhibitor or PD-L1 inhibitor.

[0068] In some embodiments, the CCR1 chemokine receptor antagonist may be administered prior to administration of the PD-L1 inhibitor. The CCR1 chemokine receptor antagonist may be administered after administration of the PD-1 inhibitor or the PD-L1 inhibitor.

[0069] In some embodiments, the CCR1 chemokine receptor antagonist may be administered following administration of a PD-L1 inhibitor.

[0070] In some embodiments, the subject is a human subject.

[0071] In some embodiments, the solid tumor can be a brain cancer, breast cancer, bladder cancer, bone cancer, colon cancer, lung cancer, kidney cancer, liver cancer, stomach cancer, prostate cancer, sarcoma, melanoma, carcinoma, and lymphoma.

[0072] In some embodiments, the solid tumor is breast cancer.

[0073] In some embodiments, the solid tumor is triple-negative breast cancer.

[0074] In a second aspect, the present invention provides a composition for treating a subject having a solid tumor, the composition comprising a therapeutically effective amount of a CCR1 chemokine receptor antagonist, a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor, and a pharma- ceutically acceptable carrier or excipient.

[0075] In some embodiments, the composition comprises a therapeutically effective amount of a CCR1 chemokine receptor antagonist, a therapeutically effective amount of a PD-L1 inhibitor, and a pharma- ceutically acceptable carrier or excipient.

[0076] In some embodiments, the CCR1 chemokine receptor antagonist is a compound selected from Formulas IV below.

[0077] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of 1.001, 3.002, 4.005, 5.005, and 3.001, or a pharma- ceutically acceptable salt thereof.

[0078] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of BL-5923, UCB-35625, BX-471, BI-638683, PS-031291, MLN-3701, AZD-4818, MLN-3897, CP-481715, F-18-CCR1, AOP-RANTES, PS-375179, and NSC-651016.

[0079] In some embodiments, the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, STI-1110, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0080] In some embodiments, the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, and STI-1110.

[0081] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0082] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0083] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, and KY-1003.

[0084] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from compounds disclosed in WO14151634, WO15160641, WO16039749, WO16077518, WO16100608, WO16149351, WO2016057624, WO2016100285, US2016194307, US2016222060, US2014294898, US2015291549, and US2016194307 (BRISTOL MYERS SQUIBB CO), which are incorporated by reference herein.

[0085] In some embodiments, the PD-1 or PD-L1 inhibitor is selected from the compounds disclosed in U.S. Provisional Patent Application No. 62 / 355,119 or 62 / 440,100, which are incorporated herein by reference.

[0086] In some embodiments, the PD-1 and / or PD-L1 inhibitor is one of the following: [ka] is selected from the group consisting of:

[0087] In some embodiments, the PD-1 and / or PD-L1 inhibitors are disclosed in WO16142886, WO16142894, WO16142852, WO16142833, WO15033301, WO15033299, WO11161699, WO12168944, WO13132317, WO13144704, WO15033303, WO15036927, WO15044900, WO16142835, US2015073024, US8907053, US9044442, US9096642, US9233940, and US2016194295 (Aurigene discovery tech The compound is selected from those disclosed in US Pat. No. 6,399,363, issued Dec. 23, 1997, and entitled "Compounds for the Preparation of Compounds of the Invention."

[0088] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, pembrolizumab, nivolumab, AP-106, AP-105, MSB-2311, CBT-501, avelumab, AK-105, IO-102, IO-103, PDR-001, CX-072, SHR-1316, JTX-4014, GNS-1480, recombinant humanized anti-PD1 mAb (Shanghai Junshi Biosciences), REGN-2810, pelareorep, SHR-1210, PD1 / PDL1 inhibitor vaccine (THERAVECTYS), BGB-A317, recombinant humanized anti-PD-1 mAb (Bio-Thera Solutions), Probody targeting PD-1 (CytomX), XmAb-20717, FS-118, PSI-001, SN-PDL01, SN-PD07, PD-1 modified TILs (Sangamo Therapeutics), PRS-332, FPT-155, jienuo mAb (Genor Biopharma), TSR-042, REGN-1979, REGN-2810, resminostat, FAZ-053, PD-1 / CTLA-4 bispecific antibody (MacroGenics), MGA-012, MGD-013, M-7824, PD-1 based bispecific antibody (Beijing Hanmi Pharmaceutical), AK-112, AK-106, AK-104, AK-103, BI-754091, ENUM-244C8, MCLA-145, MCLA-134, anti-PD1 oncolytic monoclonal antibody (Transgene SA), AGEN-2034, IBI-308, WBP-3155, JNJ-63723283, MEDI-0680, SSI-361, CBT-502, anti-PD-1 bispecific antibody, dual-targeted anti-PD-1 / LAG-3 mAbs (TESARO), dual-targeted anti-PD-1 / TIM-3mAbs (TESARO), PF-06801591, LY-3300054, BCD-100, STI-1110, pembrolizumab biosimilar, nivolumab biosimilar, PD-L1-TGF-beta therapy, KY-1003, STI-1014, GLS-010, AM-0001, GX-P2, KD-033, PD-L1 / BCMA bispecific antibody (Immune Pharmaceuticals), PD-1 / Ox40-targeted bispecific antibody (Immune Pharmaceuticals), BMS-936559, anti-PD-1 / VEGF-A DARPins (Molecular Partners), mDX-400, ALN-PDL, PD-1 inhibitor peptide (Aurigene), siRNA-loaded dendritic cell vaccine (Alnylam Pharmaceuticals), GB-226, PD-L1-targeted CAR-TNK-based immunotherapy (TNK Therapeutics / NantKwest), INSIX RA, INDUS-903, AMP-224, anti-CTLA-4 / anti-PD-1 bispecific humanized antibody (Akeso Biopharma), B7-H1 vaccine (State Key Laboratory of Cancer Biology / Fourth Military Medical University), and GX-D1.

[0089] In some embodiments, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or PD-L1 inhibitor are formulated for co-administration.

[0090] In other embodiments, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or PD-L1 inhibitor are formulated for sequential administration.

[0091] In yet another aspect, provided herein is a kit for treating a subject having a solid tumor, the kit comprising a therapeutically effective amount of a CCR1 chemokine receptor antagonist and a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor, together with instructions for effective administration.

[0092] In some embodiments, the kit comprises a therapeutically effective amount of a CCR1 chemokine receptor antagonist and a therapeutically effective amount of a PD-L1 inhibitor, together with instructions for effective administration.

[0093] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of 1.001, 3.002, 4.005, 5.005, and 3.001, or a pharma- ceutically acceptable salt thereof.

[0094] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of BL-5923, UCB-35625, BX-471, BI-638683, PS-031291, MLN-3701, AZD-4818, MLN-3897, CP-481715, F-18-CCR1, AOP-RANTES, PS-375179, and NSC-651016.

[0095] In some embodiments, the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, STI-1110, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0096] In some embodiments, the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, and STI-1110.

[0097] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0098] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0099] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, and KY-1003.

[0100] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from compounds disclosed in WO14151634, WO15160641, WO16039749, WO16077518, WO16100608, WO16149351, WO2016057624, WO2016100285, US2016194307, US2016222060, US2015291549, US2016194307, and US2014294898 (BRISTOL MYERS SQUIBB CO), which are incorporated by reference herein.

[0101] In some embodiments, the PD-1 or PD-L1 inhibitor is selected from the compounds disclosed in U.S. Provisional Patent Application No. 62 / 355,119 or 62 / 440,100, which are incorporated herein by reference.

[0102] In some embodiments, the PD-1 and / or PD-L1 inhibitor is one of the following: [ka] is selected from the group consisting of:

[0103] In some embodiments, the PD-1 and / or PD-L1 inhibitors are disclosed in WO16142886, WO16142894, WO16142852, WO16142833, WO15033301, WO15033299, WO11161699, WO12168944, WO13132317, WO13144704, WO15033303, WO15036927, WO15044900, WO16142835, US2015073024, US8907053, US9044442, US9096642, US9233940, and US2016194295 (Aurigene discovery tech The compound is selected from those disclosed in US Pat. No. 6,399,363, issued Dec. 23, 1997, and entitled "Compounds for the Preparation of Compounds of the Invention."

[0104] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, pembrolizumab, nivolumab, AP-106, AP-105, MSB-2311, CBT-501, avelumab, AK-105, IO-102, IO-103, PDR-001, CX-072, SHR-1316, JTX-4014, GNS-1480, recombinant humanized anti-PD1 mAb (Shanghai Junshi Biosciences), REGN-2810, pelareorep, SHR-1210, PD1 / PDL1 inhibitor vaccine (THERAVECTYS), BGB-A317, recombinant humanized anti-PD-1 mAb (Bio-Thera Solutions), Probody targeting PD-1 (CytomX), XmAb-20717, FS-118, PSI-001, SN-PDL01, SN-PD07, PD-1 modified TILs (Sangamo Therapeutics), PRS-332, FPT-155, jienuo mAb (Genor Biopharma), TSR-042, REGN-1979, REGN-2810, resminostat, FAZ-053, PD-1 / CTLA-4 bispecific antibody (MacroGenics), MGA-012, MGD-013, M-7824, PD-1 based bispecific antibody (Beijing Hanmi Pharmaceutical), AK-112, AK-106, AK-104, AK-103, BI-754091, ENUM-244C8, MCLA-145, MCLA-134, anti-PD1 oncolytic monoclonal antibody (Transgene SA), AGEN-2034, IBI-308, WBP-3155, JNJ-63723283, MEDI-0680, SSI-361, CBT-502, anti-PD-1 bispecific antibody, dual-targeted anti-PD-1 / LAG-3 mAbs (TESARO), dual-targeted anti-PD-1 / TIM-3mAbs (TESARO), PF-06801591, LY-3300054, BCD-100, STI-1110, pembrolizumab biosimilar, nivolumab biosimilar, PD-L1-TGF-beta therapy, KY-1003, STI-1014, GLS-010, AM-0001, GX-P2, KD-033, PD-L1 / BCMA bispecific antibody (Immune Pharmaceuticals), PD-1 / Ox40-targeted bispecific antibody (Immune Pharmaceuticals), BMS-936559, anti-PD-1 / VEGF-A DARPins (Molecular Partners), mDX-400, ALN-PDL, PD-1 inhibitor peptide (Aurigene), siRNA-loaded dendritic cell vaccine (Alnylam Pharmaceuticals), GB-226, PD-L1-targeted CAR-TNK-based immunotherapy (TNK Therapeutics / NantKwest), INSIX RA, INDUS-903, AMP-224, anti-CTLA-4 / anti-PD-1 bispecific humanized antibody (Akeso Biopharma), B7-H1 vaccine (State Key Laboratory of Cancer Biology / Fourth Military Medical University), and GX-D1.

[0105] In some embodiments, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or PD-L1 inhibitor are formulated for co-administration.

[0106] In other embodiments, the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or PD-L1 inhibitor are formulated for sequential administration.

[0107] A. CCR1 Antagonists The methods, compositions, and kits provided herein include a CCR1 antagonist. In some embodiments, the CCR1 antagonist is selected from formulas I, II, III, IV, and V, as well as the subformulas provided below. In some embodiments, the CCR1 antagonist is selected from compounds 1.001, 3.002, 4.005, 5.005, or 3.001, as described below, or pharma- ceutically acceptable salts thereof. In some cases, the CCR1 antagonist may be any compound capable of antagonizing or inhibiting the chemokine receptor CCR1, including, but not limited to, those described in, for example, U.S. Pat. Nos. 7,524,845; 7,576,106; 7,629,344; 8,343,975; 9,169,248; and U.S. Patent Application Nos. 2014 / 0171420 and 2014 / 0179733 (the disclosures of which are incorporated by reference in their entireties for all purposes).

[0108] In some embodiments, compounds that inhibit one or more functions of CCR1 may be administered to a subject to treat a solid tumor. In other embodiments, compounds that inhibit one or more functions of CCR1 are administered to stimulate (induce or enhance) an immune response, resulting in beneficial stimulation of an anti-cancer response.

[0109] In some embodiments, provided herein is a method of reducing lung metastasis by administering a CCR1 antagonist monotherapy. The CCR1 antagonist may be any one of those disclosed herein.

[0110] In some embodiments, the CCR1 antagonist has the formula: [ka] or a pharma- ceutically acceptable salt, rotamer, or optical isomer thereof.

[0111] In formula I, the subscript n is an integer from 0 to 3;1a and R 1b , H, C 1-8 Alkyl, C 1-8 Haloalkyl, C 3-6 Cycloalkyl, -COR a , -CO 2 R a , -CONR a R b , -NR a R b , -NR a COR b , -OR a , -X 1 COR a , -X 1 CO 2 R a , -X 1 CONR a R b , -X 1 NR a COR b , -X 1 NR a R b , and -X 1 OR a X is a member independently selected from the group consisting of 1 is C 1-4 alkylene, and each R a and R b are independently hydrogen, C 1-8 Alkyl, C 1-8 Haloalkyl and C 3-6 cycloalkyl, and optionally two R on adjacent carbon atoms. 1a R groups taken together form a 5-, 6-, or 7-membered carbocyclic or heterocyclic ring; 2a and R 2b Each of the is H, hydroxyl, C 1-8 Alkyl, C 1-8 Haloalkyl, C 1-8 Alkoxy, C 1-4 Alkoxy-C 1-4 Alkyl, C 1-8 Hydroxyalkyl, C 1-4 Alkoxy-C 1-4 Alkoxy, C 3-6 Cycloalkyl, C3-6 Cycloalkyl-C 1-4 Alkyl, 3- to 7-membered heterocycloalkyl, 3- to 7-membered heterocycloalkyl-C 1-4 Alkyl, -X 1 CO 2 R a , -X 1 CONR a R b , -X 1 NR a COR b , -X 1 NR a R b X is a member independently selected from the group consisting of 1 , R a , and R b is defined above.

[0112] Symbol Ar 1 represents a 6- or 10-membered monocyclic or fused bicyclic aryl ring, or a 5- to 10-membered monocyclic or fused bicyclic heteroaryl ring; each of these is selected from H, halogen, -OR c , -OC(O)R c , -NR c R d , -SR c , -R e , -CN, -NO 2 , -CO 2 R c , -CONR c R d , -C(O)R c , -OC(O)NR c R d , -NR d C(O)R c , -NR d C(O) 2 R e , -NR c -C(O)NR c R d , -NH-C(NH 2 )=NH, -NR e C(NH 2 )=NH, -NH-C(NH 2 )=NR e , -NH-C(NHR e )=NH, -S(O)Re 、-S(O) 2 R e 、-NR c S(O) 2 R e 、-S(O) 2 NR c R d 、-N 3 、-X 2 OR c 、-O-X 2 OR c 、-X 2 OC(O)R c 、-X 2 NR c R d 、-O-X 2 NR c R d 、-X 2 SR c 、-X 2 CN、-X 2 NO 2 、-X 2 CO 2 R c 、-O-X 2 CO 2 R c 、-X 2 CONR c R d 、-O-X 2 CONR c R d 、-X 2 C(O)R c 、-X 2 OC(O)NR c R d 、-X 2 NR d C(O)R c 、-X 2 NR d C(O) 2 R e 、-X 2 NR c C(O)NR c R d 、-X 2 NH-C(NH 2 )=NH、-X 2 NR e C(NH 2 )=NH、-X 2 NH-C(NH 2)=NR e , -X 2 NH-C(NHR e )=NH, -X 2 S(O)R e , -X 2 S(O) 2 R e , -X 2 NR c S(O) 2 R e , -X 2 S(O) 2 NR c R d , -X 2 N 3 , -NR d -X 2 OR c , -NR d -X 2 NR c R d , -NR d -X 2 CO 2 R c , and -NR d -X 2 CONR c R d 1 to 5 substituents R independently selected from the group consisting of 3 , R 3a , R 3b , R 4 , and R 4a Replaced by each X 2 is C 1-4 alkylene, and each R c and R d are independently hydrogen, C 1-8 Alkyl, C 1-8 Hydroxyalkyl, C 1-8 Haloalkyl and C 3-6 cycloalkyl, or optionally R c and R d when attached to the same nitrogen atom, can be combined with the nitrogen atom to form a 5- or 6-membered ring having 0 to 2 additional heteroatoms as ring members; each R e is independently 1-8 Alkyl, C 1-8Hydroxyalkyl, C 1-8 Haloalkyl and C 3-6 cycloalkyl.

[0113] Symbol Ar 2 represents a 6- or 10-membered monocyclic or fused bicyclic aryl ring, or a 5- to 10-membered monocyclic or fused bicyclic heteroaryl ring; each of these is selected from H, halogen, -OR f , -OC(O)R f , -NR f R g , -SR f , -R h , -CN, -NO 2 , -CO 2 R f , -CONR f R g , -C(O)R f , -OC(O)NR f R g , -NR g C(O)R f , -NR g C(O) 2 R h , -NR f -C(O)NR f R g , -NH-C(NH 2 )=NH, -NR h C(NH 2 )=NH, -NH-C(NH 2 )=NR h , -NH-C(NHR h )=NH, -S(O)R h , -S(O) 2 R h , -NR f S(O) 2 R h , -S(O) 2 NR f R g , -NR f S(O) 2 NR f R g , -N 3 , -X 3 OR f , -X 3 O.C.(O)R f、-X 3 NR f R g 、-X 3 SR f 、-X 3 CN、-X 3 NO 2 、-X 3 CO 2 R f 、-X 3 CONR f R g 、-X 3 C(O)R f 、-X 3 OC(O)NR f R g 、-X 3 NR g C(O)R f 、-X 3 NR g C(O) 2 R h 、-X 3 NR f -C(O)NR f R g 、-X 3 NH-C(NH 2 )=NH、-X 3 NR h C(NH 2 )=NH、-X 3 NH-C(NH 2 )=NR h 、-X 3 NH-C(NHR h )=NH、-X 3 S(O)R h 、-X 3 S(O) 2 R h 、-X 3 NR f S(O) 2 R h 、-X 3 S(O) 2 NR f R g 、-Y、-X 3 Y、-S(O) 2 Y、-C(O)Y、-X 3 N 3 、-O-X 3 OR f 、-O-X 3 NRf R g , -OX 3 CO 2 R f , -OX 3 CONR f R g , -NR g -X 3 OR f , -NR g -X 3 NR f R g , -NR g -X 3 CO 2 R f , and -NR g -X 3 CONR f R g 1 to 5 substituents R independently selected from the group consisting of 5 , R 6 , R 7 , R 8 , and R 9 and Y is a halogen, -OR f , -OC(O)R f , -NR f R g , -R h , -SR f , -CN, -NO 2 , -CO 2 R f , -CONR f R g , -C(O)R f , -NR g C(O)R f , -NR g C(O) 2 R h , -S(O)R h , -S(O) 2 R h , -NR f S(O) 2 R h , -S(O) 2 NR f R g , -X 3 OR f , X 3 S.R. f , -X 3 CN, -X 3NO 2 、-X 3 CO 2 R f 、-X 3 CONR f R g 、-X 3 C(O)R f 、-X 3 OC(O)NR f R g 、-X 3 NR g C(O)R f 、-X 3 NR g C(O) 2 R h 、-X 3 NR f -C(O)NR f R g 、-X 3 OC(O)R f 、-X 3 S(O)R h 、-X 3 S(O) 2 R h 、-X 3 NR f R g 、-X 3 NR f S(O) 2 R h 、-X 3 S(O) 2 NR f R g 、-O-X 3 OR f 、-O-X 3 NR f R g 、-O-X 3 CO 2 R f 、-O-X 3 CONR f R g 、-NR g -X 3 OR f 、-NR g -X 3 NR f R g 、-NR g -X 3 CO 2 R f, and -NR g -X 3 CONR f R g Each X is a 5- or 6-membered aryl, heteroaryl, or heterocycle, optionally substituted with 1 to 3 substituents selected from the group consisting of 3 is independently 1-4 alkylene, and each R f and R g are independently hydrogen, C 1-8 Alkyl, C 1-8 Hydroxyalkyl, C 1-8 Haloalkyl and C 3-6 cycloalkyl, or, when attached to the same nitrogen atom, can be combined with the nitrogen atom to form a 5- or 6-membered ring having 0 to 2 additional heteroatoms as ring members, and each R h is independently 1-8 Alkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Hydroxyalkyl, C 1-8 Haloalkyl and C 3-6 cycloalkyl; or R 5 , R 6 , R 7 , R 8 , and R 9 Two of them are Ar 2 When attached to adjacent ring vertices of, they optionally combine to form a 5- or 6-membered ring having 0, 1, or 2 heteroatoms selected from O and N as ring members.

[0114] In some embodiments, the compound of formula I is Ar 1 is phenyl, naphthyl, pyridyl, pyrazinyl, pyridazinyl, pyrimidinyl, triazinyl, quinolinyl, quinoxalinyl, and purinyl, each of which is optionally represented by R 3 , R 3a , R 3b , R 4 , and R 4a (substituted with).

[0115] In another embodiment, the compound of formula I is Ar 1 phenyl, naphthyl, and pyridyl (each of which is optionally represented by R 3 , R 3a , R 3b , R 4 , and R 4a (substituted with).

[0116] In yet another embodiment, the compound of formula I is Ar 2 is phenyl, pyrazolyl, imidazolyl, triazolyl, tetrazolyl, oxazolyl, isoxazolyl, oxadiazolyl, oxathiadiazolyl, pyrrolyl, thiazolyl, isothiazolyl, benzimidazolyl, benzoxazolyl, benzopyrazolyl, benzotriazolyl, pyrazolo[3,4-b]pyridine, pyrazolo[3,4-d]pyrimidine, imidazo[4,5-b]pyridine, imidazo[1,5-a]pyridine, and pyrrolo[2,3-b]pyridine, each of which is optionally selected from R 5 , R 6 , and R 7 (substituted with).

[0117] In yet another embodiment, the compound of formula I is Ar 2 pyrazolyl, imidazolyl, and triazolyl (each of which is R 5 , R 6 , and R 7 (substituted with).

[0118] In certain embodiments, the compound of formula I is Ar 1 phenyl, naphthyl, and pyridyl (each of which may contain 1 to 5 substituents R 3 , R 3a , R 3b , R 4 , and R 4a substituted with Ar 2 pyrazolyl, imidazolyl, and triazolyl (each of which is R5 , R 6 , and R 7 (substituted with).

[0119] In selected embodiments, the compound of formula I is Ar 1 is phenyl (1 to 5 substituents R 3 , R 3a , R 3b , R 4 , and R 4a substituted with Ar 2 pyrazolyl, imidazolyl, benzimidazolyl, benzopyrazolyl, pyrazolo[3,4-b]pyridine, pyrazolo[3,4-d]pyrimidine, imidazo[4,5-b]pyridine, imidazo[1,5-a]pyridine, and pyrrolo[2,3-b]pyridine, each of which is optionally represented by R 5 , R 6 , and R 7 (substituted with).

[0120] Yet other embodiments of the invention are compounds of formula Ia, Ia1, Ia2, Ib, Ic, Id, II, IIa, IIb, IIb1, IIb2, IIb2a, IIb2b, IIb2c, IIc, IIb3, IIb2d, IIb2e, IIb2f, III, IIIa, IIIb, IIIc, IIb1, IIIb1a, IIIb1b, IIIb1c, IIIb2, IIIb3a, IIIb3b, IIIb3c, IV, IVa, IVb, IVc, IVd, V, Va, and Vb.

[0121] Thus, in some embodiments, the compound has formula Ia: [ka] [In the formula, R 3 and R 4 are independently H, halogen, -R e , -CN, and -SO 2 R e The group R 1a , R 2a , and Ar2 has the meaning provided for in formula I above or other embodiments provided. or a pharma- ceutically acceptable salt, rotamer, or optical isomer thereof.

[0122] In yet other embodiments of Formula I or Ia, Ar 2 is a heteroaryl group; in other embodiments, Ar 2 is an optionally substituted heteroaryl group attached to the remainder of the molecule through a nitrogen atom ring vertex; in yet other embodiments, Ar 2 is the expression: [ka] [In the formula, R 5 , R 6 , and R 7 are independently H, halogen, -R h , -CN, -SO 2 R h , -CO 2 R f , -CONR f R g -R h , R f , R g and Y has the meaning provided above for formula I. has.

[0123] In one group of selected embodiments, the compound has the formula: [ka] [In the formula, R 4 is selected from the group consisting of F and Cl; the group R 1a , R 2a , R 3 , and Ar 2 has the meaning provided above for formula I or Ia or other embodiments provided. or a pharma- ceutically acceptable salt, rotamer, or optical isomer thereof.

[0124] In another group of selected embodiments, the compound has the formula: [ka] [In the formula, R 3 H, halogen, C 1-8 Alkyl, C 1-8 Haloalkyl and C 1-8 alkoxy; R 1a and R 2a are independently H, C 1-8 Alkyl, C 1-8 Haloalkyl, C 1-8 Alkoxy and C 1-8 hydroxyalkyl; Ar 2 has the meaning provided above in relation to formula I or Ia or the embodiments provided. or a pharma- ceutically acceptable salt, rotamer, or optical isomer thereof.

[0125] In yet another group of selected embodiments, the compound has the formula: [ka] [In the formula, R 1a and R 2a are independently H, C 1-8 Alkyl, C 1-8 Haloalkyl, C 1-8 Alkoxy and C 1-8 hydroxyalkyl; R 5 , R 6 , and R 7 are independently H, halogen, -R h , -CN, -SO 2 R h , -CO 2 R f , -CONR f R g -R h , R f , R g and Y has the meaning provided above for formula I. or a pharma- ceutically acceptable salt, rotamer, or optical isomer thereof.

[0126] In yet another group of selected embodiments, the compound has the formula: [ka] [In the formula, R 1a and R 2a are independently H, C 1-8 Alkyl, C 1-8 Haloalkyl, C 1-8 Alkoxy and C 1-8 hydroxyalkyl; R 5 , R 6 , and R 7 are independently H, halogen, -R h , -CN, -SO 2 R h , -CO 2 R f , -CONR f R g -R h , R f , R g and Y has the meaning provided above for formula I. or a pharma- ceutically acceptable salt, rotamer, or optical isomer thereof.

[0127] In another group of selected embodiments, the compound has the formula: [ka] [In the formula, R 1a and R 2a are independently H, C 1-8 Alkyl, C 1-8 Haloalkyl, C 1-8 Alkoxy and C 1-8 hydroxyalkyl; R 5 and R 7 are each independently H, halogen, or -R h , -CN, -SO 2 R h , -CO2 R f , -CONR f R g -R h , R f , R g and Y has the meaning provided above for formula I. or a pharma- ceutically acceptable salt, rotamer, or optical isomer thereof.

[0128] For any of the above embodiments, when Y is present, selected embodiments are those in which Y is selected from the group consisting of pyridyl, pyrimidinyl, imidazolyl, oxazolyl, oxadiazolyl, triazolyl, thiazolyl, imidazolinyl, and pyrazolyl.

[0129] In some embodiments, the CCR1 antagonist is: [ka] or a pharma- ceutically acceptable salt thereof.

[0130] In a particular embodiment, the CCR1 antagonist is compound 1.001: [ka] or a pharma- ceutically acceptable salt thereof.

[0131] In still other embodiments, the CCR1 antagonist is a compound of formula II: [ka] or a pharma- ceutically acceptable salt, hydrate, solvate, N-oxide, or rotamer thereof. Each A is independently selected from the group consisting of N and CH; X and Z are each independently selected from the group consisting of: (i) monocyclic or fused bicyclic aryl and heteroaryl, where the heteroaryl group has 1 to 4 heteroatoms selected from N, O, and S as ring members; (ii) a monocyclic 4-, 5-, 6-, or 7-membered ring selected from the group consisting of cycloalkanes and heterocycloalkanes, where the heterocycloalkane ring has 1 to 3 heteroatoms selected from N, O, and S as ring members; wherein each of the rings in (i) and (ii) is optionally selected from halogen, CN, C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 R a , -SO 2 R a , -NR a R b , -CONR a R b , aryl, 5- or 6-membered heteroaryl, and 3-, 4-, 5-, or 6-membered heterocycloalkane, the heteroatoms present as ring vertices of the heteroaryl and heterocycloalkane rings being selected from N, O, and S, and the alkyl, cycloalkyl, aryl, heteroaryl, and heterocycloalkane portions of the substituents are optionally substituted with 1 to 3 R a optionally, two substituents on adjacent ring vertices are linked to form an additional 5- or 6-membered ring that is saturated, unsaturated, or aromatic having a ring vertex selected from C, O, N, and S; R 3 H, halogen, CN, C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 Ra , -NR a R b , -CONR a R b R is a member selected from the group consisting of aryl, 5- or 6-membered heteroaryl, and 3-, 4-, 5-, or 6-membered heterocycle, wherein the heteroatoms present as ring vertices of the heteroaryl and heterocycle are selected from N, O, and S; 3 The alkyl, cycloalkyl, aryl, heteroaryl, and heterocyclic moieties of a Further substituted with; R 4 H, -OR a , and -OR a or -NR a R b C optionally substituted with 1-8 alkyl; or R 4 combines with X to form a bicyclic fused ring system; and Each R a and R b are independently hydrogen, hydroxyl, halogen, cyano, C 1-8 Alkyl, C 1-8 Alkoxy, C 1-8 Haloalkyl, C 3-6 Cycloalkyl, C 3-6 Cycloalkylalkyl, amino, C 1-8 Alkylamino, DiC 1-8 Alkylamino, carboxamide, carboxy C 1-4 Alkyl esters, carboxylic acids, and -SO 2 -C 1-8 alkyl.

[0132] One of skill in the art will understand that the description of substituents refers only to those that are generally stable (e.g., less than 20% decomposition upon storage), and the group -OR a is R a is not intended to include moieties where the radical is alkoxy (resulting in a peroxy or -OO-alkyl group).

[0133] In some selected embodiments, the compound of formula II has formula IIa: [ka] [In the formula, A 1 is N or C(R 5 ) and; A 2 is N or C(R 7 ) and R 5 , R 6 , R 7 , and R 8 are each independently H, halogen, CN, or C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 R a , -NR a R b , -CONR a R b , aryl, 5- or 6-membered heteroaryl, and 3-, 4-, 5-, or 6-membered heterocycloalkane, the heteroatoms present as ring vertices of the heteroaryl and heterocycloalkane rings being selected from N, O, and S; R 5 , R 6 , R 7 , and R 8 The alkyl, cycloalkyl, aryl, heteroaryl, and heterocycloalkane moieties of a and optionally further substituted with R 4 and R 5 , R 4 and R 8 , or R 5 , R 6 , R 7 , and R 8 adjacent members of are linked to form an additional 5- or 6-membered ring, which is saturated, unsaturated, or aromatic, having ring vertices selected from C, O, N, and S. or a pharma- ceutically acceptable salt, hydrate, solvate, rotamer, or N-oxide thereof.

[0134] In other selected embodiments, the compound of formula IIa is R 8 is other than H.

[0135] In other selected embodiments, the compound of formula IIa has formula IIb: [ka] [In the formula, R 1 and R 2 are each independently H, halogen, CN, or C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 R a , -SO 2 R a , -NR a R b , -CONR a R b and 3-, 4-, 5-, or 6-membered heterocycloalkanes, the heteroatoms present as ring vertices of the heterocycloalkane ring being selected from N, O, and S; R 1 and R 2 The alkyl, cycloalkyl, and heterocycloalkane portions of the formula (I) are optionally selected from 1 to 3 R a is further replaced by It is represented by:

[0136] In selected embodiments of Formula IIb, each R 1 and R 2 are independently H, halogen, CN, C 1-8 Alkyl, C 1-8 Haloalkyl, -CO 2 R a , and -SO 2 R ais selected from.

[0137] In other selected embodiments of the compound of formula IIb, the compound has the structure: [ka] It is represented by:

[0138] In other selected embodiments of compounds of formula IIb and IIb1, N, A, and B are each independently selected from the group consisting of N, A, and B, as ring vertices. 1 , and A 2 The ring moiety having the following structure: [ka] is selected from.

[0139] In still other selected embodiments of compounds of formula IIb and IIb1, N, A, and B are each independently selected from the group consisting of N, A, and B, as ring vertices. 1 , and A 2 The ring moiety having the following structure: [ka] [In the formula, R 7 is H or Cl, R 8 is one or two R a C optionally substituted with 1-8 is alkyl] is selected from.

[0140] In still other selected embodiments of Formula IIb or IIb1, R 4 is H or CH 3 It is.

[0141] Returning to Formula II, some selected embodiments have the formula IIb2: [ka] [In the formula, R 1 is Cl or F; R 3 is C 1-8 Alkyl, C 1-8Haloalkyl, C 1-8 hydroxyalkyl; R 3 The alkyl portion of the formula (I) may optionally be selected from 1 to 3 R a Further substituted with; R 7 and R 8 do not join together to form a ring] It is a compound represented by:

[0142] In still other selected embodiments, the compounds of formula II, IIb, IIb1, and IIb2 are represented by formula IIb2a, IIb2b, and IIb2c. [ka]

[0143] In some selected embodiments, the compound has formula IIc: [ka] [wherein the subscript n is 0 or 1] It is represented by:

[0144] In some selected embodiments, the compound has formula IIb3: [ka] It is represented by:

[0145] In some selected embodiments of Formula IIb, the compounds are represented by Formulas IIb2d, IIb2e, and IIb2f. [ka]

[0146] In selected embodiments of any of Formulas II, IIa, IIb, IIb1, IIb2, IIb2a, IIb2b, IIb2c, IIb2d, IIb2e, IIb2f, IIb3, and IIc, R 3 is C 1-8 It is an alkyl.

[0147] In other embodiments, a CCR1 antagonist useful in the methods and compositions herein has Formula III: [ka] or a pharma- ceutically acceptable salt, hydrate, solvate, N-oxide, or rotamer thereof. In formula III, the letter n is an integer from 0 to 3; Each A is independently selected from the group consisting of N and CH; X and Z are each independently selected from the group consisting of: (i) monocyclic or fused bicyclic aryl and heteroaryl, where the heteroaryl group has 1 to 4 heteroatoms selected from N, O, and S as ring members; (ii) a monocyclic 4-, 5-, 6-, or 7-membered ring selected from the group consisting of cycloalkanes and heterocycloalkanes, where the heterocycloalkane ring has 1 to 3 heteroatoms selected from N, O, and S as ring members; wherein each of the rings in (i) and (ii) is optionally selected from halogen, CN, C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 R a , -SO 2 R a , -NR a R b , -CONR a R b, aryl, 5- or 6-membered heteroaryl, and 3-, 4-, 5-, or 6-membered heterocycloalkane, the heteroatoms present as ring vertices of the heteroaryl and heterocycloalkane rings being selected from N, O, and S, and the alkyl, cycloalkyl, aryl, heteroaryl, and heterocycloalkane portions of the substituents are optionally substituted with 1 to 3 R a optionally, two substituents on adjacent ring vertices are linked to form an additional 5- or 6-membered ring that is saturated, unsaturated, or aromatic having a ring vertex selected from C, O, N, and S; R 3 H, halogen, CN, C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 R a , -NR a R b , -CONR a R b R is a member selected from the group consisting of aryl, 5- or 6-membered heteroaryl, and 3-, 4-, 5-, or 6-membered heterocycle, wherein the heteroatoms present as ring vertices of the heteroaryl and heterocycle are selected from N, O, and S; 3 The alkyl, cycloalkyl, aryl, heteroaryl, and heterocyclic moieties of a Further substituted with; R 4 H, -OR a , and -OR a C optionally substituted with 1-8 is a member selected from the group consisting of alkyl; R 9 H and -OR a C optionally substituted with 1-8 is a member selected from the group consisting of alkyl; Each R a and Rb are independently hydrogen, hydroxyl, halogen, cyano, C 1-8 Alkyl, C 1-8 Alkoxy, C 1-8 Haloalkyl, C 3-6 Cycloalkyl, C 3-6 Cycloalkylalkyl, amino, C 1-8 Alkylamino, DiC 1-8 Alkylamino, carboxamide, carboxy C 1-4 Alkyl esters, carboxylic acids, and -SO 2 -C 1-8 alkyl.

[0148] In some selected embodiments, the compound of formula III has formula IIIa: [ka] [In the formula, A 1 is N or C(R 5 ) and; A 2 is N or C(R 7 ) and R 5 , R 6 , R 7 , and R 8 are each independently H, halogen, CN, or C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 R a , -NR a R b , -CONR a R b , aryl, 5- or 6-membered heteroaryl, and 3-, 4-, 5-, or 6-membered heterocycloalkane, the heteroatoms present as ring vertices of the heteroaryl and heterocycloalkane rings being selected from N, O, and S; R 5 , R 6 , R 7 , and R 8The alkyl, cycloalkyl, aryl, heteroaryl, and heterocycloalkane moieties of a and optionally further substituted with R 5 , R 6 , R 7 , and R 8 adjacent members of are linked to form an additional 5- or 6-membered ring, which is saturated, unsaturated, or aromatic, having ring vertices selected from C, O, N, and S. or a pharma- ceutically acceptable salt, hydrate, solvate, rotamer, or N-oxide thereof.

[0149] In other selected embodiments, the compound of formula IIIa is R 8 is other than H.

[0150] In other selected embodiments, the compound of formula IIIa has formula IIIb: [ka] [In the formula, R 1 and R 2 are each independently H, halogen, CN, or C 1-8 Alkyl, C 3-8 Cycloalkyl, C 2-8 Alkenyl, C 2-8 Alkynyl, C 1-8 Haloalkyl, C 1-8 Hydroxyalkyl, -OR a , -CO 2 R a , -SO 2 R a , -NR a R b , -CONR a R b and 3-, 4-, 5-, or 6-membered heterocycloalkanes, the heteroatoms present as ring vertices of the heterocycloalkane ring being selected from N, O, and S; R 1 and R 2 The alkyl, cycloalkyl, and heterocycloalkane portions of the formula (I) are optionally selected from 1 to 3 R a is further replaced by It is represented by:

[0151] In selected embodiments of Formula IIIb, each R 1 and R 2 are independently H, halogen, CN, C 1-8 Alkyl, C 1-8 Haloalkyl, -CO 2 R a , and -SO 2 R a is selected from.

[0152] In other selected embodiments of compounds of formula IIIb, N, A, and B are each independently selected from the group consisting of N, A, and B as ring vertices. 1 , and A 2 The ring moiety having the following structure: [ka] is selected from.

[0153] In still other selected embodiments of the compound of formula IIIb, N, A, 1 , and A 2 The ring moiety having the following structure: [ka] [In the formula, R 7 is H or Cl, R 8 is one or two R a C optionally substituted with 1-8 is alkyl] is selected from.

[0154] In still other selected embodiments of Formula IIIb, R 9 is H or CH 3 It is.

[0155] Returning to formula III, some select embodiments have the formula IIIc: [ka] wherein the letter n is 1, 2, or 3. In another embodiment, n is 1.

[0156] In still other selected embodiments, the compound of formula IIIb has formula IIIb1: [ka] [In the formula, R 1 is Cl or F. It is expressed by:

[0157] In still other selected embodiments, the compounds of formula IIIb1 are represented by formulas IIIb1a, IIIb1b, and IIIb1c. [ka]

[0158] In some selected embodiments of Formula IIIb, the compound has Formula IIIb2: [ka] [In the formula, R 1 is Cl or F. It is represented by:

[0159] In some selected embodiments of Formula IIIb, the compounds are represented by Formulas IIIb3a, IIIb3b, and IIIb3c. [ka]

[0160] In selected embodiments of any of Formulas III, IIIa, IIIb, IIIc, IIIb1, IIIb1a, IIIb1b, IIIb1c, IIIb2, IIIb3a, IIIb3b, and IIIb3c, R 3 , H, C 1-8 Alkyl, C 3-8 Cycloalkyl and C 2-8 alkenyl.

[0161] In some selected embodiments, the CCR1 antagonist is: [ka] is selected from.

[0162] In some selected embodiments, the CCR1 antagonist is: [ka] It is.

[0163] In some selected embodiments, the CCR1 antagonist is: [ka] It is.

[0164] In other embodiments, a CCR1 antagonist useful in the methods and compositions herein has Formula IV: [ka] or a pharma- ceutically acceptable salt, hydrate, or N-oxide thereof. 1 is C 1-4 Alkyl or C 1-4 In Formula IV, R is haloalkyl and the subscript m is an integer from 0 to 1. 2a , R 2c , R 2d are hydrogen, halogen, and C, respectively. 1-4 Alkoxy, C 1-4 Alkyl, -OC 1-4 Haloalkyl and C 1-4 haloalkyl; R 3 is hydrogen and C 1-4 alkyl; R 4 is C 1-4 alkyl; and the subscript n is an integer from 0 to 2. In one embodiment, R3 is hydrogen.

[0165] In another embodiment, R 3 is hydrogen and the subscript n is 0.

[0166] In another embodiment, R in formula IV 1 is methyl, trifluoromethyl, or ethyl, and the subscript m is 1.

[0167] In another embodiment, the subscript m is 0.

[0168] In yet another embodiment, R 2a , R 2c , and R 2d are each independently selected from the group consisting of fluoro, chloro, bromo, iodo, methoxy, ethoxy, trifluoromethoxy, methyl, ethyl, trifluoromethyl, and 2-fluoroethoxy.

[0169] In yet another embodiment, R 2a is hydrogen, and R 2c and R 2d are each independently selected from the group consisting of fluoro, chloro, bromo, iodo, methoxy, ethoxy, trifluoromethoxy, methyl, ethyl, trifluoromethyl, and 2-fluoroethoxy.

[0170] In one preferred embodiment, the CCR1 antagonist is of formula IVa or IVb: [ka]

[0171] In one embodiment, R in formula IVa or IVb 2a and R 2c are each independently selected from the group consisting of fluoro, chloro, bromo, and iodo; R 2dis selected from the group consisting of methoxy, ethoxy, trifluoromethoxy, methyl, ethyl, trifluoromethyl, and 2-fluoroethoxy.

[0172] In specific embodiments, the compound of formula IVa or IVb is: [ka] is selected from the group consisting of:

[0173] In another specific embodiment, the compound of the invention has formula IVc or IVd: [ka] It is of the following.

[0174] In Formulas IVc and IVd, in certain embodiments, R 2c is selected from the group consisting of fluoro, chloro, bromo, and iodo; R 2d is selected from the group consisting of methoxy, ethoxy, trifluoromethoxy, methyl, ethyl, trifluoromethyl, and 2-fluoroethoxy.

[0175] In specific embodiments, the compound of formula IVc or IVd is: [ka] is selected from the group consisting of:

[0176] In yet another embodiment of the present invention, the compound of formula IVd has the following structure: [ka] has.

[0177] In other embodiments, a CCR1 antagonist useful in the methods and compositions herein has Formula V: [ka] or a pharma- ceutically acceptable salt, hydrate, or N-oxide thereof. 1a and R 1b are each independently H and CH 3 R 2a is selected from the group consisting of H and F; R 2d , H, C 1-4 Alkoxy and C 1-4 In one embodiment, R is selected from the group consisting of haloalkoxy. 2a is hydrogen.

[0178] In another embodiment, R 1a and R 1b are H, respectively.

[0179] In another embodiment, R 1b is methyl, R 1a is H.

[0180] In yet another embodiment, R 1a and R 1b are each methyl.

[0181] In yet another embodiment, R 2a is hydrogen, and R 2d is selected from the group consisting of methoxy, ethoxy, and trifluoromethoxy.

[0182] In one preferred embodiment, the compound has formula Va or Vb: [ka] [In the formula, R 2a is selected from the group consisting of H and F; R 2d is selected from the group consisting of methoxy, ethoxy, and trifluoromethoxy. It is of the following.

[0183] In a specific embodiment, the CCR1 antagonist compound is: [ka] is selected from the group consisting of:

[0184] In another specific embodiment, the CCR1 antagonist compound is: [ka] is selected from the group consisting of:

[0185] In yet another embodiment, the CCR1 antagonist compound has the structure 5.005: [ka] or a pharma- ceutically acceptable salt thereof.

[0186] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of BL-5923, UCB-35625, BX-471, BI-638683, PS-031291, MLN-3701, AZD-4818, MLN-3897, CP-481715, F-18-CCR1, AOP-RANTES, PS-375179, and NSC-651016.

[0187] B. PD-1 Inhibitors and PD-L1 Inhibitors The methods, compositions, and kits provided herein include immune checkpoint inhibitors, e.g., PD-1 / PD-L1 pathway inhibitors (agents).

[0188] In some embodiments, the PD-1 pathway inhibitor can be a PD-1 antagonist, a PD-1 binding antagonist, a small molecule PD-1 antagonist, a PD-1 inhibitor, an anti-PD-1 biological product (e.g., an antibody or fragment thereof that specifically binds to PD-1), a PD-L1 antagonist, a small molecule PD-L1 antagonist, a PD-L1 binding antagonist, a PD-L1 inhibitor, an anti-PD-L1 biological product (e.g., an antibody or fragment thereof that specifically binds to PD-L1), etc.

[0189] In some embodiments, the PD-L1 inhibitor can be durvalumab or atezolizumab or avelumab or BMS-936559 (MDX-1105) or ALN-PDL or TSR-042 or KD-033 or CA-170 or CA-327 or STI-1014 or MEDI-0680 or KY-1003.

[0190] In some embodiments, the PD-L1 inhibitor can be durvalumab or atezolizumab or avelumab or BMS-936559 (MDX-1105) or ALN-PDL or TSR-042 or KD-033 or CA-170 or STI-1014 or MEDI-0680 or KY-1003. Durvalumab (MEDI4736) is a human monoclonal antibody against PD-L1. Atrexolizumab (MPDL3280A) is a fully humanized, engineered IgG1 monoclonal antibody against PD-L1. Avelumab (MSB0010718C) is a fully humanized, engineered IgG1 monoclonal antibody against PD-L1. BMS-936559 (MDX-1105) is a fully human IgG4 monoclonal antibody against PD-L1. ALN-PDL is an inhibitory RNA (RNAi) targeting PD-L1. TSR-042 refers to an engineered chimeric antibody directed at the PD-1 / PD-L1 pathway. KD-033 refers to a bifunctional anti-PD-L1 / IL-15 fusion protein in which an anti-PD-L1 antibody is bound at its tail to the cytokine IL-15 by the sushi domain of the IL-15 receptor. CA-170 refers to a small molecule antagonist of PD-L1 and VISTA. STI-1014 refers to an anti-PD-L1 antibody. KY-1003 is a monoclonal antibody against PD-L1. CA-327 refers to a small molecule antagonist of PD-L1 and TIM3.

[0191] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, pembrolizumab, nivolumab, AP-106, AP-105, MSB-2311, CBT-501, avelumab, AK-105, IO-102, IO-103, PDR-001, CX-072, SHR-1316, JTX-4014, GNS-1480, recombinant humanized anti-PD1 mAb (Shanghai Junshi Biosciences), REGN-2810, pelareorep, SHR-1210, PD1 / PDL1 inhibitor vaccine (THERAVECTYS), BGB-A317, recombinant humanized anti-PD-1 mAb (Bio-Thera Solutions), Probody targeting PD-1 (CytomX), XmAb-20717, FS-118, PSI-001, SN-PDL01, SN-PD07, PD-1 modified TILs (Sangamo Therapeutics), PRS-332, FPT-155, jienuo mAb (Genor Biopharma), TSR-042, REGN-1979, REGN-2810, resminostat, FAZ-053, PD-1 / CTLA-4 bispecific antibody (MacroGenics), MGA-012, MGD-013, M-7824, PD-1 based bispecific antibody (Beijing Hanmi Pharmaceutical), AK-112, AK-106, AK-104, AK-103, BI-754091, ENUM-244C8, MCLA-145, MCLA-134, anti-PD1 oncolytic monoclonal antibody (Transgene SA), AGEN-2034, IBI-308, WBP-3155, JNJ-63723283, MEDI-0680, SSI-361, CBT-502, anti-PD-1 bispecific antibody, dual-targeted anti-PD-1 / LAG-3 mAbs (TESARO), dual-targeted anti-PD-1 / TIM-3mAbs (TESARO), PF-06801591, LY-3300054, BCD-100, STI-1110, pembrolizumab biosimilar, nivolumab biosimilar, PD-L1-TGF-beta therapy, KY-1003, STI-1014, GLS-010, AM-0001, GX-P2, KD-033, PD-L1 / BCMA bispecific antibody (Immune Pharmaceuticals), PD-1 / Ox40-targeted bispecific antibody (Immune Pharmaceuticals), BMS-936559, anti-PD-1 / VEGF-A DARPins (Molecular Partners), mDX-400, ALN-PDL, PD-1 inhibitor peptide (Aurigene), siRNA-loaded dendritic cell vaccine (Alnylam Pharmaceuticals), GB-226, PD-L1-targeted CAR-TNK-based immunotherapy (TNK Therapeutics / NantKwest), INSIX RA, INDUS-903, AMP-224, anti-CTLA-4 / anti-PD-1 bispecific humanized antibody (Akeso Biopharma), B7-H1 vaccine (State Key Laboratory of Cancer Biology / Fourth Military Medical University), and GX-D1.

[0192] In some embodiments, the PD-1 inhibitor can be pembrolizumab or nivolumab or IBI-308 or mDX-400 or BGB-108 or MEDI-0680 or SHR-1210 or PF-06801591 or PDR-001 or GB-226 or STI-1110. Nivolumab (also known as OPDIVO™, MDX-1106, BMS-936558, and ONO-4538) is a human IgG4 monoclonal antibody against PD-1. Pembrolizumab (also known as KEYTRUDA®, lambrolizumab, and MK-34) is a humanized IgG4 kappa isotype monoclonal antibody against PD-1. IBI-308 refers to a monoclonal antibody against PD-1. mDX-400 refers to a murine antibody against PD-1. BGB-108 is a humanized monoclonal antibody against PD-1. MEDI-0680 (AMP-514) is a humanized IgG4 monoclonal antibody against PD-1. SHR-1210 refers to a monoclonal antibody against PD-1. PF-06801591 is a monoclonal antibody against PD-1. PDR-001 refers to a monoclonal antibody against PD-1. GB-226 refers to a monoclonal antibody against PD-1. STI-1110 refers to a monoclonal antibody against PD-1.

[0193] The anti-PD-1 antibodies and antibody fragments described herein include proteins that have amino acid sequences that differ from those of the described antibodies, but which retain the ability to bind to PD-1.

[0194] In some embodiments, anti-PD-1 antibodies include bispecific antibodies and antibody-like therapeutic proteins, such as DARTs®, DUOBODIES®, BITES®, XmAbs®, TandAbs®, Fab derivatives that bind to PD-1, and the like.

[0195] The anti-PD-L1 antibodies and antibody fragments described herein include proteins having amino acid sequences that differ from those of the described antibodies, but which retain the ability to bind to PD-L1. Such variant antibodies and fragments thereof may contain one or more additions, deletions, or substitutions of amino acids when compared to the parent sequence, but may exhibit essentially equivalent, or essentially biologically equivalent, biological activity to the biological activity of the described antibodies.

[0196] In some embodiments, anti-PD-L1 antibodies include bispecific antibodies and antibody-like therapeutic proteins, such as DARTs®, DUOBODIES®, BITES®, XmAbs®, TandAbs®, Fab derivatives, etc., that bind to PD-L1.

[0197] Additional non-limiting examples of PD-1 / PD-L1 pathway inhibitors are described, for example, in Chen and Han, Jour Clin Invest, 2015, 125(9):3384-3391, U.S. Patent Nos. 8,168,757; 8,354,509; 8,552,154; 8,741,295; and 9,212,224; U.S. Patent Application Publication Nos. 2014 / 0341917; 2015 / 0203580 and 2015 / 0320859; and International Patent Application Publication No. WO2015 / 026634.

[0198] A biological product, such as an antibody or a fragment thereof, is considered a biosimilar, for example, if the biological product is very similar to a biological product already approved by the FDA, known as a reference product. A biosimilar has no clinically meaningful differences in safety and efficacy from the reference product. A biosimilar can also have the same mechanism of action, route of administration, dosage form, and strength as the reference product.

[0199] Two biological products, such as antibodies or fragments thereof, are considered bioequivalent if, for example, they are pharmaceutical equivalents or pharmaceutical substitutes that do not show significant differences in absorption rate and extent when administered at the same molar dose under comparable experimental conditions, either in single or multiple doses. Some antibodies may be considered equivalents or pharmaceutical substitutes and still be considered bioequivalent if they are equivalent in their extent of absorption but not in their rate of absorption, because such differences in rate of absorption are intentional, reflected in the label, are not essential to achieving effective body drug concentrations, e.g., for chronic use, and are not considered medically significant for the particular drug product being studied.

[0200] In some embodiments, two biological products (eg, two antibodies or fragments thereof) are bioequivalent if there are no clinically meaningful differences in their safety, purity, or potency.

[0201] In other embodiments, two biological products (e.g., two antibodies or fragments thereof) are bioequivalent if a patient can be switched one or more times between the reference product and the biological product without a predicted increase in risk of adverse effects, e.g., clinically meaningful changes in immunogenicity, or reduced efficacy, compared to continuous therapy without switching.

[0202] In yet other embodiments, two biological products (e.g., two antibodies or fragments thereof) are bioequivalent if they both act by a common mechanism of action for a given condition of use, so long as such mechanism is known.

[0203] Bioequivalence can be demonstrated by in vivo and / or in vitro methods. Bioequivalence measurements include, for example, (a) in vivo studies in humans or other mammals where the concentration of the antibody or its metabolites is measured as a function of time in blood, plasma, serum, or other biological fluids; (b) in vitro studies that correlate with and are reasonably predictive of human in vivo bioavailability data; (c) in vivo studies in humans or other mammals where the relevant acute pharmacological effects of the antibody (or its target) are measured as a function of time; and (d) well-controlled clinical trials that establish the safety, efficacy, or bioavailability or bioequivalence of the antibody.

[0204] A biobetter variant of the antibodies described herein can be based on an existing reference antibody specific for a target antigen, e.g., PD-1 or PD-L1, that has been altered, e.g., to have a higher binding affinity for its target antigen and / or bind to a different epitope than the reference antibody, or to have more desirable therapeutic efficacy, expression, and / or biophysical properties.

[0205] C. Pharmaceutical Compositions The pharmaceutical compositions provided herein, for example, a pharmaceutical composition comprising a compound for modulating CCR1 activity and an agent for blocking the PD-1 / PD-L1 pathway, may contain a pharmaceutical carrier or diluent.

[0206] The term "composition," as used herein, is intended to encompass a product containing the specified amounts of the specified ingredients, and any product resulting directly or indirectly from combining the specified amounts of the specified ingredients. "Pharmaceutically acceptable" means the carrier, diluent, or excipient must be compatible with the other ingredients of the formulation and not deleterious to the recipient thereof.

[0207] Biological products such as antibodies of the present invention may be comprised of pharmaceutical compositions containing one or more antibodies or fragments thereof and a pharma- ceutically acceptable carrier. As used herein, "pharmaceutically acceptable carrier" includes any and all physiologically compatible solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like. Preferably, the carrier is suitable for intravenous, intramuscular, subcutaneous, parenteral, spinal, or epidermal administration (e.g., by injection or infusion). Pharmaceutical compositions of the present invention may include one or more pharma- ceutically acceptable salts, antioxidants, aqueous and non-aqueous carriers, and / or adjuvants, such as preservatives, wetting agents, emulsifying agents, and dispersing agents.

[0208] The pharmaceutical composition for administration of the compounds and agents of the present invention can be conveniently provided in unit dosage form and can be prepared by any method known in the art of pharmacy and drug delivery.All methods include the step of contacting the active ingredient with a carrier that constitutes one or more accessory ingredients.In general, pharmaceutical compositions are prepared by uniformly and intimately contacting the active ingredient with a liquid carrier or finely divided solid carrier or both, and then, if necessary, shaping the product into the desired formulation.In the pharmaceutical composition, the active object compound is included in an amount sufficient to produce the desired effect on the process or condition of a disease.

[0209] The pharmaceutical composition containing the active ingredient may be in a form suitable for oral use, such as tablets, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules, emulsions and self-emulsifying formulations as described in U.S. Pat. No. 6,451,339, hard or soft capsules, syrups, elixirs, solutions, buccal patches, oral gels, chewing gums, chewable tablets, effervescent powders, and effervescent tablets. Compositions intended for oral use may be prepared according to any method known in the art for the manufacture of pharmaceutical compositions, and such compositions may contain one or more agents selected from the group consisting of sweeteners, flavoring agents, coloring agents, antioxidants, and preservatives to provide pharmacologic high quality and palatable preparations. Tablets contain the active ingredient in admixture with non-toxic pharmacologic acceptable excipients suitable for the manufacture of tablets. These excipients can be, for example, inert diluents such as cellulose, silicon dioxide, aluminum oxide, calcium carbonate, sodium carbonate, glucose, mannitol, sorbitol, lactose, calcium phosphate, or sodium phosphate; granulating and disintegrating agents such as corn starch or alginic acid; binders such as PVP, cellulose, PEG, starch, gelatin, or acacia, and lubricants such as magnesium stearate, stearic acid, or talc. The tablets can be uncoated or enterically or otherwise coated by known techniques to delay disintegration and absorption in the gastrointestinal tract, thereby providing a sustained action over a longer period of time. For example, a time-delay material such as glyceryl monostearate or glyceryl distearate can be used. They can also be coated by the techniques described in U.S. Pat. Nos. 4,256,108; 4,166,452; and 4,265,874 to form osmotic therapeutic tablets for controlled release.

[0210] Formulations for oral use may also be provided as hard gelatin capsules in which the active ingredient is mixed with an inert solid diluent, such as calcium carbonate, calcium phosphate, or kaolin, or as soft gelatin capsules in which the active ingredient is mixed with water or an oil medium, such as peanut oil, liquid paraffin, or olive oil.Furthermore, emulsions can be prepared using water-immiscible ingredients such as oils and stabilized with surfactants such as mono-diglycerides, PEG esters, etc.

[0211] Aqueous suspensions contain the active substance mixed with excipients suitable for the manufacture of aqueous suspensions.Such excipients are suspending agents, for example, sodium carboxymethylcellulose, methylcellulose, hydroxy-propylmethylcellulose, sodium alginate, polyvinyl-pyrrolidone, gum tragacanth, and gum acacia; dispersing agents or wetting agents can be natural phosphatides, for example, lecithin, or condensation products of alkylene oxides with fatty acids, for example, polyoxy-ethylene stearates, or condensation products of ethylene oxide with long-chain aliphatic alcohols, for example, heptadecaethyleneoxycetanol, or condensation products of ethylene oxide with partial esters derived from fatty acids and hexitols, for example, polyoxyethylene sorbitol monooleate, or condensation products of ethylene oxide with partial esters derived from fatty acids and hexitol anhydrides, for example, polyethylene sorbitan monooleate. The aqueous suspensions may also contain one or more preservatives, for example ethyl, or n-propyl, p-hydroxybenzoate, one or more coloring agents, one or more flavoring agents, and one or more sweetening agents, such as sucrose or saccharin.

[0212] Oily suspensions can be formulated by suspending the active ingredient in a vegetable oil, such as arachis oil, olive oil, sesame oil, or coconut oil, or in a mineral oil, such as liquid paraffin. Oily suspensions may contain a thickening agent, such as beeswax, hard paraffin, or cetyl alcohol. In order to provide a palatable oral preparation, sweetening agents, such as those mentioned above, and flavoring agents may be added. These compositions may be preserved by the addition of an antioxidant, such as ascorbic acid.

[0213] Dispersible powders and granules suitable for preparing aqueous suspension by adding water provide the active ingredient in admixture with a dispersing or wetting agent, a suspending agent, and one or more preservatives.Suitable dispersing or wetting agents and suspending agents are exemplified by those already mentioned above.Additional excipients, such as sweeteners, flavorings, and colorings, may also be present.

[0214] The pharmaceutical composition of the present invention may also be in the form of an oil-in-water emulsion. The oil phase may be a vegetable oil, such as olive oil or arachis oil, or a mineral oil, such as liquid paraffin, or a mixture thereof. Suitable emulsifiers may be natural gums, such as gum acacia or gum tragacanth, natural phosphatides, such as soybean, lecithin, and esters or partial esters derived from fatty acids and hexitol anhydrides, such as sorbitan monooleate, and the condensation products of said partial esters with ethylene oxide, such as polyoxyethylene sorbitan monooleate. The emulsion may also contain sweeteners and flavoring agents.

[0215] Syrups and elixirs can be formulated with sweetening agents, for example, glycerol, propylene glycol, sorbitol, or sucrose. Such formulations may also contain a demulcent, a preservative, and flavoring and coloring agents. Oral solutions can be prepared in combination with, for example, cyclodextrin, PEG, and surfactants.

[0216] The pharmaceutical compositions may be in the form of a sterile injectable aqueous or oleaginous suspension. The suspension may be formulated according to known techniques using suitable dispersing or wetting agents and suspending agents mentioned above. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally acceptable diluent or solvent, for example a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be used are water, Ringer's solution, and isotonic sodium chloride solution. In addition, sterile fixed oils are conventionally used as a solvent or suspending medium. For this purpose, any bland fixed oil may be used, including synthetic mono- or diglycerides. In addition, fatty acids such as oleic acid are used in the preparation of injectables.

[0217] The compounds and agents of the present invention may also be administered in the form of suppositories for rectal administration of drugs. These compositions can be prepared by mixing the drug with a suitable non-irritating excipient that is solid at room temperature but liquid at rectal temperature, and therefore dissolves in the rectum to release the drug. Such materials include cocoa butter and polyethylene glycol. In addition, the compounds can be administered by delivery to the eye using a solution or ointment. Furthermore, transdermal delivery of the target compounds can be achieved by iontophoretic patches and the like. For topical use, creams, ointments, jellies, solutions, or suspensions containing the compounds of the present invention are used. As used herein, topical application is also intended to include the use of mouthwashes and gargles.

[0218] The compounds of the present invention may also be bound to carriers that are suitable polymers as targetable drug carriers. Such polymers may include polyvinylpyrrolidone, pyran copolymers, polyhydroxy-propyl-methacrylamide-phenol, polyhydroxyethyl-aspartamide-phenol, or polyethylene oxide-polylysine substituted with palmitoyl residues. In addition, the compounds of the present invention may be bound to carriers that are a class of biodegradable polymers useful for achieving controlled release of drugs, such as polylactic acid, polyglycolic acid, copolymers of polylactic acid and polyglycolic acid, polyepsilon caprolactone, polyhydroxybutyric acid, polyorthoesters, polyacetals, polydihydropyrans, polycyanoacrylates, and crosslinked or amphiphilic block copolymers of hydrogels. The polymers and semipermeable polymer matrices may be formed into shaped articles, such as valves, stents, tubing, prosthetic devices, etc. In one embodiment of the present invention, the compounds of the present invention are bound to polymers or semipermeable polymer matrices that are formed as stents or stent graft devices.

[0219] The compounds and agents of the present invention may be formulated for deposition on a medical device, which may include any of a variety of conventional grafts, stents, such as stent grafts, catheters, balloons, baskets, or other devices that can be placed or permanently implanted in a body cavity.As a particular example, it is desirable to have devices and methods that can deliver the compounds of the present invention to areas of the body that have been treated by interventional techniques.For example, the compounds and agents can be delivered to a tumor or the microenvironment surrounding a tumor.

[0220] In some embodiments, compounds and drugs can be deposited in medical devices such as stents and delivered to a treatment site for treatment of a part of the body. Stents are used as a delivery vehicle for therapeutic agents. Intravascular stents are generally permanently implanted in coronary arteries or peripheral vessels. Stent designs include those in U.S. Pat. Nos. 4,733,655; 4,800,882; and 4,886,062. Such designs include both metallic and polymeric stents, as well as self-expanding and balloon-expandable stents. Stents may also be used to deliver therapeutic agents to a site of contact with the vasculature, as disclosed, for example, in U.S. Pat. No. 5,102,417 and International Patent Application Nos. WO 91 / 12779 and WO 90 / 13332, U.S. Pat. Nos. 5,419,760 and 5,429,634.

[0221] The term "deposited" means that the compounds and agents are coated, adsorbed, placed, or otherwise incorporated into the device by methods known in the art. For example, the compounds and agents may be embedded in and released from a polymeric material that coats or spans the medical device ("matrix type"), or may be surrounded by and released through the polymeric material ("reservoir type"). In the latter example, the compounds and agents may be entrapped within or bound to the polymeric material using one or more techniques for producing such materials known in the art. In other formulations, the compounds and agents are bound to the surface of the medical device by a releasable bond, without the need for a coating, and may be released over time, may be removed by aggressive mechanical or chemical processes, or are in a permanently immobilized form that presents the inhibitor at the implantation site.

[0222] In one embodiment, compounds and drugs may be incorporated into the polymer composition during the formation of a biocompatible coating for a medical device such as a stent. The coatings produced from these components are typically homogeneous and are useful for coating many devices designed for implantation.

[0223] The polymer may be either a biostable polymer or a bioabsorbable polymer, depending on the desired release rate or the degree of polymer stability desired, although bioabsorbable polymers are preferred for this embodiment because, unlike biostable polymers, they do not persist long after implantation to cause any adverse chronic local responses. Bioabsorbable polymers that may be used include, but are not limited to, poly(L-lactic acid), polycaprolactone, polyglycolide (PGA), poly(lactide-co-glycolide) (PLLA / PGA), poly(hydroxybutyrate), poly(hydroxybutyrate-co-valerate), polydioxanone, polyorthoesters, polyanhydrides, poly(glycolic acid), poly(D-lactic acid), poly(L-lactic acid), poly(D,L-lactic acid), poly(D,L-lactide) (PLA), poly(L-lactide) (PLLA), poly(glycolic acid-co-trimethylene carbonate) (PGA / PTMC), polyethylene oxide (PEO), polydioxanone (PDS), polyphosphoelastomers, and the like. Examples of suitable bioabsorbable polymers include esters, polyphosphoester urethanes, poly(amino acids), cyanoacrylates, poly(trimethylene carbonate), poly(iminocarbonates), copoly(ether-esters) (e.g., PEO / PLA), polyalkylene oxalates, polyphosphazenes, and biomolecules such as fibrin, fibrinogen, cellulose, starch, collagen, and hyaluronic acid, polyepsilon caprolactone, polyhydroxybutyric acid, polyorthoesters, polyacetals, polydihydropyrans, polycyanoacrylates, crosslinked or amphiphilic block copolymers of hydrogels, and other suitable bioabsorbable popolymers known in the art.Also, biostable polymers having a relatively low chronic tissue response can be used, such as polyurethanes, silicones, and polyesters, and other polymers can be used provided they can be dissolved, cured, or polymerized on the medical device, such as polyolefins, polyisobutylene, and ethylene-alphaolefin copolymers; acrylic polymers and copolymers, vinyl halide polymers and copolymers, such as polyvinyl chloride; polyvinylpyrrolidone; polyvinyl ethers, such as polyvinyl methyl ether; polyvinylidene halides, such as polyvinylidene fluoride and polyvinylidene chloride; polyacrylonitrile, polyvinyl ketone; polyvinyl aromatics, such as polystyrene, polyvinyl esters, such as polyvinyl acetate; copolymers of vinyl monomers and olefins, such as ethylene-methyl methacrylate copolymer, acrylonitrile-styrene copolymer, ABS resin, and ethylene-vinyl acetate copolymer; pyran copolymers; polyhydroxy-propyl-methacrylamide-phenol; polyhydroxyethyl-aspartamide-phenol; Polyethylene oxide-polylysine substituted with palmitoyl residues; polyamides such as Nylon 66 and polycaprolactam; alkyd resins, polycarbonates; polyoxymethylene; polyimides; polyethers; epoxy resins, polyurethanes; rayon; rayon-triacetate; cellulose, cellulose acetate, cellulose butyrate; cellulose acetate butyrate; cellophane; cellulose nitrate; cellulose propionate; cellulose ethers; and carboxymethylcellulose.

[0224] In some embodiments, the compounds and agents are formulated for release from the polymer coating into the environment in which the medical device is placed. Preferably, the compounds and agents are released in a controlled manner over an extended time frame (e.g., weeks or months) using at least one of several well-known techniques involving polymeric carriers or layers that control elution. Some of these techniques have been previously described in U.S. Patent Application Publication No. 20040243225.

[0225] D. Methods for Treating Solid Tumors In some aspects, the present invention provides a method of treating a solid tumor in a subject in need thereof by administering to the subject having cancer a therapeutically effective amount of a CCR1 antagonist and a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor. The subject can be administered a CCR1 antagonist and a PD-1 inhibitor. Alternatively, the subject can be administered a CCR1 antagonist and a PD-L1 inhibitor.

[0226] In some embodiments, the CCR1 antagonists and PD-1 or PD-L1 inhibitors described herein may be used with or combined with one or more additional therapeutic agents or treatments, including but not limited to radiation therapy.

[0227] A "subject" is defined herein to include animals such as mammals, including but not limited to humans, other primates, cows, sheep, goats, horses, dogs, cats, rabbits, rats, mice, etc. The compounds, agents, and compositions described herein are useful in the treatment of a variety of cancers, including solid tumors.

[0228] The compositions, methods, and kits described herein can be used to treat a subject diagnosed with cancer or a tumor.

[0229] In some embodiments, a tumor may be a malignant or potentially malignant neoplasm or tissue mass of any size, including primary tumors and secondary neoplasms. A solid tumor may be an abnormal growth or tissue mass that does not contain cysts or liquid areas.

[0230] In some embodiments, administering the compounds, agents, and compositions of the present invention can reduce or decrease tumor burden, tumor load, tumor size, and / or tumor number in a subject. In some cases, the compounds, agents, and compositions can prevent or minimize tumor metastasis. In other cases, the compounds, agents, and compositions can promote or increase tumor necrosis.

[0231] In some embodiments, administration of the compounds, agents, and compositions of the present invention can result in a partial or complete response (progression-free survival), delay progressive disease, and / or improve overall survival. In some cases, the compounds, agents, and compositions can increase the durability of the overall response to treatment, promote tumor regression, cancer regression, or disease stabilization, and / or provide clinical benefit. In other cases, the compounds, agents, and compositions can reduce the severity of at least one disease symptom, increase the frequency and duration of disease symptom-free periods, or prevent damage or disability due to cancer. In some cases, the onset of cancer or recurrence of cancer can be reduced.

[0232] The subject in need of treatment may have a cancer or solid tumor, including, but not limited to, adenocarcinoma, bladder cancer, breast cancer, triple negative breast cancer, colorectal cancer, colon cancer, liver cancer, lung cancer, non-small cell lung cancer, small intestine cancer, renal cancer, renal cell carcinoma, esophageal cancer, sarcoma, melanoma, multiple myeloma, bone cancer, pancreatic cancer, prostate cancer, gastric cancer, skin cancer, head and neck cancer, cutaneous or intraocular malignant melanoma, gastric cancer, bladder cancer, urothelial bladder cancer, uterine cancer, ovarian cancer, rectal cancer, The patient may have cancer of the anal region, cancer of the testes, cancer of the uterus, carcinoma of the fallopian tubes, carcinoma of the endometrium, carcinoma of the cervix, carcinoma of the vagina, carcinoma of the vulva, metastatic Merkel cell carcinoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma, cancer of the endocrine system, cancer of the thyroid gland, cancer of the parathyroid gland, cancer of the adrenal gland, sarcoma of soft tissue, cancer of the urethra, cancer of the penis, solid tumors of childhood, carcinoma of the renal pelvis, neoplasms of the central nervous system (CNS), primary CNS lymphoma, glioblastoma, glioma, tumor angiogenesis, spinal axis tumor, brain stem glioma, pituitary adenoma, Kaposi's sarcoma, epidermoid carcinoma, squamous cell carcinoma, T-cell lymphoma, environmentally induced cancer, any combination of the above cancers, metastatic lesions of the above cancers, advanced cancers or malignancies, and advanced solid tumors.

[0233] Further examples of solid tumors include, but are not limited to, fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcoma, endotheliosarcoma, lymphangiosarcoma, lymphangioendotheliosarcoma, synovium, mesothelioma, Ewing's tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, squamous cell carcinoma, basal cell carcinoma, sweat gland carcinoma, sebaceous gland carcinoma, nipple carcinoma, and sarcoma. tumors, papillary adenocarcinoma, cystadenocarcinoma, medullary carcinoma, bronchogenic carcinoma, renal cell carcinoma, hepatoma, cholangiocarcinoma, choriocarcinoma, seminoma, embryonal carcinoma, Wilms' tumor, testicular tumor, lung carcinoma, small cell lung carcinoma, bladder carcinoma, epithelial carcinoma, glioma, astrocytoma, medulloblastoma, craniopharyngioma, ependymoma, pinealoma, hemangioblastoma, acoustic neuroma, oligodendroglioma, meningioma, melanoma, neuroblastoma, and retinoblastoma.

[0234] In some embodiments, the CCR1 antagonist and PD-1 or PD-L1 inhibitor may be used with or combined with one or more additional therapeutic agents or treatments, including, but not limited to, chemotherapy, radiation therapy, and other cancer therapies.

[0235] In some embodiments, the CCR1 antagonists and PD-1 or PD-L1 inhibitors described herein may be used with or combined with one or more of chemotherapeutic agents, anti-cancer agents, anti-angiogenic agents, anti-proliferative / anti-mitotic agents, poly(ADP-ribose) polymerase inhibitors, DNA damaging agents, such as platinum drugs, anti-fibrotic agents, anti-hormonal agents, immunotherapeutic agents, therapeutic antibodies, bispecific antibodies, "antibody-like" therapeutic proteins (e.g., DARTs®, Duobodies®, Bites®, XmAbs®, TandAbs®, Fab derivatives), antibody-drug conjugates (ADCs), radiotherapeutic agents, anti-neoplastic agents, anti-proliferative agents, oncolytic viruses, gene modifiers or editors, such as CRISPR (including CRISPR / Cas9), zinc finger nucleases or synthetic nucleases (TALENs), CAR (chimeric antigen receptor) T-cell immunotherapeutics, or any combination thereof.

[0236] In some embodiments, these therapeutic agents are in the form of a compound, an antibody, a polypeptide, or a polynucleotide.

[0237] In some embodiments, the CCR1 antagonists and PD-1 or PD-L1 inhibitors described herein are combined with one or more of the following inhibitors, agonists, antagonists, ligands, modulators, stimulators, blockers, activators, or suppressors:Hedgehog proteins, FGF receptors, placental growth factor, tyrosine kinases (including but not limited to Axl, MET, Abl, Bcr proteins, EPH family, Fyn, Kit, Ltk, Lck, Src, Yes, Flt3, RET, Raf, Erbb, Erbb4, Erbb2, Jak, Jak1, Jak2, Btk, EGFR), DHFR, epidermal growth factor, cyclin-dependent kinase, interferon beta, VEGF ligand, PDGF-B ligand, VEGF, CSF-1 , tubulin, mTOR, HDAC, PARP, poly ADP-ribose polymerase, proteasome, cyclooxygenase 2, GNRH, estrogen receptor, somatostatin receptor, aromatase, thymidylate synthase, transferase, cytotoxic T lymphocyte protein-4, macrophage mannose receptor 1, MEK-1 protein kinase, MEK-2 protein kinase, thymidylate synthase, GCSF receptor, CSF2 gene, retinoid X receptor, DNA polymerase, topoisomerase II , dihydropyrimidine dehydrogenase, orotate phosphoribosyltransferase, DNA gyrase, cytosine DNA methyltransferase, topoisomerase I, chorionic gonadotropin, luteinizing hormone receptor, interleukin-2 ligand, interleukin-2, estradiol 17 beta dehydrogenase, glucocorticoid, progesterone receptor, dopamine D2 receptor, IL17 gene, interleukin 17E, neurokinin receptor, retinoid X receptor, ornithine decarboxylase Cirrhase, interferon alpha 2, interleukin-2 ligand, interleukin-2, albumin, microtubules, cyclin G1 thymidylate synthase, checkpoint inhibitors, CTLA-4, 4-1BB (CD137), 4-1BBL (CD137L), B7-H3, B7-H4, BTLA, HVEM, TIM3, GAL9, LAG3, TIM3, B7H3, B7H4, VISTA, KIR, 2B4, CD160 (also known as BY55), CGEN-15049, OX40, or any combination thereof.

[0238] In some embodiments, the CCR1 antagonist and PD-1 or PD-L1 inhibitor described herein are selected from the group consisting of sonidegib, nintedanib, aflibercept, sorafenib, eribulin mesylate, pralatrexate, cetuximab, palbociclib, bevacizumab, recombinant interferon beta-1a, dasatinib, ramucirumab, pazopanib, trastuzumab emtansine, everoli Mus, sunitinib, perfluorobutan, zoledronic acid, ruxolitinib, ibrutinib, panobinostat, lapatinib, olaparib, bortezomib, celecoxib, gefitinib, goserelin acetate, raloxifene, octreotide acetate, octreotide, anastrozole, gemcitabine, letrozole, pemetrexed disodium, cabozantinib, ipilimumab, technetium Tc 99m tilmanocept, cobimetinib, paclitaxel, pertuzumab, capecitabine, erlotinib, filgrastim, talimogene laherparepvec, trastuzumab, bazedoxifene, nimotuzumab, trabectedin, bexarotene, doxorubicin, docetaxel, CS-055, abiraterone, vorinostat, afatinib, leuprolide acetate, vandetanib, triptorelin pamoate, tegafur, gimeracil, oteracil potassium, pixantrone, carboplatin, exemestane, mitoxantrone, technetium Tc 99m-Tetrofosmin, Ganirelix acetate, Decitabine, Irinotecan, Bosutinib, Epirubicin, Apatinib, Temsirolimus, Choriogonadotropin alfa, Vinorelbine, Tamoxifen, Triptorelin acetate, Triptorelin, Aldesleukin, Mifepristone, Vinflunine, Gadobutrol, Octafluoropropane, Talaporfin, Miltefosine, Bromocriptine, DaunoXome, Cetrorelix, Pamidronate, Virulizin, DLBS-1425, 99mTc-Sestamibi, Arcitumomab, Nafarelin, Alitretinoin, Formestane, Trilostane, Pirarubicin, Eflornithine, Histrelin, 111In-Satumomab pendetidependetide, interferon alpha-2b, interleukin-2, recombinant human interleukin-2, gadofosveset, Glutoxim, Rexin-G, doxifluridine, Prosorba, fadrozole, ipilimumab, tremelimumab, AGEN-1884, ADC-1015, PSI-001, JHL-1155, and lobaplatin, or any combination thereof.

[0239] In some embodiments, the CCR1 antagonist of the present invention and either the PD-1 inhibitor or the PD-L1 inhibitor can be administered in combination with other suitable anti-cancer therapeutic agents, such as chemotherapeutic agents, radiation, biologics, immunotherapy, etc. The selection of suitable agents for use in combination therapy can be performed by those skilled in the art according to conventional pharmaceutical principles. The combination of therapeutic agents can act synergistically to provide treatment or prevention of various disorders, such as cancer. Using this approach, therapeutic efficacy can be achieved using lower doses of each agent, thus reducing the possibility of adverse side effects.

[0240] In some embodiments, the CCR1 antagonist described herein, the PD-1 or PD-L1 inhibitor, and the one or more additional therapeutic agents are administered simultaneously, separately, or sequentially.

[0241] E. Method of Administration Depending on the cancer and condition or disease state of the subject, the compounds, agents, and compositions of the invention can be administered orally, parenterally (e.g., intramuscular, intraperitoneal, intravenous, ICV, intracisternal injection or infusion, subcutaneous injection, or implant), by implantation (such as when the compound is attached to a stent device), by inhalation spray, nasal, vaginal, rectal, sublingual, or topical routes of administration, and can be formulated, alone or together, in appropriate dosage unit formulations containing conventional non-toxic pharmacologic acceptable carriers, adjuvants, and vehicles appropriate for each route of administration.

[0242] In the treatment of cancer, such as solid tumors requiring chemokine receptor modulation, suitable dosage levels of CCR1 antagonists are generally about 0.001-100 mg / kg of patient body weight per day, which can be administered in single or multiple doses. Preferably, the dosage level is about 0.01-25 mg / kg per day, more preferably about 0.05-10 mg / kg per day. Suitable dosage levels can be about 0.01-25 mg / kg per day, about 0.05-10 mg / kg per day, or about 0.1-5 mg / kg per day. Within this range, dosages can be 0.005-0.05, 0.05-0.5, or 0.5-5.0 mg / kg per day. For oral administration, the composition is preferably provided in the form of a tablet containing 1.0 to 1000 milligrams of active ingredient, in particular 1.0, 5.0, 10.0, 15.0, 20.0, 25.0, 50.0, 75.0, 100.0, 150.0, 200.0, 250.0, 300.0, 400.0, 500.0, 600.0, 750.0, 800.0, 900.0, and 1000.0 milligrams of active ingredient, for symptomatic adjustment of the dosage to the patient to be treated. The compound may be administered on a regimen of 1 to 4 times per day, preferably once or twice per day.

[0243] Suitable dosage levels of PD-1 inhibitors or PD-L1 inhibitors are generally about 0.0001 to about 100 mg per kg of subject body weight, usually about 0.001 to about 20 mg, more usually about 0.01 to about 10 mg per kg of subject body weight. Preferably, dosages are in the range of 0.1 to 10 mg / kg body weight. For example, dosages can be 0.1, 0.3, 1, 3, 5, or 10 mg / kg body weight, more preferably 0.3, 1, 3, or 10 mg / kg body weight. Dosing schedules can typically be designed to achieve exposures that result in sustained receptor occupancy (RO) based on typical pharmacokinetic properties of antibodies. Exemplary treatment regimes involve administration once a week, once every 2 weeks, once every 3 weeks, once every 4 weeks, once a month, once every 3 months, or once every 3 to 6 months. Dosages and scheduling can vary during the course of treatment. For example, dosing schedules may include administering the antibody (i) every 2 weeks for a 6 week cycle; (ii) every 4 weeks for 6 doses, then every 3 months; (iii) every 3 weeks; (iv) once at 3-10 mg / kg body weight, then 1 mg / kg body weight every 2-3 weeks. Considering that IgG4 antibodies typically have a half-life of 2-3 weeks, a preferred dosing regimen for anti-PD-1 or anti-PD-L1 antibodies includes 0.3-10 mg / kg body weight, preferably 3-10 mg / kg body weight, more preferably 3 mg / kg body weight, administered intravenously, with the antibody administered every 14 days in cycles of 6 or up to 12 weeks until a complete response or until progressive disease is confirmed.

[0244] In some embodiments, two or more antibodies with different binding specificities are administered simultaneously, in which case the dosage of each antibody administered falls within the ranges indicated. The antibodies can be administered multiple times. The interval between single doses can be, for example, weekly, every two weeks, every three weeks, monthly, every three months, or yearly. The intervals can be irregular, as indicated by measuring blood levels of antibodies against the target antigen in the patient. In some methods, the dosage is adjusted to achieve a plasma antibody concentration of about 1-1000 mg / ml, and in some methods about 25-300 mg / ml.

[0245] Alternatively, the antibody can be administered as a sustained release formulation, in which case less frequent administration is required. The dosage and frequency vary depending on the half-life of the antibody in the patient. In general, human antibodies exhibit the longest half-life, followed by humanized antibodies, chimeric antibodies, and non-human antibodies. The dosage and frequency can vary depending on whether the treatment is preventive or therapeutic. In preventive applications, relatively low dosages are administered at relatively infrequent intervals for an extended period of time. Some patients continue to receive treatment for the rest of their lives. In therapeutic applications, relatively high dosages at relatively short intervals may be required until the progression of the disease is reduced or terminated, preferably until the patient shows partial or complete improvement of the symptoms of the disease. The patient can then be administered a preventive regime.

[0246] The actual dosage level of the active ingredient in the pharmaceutical composition may be varied to obtain an amount of the active ingredient effective to achieve the desired therapeutic response for a particular patient, composition, and mode of administration without undue toxicity to the patient. The selected dosage level depends on various pharmacokinetic factors, such as the activity of the particular composition of the present invention used, the route of administration, the time of administration, the excretion rate of the particular compound used, the duration of treatment, other drugs, compounds and / or substances used in combination with the particular composition used, the age, sex, weight, condition, general health, and previous medical history of the patient being treated, and similar factors well known in the medical field. The composition can be administered by one or more routes of administration using one or more of a variety of methods well known in the art. As will be understood by those skilled in the art, the route and / or mode of administration will vary depending on the desired result.

[0247] The therapeutic compounds and agents in the combination therapies disclosed herein may be administered either alone or in pharmaceutical compositions comprising the therapeutic compounds and agents and one or more pharma- ceutically acceptable carriers, excipients, and diluents.

[0248] In some embodiments, the therapeutic compounds and agents are each provided in an amount that is sub-therapeutic when provided alone or without the other. One of skill in the art will understand that "combination" can include combination in treatment (i.e., two or more drugs can be administered as a mixture, or at least simultaneously, or can be introduced into a subject at different times but both are present in the subject at the same time).

[0249] Similarly, the compounds, drugs, and compositions of the present invention may be used in combination with other drugs used to treat, prevent, suppress, or improve cancer. Such other drugs may be administered simultaneously or sequentially with the compounds, drugs, or compositions of the present invention by a route and amount commonly used therefor. When the compounds, drugs, or compositions of the present invention are used simultaneously with one or more other drugs, pharmaceutical compositions containing such other drugs in addition to the compounds, drugs, or compositions of the present invention are preferred. Thus, pharmaceutical compositions can include pharmaceutical compositions containing one or more other active ingredients or therapeutic agents in addition to the compounds, drugs, or compositions of the present invention.

[0250] The compounds, agents, and compositions disclosed herein can be provided at dosage levels and dosing frequencies that provide a synergistic effect of the CCR1 antagonist in combination with a PD-1 inhibitor or a PD-L1 inhibitor.

[0251] It will be understood, however, that the specific dose level and frequency of administration for any particular patient may vary and will depend on a variety of factors, such as the activity of the specific compound used, the metabolic stability and length of action of that compound, the subject's age, weight, genetic characteristics, general health, sex, and diet, as well as the mode and time of administration, rate of excretion, drug combination, and the severity of the particular condition of the subject undergoing therapy.

[0252] Combination therapy includes simultaneous administration of a CCR1 antagonist and a PD-1 or PD-L1 pathway inhibitor, sequential administration of a CCR1 antagonist and a PD-1 or PD-L1 pathway inhibitor, administration of a composition containing a CCR1 antagonist and a PD-1 or PD-L1 pathway inhibitor, or simultaneous administration of separate compositions, such as one composition containing a CCR1 antagonist and another composition containing a PD-1 or PD-L1 pathway inhibitor.

[0253] F. Kit In some embodiments, provided herein is a kit containing a CCR1 chemokine receptor antagonist as described herein and either a PD-1 inhibitor or a PD-L1 inhibitor as described herein. Such a kit is useful for treating a subject having cancer, e.g., a solid tumor. The kit can contain a pharmaceutical composition containing a CCR1 chemokine receptor antagonist and a PD-1 inhibitor or a PD-L1 inhibitor. The kit can contain a pharmaceutical composition containing a CCR1 chemokine receptor antagonist and a PD-1 inhibitor. The kit can contain a pharmaceutical composition containing a CCR1 chemokine receptor antagonist and a PD-L1 inhibitor. The CCR1 chemokine receptor antagonist can be 1.001, 3.002, 4.005, 5.005, or 3.001, an analog thereof, or a derivative thereof.

[0254] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of BL-5923, UCB-35625, BX-471, BI-638683, PS-031291, MLN-3701, AZD-4818, MLN-3897, CP-481715, F-18-CCR1, AOP-RANTES, PS-375179, and NSC-651016. The PD-1 inhibitor can be pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, STI-1110, biosimilars thereof, biobetters thereof, or bioequivalents thereof. The PD-1 inhibitor can be pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, or STI-1110. The PD-L1 inhibitor can be durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, or bioequivalents thereof. The PD-L1 inhibitor can be durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, STI-1014, or KY- 1003. The PD-L1 inhibitor can be durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, KY-1003, a biosimilar thereof, a biobetter thereof, or a bioequivalent thereof. The PD-L1 inhibitor can be durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, or KY-1003.

[0255] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from compounds disclosed in WO14151634, WO15160641, WO16039749, WO16077518, WO16100608, WO16149351, WO2016057624, WO2016100285, US2016194307, US2016222060, US2015291549, US2016194307, and US2014294898 (BRISTOL MYERS SQUIBB CO), which are incorporated by reference herein.

[0256] In some embodiments, the PD-1 or PD-L1 inhibitor is selected from the compounds disclosed in U.S. Provisional Patent Application No. 62 / 355,119 or 62 / 440,100, which are incorporated herein by reference.

[0257] In some embodiments, the PD-1 and / or PD-L1 inhibitor is one of the following: [ka] is selected from the group consisting of:

[0258] In some embodiments, the PD-1 and / or PD-L1 inhibitors are disclosed in WO16142886, WO16142894, WO16142852, WO16142833, WO15033301, WO15033299, WO11161699, WO12168944, WO13132317, WO13144704, WO15033303, WO15036927, WO15044900, WO16142835, US2015073024, US8907053, US9044442, US9096642, US9233940, and US2016194295 (Aurigene discovery tech The compound is selected from those disclosed in US Pat. No. 6,399,363, issued Dec. 23, 1997, and entitled "Compounds for the Preparation of Compounds of the Invention."

[0259] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, pembrolizumab, nivolumab, AP-106, AP-105, MSB-2311, CBT-501, avelumab, AK-105, IO-102, IO-103, PDR-001, CX-072, SHR-1316, JTX-4014, GNS-1480, recombinant humanized anti-PD1 mAb (Shanghai Junshi Biosciences), REGN-2810, pelareorep, SHR-1210, PD1 / PDL1 inhibitor vaccine (THERAVECTYS), BGB-A317, recombinant humanized anti-PD-1 mAb (Bio-Thera Solutions), Probody targeting PD-1 (CytomX), XmAb-20717, FS-118, PSI-001, SN-PDL01, SN-PD07, PD-1 modified TILs (Sangamo Therapeutics), PRS-332, FPT-155, jienuo mAb (Genor Biopharma), TSR-042, REGN-1979, REGN-2810, resminostat, FAZ-053, PD-1 / CTLA-4 bispecific antibody (MacroGenics), MGA-012, MGD-013, M-7824, PD-1 based bispecific antibody (Beijing Hanmi Pharmaceutical), AK-112, AK-106, AK-104, AK-103, BI-754091, ENUM-244C8, MCLA-145, MCLA-134, anti-PD1 oncolytic monoclonal antibody (Transgene SA), AGEN-2034, IBI-308, WBP-3155, JNJ-63723283, MEDI-0680, SSI-361, CBT-502, anti-PD-1 bispecific antibody, dual-targeted anti-PD-1 / LAG-3 mAbs (TESARO), dual-targeted anti-PD-1 / TIM-3mAbs (TESARO), PF-06801591, LY-3300054, BCD-100, STI-1110, pembrolizumab biosimilar, nivolumab biosimilar, PD-L1-TGF-beta therapy, KY-1003, STI-1014, GLS-010, AM-0001, GX-P2, KD-033, PD-L1 / BCMA bispecific antibody (Immune Pharmaceuticals), PD-1 / Ox40-targeted bispecific antibody (Immune Pharmaceuticals), BMS-936559, anti-PD-1 / VEGF-A DARPins (Molecular Partners), mDX-400, ALN-PDL, PD-1 inhibitor peptide (Aurigene), siRNA-loaded dendritic cell vaccine (Alnylam Pharmaceuticals), GB-226, PD-L1-targeted CAR-TNK-based immunotherapy (TNK Therapeutics / NantKwest), INSIX RA, INDUS-903, AMP-224, anti-CTLA-4 / anti-PD-1 bispecific humanized antibody (Akeso Biopharma), B7-H1 vaccine (State Key Laboratory of Cancer Biology / Fourth Military Medical University), and GX-D1.

[0260] In some cases, the kits include written materials, such as instructions for use of the compounds, agents, antibodies, or pharmaceutical compositions thereof. Without limitation, the kits may include buffers, diluents, filters, needles, syringes, and package inserts with instructions for practicing any of the methods disclosed herein.

[0261] G. Metastasis In some embodiments, a method of reducing or preventing metastasis in a subject having a solid tumor is provided, comprising administering to a subject in need thereof a therapeutically effective amount of a CCR1 chemokine receptor antagonist.

[0262] In some embodiments, the metastasis is a lung metastasis.

[0263] In some embodiments, the CCR1 chemokine receptor antagonist has formula (IIIb1a): [ka] wherein each A is N or CH, and at least one A is N; R 1 is a halogen; R 3 is C 1-8 Alkyl, C 3-8 Cycloalkyl and C 2-8 alkenyl; R 8 is C 1-8 is alkyl] or a pharma- ceutically acceptable salt thereof.

[0264] In some embodiments, the CCR1 chemokine receptor antagonist is: [ka] or a pharma- ceutically acceptable salt thereof.

[0265] In some embodiments, the CCR1 chemokine receptor antagonist is: [ka] or a pharma- ceutically acceptable salt thereof.

[0266] In some embodiments, the CCR1 chemokine receptor antagonist is: [ka] or a pharma- ceutically acceptable salt thereof.

[0267] In some embodiments, the CCR1 chemokine receptor antagonist is selected from the group consisting of BL-5923, UCB-35625, BX-471, BI-638683, PS-031291, MLN-3701, AZD-4818, MLN-3897, CP-481715, F-18-CCR1, AOP-RANTES, PS-375179, and NSC-651016.

[0268] In some embodiments, the subject is a human subject.

[0269] In some embodiments, the solid tumor is selected from the group consisting of brain cancer, breast cancer, triple-negative breast cancer, bladder cancer, bone cancer, colon cancer, lung cancer, kidney cancer, liver cancer, gastric cancer, prostate cancer, sarcoma, melanoma, carcinoma, and lymphoma.

[0270] In some embodiments, the solid tumor is triple-negative breast cancer.

[0271] In some embodiments, the CCR1 antagonist is administered with one or more additional therapeutic agents.

[0272] In some embodiments, the one or more additional therapeutic agents is a PD-1 inhibitor or a PD-L1 inhibitor.

[0273] In some embodiments, the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, STI-1110, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0274] In some embodiments, the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, KY-1003, biosimilars thereof, biobetters thereof, and bioequivalents thereof.

[0275] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from compounds disclosed in WO14151634, WO15160641, WO16039749, WO16077518, WO16100608, WO16149351, WO2016057624, WO2016100285, US2016194307, US2016222060, and US2014294898 (BRISTOL MYERS SQUIBB CO), which are incorporated by reference herein.

[0276] In some embodiments, the PD-1 or PD-L1 inhibitor is selected from the compounds disclosed in U.S. Provisional Patent Application No. 62 / 355,119 or 62 / 440,100, which are incorporated herein by reference.

[0277] In some embodiments, the PD-1 and / or PD-L1 inhibitor is one of the following: [ka] is selected from the group consisting of:

[0278] In some embodiments, the PD-1 and / or PD-L1 inhibitors are disclosed in WO16142886, WO16142894, WO16142852, WO16142833, WO15033301, WO15033299, WO11161699, WO12168944, WO13132317, WO13144704, WO15033303, WO15036927, WO15044900, WO16142835, US2015073024, US8907053, US9044442, US9096642, US9233940, and US2016194295 (Aurigene discovery tech The compound is selected from those disclosed in US Pat. No. 6,399,363, issued Dec. 23, 1997, and entitled "Compounds for the Preparation of Compounds of the Invention."

[0279] In some embodiments, the PD-1 and / or PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, pembrolizumab, nivolumab, AP-106, AP-105, MSB-2311, CBT-501, avelumab, AK-105, IO-102, IO-103, PDR-001, CX-072, SHR-1316, JTX-4014, GNS-1480, recombinant humanized anti-PD1 mAb (Shanghai Junshi Biosciences), REGN-2810, pelareorep, SHR-1210, PD1 / PDL1 inhibitor vaccine (THERAVECTYS), BGB-A317, recombinant humanized anti-PD-1 mAb (Bio-Thera Solutions), Probody targeting PD-1 (CytomX), XmAb-20717, FS-118, PSI-001, SN-PDL01, SN-PD07, PD-1 modified TILs (Sangamo Therapeutics), PRS-332, FPT-155, jienuo mAb (Genor Biopharma), TSR-042, REGN-1979, REGN-2810, resminostat, FAZ-053, PD-1 / CTLA-4 bispecific antibody (MacroGenics), MGA-012, MGD-013, M-7824, PD-1 based bispecific antibody (Beijing Hanmi Pharmaceutical), AK-112, AK-106, AK-104, AK-103, BI-754091, ENUM-244C8, MCLA-145, MCLA-134, anti-PD1 oncolytic monoclonal antibody (Transgene SA), AGEN-2034, IBI-308, WBP-3155, JNJ-63723283, MEDI-0680, SSI-361, CBT-502, anti-PD-1 bispecific antibody, dual-targeted anti-PD-1 / LAG-3 mAbs (TESARO), dual-targeted anti-PD-1 / TIM-3mAbs (TESARO), PF-06801591, LY-3300054, BCD-100, STI-1110, pembrolizumab biosimilar, nivolumab biosimilar, PD-L1-TGF-beta therapy, KY-1003, STI-1014, GLS-010, AM-0001, GX-P2, KD-033, PD-L1 / BCMA bispecific antibody (Immune Pharmaceuticals), PD-1 / Ox40-targeted bispecific antibody (Immune Pharmaceuticals), BMS-936559, anti-PD-1 / VEGF-A DARPins (Molecular Partners), mDX-400, ALN-PDL, PD-1 inhibitor peptide (Aurigene), siRNA-loaded dendritic cell vaccine (Alnylam Pharmaceuticals), GB-226, PD-L1-targeted CAR-TNK-based immunotherapy (TNK Therapeutics / NantKwest), INSIX RA, INDUS-903, AMP-224, anti-CTLA-4 / anti-PD-1 bispecific humanized antibody (Akeso Biopharma), B7-H1 vaccine (State Key Laboratory of Cancer Biology / Fourth Military Medical University), and GX-D1. EXAMPLES

[0280] IV. Working Examples The following examples are offered to illustrate, but not to limit, the claimed invention.

[0281] The small molecule CCR1 antagonist used was compound 3.002 and the anti-PD-L1 monoclonal antibody was BioLegend® 10F.9G2.

[0282] Example 1. Combination chemotherapy of chemokine receptor inhibition and PD-L1 blockade enhances antitumor effects in mouse models of breast cancer. Trafficking and expansion of myeloid-derived suppressor cells (MDSCs) play a major role in tumor immune suppression. MDSCs express chemokine receptors that may mediate their recruitment to the tumor microenvironment. T cell suppression is also mediated by the interaction of programmed death-1 (PD-1) with its ligands, which are abundantly expressed on cancer cells and immune infiltrates, including MDSCs.

[0283] Breast cancer is one of the leading causes of cancer-related deaths. There were an estimated 231,840 new cases in 2015. Targeted therapies have been successful for some subtypes of breast cancer, such as trastuzumab (Herceptin®) for HER2+ subtypes, and hormonal therapy for estrogen receptor (ER)+ or progesterone receptor (PR)+ subtypes. Unfortunately, there are no effective targeted therapies for triple-negative breast cancer (TNBC; HER2-ER-PR-). TNBC is more immunogenic than other types. Triple-negative breast cancer produces neoantigens that are highly mutagenic and can induce an immune response. Immunomodulatory therapies may be effective in treating this and similar cancers.

[0284] This example shows that targeting both pathways by administration of a small molecule chemokine receptor antagonist (compound 3.002, which blocks CCR1) and an anti-PD-L1 monoclonal antibody (BioLegend® 10F.9G2) significantly reduced tumor burden in an orthotopic breast cancer mouse model.

[0285] Analysis of human breast cancer patient samples from The Cancer Genome Atlas (TCGA) database revealed that the CCR1 ligands MCP-7 (CCL7) and RANTES (CCL5) are present at significantly higher levels in breast cancer compared to normal breast tissue. Furthermore, CCR1 and its ligands, as well as PD-L1, are significantly higher in triple-negative breast cancer samples than in other breast cancer subtypes.

[0286] The chemokine receptor CCR1 ligands CCL5 (RANTES; Figure 1A) and CCL7 (MCP-3; Figure 1B), as well as the PD-1 ligand (PD-L1; Figure 1D), were detected at higher expression levels in tissue samples from human patients with triple-negative breast cancer compared to normal tissue samples and tissue samples from all other types of breast cancer. The elevated expression was statistically significant. The mRNA expression of the CCR1 ligand CCL3 (MIP-1α; Figure 1C) was not elevated in breast cancer samples, including triple-negative breast cancer samples.

[0287] Expression of CCR1 and PD-L1 correlated well in human breast cancer patient samples (Figure 1E). Each point on the graph represents a breast tumor sample from an individual patient with breast cancer. In Figure 1E, "r" represents the Pearson correlation coefficient.

[0288] In this study, we investigated the therapeutic effect of CCR1 blockade in combination with a PD-L1 monoclonal antibody using a murine triple-negative breast cancer model (4T1 breast cancer mouse model).

[0289] 5×10 4 4T1 breast cancer cells were orthotopically injected into the mammary glands of 6- to 8-week-old female BALB / C mice. Thirteen days after implantation, each group had similar tumor volumes, with a mean volume of approximately 150 mm. 3 Mice were randomized based on tumor volume to have a tumor volume of 0.01 mm or less. Tumor volumes were measured by caliper measurement and calculated as width x (length). 2The tumor volume was calculated by the formula: ##EQU1## On day 13 post-implantation, CCR1 antagonist 3.002 was administered by oral gavage at 15 mg / kg twice daily for the following 10 days. Anti-PD-L1 monoclonal antibody (BioLegend, 10F.9G2) was administered intraperitoneally at 200 μg per mouse on days 13, 17, and 20. Mice in the vehicle group were administered an equal volume of vehicle (PEG400) and an equal amount of isotype control antibody (rat IgG, BioLegend). Tumor volumes were measured three times a week until day 23 post-implantation (Figures 3A-3D). Mice receiving the combination treatment showed reduced tumor progression (Figure 3D) compared to mice receiving CCR1 antagonist alone (Figure 3B), mice receiving PD-L1 mAb (Figure 3C), and mice receiving vehicle (Figure 3A).

[0290] On day 23 after implantation, the mice were sacrificed and the tumors and lungs were harvested. The total wet weight of the tumors was measured. Figure 3E shows that mice receiving a therapy containing a CCR1 antagonist together with an anti-PD-L1 monoclonal antibody had the lowest tumor weight.

[0291] Primary tumor growth was not significantly altered by either agent alone (Figures 3B and 3C), but the combination of a CCR1 inhibitor plus an anti-PD-L1 antibody (Figure 3D) resulted in a significantly reduced tumor burden. Tumor weight was significantly reduced in mice receiving the combination therapy (Figure 3E).

[0292] Lungs were fixed overnight in Bouin's solution and the number of surface metastatic nodules was counted visually (Figure 4A). Student's t-test was performed for statistical analysis. *; p<0.05, **; p<0.005, ****; p<0.0001. Mice treated with CCR1 antagonist alone had fewer metastatic nodules per lung compared to vehicle-treated mice (Figure 4B).

[0293] Lung metastasis was statistically reduced when CCR1 antagonist alone was administered to the 4T1 mouse model, and Figure 4A shows that the number of metastatic nodes per lung was reduced in mice treated with CCR1 antagonist compared to vehicle.

[0294] Myeloid-derived suppressor cells (MDSCs) rapidly expand during inflammation, infection, and cancer and inhibit immune responses. MDSCs are strongly involved in suppressing tumor-induced immune responses. As shown in Table 1, there are two main types of MDSCs.

[0295] [Table 1]

[0296] Orthotopic breast cancer cell transplantation is characterized by CD11b 陽性 Ly6G 高 Ly6C 高 It induces a robust expansion of MDSC or G-MDSC, a subpopulation of which expresses CCR1. Figure 5A shows a dramatic increase in G-MDSC in the blood (Figure 5A) and spleen (Figure 5B) of 4T1 tumor-bearing mice. The majority of immune cells infiltrating 4T1 tumors were G-MDSC (Figure 5C). Also, the majority of CCR1-expressing cells in the spleen of 4T1 tumor mice were G-MDSC. FACS analysis shown in Figure 6A revealed that the population CD45 陽性 and CCR1 陽性 This population was further analyzed to determine the expression of G-MDSC (CD11b 陽性 Ly6G 高 Ly6C 高 ), M-MDSC (CD11b 陽性 Ly6G 陰性 Ly6C 高 ), and macrophages (CD11b 陽性 Ly6G 陰性 Ly6C 陰性 F4 / 80 陽性) was determined. This analysis also revealed that tumors with more C-MDSC and less T cell infiltration were larger. For example, FIG. 7A shows that tumor weight correlated with an increased proportion of G-MDSC among tumor-infiltrating immune cells. FIG. 7B shows that tumor weight also correlated with a decreased percentage of CD8+ T cells among tumor-infiltrating immune cells.

[0297] The number or percentage of G-MDSCs among tumor-infiltrating cells in the blood of 4T1 tumor-bearing mice was dramatically reduced after treatment of the mice with a combination of a small molecule CCR1 antagonist (3.002) and a PD-L1 mAb (Figure 8A). The combination treatment did not affect the number or percentage of M-MDSCs in the blood (Figure 8B).

[0298] Analysis of tumor-infiltrating cells revealed that 3.002 alone or in combination with PD-L1 mAb significantly reduced the number of G-MDSC in primary tumors (Figure 9A). This result indicates that CCR1 blockade of G-MDSC trafficking leads to a reduction in tumor burden. The treatment regimen did not change the number or percentage of M-MDSC in primary tumors (Figure 9B). Treatment with CCR1 antagonist alone or in combination with PD-L1 mAb significantly increased the percentage of CD8+ T cells (Figure 9C). In some 4T1 tumors, 3.002 alone or in combination with PD-L1 mAb also increased B cell infiltration.

[0299] In summary, the data show that CCR1 mediates G-MDSC recruitment to tumors or tumor microenvironment and promotes tumor progression (Figure 10). CCR1 receptor ligand and PD-L1 expression are significantly elevated in human breast cancer tumors, especially in triple-negative breast cancer. G-MDSC are increased in mice bearing 4T1 triple-negative breast tumors and positively correlate with larger tumors. Administration of small molecule CCR1 antagonist 3.002 in combination with PD-L1 mAb significantly reduces primary tumor progression. Administration of small molecule CCR1 antagonist 3.002 significantly reduces lung metastasis. Additionally, CCR1 antagonist and PD-L1 mAb reduce circulating and tumor-infiltrating G-MDSC and increase CD8 T cell and B cell infiltration in 4T1 triple-negative tumors. This combination therapy enhances antitumor immune responses. Thus, combination therapy comprising a CCR1 antagonist and a PD-L1 mAb may have therapeutic efficacy in treating human patients with triple-negative breast cancer.

[0300] Although the foregoing invention has been described in some detail by way of illustration and example for clarity of understanding, those skilled in the art will recognize that certain changes and modifications can be practiced within the scope of the appended claims. Further, each reference provided herein is incorporated by reference in its entirety to the same extent as if each reference was individually incorporated by reference.

Claims

1. 1. Use of a CCR1 chemokine receptor antagonist in the manufacture of a medicament for the treatment of triple-negative breast cancer in combination with a PD-1 inhibitor or a PD-L1 inhibitor, comprising: The CCR1 chemokine receptor antagonist has the formula (IIIb1a): 【Chemistry 1】 wherein each A is N or CH, and at least one A is N; R 1 is a halogen; R 3 is C 1-8 Alkyl, C 3-8 Cycloalkyl and C 2-8 alkenyl; R 8 is C 1-8 is alkyl] or a pharma- ceutically acceptable salt thereof; the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, and STI-1110; the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, and KY-1003; use.

2. 2. The use according to claim 1, wherein a CCR1 chemokine receptor antagonist and a PD-1 inhibitor are administered in the treatment.

3. 2. The use according to claim 1, wherein a CCR1 chemokine receptor antagonist and a PD-L1 inhibitor are administered in the treatment.

4. CCR1 chemokine receptor antagonists include: 【Chemistry 2】 The use according to any one of claims 1 to 3, wherein the compound is selected from the group consisting of:

5. The use according to any one of claims 1 to 4, wherein the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or the PD-L1 inhibitor are administered simultaneously in the treatment.

6. The use according to claim 5, wherein the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or the PD-L1 inhibitor are administered in a combined formulation.

7. The use according to any one of claims 1 to 4, wherein the CCR1 chemokine receptor antagonist and the PD-1 inhibitor or the PD-L1 inhibitor are administered sequentially in the treatment.

8. The use according to claim 7, wherein the CCR1 chemokine receptor antagonist is administered prior to administration of a PD-1 inhibitor or a PD-L1 inhibitor.

9. The use according to claim 7, wherein the CCR1 chemokine receptor antagonist is administered following administration of a PD-1 inhibitor or a PD-L1 inhibitor.

10. The use according to any one of claims 1 to 9, wherein the CCR1 chemokine receptor antagonist is administered orally and the PD-1 inhibitor or PD-L1 inhibitor is administered intravenously.

11. The use according to any one of claims 1 to 10, wherein the subject is a human subject.

12. 1. A composition for treating a subject with triple-negative breast cancer, comprising a therapeutically effective amount of a CCR1 chemokine receptor antagonist, a therapeutically effective amount of a PD-1 inhibitor or a PD-L1 inhibitor, and a pharma- ceutically acceptable carrier or excipient, The CCR1 chemokine receptor antagonist has the formula (IIIb1a): 【Chemistry 3】 wherein each A is N or CH, and at least one A is N; R 1 is a halogen; R 3 is C 1-8 Alkyl, C 3-8 Cycloalkyl and C 2-8 alkenyl; R 8 is C 1-8 is alkyl] or a pharma- ceutically acceptable salt thereof; the PD-1 inhibitor is selected from the group consisting of pembrolizumab, nivolumab, IBI-308, mDX-400, BGB-108, MEDI-0680, SHR-1210, PF-06801591, PDR-001, GB-226, and STI-1110; the PD-L1 inhibitor is selected from the group consisting of durvalumab, atezolizumab, avelumab, BMS-936559, ALN-PDL, TSR-042, KD-033, CA-170, CA-327, STI-1014, and KY-1003; composition.

13. 13. The composition of claim 12, comprising a CCR1 chemokine receptor antagonist, a PD-1 inhibitor, and a pharma- ceutically acceptable carrier or excipient.

14. 13. The composition of claim 12, comprising a CCR1 chemokine receptor antagonist, a PD-L1 inhibitor, and a pharma- ceutically acceptable carrier or excipient.

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