Formulation of phosphoramidite derivatives of nucleoside drugs - Patent Application 20070233633

Abstract

To provide pharmaceutical formulations or kits that deliver effective doses of lipophilic protides (phosphoramidate derivatives of nucleosides), particularly 5-fluoro-2'-deoxyuridine-5'-O-[1-naphthyl(benzoxy-L-alaninyl)]phosphate (NUC-3373).SOLUTION: A pharmaceutical formulation comprises NUC-7738, a polar aprotic solvent, and optionally pharmaceutically acceptable excipients.SELECTED DRAWING: None

Description

[Technical field]

[0001] The present invention relates to pharmaceutical formulations and formulation strategies of protides (phosphoramidite derivatives of nucleosides) and in particular to protides useful for cancer treatment such as NUC-3373 (5-fluoro-2'-deoxyuridine-5'-O-[1-naphthyl(benzoxy-L-alaninyl)] phosphate) and NUC-7738 (3'-deoxyadenosine-5'-O-[phenyl(benzoxy-L-alaninyl)] phosphate), and CPF-448 (2-chloro-2'-β-fluoro-2'-deoxyadenosine-5'-O-[phenyl(benzoxy-L-alaninyl)] phosphate). In particular, the present invention relates to formulations comprising polar aprotic solvents, e.g. dimethylacetamide (DMA). [Background technology]

[0002] Protides are masked phosphate derivatives of nucleosides. They have been shown to be particularly promising therapeutic agents in both the antiviral and oncology fields. Protides are, more specifically, prodrugs of monophosphorylated nucleosides. These compounds appear to circumvent many of the inherent and acquired resistance mechanisms that limit the usefulness of the parent nucleosides (see, for example, "Application of Protide Technology to Gemcitabine: A Successful Approach to Overcome a Critical Cancer Resistance Mechanism Leads to a New Agent (NUC-1031) in Clinical Development"; Slusarczyk et al.; J. Med. Chem.; 2014, 57, 1531-1542).

[0003] NUC-3373 (5-fluoro-2'-deoxyuridine-5'-O-[1-naphthyl(benzoxy-L-alaninyl)]phosphate) is a protide adaptation of 5FU / FUDR, the current base treatment for colon cancer. NUC-3373 and various related compounds have shown activity in vivo against various cancer models, and in many cases, particularly with NUC-3373, the activity is outstanding and significantly better than the results obtained with 5-fluorouracil. The addition of a protide phosphoramidite moiety to the 5-fluorouracil / FUDR molecule confers the special advantage of delivering the key active form of the agent (FdUMP) to tumor cells. No clinical trials have demonstrated that NUC-3373 overcomes key tumor cell resistance mechanisms involving 5-FU and its oral prodrug capecitabine, generating high intracellular levels of the active FdUMP metabolite and resulting in significant inhibition of tumor cell growth. Moreover, in formal canine toxicology trials, NUC-3373 was significantly better tolerated than 5-FU (see WO 2012 / 117246; McGuigan et al., "Phosphoramidite ProTides of the Anticancer Drug FUDR Successfully Deliver the Bioactive Monophosphate Inside Cells, Offering Advantages Over the Parent Nucleoside"; J. Med. Chem.; 2011, 54, 7247-7258; and Vande Voorde et al., "The Cytostatic Action of NUC-3073, a Phosphoramidite Prodrug of 5-Fluoro-2'-Deoxyuridine, Is Independent of Activation by Thymidine Kinase and Insensitive to Degradation by Phospholytic Enzymes"; Biochem. Pharmacol.; 2011, 82, 441-452).

[0004] Protide derivatives of purine nucleosides, such as clofarabine and deoxyadenosine and related compounds, also show good activity in vivo against a variety of solid tumors, leukemias, and lymphomas (see WO 2006 / 100439 and WO 2016 / 083830 (PCT / GB2015 / 053628)). Deoxyadenosine itself is not a particularly promising anticancer agent. Summary of the Invention [Problem to be solved by the invention]

[0005] Unfortunately, protides are often very lipophilic and therefore poorly water soluble, and ionizable moieties tend to have calculated pKa values ​​that lie outside the pH range suitable for parenteral administration. Despite salt content or pH within the physiological range, many are essentially water insoluble, which poses limitations to the development of clinically acceptable methods to deliver the compounds at sufficiently high doses for effective therapy. [Means for solving the problem]

[0006] It is an object of some embodiments of the present invention to provide pharmaceutical formulations of protides that deliver an effective dose.

[0007] It is an object of some embodiments of the present invention to provide suitable pharmaceutical formulations of protides. Suitable infusion formulations for intravenous administration should generally be stable for more than 30 minutes and up to 48 hours. Typically, for intravenous administration, the formulation should be stable to both precipitation of the protide and degradation of the protide.

[0008] It is an object of some embodiments of the present invention to provide pharmaceutical formulations of protides that deliver effective doses intravenously.

[0009] It is an object of some embodiments of the present invention to provide a pharmaceutical formulation of protide that is administered intravenously or via a central venous access device (CVAD). Thus, it is an object of some embodiments of the present invention to provide a formulation that has an acceptable osmolarity and pH for administration via an intravenous route, the osmolarity and pH being such that the level of pain experienced by the patient is acceptable.

[0010] Some embodiments of the present invention meet some or all of the above objectives. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] According to a first aspect of the present invention, Protide; Polar aprotic solvents; and Optionally, one or more pharma- ceutically acceptable excipients wherein the protide is not gemcitabine-[phenyl(benzoxy-L-alaninyl)]phosphate (NUC-1031).

[0012] The polar aprotic solvent is selected from dimethylacetamide (DMA), dimethylsulfoxide (DMSO), and N-methylpyrrolidone (NMP). Preferably, the polar aprotic solvent is DMA. In another preferred embodiment, the polar aprotic solvent is NMP. For some protides, DMA provides the best solubility profile among those tested. For others, NMP may provide the best solubility profile.

[0013] A polar aprotic solvent is a solvent molecule that comprises at least one heteroatom (e.g., O, N, or S), but does not have a hydrogen atom bonded to any heteroatom in the molecule, or if there is more than one heteroatom present. The polar aprotic solvent (e.g., DMA, DMSO, or NMP) is pharmaceutical grade. The polar aprotic solvent (e.g., DMA) may be the administration vehicle, or the formulation may be diluted with an administration vehicle that provides the desired properties prior to use. Thus, the formulation may be prepared as an infusion and have a polar aprotic solvent (e.g., DMA) as the major component; or may be a formulation having a polar aprotic solvent (e.g., DMA) as the major component and diluted prior to administration to produce a formulation prepared as an infusion and having only a polar aprotic solvent (e.g., DMA) as the major component; or may be a formulation prepared as an infusion and having only a polar aprotic solvent (e.g., DMA) as the major component, resulting from dilution of a formulation in which the polar aprotic solvent (e.g., DMA) is the major component. Thus, the polar aprotic solvent (e.g., DMA) may constitute 0.1% (v / v) to 100% (v / v) of the formulation.

[0014] A very small number of pharma- ceutically acceptable solvents dissolve sufficient amounts of protides to deliver therapeutically effective doses intravenously. Many of these solvents do not form stable solutions and tend to cause protides to precipitate. The inventors have surprisingly found that the solvents that produce stable solutions are generally polar aprotic solvents, such as DMA, DMSO, and NMP. Among these solvents found to be capable of dissolving protides, the inventors have found that some polar aprotic solvents, particularly DMA, by itself or in combination with other solubilizers, can retain some protides in solution at the concentration required to deliver the desired dose when the solution is diluted in an aqueous vehicle. For other protides, they have been found to be the most effective in that they can retain some protides in solution when the solution is diluted in an aqueous vehicle.

[0015] Thus, the use of polar aprotic solvents, particularly DMA, offers advantages over other formulation solvents that surprisingly make it an effective vehicle for delivering protides to patients in a practical and therapeutically effective manner.

[0016] The formulations of the present invention may be diluted by a predetermined amount just prior to administration, ie, up to 48 hours (eg, up to 24, 12, or 2 hours) prior to administration.

[0017] The formulation may also comprise one or more pharma- ceutically acceptable solubilizers, such as pharma-ceutically acceptable non-ionic solubilizers. Solubilizers are also called surfactants. Illustrative solubilizers include polyethoxylated fatty acids and fatty acid esters and mixtures thereof. Suitable solubilizers include polyethoxylated castor oil (e.g., sold under the trade name Kolliphor® ELP); or polyethoxylated stearic acid (e.g., sold under the trade name Solutol® or Kolliphor® HS15); or polyethoxylated (e.g., polyoxyethylene (20)) sorbitan monooleate (e.g., sold under the trade name Polysorbate 80, or Tween® 80). For example, Tween® 80 has been shown to be particularly effective in formulations of NUC-7738.

[0018] In some preferred embodiments, the formulation comprises more than one pharma- ceutically acceptable solubilizing agent. Formulations comprising more than one solubilizing agent have been shown to be particularly effective in formulating NUC-3373.

[0019] The formulation may also comprise an aqueous vehicle. The formulations of the invention may be ready for administration, in which case they will typically comprise an aqueous vehicle.

[0020] The formulation may be for parenteral administration, e.g., for intravenous, subcutaneous, or intramuscular administration. Preferably, the formulation is for intravenous administration. Administration may be via a CVAD or via a peripheral vein.

[0021] The total dosage of the protide in a formulation suitable for administration is generally 250 mg to 5 g, 250 mg to 3 g, 500 mg to 2 g, or 1 g to 1.5 g.

[0022] Although the formulations of the present invention are preferably for parenteral administration, some embodiments of the present invention are for oral administration.

[0023] In a second aspect of the present invention, Protide; A polar aprotic solvent (e.g., DMA); and Optionally, one or more pharma- ceutically acceptable excipients wherein the formulation is for medical use and the protide is not gemcitabine-[phenyl(benzoxy-L-alaninyl)]phosphate.

[0024] In a third aspect of the present invention, Protide; A polar aprotic solvent (e.g., DMA); and Optionally, one or more pharma- ceutically acceptable excipients wherein the formulation is for the treatment of cancer and the protide is not gemcitabine-[phenyl(benzoxy-L-alaninyl)]phosphate.

[0025] The cancer is selected from pancreatic cancer, breast cancer, ovarian cancer, bladder cancer, colon cancer, lung cancer, prostate cancer, bile duct cancer, kidney cancer, cervical cancer, thymic cancer, cancer of unknown primary, lymphoma, and leukemia.

[0026] Stock solution preparation The polar aprotic solvent (e.g., DMA) can comprise 30% or more by volume of the formulation. Thus, the polar aprotic solvent (e.g., DMA) can comprise 50% or more by volume of the formulation, for example 60% or more by volume. The polar aprotic solvent (e.g., DMA) can comprise 95% or less by volume of the formulation, for example 90% or less by volume. The formulation can also comprise an aqueous vehicle (e.g., saline). The aqueous vehicle can comprise 50% or less by volume of the formulation, for example 30% or less by volume of the formulation. Typically, the aqueous vehicle (e.g., saline) can comprise 5% or more by volume of the formulation, for example 10% or more by volume.

[0027] The concentration of the protide in the formulation solvent is 1 g / ml or less. The concentration may be 500 mg / ml or more. The concentration may be 100 mg / ml or more. Preferably, the concentration is 200 to 300 mg, 225 to 275 mg, for example, about 250 mg per ml.

[0028] Some preferred formulations include: DMA30~95 capacity%; 5 to 50 volume percent of an aqueous vehicle; and Protide 100-400 mg (e.g., 100-300 mg) / ml The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0029] A more preferred formulation is DMA70~90 capacity%; 10-30% by volume of an aqueous vehicle (e.g., saline); and Protide 200-300mg / ml The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0030] The formulations described in the previous four paragraphs, which have as a major component a polar aprotic solvent (e.g., DMA), are administered (e.g., by infusion or injection) without dilution prior to administration. They are administered, for example, via a central venous administration device (CVAD). When administered via a CVAD, the formulations are generally not diluted.

[0031] Alternatively, these formulations may be stock solutions which are diluted prior to use to form formulations suitable for administration via a peripheral vein.

[0032] Surfactant solution preparation The polar aprotic solvent (e.g., DMA) can comprise 10% or more by volume of the formulation, for example 20% or more by volume. Thus, the polar aprotic solvent (e.g., DMA) can comprise 80% or less by volume of the formulation, for example 70% or less by volume. The polar aprotic solvent (e.g., DMA) can comprise 55% or less by volume of the formulation. The formulation can also comprise one or more solubilizers (e.g., one or more polyethoxylated fatty acids). The one or more solubilizers can comprise 70% or less by volume of the formulation, for example 60% or less by volume of the formulation. Typically, the solubilizers can comprise 20% or more by volume of the formulation, for example 35% or more by volume. The formulation can also comprise an aqueous vehicle, for example in an amount of 1-15% by volume, or 5-12% by volume.

[0033] The concentration of the protide in the formulation solvent is 200 mg or less per ml, for example, 150 mg or less, or 130 mg or less. The concentration may be 40 mg / ml or more, for example, 60 mg / ml or more. Preferably, the concentration is 70 to 120 mg / ml, for example, about 100 mg / ml.

[0034] Some preferred formulations include: DMA20~70 capacity%; 20-70% by volume of solubilizer; and Protide 50-150mg / ml The formulation may also comprise an aqueous vehicle, for example in an amount of 1 to 15% by volume.

[0035] Some particularly preferred formulations include DMA30~60 capacity%; 10-35% by volume of a first solubilizer; 10-35% by volume of a second solubilizer; 2 to 15 volume percent of an aqueous vehicle; and Protide 50-150mg / ml The first solubilizer is a polyethoxylated castor oil (e.g., sold under the trade name Kolliphor® ELP). The second solubilizer is a polyethoxylated sorbitan monooleate (e.g., sold under the trade name Tween® 80).

[0036] The formulation is DMA35~50 capacity%; 15-30% by volume of a first solubilizer; 15-30% by volume of a second solubilizer; 5 to 12 volume percent of an aqueous vehicle; and Protide 50-150mg / ml The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0037] The surfactant solution formulations described in the previous five paragraphs, which have a polar aprotic solvent (e.g., DMA) as the main component, are typically diluted in an aqueous vehicle prior to administration. They are typically prepared from the above stock solutions before being further diluted in preparation for administration. Once diluted, they are administered via a peripheral vein.

[0038] These formulations are formed by diluting a stock solution formulation that does not contain any solubilizer with a solution that contains a solubilizer.

[0039] Intravenous solution preparations The polar aprotic solvent (e.g., DMA) can comprise 0.1% or more by volume of the formulation, such as 0.5% or more by volume, or 1% or more by volume. Thus, DMA can comprise 12% or less by volume of the formulation, such as 10% or less by volume, or 8% or less by volume. The formulation can also comprise an aqueous vehicle (e.g., saline or WFI). The aqueous vehicle can be present at 99.5% or less by volume of the formulation, such as 99% or less by volume or 98% or less by volume. Typically, the aqueous vehicle comprises 80% or more by volume of the formulation, such as 95% or more by volume. The formulation can also comprise one or more solubilizers (e.g., one or more polyethoxylated fatty acids). The one or more solubilizers can comprise 12% or less by volume of the formulation, such as 10% or less by volume, or 8% or less by volume of the formulation. Typically, the one or more solubilizers can comprise 0.1% or more by volume of the formulation, such as 0.5% or more by volume, or 1% or more by volume.

[0040] The concentration of the protide in the formulation solvent is 15.0 mg / ml or less, or 12.0 mg / ml or less, for example, 10.0 mg / ml or less, or 8 mg / ml or less. The concentration may be 1.0 mg / ml or more, for example, 2.0 mg / ml. Preferably, the concentration is 2.5-12 mg per ml, for example, about 3-11 mg / ml.

[0041] Some preferred formulations include: DMA0.1~10 capacity%; solubilizer 0.1-10% by volume; 85-99% by volume of aqueous vehicle; and Protide 2.0-12.0mg / ml The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0042] Some particularly preferred formulations include DMA1~8 capacity%; 0.5-4% by volume of a first solubilizer; 0.5-4% by volume of a second solubilizer; 85-99% by volume of aqueous vehicle; and Protide 2.0-12.0mg / ml The first solubilizer is a polyethoxylated castor oil (e.g., sold under the trade name Kolliphor® ELP). The second solubilizer is a polyethoxylated sorbitan monooleate (e.g., sold under the trade name Tween® 80).

[0043] The infusion solution formulations described in the previous four paragraphs (having a polar aprotic solvent (e.g. DMA) as the major component) are typically prepared by diluting a concentrated solution of protide with an aqueous vehicle up to 48 hours prior to administration. The concentrated solutions are either a solution of protide in a polar organic solvent (see above heading "Stock solution formulations") or a solution of protide in a polar organic solvent and a solubiliser (see above heading "Surfactant solution formulations"). These formulations (having a polar organic solvent (e.g. DMA) as the major component) are administered via a peripheral vein. The low concentration of polar organic solvent (e.g. DMA) in the formulations means that they do not cause pain when administered peripherally.

[0044] Treatment methods and kits In a fourth aspect of the invention, there is provided a method of treating cancer, the method comprising administering to a subject in need of treatment: Protide; A polar aprotic solvent (e.g., DMA); and Optionally, one or more pharma- ceutically acceptable excipients wherein the protide is not gemcitabine-[phenyl(benzoxy-L-alaninyl)]phosphate.

[0045] The method is: diluting the solution comprising the protide, a polar aprotic solvent (e.g., DMA), and optionally one or more pharma- ceutically acceptable excipients, with an aqueous vehicle to provide a formulation for infusion or injection; and Administering the infusion or injection formulation to the subject by infusion or injection. The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0046] The method is: diluting a first solution comprising a protide and a polar aprotic solvent (e.g., DMA) and optionally one or more pharma- ceutically acceptable excipients with a second solution comprising a polar aprotic solvent (e.g., DMA) and one or more solubilizing agents to form a third solution (surfactant solution formulation); diluting the third solution with an aqueous vehicle to form a fourth solution (the infusion solution formulation); and administering the fourth solution to the subject by infusion or injection. The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0047] The second solution may also comprise one or more solubilizing agents.Typically, the second formulation does not contain a pharma- ceutical active substance.

[0048] The or each dilution is made in a predetermined amount. The second solution is referred to as the "diluent solution."

[0049] The first solution may be a formulation of the first embodiment (see above under the heading "Stock solution formulation"). Similarly, the third solution may be a formulation of the first embodiment (see above under the heading "Surfactant solution formulation"). Similarly, the fourth solution may be a formulation of the first embodiment (see above under the heading "Infusion solution formulation").

[0050] The fourth solution is administered via a CVAD, however, preferably, the fourth solution is administered via a peripheral vein.

[0051] The first solution is DMA30~95 capacity%; 5 to 50 volume percent of an aqueous vehicle; and 100-400 mg (e.g., 100-300 mg) per ml of Protide The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0052] The second solution is DMA10~50 capacity%; 20-60% by volume of a first solubilizer; 20-65% by volume of a second solubilizer; The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0053] The administering step occurs after the dilution step, for example, up to 48 hours (eg, up to 12 hours or 2 hours) after the second dilution step producing the fourth solution.

[0054] In a fifth aspect of the present invention there is provided a kit comprising: a first formulation comprising a polar aprotic solvent (e.g., DMA), a protide, and an optional aqueous vehicle; and A second formulation comprising a polar aprotic solvent and one or more solubilizing agents. wherein the protide is not gemcitabine-[phenyl(benzoxy-L-alaninyl)] phosphate.

[0055] Thus, the kit DMA30~95 capacity%, 5 to 50% by volume of an aqueous vehicle, and 100-400 mg per ml of Protide (e.g., 100-300 mg / ml) a first formulation comprising: DMA10~50 capacity%, First solubilizer 20-60% by volume Second solubilizer 20-60% by volume A second formulation comprising The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0056] Typically, the second formulation does not contain an active agent. The kit of the fifth aspect is useful for preparing a formulation suitable for peripheral administration. The first formulation is diluted with the second formulation up to 48 hours, for example up to 24 hours, prior to administration to form a third formulation. Furthermore, prior to administration, the third formulation is diluted with an aqueous vehicle to form a formulation administered to a patient by infusion or injection. In order to achieve a formulation for parenteral administration that is stable with respect to precipitation of the protide, it is generally desirable to include a solubilizer. However, protides tend to degrade in the presence of such solubilizers. Thus, in some embodiments of the present invention, the two-step dilution method is a suitable means for achieving a formulation for parenteral administration.

[0057] The method is: flushing the CVAD with a first portion of a first solution, the first solution comprising a polar aprotic solvent (e.g., DMA) and an aqueous vehicle: administering a second formulation to the patient via the CVAD, the second formulation comprising a polar aprotic solvent, an aqueous vehicle, and a protide; and Optionally, flushing the CVAD with a second portion of the first formulation. The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0058] Preferably, the relative amounts of the polar aprotic solvent and the aqueous vehicle in the first formulation are the same as the relative amounts in the second formulation.

[0059] Thus, the treatment is flushing the CVAD with a first portion of a first solution, said first solution comprising 30-95% by volume DMA; 5-50% by volume aqueous vehicle; administering a second formulation to the patient via the CVAD, the second formulation comprising 30-95% by volume of DMA, 5-50% by volume of an aqueous vehicle, and 100-400 mg (e.g., 100-300 mg) of protide per ml; and Optionally, flushing the administration device with a second portion of the first formulation. Typically, the first formulation does not contain an active agent.

[0060] In a sixth aspect of the present invention there is provided a kit comprising: a first solution comprising a polar aprotic solvent (e.g., DMA) and an aqueous vehicle; and A second formulation comprising a polar aprotic solvent, an aqueous vehicle, and a protide. wherein the protide is not gemcitabine-[phenyl(benzoxy-L-alaninyl)] phosphate.

[0061] Thus, the kit DMA30~95 capacity%, Water-based vehicle: 5-50% by volume a first formulation comprising: DMA30~95 capacity%, 5 to 50% by volume of an aqueous vehicle, and 100-400 mg (e.g., 100-300 mg) per ml of Protide A second formulation comprising The present invention relates to a method for producing a semiconductor device comprising the steps of:

[0062] The first formulation generally does not contain a pharma- ceutical active substance. Thus, the first formulation generally does not contain a protide. The first formulation is provided in two separate containers or in a single container.

[0063] The kit of the sixth aspect of the present invention is useful for intravenous administration of a protide via a CVAD. Prior to administration of the second formulation, the CVAD is flushed with the first formulation. This reduces the risk of protide precipitation in the intravenous administration device, i.e., the CVAD, or at the inlet, by avoiding direct contact of the active formulation with an aqueous medium (e.g., saline flushing solution). After administration of the second formulation, the CVAD can also be flushed with the first formulation. This further prevents precipitation.

[0064] Preparation of the formulation In a fifth aspect of the present invention, there is provided a method for preparing a pharmaceutical formulation of a protide for infusion or injection, the method comprising the steps of: A solution comprising a protide, a polar aprotic solvent (e.g., DMA), and optionally one or more pharma- ceutically acceptable excipients is diluted with an aqueous vehicle to provide a formulation for infusion or injection. wherein the protide is not gemcitabine-[phenyl(benzoxy-L-alaninyl)] phosphate.

[0065] The dilution is performed in a predetermined amount.

[0066] The starting solution may be a formulation of the first aspect (see headings "Stock solution formulations" and "Surfactant solution formulations"). Similarly, the formulation for infusion or injection may be a formulation of the first aspect (see heading "Infusion solution formulations"). The administration step may be performed up to 48 hours (e.g. up to 12 or 2 hours) after the dilution step.

[0067] The aqueous vehicle is selected from saline (e.g., 0.9% saline or 0.45% saline), glucose solution, water for infusion (WFI). The aqueous vehicle is WFI. Alternatively, the aqueous vehicle may be 0.9% saline.

[0068] The osmolarity of the infusion solution will depend clinically on the required dose as well as the volume and type of aqueous medium used (i.e., the amount of surfactant solution used in saline and the % of saline (0.45 or 0.9%)). If the formulation is for administration via a peripheral vein, the aqueous vehicle is selected such that the osmolarity of the infusion solution is 200-600 mosm / l at the desired dose and volume. Preferably, if the formulation is for administration via a peripheral vein, the aqueous vehicle is selected such that the infusion solution is substantially isotonic with blood (e.g., the osmolarity of the infusion solution is 250-400 mosm / l).

[0069] The aqueous vehicle may comprise one or more pharma- ceutically acceptable solubilizers (also known as surfactants), such as pharma- ceutically acceptable non-ionic solubilizers. An example of a solubilizer is polyoxyethylene (20) sorbitan monooleate (sold as Tween® 80).

[0070] Protid The formulations and methods of preparation described herein are suitable for the administration of a variety of protides, however, NUC-1031 (gemcitabine-[phenyl(benzoxy-L-alaninyl)]phosphate, or its chemical name 2'-deoxy-2',2'-difluoro-D-cytidine-5'-O-[phenyl(benzoxy-L-alaninyl)]phosphate) is expressly excluded from the scope of this application.

[0071] The term "protide" is readily understood in the art to mean an aryloxy α-amino acid ester phosphoramidate derivative of a nucleoside or nucleoside analog. Thus, a protide is a compound having the structure of formula (I). Formula (I) [ka] Where: R 1 is aryl; R 2 is C1~C 24 -Alkyl, C3-C 24 -Alkenyl, C3-C 24 -alkynyl, C0-C4-alkylene-C3-C6-cycloalkyl, or C0-C4-alkylene-aryl; R 3 and R 4 are each independently H, C1-C6-alkyl and C1-C3-alkylene-R 6 or R 3 and R 4 together with the atom to which they are attached form a 3- or 6-membered cycloalkyl or heterocycloalkyl group; R 5 is a nucleoside or nucleoside analog; R 6 are independently aryl (e.g., phenyl), imidazole, indole, SR a , OR a , CO2R a , CO2NR a R a , N.R. a R b and NH(=NH)NH2; wherein any aryl group is a phenyl or naphthyl group, and wherein any phenyl or naphthyl group is optionally selected from halo, nitro, cyano, NR a R a , N.R. a S(O)2R a , N.R. a C(O)R a , N.R. a CONR a R a , N.R. a CO2R a , OR a , S.R. a , SOR a , SO3R a , SO2R a , SO2NR a R a , CO2R a C(O)R a ,CONR a R a , C.R. a R a NR a R a , substituted by 1 to 4 substituents selected from C1 to C4-alkyl, C2 to C4-alkenyl, C2 to C4-alkynyl, and C1 to C4-haloalkyl; Here, R a are each independently selected from H and C1-C4-alkyl; and R b are each independently selected from H, and C1-C4-alkyl and C(O)-C1-C4-alkyl.

[0072] A nucleoside or nucleoside analog has the structure [ka] (where: Q is independently O, NR a and CH2; R 7 OR a , S.R. a , N.R. a R b , halo (e.g., F), cyano, C1-C4-alkyl, C2-C4-alkenyl, and C2-C4-alkynyl; R 8 and R 9 together with the nitrogen to which they are attached form a substituted pyrimidine or a substituted purine; wherein the purine or pyrimidine is a , S.R. a , N.R. a R b , halo, cyano, C1-C4-alkyl, C2-C4-alkenyl, and C2-C4-alkynyl; n is typically an integer of 0 to 4. has.

[0073] As will be readily appreciated by those skilled in the art, when a pyrimidine or purine is substituted with an OH group attached to one of the nitrogen atoms and the adjacent carbon atom in the pyrimidine or purine ring, the pyrimidine or purine typically exists primarily as a tautomer, i.e., in which there is no double bond between the nitrogen and the adjacent carbon, but there is a double bond between the adjacent carbon and the oxygen of the OH group. The nitrogen may itself be substituted, for example, with a C1-C4-alkyl group.

[0074] R 8 and R 9 may, together with the nitrogen to which they are attached, form a substituted pyrimidine. 8 and R 9 may, together with the nitrogen to which they are attached, form substituted purines.

[0075] The protide may be a compound having the structure of formula (II). Formula (II) [ka] Here, R 1 , R 2 , R 3 and R 4 is as described above for compounds of formula (I). NUC-1031 is excluded from the scope of this application, and thus, without any doubt, when the protide is a compound of formula (II), R 1 is unsubstituted phenyl, R 2 is unsubstituted benzyl, and R 3 is Me and R 4 There is no case where H

[0076] The protide may be a compound having the structure of formula (III): Formula (III) [ka] Here, R 1 , R 2 , R 3 and R 4 is as described above for compounds of formula (I).

[0077] The protide may be a compound having the structure of formula (IV). Formula (IV) [ka] Here, R 1 , R 2 , R 3 and R 4 is as described above for compounds of formula (I); and Y is independently selected from H, F, Cl, and OMe. In some preferred embodiments, Y is H. In other preferred embodiments, Y is F.

[0078] The protide may be a compound having the structure of formula (V). Formula (V) [ka] Here, R 1 , R 2 , R 3 and R 4 are as described above for compounds of formula (I). The protides of formula (V) are derivatives of clofarabine.

[0079] The protide may be a compound having the structure of formula (VI). Formula (VI) [ka] Here, R 1 , R 2 , R 3 and R 4 are as described above for compounds of formula (I). The protides of formula (VI) are derivatives of fludarabine.

[0080] The protide may be a compound having the structure of formula (VII). Formula (VII) [ka] Here, R 1 , R 2 , R 3 and R 4 are as described above for compounds of formula (I). The protides of formula (VII) are derivatives of cladribine.

[0081] The following statements apply to any of the protides of formulae (I)-(V). These statements are independent and interchangeable. In other words, any of the features described in any of the following statements may be combined (if chemically possible) with features described in one or more of the other statements below. In particular, when a compound is exemplified or detailed in this specification, any two or more of the following statements describing the characteristics of the compound may be combined, regardless of the general level expressed, to represent the subject matter considered as part of the disclosure of the present invention herein.

[0082] R 1 R may be a substituted or unsubstituted phenyl. 1 may be substituted or unsubstituted naphthyl (e.g., 1-naphthyl). 1 is unsubstituted phenyl or unsubstituted naphthyl (e.g., 1-naphthyl). Thus, R 1 Alternatively, R may be an unsubstituted phenyl. 1 may be an unsubstituted naphthyl (eg, 1-naphthyl).

[0083] R 2 is preferably R 2 is selected to contain 5 or more carbon atoms. Therefore, R 2 is R 2 R may be selected to contain 6 or more carbon atoms. 2 is preferably R 2 is selected to contain only carbon and hydrogen atoms. 2 is selected from C5-C7-cycloalkyl, C5-C8-alkyl and benzyl, where said groups are optionally unsubstituted. 2 may be benzyl.

[0084] R 4 may be H. 3 is C1-C6-alkyl and C1-C3-alkylene-R 6 may be selected from R 3 R may be C1-C4 alkyl.3 may be methyl.

[0085] Q is preferably O.

[0086] n may be an integer from 1 to 3. n may be 1. n may be 2. n may be 3.

[0087] The protides are preferably compounds useful in the treatment of cancer.

[0088] Exemplary protides of formula (II) include those compounds described in WO 2005 / 012327, which is incorporated herein by reference. Exemplary protides of formula (II) include the following compounds: [ka] , [ka] , [ka] , and [ka] .

[0089] Exemplary protides of formula (III) include those compounds described in WO 2012 / 117246, which is incorporated herein by reference. Exemplary protides of formula (III) include the following compounds: [ka] (NUC-3373), [ka] , [ka] , [ka] , [ka] , [ka] , and [ka] .

[0090] Exemplary protides of formula (IV) include those compounds described in International Publication No. WO 2016 / 083830 (PCT / GB2015 / 053628; incorporated herein by reference). Exemplary protides of formula (IV) include the following compounds: [ka] , [ka] , [ka] , [ka] [ka] (NUC-7738), and [ka] .

[0091] Exemplary protides of formula (V), (VI), and (VII) include those compounds described in WO 2006 / 100439, which is incorporated herein by reference. Exemplary protides of formula (V) include the following compounds: [ka] (CPF-448), [ka] , [ka] , and [ka] .

[0092] Exemplary protides of formula (VI) include the following compounds: [ka] , [ka] , [ka] , and [ka] .

[0093] Exemplary protides of formula (VII) include the following compounds: [ka] , [ka] .

[0094] The protide may be NUC-3373. The protide may be NUC-3373 and the polar aprotic solvent may be DMA. The protide may be NUC-7738. The protide may be NUC-7738 and the polar aprotic solvent may be DMA. The protide may be NUC-7738 and the polar aprotic solvent may be NMP. The protide may be CPF-448. The protide may be CPF-448 and the polar aprotic solvent may be DMA. The protide may be CPF-448 and the polar aprotic solvent may be NMP.

[0095] Protides generally have a chiral center at the phosphorus atom. Protides can exist as a mixture of phosphate diastereoisomers, as an (S)-epimer at the phosphorus atom in substantially diastereoisomerically pure form, or as an (R)-epimer at the phosphorus atom in substantially diastereoisomerically pure form. "Substantially diastereoisomerically pure" is defined for purposes of the present invention as a diastereoisomeric purity of about 90% or greater. When present in substantially diastereoisomerically pure form, protides have a diastereoisomeric purity of 95%, 98%, 99%, or 99.5% or greater. Alternatively, protides may exist as a mixture of phosphate diastereoisomers.

[0096] The (R)- and / or (S)-epimers of the protides are obtained in substantially diastereomerically pure form by chromatography, for example, HPLC, optionally using a chiral column. Alternatively, the (R)- and / or (S)-epimers of the protides are obtained in substantially diastereomerically pure form by crystallization from a suitable solvent or solvent system. Furthermore, the (R)- and / or (S)-epimers of the protides are synthesized in substantially diastereomerically pure form by diastereoselective synthesis. Various combinations of these techniques can be used to provide diastereomerically pure forms, for example, diastereoisomeric synthesis followed by crystallization or chromatography.

[0097] The term "saline" refers to an aqueous solution of sodium chloride. Saline solutions of the present invention are generally sterile and of a concentration suitable for parenteral administration. Suitable concentrations are up to 2% w / v, or up to 1% w / v. Different concentrations of saline, for example 0.9% or 0.45%, can be used in the formulations of the present invention to optimize osmolality.

[0098] The formulations of the present invention are used in the treatment of the human body. They are also used in the treatment of the animal body. In particular, the compounds of the present invention are used to treat commercial animals such as livestock. Alternatively, the compounds of the present invention are used to treat pets such as cats, dogs, etc.

[0099] The compounds in the formulations of the present invention are obtained, stored and / or administered in the form of pharma- ceutically acceptable salts.Suitable pharma-ceutically acceptable salts include, but are not limited to, pharma-ceutically acceptable inorganic acids such as hydrochloric acid, sulfuric acid, phosphoric acid, nitric acid, carbonic acid, boric acid, sulfamic acid and hydrobromic acid salts, or pharma-ceutically acceptable organic acids such as acetic acid, propionic acid, butyric acid, tartaric acid, maleic acid, hydroxymaleic acid, fumaric acid, malic acid, citric acid, lactic acid, mucic acid, gluconic acid, benzoic acid, succinic acid, oxalic acid, phenylacetic acid, methanesulfonic acid, toluenesulfonic acid, benzenesulfonic acid, salicylic acid, sulfanilic acid, aspartic acid, glutamic acid, edetic acid, stearic acid, palmitic acid, oleic acid, lauric acid, pantothenic acid, tannic acid, ascorbic acid and valeric acid salts.Suitable base salts are formed from bases that form non-toxic salts. Examples include aluminum, arginine, benzathine, calcium, choline, diethylamine, diolamine, glycine, lysine, magnesium, meglumine, olamine, potassium, sodium, tromethamine, and zinc salts. Hemi-salts of acids or bases are also formed, such as hemi-sulfate, hemi-oxalate, and hemicalcium salts. Preferably, the compounds of the present invention are not in the form of a salt, i.e., in the form of a free base / free acid.

[0100] In the above formulations of the present invention, the dosage administered will of course vary depending on the compound used, the exact mode of administration, the desired treatment, and the disorder indicated.The dosage level, frequency of administration, and duration of treatment of the compounds of the present invention are expected to vary depending on the formulation and clinical symptoms.The dosage size of the compounds of the present invention for therapeutic purposes will naturally vary according to the condition and severity of the patient, age and sex, and route of administration, according to well-known principles of medicine.

[0101] A pharmaceutical formulation typically has the form of a composition in which an active compound, or a pharma- ceutical acceptable salt thereof, is combined with a pharma- ceutical acceptable adjuvant, diluent or carrier. One such pharma- ceutical acceptable adjuvant, diluent or carrier in the formulation of the present invention is a polar aprotic solvent. General procedures for the selection and preparation of suitable pharmaceutical formulations are described, for example, in "Pharmaceuticals - The Science of Dosage Form Design", MEAulton, Churchill Livingstone, 1988.

[0102] The formulations are suitable for topical application (eg, to the skin or bladder), oral or parenteral administration (eg, intravenous administration).

[0103] The various solvents used in the pharmaceutical formulations of the present invention must be of pharmaceutical grade, meaning that they have an impurity profile that makes them suitable for administration to humans (e.g., intravenous administration).

[0104] For oral administration, the preparations of the present invention comprise the active compound mixed with adjuvants or carriers, such as lactose, sucrose, sorbitol, mannitol; starches, such as potato starch, corn starch or amylopectin; cellulose derivatives; binders, such as gelatin or polyvinylpyrrolidone; and / or lubricants, such as magnesium stearate, calcium stearate, polyethylene glycol, wax, paraffin, etc., and then compressed into tablets. If coated tablets are desired, the cores prepared as described above are coated with a concentrated sugar solution (which may contain, for example, gum arabic, gelatin, talcum and titanium dioxide). Alternatively, the tablets can be coated with a suitable polymer dissolved in a readily volatile organic solvent.

[0105] For the preparation of soft gelatin capsules, the active compound is mixed with, for example, vegetable oil or polyethylene glycol.On the other hand, hard gelatin capsules can contain granules of the compound using any of the additives mentioned above for tablets.Also, liquid or semi-solid preparations of the active compound can be filled into hard gelatin capsules.

[0106] Liquid preparations for oral administration are in the form of syrups or suspensions, e.g., solutions containing the compound of the invention, the balance being sugar and a mixture of ethanol, water, glycerin and propylene glycol. Optionally, such liquid preparations can contain colorants, flavors, sweeteners (e.g., saccharin), preservatives and / or carboxymethylcellulose as a thickening agent or other additives known to those skilled in the art.

[0107] However, preferably, the pharmaceutical compositions of the present invention are for parenteral (e.g., intravenous) administration or for dilution to form a formulation for parenteral (e.g., intravenous) administration. For parenteral (e.g., intravenous) administration, the active compound is administered as a sterile aqueous or oily solution. Preferably, the active compound is administered as a sterile aqueous solution.

[0108] The pharmaceutical formulation of the present invention preferably comprises 0.05 to 99% by mass of protide, more preferably 0.05 to 80% by mass of protide, even more preferably 0.10 to 70% by mass of protide, and even more preferably 0.10 to 50% by mass of protide (all mass percentages are based on the total composition).

[0109] Cyclodextrins have found wide application in drug delivery (Rasheed et al., Sci. Pharm., 2008, 76, 567-598). Cyclodextrins are cyclic oligosaccharides. They function as "molecular cargo" to encapsulate drug molecules and alter their properties, such as solubility. Cyclodextrins comprise (α-1,4) linked α-D-glucopyranose units. Cyclodextrins can contain 6, 7, or 8 glucopyranose units (referred to as α-, β-, or γ-cyclodextrin, respectively). Cyclodextrins used in pharmaceutical formulations are often β-cyclodextrins. The pendant hydroxyl groups are alkylated with C1-C6 substituted or unsubstituted alkyl groups. Examples of cyclodextrins include α-cyclodextrin, β-cyclodextrin, γ-cyclodextrin, 2-hydroxypropyl-β-cyclodextrin (HP-β-CD), sulfobutyl ether β-cyclodextrin, and partially methylated β-cyclodextrin. The formulations of the present invention may also include at least one cyclodextrin.

[0110] The term “C m -C n " refers to a group having m to n carbon atoms.

[0111] The term "alkyl" refers to a linear or branched hydrocarbon group. The alkyl group is monovalent. For example, C1-C6-alkyl groups include methyl, ethyl, n-propyl, iso-propyl, n-butyl, sec-butyl, tert-butyl, n-pentyl, and n-hexyl. The alkyl group is preferably unsubstituted.

[0112] The term "alkylene" refers to a straight-chain hydrocarbon chain. Alkylene groups are divalent. For example, a C1-alkylene group refers to a CH2 group. A C2-alkylene group refers to a -CH2-CH2- group. Alkylene groups are preferably unsubstituted.

[0113] The term "haloalkyl" refers to a hydrocarbon chain substituted with at least one halogen atom, each independently selected from fluorine, chlorine, bromine, and the elements. The halogen atom can be present at any position of the hydrocarbon chain. For example, C1-C4-haloalkyl refers to chloromethyl, fluoromethyl, trifluoromethyl, chloroethyl (e.g., 1-chloroethyl, 2-chloroethyl), trichloroethyl (e.g., 1,2,2-trichloroethyl, 2,2,2-trichloroethyl), fluoroethyl (e.g., 1-fluoroethyl and 2-fluoroethyl), trifluoroethyl (e.g., 1,2,2-trifluoroethyl, 2,2,2-trifluoroethyl), chloropropyl, trichloropropyl, fluoropropyl, trifluoropropyl. The haloalkyl group may also be a fluoroalkyl group, e.g., a hydrocarbon chain substituted with at least one fluorine atom.

[0114] The term "alkenyl" refers to a branched or straight hydrocarbon chain containing at least one carbon-carbon double bond. The double bond can be present as an E or Z isomer. The double bond is in any possible position of the hydrocarbon chain. For example, C2-C4-alkenyl groups refer to ethenyl, allyl and butenyl. The alkenyl group is preferably unsubstituted.

[0115] The term "alkynyl" refers to a branched or straight hydrocarbon chain containing at least one carbon-carbon triple bond. The triple bond is in any possible position of the hydrocarbon chain. For example, C2-C6-alkynyl refers to ethynyl, propynyl, butynyl. The alkenyl group is preferably unsubstituted.

[0116] The term "cycloalkyl" refers to a saturated hydrocarbon ring system containing 3, 4, 5, or 6 carbon atoms. For example, 3- to 6-membered cycloalkyl refers to cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl. Cycloalkyl groups are preferably unsubstituted.

[0117] The term "heterocycloalkyl" refers to a saturated monocyclic group comprising one or two heteroatoms independently selected from O, S, and N in the ring system (in other words, one or two of the atoms forming the ring system are selected from O, S, and N). Examples of heterocyclic alkyl groups include piperidine, piperazine, morpholine, thiomorpholine, pyrrolidine, tetrahydrofuran, tetrahydrothiophene, tetrahydropyran, dihydropyran, dioxane, azepine. Heterocycloalkyl groups are preferably unsubstituted or substituted.

[0118] The present invention also includes preparations of all compounds in pharma- ceutically acceptable isotopically labeled form (wherein one or more atoms are replaced by an atom having the same atomic number, but an atomic mass or mass number different from the atomic mass or mass number of the predominant isotope commonly found in nature).

[0119] Examples of isotopes suitable for incorporation in the compounds of the invention include isotopes of hydrogen, e.g., 2 H and 3 H, isotopes of carbon, e.g. 11 C. 13 C and 14 C, an isotope of chlorine, e.g. 36 Cl, isotopes of fluorine, e.g. 18 F, an isotope of iodine, e.g. 123 I and 125 I, isotopes of nitrogen, e.g. 13 N and 15 N, isotopes of oxygen, e.g. 15 O. 17 O and 18 O, isotopes of phosphorus, e.g. 32 P, and sulfur isotopes, e.g. 35 Contains S.

[0120] Some isotopically labeled compounds, for example those containing a radioactive isotope, are useful in drug and / or substrate tissue distribution studies. The radioactive isotope tritium, i.e. 3 H and carbon 14, i.e. 14 C, and 18 F is particularly useful for this purpose given its ease of introduction and existing means of detection.

[0121] Heavier isotopes, such as deuterium, i.e. 2 Substitution with H may provide certain therapeutic advantages resulting from greater metabolic stability, such as increased in vivo half-life or reduced dosage requirements, and may therefore be preferred in some circumstances.

[0122] Isotopically labeled compounds are generally prepared by common techniques known to those of skill in the art or by methods analogous to known methods using a suitable isotopically labeled reagent in place of the non-labeled reagent previously used.

[0123] Therapeutic methods for or formulations for use in cancer treatment include, in addition to the formulations of the present invention, conventional surgery or radiation therapy or chemotherapy, which may include the administration of one or more other active agents.

[0124] When additional active agents are administered as part of the therapeutic method of the present invention, such combination therapy may be achieved by simultaneous, sequential or separate dosing of the individual components of the treatment. Such combination products employ the compounds of the present invention within the therapeutically effective dosage ranges described above and one or more other pharmacologic active agents within their approved dosage ranges.

[0125] Thus, the pharmaceutical formulations of the present invention can comprise other active agents.

[0126] The one or more other active agents may be one or more of the following categories of antitumor agents: (i) Antiproliferative / Antineoplastic therapeutic agents and combinations thereof, such as alkylating agents (e.g., cyclophosphamide, nitrogen mustard, bendamustine, melphalan, chlorambucil, busulfan, temozolomide, and nitrosoureas); antimetabolites (e.g., gemcitabine, and antifolates (e.g., fluoropyrimidines (5-fluorouracil and tegafur), raltitrexed, methotrexate, pemetrexed, cytosine arabinoside, and hydroxyurea); antibiotics (e.g., adriamycin, bleomycin, doxorubicin, daunomycin, epirubicin, anthracyclines such as vincalcatoids (e.g., vincristine, vinblastine, vindesine, and vinorelbine) and taxoids (e.g., taxol and taxotere, and polo kinase inhibitors); proteasome inhibitors such as carfilzomib and bortezomib; interferon therapy; and topoisomerase inhibitors (e.g., epipodophyllotoxins (e.g., etoposide and teniposide), amsacrine, topotecan, mitoxantrone, and camptothecin);

[0127] (ii) Cytostatic agents, such as antiestrogens (e.g. tamoxifen, fulvestrant, toremifene, raloxifene, droloxifene and idoxifene), antiandrogens (e.g. bicalutamide, flutamide, nilutamide and cyproterone acetate), LHRH antagonists or agonists (e.g. goserelin, leuprorelin and buserelin), progestogens (e.g. megestrol acetate), aromatase inhibitors (e.g. anastrozole, letrozole, vorozole and exequestane) and inhibitors of 5α-reductase, such as finasteride;

[0128] (iii) anti-invasive agents, such as dasatinib and bosutinib (SKI-606), and metalloprotease inhibitors, urokinase-type plasminogen activator receptor function inhibitors, or antibodies against heparanase;

[0129] (iv) inhibitors of growth factor function, for example such inhibitors include growth factor antibodies and growth factor receptor antibodies (e.g., the anti-erbB2 antibody trastuzumab (Herceptin®), the anti-EGFR antibody panitumumab, the anti-erbB1 antibody cetuximab), tyrosine kinase inhibitors, for example inhibitors of the epidermal growth factor family (e.g., EGFR family tyrosine kinase inhibitors such as gefitinib, erlotinib and 6-acrylamido-N-(3-chloro-4-fluorophenyl)-7-(3-morpholinopropoxy)-quinazolin-4-amine (Cl1033), erbB2 tyrosine kinase inhibitors such as lapatinib); inhibitors of the hepatocyte growth factor family; inhibitors of the insulin growth factor family; cell apoptosis inhibitors (C1033); Modulators of protein regulators of poptosis (e.g., Bcl-2 inhibitors); inhibitors of the platelet-derived growth factor family, e.g., imatinib and / or nilotinib (AMN107); inhibitors of serine / threonine kinases (e.g., Ras / Raf signaling pathway inhibitors such as farnesyltransferase inhibitors (e.g., sorafenib, tipifarnib and lonafarnib)), inhibitors of cell signaling pathways via MEK and / or AKT kinases, c-kit inhibitors, abl kinase inhibitors, PI3 kinase inhibitors, PIt3 kinase inhibitors, CSF-1R kinase inhibitors, IGF receptor kinase inhibitors; Aurora kinase inhibitors and cyclin-dependent kinase inhibitors, e.g., CDK2 and / or CDK4 inhibitors;

[0130] (v) Antiangiogenic agents, such as those that inhibit the effects of vascular endothelial growth factor (e.g., the anti-vascular endothelial growth factor antibody bevacizumab (Avastin®); thalidomide; lenalidomide; and VEGF receptor tyrosine kinase inhibitors such as vandetanib, vatalanib, sunitinib, axitinib, and pazopanib;

[0131] (vi) gene therapy approaches, including approaches to replace abnormal genes, such as abnormal p53, abnormal BRCA1 or BRCA2;

[0132] (vii) antibody therapies, such as, for example, alemtuzumab, rituximab, ibritumomab tiuxetan (Zevalin®), and ofatumumab; interferons, such as interferon alpha; interleukins, such as IL-2 (aldesleukin); interleukin inhibitors, for example, IRAK4 inhibitors; cancer vaccines, including prophylactic and therapeutic vaccines, such as HPV vaccines (e.g., Gardasil, Cervarix, Oncophage, and Sipuleucel-T (Provenge)); and immunotherapies, including toll-like receptor modulators (e.g., TLR-7 or TLR-9 agonists); and

[0133] (viii) Cytotoxic drugs, such as fludarabine (Fludara), cladribine, pentostatin (Nipent®);

[0134] (ix) steroids such as corticosteroids (including glucocorticoids and mineralocorticoids), for example, alclometasone, alclometasone dipropionate, aldosterone, amcinonide, beclomethasone, beclomethasone dipropionate, betamethasone, betamethasone dipropionate, betamethasone sodium phosphate, betamethasone valerate, budesonide, clobetasone, clobetasone butyrate, clobetasone propionate, phosphate, cloprednol, cortisone, cortisone acetate, cortivazol, deoxycortone, desonide, desoxymethasone, dexamethasone, dexamethasone sodium phosphate, dexamethasone isonicotinate, difluorocortolone, fluclorolone, flumethasone, flunisolide, fluocinolone, fluocinolone acetonide, fluocinonide, fluocortin butyl, fluorocortisone, fluorocortolone, fluorocortolone caproate acetate, fluorocortolone pivalate, fluorometholone, fluprednidene, purprednidene acetate, flurandrenolone, fluticasone, fluticasone propionate, halcinonide, hydrocortisone, hydrocortisone acetate, hydrocortisone butyrate, hydrocortisone aceponate, hydrocortisone butyrate propionate, hydrocortisone valerate, icometasone, icometasone butanoate acetate, meprednisone, methylprednisolone, mometasone, paramethasone, mometasone furoate monohydrate, prednicarbate, prednisolone, prednisone, tixocortol, tixocortol pivalate, triamcinolone, triamcinolone acetonide, triamcinolone alcohol, and their respective pharma- ceutically acceptable derivatives (combinations of steroids, e.g., combinations of two or more of the steroids described in this paragraph, may be used);

[0135] (x) targeted therapy, such as PI3Kd inhibitors (e.g., idelalisib and perifosine, or compounds that inhibit PD-1, PD-L1 and CAT T).

[0136] The one or more other active agents may be an antibiotic.

[0137] Throughout this specification and the claims, the terms "comprise" and "contain" and variations thereof are intended to mean "including, but not limited to," and are not intended to (and do not) exclude other moieties, additives, components, integers, or steps. Throughout this specification and the claims, the singular also includes the plural, unless otherwise required. In particular, when using the indefinite article, the specification must be understood as including the plural as well as the singular, unless otherwise required.

[0138] It is to be understood that any feature, integer, property, compound, chemical moiety and group, embodiment or example of the invention described in conjunction with a particular embodiment may also be applied to any other embodiment, embodiment or example described herein, unless inconsistent. All features disclosed in this specification (including the claims, abstract and drawings), and / or all steps of methods and processes similarly disclosed, may be combined in any manner, except combinations in which at least some of such features and / or steps are mutually exclusive. The invention is not limited to the details of the embodiments described above. The invention extends to any novel one or novel combination of features disclosed in this specification, or to any novel one or novel combination of steps of any method or process similarly disclosed.

[0139] The reader's attention is directed to all articles and documents filed contemporaneously with or prior to this specification related to this application, or submitted for inspection together with this specification, the contents of all such articles and documents being incorporated herein by reference.

[0140] The following abbreviations are used throughout this specification: DMA = dimethylacetamide; DMF = N,N-dimethylformamide; DMSO = dimethylsulfoxide; IPA = isopropyl alcohol; NMP = N-methylpyrrolidinone; PEG = polyethylene glycol. [Example]

[0141] Example 1 - Solubility of NUC-3373 The solubility of NUC-3373 in various solvents is shown in Table 1.

[0142] [Table 1]

[0143] As can be easily seen, the solubility of NUC-3373 in water is extremely low. Among the solvents tested, polar aprotic solvents, especially DMSO and DMA, showed the best solubility.

[0144] Example 2—Development of an Aqueous Formulation of NUC-3373 The successful development of a diluent solution to enable the preparation of NUC-1031 facilitated the development of an aqueous formulation of NUC-3373. The aqueous NUC-3373 formulation was developed by adding 6.7 ml of a 250 mg / ml NUC-3373 solution in DMA 80%-0.9% Saline 20% to 10 ml of diluent solution to generate a 100 mg / ml NUC-3373 surfactant solution (see Table 4) prior to subsequent dilution into an IV bag. The clinical dose of NUC-3373 has not yet been established, but potential doses are up to 3,000 mg, which sets an upper limit for formulation development studies. Table 2 shows the volumes of 100 mg / ml NUC-3373 interface formulation solution required to be added to a 250 ml infusion bag for various doses, and the composition of the resulting aqueous infusion solutions.

[0145] [Table 2]

[0146] The stability of 100 mg / ml NUC-3373 surfactant solution under two storage conditions (5° C. and 20° C.) showed that it was stable for 48 hours under both conditions (see Table 3).

[0147] [Table 3]

[0148] The stability of the aqueous infusion solution was also evaluated under two storage conditions (5° C. and 20° C.) using three different doses of NUC-3373 (1,000 mg, 2,000 mg, and 3,000 mg) diluted in 250 ml 0.9% saline bags. The results, shown in Tables 4, 5, and 6, indicate that the aqueous infusion solution at both doses is stable for up to 48 hours under both storage conditions.

[0149] [Table 4]

[0150] [Table 5]

[0151] [Table 6]

[0152] The pH and osmolality of the 1,000 mg and 2,000 mg dose solutions in 250 ml 0.9% saline bags are specified as stable for intravenous administration via a CVAD or peripheral vein.

[0153] Aqueous drip solution In the stability studies above, a 250ml 0.9% saline bag was used as the base infusion solution. However, using a different aqueous infusion solution (e.g., water for injection (WFI), 0.45% saline) or increasing the volume of the infusion bag (e.g., 500ml) showed similar stability results. Lower saline concentrations or increased infusion volumes do not affect stability over 48 hours and act to reduce the osmolality of the infusion solution without significantly changing the pH. For example, using 0.45% saline or WFI reduces the osmolality of high dose NUC-3373 (10 mg / ml) from 812 mosm / l to 715 and 557 mosm / l H2O, respectively, while increasing the volume of the 0.9% saline infusion bag from 250 ml to 500 ml for high dose (3,000 mg) NUC-3373 reduces the osmolality from 812 mosm / l to 524 mosm / l. These alternative infusion solutions make the high dose NUC-3373 aqueous base formulation suitable for peripheral intravenous infusion as well as CVAD infusion.

[0154] Example 3 - Illustrative description of formulation method A formulation method has been developed for intravenous administration of protides (see WO 2015 / 198059 (PCT / GB2015 / 051858)) that has been shown to be effective in clinical trials for NUC-1031, which has roughly the same solubility as NUC-3373 and NUC-7738. A 250 mg / ml solution of protides (S-epimer, R-epimer, or mixture thereof) is made in an 80:20 (by volume) mixture of DMA and 0.9% saline. This stock solution formulation is generally sufficiently stable for long-term storage and shipping of the protides. This stock solution formulation is administered intravenously to patients via a CVAD (e.g., Hickman line, PICC line). The intravenous device is typically flushed with an 80:20 (by volume) mixture of DMA and 0.9% saline both before and after administration of the formulation comprising the protide. This helps reduce the risk of possible precipitation of the protide in the intravenous device upon contact with the saline flush. Alternatively, if intravenous administration using saline bag infusion is the preferred method of administration, the stock solution formulation is diluted to 100 mg / ml in a diluent that is a 20%:40%:40% mixture of DMA:Tween® 80:Kolliphor® ELP (e.g., 6.7 ml of a 250 mg protide solution in an 80:20 mixture of DMA:0.9% saline is added to 10 ml of a diluent solution of DMA:Tween® 80:Kolliphor® ELP). The resulting (surfactant solution) formulation is typically stable for up to 5 days. The surfactant solution formulation is then diluted with 0.9% saline to a desired concentration to prepare an infusion solution formulation. For NUC-1031, 4, 8, and 10 mg / ml solutions of the S-isomer alone or a mixture of the R and S epimers have been shown to be stable (both with respect to precipitation of NUC-1031 and degradation of NUC-1031) over a range of pH values ​​(4.5, 6.0, and 7.0) for 48 hours after dilution of the formulation in both 0.45% and 0.9% saline, without agitation of the mixture. The osmolarity of all NUC-1031 solutions has been shown to be acceptable for peripheral administration. In clinical trials of NUC-3373, this method of administration allows NUC-3373 to be successfully administered via a CVAD. Early results indicate that an infusion solution of NUC-3373 prepared as described in this example has some efficacy in the treatment of cancer.

[0155] Example 4 - Solubility of NUC-7738 The solubility of NUC-7738 in various solvents is shown in Table 7.

[0156] [Table 7]

[0157] As can be easily seen, the solubility of NUC-7738 in water is extremely low, even when the water is formulated with a solubilizing agent. NUC-7738 is, however, soluble in polar aprotic solvents including NMP, DMSO, and DMA.

[0158] Example 5—Development of an Aqueous Formulation of NUC-7738 50 μl of 100 mg / ml concentrate of NUC-7738 (mixture of diastereoisomers) in various solvents (DMA, DMSO, NMP, ethanol, benzyl alcohol) was mixed with 50 μl of Tween® 80 and added to 1.150 ml of saline, and the resulting solution was visually checked for precipitation of NUC-7738. Similarly, 50 μl of NUC-7738 concentrate in Tween® 80 was mixed with 50 μl of water for injection and then added to 1.150 ml of saline. The results are shown in Table 8.

[0159] [Table 8]

[0160] Table 8 shows that DMSO, DMA, and NMP are significantly more effective at keeping NUC-7738 in aqueous solution than other solvents, such as ethanol, in which NUC-7738 has good solubility under non-aqueous conditions, yet the solubilizers are not as effective at keeping NUC-7738 in solution under aqueous conditions in the absence of polar aprotic solvents.

[0161] The solutions prepared above were assayed for NUC-7738 content and purity upon preparation and after 48 hours. Both content and purity were substantially unchanged after 48 hours, indicating that the solutions were chemically and physically stable over this period.

[0162] Further experiments were carried out to determine the minimum concentration of NUC-7738 in a solvent that could be diluted with saline without precipitation. Various concentrations of solutions of NUC-7738 (mixture of diastereoisomers) in NMP, DMSO, and DMA were prepared and 100 μl of the solution was added to 2.40 ml of saline. The resulting aqueous solutions were observed for precipitation of NUC-7738. The results are shown in Table 9.

[0163] [Table 9]

[0164] As can be seen, the best solvent for keeping NUC-7738 in aqueous solution was NMP, which provided a clear solution upon dilution of the 25 mg / ml solution in saline.

Claims

1. 5-fluoro-2'-deoxyuridine-5'-O-[1-naphthyl(benzoxy-L-alaninyl)]phosphate (NUC-3373) having a concentration of 40 mg / ml or more; a polar aprotic solvent; and Optionally, one or more pharma- ceutically acceptable excipients 23. A pharmaceutical formulation comprising:

2. 2. The pharmaceutical formulation according to claim 1, wherein the polar aprotic solvent is selected from dimethylsulfoxide (DMSO) and N-methylpyrrolidone (NMP).

3. 3. The pharmaceutical formulation of claim 1 or 2, wherein the formulation further comprises an aqueous vehicle.

4. 4. The pharmaceutical formulation of claim 3, wherein the aqueous vehicle is saline.

5. 4. The pharmaceutical formulation of claim 3, wherein the aqueous vehicle is water for injection (WFI).

6. The pharmaceutical formulation according to any one of claims 1 to 5, wherein the formulation further comprises a solubilizing agent.

7. 7. The pharmaceutical formulation of claim 6, wherein the formulation comprises two or more solubilizing agents.

8. 8. A pharmaceutical formulation according to claim 6 or 7, wherein the or each solubiliser is a polyethoxylated fatty acid or a mixture thereof.

9. The pharmaceutical preparation according to any one of claims 1 to 8, which is for treating cancer.

10. a first formulation comprising a polar aprotic solvent, NUC-3373, and an optional aqueous vehicle, wherein the concentration of NUC-3373 is 40 mg / ml or greater; and A second formulation comprising a polar aprotic solvent and one or more solubilizing agents. A kit comprising:

11. a first formulation comprising a polar aprotic solvent and an aqueous vehicle; and A second formulation comprising a polar aprotic solvent, an aqueous vehicle, and NUC-3373, wherein the concentration of NUC-3373 is 40 mg / ml or greater. A kit comprising:

12. The kit according to claim 10 or 11, wherein the polar aprotic solvent is selected from dimethylsulfoxide (DMSO) and N-methylpyrrolidone (NMP).

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