Semi-solid pharmaceutical compositions containing stearic acid and palmitic acid
The semi-solid composition of 5-ALA, triglycerides, and stearic/palmitic acid addresses dispersion and administration issues in PDT, achieving rapid absorption and improved treatment efficacy for cervical and vaginal conditions.
Patent Information
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- JIANGSU YAHONG MEDITECH CO LTD
- Filing Date
- 2026-01-26
- Publication Date
- 2026-07-30
AI Technical Summary
Existing photodynamic therapy (PDT) formulations for cervical and vaginal administration face challenges in ensuring uniform dispersion and easy drug administration, with suboptimal physical properties leading to inefficient treatment efficacy.
A semi-solid pharmaceutical composition comprising 5-aminolevulinic acid (5-ALA) or its derivatives, triglycerides, and a mixture of stearic acid and palmitic acid in specific ratios, optimized for rapid melting and absorption, facilitating uniform dispersion and enhanced treatment efficacy.
The composition ensures uniform dispersion and rapid absorption of the active ingredient, improving treatment efficacy by enhancing the photodynamic therapy's effectiveness in treating cervical and vaginal conditions.
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Figure PCTCN2026074774-FTAPPB-I100001 
Figure PCTCN2026074774-FTAPPB-I100002 
Figure PCTCN2026074774-FTAPPB-I100003
Abstract
Description
SEMI-SOLID PHARMACEUTICAL COMPOSITIONS CONTAINING STEARIC ACID AND PALMITIC ACID
[0001] TECHINICAL FIELD
[0002] The application relates to the field of pharmaceutical preparation, and specifically relates to semi-solid pharmaceutical compositions containing stearic acid and palmitic acid, preparation methods thereof, and uses thereof.BACKGROUND
[0003] One of the most serious cervix infections is human papilloma virus (HPV) which can develop into cervical cancer. HPV infection is a common factor in the development of almost all cervical cancer cases. Estimates for the prevalence of HPV infections vary, but can typically be around 30%in all women.
[0004] Cervical intraepithelial neoplasia (CIN) , also known as cervical dysplasia, is the potentially premalignant transformation and abnormal growth of squamous cells on the surface of the cervix. Corresponding thereto, endometrial intraepithelial neoplasia of the uterine lining (EIN) , vulvar intraepithelial neoplasia (VIN) , vaginal intraepithelial neoplasia (VAIN) , anal intraepithelial neoplasia (AIN) and penile intraepithelial neoplasia (PeIN) also known as endometrial, vulvar, vaginal, anal and penile dysplasia, are the potentially premalignant transformation and abnormal growth of squamous cells on the uterine lining, in the vulva, the vagina (usually in the upper 1 / 3 of vagina, may be confluent with cervical lesions) , the anus (on perianal skin or in the anal canal in flat mucosa) and on the surface of the penis. Most cases of such dysplasia remain stable, or are eliminated by the body's immune system without intervention. However, a small percentage of cases progress to become cancer, usually squamous cell carcinoma (SCC) , if left untreated. The major cause of CIN, EIN, VIN, VAIN, AIN and PeIN is chronic infection of the affected organs or tissue with HPV, especially the high risk HPV types 16 or 18.
[0005] Photodynamic treatment (PDT) is a technique for the treatment of pre-cancerous lesions, cancer and non-cancerous diseases. PDT involves the administration of a photosensitiser or a precursor thereof to an area of interest. The photosensitiser or precursor thereof is taken up into the cells, where a precursor of a photosensitiser is converted into a photosensitiser. Upon exposure of the area of interest to light, the photosensitiser is excited, usually from a ground singlet state to an excited singlet state. It then undergoes intersystem crossing to a longer-lived excited triplet state. One of the few chemical species present in tissue with a ground triplet state is molecular oxygen. When the photosensitiser and an oxygen molecule are in proximity, an energy transfer can take place that allows the photosensitiser to relax to its ground singlet state, and create an excited singlet state oxygen molecule. Singlet oxygen is a very aggressive chemical species and will very rapidly react with any nearby biomolecules. Ultimately, these destructive reactions will kill cells through apoptosis or necrosis, whereby for instance cancer cells are selectively killed.
[0006] Several photosensitisers are known and described in the literature including 5-aminolevulinic acid (5-ALA) and certain derivatives thereof, e.g. 5-ALA esters, which both are precursors of photosensitisers, and which are converted to protoporphyrins, such as protoporphyrin IX (PpIX) . Both 5-ALA and esters of 5-ALA esters have been used in PDT of CIN.
[0007] WO 2010 / 142457 describes semi-solid compositions comprising 5-ALA or a precursor or a derivative of 5-ALA or a pharmaceutically acceptable salt thereof. Compared with other preparations, these compositions can significantly improve the stability of 5-ALA hexyl ester. In combination with devices, the disclosed compositions can provide corresponding photodynamic therapy, including developmental abnormalities of the female reproductive system, anus and penis, and HPV infections.
[0008] BRIEF SUMMARY
[0009] The application describes new semi-solid pharmaceutical compositions for photodynamic therapy (PDT) , particularly suitable for cervical and vaginal administration, which can overcome the inability of the existing PDT formulations by meeting practical requirements, specifically ensuring uniform dispersion of the active ingredient and facilitating easy drug administration. Furthermore, the formulations possess optimized physical properties, which enable rapid melting and rapid absorption into the target tissue to achieving greater treatment efficacy.
[0010] In one general aspect, provided here is a semi-solid pharmaceutical composition, which comprises:
[0011] a) an active ingredient selected from the group consisting of 5-aminolevulinic acid (5-ALA) , a 5-ALA precursor, a 5-ALA derivative, and a pharmaceutically acceptable salt thereof;
[0012] b) one or more triglycerides; and
[0013] c) a mixture of stearic acid and palmitic acid, wherein the weight ratio of the stearic acid to the palmitic acid in the mixture is between about 1: 4 to about 4: 1, preferably about 3: 7 to about 11: 9, more preferably from about 3: 7 to about 1: 1.
[0014] In some embodiments, the active ingredient is a pharmaceutically acceptable salt of 5-aminolevulinic acid. In certain embodiments, the active ingredient is 5-ALA hexyl ester. In certain embodiments, the active ingredient is HCl salt of 5-ALA hexyl ester.
[0015] In some embodiments, the active ingredient is present in an amount of about 3%to about 7%by mass of the semi-solid pharmaceutical composition, preferably from about 4%to about 6%, more preferably about 5%.
[0016] In some embodiments, the one or more triglycerides are present in an amount of about 72%to about 82%by mass of the semi-solid pharmaceutical composition, preferably from about 74%to about 80%, more preferably from about 76%to about 78%, most preferably about 77%.
[0017] In some embodiments, the mixture of stearic acid and palmitic acid is present in an amount of about 11%to about 25%by mass of the semi-solid pharmaceutical composition, preferably from about 14%to about 22%, more preferably from about 15%to about 21%, most preferably about 18%.
[0018] In another general aspect, provided here in is a method of treating cancer, pre-cancerous conditions and non-cancerous conditions in female reproductive system, anus and penis by photodynamic treatment (PDT) , the method comprising administering an effective amount of the semi-solid pharmaceutical composition described herein to a subject in need thereof.
[0019] In some embodiments, the method further comprises photoactivating the active ingredient in combination with a device, wherein the device receives an effective amount of the semi-solid pharmaceutical composition.
[0020] In some embodiments, the device comprises an irradiation means, such as a laser or a lamp, preferably a lamp, more preferably a LED lamp.
[0021] In some embodiments, the semi-solid pharmaceutical composition is contained in a drug delivery system.
[0022] In certain embodiments, the drug delivery system is selected from the group consisting of pessaries, diaphragms, caps, adhesive bandages or patches.
[0023] In one another general aspect, provided here is a kit comprising a drug delivery system and the semi-solid composition described herein.
[0024] In some embodiments, the drug delivery system is selected from the group consisting of pessaries, diaphragms, caps, adhesive bandages or patches.
[0025] In some embodiments, the kit is used in combination with a device, wherein the device receives an effective amount of the semi-solid pharmaceutical composition.
[0026] The details of one or more embodiments of the application are set forth in the description below. Other features and advantages will be apparent from the following detailed description, and the appended claims.BRIEF DESCRIPTION OF THE DRAWINGS
[0027] The foregoing and other objects, aspects, features, and advantages of exemplary embodiments will become more apparent and may be better understood by referring to the following description taken in conjunction with the accompanying drawings.
[0028] FIG. 1 illustrates in vitro release testing (IVRT) of hexaminolevulinate hydrochloride ointments in Example 6.
[0029] FIG. 2 illustrates mean cumulative permeation amount –time curves (24h) for Formulations 4, 6, and 7 in Example 7.
[0030] FIG. 3 illustrates mean cumulative permeation amount –time curves (24h) for Formulations 1 and 4 in Example 7.
[0031] FIG. 4 illustrates mean cumulative permeation amount –time curves (24h) for Formulations 2, 4, and 5 in Example 7.
[0032] FIG. 5 illustrates mean skin concentration after TDDS dosing in Example 9.DETAILED DESCRIPTION
[0033] The disclosed pharmaceutical compositions and methods may be understood more readily by reference to the following detailed description, which form a part of this disclosure. It is to be understood that the disclosed methods are not limited to the specific methods described and / or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting of the claimed methods.
[0034] Various publications, articles and patents are cited or described in the background and throughout the specification; each of these references is herein incorporated by reference in its entirety. Discussion of documents, acts, materials, devices, articles or the like which has been included in the present specification is for the purpose of providing context for the invention. Such discussion is not an admission that any or all of these matters form part of the prior art with respect to any inventions disclosed or claimed.
[0035] Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art to which this invention pertains. Otherwise, certain terms used herein have the meanings as set forth in the specification. All patents, published patent applications and publications cited herein are incorporated by reference as if set forth fully herein.
[0036] Definitions
[0037] It must be noted that as used herein and in the appended claims, the singular forms “a, ” “an, ” and “the” include plural reference unless the context clearly dictates otherwise.
[0038] When a list is presented, unless stated otherwise, it is to be understood that each individual element of that list, and every combination of that list, is a separate embodiment. For example, a list of embodiments presented as “A, B, or C” is to be interpreted as including the embodiments, “A, ” “B, ” “C, ” “A or B, ” “A or C, ” “B or C, ” or “A, B, or C. ”
[0039] As used herein, the term “about” preceding a numerical value or a series of numerical values means ±10%of the numerical value unless otherwise indicated. For example, “about 100 mg” means 90 to 110 mg.
[0040] Unless otherwise indicated, the term “at least” preceding a series of elements is to be understood to refer to every element in the series. Those skilled in the art will recognize or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments of the invention described herein. Such equivalents are intended to be encompassed by the invention.
[0041] Throughout this specification and the claims which follow, unless the context requires otherwise, the word “comprise” , and variations such as “comprises” and “comprising” , will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integer or step. When used herein the term “comprising” can be substituted with the term “containing” or “including” or sometimes when used herein with the term “having” .
[0042] When used herein “consisting of” excludes any element, step, or ingredient not specified in the claim element. When used herein, “consisting essentially of” does not exclude materials or steps that do not materially affect the basic and novel characteristics of the claim. Any of the aforementioned terms of “comprising” , “containing” , “including” , and “having” , whenever used herein in the context of an aspect or embodiment of the invention can be replaced with the term “consisting of” or “consisting essentially of” to vary scopes of the disclosure.
[0043] As used herein, the conjunctive term “and / or” between multiple recited elements is understood as encompassing both individual and combined options. For instance, where two elements are conjoined by “and / or” , a first option refers to the applicability of the first element without the second. A second option refers to the applicability of the second element without the first. A third option refers to the applicability of the first and second elements together. Any one of these options is understood to fall within the meaning, and therefore satisfy the requirement of the term “and / or” as used herein. Concurrent applicability of more than one of the options is also understood to fall within the meaning, and therefore satisfy the requirement of the term “and / or. ” As used herein, “treatment” or “treat” refers to the treatment of a disease, disorder, or medical condition (such as a gastrointestinal inflammatory disease) , in a patient, such as a mammal (particularly a human) which includes one or more of the following:
[0044] (a) preventing the disease, disorder, or medical condition from occurring, i.e., preventing the reoccurrence of the disease or medical condition or prophylactic treatment of a patient that is pre-disposed to the disease or medical condition;
[0045] (b) ameliorating the disease, disorder, or medical condition, i.e., eliminating or causing regression of the disease, disorder, or medical condition in a patient, including counteracting the effects of other therapeutic agents;
[0046] (c) suppressing the disease, disorder, or medical condition, i.e., slowing or arresting the development of the disease, disorder, or medical condition in a patient; or
[0047] (d) alleviating the symptoms of the disease, disorder, or medical condition in a patient.
[0048] The terms “efficacy” and “effective” as used herein in the context of a dose, dosage regimen, treatment or method refer to the effectiveness of a particular dose, dosage or treatment regimen. Efficacy can be measured based on change in the course of the disease in response to an agent of the present invention. For example, the compound of formula (I) can be administered to a subject in an amount and for a time sufficient to induce an improvement, preferably a sustained improvement, in at least one indicator that reflects the severity of the disorder that is being treated. Various indicators that reflect the extent of the subject's illness, disease or condition can be assessed for determining whether the amount and time of the treatment is sufficient. Such indicators include, for example, clinically recognized indicators of disease severity, symptoms, or manifestations of the disorder in question. The degree of improvement generally is determined by a physician, who can make this determination based on signs, symptoms, biopsies, or other test results, and who can also employ questionnaires that are administered to the subject, such as quality-of-life questionnaires developed for a given disease.
[0049] The term “an effective amount” means an amount sufficient to affect treatment when administered to a patient in need of treatment.
[0050] “Pharmaceutically acceptable carrier” or “excipient” refers to an ingredient in a pharmaceutical composition, other than the active ingredient, which is nontoxic to a subject. Exemplary pharmaceutically acceptable carriers are emulsifier, mucoadhesive, other pharmaceutically acceptable excipient, surface penetration agent, or chelating agent.
[0051] “Subject” includes any human or nonhuman animal. “Nonhuman animal” includes all vertebrates, e.g., mammals and non-mammals, such as nonhuman primates, sheep, dogs, cats, horses, cows, chickens, amphibians, reptiles, etc. The terms “subject” and “patient” can be used interchangeably herein.
[0052] Pharmaceutical Compositions
[0053] In one general aspect, the application provides a semi-solid pharmaceutical composition comprising:
[0054] a) an active ingredient which is a 5-aminolevulinic acid (5-ALA) ester or a pharmaceutically acceptable salt thereof;
[0055] b) one or more triglycerides; and
[0056] c) a mixture of stearic acid and palmitic acid, wherein the weight ratio of the stearic acid to the palmitic acid in the mixture is between about 1: 4 to about 4: 1, preferably about 3: 7 to about 11: 9, more preferably from about 3: 7 to about 1: 1.
[0057] The term “semi-solid” as used herein refers to a physical state which is neither solid nor liquid. Semi-solids (or quasi-solids) are similar to a solid in some respects, e.g. a semi-solid can support its own weight and hold its shape but also shares some properties of liquids, such as shape conformity to something applying pressure to it, or the ability to flow under pressure. Semi-solids are characterized by a three-dimensional structure that is sufficient to impart solid-like character to the undisturbed system but that is easily broken down and realigned under an applied force. Semi-solids have a rigidity and viscosity intermediate between a solid and a liquid.
[0058] According to the embodiments of the application, the semi-semi-solid pharmaceutical compositions are creams, ointments, pastes and gels for topical application to the skin and to mucous membranes:
[0059] ·creams are semi-solid emulsion systems with an opaque appearance. Their consistency and rheologic properties are based on whether the emulsion is o / w or w / o and on the nature of the solid in the internal phase;
[0060] ·ointments are composed mostly of fluid hydrocarbons meshed in a matrix of higher melting solid hydrocarbons;
[0061] ·pastes are basically ointments into which a high percentage of insoluble solids have been added; and
[0062] ·gels are semi-solid systems in which a liquid phase is constrained within a three-dimensional polymeric matrix in which a high degree of physical cross-linking has been introduced.
[0063] The term “active ingredient” used herein refers to 5-ALA and pharmaceutically acceptable salts thereof, precursors of 5-ALA and pharmaceutically acceptable salts thereof, and derivatives of 5-ALA and pharmaceutically acceptable salts thereof.
[0064] The term “5-ALA” denotes 5-aminolevulinic acid, i.e. 5-amino-4-oxo-pentanoic acid.
[0065] The term “precursor of 5-ALA” refers to compounds which are converted metabolically to 5-ALA and are thus essentially equivalent thereto. Therefore, the term “precursor of 5-ALA” covers biological precursors for protoporphyrin in the metabolic pathway for heme biosynthesis.
[0066] The term “derivative of 5-ALA” includes chemically modified 5-ALA, for example esters.
[0067] The use of 5-ALA and derivatives thereof, e.g. 5-ALA esters, in PDT is well known in the scientific and patent literature, see, for example, WO 2006 / 051269, WO 2005 / 092838, WO 03 / 011265, WO 02 / 09690, WO 02 / 10120, WO 2003 / 041673 and U.S. Pat. No. 6,034,267, the contents of which are incorporated herein by reference. All such derivatives of 5-ALA and their pharmaceutically acceptable salts are suitable for use in the methods described herein.
[0068] The synthesis of 5-ALA is known in the art. Further, 5-ALA and pharmaceutically acceptable salts thereof are commercially available, for instance from Sigma Aldrich.
[0069] As used herein, the pharmaceutically acceptable salt means a salt that is suitable for being used in the semi-solid pharmaceutical composition and that is acceptable for administration to a human subject, e.g., salts having acceptable mammalian safety for a given dosage regime. Representative pharmaceutically acceptable salts include salts of acetic, ascorbic, benzenesulfonic, benzoic, camphorsulfonic, citric, ethanesulfonic, edisylic, fumaric, gentisic, gluconic, glucoronic, glutamic, hippuric, hydrobromic, hydrochloric, isethionic, lactic, lactobionic, maleic, malic, mandelic, methanesulfonic, mucic, naphthalenesulfonic, naphthalene-1, 5-disulfonic, naphthalene-2,6-disulfonic, nicotinic, nitric, orotic, pamoic, pantothenic, phosphoric, succinic, hydrochloric, hydrobromic, hydroiodic, sulfuric, tartaric, p-toluenesulfonic and xinafoic acid, and the like.
[0070] The pharmaceutical compositions of the application typically contain an effective amount of the active ingredient thereof. Those skilled in the art will recognize, however, that a pharmaceutical composition can contain more than an effective amount, e.g., bulk compositions, or less than an effective amount, e.g., individual unit doses designed for multiple administration to achieve an effective amount.
[0071] In some embodiments, the active ingredient is a 5-ALA ester of formula (I) or a pharmaceutical acceptable salt thereof:
[0072] wherein R1 is a substituted or unsubstituted alkyl group, preferably a C1-6 alkyl group.
[0073] As used herein, the term “alkyl” , unless stated otherwise, includes any long or short chain, cyclic, straight-chained or branched saturated or unsaturated aliphatic hydrocarbon group. Unsaturated alkyl groups may be mono-or polyunsaturated and include both alkenyl and alkynyl groups. Unless stated otherwise, such alkyl groups may contain up to 40 carbon atoms. However, alkyl groups containing up to 30 carbon atoms, preferably up to 10, particularly preferably up to 8, especially preferably up to 6 carbon atoms are preferred.
[0074] In preferred embodiments, R1 is methyl or hexyl, more preferably n-hexyl. Accordingly, the preferred active ingredient is 5-ALA methyl ester, 5-ALA hexyl ester or a pharmaceutically acceptable salt thereof.
[0075] In some embodiments, the pharmaceutically acceptable salt thereof is HCl salt, HBr salt, HI salt, sulfate, hydrogen sulfate, nitrate, phosphate, formate, acetate, trifluoroacetate, propionate, pyruvate, hydroxyl Acetate, oxalate, malonate, fumarate, maleate, lactate, malate, citrate, tartrate, methanesulfonate, ethanesulfonate, benzene Sulfonate, salicylate, picrate, glutamate, ascorbate, camphorate, camphorsulfonate, preferably the HCl salt or sulfonic acid salt or sulfonic acid salt.
[0076] In a preferred embodiment, the active ingredient is 5-ALA methyl ester, 5-ALA hexyl ester, or the HCL salt thereof.
[0077] 5-ALA esters and pharmaceutically acceptable salts thereof for use in the application can be prepared by any conventional procedure available in the art, e.g. as described in WO 96 / 28412 and WO 02 / 10120, the contents of which are incorporated herein by reference.
[0078] The 5-ALA esters for use in the application can be in the form of a free amine or preferably in the form of a pharmaceutically acceptable salt. Such salts preferably are acid addition salts with pharmaceutically acceptable organic or inorganic acids. Suitable acids include, for example, hydrochloric, nitric, hydrobromic, phosphoric, sulfuric, sulfonic and sulfonic acid derivatives, the latter are described in WO2005 / 092838, the entire contents of which are incorporated herein by reference. A preferred acid is hydrochloride acid, HCl, sulfonic acid and sulfonic acid derivatives. Procedures for salt formation are conventional in the art.
[0079] In certain embodiments, the active ingredient is HCl salt of 5-ALA hexyl ester, which is also called hexaminolevulinate hydrochloride, abbreviated as HAL.
[0080] In some embodiments, the active ingredient is present in an amount of about 3%to about 7%by mass of the semi-solid pharmaceutical composition, such as 3%, 4%, 5%, 6%, or 7%, or any amount in between thereof.
[0081] In certain embodiments, the active ingredient is present in an amount of about 3%to about 7%by mass of the semi-solid pharmaceutical composition, preferably from about 4%to about 6%, more preferably about 5%.
[0082] As used herein, the term “triglyceride” is a compound comprised of one molecule glycerol and three fatty acid molecules. The three fatty acids can be identical or different fatty acids. The triglycerides used in the application can be liquid or semi-solid at room temperature, i.e. at temperatures of about 18℃. to about 25℃. The triglycerides are vehicles and / or carriers, and are inert compounds, i.e. compounds which do not react with the active ingredient or promote degradation of the active ingredient.
[0083] The triglycerides can be synthetic, semi-synthetic or of animal and / or vegetable origin. The triglycerides can be pure / isolated triglycerides or a part of a mixture, such as a mixture of triglycerides, monoglycerides and / or diglycerides and / or free fatty acids and / or unsaponifiable lipids. Such mixtures are typically found edible oils of animal and / or vegetable origin. If the triglycerides are part of a mixture, they preferably constitute the major part of said mixture. In the following, such mixtures are also denoted “triglycerides” .
[0084] Since the triglycerides are used in the pharmaceutical composition according to the application, which is for use in a human or non-human animal, they need to be of pharmaceutical grade and fulfill the requirements and standards of such products with regard to physiological acceptance, tolerability and safety.
[0085] The term “one or more triglycerides” means that the semi-solid pharmaceutical composition described herein contains one triglyceride or several different triglycerides. By way of example, the semi-solid pharmaceutical composition can contain tricaprylin (caprylic acid triglyceride) or tricaprylin and caprylic / capric triglyceride.
[0086] Preferred liquid triglycerides are selected from edible oils of animal and / or vegetable origin and / or fractions thereof, such as soybean oil, palm kernel oil, corn oil, olive oil, almond oil, safflower oil, peanut oil, coconut oil, sunflower oil, castor oil or pine oil. Other examples of liquid triglycerides include hydrogenated or preferably partially hydrogenated triglycerides selected from partially or fully hydrogenated soybean oil, rapeseed oil, sunflower oil, coconut oil and fractions thereof. The liquid triglycerides oil can be synthetic or semi-synthetic, such as medium-chain triglycerides (MCT) .
[0087] Preferred semi-solid triglycerides are selected from edible semi-solid fats of animal and / or vegetable origin and / or fractions thereof, such as palm oil, cottonseed oil or lard. Other examples of semi-solid triglycerides include hydrogenated or partially hydrogenated triglycerides selected from partially or fully hydrogenated soybean oil, rapeseed oil, sunflower oil, coconut oil and fractions thereof.
[0088] In some embodiments, the triglyceride is a triglyceride of glycerol and three identical or different C2-22 fatty acids, more preferably three identical or different C4-18 fatty acids, even more preferably three identical or different C6-18 fatty acids and most preferably three identical or different C6-12 fatty acids.
[0089] In preferred embodiments, the triglyceride is a triglyceride of glycerol and three different C2-22 fatty acids, more preferably three different C4-18 fatty acids, even more preferably three different C6-18 fatty acids and most preferably three identical C6-12 fatty acids.
[0090] More preferred triglycerides are tricaprylin, tricaproin, triheptanoin, caprylic / capric triglyceride and caprylic / capric / linoleic triglyceride and caprylic / capric / succinic triglyceride. Some of these triglycerides are marketed under the name , e.g. with Miglyol 812 being caprylic / capric triglyceride, Miglyol 818 being caprylic / capric / linoleic triglyceride and Miglyol 808 being tricaprylin. A manufacturer or such triglycerides is for instance Sasol, Witten, Germany.
[0091] In a preferred embodiment, the one or more triglycerides are selected from tricaprylin, tricaproin, triheptanoin, caprylic / capric triglyceride, caprylic / capric / linoleic triglyceride and caprylic / capric / succinic triglyceride.
[0092] The triglycerides used in the application can be prepared using standard processes and procedures well-known in the art, although many are commercially available from various manufacturers such like Sasol, Croda, Gattefossé and others.
[0093] In some embodiments, the one or more triglycerides are present in an amount of about 72%to about 82%by mass of the semi-solid pharmaceutical composition, such as 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81%, or 82%, or any amount in between thereof.
[0094] In certain embodiments, the one or more triglycerides are present in an amount of about 72%to about 82%by mass of the semi-solid pharmaceutical composition, preferably from about 74%to about 80%, more preferably from about 76%to about 78%, most preferably about 77%.
[0095] As used herein, the term “stearic acid” refers to a saturated fatty acid with a chemical formula of CH3 (CH2) 16COOH, which is also called octadecanoic acid.
[0096] As used herein, the term “palmitic acid” refers to a saturated fatty acid with a chemical formula of CH3 (CH2) 14COOH, which is also called hexadecanoic acid.
[0097] According to embodiments of the application, the semi-solid pharmaceutical composition described herein comprises a mixture of stearic acid and palmitic acid. Without wishing to be bound by theory, the mixture of stearic acid and palmitic acid functions as a viscosity enhancer, which thickens or stiffens a mixture of the active ingredient and the one or more triglycerides. If a liquid triglyceride is used, the mixture of the active ingredient and the triglyceride is a liquid, e.g. a solution or a suspension, and by adding the mixture of stearic acid and palmitic acid, the resulting mixture will become semi-solid.
[0098] Inventors of the application have found that mixtures of palmitic acid and stearic acid in different proportions have different freezing points and rheological properties, and that the semi-solid pharmaceutical compositions comprising such mixture and the one or more triglycerides (such as medium-chain triglycerides) have different viscosity, rheological, release characteristics, and in vivo performance of the active ingredient.
[0099] In some embodiments, the weight ratio of the stearic acid to the palmitic acid in the mixture is between about 1: 4 to about 4: 1, such as 1: 4, 3: 7, 2: 3, 1: 1, 3: 2, 7: 3, or 4: 1, or any ratio in between thereof.
[0100] In certain embodiments, the weight ratio of the stearic acid to the palmitic acid in the mixture is between about 1: 4 to about 7: 3, preferably about 3: 7 to about 11: 9, more preferably from about 3: 7 to about 1: 1.
[0101] The present invention can be achieved by maintaining the weight ratio of stearic acid to palmitic acid within the range of about 1: 4 to about 4: 1, wherein optimal semi-solid characteristics for cervical and vaginal delivery are realized across this entire range, enabling accurate dosing, ease of administration, and rapid melting with efficient tissue absorption to enhance photodynamic therapy efficacy. When the ratio is further adjusted to from about 3: 7 to about 11: 9, more consistent product stability and improved bioavailability are achieved, with the most favorable performance observed in the range of about 3: 7 to about 1: 1, where the formulation exhibits exceptionally rapid phase transition and maximal active agent release.
[0102] In some embodiments, the weight percentage of stearic acid in the mixture is between about 20%to 67%, such as 20%, 25%, 30%, 33%, 40%, 50%, 60%, or 67%, or any number in between thereof.
[0103] In certain embodiments, the weight percentage of stearic acid in the mixture is between about 20%to 67%, preferably between about 30%to about 67%, more preferably about 40%to 60%.
[0104] The mixture of stearic acid and palmitic acid is present in an amount which is necessary to obtain a semi-solid pharmaceutical composition. The actual amount will depend on the nature of the mixture of the active ingredient and the one or more triglycerides, e.g. its viscosity, and also on the nature of mixture of steric acid and palmitic acid. The amount and the nature of the mixture of stearic acid and palmitic acid impacts the drop point of the semi-solid pharmaceutical composition described herein, and a drop point well above the body temperature would limit the spreading of the pharmaceutical composition to the surface of the tissue or organ to be treated and thus negatively impact the bioavailability of the active ingredient. The drop point is defined and determined as described in European Pharmacopoeia 6.0 section 2.2.17: the drop point is the temperature at which the first drop of melting substance to be examined falls from a cup under defined conditions.
[0105] In some embodiments, the semi-solid pharmaceutical composition has a drop point ranging from about 25 to about 50 ℃, from about 25 to about 45 ℃, from about 30 to about 42 ℃, from about 32 to about 41 ℃, or from about 33 to about 40 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point ranging from about 25 to about 50 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point ranging from about 25 to about 45 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point ranging from about 30 to about 42 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point ranging from about 32 to about 41 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point ranging from about 33 to about 40 ℃.
[0106] In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 33, about 34, about 35, about 36, about 37, about 38, about 39, or about 40 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 33 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 34 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 35 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 36 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 37 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 38 ℃. In certain embodiments, the semi-solid pharmaceutical composition has a drop point of about 39 ℃. In certain embodiments, the semi-solid pharmaceutical composition described herein has a drop point of about 40 ℃.
[0107] In some embodiments, the mixture of stearic acid and palmitic acid is present in an amount of about 11%to about 25%by mass of the semi-solid pharmaceutical composition, such as 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, or 25%, or any amount in between thereof.
[0108] In certain embodiments, the mixture of stearic acid and palmitic acid is present in an amount of about 11%to about 25%by mass of the semi-solid pharmaceutical composition, preferably from about 14%to about 22%, more preferably from about 15%to about 21%, most preferably about 18%.
[0109] The semi-solid pharmaceutical compositions described herein can further comprise a pharmaceutically acceptable carrier. As used herein, the term “carrier” refers to any excipient, diluent, buffer, stabilizer, or other material well known in the art for pharmaceutical formulations. Pharmaceutically acceptable carriers in particular are non-toxic and should not interfere with the efficacy of the active ingredient. The pharmaceutically acceptable carriers include excipients and / or additives suitable for use in the semi-slid pharmaceutical compositions are described in WO 2010 / 142457, the entire content of which is incorporated herein by reference.
[0110] The semi-solid pharmaceutical composition described herein are formulated as a cream, an ointment, a paste or a gel. Conventional and known methods may be used to prepare such creams, ointments, pastes and gels. Mixture of the active ingredients, the one or more triglycerides, and the mixture of stearic acid and palmitic acid can be promoted by methods known in the art, e.g. stirring, optionally along with heating the mixture. Generally, the one or more triglycerides and the mixture of stearic acid and palmitic acid are mixed during stirring and optionally heating until a homogenous mixture, preferably fluid, is achieved. If the homogenous mixture is heated, the temperature is decreased while stirring, and then the active ingredient is added during cooling and stirring at a temperature of about 40 ℃ or below. The stirring of the final product is continued until room temperature is reached.
[0111] In some embodiments, the semi-solid pharmaceutical composition is a paste, preferably an ointment.
[0112] The semi-solid pharmaceutical composition described herein are preferably viscous or to a certain degree viscous at the subject's body temperature. This makes the composition easy to handle, e.g. the composition can be easily administered to the female reproductive system, the anus or the penis, without becoming immediately low viscous or liquid upon rise of temperature from room temperature to body temperature. It further ensures that the pharmaceutical composition remains at the site of administration, i.e. on the surface of the uterus, cervix, vagina, vulva, anus or penis.
[0113] In some embodiments, the viscosity of the pharmaceutical composition at the subject's body temperature is as such that no additional means like pessaries, diaphragms, caps, plugs, adhesive bandages or patches are needed for keeping the pharmaceutical composition at the site of administration for the desired time.
[0114] In other embodiments, the viscosity the pharmaceutical composition at room temperature is as such that it is preferred to apply it to pessaries, diaphragms, caps, adhesive bandages or patches which are placed at the site of treatment ensuring that the pharmaceutical composition remains at those sites of administration.
[0115] In some embodiment, the semi-solid pharmaceutical compositions are for use in photodynamic treatment of cancer, pre-cancerous conditions and non-cancerous conditions in female reproductive system, anus and penis by photodynamic treatment (PDT) .
[0116] In preferred embodiments, the semi-solid pharmaceutical compositions are for use in photodynamic treatment of dysplasia and HPV infections in the female reproductive system, the anus and the penis, more preferably endometrial, cervical, vaginal, vulvar, anal and penile dysplasia and HPV infections of the uterus, cervix, vagina, vulva, anus and penis. In a more preferred embodiment, the semi-solid pharmaceutical products according to the invention are for use in photodynamic treatment of endometrial, cervical, vaginal, and vulvar dysplasia and HPV infections in the uterus, cervix, vagina and vulva. In a most preferred embodiment, the semi-solid pharmaceutical products according to the invention are for use in photodynamic treatment of cervical and vaginal dysplasia and HPV infections in cervix and vagina.
[0117] In said most preferred embodiments, it is preferred to use a device which is adapted to receive an effective amount, i.e. dose of semi-solid pharmaceutical compositions described herein. The preferred device is body shaped to allow full and secure insertion into the vagina. The preferred device further comprises irradiation means, i.e. a light source which is suitable to irradiate light suitable for photoactivation, i.e. to achieve the desired photodynamic effect. Such devices, e.g. caps or rod-shaped devices, are described in WO2010 / 078929 and WO2014 / 166993, the contents of which are incorporated by reference.
[0118] After administration of the pharmaceutical composition to the site to be treated, said site is exposed to light to achieve the desired photoactivation and photodynamic treatment. Generally, suitable light sources are lasers, lamps and preferably LED lamps. The energy consumption per unit time of the light source should be such that the heating of tissue does not result in discomfort or damage to the subject.
[0119] In preferred embodiments, the semi-solid pharmaceutical composition provides the characteristics for its intended use. At normal temperature or room temperature, such as a temperature not exceeding 25 ℃, it maintains a stable semi-solid form, thereby preventing phase separation. Upon administration and exposure to the in vivo environment (e.g., body temperature around 37℃) , it transitioning into relatively low viscosity (to spread easily) but not flow (to prevent stratification) . Such characteristics of the semi-solid pharmaceutical compositions can facilitate easy administration and quick absorption of the active ingredient.
[0120] The semi-solid pharmaceutical compositions described herein can be provided separately (e.g. in a tube or jar) or already contained in a drug delivery system, e.g. pessaries, diaphragms, caps, adhesive bandages or patches or a device, e.g. a cap, as described in WO2010 / 078929 and WO2014 / 166993. Alternatively, the semi-solid pharmaceutical compositions can be provided in the form of a kit comprising the pharmaceutical composition and a drug delivery system.
[0121] The disclosed semi-solid pharmaceutical compositions and method for photodynamic therapy can combined with other therapeutic procedures, for example administration of other therapeutic drugs. These therapeutic drugs might be administered to the patient prior, together or subsequent to the semi-solid pharmaceutical products. Other routes of administration may be oral, intravascular or dermal. Typical such drugs include hormones, antibacterial agents, antifungal agents, antiviral agents, anticancer agents or combination of such drugs.
[0122] Methods of Use
[0123] In another general aspect, the application provides a use of the pharmaceutical composition described herein for photodynamic treatment (PDT) of a disease, disorder, or a condition.
[0124] Provided herein is a photodynamic therapeutic (PDT) method for treating, preventing, or ameliorating one or more symptoms of a disorder, disease, or condition in a subject in need thereof, comprising administering to the subject an effective amount of the pharmaceutical composition.
[0125] Provided herein is a PDT method for treating, preventing, or ameliorating one or more symptoms of a cervix disorder or condition in a subject in need thereof, comprising administering intravaginally to the subject an effective amount of the pharmaceutical composition.
[0126] Provided herein is a PDT method for inhibiting the replication of HPV in an HPV-positive subject, comprising administering intravaginally to the subject an effective amount of the pharmaceutical composition.
[0127] Provided herein is a PDT method for reducing an HPV proliferation rate in an HPV-positive subject, comprising administering intravaginally to the subject an effective amount of the pharmaceutical composition.
[0128] Provided herein is a PDT method for eliminating HPV in an HPV-positive subject, comprising administering intravaginally to the subject an effective amount of the pharmaceutical composition.
[0129] Provided herein is a PDT method for clearing HPV in an HPV-positive subject, comprising administering intravaginally to the subject.
[0130] The embodiments below apply to all the above methods of use.
[0131] In some embodiments, the pharmaceutical composition is administered to the subject locally, intravesically, or intravaginally.
[0132] In some embodiments, the disease, disorder, or condition is a precancerous condition, or cancer.
[0133] In certain embodiments, the cancer is bladder cancer.
[0134] In certain embodiments, the cancer is cervical cancer. In certain embodiments, the cervical cancer is associated with an HPV infection. In certain embodiments, the cervical cancer is associated with a high-risk HPV infection. In certain embodiments, the cervical cancer is associated with an HPV 16, HPV 18, HPV 31, HPV 33, HPV 35, HPV 39, HPV 45, HPV 51, HPV 52, HPV 56, HPV 58, HPV 59, HPV 66, or HPV 68 infection. In certain embodiments, the cervical cancer is associated with an HPV 16, HPV 31, or HPV 33 infection. In certain embodiments, the cervical cancer is associated with an HPV 16, HPV 52, or HPV 58 infection. In certain embodiments, the cervical cancer is associated with an HPV 16 or HPV 18 infection. In certain embodiments, the cervical cancer is associated with an HPV 16 infection. In certain embodiments, the cervical cancer is associated with an HPV 18 infection. In certain embodiments, the cervical cancer is associated with an HPV 31 infection. In certain embodiments, the cervical cancer is associated with an HPV 33 infection. In certain embodiments, the cervical cancer is associated with an HPV 35 infection. In certain embodiments, the cervical cancer is associated with an HPV 39 infection. In certain embodiments, the cervical cancer is associated with an HPV 45 infection. In certain embodiments, the cervical cancer is associated with an HPV 51 infection. In certain embodiments, the cervical cancer is associated with an HPV 52 infection. In certain embodiments, the cervical cancer is associated with an HPV 56 infection. In certain embodiments, the cervical cancer is associated with an HPV 58 infection. In certain embodiments, the cervical cancer is associated with an HPV 59 infection. In certain embodiments, the cervical cancer is associated with an HPV 66 infection. In certain embodiments, the cervical cancer is associated with an HPV 68 infection.
[0135] In certain embodiments, the cervical cancer is squamous cell carcinoma or adenocarcinoma. In certain embodiments, the cervical cancer is squamous cell carcinoma. In certain embodiments, the cervical cancer is adenocarcinoma. In certain embodiments, the cervical cancer is stage I, II, III, or IV. In certain embodiments, the cervical cancer is stage I. In certain embodiments, the cervical cancer is stage IA, IA1, IA2, IB, IB1, IB2, or IB3. In certain embodiments, the cervical cancer is stage IA. In certain embodiments, the cervical cancer is IA1. In certain embodiments, the cervical cancer is stage IA2. In certain embodiments, the cervical cancer is stage IB. In certain embodiments, the cervical cancer is stage IB1. In certain embodiments, the cervical cancer is stage IB2. In certain embodiments, the cervical cancer is stage IB3. In certain embodiments, the cervical cancer is stage II. In certain embodiments, the cervical cancer is stage IIA, IIA1, IIA2, or IIB. In certain embodiments, the cervical cancer is stage IIA. In certain embodiments, the cervical cancer is stage IIA1, In certain embodiments, the cervical cancer is stage IIA2. In certain embodiments, the cervical cancer is stage IIB. In certain embodiments, the cervical cancer is stage III. In certain embodiments, the cervical cancer is stage IIIA, IIIB, or IIIC. In certain embodiments, the cervical cancer is stage IIIA. In certain embodiments, the cervical cancer is stage IIIB. In certain embodiments, the cervical cancer is stage IIIC. In certain embodiments, the cervical cancer is stage IV. In certain embodiments, the cervical cancer is stage IVA or IVB. In certain embodiments, the cervical cancer is stage IVA. In certain embodiments, the cervical cancer is stage IVB.
[0136] In some embodiments, the precancerous condition is actinic keratosis.
[0137] In some embodiments, the disease, disorder, or condition is cervix disorder or condition such as human papillomavirus (HPV) infection.
[0138] In certain embodiments, the cervix disorder or condition is a precancerous disorder or condition. In certain embodiments, the cervix disorder or condition is a precancerous disorder or condition associated with an HPV infection. In certain embodiments, the precancerous disorder or condition is associated with a high-risk HPV infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 16, HPV 18, HPV 31, HPV 33, HPV 35, HPV 39, HPV 45, HPV 51, HPV 52, HPV 56, HPV 58, HPV 59, HPV 66, or HPV 68 infection. In certain embodiments, the precancerous cervix disorder or condition is associated with an HPV 16, HPV 31, or HPV 33 infection. In certain embodiments, the precancerous cervix disorder or condition is associated with an HPV 16, HPV 52, or HPV 58 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 16 or HPV 18 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 16 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 18 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 31 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 33 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 35 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 39 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 45 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 51 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 52 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 56 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 58 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 59 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 66 infection. In certain embodiments, the precancerous disorder or condition is associated with an HPV 68 infection.
[0139] In certain embodiments, the precancerous cervix disorder or condition is cervical adenocarcinoma in situ, cervical intraepithelial neoplasia (CIN) , or squamous intraepithelial lesion (SIL) . In certain embodiments, the precancerous cervix disorder or condition is cervical adenocarcinoma in situ. In certain embodiments, the precancerous cervix disorder or condition is CIN, which is also known as cervical dysplasia.
[0140] In certain embodiments, the precancerous cervix disorder or condition is cervical intraepithelial neoplasia 1 (CIN1) , cervical intraepithelial neoplasia 2 (CIN2) , or cervical intraepithelial neoplasia 3 (CIN3) . In certain embodiments, the precancerous cervix disorder or condition is CIN1. In certain embodiments, the precancerous cervix disorder or condition is CIN2 or CIN3. In certain embodiments, the precancerous cervix disorder or condition is CIN2. In certain embodiments, the precancerous cervix disorder or condition is CIN3.
[0141] In certain embodiments, the precancerous cervix disorder or condition is SIL. In certain embodiments, the precancerous cervix disorder or condition is low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL) . In certain embodiments, the precancerous cervix disorder or condition is LSIL. In certain embodiments, the precancerous cervix disorder or condition is HSIL.
[0142] In certain embodiments, the precancerous cervix disorder or condition is an HPV infection. In certain embodiments, the precancerous cervix disorder or condition is a low-risk HPV infection. In certain embodiments, the precancerous cervix disorder or condition is a high-risk HPV infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 16, HPV 18, HPV 31, HPV 33, HPV 35, HPV 39, HPV 45, HPV 51, HPV 52, HPV 56, HPV 58, HPV 59, HPV 66, or HPV 68 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 16, HPV 31, or HPV 33 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 16, HPV 52, or HPV 58 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 16 or HPV 18 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 16 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 18 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 31 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 33 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 35 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 39 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 45 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 51 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 52 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 56 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 58 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 59 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 66 infection. In certain embodiments, the precancerous cervix disorder or condition is an HPV 68 infection.
[0143] In certain embodiments, the cervix disorder or condition is a cancerous cervix disorder or condition (also called cervix cancer) . In certain embodiments, the cancerous cervix disorder or condition is a cancerous cervix disorder or condition associated with an HPV infection. In certain embodiments, the cancerous cervix disorder or condition is associated with a high-risk HPV infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 16, HPV 18, HPV 31, HPV 33, HPV 35, HPV 39, HPV 45, HPV 51, HPV 52, HPV 56, HPV 58, HPV 59, HPV 66, or HPV 68 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 16, HPV 31, or HPV 33 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 16, HPV 52, or HPV 58 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 16 or HPV 18 infection. In certain embodiments, the cervix cancerous disorder or condition is associated with an HPV 16 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 18 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 31 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 33 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 35 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 39 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 45 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 51 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 52 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 56 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 58 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 59 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 66 infection. In certain embodiments, the cancerous cervix disorder or condition is associated with an HPV 68 infection.
[0144] In certain embodiments, the cervical cancer is squamous cell carcinoma or adenocarcinoma. In certain embodiments, the cervical cancer is squamous cell carcinoma. In certain embodiments, the cervical cancer is adenocarcinoma. In certain embodiments, the cervical cancer is stage I, II, III, or IV. In certain embodiments, the cervical cancer is stage I. In certain embodiments, the cervical cancer is stage IA, IA1, IA2, IB, IB1, IB2, or IB3. In certain embodiments, the cervical cancer is stage IA. In certain embodiments, the cervical cancer is IA1. In certain embodiments, the cervical cancer is stage IA2. In certain embodiments, the cervical cancer is stage IB. In certain embodiments, the cervical cancer is stage IB1. In certain embodiments, the cervical cancer is stage IB2. In certain embodiments, the cervical cancer is stage IB3. In certain embodiments, the cervical cancer is stage II. In certain embodiments, the cervical cancer is stage IIA, IIA1, IIA2, or IIB. In certain embodiments, the cervical cancer is stage IIA. In certain embodiments, the cervical cancer is stage IIA1, In certain embodiments, the cervical cancer is stage IIA2. In certain embodiments, the cervical cancer is stage IIB. In certain embodiments, the cervical cancer is stage III. In certain embodiments, the cervical cancer is stage IIIA, IIIB, or IIIC. In certain embodiments, the cervical cancer is stage IIIA. In certain embodiments, the cervical cancer is stage IIIB. In certain embodiments, the cervical cancer is stage IIIC. In certain embodiments, the cervical cancer is stage IV. In certain embodiments, the cervical cancer is stage IVA or IVB. In certain embodiments, the cervical cancer is stage IVA. In certain embodiments, the cervical cancer is stage IVB.
[0145] In certain embodiments, the cervical cancer is persistent. In certain embodiments, the cervical cancer is persistent squamous cell carcinoma or persistent adenocarcinoma. In certain embodiments, the cervical cancer is persistent squamous cell carcinoma. In certain embodiments, the cervical cancer is persistent adenocarcinoma. In certain embodiments, the persistent cervical cancer is stage I, II, III, or IV. In certain embodiments, the persistent cervical cancer is stage I. In certain embodiments, the persistent cervical cancer is stage IA, IA1, IA2, IB, IB1, IB2, or IB3. In certain embodiments, the persistent cervical cancer is stage IA. In certain embodiments, the persistent cervical cancer is stage IA1. In certain embodiments, the persistent cervical cancer is stage IA2. In certain embodiments, the persistent cervical cancer is stage IB. In certain embodiments, the persistent cervical cancer is stage IB1. In certain embodiments, the persistent cervical cancer is stage IB2. In certain embodiments, the persistent cervical cancer is stage IB3. In certain embodiments, the persistent cervical cancer is stage II. In certain embodiments, the persistent cervical cancer is stage IIA, IIA1, IIA2, or IIB. In certain embodiments, the persistent cervical cancer is stage IIA. In certain embodiments, the persistent cervical cancer is stage IIA1. In certain embodiments, the persistent cervical cancer is stage IIA2. In certain embodiments, the persistent cervical cancer is stage IIB. In certain embodiments, the persistent cervical cancer is stage III. In certain embodiments, the persistent cervical cancer is stage IIIA, IIIB, or IIIC. In certain embodiments, the persistent cervical cancer is stage IIIA. In certain embodiments, the persistent cervical cancer is stage IIIB. In certain embodiments, the persistent cervical cancer is stage IIIC. In certain embodiments, the persistent cervical cancer is stage IV. In certain embodiments, the persistent cervical cancer is stage IVA or IVB. In certain embodiments, the persistent cervical cancer is stage IVA. In certain embodiments, the persistent cervical cancer is stage IVB.
[0146] In certain embodiments, the cervical cancer is recurrent. In certain embodiments, the cervical cancer is recurrent squamous cell carcinoma or recurrent adenocarcinoma. In certain embodiments, the cervical cancer is recurrent squamous cell carcinoma. In certain embodiments, the cervical cancer is recurrent adenocarcinoma. In certain embodiments, the recurrent cervical cancer is stage I, II, III, or IV. In certain embodiments, the recurrent cervical cancer is stage I. In certain embodiments, the recurrent cervical cancer is stage IA, IA1, IA2, IB, IB1, IB2, or IB3. In certain embodiments, the recurrent cervical cancer is stage IA. In certain embodiments, the recurrent cervical cancer is stage IA1. In certain embodiments, the recurrent cervical cancer is stage IA2. In certain embodiments, the recurrent cervical cancer is stage IB. In certain embodiments, the recurrent cervical cancer is stage IB1. In certain embodiments, the recurrent cervical cancer is stage IB2. In certain embodiments, the recurrent cervical cancer is stage IB3. In certain embodiments, the recurrent cervical cancer is stage II. In certain embodiments, the recurrent cervical cancer is stage IIA, IIA1, IIA2, or IIB. In certain embodiments, the recurrent cervical cancer is stage IIA. In certain embodiments, the recurrent cervical cancer is stage IIA1. In certain embodiments, the recurrent cervical cancer is stage IIA2. In certain embodiments, the recurrent cervical cancer is stage IIB. In certain embodiments, the recurrent cervical cancer is stage III. In certain embodiments, the recurrent cervical cancer is stage IIIA, IIIB, or IIIC. In certain embodiments, the recurrent cervical cancer is stage IIIA. In certain embodiments, the recurrent cervical cancer is stage IIIB. In certain embodiments, the recurrent cervical cancer is stage IIIC. In certain embodiments, the recurrent cervical cancer is stage IV. In certain embodiments, the recurrent cervical cancer is stage IVA or IVB. In certain embodiments, the recurrent cervical cancer is stage IVA. In certain embodiments, the recurrent cervical cancer is stage IVB.
[0147] In certain embodiments, the cervical cancer is refractory and / or relapsed. In certain embodiments, the cervical cancer is refractory. In certain embodiments, the cervical cancer is relapsed. In certain embodiments, the cervical cancer is metastatic. In certain embodiments, the cervical cancer is unresectable.
[0148] In certain embodiments, the cervical cancer is drug-resistant. In certain embodiment, the cervical cancer is multidrug-resistant. In certain embodiments, the cervical cancer is resistant to a chemotherapy. In certain embodiments, the cervical cancer is resistant to an immunotherapy. In certain embodiments, the cervical cancer is resistant to a standard therapy for the cancer.
[0149] In some embodiments, the pharmaceutical composition is used for the diagnosis and management of bladder cancer in patients with known or high suspicion of bladder cancer.
[0150] In some embodiments, the pharmaceutical composition is an optical imaging agent used in the cystoscopic detection of carcinoma of the bladder, including carcinoma in situ (CIS) , among patients suspected or known to have lesion (s) on the basis of a prior cystoscopy, or in patients undergoing surveillance cystoscopy for carcinoma of the bladder.
[0151] In some embodiments, the method further comprises photoactivating hexaminolevulinate or a pharmaceutically acceptable salt in combination with a device for diagnosis or treatment of the disease. The devices are described in WO1999 / 053962, the content of which is incorporated by reference.
[0152] In certain embodiments, the PDT method is a neoadjuvant therapy for bladder cancer in bladder cancer patients who are scheduled for a cystectomy, e.g., as disclosed in WO 2017 / 103283A1, the disclosure of which is incorporated herein by reference in its entirety.
[0153] In certain embodiments, the PDT method comprises a step of exposing the inside of the bladder to blue light having a fluence rate / irradiance of 1.5 to 12.5 mW / cm2. In certain embodiments, said blue light is provided at light dose / fluence of 0.2 to 15 J / cm2. In certain embodiments, the PDT method for the treatment of bladder cancer is one as disclosed in WO 2017 / 103285A1, the disclosure of which is incorporated herein by reference in its entirety.
[0154] In certain embodiments, the PDT method for the treatment of bladder cancer is combined with the administration of anti-PD-L1 antibodies and / or anti-PD-l antibodies, e.g., as disclosed in WO 2017 / 103280A1, the disclosure of which is incorporated herein by reference in its entirety.
[0155] In certain embodiments, the PDT method for the treatment of bladder cancer is one as disclosed in international patent application no. PCT / EP2024 / 055897, the disclosure of which is incorporated herein by reference in its entirety.
[0156] Kits
[0157] In one another general aspect, the application provides a kit comprising a drug delivery system and the semi-solid composition described herein. Example of the drug delivery system include, but not limited to pessaries, diaphragms, caps, adhesive bandages or patches or a device, as described in WO2010 / 078929, WO2014 / 166993, WO2020012545A1, WO2021216605A1 and US20180361170A1.
[0158] In some embodiments, the device comprises an irradiation means, such as a laser or a lamp, preferably a lamp, more preferably a LED lamp, most preferably a photodynamic therapy lamp. The energy consumption per unit time of the irradiation means should be such that the heating of tissue does not result in discomfort or damage to the subject.
[0159] EXAMPLES
[0160] The following examples are to further illustrate the nature of the present disclosure. It should be understood that the following examples do not limit the disclosure and the scope of the present disclosure is to be determined by the appended claims.
[0161] Example 1: Preparation of Semi-Solid Pharmaceutical Compositions
[0162] The preparation process includes the following steps:
[0163] 1. Heating of auxiliary materials: A certain amount of medium-chain triglycerides (MCTs) and various mixing ratios of stearic acid and palmitic acid were added into a 500mL beaker, followed by heating in a water bath of 62℃. With mechanical stirring at 400rpm, the mixture in the 500mL beaker was heated to a temperature of about 60℃. Part of the hot water in the water bath was replaced with cold water in order to gradually cool the mixture at a stirring speed of 400rpm.
[0164] 2. Cooling of auxiliary materials and addition of API: After the mixture was cooled to about 45-40℃, hexaminolevulinate hydrochloride was added to the 500mL beaker.
[0165] 3. Mixing and stirring: The stirring speed was increased to 900rpm, and the resulting was stirred for 3min.
[0166] 4. Cooling of materials: The hot water in the water bath was replaced with cold water, the mixture was stirred at 400rpm to gradually cool down to below 25℃ over a period of about 90min.
[0167] Example 2: Effects of ratio of stearic acid to palmitic acid on the semi-solid pharmaceutical compositions’ properties
[0168] Different formulations were prepared according to the Table 1 below.
[0169] Table 1
[0170] The properties of the above prepared semi-solid pharmaceutical compositions were tested. Specifically, the viscosity and drop points of the above formulations were measured, and the results are shown in Table 2.
[0171] The drop points were determined according to Method –Ph. Eur. 2.2.17 (A) , and the viscosity was determined according to General Chapter 0633 Determination of Viscosity (Method 3) , Volume IV, the Chinese Pharmacopoeia (Edition 2020) .
[0172] In addition, the content of hexaminolevulinate hydrochloride was measured as follows: : The sample solution was prepared using isopropanol-phosphate buffer (70: 30) as solvent; C8 column was used; the gradient elution was performed with the mobile phases of methanol-phosphate buffer (pH 6.8) ; detection wavelength was 210 nm ; the content of hexaminolevulinate hydrochloride was determined by external standard method.
[0173] Table 2 *The current method for measuring viscosity at 25℃ uses a rotation speed of 10r. However, due to the excessively high viscosity of formulations 1, 6, and 7, the rotation speed was adjusted, and the corresponding data were measured. ; **The current method for measuring viscosity at 37℃ uses a rotation speed of 100r. However, due to the excessively high viscosity of formulations 1, 6, and 7, the rotation speed was adjusted, and the corresponding data were measured.
[0174] For ointment products, a certain viscosity is required to ensure uniform dispersion of the medication within the base. If the viscosity is too low, the medication may settle or separate, affecting dosage accuracy and efficacy. Conversely, if the viscosity is too high, it is difficult to apply evenly, impacting therapeutic effects. As demonstrated in the above table, dropping point is positively correlated with viscosity, indicating that the ointment has some melting properties, which allows the ointment to remain semi-solid at room temperature. When used on the human body, the ointment softens upon contact with body temperature, facilitating application and drug absorption. In clinical use, this product needs to be squeezed into the mouth of the instrument cup and placed at the cervix to closely fit the cervical surface. Therefore, the temperature of the application site is about 37℃. At this temperature, the product needs to have a certain viscosity (to spread easily) but not flow (to prevent stratification) .
[0175] The test results above indicate that Formula 9 (stearic acid: palmitic acid = 19: 1) exhibits phase separation at room temperature, resulting in uneven drug distribution in the ointment. Formulas 1 (stearic acid: palmitic acid = 4: 16) to 8 (stearic acid: palmitic acid = 16: 4) should be selected as the preferred formulations. Formulas 1, 6, and 7 have high viscosity, maintaining a high viscosity even at 37℃. To prevent the ointment from being difficult to spread or unevenly spread, Formulas 2 (stearic acid: palmitic acid = 6: 14) to 5 (stearic acid: palmitic acid = 11: 9) and Formula 8 (stearic acid: palmitic acid = 16: 4) should be selected as the preferred formulations.
[0176] Example 3: Effects of ratio of stearic acid to palmitic acid on stability
[0177] This example investigated the effects of the ratio of stearic acid to palmitic acid on stability. Ointment samples were stored at 30℃ for 6 months prior to stability test, and the assay of the ointment from both the top and bottom positions of the container was tested. The results are shown in Table 3.
[0178] Table 3
[0179] This product is an ointment in which the API is suspended in an oily matrix. Therefore. accelerated stability studies are needed to investigate the distribution of the drug within the matrix to assess quality changes and efficacy during use and storage. Accelerated stability studies at 30℃ / 65%RH revealed that Formula 8 (stearic acid: palmitic acid = 16: 4) exhibited a low content in the upper layer, suggesting potential drug sedimentation. Therefore, Formulas 1 (stearic acid: palmitic acid = 4: 16) to 7 (stearic acid: palmitic acid = 14: 6) are recommended to ensure product quality stability during use and storage.
[0180] Conclusion:
[0181] According to the above data in Example 2 and Example 3, it is clear that only when the ratio of stearic acid to palmitic acid is between about 4: 16 to about 16: 4, preferably about 6: 14 to about 11: 9, the formed pharmaceutical compositions not only exhibit excellent stability but also possess good flowability. These properties enable the formulations to rapidly change to a flowing liquid form in the in vivo temperature, thus facilitating easy drug administration and absorption.
[0182] Example 4: Effects of ratio of stearic acid to palmitic acid on centrifugal stability
[0183] This product is a suspension ointment composed of API, a mixture of stearic acid and palmitic acid, and MCT. Considering subsequent steps such as product transfer, transportation, and storage, the centrifugal stability of each formulation under different ratios was evaluated at a speed of 1000 rpm for 15 minutes. The results are shown in Table 4.
[0184] Table 4
[0185] Centrifugal stability is an important evaluation of the physical stability of ointments, as it can simulate problems such as stratification and phase separation that may occur during long-term storage. At 1000 rpm for 15 minutes, Formulation 8 (stearic acid: palmitic acid = 16: 4) exhibited phase separation. Therefore, it is inferred that among Formulations 1 to 8, Formulation 8 has the worst physical stability, and products from Formulations 1 (stearic acid: palmitic acid = 4: 16) to 7 (stearic acid: palmitic acid = 14: 6) should be preferred.
[0186] ·
[0187] Example 5: Effects of ratio of stearic acid to palmitic acid on transmittance studies
[0188] This product needs to be used in conjunction with an optical instrument in clinical practice to form a photodynamic therapy system. Accordingly, the light source must penetrate the ointment to irradiate the affected area, working in conjunction with the ointment to achieve the therapeutic effect. Therefore, this product needs to have a certain light transmittance in the mouth of instrument cup. The specific method for testing light transmittance is as follows:
[0189] 1. The instrument is placed on the instrument mold, and the fiber optic probe is placed in the mold's socket.
[0190] 2. The other end of the fiber optic cable is connected to a radiometer and an Ocean Insight spectrometer.
[0191] 3. The transmittance of the ointment is tested by coupling the fiber optic cable to a cosine diffuser optical probe and using spectral software.
[0192] 4. Since the instrument light source used in clinical applications has a wavelength of 631.5 nm, the transmittance at a wavelength of 631 nm is extracted in the software.
[0193] The transmittance of ointments with different stearic acid: palmitic acid ratios under the device's light source was investigated. The results are shown in Table 5.
[0194] Table 5
[0195] The above test results show that the light transmittance of Formulations 2 (stearic acid: palmitic acid = 6: 14) to 4 (stearic acid: palmitic acid = 10: 10) were better than other formulations, affording a transmittance >75%, which allows the instrument light source to pass through the ointment better, thereby achieving better quality results.
[0196] Example 6: Effects of ratio of stearic acid to palmitic acid on in vitro release test (IVRT) studies
[0197] In vitro release testing (IVRT) can characterize the release rate of ointment formulations in vitro, thereby inferring the release behavior of the ointment product during use. IVRT is one of the key methods for evaluating the quality and performance of semi-solid formulations (such as ointments) . IVRT can simulate the process of drug release from the ointment matrix to the site of action. The slope of the release curve in the figure can be used to obtain the rate at which the drug is released from the matrix in the ointment, and the cumulative release amount in the table can be used to detect the cumulative amount of drug released in the ointment.
[0198] IVRT was performed using a flow-through cell method with citrate buffer (pH 4.0) -isopropanol (8: 2) as the medium, at a temperature of 37℃ and a flow rate of 16 mL / min, and the release curve was determined by HPLC external standard method. The experimental results are summarized in Tables 6-7 and FIG. 1.
[0199] Table 6
[0200] Table 7
[0201] According to the above in vitro release results, as the proportion of stearic acid gradually increases, the release rate of the ointment gradually slows down. When the ratio of stearic acid to palmitic acid is 4: 16 to 10: 10 (Formulation 1 to Formulation 5) , the ointment achieves better in vitro release effect. It is speculated that the drug may be better released in the human body, thereby achieving better therapeutic effect.
[0202] Example 7: Effects of ratio of stearic acid to palmitic acid on in vitro permeation test (IVPT) studies
[0203] The assay of Franz diffusion cell was used to test in vitro permeation of the prepared semi-solid pharmaceutical compositions. The receptor solution was physiological saline with 37 ℃, and the rotation speed was 600 rpm. All receptor solutions were taken out at 0.5, 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24 hours, and an equal amount of constant temperature receptor solution was added. LC-MS / MS method was used to analysis the sample solutions, and the total cumulative amount (Q) , mean permeation rate (J) , and drug permeation rate in each diffusion cell at each sampling point were calculated throughout the study period.
[0204] The results of IVPT measurements for stearic acid : palmitic acid ranges from 10: 10 to 14:6 are shown in Tables 8-9 and FIG. 2.
[0205] Table 8
[0206] Table 9
[0207] The results of IVPT measurements for stearic acid : palmitic acid of 10: 10 and 4: 16 are shown in Tables 10-11 and FIG. 3.
[0208] Table 10
[0209] Table 11
[0210] The results of IVPT measurements for stearic acid : palmitic acid ranges from 11: 9 to 6: 14 are shown in Table 8-9 and FIG. 4.
[0211] Table 12
[0212] Table 13
[0213] In vitro permeation testing (IVPT) is a key method for evaluating the ability of topical medications such as ointments to permeate the skin barrier. Its core significance lies in simulating the permeation and absorption behavior of drugs on human skin, providing a scientific basis for the safety, efficacy, and quality consistency of products. The IVPT curve plots permeation time on the x-axis and cumulative permeation volume on the y-axis, with the slope J value representing the average permeation rate. The ratio of average permeation rates and the independent samples t-test p-value of cumulative permeation rate are used to determine whether the permeation of each tested formulation is consistent with that of a reference formulation, which is Formulation 4 in this Example.
[0214] As shown in FIG. 2 and FIG. 3, the IVPT results indicate that compared to ointments with stearic acid to palmitic acid ratios of 4: 16, 12: 8, and 14: 6, the ointment with a stearic acid: palmitic acid ratio of 10: 10 exhibits a higher average penetration rate (J) and a higher cumulative penetration volume. FIG. 4 shows that the IVPT results for ointments with stearic acid: palmitic acid ratios of 11: 9 and 6: 14 are similar to those for the 10: 10 ointment. In summary, based on the above IVPT results, ointment products achieving a better penetration rate and penetration volume within the stearic acid: palmitic acid ratio range of 6: 14 to 11: 9 yield better therapeutic effects.
[0215] Example 8: Efficacy of the ointment with the indicated stearic acid to palmitic acid ratio in rabbit CRPV model
[0216] The ointments used in the animal study had a stearic acid to palmitic acid ratio of 8: 12 to 10: 10. The methods and results of the animal efficacy experiments are as follows. Method: A skin wart lesion model was established in experimental animals by inoculating them with CRPV genomic plasmids after skin lacerations on their backs. Two weeks after plasmid inoculation, animals were given prophylactic hexaminolevulinate hydrochloride in combination with photodynamic therapy, i.e., HAL-PDT treatment. Changes in GMD values of the skin warts were monitored regularly after treatment. The endpoint of the experiment was reached 28 days after the second HAL-PDT treatment.
[0217] Results: See Table 14 below and FIG. 5.
[0218] Table 14
[0219] Conclusion: The ointment was administered prophylactically in combination with different doses of light exposure, and the GMD values of warts at the treatment sites were monitored periodically after administration. Results showed that the GMD values of warts in the Negative control group (NC group) , HAL monotherapy group, and light exposure (30 J / cm2) group gradually increased from Day 0 to Day 42. The HAL monotherapy group and light exposure (30 J / cm2) group showed a slightly higher growth trend than the NC group, but the difference was not statistically significant (p > 0.05) . Compared with the NC group, the GMD values of warts in all HAL-PDT groups were significantly reduced starting at Day 12 (p < 0.05) ; the HAL-PDT (15 J / cm2) group showed the most significant effect, with no warts appearing throughout the trial; warts appeared at two treatment sites in each of the other treatment and light exposure groups.
[0220] Therefore, when the ratio of stearic acid to palmitic acid ranges between 8: 12 to 10: 10, the combination of the ointment with instruments that provide appropriate light exposure, can achieve the desired therapeutic effect.
[0221] Example 9: Effects of ratio of stearic acid to palmitic acid on animal experiment.
[0222] The animal test method and test results were listed as follows.
[0223] Method for the Nude Mouse Experiment: Anesthetize the mice using a gas anesthesia machine; according to the administration site, draw a 1x2 cm2 area on the back of the nude mouse (near the tail) as the dosing area. Then, slowly and evenly extrude 40 μL of ointment sample onto the skin in the dosing area and spread it uniformly. After the drug is evenly applied within the dosing area, wrap the mouse with sterile dressing around once, followed by securing it with a bandage to prevent the mouse from scratching or licking the area once it regains consciousness. Post-administration, house each mouse individually in separate cages. After sampling, maintain samples in darkness or under yellow light, and store them on dry ice or at -60℃ until homogenization. Results: See Table 15 and FIG. 5.
[0224] Table 15
[0225] In this nude mouse experiment, the cumulative amount of protoporphyrin IX (PPIX) derived from the conversion of hexaminolevulinate hydrochloride in the formulation with a stearic acid to palmitic acid ratio of 10: 10 was higher than that in the formulation with a stearic acid to palmitic acid ratio of 14: 6, indicating superior fluorescence performance. The result was shown in FIG. 5.
[0226] Example 10: Effects of stearic acid / palmitic amounts on the semi-solid pharmaceutical compositions
[0227] A robustness study of the ointment formulation was conducted using a mixture of stearic acid and palmitic acid in a ratio between 8: 12 and 10: 10. The proportion of the mixture in the formulation was set at 18%, 15%, and 21%, and the key quality characteristics of the ointment were tested.
[0228] Different formulations were prepared according to Table 15 below.
[0229] Table 16
[0230] The properties were tested according to the Table 16 below.
[0231] Table 16
[0232] The above results demonstrated that the amount of the stearic acid / palmitic mixture is positively correlated with the dropping point and viscosity. When the mixture of stearic acid and palmitic acid is present in an amount of from about 14%to about 22%, more preferably from about 15%to about 21%, most preferably about 18%, both the viscosity and the dropping point exhibit favorable performance.
[0233] It will be appreciated by those skilled in the art that changes could be made to the embodiments described above without departing from the broad inventive concept thereof. It is understood, therefore, that this invention is not limited to the particular embodiments disclosed, but it is intended to cover modifications within the spirit and scope of the present inventions as defined by the specific description.
Claims
1.A semi-solid pharmaceutical comprising:a) an active ingredient selected from the group consisting of 5-aminolevulinic acid (5-ALA) , a 5-ALA precursor, a 5-ALA derivative, and a pharmaceutically acceptable salt thereof;b) one or more triglycerides; andc) a mixture of stearic acid and palmitic acid, wherein the weight ratio of the stearic acid to the palmitic acid in the mixture is between about 1: 4 to about 4: 1, preferably about 3: 7 to about 11: 9, more preferably from about 3: 7 to about 1: 1.2.The semi-solid pharmaceutical composition of claim 1, wherein the active ingredient is a compound of formula (I) or a pharmaceutically acceptable salt thereof: wherein R1 is a substituted or unsubstituted alkyl group, preferably a C1-6 alkyl group.3.The semi-solid pharmaceutical composition of claim 1 or 2, wherein the active ingredient is 5-ALA hexyl ester.4.The semi-solid pharmaceutical composition of any one of claims 1-3, wherein the active ingredient is HCl salt of 5-ALA hexyl ester.5.The semi-solid pharmaceutical composition of any one of claims 1-4, wherein the active ingredient is present in an amount of about 3%to about 7%by mass of the semi-solid pharmaceutical composition, preferably from about 4%to about 6%, more preferably about 5%.6.The semi-solid pharmaceutical composition of any one of claims 1-5, wherein the one or more triglycerides are triglycerides of glycerol and 3 identical or different C6-12 fatty acids.7.The semi-solid pharmaceutical composition of any one of claims 1-6, comprising one triglyceride which is a caprylic / capric triglyceride.8.The semi-solid pharmaceutical composition of any one of claims 1-7, wherein the one or more triglycerides are present in an amount of about 72%to about 82%by mass of the semi-solid pharmaceutical composition, preferably from about 74%to about 80%, more preferably from about 76%to about 78%, most preferably about 77%.9.The semi-solid pharmaceutical composition of any one of claims 1-8, wherein the mixture of stearic acid and palmitic acid is present in an amount of about 11%to about 25%by mass of the semi-solid pharmaceutical composition, preferably from about 14%to about 22%, more preferably from about 15%to about 21%, most preferably about 18%.10.The semi-solid pharmaceutical composition of any one of claims 1-9, which is a paste, preferably an ointment.11.A method of treating cancer, pre-cancerous conditions and non-cancerous conditions in female reproductive system, anus and penis by photodynamic treatment (PDT) , the method comprising administering an effective amount of the semi-solid pharmaceutical composition of any one of claims 1-10 to a subject in need thereof.12.The method of claim 11, wherein the method further comprises photoactivating the active ingredient in combination with a device which receives an effective amount of the semi-solid pharmaceutical composition.13.The method of claim 11 or 12, wherein the device comprises an irradiation means, such as a laser or a lamp, preferably a lamp, more preferably a LED lamp.14.The method of any one of claims 11-13, wherein the semi-solid pharmaceutical composition is contained in a drug delivery system.15.The method of claim 14, wherein the drug delivery system is selected from the group consisting of pessaries, diaphragms, caps, adhesive bandages or patches.16.The method of any one of claims 11-15, wherein the method is photodynamic treatment of dysplasia or neoplasia or human papilloma virus (HPV) infections in the female reproductive system, the anus or the penis, photodynamic treatment of endometrial, cervical, vaginal, vulvar, anal or penile dysplasia or neoplasia, or photodynamic treatment of HPV infections of the uterus, cervix, vagina, vulva, anus or penis.17.The method of claim 16, wherein the method is photodynamic treatment of cervical dysplasia, cervical neoplasia, or treatment of HPV infections of the cervix.18.The method of claim 16, wherein the method is photodynamic treatment of cervical intraepithelial neoplasia (CIN) .19.The method of claim 16, wherein the method is photodynamic treatment of HPV infections of the cervix.20.A kit comprising a drug delivery system and the semi-solid composition of any one of claims 1-10.21.The kit of claim 20, wherein the drug delivery system is selected from the group consisting of pessaries, diaphragms, caps, adhesive bandages or patches.22.The kit of claim 20 or 21, wherein the kit is used in combination with a device which receives an effective amount of the semi-solid pharmaceutical composition.23.The kit of any one of claims 20-22, wherein the device comprises an irradiation means, such as a laser or a lamp, preferably a lamp, more preferably a LED lamp.