KR20150092739A - 예측변수 인자들을 이용하여 동정된 환자 부분모집단에서 암 치료를 위한 마시티닙의 용도 - Google Patents
예측변수 인자들을 이용하여 동정된 환자 부분모집단에서 암 치료를 위한 마시티닙의 용도 Download PDFInfo
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- KR20150092739A KR20150092739A KR1020157011764A KR20157011764A KR20150092739A KR 20150092739 A KR20150092739 A KR 20150092739A KR 1020157011764 A KR1020157011764 A KR 1020157011764A KR 20157011764 A KR20157011764 A KR 20157011764A KR 20150092739 A KR20150092739 A KR 20150092739A
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Abstract
Description
도 1은: 다변량분석에서 사망에 대한 위험 비율 대 VAS 점수를 나타내고;
도 2는: VAS 스케일 및 사용자 지침을 예시한 도면이다.
도 3은: 통증 강도 및 현유전자 발현의 예측변수 인자에 기초한 치료 관리 플랜을 도시한 것이고;
도 4는: '통증' 부분모집단에 있어서의 생존 확률 평가도 (다변량분석);
도 5는: '무통, 무모르핀' 부분모집단에 있어서의 생존 확률 평가도 (다변량분석);
도 6은: '중앙 미만의 통증' 부분모집단에 있어서의 생존 확률에 대한 카플란-마이어 평가도이다(다변량분석).
도 7은: '유전자 지문' 부분모집단에 있어서의 생존 확률(다변량분석)을 나타내고,
도 8은: '비유전자 지문' 부분모집단에 있어서의 생존 확률(다변량분석)을 나타낸다.
Claims (67)
- 적어도 1종의 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제를 인간 환자에게 투여하는 것을 포함하는, 인간 환자에 있어서 암의 치료방법.
- 제1항에 있어서, 상기 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 적어도 1종의 항종양제와 조합 투여되는 것인 방법.
- 제2항에 있어서, 상기 항종양제는 알킬화제, 항유사분열제, 항대사산물제, I형 항토포이소머라제 약물, 백금유사체, 항생제, 호르몬제, 항혈관형성제, 유전자독성제, 세포독성제, 생물제제, 또는 부가적인 티로신 키나제 저해제로부터 선택되며; 특히: 아바렐릭스, 아비라테론 아세테이트, 알데스류킨, 알트레타민, 아나스트로졸, 삼산화비소, 아스파라기나제, 악시티닙, 아자시티딘, 벤다무스틴 염산염, 베바시주맙, 벡사로텐, 비칼루타미드, 레오마이신, 보르테조밉, 브렌툭시맙 베도틴, 부술판, 카바지탁셀, 캄파트, 캄토사르, 카페시타빈, 카르보플라틴, 카르필조밉, 카르무스틴, 세툭시맙, 클로람부실, 시스플라틴, 클라드리빈(2CDA), 클로파라빈, 크리조티닙, 시클로포스파미드, 시타라빈(ARA-C), 시토신 아라비노사이드, 다카르바진, 닥티오마이신, 다사티닙, 다우노루비신, 데시티빈, 데가렐릭스, 데니류킨, 도세탁셀, 독소루비신, 에피루비신, 에리불린 메실레이트, 엘로티닙, 에스트라무스틴 포스페이트, 에토포시드, 에베롤리무스, 엑세메스탄, 플룩스우리딘, 플루다라빈, 플루오로-5-우라실(5 플루오로우라실), 플루오로우리딘-데속시리보스, 플루타미드, 풀베스트란트, 게피티닙, 겜시타빈, 겜투주맙 오조가미신, 히드록시우레아, 이브리투모맙 티욱세탄, 이다루비신, 이포스파미드, 이마티닙, 이필리무맙, 이리노테칸,익사베필론, 라파티닙, 레트로졸, 류코보린, 류프롤리드 아세테이트, 로무스틴, 메클로레타민, 메게스트롤, 멜팔란, 메르캅토퓨린, 메토트렉세이트, 미토마이신, 미토탄, 미토잔트론, 텔라라빈, 닐로티닙,, 닐루타미드, 놀바덱스, 오파투무맙, 옥살리플라틴, 파클리탁셀, 파니투무맙, 파조파닙, 페가스파라가제, peg인터페론, α-2b, 페메트렉세드, 펜토스타틴, 퍼투주맙, 플레릭사포, 프랄라트렉세이트, 프로카르바진, 프로류킨, 로미뎁신, 사파시타빈, 시풀레우셀-T, 소라페닙, 스트렙토조신, 수니티닙, 타목시펜, 테모졸로미드, 템시롤리무스, 테니포시드, 테스토락톤, 데자시타빈, 티오구아닌, 티오테파, 토포테칸, 토르미펜 시트레이트, 트라스투주맙, 트립토렐린, 트록사시타빈, 발루비신, 발스타르, 반데타닙, 베무라페닙, 빈블라스틴, 빈크리스틴 술페이트, 비노렐빈, 비스모데깁, 보리노스타트, 젤로다, 지브-아플리베르셉트, 졸레드론산, FOLFOX (옥살리플라틴 + 5 플루오로우라실 + 폴린산), FOLFIRI (이리노테칸 + 5 플루오로우라실 + 폴린산), 폴피리녹스 (옥살리플라틴 + 이리노테칸 + 5 플루오로우라실 + 폴린산), 및 이들 항종양제들의 조합으로부터 선택되는 것인 방법.
- 제1항 내지 제3항 중 하나 이상의 항에 있어서, 상기 환자는: 급성 림프구 백혈병 (ALL), 급성 골수성 백혈병 (AML), 부신피질암종, 항문암, B세포 림프종, 기저세포암종, 담관암, 방광암, 골암, 뇌간교종, 뇌종양, 유방암, 자궁경부암, 만성 림프구 백혈병 (CLL), 만성 골수성 백혈병 (CML), 대장암 (CRC), 자궁내막암, 식도암, 안암, 담낭암, 위암, 위장관기질종양 (GIST), 다형교모세포종 (GBM), 털세포 백혈병, 두경부암, 심장암, 간세포(간)암종 (HCC), 호지킨 림프종 및 비-호지킨 림프종s, 카포시 육종, 후두암, 비만세포증, 흑색종, 골수섬유증, 골수형성이상 증후군 (MDS), 다발골수종, 비소세포폐암종 (NSCLC), 폐암(소세포), 흑색종, 코인두암종, 신경내분비종, 신경모세포종, 구강암, 임인두암, 난소암, 췌장암, 부비동 및 비강암, 부갑상선암, 음경암, 인두암, 뇌하수체 선종, 전립선암, 직장암, 신장세포(신장)암종 (RCC), 침샘암, 피부암 (비흑색종), 소장암, 소림프구림프종 (SSL), 연조직 육종, 편평세포암종, T 세포 림프종, 고환암, 구협암, 갑상선암, 삼중음성 유방암, 요도암, 및 자궁암으로부터 선택된 적어도 1종의 암의 치료를 필요로 하는 환자인 것인 방법.
- 제1항 내지 제4항 중 하나 이상의 항에 있어서, 상기 티로신 키나제 저해제 또는 비만세포 저해제는 티로신 키나제인: c-Kit, PDGFR, Lyn, Fyn 및 DDR1로부터 선택된 키나제 활성의 저해제인 것인 방법.
- 제5항에 있어서, 상기티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 마시티닙 또는 약학적으로 허용가능한 그의 염인 것인 방법.
- 제6항에 있어서, 마시티닙의 약학적으로 허용가능한 염은 메실레이트 염인 것인 방법.
- 제1항 내지 제7항 중 하나 이상의 항에 있어서, 상기 환자는 질병 관련 통증 강도의 예측변수 인자에 기초해서 치료되도록 초기에 선택된 것인 방법.
- 제8항에 있어서, 상기 환자는 통증에 관련되거나 또는 질병 관련 통증의 치료를 위해 아편유사 진통제를 필요로 하는 암에 걸린 환자인 것인 방법.
- 제9항에 있어서, 상기 통증은 통증 강도 평가 툴을 이용하여 탐지 시, 0이 아닌(non-zero) 통증 강도가 적어도 한 번 일어난 것으로 보고된 것으로 정의되는 것인 방법.
- 제9항에 있어서, 상기 질병 관련 통증은 20%를 초과하는 일차원 통증 강도 평가 툴 점수가 적어도 한 번 일어난 것으로 보고된 것으로 정의되는 것인 방법.
- 제9항에 있어서, 상기 환자는 사용된 통증 평가 툴에 따라 보통 내지 참을 수 없는 암 관련 통증 강도를 갖는 것으로 진단되는 것인 방법.
- 제8항에 있어서, 상기 환자는 통증과 관련된 암 또는 질병 관련 통증의 치료를 위해 아편유사 진통제의 투여를 필요로 하는 암에 걸려 있고, 상기 질병 관련 통증은 100 mm 스케일 상에서 5 mm를 초과하는 시각상사척도 (VAS) 통증 강도 점수가 적어도 한 번 일어난 것으로 보고된 것으로 정의된 것인 방법.
- 제8항에 있어서, 상기 환자는 통증과 관련된 췌장암 또는 질병 관련 통증의 치료를 위해 아편유사 진통제의 투여를 필요로 하는 췌장암에 걸려 있고, 상기 질병 관련 통증은 100 mm 스케일 상에서 20 mm를 초과하는 시각상사척도 (VAS) 통증 강도 점수가 적어도 한 번 일어난 것으로 보고된 것으로 정의된 것인 방법.
- 제1항 내지 제7항 중 하나 이상의 항에 있어서, 상기 환자는 유전자 발현의 예측변수 인자에 기초하여 치료에 처음 선택되는 것인 방법.
- 제15항에 있어서, 상기 유전자 발현 예측변수 인자는 말초혈액세포 샘플에서 RNA 발현 분석으로부터 유도되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 ACOX-1의 상향조절에 기초하여 처음 치료에 선택되며, 좋기로는 델타 사이클 역치 값이 3.81 이하; 더욱 좋기로는 3.36 이하; 및 더더욱 좋기로는 3.05 이하에 대응하는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 좋기로는 3.05 이하의 델타 사이클 역치값에 대응하는 유전자 ACOX-1의 상향조절과 좋기로는 6.1 이하의 델타 사이클 역치값에 대응하는 TNFRSF10B의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 좋기로는 0.35 이하의 델타 사이클 역치값에 대응하는 유전자 RPS23의 상향조절과 좋기로는 3.05 이하의 델타 사이클 역치값에 대응하는 유전자 ACOX-1의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 좋기로는 4.3 이하의 델타 사이클 역치값에 대응하는 유전자 ABCC3의 상향조절과 좋기로는 1.65 이하의 델타 사이클 역치값에 대응하는 유전자에 대응하는 유전자 LYN의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 좋기로는 3.95 이하의 델타 사이클 역치값에 대응하는 유전자 HIF1A의 상향조절과, 좋기로는 5.65 이하의 델타 사이클 역치값에 대응하는 유전자 TNFRSF10의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 좋기로는 3.5를 초과하는 델타 사이클 역치값에 대응하는 유전자 ABCC1의 하향조절과 7.05를 초과하는 델타 사이클 역치값에 대응하는 유전자 IGJ의 하향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 좋기로는 3.7을 초과하는 델타 사이클 역치값에 대응하는 유전자 UBE2H의 상향조절과, 좋기로는 7.1을 초과하는 델타 사이클 역치값에 대응하는 유전자 PARP-2의 하향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 3.36 이하의 델타 사이클 역치값에 대응하는 유전자 ACOX-1의 상향조절과, 6.71 이하의 델타 사이클 역치값에 대응하는 유전자 TNFRSF10B의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 0.32를 초과하는 델타 사이클 역치값에 대응하는 유전자 RPS23의 하향조절과, 3.36 이하의 델타 사이클 역치값에 대응하는 유전자 ACOX-1의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 4.73 이하의 델타 사이클 역치값에 대응하는 유전자 ABCC3의 상향조절과, 1.82 이하의 델타 사이클 역치값에 대응하는 유전자 LYN의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 4.35 이하의 델타 사이클 역치값에 대응하는 유전자 HIF1A의 상향조절과, 6.22 이하의 델타 사이클 역치값에 대응하는 유전자 TNFRSF10의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 3.15를 초과하는 델타 사이클 역치값에 대응하는 유전자 ABCC1의 하향조절과, 6.35를 초과하는 델타 사이클 역치값에 대응하는 유전자 IGJ의 하향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 3.33을 초과하는 델타 사이클 역치값에 대응하는 유전자 UBE2H의 상향조절과, 6.39를 초과하는 델타 사이클 역치값에 대응하는 유전자 PARP-2의 하향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 3.81 이하의 델타 사이클 역치값에 대응하는 유전자 ACOX-1의 상향조절과, 7.63 이하의 델타 사이클 역치값에 대응하는 유전자 TNFRSF10B의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 0.26을 초과하는 델타 사이클 역치값에 대응하는 유전자 RPS23의 하향조절과, 3.81 이하의 델타 사이클 역치값에 대응하는 유전자 ACOX-1의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 5.38 이하의 델타 사이클 역치값에 대응하는 유전자 ABCC3의 상향조절과, 2.06 이하의 델타 사이클 역치값에 대응하는 유전자 LYN의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 4.94 이하의 델타 사이클 역치값에 대응하는 유전자 HIF1A의 상향조절과, 7.06 이하의 델타 사이클 역치값에 대응하는 유전자 TNFRSF10의 상향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 2.63을 초과하는 델타 사이클 역치값에 대응하는 유전자 ABCC1의 하향조절과, 5.29를 초과하는 델타 사이클 역치값에 대응하는 유전자 IGJ의 하향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제15항 내지 제16항 중 하나 이상의 항에 있어서, 상기 환자는 2.78을 초과하는 델타 사이클 역치값에 대응하는 유전자 UBE2H의 상향조절과, 5.33을 초과하는 델타 사이클 역치값에 대응하는 유전자 PARP-2의 하향조절을 동시에 갖는 것으로 정의되는 유전자 발현 예측인자 변수에 기초하여 처음 치료에 선택되는 것인 방법.
- 제6항 내지 제16항 중 하나 이상의 항에 있어서, 마시티닙은 4.5 내지 12.0 mg/kg/일 (1일 체중 1 kg 당 mg)의 1일 투여량으로 투여되는 것인 방법.
- 제36항에 있어서, 마시티닙은 6.0 내지 7.5 mg/kg/일의 출발 투여량으로 투여되는 것인 방법.
- 제36항 내지 제37항 중 하나 이상의 항에 있어서, 마시티닙은 최대 12.0 mg/kg/일에 도달할 때까지 1.5 mg/kg/일씩 증분되어 투여되는 것인 방법.
- 선행하는 항들 중 하나 이상의 항에 있어서, 상기 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 경구 투여되는 것인 방법.
- 선행하는 항들 중 하나 이상의 항에 있어서, 상기 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 1일 2회 투여되는 것인 방법.
- 선행하는 항들 중 하나 이상의 항에 있어서, 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제의 유효량은 3 개월을 초과하는 장기간 동안 투여되는 것인 방법.
- 제2항 내지 제41항 중 하나 이상의 항에 있어서, 상기 환자는 상기 적어도 1종의 항종양제에 대해 나이브하거나 상기 적어도 1종의 항종양제를 이용하는 치료에 대해 반응성인 환자인 것인 방법.
- 제2항 내지 제41항 중 하나 이상의 항에 있어서, 상기 환자는 상기 적어도 1종의 항종양제에 대해 무반응성이거나 내성을 나타내는 환자인 것인 방법.
- 제2항 내지 제43항 중 하나 이상의 항에 있어서, 상기 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 네오아쥬반트, 아주반트, 부수요법 또는 동시요법으로서 적어도 1종의 항종양제와 조합 투여되는 것인 방법.
- 제2항 내지 제44항 중 하나 이상의 항에 있어서, 상기 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 상기 적어도 1종의 항종양제와 동시, 별도 또는 순차적인 사용을 위하여 조합 투여되는 것인 방법.
- 선행하는 항들 중 하나 이상의 항에 있어서,
제2항 내지 제44항 중 하나 이상의 항에 있어서, 상기 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 제3항에 기재된 적어도 1종의 항종양제와 조합 투여되는 것인 췌장암의 치료 방법. - 선행하는 항들 중 하나 이상의 항에 있어서, 상기 환자는 절제불가능한 선암종 췌장암을 앓는 환자인 것인 방법.
- 제1항 내지 제46항 중 하나 이상의 항에 있어서, 상기 환자는 전이성 선암종 췌장암을 앓는 환자인 것인 방법.
- 제45항에 있어서, 상기 적어도 1종의 항종양제는 겜시타빈인 것인 방법.
- 제46항에 있어서, 겜시타빈은 항종양제로서 사용되고 마시티닙 또는 약학적으로 허용되는 그의 염 또는 수화물은 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제로서 사용되는 것인 방법.
- 제46항에 있어서, 마시티닙은 출발 투여량을 6.0 ± 1.5 mg/kg/일로 하되 최대 허용가능한 투여량을 9.0 mg/kg/일로 하여 투여되고, 겜시타빈은 1주일 투여량을 1000 ± 250 mg/m2의 환자 체표면적으로 하여 처음 최대 7주일 동안 연속 투여한 다음 1주일간 투여를 중단하고 이어서 28일마다, 3주일 동안 1주일에 1000 ±250 mg/m2의 투여량으로 투여되는 것인 방법.
- 제1항 내지 제52항 중 어느 하나의 항에서 정의된 암의 치료방법에 사용되기 위한 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제.
- 제53항에 있어서, 적어도 1종의 항종양제와 조합되는 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제.
- 제1항 내지 제52항 중 어느 하나의 항에서 정의된 암의 치료방법에 사용되기 위한, 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제를 포함하는 의약 조성물 또는 키트.
- 제55항에 있어서, 적어도 1종의 항종양제를 포함하는 의약 조성물 또는 키트.
- 제1항 내지 제54항 중 어느 하나의 항에서 정의된 암의 치료를 위한 의약 또는 의약 조성물의 제조를 위한 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제의 용도.
- 제57항에 있어서, 상기 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제는 적어도 1종의 항종양제와 조합 사용되는 것인 용도.
- 유전자 발현의 예측변수 인자에 기초하여 치료가능한 환자들을 동정하기 위한, 인간 환자에 있어서, 암, 특히 췌장암의 치료를 위한 치료 관리 플랜으로서, 상기 관리 플랜은 상기 환자가 제17항 내지 제35항에서 정의된 적어도 하나의 유전자 발현 예측변수 인자들과 관련된 암에 걸렸는지를 탐지하는 것을 포함하는 것인 치료 관리 플랜.
- 제59항에 있어서, 상기 플랜은 췌장암 환자에게 적용되며:
- 환자가 적어도 1종의 유전자 발현 예측변수 인자를 나타내면 그 환자를 임의로 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 임의로 조합하여 적어도 1종의 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙으로 치료하고;
- 환자가 적어도 1종의 유전자 발현 예측변수 인자를 나타내지 않으면 그 환자를 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈으로 치료하는 것인,
치료 관리 플랜. - 제59항에 있어서, 상기 플랜은 암 환자에게 적용되며:
- 환자가 적어도 1종의 유전자 발현 예측변수 인자를 나타내면 그 환자를 임의로 적어도 1종의 항종양제와 조합하여, 적어도 1종의 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙으로 치료하고:
- 환자가 적어도 1종의 유전자 발현 예측변수 인자를 나타내지 않으면 그 환자를 적어도 1종의 항종양제로 치료하는 것인,
치료 관리 플랜. - 통증 강도의 예측변수 인자에 기초하여 치료가능한 환자들을 동정하기 위한, 인간 환자에 있어서, 암, 특히 췌장암의 치료를 위한 치료 관리 플랜으로서, 상기 관리 플랜은:
a) 상기 환자가 통증과 연관되거나 또는 질병 관련 통증의 치료를 위해 적어도 1종의 아편유사 진통제의 투여를 필요로 하는 암에 걸려있는지를 탐지하는 단계로서, 여기서 상기 통증의 강도는 좋기로는 100 mm 스케일 상에서 5 mm를 초과하는시각상사척도 (VAS) 점수가 일어난 것으로 정의되는 것인 단계; 및
임의로
b) 상기 질병 관련 통증이 100 mm 스케일 상에서 상기 암에 대해 사전정의된 값보다 더 높은 시각상사척도 (VAS) 통증 강도 점수가 일어난 것인지, 특히 췌장암에 있어서, 100 mm 스케일 상에서 시각상사척도 (VAS) 통증 강도 점수가 20 mm를 초과하는지를 탐지하는 단계
를 포함하는 것인 치료 관리 플랜. - 제62항에 있어서, 상기 플랜은 췌장암 환자에게 적용되며:
- 단계 (a)의 결과가 부정적이면, 환자를 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈으로 치료하고:
- 단계 (a)의 결과가 긍정적이고 단계 (b)의 결과가 부정적이면, 적어도 1종의 약물 표적 표피성장인자 수용체 (EGFR), 특히 엘로티닙을 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합한 것; 또는 적어도 1종의 유사분열 저해제, 특히 파클리탁셀을 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합한 것; 또는 플루오로우라실, 류코보린, 이리노테칸, 또는 옥살리플라틴, 특히 폴피리녹스를 포함하는 약물들의 적어도 1종의 조합으로 환자를 치료하며
- 단계 (a)의 결과가 긍정적이고 단계 (b)의 결과도 긍정적이면, 적어도 1종의 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙을, 임의로 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합하여 환자를 치료하는 것인 치료 관리 플랜. - 제62항에 있어서, 상기 플랜은 췌장암이 아닌 암 환자에게 적용되며:
- 단계 (a)의 결과가 부정적이면, 환자를 적어도 1종의 항종양제로 치료하고:
- 단계 (a)의 결과가 긍정적이고 단계 (b)의 결과가 부정적이면, 환자를 적어도 1종의 항종양제로 치료하며
- 단계 (a)의 결과가 긍정적이고 단계 (b)의 결과도 긍정적이면, 적어도 1종의 티로신 키나제저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙을 임의로 적어도 1종의 항종양제와 조합하여 환자를 치료하는 것인 치료 관리 플랜. - 제59항에 정의된 유전자 발현 치료 관리 플랜 및 제65항에 정의된 통증 강도 치료 관리 플랜의 순차 적용에 기초하여 치료가능한 환자들을 동정하기 위한, 인간 환자에 있어서, 암, 특히 췌장암의 치료를 위한 치료 관리 플랜으로서, 상기 통증 강도 치료 관리 플랜의 단계 (a)에 앞서서, 환자가 제17항 내지 제35항에 정의된 바와 같은 적어도 1개의 유전자 발현 예측변수 인자와 연관된 암에 걸렸는지를 탐지하는 것으로 이루어진 단계 (a)를 먼저 실시하는 것인 전체 치료 관리 플랜.
- 제65항에 있어서, 상기 플랜은 췌장암 환자에게 적용되며:
- 단계 (a')의 결과가 긍정적이면, 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙을 임의로 적어도 1종의 뉴클레오타이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합하여 환자를 치료하고;
- 단계 (a')의 결과가 부정적이면, 췌장암에 대한 통증 강도 치료 관리 플랜의 단계 (a)를 적용하되( 제62항 및 제63항에 정의된 바와 같음), 특히, 상기 관리 플랜은:
a) 상기 환자가 통증과 연관된 췌장암에 걸렸는지 또는 통증, 좋기로 는 100 mm 스케일에서 5 mm를 초과하는 시각상사척도(VAS) 점수를 나 타내는 것으로 보고된 것으로 정의된 질병 관련 통증의 치료를 위해 적어도 1종의 아편유사 진통제의 투여를 필요로 하는지를 결정하는 단 계; 및 임의로
b) 상기 질병 관련 통증이 100 mm 스케일에서 20 mm를 초과하는 시각 상사척도 (VAS) 통증 강도 점수를 나타내는지를 결정하는 단계
를 포함하는 것임.
- 단계 (a)의 결과가 부정적이면, 환자를 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈으로 치료하고,
- 단계 (a)의 결과가 긍정적이고, 단계 (b)의 결과는 부정적이면, 적어도 1종의 약물 표적 표피성장인자 수용체 (EGFR), 특히 엘로티닙을 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합한 것; 또는 적어도 1종의 유사분열 저해제, 특히 파클리탁셀을 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합한 것; 플루오로우라실, 류코보린, 이리노테칸, 또는 옥살리플라틴, 특히 폴피리녹스를 포함하는 약물들의 적어도 1 가지 조합으로 환자를 치료하며,
- 단계 (a)의 결과가 긍적적이고, 단계 (b)의 결과도 긍정적이면, 적어도 1종의 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙을, 임의로 적어도 1종의 뉴클레오사이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합하여 환자를 치료하는 것인, 치료 관리 플랜. - 제65항에 있어서, 상기 플랜은 췌장암이 아닌 암 환자에게 적용되며:
- 단계 (a')의 결과가 긍정적이면, 적어도 1종의 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙을 임의로 적어도 1종의 뉴클레오타이드 유사체, 특히 시티딘 유사체, 특히 겜시타빈과 조합하여 환자를 치료하고;
- 단계 (a')의 결과가 부정적이면, 암에 대한 통증 강도 치료 관리 플랜의 단계 (a)를 적용하되 (제62항 및 제64항에 정의된 바와 같음), 상기 관리 플랜은:
a) 상기 환자가 통증과 연관된 암에 걸렸는지 또는 100 mm 스케일에서 5 mm를 초과하는 시각상사척도(VAS) 점수를 나타내는 것으로 보고된 것으로 정의된 질병 관련 통증의 치료를 위해 적어도 1종의 아편유사 진통제의 투여를 필요로 하는지를 결정하는 단계; 및 임의로
b) 상기 질병 관련 통증이 100 mm 스케일에서 20 mm를 초과하는 시각 상사척도 (VAS) 통증 강도 점수를 나타내는 지를 결정하는 단계
를 포함하는 것이고;
- 단계 (a)의 결과가 부정적이면, 환자를 적어도 1종의 항종양제로 치료하며,
- 단계 (a)의 결과가 긍정적이고, 단계 (b)의 결과는 부정적이면, 환자를 적어도 1종의 항종양제로 치료하고,
- 단계 (a)의 결과가 긍정적이고 단계 (b)의 결과도 긍정적이면, 적어도 1종의 티로신 키나제 저해제, 비만세포 저해제 또는 c-Kit 저해제, 특히 마시티닙을 임의로 적어도 1종의 항종양제와 조합하여 환자를 치료하는 것인 치료 관리 플랜.
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TW201615194A (zh) * | 2014-10-24 | 2016-05-01 | 朗齊生物醫學股份有限公司 | 氨苯蝶啶藥物應用於癌症治療 |
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BR112015007144A2 (pt) | 2017-12-12 |
IL238107B (en) | 2018-03-29 |
AR092899A1 (es) | 2015-05-06 |
CN104968347A (zh) | 2015-10-07 |
JP6234466B2 (ja) | 2017-11-22 |
AU2013326463A1 (en) | 2015-04-16 |
MX2015004264A (es) | 2015-10-12 |
TW201414475A (zh) | 2014-04-16 |
ZA201503054B (en) | 2016-11-30 |
DK2903616T3 (da) | 2018-01-29 |
CA2886979C (en) | 2021-01-05 |
EP2903616B1 (en) | 2017-12-13 |
US10238649B2 (en) | 2019-03-26 |
EP2903616B8 (en) | 2018-02-07 |
SI2903616T1 (en) | 2018-02-28 |
WO2014053650A1 (en) | 2014-04-10 |
ES2656640T3 (es) | 2018-02-27 |
EP2903616A1 (en) | 2015-08-12 |
SG11201502626PA (en) | 2015-05-28 |
US20150272945A1 (en) | 2015-10-01 |
TWI609686B (zh) | 2018-01-01 |
NZ706420A (en) | 2018-08-31 |
KR102149483B1 (ko) | 2020-08-28 |
MX369999B (es) | 2019-11-28 |
AU2013326463B2 (en) | 2018-01-18 |
CA2886979A1 (en) | 2014-04-10 |
EA037368B1 (ru) | 2021-03-19 |
EA201500373A1 (ru) | 2016-02-29 |
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