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WO2016128912A1 - Combinaisons thérapeutiques d'un inhibiteur de btk, d'un inhibiteur de pi3k, d'un inhibiteur de jak-2, d'un inhibiteur de pd-1, et/ou d'un inhibiteur de pd-l1 - Google Patents

Combinaisons thérapeutiques d'un inhibiteur de btk, d'un inhibiteur de pi3k, d'un inhibiteur de jak-2, d'un inhibiteur de pd-1, et/ou d'un inhibiteur de pd-l1 Download PDF

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Publication number
WO2016128912A1
WO2016128912A1 PCT/IB2016/050704 IB2016050704W WO2016128912A1 WO 2016128912 A1 WO2016128912 A1 WO 2016128912A1 IB 2016050704 W IB2016050704 W IB 2016050704W WO 2016128912 A1 WO2016128912 A1 WO 2016128912A1
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WO
WIPO (PCT)
Prior art keywords
inhibitor
cancer
alkyl
pi3k
lymphoma
Prior art date
Application number
PCT/IB2016/050704
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English (en)
Inventor
Ahmed HAMDY
Wayne Rothbaum
Raquel IZUMI
Brian Lannutti
Todd Covey
Roger ULRICH
Dave Johnson
Tjeerd Barf
Allard Kaptein
Original Assignee
Acerta Pharma B.V.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from PCT/IB2015/056123 external-priority patent/WO2016024228A1/fr
Application filed by Acerta Pharma B.V. filed Critical Acerta Pharma B.V.
Publication of WO2016128912A1 publication Critical patent/WO2016128912A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/415—1,2-Diazoles
    • A61K31/4155—1,2-Diazoles non condensed and containing further heterocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/415—1,2-Diazoles
    • A61K31/416—1,2-Diazoles condensed with carbocyclic ring systems, e.g. indazole
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445—Non condensed piperidines, e.g. piperocaine
    • A61K31/4523—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems
    • A61K31/454—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems containing a five-membered ring with nitrogen as a ring hetero atom, e.g. pimozide, domperidone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings

Definitions

  • PD- 1 programmed death 1
  • PD-Ll or PD-L2 PD-1 ligand
  • BTK Bruton's tyrosine kinase
  • JAK-2 Janus kinase 2
  • PI3K phosphoinositide 3 -kinase
  • BTK Bruton's tyrosine kinase
  • BCR B cell receptor
  • BTK is expressed in numerous B cell lymphomas and leukemias.
  • Other diseases with an important role for dysfunctional B cells are B cell malignancies, as described in Hendriks, et al. , Nat. Rev. Cancer, 2014, 14, 219-231.
  • the reported role for BTK in the regulation of proliferation and apoptosis of B cells indicates the potential for BTK inhibitors in the treatment of B cell lymphomas.
  • BTK inhibitors have thus been developed as potential therapies for many of these malignancies, as described in D'Cruz, et ah, OncoTargets and Therapy 2013, 6, 161-176.
  • PD-1 Programmed death 1
  • PD-1 is a 288-amino acid transmembrane
  • PD-1 which is also known as CD279, is an immunoreceptor belonging to the CD28 family and in humans is encoded by the Pdcdl gene on chromosome 2.
  • PD-1 consists of one immunoglobulin (Ig) superfamily domain, a transmembrane region, and an intracellular domain containing an Ig protein
  • ITIM immunoreceptor tyrosine-based inhibitory motif
  • ITMS immunoreceptor tyrosine-based switch motif
  • PD-1 and its ligands (PD-L1 and PD-L2) play a key role in immune tolerance, as described in Keir, et al., Annu. Rev. Immunol. 2008, 26, 677-704.
  • PD-1 provides inhibitory signals that negatively regulate T cell immune responses.
  • PD- Ll also known as B7-H1 or CD274
  • PD-L2 also known as B7-DC or CD273 are expressed on tumor cells and stromal cells, which may be encountered by activated T cells expressing PD-1, leading to immunosuppression of the T cells.
  • PD-L1 is a 290 amino acid transmembrane protein encoded by the Cd274 gene on human chromosome 9. Blocking the interaction between PD-1 and its ligands PD-L1 and PD-L2 by use of a PD- 1 inhibitor, a PD-L1 inhibitor, and/or a PD-L2 inhibitor can overcome immune resistance, as demonstrated in recent clinical studies, such as that described in Topalian, et ah, N. Eng. J. Med. 2012, 366, 2443. PD-L1 is expressed on many tumor cell lines, while PD-L2 is expressed is expressed mostly on dendritic cells and a few tumor lines. In addition to T cells (which inducibly express PD-1 after activation), PD-1 is also expressed on B cells, natural killer cells, macrophages, activated monocytes, and dendritic cells.
  • the supportive microenvironment (which may make up the majority of the tumor mass) is a dynamic force that enables tumor survival.
  • the tumor microenvironment is generally defined as a complex mixture of "cells, soluble factors, signaling molecules, extracellular matrices, and mechanical cues that promote neoplastic transformation, support tumor growth and invasion, protect the tumor from host immunity, foster therapeutic resistance, and provide niches for dominant metastases to thrive," as described in Swartz, et ah, Cancer Res., 2012, 72, 2473.
  • tumors express antigens that should be recognized by T cells, tumor clearance by the immune system is rare because of immune suppression by the microenvironment. Addressing the tumor cells themselves with e.g.
  • the supportive microenvironment also plays a critical role in many B cell cancers such as acute leukemias, myelodysplastic syndromes, chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL), mucosa-associated lymphoid tissue (MALT) lymphomas, and multiple myeloma (MM).
  • CLL and SLL cells rapidly accumulate and are resistant to apoptosis in vivo, but are known to die rapidly in vitro.
  • PI3K inhibitors are members of a unique and conserved family of intracellular lipid kinases that phosphorylate the 3'-OH group on phosphatidylinositols or
  • PI3K inhibitors are key signaling enzymes that relay signals from cell surface receptors to downstream effectors.
  • the PI3K family comprises 15 kinases with distinct substrate specificities, expression patterns, and modes of regulation.
  • the class I PI3K inhibitors (pi 10a, pi 10 ⁇ , pi 105, and pi 10 ⁇ ) are typically activated by tyrosine kinases or G-protein coupled receptors to generate PIP3, which engages downstream effectors such as those in the Akt/PDKl pathway, mTOR, the Tec family kinases, and the Rho family GTPases.
  • the PI3K signaling pathway is known to be one of the most highly mutated in human cancers. PI3K signaling is also a key factor in disease states including hematologic malignancies, non-Hodgkin's lymphoma (such as diffuse large B-cell lymphoma), allergic contact dermatitis, rheumatoid arthritis, osteoarthritis, inflammatory bowel diseases, chronic obstructive pulmonary disorder, psoriasis, multiple sclerosis, asthma, disorders related to diabetic complications, and inflammatory complications of the cardiovascular system such as acute coronary syndrome.
  • the role of PI3K in cancer has been discussed, for example, in Engleman, Nat. Rev. Cancer 2009, 9, 550-562.
  • the PI3K-5 and ⁇ 3 ⁇ - ⁇ isoforms are preferentially expressed in normal and malignant leukocytes.
  • the delta ( ⁇ ) isoform of class I PI3K (PI3K-5) is involved in mammalian immune system functions such as T-cell function, B-cell activation, mast cell activation, dendritic cell function, and neutrophil activity. Due to its role in immune system function, PI3K-5 is also involved in a number of diseases related to undesirable immune response such as allergic reactions, inflammatory diseases, inflammation mediated angiogenesis, rheumatoid arthritis, auto-immune diseases such as lupus, asthma, emphysema and other respiratory diseases.
  • diseases related to undesirable immune response such as allergic reactions, inflammatory diseases, inflammation mediated angiogenesis, rheumatoid arthritis, auto-immune diseases such as lupus, asthma, emphysema and other respiratory diseases.
  • the gamma ( ⁇ ) isoform of class I PI3K ( ⁇ 3 ⁇ - ⁇ ) is also involved in immune system functions and plays a role in leukocyte signaling and has been implicated in inflammation, rheumatoid arthritis, and autoimmune diseases such as lupus.
  • Downstream mediators of the PI3K signal transduction pathway include Akt and mammalian target of rapamycin (mTOR).
  • Akt mammalian target of rapamycin
  • mTOR mammalian target of rapamycin
  • Akt is a serine-threonine kinase related to the lipid kinases of the PI3K family and has been implicated in a wide range of biological processes including cell growth, cell proliferation, cell motility and survival. Disregulation of the mTOR pathway has been reported in various types of cancer.
  • PI3K inhibitors are prime targets for drug development, as described in Kurt, et ah, Anticancer Res. 2012, 32, 2463-70.
  • PI3K inhibitors are prime targets for drug development, as described in Kurt, et ah, Anticancer Res. 2012, 32, 2463-70.
  • PI3K inhibitors are known, including those that are PI3K-5 inhibitors, ⁇ 3 ⁇ - ⁇ inhibitors
  • the present invention includes the unexpected discovery that combinations of a BTK inhibitor, a PD-1 inhibitor, and/or a PI3K inhibitor exhibit surprising and synergistic effectiveness in the treatment of any of several types of cancers such as solid tumor cancers and hematological cancers, as well as other disorders.
  • the present invention also includes the unexpected discovery that the combination of a PD-1 inhibitor and a BTK inhibitor is effective and synergistic in the treatment of any of several types of cancers such as solid tumor cancers.
  • the present invention further includes the unexpected discovery that the combination of a PD-1 inhibitor and a PI3K inhibitor is effective and synergistic in the treatment of any of several types of cancers such as solid tumor cancers.
  • the present invention additionally includes the unexpected discovery that combinations of a BTK inhibitor, a PD-1 inhibitor (such as an anti-PD-1 antibody) and/or a PD-L1 inhibitor (such as an anti-PD-Ll antibody), and/or a PI3K inhibitor exhibit surprising synergy in the suppression of the supportive solid tumor microenvironment.
  • a BTK inhibitor such as an anti-PD-1 antibody
  • a PD-L1 inhibitor such as an anti-PD-Ll antibody
  • a PI3K inhibitor exhibit surprising synergy in the suppression of the supportive solid tumor microenvironment.
  • the invention provides a method of treating a
  • hyperproliferative disease in a subject comprising co-administering to a mammal in need thereof a therapeutically effective amount of a PD-1 inhibitor and/or a PD-L1 inhibitor and a BTK inhibitor.
  • the invention provides a method of treating leukemia, lymphoma or a solid tumor cancer in a subject, comprising co-administering to a mammal in need thereof a therapeutically effective amount of a PD-1 inhibitor and/or a PD-L1 inhibitor and a BTK inhibitor.
  • the invention provides a method of treating leukemia, lymphoma or a solid tumor cancer in a subject, comprising co-administering to a mammal in need thereof a therapeutically effective amount of a PI3K inhibitor, a PD-1 inhibitor and/or a PD-L1 inhibitor, and a BTK inhibitor.
  • the invention provides a method of treating leukemia, lymphoma or a solid tumor cancer in a subject, comprising co-administering to a mammal in need thereof a therapeutically effective amount of a ⁇ 3 ⁇ - ⁇ inhibitor, a PD-1 inhibitor and/or a PD-L1 inhibitor, and a BTK inhibitor.
  • the invention provides a method of treating leukemia, lymphoma or a solid tumor cancer in a subject, comprising co-administering to a mammal in need thereof a therapeutically effective amount of a PI3K-5 inhibitor, a PD-1 inhibitor and/or a PD-L1 inhibitor, and a BTK inhibitor.
  • the invention provides a method of treating leukemia, lymphoma or a solid tumor cancer in a subject, comprising co-administering to a mammal in need thereof a therapeutically effective amount of a ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor, a PD- 1 inhibitor and/or a PD-L1 inhibitor, and a BTK inhibitor.
  • the invention provides a method of treating leukemia, lymphoma, or a solid tumor cancer in a subject, comprising co-administering to a mammal in need thereof a therapeutically effective amount of a PD-1 inhibitor and/or a PD-L1 inhibitor and a BTK inhibitor, and further comprises the step of administering a therapeutically effective amount of an anti-CD20 antibody selected from the group
  • 131 consisting of rituximab, obinutuzumab, ofatumumab, veltuzumab, tositumomab, I- tositumomab, ibritumomab, 90 Y-ibritumomab, ul In-ibritumomab, ibritumomab tiuxetan, and fragments, derivatives, conjugates, variants, radioisotope-labeled complexes, and biosimilars thereof.
  • the invention provides a method of treating leukemia, lymphoma, or a solid tumor cancer in a subject, comprising co-administering to a mammal in need thereof a therapeutically effective amount of a PI3K inhibitor, a PD-1 inhibitor and/or a PD-L1 inhibitor, and a BTK inhibitor, and further comprises the step of administering a therapeutically effective amount of an anti-CD20 antibody selected from the group consisting of rituximab, obinutuzumab, ofatumumab, veltuzumab, tositumomab, 13 ⁇ -tositumomab, ibritumomab, 90 Y-ibritumomab, ul In-ibritumomab, ibritumomab tiuxetan, and fragments, derivatives, conjugates, variants, radioisotope- labeled complexes, and bio
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-Ll inhibitor or an antigen-binding fragment, variant, or conjugate thereof; and (2) a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • This composition is typically a pharmaceutical composition.
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-Ll inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a PI3K inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • This composition is typically a pharmaceutical composition.
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-Ll inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a PI3K-5 inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • This composition is typically a pharmaceutical composition.
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-Ll inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) an anti-coagulant or antiplatelet active
  • composition is typically a pharmaceutical composition.
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-Ll inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a PI3K inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (4) an anti-coagulant or antiplatelet active pharmaceutical ingredient.
  • This composition is typically a
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-L1 inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a PI3K-5 inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (4) an anti-coagulant or antiplatelet active pharmaceutical ingredient.
  • This composition is typically a
  • the anti- coagulant or the anti-platelet active pharmaceutical ingredient in some specific embodiments is a compound selected from the group consisting of
  • the invention provides a kit comprising (1) a PD-1 inhibitor and/or a PD-L1 inhibitor or an antigen-binding fragment, variant, or conjugate thereof; and (2) a composition comprising a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • These compositions are typically pharmaceutical compositions.
  • the kit is for co-administration of a PD-1 and/or PD-L1 inhibitor and a BTK inhibitor, either simultaneously or separately.
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-L1 inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a composition comprising a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a composition comprising a PI3K inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • These compositions are typically pharmaceutical compositions.
  • the kit is for co-administration of PD-1 and/or PD-L1 inhibitor, a BTK inhibitor, and a PI3K inhibitor, either simultaneously or separately.
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-L1 inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a composition comprising a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a composition comprising a PI3K-5 inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • These compositions are typically pharmaceutical compositions.
  • the kit is for co-administration of a PD-1 and/or a PD-L1 inhibitor, a BTK inhibitor, and an anticoagulant or antiplatelet active pharmaceutical ingredient, either simultaneously or separately.
  • the invention provides a composition comprising (1) a PD-1 inhibitor and/or a PD-L1 inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a composition comprising a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) an anti-coagulant or antiplatelet active pharmaceutical ingredient.
  • These compositions are typically pharmaceutical compositions.
  • the kit is for co-administration of a PD-1 and/or a PD-L1 inhibitor, a BTK inhibitor, and an anti- coagulant or antiplatelet active pharmaceutical ingredient, either simultaneously or separately.
  • the invention provides a composition comprising (1) a composition comprising a PD-1 inhibitor and/or a PD-L1 inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a composition comprising a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a composition comprising a PI3K inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (4) an anti-coagulant or antiplatelet active pharmaceutical ingredient.
  • These compositions are typically pharmaceutical compositions.
  • the kit is for co-administration of a PI3K-5 inhibitor and an anticoagulant or antiplatelet active pharmaceutical ingredient, either simultaneously or separately.
  • the invention provides a composition comprising (1) a composition comprising a PD-1 inhibitor and/or a PD-Ll inhibitor or an antigen-binding fragment, variant, or conjugate thereof; (2) a composition comprising a BTK inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (3) a composition comprising a PI3K-5 inhibitor or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof; and (4) an anti-coagulant or antiplatelet active pharmaceutical ingredient.
  • These compositions are typically pharmaceutical compositions.
  • the kit is for co-administration of a PD-1 and/or a PD-Ll inhibitor, a BTK inhibitor, a PI3K-5 inhibitor, and an anti-coagulant or antiplatelet active pharmaceutical ingredient.
  • compositions and the kits disclosed herein are for use in treating cancer.
  • a B cell hematological malignancy selected from the hematological malignancy is selected from the group consisting of chronic lymphocytic leukemia (CLL), small lymphocytic leukemia (SLL), non-Hodgkin's lymphoma (NHL), diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), mantle cell lymphoma (MCL), Hodgkin's lymphoma, B cell acute lymphoblastic leukemia (B-ALL), Burkitt's lymphoma,
  • CLL chronic lymphocytic leukemia
  • SLL small lymphocytic leukemia
  • NHL non-Hodgkin's lymphoma
  • DLBCL diffuse large B cell lymphoma
  • FL mantle cell lymphoma
  • NHL B cell acute lymphoblastic leukemia
  • Burkitt's lymphoma Burkitt'
  • W Waldenstrom's macroglobulinemia
  • MM multiple myeloma
  • myelofibrosis
  • compositions and the kits disclosed herein are for use in treating a cancer selected from the group consisting of bladder cancer, squamous cell carcinoma including head and neck cancer, pancreatic ductal adenocarcinoma (PDA), pancreatic cancer, colon carcinoma, mammary carcinoma, breast cancer, fibrosarcoma, mesothelioma, renal cell carcinoma, lung carcinoma, thyoma, prostate cancer, colorectal cancer, ovarian cancer, acute myeloid leukemia, thymus cancer, brain cancer, squamous cell cancer, skin cancer, eye cancer, retinoblastoma, melanoma, intraocular melanoma, oral cavity and oropharyngeal cancers, gastric cancer, stomach cancer, cervical cancer, head, neck, renal cancer, kidney cancer, liver cancer, ovarian cancer, prostate cancer, colorectal cancer, esophageal cancer, testicular cancer, gynecological cancer, thyroid cancer
  • a cancer selected from the group
  • compositions and the kits disclosed herein are for use in treating a solid tumor cancer selected from the group consisting of bladder cancer, non-small cell lung cancer, cervical cancer, anal cancer, pancreatic cancer, squamous cell carcinoma including head and neck cancer, renal cell carcinoma, melanoma, ovarian cancer, small cell lung cancer, glioblastoma, glioma, gastrointestinal stromal tumor, breast cancer, lung cancer, colorectal cancer, thyroid cancer, bone sarcoma, stomach cancer, oral cavity cancer, oropharyngeal cancer, gastric cancer, kidney cancer, liver cancer, prostate cancer, colorectal cancer, esophageal cancer, testicular cancer, gynecological cancer, thyroid cancer, colon cancer, and brain cancer.
  • a solid tumor cancer selected from the group consisting of bladder cancer, non-small cell lung cancer, cervical cancer, anal cancer, pancreatic cancer, squamous cell carcinoma including head and neck cancer, renal cell carcinoma, melanoma, ovarian cancer, small
  • compositions and the kits disclosed herein are for use in treating a solid tumor cancer, wherein the compositions are in a dosage that is effective in inhibiting signaling between the cells of the solid tumor cancer and at least one tumor microenvironment selected from the group consisting of macrophages, monocytes, mast cells, helper T cells, cytotoxic T cells, regulatory T cells, natural killer cells, myeloid- derived suppressor cells, regulatory B cells, neutrophils, dendritic cells, and fibroblasts.
  • tumor microenvironment selected from the group consisting of macrophages, monocytes, mast cells, helper T cells, cytotoxic T cells, regulatory T cells, natural killer cells, myeloid- derived suppressor cells, regulatory B cells, neutrophils, dendritic cells, and fibroblasts.
  • compositions and the kits disclosed herein are for use in treating a solid tumor cancer, wherein the compositions are in a dosage that is effective in increasing immune system recognition and rejection of the solid tumor by the human body receiving the treatment.
  • compositions and the kits disclosed herein are for use in treating cancer, wherein the PD-1 and/or PD-Ll inhibitor is administered before administration of the BTK inhibitor.
  • compositions and the kits disclosed herein are for use in treating cancer, wherein the PD-1 and/or PD-Ll inhibitor is administered concurrently with the administration of the BTK inhibitor.
  • compositions and the kits disclosed herein are for use in treating cancer, wherein the PD-1 and/or PD-Ll inhibitor is administered to the subject after administration of the BTK inhibitor.
  • FIG. 1 illustrates the sensitivity of the TMD8 diffuse large B cell lymphoma (DLBCL) cell line to individual treatment with the BTK inhibitor of Formula XVTII ("Tested Btk Inhibitor") and the PI3K inhibitor of Formula IX (“Tested PI3K Inhibitor”) and combined treatment with Formula XVTII and Formula IX (“Btki + PI3Ki”) at different concentrations.
  • BTK inhibitor the concentration of the individual active pharmaceutical ingredients
  • concentration of the individual active pharmaceutical ingredients is given on the x-axis
  • concentration of the added PI3K inhibitor in combination with the BTK inhibitor is given in the legend.
  • FIG. 2 illustrates the sensitivity of the MINO mantle cell lymphoma cell to individual treatment with the BTK inhibitor of Formula XVTII ("Tested Btk Inhibitor") and the PI3K inhibitor of Formula IX (“Tested PI3K Inhibitor”) and combined treatment with Formula XVTII and Formula IX (“Btki + PI3Ki”) at different concentrations.
  • the concentration of the first active pharmaceutical ingredient in the combination (the BTK inhibitor) and the concentration of the individual active pharmaceutical ingredients is given on the x-axis, and the concentration of the added PI3K inhibitor in combination with the BTK inhibitor is given in the legend.
  • FIG. 3 illustrates the proproliferative activity in primary mantle cell lymphoma cells of Formula XVIII (“Tested Btki”) and Formula IX (“Tested ⁇ 3 ⁇ ).
  • the percentage viability of cells (“% viability", y-axis) is plotted versus the concentration of the active pharmaceutical ingredient or active pharmaceutical ingredients.
  • Single-active pharmaceutical ingredient BTK (“Tested Btki”) and PI3K inhibitors (“Tested PI3Ki”) are compared to four combinations of Formula XVTII and Formula IX (“(10 ⁇ ) Tested ⁇ 3 ⁇ , "1.0 ⁇ Tested PI3Ki,” “0.1 ⁇ Tested PI3Ki,” “0.01 ⁇ Tested ⁇ 3 ⁇ ).
  • FIG. 4 illustrates the interaction index of the combination of the BTK inhibitor of Formula XVTII and the PI3K inhibitor of Formula IX in primary mantle cell lymphoma cells from different patients (MCL-1 to MCL-5). Each symbol represents a concentration from 10 uM to 0.0001 uM.
  • FIG. 5 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the PI3K-5 inhibitor of Formula IX are combined.
  • the tested cell lines include Maver-1 (B cell lymphoma, mantle), Jeko (B cell lymphoma, mantle), CCRF (B lymphoblast, acute lymphoblastic leukemia), and SUP-B15 (B lymphoblast, acute lymphoblastic leukemia).
  • the dose-effect curves for these cell lines are given in FIG. 6, FIG. 7, FIG. 8, and FIG. 9.
  • ED25, ED50, ED75, and ED90 refer to the effective doses causing 25%, 50%, 75%, and 90% of the maximum biological effect (proliferation).
  • FIG. 6 illustrates the dose-effect curves obtained for the tested Maver-1 cell line (B cell lymphoma, mantle) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1") and the PI3K-5 inhibitor of Formula IX ("Inh.3").
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 7 illustrates the dose-effect curves obtained for the tested Jeko cell line (B cell lymphoma, mantle) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 8 illustrates the dose-effect curves obtained for the tested CCRF cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 9 illustrates the dose-effect curves obtained for the tested SUP-B15 cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the PI3K-5 inhibitor of Formula IX ("Inh.3").
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 10 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the PI3K-5 inhibitor of Formula IX are combined.
  • the tested cell lines include Jeko (B cell lymphoma, mantle) and SU-DHL-4 (diffuse large B cell lymphoma, ABC).
  • Jeko B cell lymphoma, mantle
  • SU-DHL-4 diffuse large B cell lymphoma, ABC
  • FIG. 11 illustrates the dose-effect curves obtained for the tested Jeko cell line (B cell lymphoma, mantle) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the PI3K-5 inhibitor of Formula IX ("Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 12 illustrates the dose-effect curves obtained for the tested SU-DHL-4 cell line (diffuse large B cell lymphoma, ABC) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1") and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 13 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the PI3K-5 inhibitor of Formula IX are combined.
  • the tested cell lines include CCRF (B lymphoblast, acute lymphoblastic leukemia), SUP-B15 (B lymphoblast, acute lymphoblastic leukemia), JVM-2 (prolymphocytic leukemia), Ramos (Burkitt's lymphoma), and Mino (mantle cell lymphoma).
  • the dose-effect curves for these cell lines are given in FIG. 14, FIG. 15, FIG. 16, and FIG. 17. No dose-effect curve is given for Ramos (Burkitt's lymphoma) because of negative slope.
  • FIG. 14 illustrates the dose-effect curves obtained for the tested CCRF cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 15 illustrates the dose-effect curves obtained for the tested SUP-B15 cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 16 illustrates the dose-effect curves obtained for the tested JVM-2 cell line (prolymphocytic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 17 illustrates the dose-effect curves obtained for the tested Mino cell line (mantle cell lymphoma) using combined dosing of the BTK inhibitor of Formula XVQI ("Inh.1”) and the PI3K-5 inhibitor of Formula IX ("Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 18 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the PI3K-5 inhibitor of Formula IX are combined.
  • the tested cell lines include Raji (B lymphocyte, Burkitt's lymphoma), SU-DHL-1 (DLBCL- ABC), and Pfeiffer (follicular lymphoma).
  • the dose-effect curves for these cell lines are given in FIG. 19, FIG. 20, and FIG. 21.
  • FIG. 20 illustrates the dose-effect curves obtained for the tested SU-DHL-1 cell line (Activated B-cell like diffuse large B-cell lymphoma, DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 21 illustrates the dose-effect curves obtained for the tested Pfeiffer cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the PI3K-5 inhibitor of Formula IX ("Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 22 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the PI3K-5 inhibitor of Formula IX are combined.
  • the tested cell lines include Lyl (Germinal center B-cell like diffuse large B-cell lymphoma, DLBCL-GCB), Ly7 (DLBCL-GCB), Lyl 9 (DLBCL-GCB), SU-DHL-2 (Activated B- cell like diffuse large B-cell lymphoma, DLBCL-ABC), and DOHH2 (follicular lymophoma, FL).
  • the dose-effect curves for these cell lines are given in FIG. 23, FIG. 24, FIG. 25, and FIG. 26, except for the Lyl 9 cell line, which is not graphed because of a negative slope.
  • FIG. 23 illustrates the dose-effect curves obtained for the tested Lyl cell line (DLBCL-GCB) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l”) and the PI3K-5 inhibitor of Formula IX ("Inh.3").
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 24 illustrates the dose-effect curves obtained for the tested Ly7 cell line (DLBCL-GCB) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l”) and the PI3K-5 inhibitor of Formula IX ("Inh.3").
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 25 illustrates the dose-effect curves obtained for the tested DOHH2 cell line (FL) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the PI3K-5 inhibitor of Formula IX ("Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 26 illustrates the dose-effect curves obtained for the tested SU-DHL-2 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 27 illustrates the synergy observed in certain cell lines when Formula XVTII and Formula IX are combined.
  • the tested cell lines include U937 (histiocytic lymphoma and/or myeloid), K562 (leukemia, myeloid, and/or chronic myelogenous leukemia), Daudi (human Burkitt's lymphoma), and SU-DHL-6 (DLBCL-GCB and/or peripheral T-cell lymphoma, PTCL).
  • the dose-effect curves for these cell lines are given in FIG. 28, FIG. 29, FIG. 30, and FIG. 31.
  • FIG. 28 illustrates the dose-effect curves obtained for the tested U937 cell line (histiocytic lymphoma and/or myeloid) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.l”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 29 illustrates the dose-effect curves obtained for the tested K562 cell line (leukemia, myeloid, and/or chronic myelogenous leukemia) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 30 illustrates the dose-effect curves obtained for the tested Daudi cell line (human Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1") and the PI3K-5 inhibitor of Formula IX ("Inh.3").
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 31 illustrates the dose-effect curves obtained for the tested SU-DHL-6 cell line (DLBCL-GCB and/or PTCL) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.l”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 32 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the PI3K-5 inhibitor of Formula IX are combined.
  • the tested cell lines include SU-DHL-6 (DLBCL-GCB or PTCL), TMD-8 (DLBCL-ABC), HBL-1 (DLBCL-ABC), and Rec-1 (follicular lymphoma).
  • the dose-effect curves for these cell lines are given in FIG. 34, FIG. 35, FIG. 36, and FIG. 37.
  • FIG. 33 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the PI3K-5 inhibitor of Formula IX are combined.
  • the tested cell lines include SU-DHL-6 (DLBCL-GCB or PTCL), TMD-8 (DLBCL-ABC), HBL-1 (DLBCL-ABC), and Rec-1 (follicular lymphoma). All corresponding CIs are shown for each of the combinations tested as listed on the x axis.
  • FIG. 34 illustrates the dose-effect curves obtained for the tested SU-DHL-6 cell line (DLBCL-GCB or PTCL) cell line using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.l”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 35 illustrates the dose-effect curves obtained for the tested TMD-8 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the PI3K-5 inhibitor of Formula IX ("Inh.3").
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 36 illustrates the dose-effect curves obtained for the tested HBL-1 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the PI3K-5 inhibitor of Formula IX ("Inh.3").
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 37 illustrates the dose-effect curves obtained for the tested Rec-1 cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the PI3K-5 inhibitor of Formula IX (“Inh.3”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 38 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the JAK-2 inhibitor of Formula XXX (ruxolitinib) are combined.
  • the tested cell lines included Maver-1 (B cell lymphoma, mantle), Jeko (B cell lymphoma, mantle), SUP-B15 (B lymphoblast, acute lymphoblastic leukemia), and CCRF (B lymphoblast, acute lymphoblastic leukemia).
  • the dose-effect curves for these cell lines are given in FIG. 39, FIG. 40, FIG. 41, and FIG. 42.
  • FIG. 39 illustrates the dose-effect curves obtained for the tested Maver-1 cell line (B cell lymphoma, mantle) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 40 illustrates the dose-effect curves obtained for the tested Jeko cell line (B cell lymphoma, mantle) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 41 illustrates the dose-effect curves obtained for the tested SUP-B15 cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x- axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 42 illustrates the dose-effect curves obtained for the tested CCRF cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.
  • FIG. 43 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the JAK-2 inhibitor of Formula XXX (ruxolitinib) are combined.
  • SUP-B15 B lymphoblast, acute lymphoblastic leukemia
  • CCRF B lymphoblast, acute lymphoblastic leukemia
  • FIG. 44 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the JAK-2 inhibitor of Formula XXX (ruxolitinib) are combined.
  • the tested cell lines included JVM-2 (prolymphocytic leukemia), Raji (B lymphocyte, Burkitt's lymphoma), Ramos (B lymphocyte, Burkitt's lymphoma), and Mino (mantle cell lymphoma).
  • JVM-2 prolymphocytic leukemia
  • Raji B lymphocyte, Burkitt's lymphoma
  • Ramos B lymphocyte, Burkitt's lymphoma
  • Mino mantle cell lymphoma
  • FIG. 45 illustrates the dose-effect curves obtained for the tested JVM-2 cell line (prolymphocytic leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 46 illustrates the dose-effect curves obtained for the tested Raji cell line (B lymphocyte, Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.l”) and the JAK-2 inhibitor of Formula XXX ("Inh.2”)
  • FIG. 47 illustrates the dose-effect curves obtained for the tested Ramos cell line (B lymphocyte, Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.l”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x- axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 48 illustrates the dose-effect curves obtained for the tested Mino cell line (mantle cell lymphoma) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 49 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVIII and the JAK-2 inhibitor of Formula XXX (ruxolitinib) are combined.
  • the tested cell lines included Pfeiffer (follicular lymphoma) and SU-DHL-1 (DLBCL-ABC). The dose-effect curves for these cell lines are given in FIG. 50 and FIG. 51.
  • FIG. 50 illustrates the dose-effect curves obtained for the tested Pfeiffer cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 51 illustrates the dose-effect curves obtained for the tested SU-DHL-1 cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 52 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVIII and the JAK-2 inhibitor of Formula XXX (ruxolitinib) are combined.
  • the tested cell lines included DOHH2 (follicular lymphoma), SU-DHL-1 (DLBCL-ABC), Lyl (DLBCL-GCB), Ly7 (DLBCL-GCB), and Lyl9 (DLBCL-GCB).
  • the dose-effect curves for these cell lines are given in FIG. 53, FIG. 54, FIG. 55, and FIG. 56, except for the Lyl 9 cell line, which is not graphed because of a negative slope.
  • FIG. 53, FIG. 54, FIG. 55, and FIG. 56 except for the Lyl 9 cell line, which is not graphed because of a negative slope.
  • FIG. 54 illustrates the dose-effect curves obtained for the tested SU-DHL-1 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 55 illustrates the dose-effect curves obtained for the tested Lyl cell line (DLBCL-GCB) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 56 illustrates the dose-effect curves obtained for the tested Ly7 cell line (DLBCL-GCB) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 57 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the JAK-2 inhibitor of Formula XXX (ruxolitinib) are combined.
  • the tested cell lines included U937 (histiocytic lymphoma), Daudi (human Burkitt's lymphoma), and K562 (leukemia, myeloid, and/or chronic myelogenous leukemia).
  • the dose-effect curves for these cell lines are given in FIG. 58, FIG. 59, and FIG. 60.
  • FIG. 58 illustrates the dose-effect curves obtained for the tested U937 cell line (histiocytic lymphoma) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 59 illustrates the dose-effect curves obtained for the tested Daudi cell line (human Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitimb).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 60 illustrates the dose-effect curves obtained for the tested K562 cell line (leukemia, myeloid, and/or chronic myelogenous leukemia) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh. l") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 61 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula XVTII and the JAK-2 inhibitor of Formula XXX (ruxolitinib) are combined.
  • the tested cell lines include SU-DHL-6 (DLBCL-GCB or PTCL), TMD-8 (DLBCL-ABC), HBL-l (DLBCL-ABC), and Rec-1 (follicular lymphoma).
  • the dose- effect curves for these cell lines are given in FIG. 62, FIG. 63, FIG. 64, and FIG. 65.
  • FIG. 62 illustrates the dose-effect curves obtained for the tested SU-DHL-6 cell line (DLBCL-GCB or PTCL) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh.1”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 63 illustrates the dose-effect curves obtained for the tested TMD-8 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 64 illustrates the dose-effect curves obtained for the tested HBL-l cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula XVTII ("Inh. l") and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 65 illustrates the dose-effect curves obtained for the tested Rec-1 cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula XVIII ("Inh.1”) and the JAK-2 inhibitor of Formula XXX (“Inh.2”) (ruxolitinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 66 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula (XVIII) and the JAK-2 inhibitor of Formula LIV (pacritinib) are combined.
  • the tested cell lines include Mino (mantle cell lymphoma), Maver-1 (B cell lymphoma, mantle cell lymophoma), Raji (B lymphocyte, Burkitt's lymphoma), JVM-2 (pro lymphocytic leukemia), Daudi (Human Burkitt's lymphoma), Rec-1 (follicular lymphoma), SUP-B15 (B lymphoblast, acute lymphoblastic leukemia), CCRF (B lymphoblast, acute lymphoblastic leukemia), and SU-DHL-4 (DLBCL-ABC).
  • the dose- effect curves for these cell lines are given in FIG. 67, FIG. 68, FIG. 69, FIG. 70, FIG. 71, FIG. 72, FIG. 73, FIG. 74, and FIG
  • FIG. 67 illustrates the dose-effect curves obtained for the tested Mino cell line (mantle cell lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 68 illustrates the dose-effect curves obtained for the tested Maver-1 cell line (B cell lymphoma, mantle cell lymophoma) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x- axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 69 illustrates the dose-effect curves obtained for the tested Raji cell line (B lymphocyte, Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 70 illustrates the dose-effect curves obtained for the tested JVM-2 cell line (pro lymphocytic leukemia) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacntinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 71 illustrates the dose-effect curves obtained for the tested Daudi cell line (human Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacntinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 72 illustrates the dose-effect curves obtained for the tested Rec-1 cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula (XVQI) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 73 illustrates the dose-effect curves obtained for the tested SUP-B15 cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x- axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 74 illustrates the dose-effect curves obtained for the tested CCRF cell line (B lymphoblast, acute lymphoblastic leukemia) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x- axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 75 illustrates the dose-effect curves obtained for the tested SU-DHL-4 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 76 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula (XVTII) and the JAK-2 inhibitor of Formula LIV (pacritinib) are combined.
  • the tested cell lines include EB3 (B lymphocyte, Burkitt's lymphoma), CA46 (B lymphocyte, Burkitt's lymphoma), DB (B cell lymphoma, mantle cell lymphoma), Pfeiffer (follicular lymphoma), DOHH2 (follicular lymphoma), Namalwa (B lymphocyte, Burkitt's lymphoma), JVM- 13 (B cell lymphoma, mantle cell lymphoma), SU-DHL-1 (DLBCL-ABC), and SU-DHL-2 (DLBCL-ABC).
  • the dose-effect curves for these cell lines are given in FIG. 77, FIG. 78, FIG. 79, FIG. 80, FIG. 81, FIG. 82, FIG. 83,
  • FIG. 77 illustrates the dose-effect curves obtained for the tested EB3 cell line (B lymphocyte, Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 78 illustrates the dose-effect curves obtained for the tested CA46 cell line (B lymphocyte, Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 79 illustrates the dose-effect curves obtained for the tested DB cell line (B cell lymphoma, mantle cell lymphoma) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh. l”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 80 illustrates the dose-effect curves obtained for the tested Pfeiffer cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 81 illustrates the dose-effect curves obtained for the tested DOHH2 cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacntinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 82 illustrates the dose-effect curves obtained for the tested Namalwa cell line (B lymphocyte, Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacntinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 83 illustrates the dose-effect curves obtained for the tested JVM-13 cell line (B cell lymphoma, mantle cell lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x- axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 84 illustrates the dose-effect curves obtained for the tested SU-DHL-1 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 85 illustrates the dose-effect curves obtained for the tested SU-DHL-2 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 86 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula (XVTII) and the JAK-2 inhibitor of Formula LIV (pacritinib) are combined.
  • the tested cell lines include Jeko (B cell lymphoma, mantle cell lymphoma), TMD-8 (DLBCL-ABC), SU-DHL6 (DLBCL-GCB), Ramos (human Burkitt's
  • lymphoma HBL-l (DLBCL-ABC), SU-DHL-10 (DLBCL-GCB), OCI-Ly7 (DLBCL- ABC), and OCI-Ly3 (DLBCL-ABC).
  • the dose-effect curves for these cell lines are given in FIG. 87, FIG. 88, FIG. 89, FIG. 90, FIG. 91, FIG. 92, FIG. 93, and FIG. 94.
  • FIG. 87 illustrates the dose-effect curves obtained for the tested Jeko cell line (B cell lymphoma, mantle cell lymphoma) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacntinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 88 illustrates the dose-effect curves obtained for the tested TMD-8 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 89 illustrates the dose-effect curves obtained for the tested SU-DHL6 cell line (DLBCL-GCB) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 90 illustrates the dose-effect curves obtained for the tested Ramos cell line (human Burkitt's lymphoma) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 91 illustrates the dose-effect curves obtained for the tested HBL-l cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XVTII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • 92 illustrates the dose-effect curves obtained for the tested SU-DHL-10 cell line (DLBCL-GCB) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 93 illustrates the dose-effect curves obtained for the tested OCI-Ly7 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh.1”) and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 94 illustrates the dose-effect curves obtained for the tested OCI-Ly3 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XVIII) ("Inh. l") and the JAK-2 inhibitor of Formula LIV ("Inh.4") (pacritinib).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 95 illustrates the dosing schema used for the a-PD-Ll inhibitor (BioXcell InVivoMAb anti-m-PD-Ll, Clone 10F.9G2) in combination with the BTK inhibitor of Formula (XVIII) in a syngeneic CT26 colon cancer model in the Balb/c strain of mice.
  • FIG. 96 illustrates the effect of vehicle on tumor volume in a study of the combined effect of an a-PD-Ll inhibitor and a BTK inhibitor in a syngeneic CT26 colon cancer model in mice.
  • FIG. 97 illustrates the effect of a-PD-Ll inhibitor (BioXcell InVivoMAb anti- m-PD-Ll, Clone 10F.9G2) on tumor volume in a study of the combined effect of an a- PD-L1 inhibitor and a BTK inhibitor in a syngeneic CT26 colon cancer model in mice.
  • a-PD-Ll inhibitor BioXcell InVivoMAb anti- m-PD-Ll, Clone 10F.9G2
  • FIG. 98 illustrates the effect of a-PD-Ll inhibitor (BioXcell InVivoMAb anti- m-PD-Ll, Clone 10F.9G2) in combination with the BTK inhibitor of Formula (XVTII) on tumor volume in a study of the combined effect of an a-PD-Ll inhibitor and a BTK inhibitor in a syngeneic CT26 colon cancer model in mice.
  • a-PD-Ll inhibitor BioXcell InVivoMAb anti- m-PD-Ll, Clone 10F.9G2
  • BTK inhibitor of Formula XVTII
  • FIG. 99 illustrates the synergistic effect of a-PD-Ll inhibitor (BioXcell InVivoMAb anti-m-PD-Ll, clone 10F.9G2) in combination with the BTK inhibitor of Formula (XVIII) as measured through modulation of circulating immature myeloid cells (myeloid-derived suppressor cells, or MDSCs) in a syngeneic CT26 colon cancer model in mice.
  • a-PD-Ll inhibitor BioXcell InVivoMAb anti-m-PD-Ll, clone 10F.9G2
  • BTK inhibitor of Formula (XVIII) as measured through modulation of circulating immature myeloid cells (myeloid-derived suppressor cells, or MDSCs) in a syngeneic CT26 colon cancer model in mice.
  • FIG. 100 illustrates the effects of vehicle on flux at two timepoints, as a control for comparison with FIG. 101, in the ID8 syngeneic orthotropic ovarian cancer model.
  • FIG. 101 illustrates the effects of the BTK inhibitor of Formula (XVIII) on flux at two timepoints, for comparison with FIG. 100, in the ID8 syngeneic orthotropic ovarian cancer model.
  • FIG. 102 illustrates tumor response to treatment with the BTK inhibitor of Formula (XVIII) correlates with a significant reduction in immunosuppressive tumor associated lymphocytes in tumor-bearing mice, in comparison to a control (vehicle).
  • FIG. 103 illustrates that treatment with the BTK inhibitor of Formula (XVIII) impairs ID 8 ovarian cancer growth in the syngeneic murine model in comparison to a control (vehicle).
  • FIG. 104 illustrates that treatment with the BTK inhibitor of Formula (XVIII) induces a tumor response that correlates with a significant reduction in total B cells in tumor-bearing mice.
  • FIG. 105 illustrates that treatment with the BTK inhibitor of Formula (XVIII) induces a tumor response that correlates with a significant reduction in B regulatory cells (Bregs) in tumor-bearing mice.
  • FIG. 106 illustrates that treatment with the BTK inhibitor of Formula (XVIII) induces a tumor response that correlates with a significant reduction in
  • FIG. 107 illustrates that treatment with the BTK inhibitor of Formula (XVIII) induces a tumor response that correlates with an increase in CD8 + T cells.
  • FIG. 108 illustrates bioluminescence images from mice in the different treatment arms of the ID8 ovarian cancer model study.
  • FIG. 109 illustrates bioluminescence imaging results 2 weeks after start of dosing in the ID8 ovarian cancer model study.
  • FIG. 110 illustrates tumor growth suppression in an orthotopic pancreatic cancer model. Mice were dosed orally with 15 mg/kg of the BTK inhibitor of Formula (XVIII), 15 mg/kg of the PI3K inhibitor of Formula (IX), or a combination of both drugs. The statistical p-value (presumption against null hypothesis) is shown for each tested single active pharmaceutical ingredient and for the combination against the vehicle.
  • FIG. 111 illustrates the effects of oral dosing with 15 mg/kg of the BTK inhibitor of Formula (XVIII), 15 mg/kg of the PI3K inhibitor of Formula (IX), or a combination of both inhibitors on myeloid tumor-associated macrophages (TAMs) in pancreatic tumor-bearing mice.
  • FIG. 112 illustrates the effects of oral dosing with 15 mg/kg of the BTK inhibitor of Formula (XVIII), 15 mg/kg of the PI3K inhibitor of Formula (IX), or a combination of both inhibitors on myeloid-derived suppressor cells (MDSCs) in pancreatic tumor-bearing mice.
  • FIG. 113 illustrates the effects of oral dosing with 15 mg/kg of the BTK inhibitor of Formula (XVIII), 15 mg/kg of the PI3K inhibitor of Formula (IX), or a combination of both inhibitors on regulatory T cells (Tregs) in pancreatic tumor-bearing mice.
  • FIG. 114 illustrates the effects on tumor volume of vehicle (measured in mm 3 ) of the BTK inhibitor of Formula (XVIII), a combination of the BTK inhibitor of Formula (XVIII) and gemcitabine (“Gem”), and gemcitabine alone.
  • FIG. 115 illustrates the effects on the amount of CD8 + T cells, given as a percentage of cells expressing the T cell receptor (CD3), of the BTK inhibitor of Formula (XVIII), a combination of the BTK inhibitor of Formula (XVIII) and gemcitabine (“Gem”), and gemcitabine alone.
  • FIG. 116 illustrates the effects on the percentage of CD4 + , CD25 + , and FoxP3 + T regulatory cells (“Tregs”), given as a percentage of cells expressing the T cell receptor (CD3), of the BTK inhibitor of Formula (XVIII), a combination of the BTK inhibitor of Formula (XVIII) and gemcitabine (“Gem”), and gemcitabine alone.
  • FIG. 117 illustrates the effects on the percentage of CD1 lb + , LY6C low , F4/80 + , and Csflr + tumor-associated macrophages ("TAMs"), given as a percentage of cells expressing the T cell receptor (CD3), of the BTK inhibitor of Formula (XVTQ), a combination of the BTK inhibitor of Formula (XVIII) and gemcitabine (“Gem”), and gemcitabine alone.
  • TAMs tumor-associated macrophages
  • FIG. 118 illustrates the effects on the percentage of Grl + and LY6C M , F4/80 + , and Csflr + myeloid-derived suppressor cells ("MDSCs"), given as a percentage of cells expressing the T cell receptor (CD3), of the BTK inhibitor of Formula (XVIII), a combination of the BTK inhibitor of Formula (XVIII) and gemcitabine (“Gem”), and gemcitabine alone.
  • MDSCs Csflr + myeloid-derived suppressor cells
  • FIG. 119 illustrates the effects of treatment with single-active pharmaceutical ingredient Formula (XVIII) on tumor volumes in the KPC pancreatic cancer model.
  • FIG. 120 illustrates the results of analysis of tumor tissues showing that immunosuppressive TAMs (CD1 lb + Ly6ClowF4/80 + Csflr + ) were significantly reduced with Formula (XVIII) treatment in the KPC pancreatic cancer model.
  • FIG. 121 illustrates the results of analysis of tumor tissues showing that immunosuppressive MDSCs (Grl ⁇ yeCHi) were significantly reduced with Formula (XVIII) treatment in the KPC pancreatic cancer model.
  • FIG. 122 illustrates the results of analysis of tumor tissues showing that immunosuppressive Tregs (CD4 + CD25 + FoxP3 + ) were significantly reduced with Formula (XVIII) treatment in the KPC pancreatic cancer model.
  • FIG. 123 illustrates that the decrease in immunosuppressive TAMs, MDSCs, and Tregs in the KPC pancreatic cancer model correlated with a significant increase in CD8 + cells (FIG. 123).
  • FIG. 124 illustrates representative photomicrographs and comparison of maximal thrombus size in laser injured arterioles of VWF HAl mutant mice infused with human platelets in the absence or presence of various BTK inhibitors. Representative photomicrographs are given as a comparison of maximal thrombus size in laser- injured arterioles (1 ⁇ concentrations shown).
  • FIG. 125 illustrates a quantitative comparison obtained by in vivo analysis of early thrombus dynamics in a humanized mouse laser injury model using three BTK inhibitors at a concentration 1 ⁇ .
  • FIG. 126 illustrates the effect of the tested BTK inhibitors on thrombus formation.
  • MCL bleeding events were observed with 560 mg QD and 63% CLL bleeding events were observed with 420 mg QD, where bleeding event is defined as subdural hematoma, ecchymoses, GI bleeding, or hematuria.
  • FIG. 127 illustrates the effect of the concentration of the tested BTK inhibitors on thrombus formation.
  • FIG. 129 illustrates the results of GPVI platelet aggregation studies of Formula XVIII and Formula (XX-A) (ibrutinib).
  • FIG. 130 shows in vitro analysis of antibody-dependent NK cell-mediated INF- ⁇ release with BTK inhibitors.
  • purified NK cells were isolated from healthy peripheral blood mononuclear cells and cultured with 0.1 or 1 ⁇ of ibrutinib or 1 ⁇ of Formula (XVQI) for 4 hours together with rituximab-coated (10 ⁇ g/mL) lymphoma cells, DHL4, or trastuzumab-coated (10 ⁇ g/mL) HER2+ breast cancer cells, HER18, and supernatant was harvested and analyzed by enzyme-linked
  • IFN- ⁇ immunosorbent assay for interferon- ⁇
  • FIG. 131 shows in vitro analysis of antibody-dependent NK cell-mediated degranulation with BTK inhibitors.
  • FIG. 132 shows that ibrutinib antagonizes antibody-dependent NK cell- mediated cytotoxicity using the Raji cell line.
  • FIG. 133 shows a summary of the results given in FIG. 132 at the highest concentration of rituximab ("Ab”) (10 ⁇ g/mL).
  • FIG. 134 shows that ibrutinib antagonizes antibody-dependent NK cell- mediated cytotoxicity in primary CLL cells, as with Raji cells in FIG. 132.
  • FIG. 135 illustrates the treatment schema used for the a-PD-Ll inhibitor (BioXcell InVivoMAb anti-m-PD-Ll, Clone 10F.9G2) in combination with the BTK inhibitor of Formula (XVIII), the PI3K inhibitor of Formula (IX), and the BTK inhibitor ibrutinib in a 4T1 orthotopic breast cancer model.
  • FIG. 136 illustrates tumor volumes observed in each of the ten treatment arms in the 4T1 orthotopic breast cancer model study: (1) IgG only; (2) the BTK inhibitor of Formula (XVIII) at 15 mg/kg, BID, on days 6 to 20; (3) the PI3K-5 inhibitor of Formula (IX) at 15 mg/kg, BID, on days 6 to 20; (4) the BTK inhibitor of Formula (XVIII) and the PI3K inhibitor of Formula (IX) each at 15 mg/kg, BID, on days 6 to 20; (5) the BTK inhibitor ibrutinib at 6 mg/kg, QD, on days 6 to 20; (6) a-PD-Ll antibody at 150 ⁇ g, on days 6, 9, 12, 15, and 18; (7) the BTK inhibitor of Formula (XVIII) at 15 mg/kg, BID, on days 6 to 20, combined with a-PD-Ll antibody at 150 ⁇ g, on days 6, 9, 12, 15, and 18; (8) the PI3K-5 inhibitor of Formula (I
  • FIG. 137 illustrates changes in tumor infiltrating lymphocytes ("TILs") observed in each of the ten treatment arms in the 4T1 orthotopic breast cancer model study.
  • TILs tumor infiltrating lymphocytes
  • FIG. 138 illustrates the treatment schema used for the a-PD-Ll inhibitor (BioXcell InVivoMAb anti-m-PD-Ll, Clone 10F.9G2) in combination with the BTK inhibitor of Formula (XVIII), the PI3K inhibitor of Formula (IX), and the BTK inhibitor ibrutinib in an A20 orthotopic lymphoma model.
  • FIG. 139 illustrates tumor volumes observed in each of the ten treatment arms in the A20 orthotopic lymphoma model study: (1) IgG only; (2) the BTK inhibitor of Formula (XVIII) at 15 mg/kg, BID, on days 6 to 20; (3) the PI3K-5 inhibitor of Formula (IX) at 15 mg/kg, BID, on days 6 to 20; (4) the BTK inhibitor of Formula (XVIII) and the PI3K inhibitor of Formula (IX) each at 15 mg/kg, BID, on days 6 to 20; (5) the BTK inhibitor ibrutinib at 6 mg/kg, QD, on days 6 to 20; (6) a-PD-Ll antibody at 150 ⁇ g, on days 6, 9, 12, 15, and 18; (7) the BTK inhibitor of Formula (XVTII) at 15 mg/kg, BID, on days 6 to 20, combined with a-PD-Ll antibody at 150 ⁇ g, on days 6, 9, 12, 15, and 18; (8) the PI3K-5 inhibitor of Formula
  • FIG. 140 illustrates changes in tumor infiltrating lymphocytes ("TILs") observed in each of the ten treatment arms in the A20 orthotopic lymphoma model study.
  • TILs tumor infiltrating lymphocytes
  • FIG. 141 illustrates in vivo potency of Formula (XVIII) (labeled "BTK inhibitor”) and ibrutinib.
  • XVIII labeled "BTK inhibitor”
  • Mice were gavaged at increasing drug concentration and sacrificed at one time point (3 h post-dose).
  • BCR is stimulated with IgM and the expression of activation markers CD69 and CD86 are monitored by flow cytometry to determine ECso's.
  • the results show that Formula (XVIII) is more potent at inhibiting expression of activation makers than ibrutinib.
  • FIG. 142 illustrates the results of the clinical study of Formula (XVIII) (labeled "BTK inhibitor”) in CLL, which are shown in comparison to the results reported for ibrutinib in Figure 1A of Byrd, et al, N. Engl. J. Med. 2013, 369, 32-42.
  • the results show that the BTK inhibitor of Formula (XVIII) causes a much smaller relative increase and much faster decrease in absolute lymphocyte count (ALC) relative to the BTK inhibitor ibrutinib.
  • ALC absolute lymphocyte count
  • SPD product of greatest diameters
  • FIG. 143 shows overall response data shown by SPD of enlarged lymph nodes in CLL patients as a function of dose of the BTK inhibitor of Formula (XVIII).
  • FIG. 144 shows a comparison of progression-free survival (PFS) in CLL patients treated with the BTK inhibitor ibrutinib or the BTK inhibitor of Formula (XVIII).
  • the ibrutinib data is taken from Byrd, et al, N. Engl. J. Med. 2013, 369, 32-42.
  • CLL patients treated with Formula (XVIII) for at least 8 days are included.
  • FIG. 145 shows a comparison of number of patients at risk in CLL patients treated with the BTK inhibitor ibrutinib or the BTK inhibitor of Formula (XVIII). CLL patients treated with Formula (XVIII) for at least 8 days are included.
  • FIG. 146 shows a comparison of progression-free survival (PFS) in CLL patients exhibiting the 17p deletion and treated with the BTK inhibitor ibrutinib or the BTK inhibitor of Formula (XVIII).
  • PFS progression-free survival
  • the ibrutinib data is taken from Byrd, et al., N. Engl. J. Med. 2013, 369, 32-42.
  • FIG. 147 shows a comparison of number of patients at risk in CLL patients exhibiting the 17p deletion and treated with the BTK inhibitor ibrutinib or the BTK inhibitor of Formula (XVIII).
  • the ibrutinib data is taken from Byrd, et al., N. Engl. J. Med. 2013, 369, 32-42.
  • CLL patients treated with Formula (XVIII) for at least 8 days are included.
  • FIG. 148 shows improved BTK target occupancy of Formula (XVIII) at lower dosage versus ibrutinib in relapsed/refractory CLL patients.
  • FIG. 149 shows the % change in myeloid-derived suppressor cell (MDSC) (monocytic) level over 28 days versus % ALC change at Cycle 1, day 28 (C1D28) with trendlines.
  • MDSC myeloid-derived suppressor cell
  • FIG. 150 shows the % change in MDSC (monocytic) level over 28 days versus % ALC change at Cycle 2, day 28 (C2D28) with trendlines.
  • FIG. 151 shows the % change in natural killer (NK) cell level over 28 days versus % ALC change at Cycle 1 , day 28 (C2D28) with trendlines.
  • FIG. 152 shows the % change in NK cell level over 28 days versus % ALC change at Cycle 2, day 28 (C2D28) with trendlines.
  • FIG. 153 compares the % change in MDSC (monocytic) level and % change in NK cell level over 28 days versus % ALC change with the % change in level of CD4 + T cells, CD8 + T cells, CD4 + /CD8 + T cell ratio, NK-T cells, PD-1 + CD4 + T cells, and PD- 1 + CD8 + T cells, also versus % ALC change, at Cycle 1 day 28 (C1D28). Trendlines are shown for % change in MDSC (monocytic) level and % change in NK cell level.
  • FIG. 154 compares the % change in MDSC (monocytic) level and % change in NK cell level over 28 days versus % ALC change with the % change in level of CD4 + T cells, CD8 + T cells, CD4 + /CD8 + T cell ratio, NK-T cells, PD-1 + CD4 + T cells, and PD-1 CD8 + T cells, also versus % ALC change, at Cycle 2 day 28 (C2D28). Trendlines are shown for % change in MDSC (monocytic) level and % change in NK cell level.
  • FIG. 155 shows additional clinical data related to that presented in FIG. 142.
  • FIG. 156 shows additional clinical data related to that presented in FIG. 148, and includes BID dosing results.
  • FIG. 157 illustrates PFS for patients with 17p deletion.
  • FIG. 158 illustrates PFS across relapsed/refractory patients with 17p deletion and with 1 lq deletion and no 17p deletion.
  • FIG. 159 illustrates PFS for patients with 1 lq deletion and no 17p deletion.
  • FIG. 160 illustrates shows additional clinical SPD results from the clinical study of Formula (XVIII) in relapsed/refractory CLL patients.
  • FIG. 161 illustrates that treatment of CLL patients with Formula (XVIII) resulted in increased apoptosis.
  • FIG. 162 illustrates a decrease in CXCL12 levels observed in patients treated with Formula (XVIII).
  • FIG. 163 illustrates a decrease in CCL2 levels observed in patients treated with Formula (XVIII).
  • FIG. 164 illustrates BTK inhibitory effects on MDSCs.
  • FIG. 165 illustrates the dosing schema used with the KrasLA2 non-small cell lung cancer (NSCLC) model.
  • FIG. 166 illustrates tumor volume variation from baseline as assessed by microcomputerized tomography (microCT) in the KrasL2 NSCLC model.
  • FIG. 167 illustrates TAMs in the KrasL2 NSCLC model, and indicates that Formula (XVIII) induces a tumor response that correlates with a significant reduction in immunosuppressive tumor associated TAMs.
  • FIG. 168 illustrates MDSCs in the KrasL2 NSCLC model, and indicates that Formula (XVIII) induces a tumor response that correlates with a significant reduction in immunosuppressive tumor associated MDSCs.
  • FIG. 169 illustrates Tregs in the KrasL2 NSCLC model, and indicates that Formula (XVIII) induces a tumor response that correlates with a significant reduction in immunosuppressive tumor associated Tregs.
  • FIG. 170 illustrates CD8 + T cells in the KrasL2 NSCLC model.
  • FIG. 171 illustrates in vitro potency in whole blood of Formula (XVIII), ibrutinib and CC-292 in inhibition of signals through the B cell receptor.
  • FIG. 172 illustrates EGF receptor phosphorylation in vitro for Formula (XVIII) and ibrutinib.
  • FIG. 173 shows NK cell degranulation results. The percentage of
  • FIG. 174 shows the effects of BTK inhibition on generalized NK cell mediated cytotoxicity.
  • FIG. 175 shows that Formula (XVIII) has no adverse effect on T helper 17 (Thl7) cells, which are a subset of T helper cells that produce interleukin 17 (IL-17), while ibrutinib strongly inhibits Thl7 cells.
  • FIG. 176 shows that Formula (XVIII) has no effect on regulatory T cell (Treg) development, while ibrutinib strongly increases Treg development.
  • FIG. 177 shows that Formula (XVTII) has no effect on CD8 + T cell viability, development, while ibrutinib strongly affects CD8 + T cell viability at higher doses.
  • FIG. 178 illustrates the results of the cytotoxicity assay for CD8 + T cell function.
  • Formula (XX- A) (ibrutinib) affects CD8 + T cell function as measured by % cytotoxicity, while Formula (XVIII) has no effect on CD8 + T cell function as measured by % cytotoxicity relative to vehicle.
  • FIG. 179 illustrates the results of IFN- ⁇ level measurements for CD8 + T cell function.
  • Formula (XX- A) (ibrutinib) affects CD8 + T cell function as measured by IFN- ⁇ level, while Formula (XVIII) has no effect on CD8 + T cell function as measured by IFN- ⁇ level relative to vehicle.
  • FIG. 180 shows the results of the brain penetration study, demonstrating the surprising result that Formula (XVIII) crosses the blood-brain barrier.
  • FIG. 181 shows the effect on tumor volumes in the ID8 ovarian cancer mouse model of treatment with vehicle, Formula (XVIII), a murine anti-PD-1 monoclonal antibody, and a combination of Formula (XVTQ) and a murine anti-PD-1 monoclonal antibody.
  • FIG. 182 illustrates the synergy observed in certain cell lines when the BTK inhibitor of Formula (XXVIII-R) (ONO-4059) and the PI3K-5 inhibitor of Formula (XVI) (idelalisib) are combined.
  • the tested cell lines include TMD-8 (DLBCL-ABC), Mino (MCL), RI-1 (NHL), DOHH-2 (follicular lymphoma), and SU-DHL-6 (DLBCL- GCB).
  • the dose-effect curves for these cell lines are given in FIG. 183, FIG. 184, FIG. 185, FIG. 186, and FIG. 187.
  • FIG. 183 illustrates the dose-effect curves obtained for the tested TMD-8 cell line (DLBCL-ABC) using combined dosing of the BTK inhibitor of Formula (XXVIII-R) (ONO-4059) ("Inh.6”) and the PI3K-5 inhibitor of Formula (XVI) (idelalisib) ("Inh.7”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 184 illustrates the dose-effect curves obtained for the tested Mino cell line (MCL) using combined dosing of the BTK inhibitor of Formula (XXVIII-R) (ONO- 4059) ("Inh.6") and the PI3K-5 inhibitor of Formula (XVI) (idelalisib) ("Inh.7”).
  • the y- axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis (“Dose”) is given in linear units of ⁇ .
  • FIG. 185 illustrates the dose-effect curves obtained for the tested RI-1 cell line (NHL) using combined dosing of the BTK inhibitor of Formula (XXVIII-R) (ONO-4059) ("Inh.6”) and the PI3K-5 inhibitor of Formula (XVI) (idelalisib) ("Inh.7”).
  • the y-axis (“Effect”) is given in units of Fa (fraction affected) and the x-axis ("Dose”) is given in linear units of ⁇ .
  • FIG. 186 illustrates the dose-effect curves obtained for the tested DOHH-2 cell line (follicular lymphoma) using combined dosing of the BTK inhibitor of Formula (XXVIII-R) (ONO-4059) ("Inh.6") and the PI3K-5 inhibitor of Formula (XVI)
  • FIG. 187 illustrates the dose-effect curves obtained for the tested SU-DHL-6 cell line (DLBCL-GCB) using combined dosing of the BTK inhibitor of Formula (XXVIII-R) (ONO-4059) ("Inh.6”) and the PI3K-5 inhibitor of Formula (XVI)
  • SEQ ID NO: 1 is the heavy chain amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO: 17 in International Patent Publication No. WO 2014/055648 Al).
  • SEQ ID NO:2 is the light chain amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO: 18 in International Patent Publication No. WO 2014/055648 Al).
  • SEQ ID NO: 3 is the heavy chain variable region (V H ) amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO:4 in WO 2006/121168 and SEQ ID NO: 19 in WO 2014/055648 Al).
  • SEQ ID NO: 4 is the light chain variable region (V L ) amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO: 11 in WO 2006/121168 and SEQ ID NO:21 in WO 2014/055648 Al).
  • SEQ ID NO: 5 is the heavy chain CDR1 amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO: 18 in WO 2006/121168 and SEQ ID NO:23 in WO 2014/055648 Al).
  • SEQ ID NO: 6 is the heavy chain CDR2 amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO:25 in WO 2006/121168 and SEQ ID NO:24 in WO 2014/055648 Al).
  • SEQ ID NO: 7 is the heavy chain CDR3 amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO:32 in WO 2006/121168 and SEQ ID NO:25 in WO 2014/055648 Al)
  • SEQ ID NO: 8 is the light chain CDR1 amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO:39 from WO 2006/121168 and SEQ ID NO:26 in WO 2014/055648 Al).
  • SEQ ID NO: 9 is the light chain CDR2 amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO:46 in WO 2006/121168 and SEQ ID NO:27 in WO 2014/055648 Al).
  • SEQ ID NO: 10 is the light chain CDR3 amino acid sequence of the PD-1 inhibitor nivolumab (corresponding to SEQ ID NO:53 in WO 2006/121168 and SEQ ID NO:28 in WO 2014/055648 Al).
  • SEQ ID NO: 11 is the 409A-H heavy chain full length sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO:31 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO: 12 is amino acids 20 to 466 of the heavy chain full length sequence of the PD- 1 inhibitor pembrolizumab.
  • SEQ ID NO : 13 is the K09A-L- 11 light chain variable region sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO:32 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO: 14 is the K09A-L-11 light chain full length sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO:36 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO: 15 is the hPD-1.09A light chain CDR1 sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO: 15 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO: 16 is the hPD-1.09A light chain CDR2 sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO: 16 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO: 17 is the hPD-1.09A light chain CDR3 sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO: 17 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO: 18 is the hPD-1.09 A heavy chain CDR1 sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO: 18 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO : 19 is the hPD- 1.09 A heavy chain CDR2 sequence of the PD- 1 inhibitor pembrolizumab (corresponding to SEQ ID NO: 19 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO: 20 is the hPD-1.09 A heavy chain CDR3 sequence of the PD-1 inhibitor pembrolizumab (corresponding to SEQ ID NO:20 in U.S. Patent No. 8,354,509 B2).
  • SEQ ID NO:21 is heavy chain amino acid sequence of the PD-1 inhibitor pidilizumab.
  • SEQ ID NO:22 is light chain amino acid sequence of the PD-1 inhibitor pidilizumab.
  • SEQ ID NO: 23 is the variable heavy chain region of the PD-1 inhibitor pidilizumab (corresponding to SEQ ID NO: 5 in U.S. Patent No. 8,686,119 B2).
  • SEQ ID NO: 24 is the variable light chain region of the PD-1 inhibitor pidilizumab (corresponding to SEQ ID NO: 1 in U.S. Patent No. 8,686,119 B2).
  • SEQ ID NO: 25 is the amino acid sequence of a peptide derivative PD-1 inhibitor.
  • SEQ ID NO: 26 is the amino acid sequence of a peptide derivative PD-1 inhibitor, with a branched group given by SEQ ID NO: 25.
  • SEQ ID NO: 27 is the amino acid sequence of a peptide derivative PD-1 inhibitor, with a branched group given by SEQ ID NO: 25.
  • SEQ ID NO: 28 is the amino acid sequence of a peptide derivative PD-1 inhibitor, with a branched group given by SEQ ID NO: 25.
  • SEQ ID NO: 29 is the amino acid sequence of a peptide derivative PD-1 inhibitor, with a branched group given by SEQ ID NO: 25.
  • SEQ ID NO:30 is the heavy chain of the anti-PD-Ll antibody durvalumab (MEDI4736).
  • SEQ ID NO:31 is the light chain of the anti-PD-Ll antibody durvalumab (MEDI4736).
  • SEQ ID NO:32 is the durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region (corresponding to SEQ ID NO: 72 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 33 is the durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region (corresponding to SEQ ID NO:77 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 34 is the durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR1 (corresponding to SEQ ID NO: 3 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 35 is the durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR2 (corresponding to SEQ ID NO: 4 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 36 is the durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR3 (corresponding to SEQ ID NO: 5 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 37 is the durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR1 (corresponding to SEQ ID NO: 8 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 38 is the durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR2 (corresponding to SEQ ID NO: 9 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 39 is the durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR3 (corresponding to SEQ ID NO: 10 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 40 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR1 (corresponding to SEQ ID NO: 23 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO:41 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR2 (corresponding to SEQ ID NO: 24 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO:42 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR3 (corresponding to SEQ ID NO: 25 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 43 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR1 (corresponding to SEQ ID NO: 28 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 44 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR2 (corresponding to SEQ ID NO: 29 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO:45 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR3 (corresponding to SEQ ID NO: 30 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO:46 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR1 (corresponding to SEQ ID NO: 13 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 47 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR2 (corresponding to SEQ ID NO: 14 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO:48 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR3 (corresponding to SEQ ID NO: 15 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 49 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR1 (corresponding to SEQ ID NO: 18 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 50 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR2 (corresponding to SEQ ID NO: 19 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO: 51 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR3 (corresponding to SEQ ID NO: 20 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO:52 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR1 (corresponding to SEQ ID NO: 63 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO: 53 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR2 (corresponding to SEQ ID NO: 64 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO:54 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR3 (corresponding to SEQ ID NO: 65 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO: 55 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR1 (corresponding to SEQ ID NO: 68 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO: 56 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR2 (corresponding to SEQ ID NO: 69 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO: 57 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR3 (corresponding to SEQ ID NO: 70 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO: 58 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR1 (corresponding to SEQ ID NO: 73 in U.S. Patent Application Publication No. US 2013/0034559A1).
  • SEQ ID NO: 59 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR2 (corresponding to SEQ ID NO: 74 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 60 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody heavy chain variable region CDR3 (corresponding to SEQ ID NO: 75 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 61 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR1 (corresponding to SEQ ID NO: 78 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO:62 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR2 (corresponding to SEQ ID NO: 79 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO: 63 is an alternative durvalumab (MEDI4736) anti-PD-Ll antibody light chain variable region CDR3 (corresponding to SEQ ID NO: 80 in U.S. Patent Application Publication No. US 2013/0034559 Al).
  • SEQ ID NO:64 is the heavy chain of the anti-PD-Ll antibody atezolizumab (MPDL3280A).
  • SEQ ID NO:65 is the light chain of the anti-PD-Ll antibody atezolizumab (MPDL3280A).
  • SEQ ID NO: 66 is the V H region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO:20 in U.S. Patent No. 8,217,149).
  • SEQ ID NO: 67 is the V L region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO:21 in U.S. Patent No. 8,217,149).
  • SEQ ID NO:68 is the HVR-Hl region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO: l in U.S. Patent No. 8,217,149).
  • SEQ ID NO:69 is the HVR-H2 region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO:2 in U.S. Patent No. 8,217,149).
  • SEQ ID NO:70 is the HVR-H3 region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO:3 in U.S. Patent No. 8,217,149).
  • SEQ ID NO: 71 is the HVR-L1 region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO:8 in U.S. Patent No. 8,217,149).
  • SEQ ID NO:72 is the HVR-L2 region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO:9 in U.S. Patent No. 8,217,149).
  • SEQ ID NO: 73 is the HVR-L3 region of the anti-PD-Ll antibody atezolizumab (MPDL3280A) (corresponding to SEQ ID NO: 10 in U.S. Patent No. 8,217,149).
  • SEQ ID NO:74 is the heavy chain of the anti-PD-Ll antibody avelumab (MSB0010718C).
  • SEQ ID NO:75 is the light chain of the anti-PD-Ll antibody avelumab (MSB0010718C).
  • SEQ ID NO: 76 is the V H region of the anti-PD-Ll antibody avelumab
  • SEQ ID NO: 77 is the V L region of the anti-PD-Ll antibody avelumab
  • SEQ ID NO:78 is the HVR-Hl region of the anti-PD-Ll antibody avelumab (MSB0010718C) (corresponding to SEQ ID NO: 15 in U.S. Patent Application
  • SEQ ID NO:79 is the HVR-H2 region of the anti-PD-Ll antibody avelumab (MSB0010718C) (corresponding to SEQ ID NO: 16 in U.S. Patent Application
  • SEQ ID NO: 80 is the HVR-H3 region of the anti-PD-Ll antibody avelumab (MSB0010718C) (corresponding to SEQ ID NO: 17 in U.S. Patent Application
  • SEQ ID NO:81 is the HVR-L1 region of the anti-PD-Ll antibody avelumab (MSB0010718C) (corresponding to SEQ ID NO: 18 in U.S. Patent Application
  • SEQ ID NO:82 is the HVR-L2 region of the anti-PD-Ll antibody avelumab (MSB0010718C) (corresponding to SEQ ID NO: 19 in U.S. Patent Application Publication No. US 2014/0341917 Al).
  • SEQ ID NO: 83 is the HVR-L3 region of the anti-PD-Ll antibody avelumab (MSB0010718C) (corresponding to SEQ ID NO: 20 in U.S. Patent Application
  • SEQ ID NO: 84 is the heavy chain amino acid sequence of the anti-CD20 monoclonal antibody rituximab.
  • SEQ ID NO: 85 is the light chain amino acid sequence of the anti-CD20 monoclonal antibody rituximab.
  • SEQ ID NO: 86 is the heavy chain amino acid sequence of the anti-CD20 monoclonal antibody obinutuzumab.
  • SEQ ID NO: 87 is the light chain amino acid sequence of the anti-CD20 monoclonal antibody obinutuzumab.
  • SEQ ID NO: 88 is the variable heavy chain amino acid sequence of the anti- CD20 monoclonal antibody ofatumumab.
  • SEQ ID NO: 89 is the variable light chain amino acid sequence of the anti-CD20 monoclonal antibody ofatumumab.
  • SEQ ID NO: 90 is the Fab fragment heavy chain amino acid sequence of the anti-CD20 monoclonal antibody ofatumumab.
  • SEQ ID NO: 91 is the Fab fragment light chain amino acid sequence of the anti- CD20 monoclonal antibody ofatumumab.
  • SEQ ID NO:92 is the heavy chain amino acid sequence of the anti-CD20 monoclonal antibody veltuzumab.
  • SEQ ID NO: 93 is the light chain amino acid sequence of the anti-CD20 monoclonal antibody veltuzumab.
  • SEQ ID NO:94 is the heavy chain amino acid sequence of the anti-CD20 monoclonal antibody tositumomab.
  • SEQ ID NO:95 is the light chain amino acid sequence of the anti-CD20 monoclonal antibody tositumomab.
  • SEQ ID NO: 96 is the heavy chain amino acid sequence of the anti-CD20 monoclonal antibody ibritumomab.
  • SEQ ID NO: 97 is the light chain amino acid sequence of the anti-CD20 monoclonal antibody ibritumomab.
  • co-administration encompass administration of two or more active pharmaceutical ingredients to a subject so that both active pharmaceutical ingredients and/or their metabolites are present in the subject at the same time.
  • Co-administration includes simultaneous administration in separate compositions, administration at different times in separate compositions, or
  • the term "effective amount” or “therapeutically effective amount” refers to that amount of a compound or combination of compounds as described herein that is sufficient to effect the intended application including, but not limited to, disease treatment.
  • a therapeutically effective amount may vary depending upon the intended application ⁇ in vitro or in vivo), or the subject and disease condition being treated ⁇ e.g., the weight, age and gender of the subject), the severity of the disease condition, the manner of administration, etc. which can readily be determined by one of ordinary skill in the art.
  • the term also applies to a dose that will induce a particular response in target cells, ⁇ e.g., the reduction of platelet adhesion and/or cell migration).
  • the specific dose will vary depending on the particular compounds chosen, the dosing regimen to be followed, whether the compound is administered in combination with other compounds, timing of administration, the tissue to which it is administered, and the physical delivery system in which the compound is carried.
  • a prophylactic effect includes delaying or eliminating the appearance of a disease or condition, delaying or eliminating the onset of symptoms of a disease or condition, slowing, halting, or reversing the progression of a disease or condition, or any combination thereof.
  • salts refers to salts derived from a variety of organic and inorganic counter ions known in the art.
  • Pharmaceutically acceptable acid addition salts can be formed with inorganic acids and organic acids.
  • Inorganic acids from which salts can be derived include, for example, hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid and phosphoric acid.
  • Organic acids from which salts can be derived include, for example, acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid and salicylic acid.
  • Pharmaceutically acceptable base addition salts can be formed with inorganic and organic bases.
  • Inorganic bases from which salts can be derived include, for example, sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese and aluminum.
  • Organic bases from which salts can be derived include, for example, primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines and basic ion exchange resins. Specific examples include isopropylamine, trimethylamine, diethylamine, triethylamine, tripropylamine, and ethanolamine.
  • the pharmaceutically acceptable base addition salt is chosen from ammonium, potassium, sodium, calcium, and magnesium salts.
  • cocrystal refers to a molecular complex derived from a number of cocrystal formers known in the art.
  • a cocrystal typically does not involve hydrogen transfer between the cocrystal and the drug, and instead involves intermolecular interactions, such as hydrogen bonding, aromatic ring stacking, or dispersive forces, between the cocrystal former and the drug in the crystal structure.
  • “Pharmaceutically acceptable carrier” or “pharmaceutically acceptable excipient” is intended to include any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and inert ingredients.
  • pharmaceutically acceptable carriers or pharmaceutically acceptable excipients for active pharmaceutical ingredients is well known in the art. Except insofar as any conventional pharmaceutically acceptable carrier or
  • compositions and methods are incompatible with the active pharmaceutical ingredient, its use in the therapeutic compositions of the invention is contemplated. Additional active pharmaceutical ingredients, such as other drugs, can also be incorporated into the described compositions and methods.
  • Prodrug is intended to describe a compound that may be converted under physiological conditions or by solvolysis to a biologically active compound described herein.
  • prodrug refers to a precursor of a biologically active compound that is pharmaceutically acceptable.
  • a prodrug may be inactive when administered to a subject, but is converted in vivo to an active compound, for example, by hydrolysis.
  • the prodrug compound often offers the advantages of solubility, tissue compatibility or delayed release in a mammalian organism (see, e.g., Bundgaard, H., Design of Prodrugs (1985) (Elsevier, Amsterdam).
  • prodrug is also intended to include any covalently bonded carriers, which release the active compound in vivo when administered to a subject.
  • Prodrugs of an active compound, as described herein may be prepared by modifying functional groups present in the active compound in such a way that the modifications are cleaved, either in routine manipulation or in vivo, to yield the active parent compound.
  • Prodrugs include, for example, compounds wherein a hydroxy, amino or mercapto group is bonded to any group that, when the prodrug of the active compound is administered to a mammalian subject, cleaves to form a free hydroxy, free amino or free mercapto group, respectively.
  • prodrugs include, but are not limited to, acetates, formates and benzoate derivatives of an alcohol, various ester derivatives of a carboxylic acid, or acetamide, formamide and benzamide derivatives of an amine functional group in the active compound.
  • QD means quaque die, once a day, or once daily.
  • BID means bis in die, twice a day, or twice daily.
  • TID means bis in die, twice a day, or twice daily.
  • TID means ter in die, three times a day, or three times daily.
  • QID means quater in die, four times a day, or four times daily.
  • in vivo refers to an event that takes place in a subject's body.
  • in vitro refers to an event that takes places outside of a subject's body.
  • in vitro assays encompass cell-based assays in which cells alive or dead are employed and may also encompass a cell-free assay in which no intact cells are employed.
  • ranges are used herein to describe, for example, physical or chemical properties such as molecular weight or chemical formulae, all combinations and subcombinations of ranges and specific embodiments therein are intended to be included.
  • Use of the term "about" when referring to a number or a numerical range means that the number or numerical range referred to is an approximation within experimental variability (or within statistical experimental error), and thus the number or numerical range may vary. The variation is typically from 0% to 15%, preferably from 0% to 10%, more preferably from 0% to 5% of the stated number or numerical range.
  • Alkyl refers to a straight or branched hydrocarbon chain radical consisting solely of carbon and hydrogen atoms, containing no unsaturation, having from one to ten carbon atoms ⁇ e.g., (Ci-io)alkyl or Cno alkyl).
  • a numerical range such as “1 to 10” refers to each integer in the given range - e.g., "1 to 10 carbon atoms” means that the alkyl group may consist of 1 carbon atom, 2 carbon atoms, 3 carbon atoms, etc. , up to and including 10 carbon atoms, although the definition is also intended to cover the occurrence of the term "alkyl" where no numerical range is specifically designated.
  • Typical alkyl groups include, but are in no way limited to, methyl, ethyl, propyl, isopropyl, w-butyl, zsobutyl, sec-butyl isobutyl, teri-butyl, pentyl, isopentyl, neopentyl, hexyl, septyl, octyl, nonyl and decyl.
  • the alkyl moiety may be attached to the rest of the molecule by a single bond, such as for example, methyl (Me), ethyl (Et), ⁇ -propyl (Pr), 1 -methylethyl (z ' sopropyl), w-butyl, w-pentyl, 1 , 1 -dimethylethyl and 3-methylhexyl.
  • an alkyl group is optionally substituted by one or more of substituents which are independently heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, mtro, tnmethylsilanyl, -OR a , -SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , - OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , -N(R a )C(0)OR a , -N(R a )C(0)R a , -N(R a )C(0)OR a , -N(R a )C(0)
  • Alkylaryl refers to an -(alkyl)aryl radical where aryl and alkyl are as disclosed herein, having from one to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for aryl and alkyl respectively.
  • Alkylhetaryl refers to an -(alkyl)hetaryl radical where hetaryl and alkyl are as disclosed herein, having from one to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for aryl and alkyl respectively.
  • Alkylheterocycloalkyl refers to an -(alkyl) heterocycyl radical where alkyl and heterocycloalkyl are as disclosed herein, having from one to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for heterocycloalkyl and alkyl respectively.
  • An "alkene” moiety refers to a group consisting of at least two carbon atoms and at least one carbon-carbon double bond
  • an "alkyne” moiety refers to a group consisting of at least two carbon atoms and at least one carbon-carbon triple bond.
  • the alkyl moiety, whether saturated or unsaturated, may be branched, straight chain, or cyclic.
  • alkenyl refers to a straight or branched hydrocarbon chain radical group consisting solely of carbon and hydrogen atoms, containing at least one double bond, and having from two to ten carbon atoms (i.e., (C 2 -io)alkenyl or C 2 - 10 alkenyl).
  • a numerical range such as “2 to 10” refers to each integer in the given range - e.g., "2 to 10 carbon atoms” means that the alkenyl group may consist of 2 carbon atoms, 3 carbon atoms, etc., up to and including 10 carbon atoms.
  • the alkenyl moiety may be attached to the rest of the molecule by a single bond, such as for example, ethenyl (i.e., vinyl), prop-l-enyl (i.e., allyl), but-l-enyl, pent-l-enyl and penta-l,4-dienyl.
  • ethenyl i.e., vinyl
  • prop-l-enyl i.e., allyl
  • but-l-enyl but-l-enyl
  • pent-l-enyl and penta-l,4-dienyl.
  • an alkenyl group is optionally substituted by one or more substituents which are independently alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, nitro, trimethylsilanyl, -OR a , - SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , - N(R a )C(0)OR a , -N(R a )C(0)R a , -N(R a )C(0)N(R a ) 2 , -N(R a
  • alkenyl-cycloalkyl refers to an -(alkenyl)cycloalkyl radical where alkenyl and cyclo alkyl are as disclosed herein, having from two to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for alkenyl and cycloalkyl respectively.
  • Alkynyl refers to a straight or branched hydrocarbon chain radical group consisting solely of carbon and hydrogen atoms, containing at least one triple bond, having from two to ten carbon atoms (i.e., (C 2 -io)alkynyl or C 2 - 10 alkynyl).
  • a numerical range such as “2 to 10” refers to each integer in the given range - e.g., "2 to 10 carbon atoms” means that the alkynyl group may consist of 2 carbon atoms, 3 carbon atoms, etc., up to and including 10 carbon atoms.
  • alkynyl may be attached to the rest of the molecule by a single bond, for example, ethynyl, propynyl, butynyl, pentynyl and hexynyl. Unless stated otherwise specifically in the specification, an alkynyl group is optionally substituted by one or more substituents which
  • each R a is independently hydrogen, alkyl, fluoroalkyl, carbocyclyl, carbocyclylalkyl, aryl, aralkyl, heterocycloalkyl, heterocycloalkylalkyl, heteroaryl or heteroarylalkyl.
  • Alkynyl-cycloalkyl refers to an -(alkynyl)cycloalkyl radical where alkynyl and cycloalkyl are as disclosed herein, having from two to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for alkynyl and cycloalkyl respectively.
  • Cyano refers to a -CN radical.
  • Cycloalkyl refers to a monocyclic or polycyclic radical that contains only carbon and hydrogen, and may be saturated, or partially unsaturated. Cycloalkyl groups include groups having from 3 to 10 ring atoms (i.e. (C3-io)cycloalkyl or C3-10 cycloalkyl). Whenever it appears herein, a numerical range such as “3 to 10" refers to each integer in the given range - e.g., "3 to 10 carbon atoms” means that the cycloalkyl group may consist of 3 carbon atoms, etc., up to and including 10 carbon atoms.
  • cycloalkyl groups include, but are not limited to the following moieties: cyclopropyl, cyclobutyl, cyclopentyl, cyclopentenyl, cyclohexyl, cyclohexenyl, cycloheptyl, cyclooctyl, cyclononyl, cyclodecyl, norbornyl, and the like.
  • a cycloalkyl group is optionally substituted by one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, nitro, trimethylsilanyl, -OR a , -SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , -N(R a )C(0)OR a , - N(R a )C(0)R a , -N(R a )C(0)OR a , - N(R a )
  • Cycloalkyl-alkenyl refers to a -(cycloalkyl)alkenyl radical where cycloalkyl and alkenyl are as disclosed herein, having from three to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for cycloalkyl and alkenyl, respectively.
  • Cycloalkyl-heterocycloalkyl refers to a -(cycloalkyl)heterocycloalkyl radical where cycloalkyl and heterocycloalkyl are as disclosed herein, having from three to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for cycloalkyl and heterocycloalkyl, respectively.
  • Cycloalkyl-heteroaryl refers to a -(cycloalkyl)heteroaryl radical where cycloalkyl and heteroaryl are as disclosed herein, having from three to ten carbon atoms, and which are optionally substituted by one or more of the substituents described as suitable substituents for cycloalkyl and heteroaryl, respectively.
  • alkoxy refers to the group -O-alkyl, including from 1 to 8 carbon atoms of a straight, branched, cyclic configuration and combinations thereof attached to the parent structure through an oxygen. Examples include, but are not limited to, methoxy, ethoxy, propoxy, isopropoxy, cyclopropyloxy and cyclohexyloxy. "Lower alkoxy” refers to alkoxy groups containing one to six carbons.
  • substituted alkoxy refers to alkoxy wherein the alkyl constituent is substituted (i.e., -0-(substituted alkyl)).
  • the alkyl moiety of an alkoxy group is optionally substituted by one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, nitro, trimethylsilanyl, -OR a , -SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , -C(0)N(R
  • a (Ci-6)alkoxycarbonyl group is an alkoxy group having from 1 to 6 carbon atoms attached through its oxygen to a carbonyl linker.
  • “Lower alkoxycarbonyl” refers to an alkoxycarbonyl group wherein the alkoxy group is a lower alkoxy group.
  • substituted alkoxycarbonyl refers to the group (substituted alkyl)-0- C(O)- wherein the group is attached to the parent structure through the carbonyl functionality, and wherein the alkoxy group has the indicated number of carbon atoms.
  • the alkyl moiety of an alkoxycarbonyl group is optionally substituted by one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl,
  • each R a is independently hydrogen, alkyl, fluoroalkyl, carbocyclyl, carbocyclylalkyl, aryl, aralkyl, heterocycloalkyl, heterocycloalkylalkyl, heteroaryl or heteroarylalkyl.
  • Acyl refers to the groups (alkyl)-C(O)-, (aryl)-C(O)-, (heteroaryl)-C(O)-, (heteroalkyl)-C(O)- and (heterocycloalkyl)-C(O)-, having from one to ten carbon atoms, wherein the group is attached to the parent structure through the carbonyl functionality. If the R radical is heteroaryl or heterocycloalkyl, the hetero ring or chain atoms contribute to the total number of chain or ring atoms.
  • the alkyl, aryl or heteroaryl moiety of the acyl group is optionally substituted by one or more substituents which are independently alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, nitro, trimethylsilanyl, -OR a , - SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , - N(R a )C(0)OR a , -N(R a )C(0)R a , -N(R a )C(0)OR a
  • R of an acyloxy group is optionally substituted by one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl,
  • each R a is independently hydrogen, alkyl, fluoroalkyl, carbocyclyl, carbocyclylalkyl, aryl, aralkyl, heterocycloalkyl, heterocycloalkylalkyl, heteroaryl or heteroarylalkyl.
  • Amino refers to a -N(R a ) 2 radical group, where each R a is independently hydrogen, alkyl, fluoroalkyl, carbocyclyl, carbocyclylalkyl, aryl, aralkyl, heterocycloalkyl, heterocycloalkylalkyl, heteroaryl or heteroarylalkyl, unless stated otherwise specifically in the specification.
  • R a is independently hydrogen, alkyl, fluoroalkyl, carbocyclyl, carbocyclylalkyl, aryl, aralkyl, heterocycloalkyl, heterocycloalkylalkyl, heteroaryl or heteroarylalkyl, unless stated otherwise specifically in the specification.
  • R a is independently hydrogen, alkyl, fluoroalkyl, carbocyclyl, carbocyclylalkyl, aryl, aralkyl, heterocycloalkyl, heterocycloalkylalkyl, heteroaryl or heteroaryl
  • -N(R a ) 2 is intended to include, but is not limited to, 1 - pyrrolidinyl and 4-morpholinyl.
  • an amino group is optionally substituted by one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, mtro, tnmethylsilanyl, -OR a , -SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , - OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , -N(R a ) 2 , -N(R
  • substituted amino also refers to N-oxides of the groups -NHR d , and NR d R d each as described above. N-oxides can be prepared by treatment of the corresponding amino group with, for example, hydrogen peroxide or m- chloroperoxybenzoic acid.
  • Amide or “amido” refers to a chemical moiety with formula -C(0)N(R) 2 or -NHC(0)R, where R is selected from the group consisting of hydrogen, alkyl, cycloalkyl, aryl, heteroaryl (bonded through a ring carbon) and heteroalicyclic (bonded through a ring carbon), each of which moiety may itself be optionally substituted.
  • R 2 of -N(R) 2 of the amide may optionally be taken together with the nitrogen to which it is attached to form a 4-, 5-, 6- or 7-membered ring.
  • an amido group is optionally substituted independently by one or more of the substituents as described herein for alkyl, cycloalkyl, aryl, heteroaryl, or
  • An amide may be an amino acid or a peptide molecule attached to a compound disclosed herein, thereby forming a prodrug.
  • the procedures and specific groups to make such amides are known to those of skill in the art and can readily be found in seminal sources such as Greene and Wuts, Protective Groups in Organic Synthesis, 3 rd Ed., John Wiley & Sons, New York, N.Y., 1999, which is incorporated herein by reference in its entirety.
  • Aromatic or "aryl” or “Ar” refers to an aromatic radical with six to ten ring atoms (e.g., C 6 -Cio aromatic or C 6 -Cio aryl) which has at least one ring having a conjugated pi electron system which is carbocyclic (e.g., phenyl, fluorenyl, and naphthyl).
  • Bivalent radicals formed from substituted benzene derivatives and having the free valences at ring atoms are named as substituted phenylene radicals.
  • Bivalent radicals derived from univalent poly cyclic hydrocarbon radicals whose names end in "-yl” by removal of one hydrogen atom from the carbon atom with the free valence are named by adding "-idene” to the name of the corresponding univalent radical, e.g., a naphthyl group with two points of attachment is termed naphthylidene.
  • a numerical range such as “6 to 10” refers to each integer in the given range; e.g., "6 to 10 ring atoms” means that the aryl group may consist of 6 ring atoms, 7 ring atoms, etc., up to and including 10 ring atoms.
  • an aryl moiety is optionally substituted by one or more substituents which are independently alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, nitro, trimethylsilanyl, -OR a , -SR a , -OC(0)-R a , - N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , -N(R a )C(0)OR a ,
  • alkyl refers to an (aryl)alkyl-radical where aryl and alkyl are as disclosed herein and which are optionally substituted by one or more of the
  • Ester refers to a chemical radical of formula -COOR, where R is selected from the group consisting of alkyl, cycloalkyl, aryl, heteroaryl (bonded through a ring carbon) and heteroalicyclic (bonded through a ring carbon).
  • R is selected from the group consisting of alkyl, cycloalkyl, aryl, heteroaryl (bonded through a ring carbon) and heteroalicyclic (bonded through a ring carbon).
  • the procedures and specific groups to make esters are known to those of skill in the art and can readily be found in seminal sources such as Greene and Wuts, Protective Groups in Organic Synthesis, 3 rd Ed., John Wiley & Sons, New York, N.Y., 1999, which is incorporated herein by reference in its entirety.
  • an ester group is optionally substituted by one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, trifluoromethyl, trifluoromethoxy, mtro, tnmethylsilanyl, -OR a , -SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , - OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , -N(R a )C(0)OR a , -N(R a )C(0)R a , -N(R a )C(0)OR a , -N(R a
  • Fluoroalkyl refers to an alkyl radical, as defined above, that is substituted by one or more fluoro radicals, as defined above, for example, trifluoromethyl,
  • alkyl part of the fluoroalkyl radical may be optionally substituted as defined above for an alkyl group.
  • Halo is intended to mean fluoro, chloro, bromo or iodo.
  • haloalkyl haloalkenyl
  • haloalkynyl haloalkoxy
  • Heteroalkyl “heteroalkenyl” and “heteroalkynyl” include optionally substituted alkyl, alkenyl and alkynyl radicals and which have one or more skeletal chain atoms selected from an atom other than carbon, e.g., oxygen, nitrogen, sulfur, phosphorus or combinations thereof.
  • a numerical range may be given - e.g., C 1 -C 4 heteroalkyl which refers to the chain length in total, which in this example is 4 atoms long.
  • a heteroalkyl group may be substituted with one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, nitro, oxo, thioxo, trimethylsilanyl, -OR a , -SR a , - OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , -N(R a )C(0)OR a , - N(R a )C(0)R a , -N(R a )C(0)OR a , - N(R a )C(0)R a
  • Heteroalkylaryl refers to an -(heteroalkyl)aryl radical where heteroalkyl and aryl are as disclosed herein and which are optionally substituted by one or more of the substituents described as suitable substituents for heteroalkyl and aryl, respectively.
  • Heteroalkylheteroaryl refers to an -(heteroalkyl)heteroaryl radical where heteroalkyl and heteroaryl are as disclosed herein and which are optionally substituted by one or more of the substituents described as suitable substituents for heteroalkyl and heteroaryl, respectively.
  • Heteroalkylheterocycloalkyl refers to an -(heteroalkyl)heterocycloalkyl radical where heteroalkyl and heterocycloalkyl are as disclosed herein and which are optionally substituted by one or more of the substituents described as suitable substituents for heteroalkyl and heterocycloalkyl, respectively.
  • Heteroalkylcycloalkyl refers to an -(heteroalkyl)cycloalkyl radical where heteroalkyl and cycloalkyl are as disclosed herein and which are optionally substituted by one or more of the substituents described as suitable substituents for heteroalkyl and cycloalkyl, respectively.
  • Heteroaryl or “heteroaromatic” or “HetAr” refers to a 5- to 18-membered aromatic radical (e.g., C5-C13 heteroaryl) that includes one or more ring heteroatoms selected from nitrogen, oxygen and sulfur, and which may be a monocyclic, bicyclic, tricyclic or tetracyclic ring system.
  • a numerical range such as “5 to 18” refers to each integer in the given range - e.g., "5 to 18 ring atoms” means that the heteroaryl group may consist of 5 ring atoms, 6 ring atoms, etc., up to and including 18 ring atoms.
  • Bivalent radicals derived from univalent heteroaryl radicals whose names end in "-yl” by removal of one hydrogen atom from the atom with the free valence are named by adding "-idene" to the name of the corresponding univalent radical - e.g., a pyridyl group with two points of attachment is a pyridylidene.
  • heteroaryl refers to an aromatic group in which at least one of the skeletal atoms of the ring is a nitrogen atom.
  • the polycyclic heteroaryl group may be fused or non-fused.
  • the heteroatom(s) in the heteroaryl radical are optionally oxidized.
  • One or more nitrogen atoms, if present, are optionally quaternized.
  • the heteroaryl may be attached to the rest of the molecule through any atom of the ring(s).
  • heteroaryls include, but are not limited to, azepinyl, acridinyl, benzimidazolyl, benzindolyl, 1,3 -benzodioxolyl, benzofuranyl, benzooxazolyl, benzo[ ⁇ fJthiazolyl, benzothiadiazolyl, benzo[6][l ,4]dioxepinyl, benzo[6][l ,4]oxazinyl, 1,4-benzodioxanyl, benzonaphthofuranyl, benzoxazolyl, benzodioxolyl, benzodioxinyl, benzoxazolyl, benzopyranyl, benzopyranonyl, benzofuranyl, benzofuranonyl, benzofurazanyl, benzothiazolyl, benzothienyl(benzothiophenyl), benzothieno[3,2- (fj)
  • a heteroaryl moiety is optionally substituted by one or more substituents which are independently: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, nitro, oxo, thioxo, trimethylsilanyl, -OR a , -SR a , - OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , -C(0)N(R a ) 2 , -N(R a )C(0)OR a , - N(R a )C(0)R a , -N(R a )C(0)OR a , - N(R a )C(0)R
  • Substituted heteroaryl also includes ring systems substituted with one or more oxide (-0-) substituents, such as, for example, pyridinyl N-oxides.
  • Heteroarylalkyl refers to a moiety having an aryl moiety, as described herein, connected to an alkylene moiety, as described herein, wherein the connection to the remainder of the molecule is through the alkylene group.
  • Heterocycloalkyl refers to a stable 3- to 18-membered non-aromatic ring radical that comprises two to twelve carbon atoms and from one to six heteroatoms selected from nitrogen, oxygen and sulfur. Whenever it appears herein, a numerical range such as “3 to 18" refers to each integer in the given range - e.g., "3 to 18 ring atoms” means that the heterocycloalkyl group may consist of 3 ring atoms, 4 ring atoms, etc., up to and including 18 ring atoms.
  • the heterocycloalkyl radical is a monocyclic, bicyclic, tricyclic or tetracyclic ring system, which may include fused or bridged ring systems.
  • the heteroatoms in the heterocycloalkyl radical may be optionally oxidized.
  • One or more nitrogen atoms, if present, are optionally quaternized.
  • the heterocycloalkyl radical is partially or fully saturated.
  • the heterocycloalkyl may be attached to the rest of the molecule through any atom of the ring(s).
  • heterocycloalkyl radicals include, but are not limited to, dioxolanyl, thienyl[l,3]dithianyl, decahydroisoquinolyl, imidazolinyl, imidazolidinyl, isothiazolidinyl, isoxazolidinyl, morpholinyl,
  • octahydroindolyl octahydroisoindolyl, 2-oxopiperazinyl, 2-oxopiperidinyl, 2- oxopyrrolidinyl, oxazolidinyl, piperidinyl, piperazinyl, 4-piperidonyl, pyrrolidinyl, pyrazolidinyl, quinuclidinyl, thiazolidinyl, tetrahydrofuryl, trithianyl, tetrahydropyranyl, thiomorpholinyl, thiamorpholinyl, 1 -oxo-thiomorpholinyl, and 1 , 1 -dioxo- thiomorpholinyl. Unless stated otherwise specifically in the specification, a
  • heterocycloalkyl moiety is optionally substituted by one or more substituents which independently are: alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, hydroxy, halo, cyano, nitro, oxo, thioxo, tnmethylsilanyl, -OR a , -SR a , -OC(0)-R a , -N(R a ) 2 , -C(0)R a , -C(0)OR a , -OC(0)N(R a ) 2 , - C(0)N(R a ) 2 , -N(R a )C(0)OR a , -N(R a )C(0)R a , -N(R a )C(0)OR a , -N(R a )C
  • Heterocycloalkyl also includes bicyclic ring systems wherein one non- aromatic ring, usually with 3 to 7 ring atoms, contains at least 2 carbon atoms in addition to 1-3 heteroatoms independently selected from oxygen, sulfur, and nitrogen, as well as combinations comprising at least one of the foregoing heteroatoms; and the other ring, usually with 3 to 7 ring atoms, optionally contains 1-3 heteroatoms independently selected from oxygen, sulfur, and nitrogen and is not aromatic.
  • Niro refers to the -N0 2 radical.
  • Oxa refers to the -O- radical.
  • Sulfanyl refers to groups that include -S-(optionally substituted alkyl), -S- (optionally substituted aryl), -S-(optionally substituted heteroaryl) and -S-(optionally substituted heterocycloalkyl).
  • Sulfinyl refers to groups that include -S(0)-H, -S(0)-(optionally substituted alkyl), -S(0)-(optionally substituted amino), -S(0)-(optionally substituted aryl), -S(O)- (optionally substituted heteroaryl) and -S(0)-(optionally substituted heterocycloalkyl).
  • Sulfonyl refers to groups that include -S(0 2 )-H, -S(0 2 )-(optionally substituted alkyl), -S(0 2 )-(optionally substituted amino), -S(0 2 )-(optionally substituted aryl), -S(0 2 )- (optionally substituted heteroaryl), and -S(0 2 )-(optionally substituted heterocycloalkyl).
  • a sulfonamido group is optionally substituted by one or more of the substituents described for alkyl, cycloalkyl, aryl, heteroaryl, respectively.
  • R is selected from the group consisting of alkyl, cycloalkyl, aryl, heteroaryl (bonded through a ring carbon) and heteroalicyclic (bonded through a ring carbon).
  • a sulfonate group is optionally substituted on R by one or more of the substituents described for alkyl, cycloalkyl, aryl, heteroaryl, respectively.
  • “Isomers” are different compounds that have the same molecular formula.
  • “Stereoisomers” are isomers that differ only in the way the atoms are arranged in space - i.e., having a different stereochemical configuration.
  • “Enantiomers” are a pair of stereoisomers that are non-superimposable mirror images of each other.
  • a 1 : 1 mixture of a pair of enantiomers is a "racemic” mixture.
  • the term “( ⁇ )” is used to designate a racemic mixture where appropriate.
  • “Diastereoisomers” are stereoisomers that have at least two asymmetric atoms, but which are not mirror-images of each other.
  • the absolute stereochemistry is specified according to the Cahn-Ingold-Prelog R-S system.
  • the stereochemistry at each chiral carbon can be specified by either (R) or (S).
  • Resolved compounds whose absolute configuration is unknown can be designated (+) or (-) depending on the direction (dextro- or levorotatory) which they rotate plane polarized light at the wavelength of the sodium D line.
  • Certain of the compounds described herein contain one or more asymmetric centers and can thus give rise to enantiomers, diastereomers, and other stereoisomeric forms that can be defined, in terms of absolute stereochemistry, as (R) or (S).
  • Optically active (R)- and ( ⁇ -isomers can be prepared using chiral synthons or chiral reagents, or resolved using conventional techniques.
  • R independently active
  • ⁇ -isomers can be prepared using chiral synthons or chiral reagents, or resolved using conventional techniques.
  • the compounds described herein contain olefinic double bonds or other centers of geometric asymmetry, and unless specified otherwise, it is intended that the compounds include both E and Z geometric isomers.
  • Enantiomeric purity refers to the relative amounts, expressed as a percentage, of the presence of a specific enantiomer relative to the other enantiomer. For example, if a compound, which may potentially have an (R)- or an ( ⁇ -isomeric configuration, is present as a racemic mixture, the enantiomeric purity is about 50% with respect to either the (R)- or ( ⁇ -isomer. If that compound has one isomeric form predominant over the other, for example, 80% (5)-isomer and 20% (i?)-isomer, the enantiomeric purity of the compound with respect to the (S)-isomeric form is 80%.
  • the enantiomeric purity of a compound can be determined in a number of ways known in the art, including but not limited to chromatography using a chiral support, polarimetric measurement of the rotation of polarized light, nuclear magnetic resonance spectroscopy using chiral shift reagents which include but are not limited to lanthanide containing chiral complexes or Pirkle's reagents, or derivatization of a compounds using a chiral compound such as Mosher's acid followed by chromatography or nuclear magnetic resonance spectroscopy.
  • the enantiomerically enriched composition has a higher potency with respect to therapeutic utility per unit mass than does the racemic mixture of that composition.
  • Enantiomers can be isolated from mixtures by methods known to those skilled in the art, including chiral high pressure liquid chromatography (HPLC) and the formation and crystallization of chiral salts; or preferred enantiomers can be prepared by asymmetric syntheses. See, for example, Jacques, et al, Enantiomers, Racemates and Resolutions (Wiley Interscience, New York, 1981); Eliel,
  • an enantiomerically enriched preparation of the (5)-enantiomer means a preparation of the compound having greater than 50% by weight of the (5)-enantiomer relative to the (i?)-enantiomer, such as at least 75% by weight, or such as at least 80% by weight.
  • the enrichment can be
  • enantiomerically enriched or a “substantially non-racemic” preparation, which refers to preparations of compositions which have at least 85% by weight of one enantiomer relative to other enantiomer, such as at least 90% by weight, or such as at least 95% by weight.
  • enantiomerically pure or “substantially enantiomerically pure” refers to a composition that comprises at least 98% of a single enantiomer and less than 2% of the opposite enantiomer.
  • Moiety refers to a specific segment or functional group of a molecule.
  • Chemical moieties are often recognized chemical entities embedded in or appended to a molecule.
  • Tautomerization is a form of isomerization and includes prototropic or proton-shift tautomerization, which is considered a subset of acid-base chemistry.
  • Prototropic tautomerization or “proton-shift tautomerization” involves the migration of a proton accompanied by changes in bond order, often the interchange of a single bond with an adjacent double bond. Where tautomerization is possible (e.g. in solution), a chemical equilibrium of tautomers can be reached.
  • An example of tautomerization is keto-enol tautomerization.
  • keto-enol tautomerization is the interconversion of pentane-2,4-dione and 4-hydroxypent-3-en-2-one tautomers.
  • Another example of tautomerization is phenol-keto tautomerization.
  • a specific example of phenol-keto tautomerization is the interconversion of pyridin-4-ol and pyridin-4(lH)-one tautomers.
  • a "leaving group or atom” is any group or atom that will, under selected reaction conditions, cleave from the starting material, thus promoting reaction at a specified site.
  • groups include halogen atoms and mesyloxy, p-nitrobenzensulphonyloxy and tosyloxy groups.
  • Protecting group is intended to mean a group that selectively blocks one or more reactive sites in a multifunctional compound such that a chemical reaction can be carried out selectively on another unprotected reactive site and the group can then be readily removed after the selective reaction is complete.
  • a variety of protecting groups are disclosed, for example, in T. ⁇ . Greene and P. G. M. Wuts, Protective Groups in Organic Synthesis, Third Edition, John Wiley & Sons, New York (1999).
  • Solvate refers to a compound in physical association with one or more molecules of a pharmaceutically acceptable solvent.
  • Substituted means that the referenced group may have attached one or more additional groups, radicals or moieties individually and independently selected from, for example, acyl, alkyl, alkylaryl, cycloalkyl, aralkyl, aryl, carbohydrate, carbonate, heteroaryl, heterocycloalkyl, hydroxy, alkoxy, aryloxy, mercapto, alkylthio, arylthio, cyano, halo, carbonyl, ester, thiocarbonyl, isocyanato, thiocyanato, isothiocyanato, nitro, oxo, perhaloalkyl, perfluoroalkyl, phosphate, silyl, sulfinyl, sulfonyl, sulfonamidyl, sulfoxyl, sulfonate, urea, and amino, including mono- and di-substituted amino groups, and
  • substituents themselves may be substituted, for example, a cycloalkyl substituent may itself have a halide substituent at one or more of its ring carbons.
  • optionally substituted means optional substitution with the specified groups, radicals or moieties.
  • warhead refers to a functional group present on a compound of the present invention wherein that functional group is capable of covalently binding to an amino acid residue (such as cysteine, lysine, histidine, or other residues capable of being covalently modified) present in the binding pocket of the target protein, thereby irreversibly inhibiting the protein.
  • amino acid residue such as cysteine, lysine, histidine, or other residues capable of being covalently modified
  • Compounds of the invention also include crystalline and amorphous forms of those compounds, including, for example, polymorphs, pseudopolymorphs, solvates, hydrates, unsolvated polymorphs (including anhydrates), conformational polymorphs, and amorphous forms of the compounds, as well as mixtures thereof.
  • Crystalstalline form and polymorph are intended to include all crystalline and amorphous forms of the compound, including, for example, polymorphs, pseudopolymorphs, solvates, hydrates, unsolvated polymorphs (including anhydrates), conformational polymorphs, and amorphous forms, as well as mixtures thereof, unless a particular crystalline or amorphous form is referred to.
  • Compounds of the invention also include antibodies.
  • the terms “antibody” and its plural form “antibodies” refer to whole immunoglobulins and any antigen-binding fragment ("antigen-binding portion") or single chains thereof.
  • An “antibody” further refers to a glycoprotein comprising at least two heavy (H) chains and two light (L) chains inter-connected by disulfide bonds, or an antigen-binding portion thereof.
  • Each heavy chain is comprised of a heavy chain variable region (abbreviated herein as V H ) and a heavy chain constant region.
  • the heavy chain constant region is comprised of three domains, CHI, CH2 and CH3.
  • Each light chain is comprised of a light chain variable region (abbreviated herein as V L ) and a light chain constant region.
  • the light chain constant region is comprised of one domain, C L .
  • the V H and V L regions of an antibody may be further subdivided into regions of hypervariability, which are referred to as complementarity determining regions (CDR) or hypervariable regions (HVR), and which can be interspersed with regions that are more conserved, termed framework regions (FR).
  • CDR complementarity determining regions
  • HVR hypervariable regions
  • FR framework regions
  • Each V H and V L is composed of three CDRs and four FRs, arranged from amino- terminus to carboxy -terminus in the following order: FR1, CDR1, FR2, CDR2, FR3, CDR3, FR4.
  • variable regions of the heavy and light chains contain a binding domain that interacts with an antigen epitope or epitopes.
  • the constant regions of the antibodies may mediate the binding of the immunoglobulin to host tissues or factors, including various cells of the immune system (e.g., effector cells) and the first component (Clq) of the classical complement system.
  • a monoclonal antibody composition displays a single binding specificity and affinity for a particular epitope.
  • Monoclonal antibodies specific to e.g. PD-1, PD-Ll, or PD-L2 can be made using knowledge and skill in the art of injecting test subjects with PD-1, PD-Ll, or PD-L2 antigen and then isolating hybridomas expressing antibodies having the desired sequence or functional characteristics.
  • DNA encoding the monoclonal antibodies is readily isolated and sequenced using conventional procedures (e.g., by using oligonucleotide probes that are capable of binding specifically to genes encoding the heavy and light chains of the monoclonal antibodies).
  • the hybridoma cells serve as a preferred source of such DNA.
  • the DNA may be placed into expression vectors, which are then transfected into host cells such as E. coli cells, simian COS cells, Chinese hamster ovary (CHO) cells, or myeloma cells that do not otherwise produce immunoglobulin protein, to obtain the synthesis of monoclonal antibodies in the recombinant host cells. Recombinant production of antibodies will be described in more detail below.
  • antigen-binding portion or "antigen-binding fragment” of an antibody (or simply “antibody portion”), as used herein, refers to one or more fragments of an antibody that retain the ability to specifically bind to an antigen (e.g., PD-1, PD-Ll, or PD-L2). It has been shown that the antigen-binding function of an antibody can be performed by fragments of a full-length antibody.
  • an antigen e.g., PD-1, PD-Ll, or PD-L2
  • binding fragments encompassed within the term "antigen-binding portion" of an antibody include (i) a Fab fragment, a monovalent fragment consisting of the V L , V H , C L and CHI domains; (ii) a F(ab')2 fragment, a bivalent fragment comprising two Fab fragments linked by a disulfide bridge at the hinge region; (iii) a Fd fragment consisting of the V H and CHI domains; (iv) a Fv fragment consisting of the V L and V H domains of a single arm of an antibody, (v) a domain antibody (dAb) fragment (Ward et al., Nature, 1989, 341, 544-546), which may consist of a V H or a V L domain; and (vi) an isolated complementarity determining region (CDR).
  • a Fab fragment a monovalent fragment consisting of the V L , V H , C L and CHI domains
  • F(ab')2 fragment a bivalent
  • the two domains of the Fv fragment, V L and V H are coded for by separate genes, they can be joined, using recombinant methods, by a synthetic linker that enables them to be made as a single protein chain in which the V L and V H regions pair to form monovalent molecules known as single chain Fv (scFv); see e.g., Bird et al, Science 1988, 242, 423-426; and Huston et al, Proc. Natl. Acad. Sci. USA 1988, 85, 5879-5883).
  • scFv chain antibodies are also intended to be encompassed within the terms "antigen-binding portion" or "antigen-binding fragment” of an antibody. These antibody fragments are obtained using conventional techniques known to those with skill in the art, and the fragments are screened for utility in the same manner as are intact antibodies.
  • human antibody is intended to include antibodies having variable regions in which both the framework and CDR regions are derived from human germline immunoglobulin sequences. Furthermore, if the antibody contains a constant region, the constant region also is derived from human germline
  • human antibodies of the invention may include amino acid residues not encoded by human germline immunoglobulin sequences (e.g., mutations introduced by random or site-specific mutagenesis in vitro or by somatic mutation in vivo).
  • human antibody as used herein, is not intended to include antibodies in which CDR sequences derived from the germline of another mammalian species, such as a mouse, have been grafted onto human framework sequences.
  • human monoclonal antibody refers to antibodies displaying a single binding specificity which have variable regions in which both the framework and CDR regions are derived from human germline immunoglobulin sequences.
  • the human monoclonal antibodies are produced by a hybridoma which includes a B cell obtained from a transgenic nonhuman animal, e.g., a transgenic mouse, having a genome comprising a human heavy chain transgene and a light chain transgene fused to an immortalized cell.
  • recombinant human antibody includes all human antibodies that are prepared, expressed, created or isolated by recombinant means, such as (a) antibodies isolated from an animal (e.g., a mouse) that is transgenic or
  • transchromosomal for human immunoglobulin genes or a hybridoma prepared therefrom (described further below), (b) antibodies isolated from a host cell transformed to express the human antibody, e.g., from a transfectoma, (c) antibodies isolated from a
  • recombinant, combinatorial human antibody library and (d) antibodies prepared, expressed, created or isolated by any other means that involve splicing of human immunoglobulin gene sequences to other DNA sequences.
  • Such recombinant human antibodies have variable regions in which the framework and CDR regions are derived from human germline immunoglobulin sequences.
  • such recombinant human antibodies can be subjected to in vitro mutagenesis (or, when an animal transgenic for human Ig sequences is used, in vivo somatic mutagenesis) and thus the amino acid sequences of the V H and V L regions of the recombinant antibodies are sequences that, while derived from and related to human germline V H and V L sequences, may not naturally exist within the human antibody germline repertoire in vivo.
  • isotype refers to the antibody class (e.g., IgM or IgGl) that is encoded by the heavy chain constant region genes.
  • human antibody derivatives refers to any modified form of the human antibody, e.g., a conjugate of the antibody and another active pharmaceutical ingredient or antibody.
  • conjugate or “immunoconjugate” refers to an antibody, or a fragment thereof, conjugated to a therapeutic moiety, such as a bacterial toxin, a cytotoxic drug or a radionuclide-containing toxin.
  • therapeutic moiety such as a bacterial toxin, a cytotoxic drug or a radionuclide-containing toxin.
  • Toxic moieties can be conjugated to antibodies of the invention using methods available in the art.
  • humanized antibody “humanized antibodies,” and “humanized” are intended to refer to antibodies in which CDR sequences derived from the germline of another mammalian species, such as a mouse, have been grafted onto human framework sequences. Additional framework region modifications may be made within the human framework sequences.
  • Humanized forms of non-human (for example, murine) antibodies are chimeric antibodies that contain minimal sequence derived from non-human immunoglobulin.
  • humanized antibodies are human immunoglobulins (recipient antibody) in which residues from a hypervariable region of the recipient are replaced by residues from a 15 hypervariable region of a non-human species (donor antibody) such as mouse, rat, rabbit or nonhuman primate having the desired specificity, affinity, and capacity.
  • donor antibody such as mouse, rat, rabbit or nonhuman primate having the desired specificity, affinity, and capacity.
  • Fv framework region (FR) residues of the human immunoglobulin are replaced by corresponding non-human residues.
  • humanized antibodies may comprise residues that are not found in the recipient antibody or in the donor antibody. These modifications are made to further refine antibody performance.
  • the humanized antibody will comprise substantially all of at least one, and typically two, variable domains, in which all or substantially all of the hypervariable loops correspond to those of a non-human immunoglobulin and all or substantially all of the FR regions are those of a human immunoglobulin sequence.
  • the humanized antibody optionally also will comprise at least a portion of an immunoglobulin constant region (Fc), typically that of a human immunoglobulin.
  • Fc immunoglobulin constant region
  • chimeric antibody is intended to refer to antibodies in which the variable region sequences are derived from one species and the constant region sequences are derived from another species, such as an antibody in which the variable region sequences are derived from a mouse antibody and the constant region sequences are derived from a human antibody.
  • a "diabody” is a small antibody fragment with two antigen-binding sites.
  • the fragments comprises a heavy chain variable domain (V H ) connected to a light chain variable domain (V L ) in the same polypeptide chain (V H -V L or V L -V H ).
  • V H heavy chain variable domain
  • V L light chain variable domain
  • the domains are forced to pair with the complementary domains of another chain and create two antigen-binding sites.
  • Diabodies are described more fully in, e.g., European Patent No. EP 404,097, International Patent Publication No. WO 93/11161 ; and Bolliger et al. , Proc. Natl. Acad. Sci. USA 1993, 90, 6444-6448.
  • glycosylation refers to a modified derivative of an antibody.
  • An aglycoslated antibody lacks glycosylation.
  • Glycosylation can be altered to, for example, increase the affinity of the antibody for antigen.
  • Such carbohydrate modifications can be accomplished by, for example, altering one or more sites of glycosylation within the antibody sequence. For example, one or more amino acid substitutions can be made that result in elimination of one or more variable region framework glycosylation sites to thereby eliminate glycosylation at that site.
  • Aglycosylation may increase the affinity of the antibody for antigen, as described in U.S. Patent Nos. 5,714,350 and 6,350,861.
  • an antibody can be made that has an altered type of glycosylation, such as a hypofucosylated antibody having reduced amounts of fucosyl residues or an antibody having increased bisecting GlcNac structures.
  • altered glycosylation patterns have been demonstrated to increase the ability of antibodies.
  • carbohydrate modifications can be accomplished by, for example, expressing the antibody in a host cell with altered glycosylation machinery. Cells with altered glycosylation machinery have been described in the art and can be used as host cells in which to express recombinant antibodies of the invention to thereby produce an antibody with altered glycosylation.
  • the cell lines Ms704, Ms705, and Ms709 lack the fucosyltransferase gene, FUT8 (alpha (1,6) fucosyltransferase), such that antibodies expressed in the Ms704, Ms705, and Ms709 cell lines lack fucose on their carbohydrates.
  • the Ms704, Ms705, and Ms709 FUT8-/- cell lines were created by the targeted disruption of the FUT8 gene in CHO/DG44 cells using two replacement vectors (see e.g. U.S. Patent Publication No. 2004/0110704 or Yamane-Ohnuki, et al. Biotechnol. Bioeng., 2004, 87, 614-622).
  • EP 1,176,195 describes a cell line with a functionally disrupted FUT8 gene, which encodes a fucosyl transferase, such that antibodies expressed in such a cell line exhibit hypofucosylation by reducing or eliminating the alpha 1,6 bond-related enzyme, and also describes cell lines which have a low enzyme activity for adding fucose to the N-acetylglucosamine that binds to the Fc region of the antibody or does not have the enzyme activity, for example the rat myeloma cell line YB2/0 (ATCC CRL 1662).
  • WO 99/54342 describes cell lines engineered to express glycoprotein-modifying glycosyl transferases (e.g., beta(l,4)-N- acetylglucosaminyltransferase III (GnTIII)) such that antibodies expressed in the engineered cell lines exhibit increased bisecting GlcNac structures which results in increased ADCC activity of the antibodies (see also Umana, et al, Nat. Biotech. 1999, 17, 176-180).
  • the fucose residues of the antibody may be cleaved off using a fucosidase enzyme.
  • the fucosidase alpha-L-fucosidase removes fucosyl residues from antibodies as described in Tarentino, et al, Biochem. 1975, 14, 5516-5523.
  • PEG polyethylene glycol
  • Pegylation refers to a modified antibody, or a fragment thereof, that typically is reacted with polyethylene glycol (PEG), such as a reactive ester or aldehyde derivative of PEG, under conditions in which one or more PEG groups become attached to the antibody or antibody fragment.
  • PEG polyethylene glycol
  • Pegylation may, for example, increase the biological (e.g., serum) half life of the antibody.
  • the pegylation is carried out via an acylation reaction or an alkylation reaction with a reactive PEG molecule (or an analogous reactive water-soluble polymer).
  • polyethylene glycol is intended to encompass any of the forms of PEG that have been used to derivatize other proteins, such as mono (Ci-Cio) alkoxy- or aryloxy-poly ethylene glycol or polyethylene glycol-maleimide.
  • the antibody to be pegylated may be an aglycosylated antibody. Methods for pegylation are known in the art and can be applied to the antibodies of the invention, as described for example in European Patent Nos. EP 0154316 and EP 0401384.
  • Conservative amino acid substitutions include the substitution of an amino acid in one class by an amino acid of the same class, where a class is defined by common physicochemical amino acid side chain properties and high substitution frequencies in homologous proteins found in nature, as determined, for example, by a standard Dayhoff frequency exchange matrix or BLOSUM matrix.
  • Six general classes of amino acid side chains have been categorized and include: Class I (Cys); Class II (Ser, Thr, Pro, Ala, Gly); Class III (Asn, Asp, Gin, Glu); Class IV (His, Arg, Lys); Class V (He, Leu, Val, Met); and Class VI (Phe, Tyr, Trp).
  • substitution of an Asp for another class III residue such as Asn, Gin, or Glu is a conservative substitution.
  • a predicted nonessential amino acid residue in an anti-IL-6 or anti-IL-6R antibody is preferably replaced with another amino acid residue from the same class.
  • sequence identity refers to two or more sequences or subsequences that are the same or have a specified percentage of nucleotides or amino acid residues that are the same, when compared and aligned (introducing gaps, if necessary) for maximum correspondence, not considering any conservative amino acid substitutions as part of the sequence identity.
  • the percent identity can be measured using sequence comparison software or algorithms or by visual inspection. Various algorithms and software are known in the art that can be used to obtain alignments of amino acid or nucleotide sequences. Suitable programs to determine percent sequence identity include for example the BLAST suite of programs available from the U.S.
  • BLASTN is used to compare nucleic acid sequences
  • BLASTP is used to compare amino acid sequences. ALIGN, ALIGN-2
  • MegAlign available from DNASTAR, are additional publicly available software programs that can be used to align sequences.
  • One skilled in the art can determine appropriate parameters for maximal alignment by particular alignment software. In certain embodiments, the default parameters of the alignment software are used.
  • Certain embodiments of the present invention comprise a variant of an antibody, e.g., an anti-CD20 antibody and/or an anti-PD-1 antibody, anti-PD-Ll, and/or an anti- PD-L2 antibody.
  • the term "variant" encompasses but is not limited to antibodies which comprise an amino acid sequence which differs from the amino acid sequence of a reference antibody by way of one or more substitutions, deletions and/or additions at certain positions within or adjacent to the amino acid sequence of the reference antibody.
  • the variant may comprise one or more conservative substitutions in its amino acid sequence as compared to the amino acid sequence of a reference antibody. Conservative substitutions may involve, e.g., the substitution of similarly charged or uncharged amino acids.
  • the variant retains the ability to specifically bind to the antigen of the reference antibody.
  • an antibody that "specifically binds to human PD-1" is intended to refer to an antibody that binds to human PD-1 with a K D of 1 x lCf 7 M or less, more preferably 5x1 Cf 8 M or less, more preferably l xl Cf 8 M or less, more preferably 5 ⁇ 1 Cf 9 M or less.
  • an antibody that "specifically binds to human PD-L1" is intended to refer to an antibody that binds to human PD-L1 with a K D of 1 xl0 ⁇ 7 M or less, more preferably 5 ⁇ 1 Cf 8 M or less, more preferably 1 x 1 Cf 8 M or less, more preferably 5xl(f 9 M or less.
  • an antibody that "specifically binds to human PD-L2" is intended to refer to an antibody that binds to human PD-L2 with a K D of 1 x 10 M or less, more preferably 5x 10 8 M or less, more preferably 1 x10 8 M or less, more preferably 5xl0 ⁇ 9 M or less.
  • an antibody that "specifically binds to human CD20" is intended to refer to an antibody that binds to human CD20 with a K D of 1 x 10 ⁇ 7 M or less, more preferably 5x10 ⁇ 8 M or less, more preferably l x l 0 ⁇ 8 M or less, more preferably 5xl0 ⁇ 9 M or less.
  • radioisotope-labeled complex refers to both non-covalent and covalent attachment of a radioactive isotope, such as 90 Y, m In, or m l, to an antibody, including conjugates.
  • biosimilar means a biological product that is highly similar to a U.S. licensed reference biological product notwithstanding minor differences in clinically inactive components, and for which there are no clinically meaningful differences between the biological product and the reference product in terms of the safety, purity, and potency of the product.
  • a similar biological or “biosimilar” medicine is a biological medicine that is similar to another biological medicine that has already been authorized for use by the European Medicines Agency.
  • biosimilar is also used synonymously by other national and regional regulatory agencies.
  • Biological products or biological medicines are medicines that are made by or derived from a biological source, such as a bacterium or yeast.
  • the reference anti-CD20 monoclonal antibody is rituximab
  • an anti-CD20 biosimilar monoclonal antibody approved by drug regulatory authorities with reference to rituximab is a "biosimilar to" rituximab or is a "biosimilar thereof rituximab.
  • the reference anti-PD-1 monoclonal antibody is pembrolizumab
  • an anti-PD-1 biosimilar monoclonal antibody approved by drug regulatory authorities with reference to pembrolizumab is a "biosimilar to" pembrolizumab or is a "biosimilar thereof of pembrolizumab.
  • a similar biological or "biosimilar” medicine is a biological medicine that is similar to another biological medicine that has already been authorized for use by the European Medicines Agency (EMA).
  • EMA European Medicines Agency
  • the relevant legal basis for similar biological applications in Europe is Article 6 of Regulation (EC) No 726/2004 and Article 10(4) of Directive 2001/83/EC, as amended and therefore in Europe, the biosimilar may be authorised, approved for authorisation or subject of an application for authorisation under Article 6 of Regulation (EC) No 726/2004 and Article 10(4) of Directive 2001/83/EC.
  • the already authorized original biological medicinal product may be referred to as a "reference medicinal product" in Europe.
  • Some of the requirements for a product to be considered a biosimilar are outlined in the CHMP Guideline on Similar Biological Medicinal Products.
  • a biosimilar as described herein may be similar to the reference medicinal product by way of quality characteristics, biological activity, mechanism of action, safety profiles and/or efficacy.
  • the biosimilar may be used or be intended for use to treat the same conditions as the reference medicinal product.
  • a biosimilar as described herein may be deemed to have similar or highly similar quality characteristics to a reference medicinal product.
  • a biosimilar as described herein may be deemed to have similar or highly similar biological activity to a reference medicinal product.
  • a biosimilar as described herein may be deemed to have a similar or highly similar safety profile to a reference medicinal product.
  • a biosimilar as described herein may be deemed to have similar or highly similar efficacy to a reference medicinal product.
  • a biosimilar in Europe is compared to a reference medicinal product which has been authorised by the EMA.
  • the biosimilar may be compared to a biological medicinal product which has been authorised outside the European Economic Area (a non-EEA authorised "comparator") in certain studies. Such studies include for example certain clinical and in vivo non-clinical studies.
  • biosimilar also relates to a biological medicinal product which has been or may be compared to a non-EEA authorised comparator.
  • Certain biosimilars are proteins such as antibodies, antibody fragments (for example, antigen binding portions) and fusion proteins.
  • a protein biosimilar may have an amino acid sequence that has minor modifications in the amino acid structure (including for example deletions, additions, and/or substitutions of amino acids) which do not significantly affect the function of the polypeptide.
  • the biosimilar may comprise an amino acid sequence having a sequence identity of 97% or greater to the amino acid sequence of its reference medicinal product, e.g., 97%, 98%, 99% or 100%.
  • the biosimilar may comprise one or more post-translational
  • the biosimilar may have an identical or different glycosylation pattern to the reference medicinal product. Particularly, although not exclusively, the biosimilar may have a different glycosylation pattern if the differences address or are intended to address safety concerns associated with the reference medicinal product. Additionally, the biosimilar may deviate from the reference medicinal product in for example its strength, pharmaceutical form, formulation, excipients and/or presentation, providing safety and efficacy of the medicinal product is not compromised.
  • the biosimilar may comprise differences in for example pharmacokinetic (PK) and/or pharmacodynamic (PD) profiles as compared to the reference medicinal product but is still deemed sufficiently similar to the reference medicinal product as to be authorised or considered suitable for authorisation.
  • the biosimilar exhibits different binding characteristics as compared to the reference medicinal product, wherein the different binding characteristics are considered by a Regulatory Authority such as the EMA not to be a barrier for authorisation as a similar biological product.
  • PK pharmacokinetic
  • PD pharmacodynamic
  • biosimilar exhibits different binding characteristics as compared to the reference medicinal product, wherein the different binding characteristics are considered by a Regulatory Authority such as the EMA not to be a barrier for authorisation as a similar biological product.
  • biosimilar is also used synonymously by other national and regional regulatory agencies.
  • hematological malignancy refers to mammalian cancers and tumors of the hematopoietic and lymphoid tissues, including but not limited to tissues of the blood, bone marrow, lymph nodes, and lymphatic system. Hematological malignancies are also referred to as "liquid tumors.” Hematological malignancies include, but are not limited to, ALL, CLL, SLL, acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), acute monocytic leukemia (AMoL), Hodgkin's lymphoma, and non- Hodgkin's lymphomas.
  • B cell hematological malignancy refers to hematological malignancies that affect B cells.
  • solid tumor refers to an abnormal mass of tissue that usually does not contain cysts or liquid areas. Solid tumors may be benign or malignant.
  • solid tumor cancer refers to malignant, neoplastic, or cancerous solid tumors. Solid tumor cancers include, but are not limited to, sarcomas, carcinomas, and lymphomas, such as cancers of the lung, breast, prostate, colon, rectum, and bladder.
  • the tissue structure of solid tumors includes interdependent tissue compartments including the parenchyma (cancer cells) and the supporting stromal cells in which the cancer cells are dispersed and which may provide a supporting microenvironment.
  • microenvironment may refer to the tumor microenvironment as a whole or to an individual subset of cells within the
  • An aspect of the invention is a composition, such as a pharmaceutical composition, comprising a combination of a PI3K inhibitor, a BTK inhibitor, a JAK-2 inhibitor, a PD-1 inhibitor, and/or a PD-L1 or PD-L2 inhibitor.
  • Another aspect of the invention is a method of treating leukemia, lymphoma or a solid tumor cancer in a subject, comprising co-administering to the subject in need thereof a therapeutically effective amount of a combination of a PI3K inhibitor, a BTK inhibitor, and/or a PD-1 inhbitor.
  • the PI3K inhibitor is a ⁇ 3 ⁇ - ⁇ inhibitor.
  • the PI3K inhibitor is a PI3K-5 inhibitor.
  • the PI3K inhibitor is a ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor.
  • the PI3K inhibitor is a selective PI3K inhibitor.
  • the combination of the PI3K inhibitor, ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor with the BTK inhibitor is administered by oral, intravenous, intramuscular, intraperitoneal, subcutaneous or transdermal means.
  • the PI3K inhibitor, ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor is in the form of a pharmaceutically acceptable salt, solvate, hydrate, complex, derivative, prodrug (such as an ester or phosphate ester), or cocrystal.
  • the BTK inhibitor is in the form of a pharmaceutically acceptable salt, solvate, hydrate, complex, derivative, prodrug (such as an ester or phosphate ester), or cocrystal.
  • the PI3K inhibitor, ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor is administered to the subject before administration of the BTK inhibitor.
  • the PI3K inhibitor, ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor is administered concurrently with the administration of the BTK inhibitor.
  • the PI3K inhibitor, ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, PI3K- ⁇ , ⁇ inhibitor is administered to the subject after administration of the BTK inhibitor.
  • the PD-1 inhibitor is administered to the subject before administration of the BTK inhibitor.
  • the PD-1 inhibitor is administered concurrently with the administration of the BTK inhibitor.
  • the PD-1 inhibitor is administered to the subject after administration of the BTK inhibitor.
  • the BTK inhibitor, PD-1 inhibitor, JAK-2 inhibitor, and PI3K inhibitor are administered concurrently.
  • the subject is a mammal. In an embodiment, the subject is a human. In an embodiment, the subject is a companion animal, such as a canine, feline, or equine.
  • the PI3K inhibitor may be any PI3K inhibitor known in the art. In particular, it is one of the PI3K inhibitors described in more detail in the following paragraphs.
  • PI3K inhibitor selected from the group consisting of a ⁇ 3 ⁇ - ⁇ inhibitor, a PI3K-5 inhibitor, and a ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor.
  • it is a PI3K-5 inhibitor.
  • references herein to a PI3K inhibitor may refer to a compound or a pharmaceutically acceptable salt, ester, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K inhibitor which is preferably selected from the group consisting of a ⁇ 3 ⁇ - ⁇ inhibitor, a PI3K-5 inhibitor, and a ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor, is a compound selected from the structures disclosed in U.S. Patent Nos. 8,193,182 and 8,569,323, and U.S. Patent Application Publication Nos. 2012/0184568 Al,
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (I):
  • Cy is aryl or heteroaryl substituted by 0 or 1 occurrences of R 3 and 0, 1 , 2, or 3 occurrences of R 5 ;
  • W 5 is CR 8 , CHR 8 , or N;
  • R 8 is hydrogen, alkyl, alkenyl, alkynyl, cycloalkyl, heteroalkyl, alkoxy, amido, amino, acyl, acyloxy, sulfonamido, halo, cyano, hydroxyl or nitro;
  • B is hydrogen, alkyl, amino, heteroalkyl, cycloalkyl, heterocyclyl, aryl, or heteroaryl, each of which is substituted with 0, 1, 2, 3, or 4 occurrences of R 2 ;
  • each R 2 is independently alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, alkoxy, amido, amino, acyl, acyloxy, alkoxycarbonyl, sulfonamido, halo, cyano, hydroxyl, nitro, phosphate, urea, or carbonate;
  • X is -(CH(R 9 )) Z -;
  • z is an integer of 1, 2, 3, or 4;
  • R 3 is alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, fluoroalkyl, heteroalkyl, alkoxy, amido, amino, acyl, acyloxy, sulfinyl, sulfonyl, sulfoxide, sulfone, sulfonamido, halo, cyano, aryl, heteroaryl, hydroxyl, or nitro;
  • each R 5 is independently alkyl, alkenyl, alkynyl, cycloalkyl, heteroalkyl, alkoxy, amido, amino, acyl, acyloxy, sulfonamido, halo, cyano, hydroxyl, or nitro;
  • each R 9 is independently hydrogen, alkyl, cycloalkyl, heterocyclyl, or heteroalkyl; or two adjacent occurrences of R 9 together with the atoms to which they are attached form a
  • W d is heterocyclyl, aryl, cycloalkyl, or heteroaryl, each of which is substituted with one or more R 10 , R 11 , R 12 or R 13 , and
  • R 10 , R 11 , R 12 and R 13 are each independently hydrogen, alkyl, heteroalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, alkoxy, heterocyclyloxy, amido, amino, acyl, acyloxy, alkoxycarbonyl, sulfonamido, halo, cyano, hydroxyl, nitro, phosphate, urea, carbonate or NR'R" wherein R and R" are taken together with nitrogen to form a cyclic moiety.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (1-1):
  • W c is aryl, heteroaryl, heterocycloalkyl, or cycloalkyl
  • q is an integer of 0, 1, 2, 3, or 4;
  • X is a bond or -(CH(R 9 )) Z -, and z is an integer of 1, 2, 3 or 4;
  • z is an integer of 1, 2, 3, or 4;
  • Xi, X 2 and X3 are each independently C, CR or N; and X 4 , X 5 and X 6 are each independently N, NH, CR 13 , S or O;
  • R 1 is hydrogen, alkyl, alkenyl, alkynyl, alkoxy, amido, alkoxycarbonyl, sulfonamido, halo, cyano, or nitro;
  • R 2 is alkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, heteroaryl, heteroarylalkyl, alkoxy, amino, halo, cyano, hydroxy or nitro;
  • R 3 is hydrogen, alkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, alkoxy, amido, amino, alkoxycarbonyl sulfonamido, halo, cyano, hydroxy or nitro; and each instance of R 9 is independently hydrogen, alkyl, or heterocycloalkyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (III):
  • R is alkyl, alkenyl, alkynyl, cycloalkyl, heterocycloalkyl, aryl, heteroaryl,
  • heteroarylalkyl alkoxy, amino, halo, cyano, hydroxy or nitro;
  • R 9 is hydrogen, alkyl, or heterocycloalkyl.
  • the ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor is a compound of Formula (III-A):
  • Formula (III- A) is also known as IPI-145 or duvelisib (Infinity Pharmaceuticals) and has been studied at doses of 5 mg and 25 mg in clinical trials, including those described in Flinn, et al, Blood, 2014, 124, 802, and O'Brien, et al, Blood, 2014, 124, 3334.
  • the PI3K inhibitor is a compound of Formula (IV):
  • the PI3K inhibitor is (5 -3-(l-((9H-purin-6- yl)amino)ethyl)-8-chloro-2-phenylisoquinolin-l(2H)-one or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K inhibitor is ( ⁇ S -3-amino-N-(l-(5-chloro-4- oxo-3-phenyl-3,4-dihydroquinazolin-2-yl)ethyl)pyrazine-2-carboxamide or a
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound selected from the structures disclosed in U.S. Patent Nos. 8,193,199, 8,586,739, and 8,901 ,135, the disclosure of each of which is incorporated by reference herein.
  • the PI3K inhibitor or PI3K-5 inhibitor is a compound of Formula (V):
  • X 1 is C(R 9 ) or N;
  • X 2 is C(Rio) or N;
  • Y is N(R U ), O or S;
  • Z is CR 8 or N
  • n 0, 1 , 2 or 3;
  • R 1 is a direct-bonded or oxygen -linked saturated, partially saturated or unsaturated 5-, 6- or 7-membered monocyclic ring containing 0, 1 , 2, 3 or 4 atoms selected from N, O and S, but containing no more than one 0 or S, wherein the available carbon atoms of the ring are substituted by 0, 1 or 2 oxo or thioxo groups, wherein the ring is substituted by 0 or 1 R substituents, and the ring is additionally substituted by 0, 1 , 2 or 3 substituents independently selected from halo, nitro, cyano, (Ci-4)alkyl, 0(Ci_ 4)alkyl, 0(Ci -4 )haloalkyl, NHCi -4 , N((Ci -4 )alkyl)(Ci -4 )alkyl and (Ci -4 )haloalkyl;
  • R 2 is selected from (Ci-6)alkyl, phenyl, benzyl, heteroaryl, heterocycle, — ((Ci-3)alkyl)heteroaryl,— ((Ci-3)alkyl)heterocycle,— 0((Ci-3)alkyl)heteroaryl,— 0((Ci -3 )alkyl)heterocycle,— NR a ((Ci -3 )alkyl)heteroaryl,— NR a ((Ci -3 )alkyl)heteroaryl,— NR a ((Ci -3 )alkyl)heteroaryl,— NR a ((Ci__
  • R u is H or (Ci -4 )alkyl
  • R a is independently, at each instance, H or R ;
  • R is independently, at each instance, phenyl, benzyl or (Ci-6)alkyl, the phenyl, benzyl and (Ci-6)alkyl being substituted by 0, 1, 2 or 3 substituents selected from halo, (Ci_ 4)alkyl, (Ci -3 )haloalkyl,— 0(Ci -4 )alkyl,— NH 2 ,— NHCi -4 )alkyl,— N((Ci -4 )alkyl)(Ci. 4)alkyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VI):
  • X 1 is C(R 9 ) or N;
  • X 2 is C(R 10 ) or N;
  • Y is N(R U ), O or S; is CR 8 or N;
  • 1 is a direct-bonded or oxygen-linked saturated, partially-saturated or unsaturated 5-, 6- or 7-membered monocyclic ring containing 0, 1 , 2, 3 or 4 atoms selected from N, O and S, but containing no more than one O or S, wherein the available carbon atoms of the ring are substituted by 0, 1 or 2 oxo or thioxo groups, wherein the ring is substituted by 0 or 1 R substituents, and the ring is additionally substituted by 0, 1 , 2 or 3 substituents independently selected from halo, nitro, cyano, (Ci- 4 )alkyl, 0(Ci_ 4)alkyl, 0(Ci -4 )haloalkyl, (NHCi -4 )alkyl, N(Ci -4 alkyl)(Ci -4 )alkyl and (Ci -4 )haloalkyl; R 2 is selected from halo, (Ci -4 )haloal
  • R 2 is selected from (Ci-6)alkyl, phenyl, benzyl, heteroaryl, heterocycle,— ((Ci_
  • R a is independently, at each instance, H or R ;
  • R is independently, at each instance, phenyl, benzyl or (Ci-6)alkyl, the phenyl, benzyl and (Ci-6)alkyl being substituted by 0, 1, 2 or 3 substituents selected from halo, (Ci_ 4)alkyl, (Ci -3 ) haloalkyl,— 0(Ci -4 )alkyl,— NH 2 ,— NH(Ci -4 )alkyl,— N(Ci -4 )alkyl(Ci. 4)alkyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VII):
  • X 1 is C(R 9 ) or N;
  • X 2 is C(R 10 ) or N;
  • Y is N(R U ), O or S;
  • Z is CR 8 or N
  • R 1 is a direct-bonded or oxygen-linked saturated, partially-saturated or unsaturated 5-, 6- or 7-membered monocyclic ring containing 0, 1 , 2, 3 or 4 atoms selected from N, O and S, but containing no more than one O or S, wherein the available carbon atoms of the ring are substituted by 0, 1 or 2 oxo or thioxo groups, wherein the ring is substituted by 0 or 1 R 2 substituents, and the ring is additionally substituted by 0, 1 , 2 or 3 substituents independently selected from halo, nitro, cyano, (Ci- 4 )alkyl, 0(Ci_ 4)alkyl, 0(Ci -4 )haloalkyl, NH(Ci -4 )alkyl, N(Ci -4 )alkyl(Ci -4 )alkyl and (Ci -4 )haloalkyl;
  • R 5 groups together form a C 3 - 6-spiroalkyl substituted by 0, 1, 2 or 3 substituents selected from halo, cyano, OH, 0(Ci -4 )alkyl, (Ci -4 )alkyl, (Ci -3 )haloalkyl, 0(Ci_ 4 )alkyl, NH 2 , NHCi -4 )alkyl, N(Ci -4 )alkyl)Ci -4 )alkyl;
  • R u is H or (Ci -4 )alkyl
  • R a is independently, at each instance, H or R ;
  • R is independently, at each instance, phenyl, benzyl or (Ci-6)alkyl, the phenyl, benzyl and (Ci-6)alkyl being substituted by 0, 1, 2 or 3 substituents selected from halo, (Ci_ 4)alkyl, (Ci -3 )haloalkyl,— 0(Ci -4 )alkyl,— NH 2 ,— NHCi -4 )alkyl,— N(Ci -4 )alkyl(Ci. 4)alkyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII):
  • X 1 is C(R 9 ) or N;
  • X 2 is C(R 10 ) or N;
  • Y is N(R U ), O or S;
  • Z is CR 8 or N
  • R 1 is a direct-bonded or oxygen-linked saturated, partially-saturated or unsaturated 5-, 6- or 7-membered monocyclic ring containing 0, 1 , 2, 3 or 4 atoms selected from N, O and S, but containing no more than one O or S, wherein the available carbon atoms of the ring are substituted by 0, 1 or 2 oxo or thioxo groups, wherein the ring is substituted by 0 or 1 R 2 substituents, and the ring is additionally substituted by 0, 1 , 2 or 3 substituents independently selected from halo, nitro, cyano, (Ci-4)alkyl, 0(Ci_ 4 )alkyl, 0(Ci -4 )haloalkyl, NH(Ci -4 )alkyl, N(Ci -4 alkyl)Ci -4 )alkyl and (Ci -4 )haloalkyl;s selected from halo, (Ci -4 )haloalky
  • R 2 is selected from (Ci- 6 alkyl, phenyl, benzyl, heteroaryl, heterocycle,— (C 1 -3
  • alkyl)heteroaryl — (C 1 -3 alkyl)heterocycle,— 0(Ci_3 alkyl)heteroaryl,— 0(Ci_3 alkyl)heterocycle,— NR a (Ci -3 alkyl)heteroaryl,— NR a (Ci -3 alkyl)heterocycle,— (C 1-3 alkyl)phenyl,— 0(Ci_3 alkyl)phenyl and— NR a (Ci_3 alkyl)phenyl all of which are substituted by 0, 1, 2 or 3 substituents selected from (Ci -4 haloalkyl, 0(Ci -4 )alkyl, Br, CI, F, I and (Ci -4 )alkyl;
  • N(R a )S( 0) 2 NR a R a ,— NR a (C 2-6 alkylNR a R a ,— NR a (C 2-6 alkylOR a ; or R 9 is a saturated, partially-saturated or unsaturated 5-, 6- or 7-membered monocyclic ring containing 0, 1 , 2, 3 or 4 atoms selected from N, O and S, but containing no more than one O or S, wherein the available carbon atoms of the ring are substituted by 0, 1 or 2 oxo or thioxo groups, wherein the ring is substituted by 0, 1, 2, 3 or 4 substituents selected from halo, (Ci-4)haloalkyl, cyano, nitro,— C(0)R a ,—
  • R u is H or (Ci -4 )alkyl
  • R a is independently, at each instance, H or R ;
  • R is independently, at each instance, phenyl, benzyl or (Ci-6)alkyl, the phenyl, benzyl and (Ci-6) alkyl being substituted by 0, 1, 2 or 3 substituents selected from halo, (Ci_ 4)alkyl, (Ci -3 haloalkyl,— 0(Ci -4 )alkyl,— NH 2 ,— NH(Ci -4 )alkyl,— N(Ci -4 )alkyl(Ci. 4)alkyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein X 1 is C(R 9 ) and X 2 is N.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein X 1 is C(R 9 ) and X 2 is C(R 10 ).
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is phenyl substituted by 0, 1, 2, or 3 independently selected R 2 substituents.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is phenyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is selected from 2-methylphenyl, 2-chlorophenyl, 2-trifluoromethylphenyl, 2- fluorophenyl and 2-methoxyphenyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is phenoxy.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is a direct-bonded or oxygen-linked saturated, partially-saturated or unsaturated 5-, 6- or 7-membered monocyclic ring containing 1, 2, 3 or 4 atoms selected from N, O and S, but containing no more than one O or S, wherein the available carbon atoms of the ring are substituted by 0, 1 or 2 oxo or thioxo groups, wherein the ring is substituted by 0 or 1 R 2 substituents, and the ring is additionally substituted by 0, 1, 2 or 3 substituents independently selected from halo, nitro, cyano, Ci- 4 alkyl, OCi- 4 alkyl, OCi- 4 haloalkyl, NHCi -4 alkyl, N(Ci -4 alkyl)
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is an unsaturated 5- or 6-membered monocyclic ring containing 1, 2, 3 or 4 atoms selected from N, O and S, but containing no more than one O or S, wherein the ring is substituted by 0 or 1 R 2 substituents, and the ring is additionally substituted by 0, 1, 2 or 3 substituents independently selected from halo, nitro, cyano, Ci -4 alkyl, OCi- 4 alkyl, OCi -4 haloalkyl, NHCi -4 alkyl, N(Ci -4 alkyl)Ci -4 alkyl and Ci -4 haloalkyl.
  • R 1 is an unsaturated 5- or 6-membered monocyclic ring containing 1, 2, 3 or 4 atoms selected from N, O and S, but containing no
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is an unsaturated 5- or 6-membered monocyclic ring containing 1, 2, 3 or 4 atoms selected from N, O and S, but containing no more than one O or S, wherein the ring is substituted by 0 or 1 R 2 substituents, and the ring is additionally substituted by 1, 2 or 3 substituents independently selected from halo, nitro, cyano, Ci -4 alkyl, OCi -4 alkyl, OCi -4 haloalkyl, NHCi -4 alkyl, N(Ci -4 alkyl)Ci -4 alkyl and Ci -4 haloalkyl.
  • R 1 is an unsaturated 5- or 6-membered monocyclic ring containing 1, 2, 3 or 4 atoms selected from N, O and S, but containing no more
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is an unsaturated 5- or 6-membered monocyclic ring containing 1, 2, 3 or 4 atoms selected from N, O and S.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 1 is selected from pyridyl and pyrimidinyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R is H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R is selected from F, CI, Ci- 6 alkyl, phenyl, benzyl, heteroaryl and heterocycle, wherein the Ci- 6 alkyl, phenyl, benzyl, heteroaryl and heterocycle are additionally substituted by 0, 1, 2 or 3 substituents selected from OCi -6 alkyl, Br, CI, F, I and Ci- 6 alkyl.
  • R is selected from F, CI, Ci- 6 alkyl, phenyl, benzyl, heteroaryl and heterocycle, wherein the Ci- 6 alkyl, phenyl, benzyl, heteroaryl and heterocycle are additionally substituted by 0, 1, 2 or 3 substituents selected from OCi -6 alkyl, Br, CI, F, I and Ci- 6 alkyl.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 5 is, independently, in each instance, H, halo, Ci- 6 alkyl, Ci- 4 haloalkyl, or Ci_ 6 alkyl substituted by 1, 2 or 3 substituents selected from halo, cyano, OH, OCi- 4 )alkyl, Ci -4 )alkyl, Ci -3 )haloalkyl, OCi -4 )alkyl, NH 2 , NHCi -4 )alkyl, N(Ci -4 )alkyl)Ci -4 )alkyl; or both R 5 groups together form a C3_ 6 spiroalkyl substituted by 0, 1, 2 or 3 substituents selected from halo, cyano, OH, OCi -4 )
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 5 is H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein one R 5 is S-methyl, the other is H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein at least one R 5 is halo, Ci- 6 alkyl, Ci -4 haloalkyl, or Ci- 6 alkyl substituted by 1, 2 or 3 substituents selected from halo, cyano, OH, OCi -4 )alkyl, Ci -4 )alkyl, Ci-3)haloalkyl, OCi- 4 )alkyl, NH 2 , NHCi -4 )alkyl, N(Ci -4 )alkyl)Ci -4 )alkyl.
  • R 5 is halo, Ci- 6 alkyl, Ci -4 haloalkyl, or Ci- 6 alkyl substituted by 1, 2 or 3 substituents selected from halo, cyano, OH, OCi -4 )alkyl, Ci
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 6 is H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 6 is F, CI, cyano or nitro.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 7 is H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 7 is F, CI, cyano or nitro.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 8 is selected from H, CF 3 , C 1-3 alkyl, Br, CI and F.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R is selected from H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R is selected from CF 3 , C 1-3 alkyl, Br, CI and F.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 9 is H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 10 is H.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is a compound of Formula (VIII) wherein R 11 is H.
  • the PI3K-5 inhibitor is a compound of Formula (IX):
  • the PI3K inhibitor or PI3K-5 inhibitor is (S)-N-(l - (7-fluoro-2-(pyridin-2-yl)quinolin-3-yl)ethyl)-9H-purin-6-amine or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K-5 inhibitor is a compound of Formula (X):
  • the PI3K inhibitor or PI3K-5 inhibitor is (S)-N-(l - (6-fluoro-3-(pyridin-2-yl)quinoxalin-2-yl)ethyl)-9H-purin-6-amine or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K-5 inhibitor is a compound of Formula (XI):
  • the PI3K-5 inhibitor is (5)-N-(l-(2-(3,5- difluorophenyl)-8-fluoroquinolin-3-yl)ethyl)-9H-purin-6-amine or a pharmaceutically- acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K-5 inhibitor is a compound of Formula (XII):
  • the PI3K-5 inhibitor is (5)-3-(l-((9H-purin-6- yl)amino)ethyl)-2-(pyridin-2-yl)quinoline-8-carbonitrile or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K-5 inhibitor is a compound of Formula (XIII):
  • the PI3K-5 inhibitor is (S)-JV-(l-(5,7-difluoro-2- (pyridin-2-yl)quinolin-3-yl)ethyl)-9H-purin-6-amine or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K inhibitor or PI3K-5 inhibitor is a compound selected from the structures disclosed in U.S. Patent Nos. 7,932,260 and 8,207,153, the disclosure of which is incorporated by reference herein.
  • the PI3K inhibitor or PI3K-5 inhibitor is a compound of Formula (XIV):
  • X and Y independently, are N or CH;
  • Z is N— R 7 or O
  • R 1 are the same and are hydrogen, halo, or C 1-3 alkyl
  • R 2 and R 3 independently, are hydrogen, halo, or C 1-3 alkyl
  • R 6 is hydrogen, halo, or NR a R ;
  • R is hydrogen or R and R are taken together with the atoms to which they are attached to form a five- or six-membered saturated ring;
  • R 8 is C 1-3 alkyl, halo, CF 3 , or CH 2 C 3-6 heterocycloalkyl
  • n 0, 1, or 2;
  • R a is hydrogen, (Ci -4 )alkyl, or CH 2 C 6 H 5 ;
  • R is hydrogen or C 1-3 alkyl
  • R c is hydrogen, C 1-3 alkyl, or halo
  • R 1 groups are different from hydrogen, R 2 and R 4 are the same; or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K inhibitor or PI3K-5 inhibitor is an enantiomer of Formula (XIV), as shown in Formula (XV):
  • n 1, 2, or 3 and R is Ci-3alkyl, F, CI, or CF 3 .
  • n is 0 (such that there is no R substituent).
  • X is N and Y is CH.
  • Y is CH.
  • X and Y may also both be CH.
  • R 6 is hydrogen, halo, or NH 2 .
  • R 6 is hydrogen.
  • n is 0 or l; R 8 (if n is l) is Ci -3 alkyl, F, CI, or CF 3 ; R 6 is hydrogen; X is N and Y is CH or X and Y are both CH; Z
  • R are the same and are hydrogen, halo, or Ci-3alkyl; and R and R ,
  • R 1 , R 2 , and R 3 are hydrogen.
  • R 1 is the same.
  • R 2 and R 4 may differ provided that R 1 is H.
  • R 1 is H, free rotation is unexpectedly permitted about the bond connecting the phenyl ring substituent to the quinazoline ring, and the compounds advantageously do not exhibit atropisomerism (i.e., multiple diasteromer formation is avoided).
  • R 2 and R can be the same such that the compounds advantageously do not exhibit
  • Z is N— R 7
  • the bicyclic ring system containing X and Y is:
  • X, Y, Z, R a , R , and R c are as defined above for Formula (XIV), and R is hydrogen, fluoro, chloro, methyl, or
  • R 2 is hydrogen, methyl, chloro, or fluoro
  • R 3 is hydrogen or fluoro
  • R 6 is NH 2 , hydrogen, or fluoro
  • R 7 is hydrogen or R 5 and R 7 are taken together to form
  • R 8 is methyl, trifluoromethyl, chloro, or fluoro;
  • R is methyl, ethyl, propyl, phenyl, CH 2 OH, CH 2 OCH 2 C 6 H 5 , CH 2 CF 3 ,
  • alkyl is defined as straight chained and branched hydrocarbon groups containing the indicated number of carbon atoms, e.g., methyl, ethyl, and straight chain and branched propyl and butyl groups.
  • (Ci-3)alkylene” and “(Ci-4)alkylene” are defined as
  • (C 2 -6)alkynyl is defined as a hydrocarbon group containing the indicated number of carbon atoms and a carbon-carbon triple bond.
  • (C3-6)cycloalkyl is defined as a cyclic hydrocarbon group containing the indicated number of carbon atoms.
  • (C 2 -6)heterocycloalkyl” is defined similarly as cycloalkyl except the ring contains one or two heteroatoms selected from the group consisting of O, NR a , and S.
  • halo is defined as fluoro, bromo, chloro, and iodo.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is idelalisib.
  • PI3K inhibitor which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is the compound of Formula (XVI):
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is (5)-2-(l-((9H-purin-6- yl)amino)propyl)-5-fluoro-3-phenylquinazolin-4(3H)-one or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof.
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is 4(3H)-quinazolinone, 5-fluoro-3-phenyl-2-[(l ⁇ S)-l - (9H-purin-6-y lamino)propy 1] -5 -fluoro-3 -phenyl-2- ⁇ ( 1 S)- 1 - [(7H-purin-6- yl)amino]propyl ⁇ quinazolin-4(3H)-one or a pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug thereof
  • the PI3K inhibitor (which may be a ⁇ 3 ⁇ - ⁇ inhibitor, PI3K-5 inhibitor, or ⁇ 3 ⁇ - ⁇ , ⁇ inhibitor) is GS-9901.
  • Other PI3K inhibitors suitable for use in the described combination with a BTK inhibitor also include, but are not limited to, those described in, for example, U.S. Patent No. 8,193,182 and U.S. Published Application Nos. 2013/0267521 ; 2013/0053362; 2013/0029984; 2013/0029982; 2012/0184568; and 2012/0059000, the disclosures of each of which are incorporated by reference in their entireties.
  • the BTK inhibitor may be any BTK inhibitor known in the art. In particular, it is one of the BTK inhibitors described in more detail in the following paragraphs. For avoidance of doubt, references herein to a BTK inhibitor may refer to a compound or a pharmaceutically acceptable salt, ester, solvate, hydrate, cocrystal, or prodrug thereof.
  • the BTK inhibitor is a compound of Formula (XVII):
  • X is CH, N, O or S
  • Y is C(Re), N, O or S;
  • Z is CH, N or bond
  • A is CH or N
  • Bi is N or C(R 7 );
  • B 2 is N or C(Re);
  • B 3 is N or C(R 9 );
  • B 4 is N or C(Rio);
  • R 2 is H, (Ci -3 )alkyl or (C 3-7 )cycloalkyl;
  • R 3 is H, (Ci.6)alkyl or (C 3-7 )cycloalkyl); or
  • R 2 and R 3 form, together with the N and C atom they are attached to, a (C 3- 7 )heterocycloalkyl optionally substituted with one or more fluorine, hydroxyl, (Ci_ 3)alkyl, (Ci -3 )alkoxy or oxo;
  • R 5 is H, halogen, cyano, (Ci -4 )alkyl, (Ci -3 )alkoxy, (C 3- 6)cycloalkyl, any alkyl group of which is optionally substituted with one or more halogen; or R5 is (C 6 -io)aryl or (C 2 -
  • Re is H or (Ci-3)alkyl
  • R 5 and Re together may form a (C 3 -7)cycloalkenyl or (C2-6)heterocycloalkenyl, each
  • R7 is H, halogen, CF 3 , (Ci-3)alkyl or (Ci-3)alkoxy;
  • Re is H, halogen, CF 3 , (Ci-3)alkyl or (Ci-3)alkoxy; or
  • R9 is H, halogen, (Ci-3)alkyl or (Ci-3)alkoxy;
  • Rio is H, halogen, (Ci-3)alkyl or (Ci-3)alkoxy;
  • R11 is independently selected from the group consisting of (Ci-6)alkyl, (C2-6)alkenyl and (C2-6)alkynyl, where each alkyl, alkenyl or alkynyl is optionally substituted with one or more substituents selected from the group consisting of hydroxyl, (Ci- 4 )alkyl, (C 3 -
  • Rn is (Ci_5)heteroaryl optionally substituted with one or more substituents selected from the group consisting of halogen or cyano;
  • R12 and Ri3 are independently selected from the group consisting of (C2-6)alkenyl or (C2- 6)alkynyl, both optionally substituted with one or more substituents selected from the group consisting of hydroxyl, (Ci -4 )alkyl, (C 3 -7)cycloalkyl, [(Ci -4 )alkyl]amino, di[(Ci_
  • Ri 4 is independently selected from the group consisting of halogen, cyano, (C2-6)alkenyl and (C2-6)alkynyl, both optionally substituted with one or more substituents selected from the group consisting of hydroxyl, (Ci -4 )alkyl, (C 3 -7)cycloalkyl, (Ci -4 )alkylamino, di[(Ci -4 )alkyl]amino, (Ci_3)alkoxy, (C 3 -7)cycloalkoxy, (C 6 -io)aryl, (Ci-5)heteroaryl and (C 3 -7)heterocycloalkyl;
  • (Ci-2)alkyl means an alkyl group having 1 to 2 carbon atoms, being methyl or ethyl
  • (Ci-3)alkyl means a branched or unbranched alkyl group having 1-3 carbon atoms, being methyl, ethyl, propyl or isopropyl;
  • (Ci -4 )alkyl means a branched or unbranched alkyl group having 1-4 carbon atoms, being methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl and tert-butyl, (Ci-3)alkyl groups being preferred;
  • (Ci-5)alkyl means a branched or unbranched alkyl group having 1-5 carbon atoms, for example methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, tert-butyl, pentyl and isopentyl, (Ci -4 )alkyl groups being preferred.
  • (Ci-6)Alkyl means a branched or unbranched alkyl group having 1 -6 carbon atoms, for example methyl, ethyl, propyl, isopropyl, butyl, tert-butyl, n-pentyl and n-hexyl. (Ci-5)alkyl groups are preferred,
  • (Ci.2)alkoxy means an alkoxy group having 1-2 carbon atoms, the alkyl moiety having the same meaning as previously defined;
  • (Ci_3)alkoxy means an alkoxy group having 1-3 carbon atoms, the alkyl moiety having the same meaning as previously defined. (Ci -2 )alkoxy groups are preferred;
  • (Ci -4 )alkoxy means an alkoxy group having 1-4 carbon atoms, the alkyl moiety having the same meaning as previously defined. (Ci_3)alkoxy groups are preferred, (Ci_
  • (C 2-4 )alkenyl means a branched or unbranched alkenyl group having 2-4 carbon atoms, such as ethenyl, 2-propenyl, isobutenyl or 2-butenyl;
  • (C 2- 6)alkenyl means a branched or unbranched alkenyl group having 2-6 carbon atoms, such as ethenyl, 2-butenyl, and n-pentenyl, (C 2-4 )alkenyl groups being most preferred;
  • (C 2-4 )alkynyl means a branched or unbranched alkynyl group having 2-4 carbon atoms, such as ethynyl, 2-propynyl or 2-butynyl;
  • (C 2 -6)alkynyl means a branched or unbranched alkynyl group having 2-6 carbon atoms, such as ethynyl, propynyl, n-butynyl, n-pentynyl, isopentynyl, isohexynyl or n- hexynyl.
  • (C 2 - 4 )alkynyl groups are preferred;
  • (C 3 -6)cycloalkyl means a cycloalkyl group having 3-6 carbon atoms, being cyclopropyl, cyclobutyl, cyclopentyl or cyclohexyl;
  • (C 3 -7)cycloalkyl means a cycloalkyl group having 3-7 carbon atoms, being cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl or cycloheptyl;
  • (C 2 -6)heterocycloalkyl means a heterocycloalkyl group having 2-6 carbon atoms
  • heteroatoms preferably 3-5 carbon atoms, and one or two heteroatoms selected from N, O and/or S, which may be attached via a heteroatom if feasible, or a carbon atom; preferred heteroatoms are N or O; also preferred are piperidine, morpholine, pyrrolidine and piperazine; with the most preferred (C 2 -6)heterocycloalkyl being pyrrolidine; the heterocycloalkyl group may be attached via a heteroatom if feasible;
  • (C 3 -7)heterocycloalkyl means a heterocycloalkyl group having 3-7 carbon atoms
  • heteroatoms preferably 3-5 carbon atoms, and one or two heteroatoms selected from N, O and/or S.
  • Preferred heteroatoms are N or O;
  • preferred (C3-7) heterocycloalkyl groups are azetidinyl, pyrrolidinyl, piperidinyl, homopiperidinyl or morpholinyl; more preferred (C 3 -7)heterocycloalkyl groups are piperidine, morpholine and pyrrolidine; and the heterocycloalkyl group may be attached via a heteroatom if feasible;
  • (C 3 -7)cycloalkoxy means a cycloalkyl group having 3-7 carbon atoms, with the same meaning as previously defined, attached via a ring carbon atom to an exocyclic oxygen atom;
  • (C 6 -io)aryl means an aromatic hydrocarbon group having 6-10 carbon atoms, such as phenyl, naphthyl, tetrahydronaphthyl or indenyl; the preferred (C 6 -io)aryl group is phenyl;
  • (Ci_5)heteroaryl means a substituted or unsubstituted aromatic group having 1-5 carbon atoms and 1-4 heteroatoms selected from N, O and/or S; the (Ci_5)heteroaryl may optionally be substituted; preferred (Ci_5)heteroaryl groups are tetrazolyl, imidazolyl, thiadiazolyl, pyridyl, pyrimidyl, triazinyl, thienyl or furyl, a more preferred (Ci_ 5)heteroaryl is pyrimidyl;
  • (Ci.9)heteroaryl means a substituted or unsubstituted aromatic group having 1-9 carbon atoms and 1-4 heteroatoms selected from N, O and/or S; the (Ci_9)heteroaryl may optionally be substituted; preferred (Ci_9)heteroaryl groups are quinoline, isoquinoline and indole;
  • [(Ci-4)alkyl]amino means an amino group, monosubstituted with an alkyl group
  • [(Ci-4)alkyl]amino group is methylamino
  • di[(Ci-4)alkyl]amino means an amino group, disubstituted with alkyl group(s), each
  • di[(Ci-4)alkyl]amino group is dimethylamino
  • halogen means fluorine, chlorine, bromine or iodine
  • (Ci-3)alkyl-C(0)-S-(Ci-3)alkyl means an alkyl-carbonyl-thio-alkyl group, each of the alkyl groups having 1 to 3 carbon atoms with the same meaning as previously defined;
  • (C 3 -7)cycloalkenyl means a cycloalkenyl group having 3-7 carbon atoms, preferably 5-7 carbon atoms; preferred (C 3 -7)cycloalkenyl groups are cyclopentenyl or cyclohexenyl; cyclohexenyl groups are most preferred;
  • (C 2 -6)heterocycloalkenyl means a heterocycloalkenyl group having 2-6 carbon atoms, preferably 3-5 carbon atoms; and 1 heteroatom selected from N, O and/or S; preferred (C 2 -6)heterocycloalkenyl groups are oxy cyclohexenyl and azacyclohexenyl group.
  • the attachment point is at the last group.
  • a circle in a ring of Formula (XVII) indicates that the ring is aromatic.
  • the nitrogen if present in X or Y, may carry a hydrogen.
  • the BTK inhibitor is a compound of Formula (XVII) or a pharmaceutically acceptable salt thereof, wherein:
  • X is CH or S
  • Z is CH or bond; A is CH;
  • Bi is N or C(R 7 );
  • B 2 is N or C(Re);
  • B 3 is N or CH
  • B 4 is N or CH
  • R 2 is (Ci -3 )alkyl
  • R3 is (Ci-3)alkyl
  • R 2 and R3 form, together with the N and C atom they are attached to, a (C 3 -
  • heterocycloalkyl ring selected from the group consisting of azetidinyl, pyrrolidinyl, piperidinyl, and morpholinyl, optionally substituted with one or more fluorine, hydroxyl, (Ci-3)alkyl, or (Ci-3)alkoxy;
  • R4 is H
  • R 5 is H, halogen, cyano, (Ci -4 )alkyl, (Ci-3)alkoxy, (C 3 -6)cycloalkyl, or an alkyl group which is optionally substituted with one or more halogen;
  • Re is H or (Ci -3 )alkyl
  • R 7 is H, halogen or (Ci-3)alkoxy
  • Re is H or (Ci_3)alkyl
  • R 7 and Rg form, together with the carbon atom they are attached to a (C 6 -io)aryl or (Ci.
  • R 5 and R6 together may form a (C 3-7 )cycloalkenyl or (C 2- 6)heterocycloalkenyl, each optionally substituted with (Ci-3)alkyl or one or more halogen;
  • R11 is independently selected from the group consisting of (C 2- 6)alkenyl and (C 2- 6 ) alkynyl, where each alkenyl or alkynyl is optionally substituted with one or more substituents selected from the group consisting of hydroxyl, (Ci -4 )alkyl, (C 3 .
  • Bi is C(R 7 ); B 2 is C(R 8 ); B 3 is C(R 9 ); B 4 is C(Rio); R 7 , R9, and Rio are each H; and Rs is hydrogen or methyl.
  • the ring containing X, Y and Z is selected from the group consisting of pyridyl, pyrimidyl, pyridazyl, triazinyl, thiazolyl, oxazolyl and isoxazolyl.
  • the ring containing X, Y and Z is selected from the group consisting of pyridyl, pyrimidyl and pyridazyl.
  • the ring containing X, Y and Z is selected from the group consisting of pyridyl and pyrimidyl.
  • the ring containing X, Y and Z is pyridyl.
  • R 5 is selected from the group consisting of hydrogen, fluorine, methyl, methoxy and trifluoromethyl.
  • R5 is hydrogen
  • R 2 and R3 together form a
  • heterocycloalkyl ring selected from the group consisting of azetidinyl, pyrrolidinyl, piperidinyl, homopiperidinyl and morpholinyl, optionally substituted with one or more of fluoro, hydroxyl, (Ci-3)alkyl and (Ci-3)alkoxy.
  • R 2 and R3 together form a
  • heterocycloalkyl ring selected from the group consisting of azetidinyl, pyrrolidinyl and piperidinyl.
  • R 2 and R3 together form a pyrrolidinyl ring.
  • Ri is independently selected from the group consisting of (Ci-6)alkyl, (C 2- 6)alkenyl or (C 2- 6)alkynyl, each optionally substituted with one or more substituents selected from the group consisting of hydroxyl, (Ci- 4 )alkyl, (C 3 -7)cycloalkyl, [(Ci -4 )alkyl]amino, di[(Ci -4 )alkyl] amino, (Ci_3)alkoxy, (C 3 - 7)cycloalkoxy, (Ce-io)aryl and (C 3 -7)heterocycloalkyl.
  • Bi, B 2 , B 3 and B 4 are CH; X is N; Y and Z are CH; R 5 is CH 3 ; A is N; R 2 , R 3 and R4 are H; and Ri is CO-CH 3 .
  • Bi, B 2 , B 3 and B 4 are CH; X and Y are N; Z is CH; R 5 is CH 3 ; A is N; R 2 , R 3 and R4 are H; and Ri is CO-CH 3 .
  • Bi, B 2 , B 3 and B 4 are CH; X and Y are N; Z is CH; R5 is C3 ⁇ 4; A is CH; R 2 and R3 together form a piperidinyl ring; R4 is H; and Ri is CO-ethenyl.
  • Bi, B 2 , B 3 and B 4 are CH; X, Y and Z are CH; R5 is H; A is CH; R 2 and R3 together form a pyrrolidinyl ring; R4 is H; and Ri is CO- propynyl.
  • Bi, B 2 , B 3 and B 4 are CH; X, Y and Z are CH; R5 is C3 ⁇ 4; A is CH; R 2 and R3 together form a piperidinyl ring; R4 is H; and Ri is CO-propynyl.
  • Bi, B 2 , B 3 and B 4 are CH; X and Y are N; Z is CH; R5 is H; A is CH; R 2 and R3 together form a morpholinyl ring; R4 is H; and Ri is CO-ethenyl.
  • Bi, B 2 , B 3 and B 4 are CH; X and Y are N; Z is CH; R5 is C3 ⁇ 4; A is CH; R 2 and R3 together form a morpholinyl ring; R4 is H; and Ri is CO-propynyl.
  • the BTK inhibitor is a compound of Formula (XVIII):
  • Formula (XVTII) and related compounds, such as those according to Formula (XVII), may be prepared as follows.
  • reaction mixture was refluxed at 60-65 °C overnight.
  • the reaction mixture was poured carefully in ammonium hydroxide 25% in water (250 ml)/crushed ice (500 ml) to give a yellow suspension (pH -8-9) which was stirred for 15 min until no ice was present in the suspension.
  • Ethyl acetate was added, layers were separated and the aqueous layer was extracted with ethyl acetate (3x). The organic layers were combined and washed with brine, dried over sodium sulfate, filtered and evaporated to give 7.5 g crude product.
  • the mixture was poored (slowly) in a stirred mixture of water (145 mL), ethyl acetate (145 mL) and brine (145 mL). The mixture was then transferred into a separating funnel and extracted. The water layer was extracted with 2x145 mL ethyl acetate. The combined organic layers were washed with 3x300 mL water, 300 mL brine, dried over sodium sulfate, filtered and evaporated.
  • (S)-4-(8-Amino-3-(pyrrolidin-2-yl)imidazo[l,5-alpyrazin-l-yl)-N-(pyridin- 2-yl)benzamide was prepared as follows. To (S)-benzyl 2-(8-amino-l-(4-(pyridin-2- ylcarbamoyl)phenyl)imidazo[l,5-a]pyrazin-3-yl)pyrrolidine-l- carboxylate (0.146 mmol, 78 mg) was added a 33% hydrobromic acid/acetic acid solution (1 1.26 mmol, 2 ml) and the mixture was left at room temperature for 1 hour.
  • the BTK inhibitor is ( ⁇ S)-4-(8-amino-3-(l -(but-2- ynoyl)pyrrolidin-2-yl)imidazo[l,5-a]pyrazin-l-yl)-N-(pyridin-2-yl)benzamide or pharmaceutically acceptable salt, solvate, hydrate, cocrystal, or prodrug therof.
  • the BTK inhibitor is a compound of Formula (XVIII-A):
  • the BTK inhibitor is a compound of Formula (XVIII-B):
  • the BTK inhibitor is a compound of Formula (XVIII-C):
  • the BTK inhibitor is a compound of Formula (XVIII-D):
  • the BTK inhibitor is a compound of Formula (XVIII-E):
  • the BTK inhibitor is a compound of Formula (XVIII-F):
  • the BTK inhibitors include, but are not limited to, those compounds described in International Patent Application Publication No. WO 201100549.
  • the BTK inhibitor is a compound of Formula (XIX) :
  • X is CH, N, O or S

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Abstract

La présente invention concerne des compositions thérapeutiques et des procédés d'utilisation des compositions, comprenant des combinaisons d'un inhibiteur de tyrosine kinase de Bruton (BTK), d'un inhibiteur de phosphoinositide 3-kinase (PI3K), comprenant des inhibiteurs de PI3K sélectifs pour les isoformes γ et δ et sélectifs pour les deux isoformes γ et δ (PI3K-γ,δ, PI3K-γ, et PI3K-δ,) un inhibiteur de mort programmée 1 (PD-1) ou de ligand de mort programmée 1 (PD-L1), et/ou d'un inhibiteur de Janus kinase-2 (JAK-2). Dans certains modes de réalisation, la présente invention comprend des procédés thérapeutiques d'utilisation d'un anticorps monoclonal de PD-1 et d'un inhibiteur de BTK. Dans d'autres modes de réalisation, la présente invention comprend des procédés thérapeutiques d'utilisation d'un anticorps monoclonal de PD-L1 et d'un inhibiteur de BTK. Dans d'autres modes de réalisation, la présente invention comprend des procédés thérapeutiques d'utilisation d'un inhibiteur de PD-1, d'un inhibiteur de BTK, et d'un inhibiteur de PI3K-δ. Dans d'autres modes de réalisation, la présente invention comprend des procédés thérapeutiques d'utilisation d'un inhibiteur de PD-L1, d'un inhibiteur de BTK, et d'un inhibiteur de PI3K-δ.
PCT/IB2016/050704 2015-02-12 2016-02-10 Combinaisons thérapeutiques d'un inhibiteur de btk, d'un inhibiteur de pi3k, d'un inhibiteur de jak-2, d'un inhibiteur de pd-1, et/ou d'un inhibiteur de pd-l1 WO2016128912A1 (fr)

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US201562115489P 2015-02-12 2015-02-12
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US62/181,164 2015-06-17
IBPCT/IB2015/056123 2015-08-11
PCT/IB2015/056123 WO2016024228A1 (fr) 2014-08-11 2015-08-11 Combinaisons thérapeutiques associant un inhibiteur de btk, un inhibiteur de pi3k, un inhibiteur de jak-2, un inhibiteur de pd-1 et/ou un inhibiteur de pd-l1

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US11168144B2 (en) 2017-06-01 2021-11-09 Cytomx Therapeutics, Inc. Activatable anti-PDL1 antibodies, and methods of use thereof
WO2022111714A1 (fr) * 2020-11-30 2022-06-02 杭州阿诺生物医药科技有限公司 Polythérapie pour traiter un cancer à mutation pik3ca
WO2023167856A1 (fr) * 2022-03-01 2023-09-07 Mei Pharma, Inc. Polythérapie d'inhibiteur de pi3k et d'inhibiteur de pd-1
WO2023217170A1 (fr) * 2022-05-10 2023-11-16 瑞石生物医药有限公司 Utilisation d'un inhibiteur de btk pour le traitement d'une maladie
EP3500299B1 (fr) 2016-08-19 2023-12-13 BeiGene Switzerland GmbH Combinaison de zanubrutinib avec un anticorps anti-cd20 ou anti-pd-1 pour l'utilisation dans le traitement du cancer
US12024520B2 (en) 2018-08-29 2024-07-02 Acerta Pharma B.V. Processes for the preparation of 4-{8-amino-3-[(2S)-1-(but-2-ynoyl)-pyrrolidin-2-yl]imidazo[1,5-a]-pyrazin-1-yl}N-(pyridin-2-yl)-benzamide
WO2024254757A1 (fr) * 2023-06-13 2024-12-19 Zhejiang Shimai Pharmaceutical Co., Ltd. Anticorps bispécifiques dirigés contre folr1 et leurs utilisations

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