METHOD FOR PROTECTION FROM CHEMOTHERAPEUTIC SIDE EFFECTS

Abstract: S-2-(3-aminopropylamino)ethyl dihydrogen phosphorothioate and pharmaceutically acceptable derivatives thereof are useful in protecting a patient undergoing chemotherapy from cardiotoxic and bone marrow toxic side effects associated with administration of chemotherapeutic agents.

Description: I METHOD FOR PROTECTION FROM CHEMOTHERAPEDTIC SIDE EFFECTS Chemotherapy is one of the most useful treatments available to present day medicine in the struggle against cancer. Among known chemotherapeutic agents, powerful alkylating agents, antibiotics and platinum-containing compounds have found wide use through the treatment of a variety of cancers. However, the anti-cancer effectiveness of these chemotherapeutic agents is limited by the effect the agent can have on non-cancerous portions of a patient's system. For example, doxorubicin and its derivatives can cause cardiac toxicity and bone marrow toxicity. The mitomycin family and platinum-containing compounds such as carboplatin can cause bone marrow toxicity in a patient. As a result of these side effects, the amount and frequency of chemotherapeutic agent administration may be limited to levels which are below the optimum level for treatment of the cancer from which the patient suffers. Doxorubicin (and derivatives such as the hydrochloride derivative, sold under the name ADRIAMYCIN) presently is administered in chemotherapy about once every 3 to 4 weeks in an amount of about 25 to 100 mg/m 2 patient surface area. The dosage is commonly about 60 mg/m 2 . The frequency and amount of the agent administered is limited because of the cardiotoxic and bone marrow toxic side effects associated with its administration. Another group of anti-tumor antibiotics is the mitomycin family, which includes mitomycin A, mitomycin B, mitomycin C and N-methyl mitomycin C (porfiromycin) . Mitomycin C, for example, is presently administered about once every 4 to 6 weeks in amounts of about 5 to 30 mg/m 2 , usually about 10 mg/m 2 . The frequency and amount administered is limited due to the bone marrow toxicity associated with administration of the mitomycins. Carboplatin, a second generation analog of cisplatin (both from Bristol-Myers) , is administered about once every 3 to 4 weeks in amounts of about 200-800 mg/m 2 , normally about 400 mg/m 2 . The frequency and amount administered is limited due to the bone marrow toxicity associated with carboplatin administration. This invention protects a patient against the undesired side effects of the chemotherapeutic agents without significant damage to the beneficial therapeutic properties of the chemotherapeutic agents through the administration of S-2 - ( 3 -aminopropylamino) ethyl dihydrogen phosphorothioate (and pharmaceutically acceptable derivatives thereof) in an amount sufficient to protect the patient against the cardiac toxicity and/or bone marrow toxicity discussed above. S-2-(3-aminopropylamino)ethyl dihydrogen phosphorothioate has the structural formula: NH 2 (CH 2 ) 3 NH(CH 2 ) 2 SP0 3 H 2 The present application is directed not only to S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate, but also to pharmaceutically acceptable derivatives such as alkali metal salts and hydrates thereof. S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate and its derivatives may be prepared in accordance with the methods disclosed in U.S. Patent No. 3,892,824 to Piper et al., the disclosure of which is incorporated herein by reference. The dangers of cardiac toxicity and bone marrow toxicity discussed above are significantly reduced by the administration of S-2-(3-aminopropylamino)ethyl dihydrogen phosphorothioate or a pharmaceutically useful derivatives thereof. The amount of S-2-(3-aminopropylamino)ethyl dihydrogen phosphorothioate can be from about 300 to 1,000 mg/m 2 , with a dosage of about 740 mg/m 2 being preferred. The S-2 -( 3 -aminopropylamino) ethyl dihydrogen phosphorothioate or its derivative should be administered either with, or more preferably, before administration of the chemotherapeutic agent. Particularly preferred is drip intravenous infusion in a buffered aqueous solution 15 to 30 minutes before administration of the chemotherapeutic agent. Oral administration is also desirable. By way of example, the S-2-(3-aminopropylamino)ethyl dihydrogen phosphorothioate can be stored frozen at low temperatures, e.g., -70°C. The I.V. carrier solution may be a buffered solution of 5% dextrose in Ringers lactate, having a pH of about 7.2 to 7.4. This solution can be made by adding 20 cc of 44.9 Eq sodium bicarbonate to 1 liter of 5% dextrose in Ringers lactate. 9.3 cc of the solution can be added to a vial containing 500 mg of S-2-(3- aminopropylamino) ethyl dihydrogen phosphorothioate to produce a solution containing 50 mg/cc of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate. Prior to administration, further buffered solution can be added for a total volume of 50 cc, and the resulting solution can be administered to a patient over a period of about 15 minutes, using a volumetric pump. While not wishing to be bound to one particular theory of protection, it is believed that S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate binds to normal cells in competition with the chemotherapeutic agent, but not to tumors. Thus, S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate may be taken up by normal cells, but not tumor cells. It thereby protects the normal tissues by then binding with and inactivating the chemotherapeutic agents. Since S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate is not taken up by cancerous tissues, it leaves them open to attack by the chemotherapeutic agents. Significant improvement is expected in white blood cell and granulocyte nadirs, as well as duration of nadirs (or time to recovery) . This will allow for the safer administration of conventional dosages of carboplatin and mitomycins and for the safer administration of higher clinical dosages. A significant reduction in the damage to cardiac muscle by doxorubicin will also allow for safer administration of higher cumulative clinical doses. EXAMPLES S-2-(3-aminopropylamino)ethyl dihydrogen phosphorothioate monohydrate H 2 N(CH 2 ) 3 NHCH 2 CH 2 SP0 3 H 2 .H 2 0 A solution of 2-(3-aminopropylamino)ethanol (25.0 g. 0.212 mole) in 48 percent hydrobromic acid (200 ml) is distilled until 35 ml of distillate has been collected. The solution is refluxed and periodically, more distillate is collected. The total volume of distillate removed in 7 distillation periods is 160 ml. or 80 percent of the original volume of 48 percent hydrobromic acid and the time of continuous boiling is approximately 48 hours. The residual solution is then evaporated to dryness under reduced pressure with the aid of several added portions of methanol. The crystalline residue is thoroughly triturated with acetone, collected, and washed on the funnel with acetone. After the produce has been pressed as dry as possible on the funnel, it is dissolved in a slight excess of boiling methanol and the solution is filtered. Addition of acetone to the filtrate precipitates pure N-(2- bromoethyl)-l,3-propanediamine dihydrobromide as colorless crystals, which are dried in vacuo over phosphorus pentoxide; yield 58.0 g (80%), mp 205 β -206°C. Trisodium phosphorothioate (6.93 g, 38.5 mmoles) is gradually added in small portions with vigorous stirring to water (38 ml) cooled externally by means of a water bath (15 o -20°C.) . To the resulting suspension is added N-(2- bromoethyl)-1.3-propanediamine dihydrobromide (13.3 g, 38.8 mmoles) . After a few minutes, complete solution occurs and N,N-dimethylformamide (19 ml) is added with continued external cooling at 15°-20*C. After the solution has been stirred at about 20 β C for 90 minutes, it is poured into methanol (250 ml) , and the mixture is refrigerated at 4 β C overnight. The white precipitate that formed is collected and pressed as dry as possible on the funnel. The damp solid is dissolved in water (40 ml) , and the solution is filtered. Addition of methanol (250 ml) reprecipitates the product. After the mixture has been refrigerated about 1 hour, the product is collected and washed on the funnel, first with methanol and finally with ether. The white solid is dried in vacuo at room temperature, then exposed to ambient conditions of the laboratory for 5 hours, and bottled under nitrogen and stored in a freezer. The yield of S-2-(3- aminopropylamino) ethyl dihydrogen phosphorothioate monohydrate, mp 160°-161°C. dec. is 8.15 g (91%). Anal. Calcd for C 5 H 15 N 2 0 3 PS.H 2 0: C-25.86; H-7.38; N-12.07. Found: C.25.83; H-7.27; N-11.81. Evaluation of the Effect of S-2-(3-π_mύncpxp7lam_no)etl_yl dihydrogen phcef circit- ioate on the lethality of Cdi-plafcin Ncntuxctred Charles River. n±aqe CD2F1 Bamale Animals Treatment: Dsry 1 Only Dosage Day of Death (πg kg Route & flfean Animal Weioht in Grams) 30-D_ry LDtø Name dgsel Scbaiile 8 15 16 21 28 Sacv Ud (πq/ta dose) (_ti__platin 39 IP (19) 1(16) 1 1 (14) 1 (20) (21) (22) 2/6 11 28 (20) (17) 1 1 3(13) (IS) (21) (22) 6 20 (19) (16) 2(15) (19) (20) (22) 4/6 14 (19) (17) (17) 1 (20) (21) (22) 5/6 S-2-(3-^-ui opκϊy-La_τdno)et-^^ dihydrogen phσ__pbcαxrt_ ioate 300 IP (19) (19) (19) (20) (21) (21) 6/6 >300 1) 28 (20) (IB) (15) (18) (19) (21) 6/6 (Visual De ei i 2) 300 1) 20 (IS) (17) (17) 1 (IS) (20) (21) 5/6 (ώL latin) 2) 300 1) 14 (20) (18) (18) (20) (19) (21) 6/6 2) 300 Ci__plat-Ln prepared in saline (soluble) . S-2-(3n_caτ__ncpxFylaτnino)etl^^ dihydrogen phoqp_r»ιx»t_h-_o_-te prepared in saline (soluble) While a detailed description of the present invention has been provided above, the present invention is not limited thereto, but rather is defined by the following claims.

Claims: WHAT IS CLAIMED IS: 1. A method for protecting a patient undergoing chemotherapy involving administration of doxorubicin or a pharmaceutically acceptable derivative thereof from undesired cardiotoxic side effects resulting from the administration of the doxorubicin or derivative thereof, the method for protecting comprising administering to the patient an amount of S-2-(3-aminopropylamino)ethyl dihydrogen phosphorothioate or a pharmaceutically acceptable derivative thereof sufficient to protect the patient against the cardiotoxic side effects. 2. The method of claim 1, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered intravenously. 3. The method of claim 2, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered about 15 to 30 minutes before administration of the doxorubicin or derivative thereof. 4. The method of claim 2, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 300 to 1,000 mg/m 2 of patient surface area. 5. The method of claim 4, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 740 mg/m 2 . 6. The method of claim 2, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered via drip intravenous infusion in a buffered aqueous solution. 7. A method for protecting a patient undergoing chemotherapy involving administration of doxorubicin or a pharmaceutically acceptable derivative thereof from undesired bone marrow toxic side effects resulting from the administration of the doxorubicin or derivative thereof, the method for protecting comprising administering to the patient an amount of S-2-(3-aminopropylamino) ethyl dihydrogen phosphorothioate or a pharmaceutically acceptable derivative thereof sufficient to protect the patient against the bone marrow toxic side effects. 8. The method of claim 7, wherein the S-2-(3- aminoproplamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered intravenously. 9. The method of claim 8, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered about 15 to 30 minutes before administration of the doxorubicin or derivative thereof. 10. The method of claim 8, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 300 to 1,000 mg/m 2 of patient surface area. 11. The method of claim 10, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 740 mg/m 2 . 12. The method of claim 8, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered via drip intravenous infusion in a buffered aqueous solution. 13. A method for protecting a patient undergoing chemotherapy involving administration of a mitomycin or a pharmaceutically acceptable derivative thereof from undesired bone marrow toxic side effects resulting from the administration of the mitomycin or derivative thereof, the method for protecting comprising administering to the patient an amount of S-2-(3-aminopropylamino) ethyl dihydrogen phosphorothioate or a pharmaceutically acceptable derivative thereof sufficient to protect the patient against the bone marrow toxic side effects. 14. The method of claim 13, wherein the mitomycin is mitomycin A. 15. The method of claim 13, wherein the mitomycin is mitomycin B. 16. The method of claim 13, wherein the mitomycin is mitomycin C. 17. The method of claim 13, wherein the mitomycin is N- methyl mitomycin C. 18. The method of claim 13, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered intravenously. 19. The method of claim 18, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered about 15 to 30 minutes before administration of the mitomycin or derivative thereof. 20. The method of claim 18, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 300 to 1,000 mg/m 2 of patient surface area. 21. The method of claim 20, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 740 mg/m 2 . 22. The method of claim 18, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered via drip intravenous infusion in a buffered aqueous solution. 23. A method for protecting a patient undergoing chemotherapy involving administration of carboplatin or a pharmaceutically acceptable derivative thereof from undesired bone marrow toxic side effects resulting from the administration of the carboplatin or derivative thereof, the method for protecting comprising administering to the patient an amount of S-2-(3-aminopropylamino) ethyl dihydrogen phosphorothioate or a pharmaceutically acceptable derivative thereof sufficient to protect the patient against the bone marrow toxic side effects. 24. The method of claim 23, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered intravenously. 25. The method of claim 24, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered about 15 to 30 minutes before administration of the carboplatin or derivative thereof. 26. The method of claim 24, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 300 to 1,000 mg/m 2 of patient surface area. 27. The method of claim 26, wherein the amount of S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is about 740 mg/m 2 . 28. The method of claim 24, wherein the S-2-(3- aminopropylamino)ethyl dihydrogen phosphorothioate or derivative thereof is administered via drip intravenous infusion in a buffered aqueous solution.

Inventors: SCHEIN PHILIP S, SCHEIN, PHILIP, S.
Applicants: US BIOSCIENCE, U.S. BIOSCIENCE
Application year: 1989
Main classification: A61K31
IPC codes: A61K31, A61P35, A61P39, A61P43