Combination therapy with glutaminase inhibitors and immuno-oncology agents

Abstract

The invention relates to methods of treating cancer, myeloproliferative diseases, or immunological or neurological diseases with a combination of a glutaminase inhibitor and an immuno-oncology therapeutic agent, such as an inhibitor of arginase, CTLA-4, indoleamine 2,3-dioxygenase, and/or PD-1/PD-L1.

1 . A method of treating lung cancer or renal cell carcinoma, comprising conjointly administering a glutaminase inhibitor and an immuno-oncology therapeutic agent. 
     
     
         2 . The method of  claim 1 , wherein conjointly administering the glutaminase inhibitor and the immuno-oncology therapeutic agent provides improved efficacy relative to individual administration of the glutaminase inhibitor or immuno-oncology therapeutic agent as a single agent. 
     
     
         3 . The method of  claim 2 , wherein conjointly administering the immuno-oncology therapeutic agent and glutaminase inhibitor provides an additive effect. 
     
     
         4 . The method of  claim 2 , wherein conjointly administering the immuno-oncology therapeutic agent and glutaminase inhibitor provides a synergistic effect. 
     
     
         5 . The method of  claim 1 , wherein the immuno-oncology therapeutic agent and glutaminase inhibitor are administered simultaneously. 
     
     
         6 . The method of  claim 1 , wherein the immuno-oncology therapeutic agent is administered within about 5 minutes to within about 168 hours prior or after of the glutaminase inhibitor. 
     
     
         7 . The method of  claim 1 , wherein the immuno-oncology therapeutic agent is an inhibitor of arginase, CTLA-4, indoleamine 2,3-dioxygenase, and/or PD-1/PD-L1. 
     
     
         8 . The method of  claim 1 , wherein the immuno-oncology therapeutic agent is selected from abagovomab, adecatumumab, afutuzumab, alemtuzumab, anatumomab mafenatox, apolizumab, blinatumomab, BMS-936559, catumaxomab, durvalumab, epacadostat, epratuzumab, indoximod, inotuzumab ozogamicin, intelumumab, ipilimumab, isatuximab, lambrolizumab, MED14736, MPDL3280A, nivolumab, obinutuzumab, ocaratuzumab, ofatumumab, olatatumab, pembrolizumab, pidilizumab, rituximab, ticilimumab, samalizumab, and tremelimumab. 
     
     
         9 . The method of  claim 1 , wherein the glutaminase inhibitor is a compound of formula I, 
       
         
           
           
               
               
           
         
       
       or a pharmaceutically acceptable salt thereof, wherein:
 L represents CH 2 SCH 2 , CH 2 CH 2 , CH 2 CH 2 CH 2 , CH 2 , CH 2 S, SCH 2 , CH 2 NHCH 2 , CH═CH, or 
 
       
         
           
           
               
               
           
         
          wherein any hydrogen atom of a CH or CH 2  unit may be replaced by alkyl or alkoxy, any hydrogen of an NH unit may be replaced by alkyl, and any hydrogen atom of a CH 2  unit of CH 2 CH 2 , CH 2 CH 2 CH 2  or CH 2  may be replaced by hydroxy; 
         X, independently for each occurrence, represents S, O or CH═CH, wherein any hydrogen atom of a CH unit may be replaced by alkyl; 
         Y, independently for each occurrence, represents H or CH 2 O(CO)R 7 ; 
         R 7 , independently for each occurrence, represents H or substituted or unsubstituted alkyl, alkoxy, aminoalkyl, alkylaminoalkyl, heterocyclylalkyl, or heterocyclylalkoxy; 
         Z represents H or R 3 (CO); 
         R 1  and R 2  each independently represent H, alkyl, alkoxy or hydroxy; 
         R 3 , independently for each occurrence, represents substituted or unsubstituted alkyl, hydroxyalkyl, aminoalkyl, acylaminoalkyl, alkenyl, alkoxy, alkoxyalkyl, aryl, arylalkyl, aryloxy, aryloxyalkyl, cycloalkyl, cycloalkylalkyl, heterocyclyl, heterocyclylalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, heteroaryloxyalkyl or C(R 8 )(R 9 )(R 10 ), N(R 4 )(R 5 ) or OR 6 , wherein any free hydroxyl group may be acylated to form C(O)R 7 ; 
         R 4  and R 5  each independently represent H or substituted or unsubstituted alkyl, hydroxyalkyl, acyl, aminoalkyl, acylaminoalkyl, alkenyl, alkoxyalkyl, aryl, arylalkyl, aryloxy, aryloxyalkyl, cycloalkyl, cycloalkylalkyl, heterocyclyl, heterocyclylalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, or heteroaryloxyalkyl, wherein any free hydroxyl group may be acylated to form C(O)R 7 ; 
         R 6 , independently for each occurrence, represents substituted or unsubstituted alkyl, hydroxyalkyl, aminoalkyl, acylaminoalkyl, alkenyl, alkoxyalkyl, aryl, arylalkyl, aryloxy, aryloxyalkyl, cycloalkyl, cycloalkylalkyl, heterocyclyl, heterocyclylalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, or heteroaryloxyalkyl, wherein any free hydroxyl group may be acylated to form C(O)R 7 ; and 
         R 8 , R 9  and R 10  each independently represent H or substituted or unsubstituted alkyl, hydroxy, hydroxyalkyl, amino, acylamino, aminoalkyl, acylaminoalkyl, alkoxycarbonyl, alkoxycarbonylamino, alkenyl, alkoxy, alkoxyalkyl, aryl, arylalkyl, aryloxy, aryloxyalkyl, cycloalkyl, cycloalkylalkyl, heterocyclyl, heterocyclylalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, or heteroaryloxyalkyl, or R 8  and R 9  together with the carbon to which they are attached, form a carbocyclic or heterocyclic ring system, wherein any free hydroxyl group may be acylated to form C(O)R 7 , and wherein at least two of R 8 , R 9 , and R 10  are not H. 
       
     
     
         10 . (canceled) 
     
     
         11 . The method of  claim 9 , wherein one or more of (a)-(e) applies:
 (a) L represents CH 2 CH 2 ;   (b) Y represents H;   (c) one X represents S and the other X represents CH═CH;   (d) Z represents R 3 (CO); and   (e) R 1  and R 2  each represent H.   
     
     
         12 - 14 . (canceled) 
     
     
         15 . The method of  claim 9 , wherein each occurrence of R 3  is not identical. 
     
     
         16 . (canceled) 
     
     
         17 . The method of  claim 9 , wherein R 3 , independently for each occurrence, represents substituted or unsubstituted arylalkyl, heteroarylalkyl, cycloalkyl, or heterocycloalkyl. 
     
     
         18 - 56 . (canceled) 
     
     
         57 . The method of  claim 1 , wherein the glutaminase inhibitor is a compound having the structure of formula (II): 
       
         
           
           
               
               
           
         
       
       or a pharmaceutically acceptable salt thereof. 
     
     
         58 - 84 . (canceled) 
     
     
         85 . A pharmaceutical kit comprising:
 an immuno-oncology therapeutic agent is an inhibitor of arginase, CTLA-4, indoleamine 2,3-dioxygenase, and/or PD-1/PD-L1;   a glutaminase inhibitor; and   optionally directions on how to administer the immuno-oncology agent and glutaminase inhibitor.   
     
     
         86 . The method of  claim 1 , for treating lung cancer. 
     
     
         87 . The method of  claim 1 , for treating renal cell carcinoma. 
     
     
         88 . The method of  claim 1 , wherein the immuno-oncology therapeutic agent is an anti-PD-L1 antibody. 
     
     
         89 . The method of  claim 57 , wherein the immuno-oncology therapeutic agent is an anti-PD-L1 antibody. 
     
     
         90 . The method of  claim 1 , wherein the immuno-oncology therapeutic agent is an anti-PD-1 antibody. 
     
     
         91 . The method of  claim 57 , wherein the immuno-oncology therapeutic agent is an anti-PD-1 antibody.