Methods and compositions for treating chemotherapy-induced diarrhea

Abstract

Presented herein are methods for treating diarrhea by administering to a patient in need thereof, an inhibitor of chloride-ion transport in an amount sufficient to treat diarrhea. Treatment of diarrhea includes the treatment of the diarrhea as well as the pain, abdominal discomfort and other symptoms associated with diarrhea. In one embodiment, the inhibitor of chloride-ion transport is crofelemer.

What is claimed is: 
     
         1 . A method of treating chemotherapy-induced diarrhea (CID) in a human subject undergoing chemotherapy comprising administering to a subject in need thereof a composition comprising an effective amount of proanthocyanidin polymer extract of  Croton lechleri  to treat CID, wherein the chemotherapeutic is selected from lapatinib, sunitinib, sorafenib, erlotinib, gefitinib, axitinib, imatinib, nilotinib, dasatinib, cabozantinib, ruxolitinib, bosutinib and valatinib. 
     
     
         2 . The method of  claim 1 , wherein the proanthocyanidin polymer may be administered in combination with other chemotherapy agents. 
     
     
         3 . The method of  claim 1 , wherein the proanthocyanidin polymer is administered at the same time as chemotherapy to reduce or delay the onset of CID. 
     
     
         4 . The method of  claim 1 , wherein the proanthocyanidin polymer is administered before chemotherapy to prevent, reduce or delay the onset of CID. 
     
     
         5 . The method of  claim 1 , wherein the proanthocyanidin polymer is administered after chemotherapy to reduce the onset of or treat CID. 
     
     
         6 . The method of  claim 1 , wherein the proanthocyanidin polymer is administered after a subject begins to exhibit symptoms of CID. The method of  claim 1 , wherein the proanthocyanidin polymer is administered for the duration of treatment with the chemotherapy. 
     
     
         8 . The method of  claim 1 , wherein the proanthocyanidin polymer is administered until symptoms of CID are ameliorated and then crofelemer is discontinued. 
     
     
         9 . The method of  claim 1 , wherein the administration results in a decrease in 1, 2 or 3 Grades of the Grade of diarrhea according to the Common Toxicity Criteria. 
     
     
         10 . The method of  claim 1 , wherein the administering comprises administering about 250 mg to about 1000 mg per day; administering about 250 mg per day; administering about 500 mg per day; administering about 1000 mg per day; administering about 125 mg two times per day; administering about 250 mg two times per day; or administering about 500 mg two times per day of crofelemer to a subject in need thereof. 
     
     
         11 . The method of  claim 1 , wherein the proanthocyanidin polymer is administered as an enteric coated oral dosage form. 
     
     
         12 . The method of  claim 1 , wherein the proanthocyanidin polymer is administered as an oral dosage form that is not enteric coated. 
     
     
         13 . The method of  claim 1 , wherein the subject can tolerate a chemotherapeutic agent that the subject could not tolerate without the administration of proanthocyanidin polymer or can tolerate a higher dosage of chemotherapeutic than the subject could tolerate without administration of crofelemer. 
     
     
         14 . The method of  claim 1 , wherein a subject is considered treated if the subject demonstrates one or more of a decrease in the number of bowel movements per day, a decrease in the number of watery bowel movements per day, an improvement in the daily abdominal score for pain or discomfort, an improvement in the score for daily stool consistency, a decrease in stool consistency, a decrease in the number of days per week that subjects experienced urgency, a decrease in the number of days per week that subjects experienced fecal incontinence, or a decrease in the unscheduled visit for a significant worsening of diarrhea. 
     
     
         15 . The method of  claim 1 , wherein the subject is undergoing chemotherapy to treat a cancer selected from breast cancer, ovarian cancer, prostate cancer, bladder cancer, cervical cancer, uterine cancer, testicular cancer, kidney cancer, thyroid cancer, oral or oropharyngeal cancer, astrocytoma, sarcoma, mesothelioma, meningioma, lymphoma, myeloma, head and neck cancer, lung cancer, carcinoma (e.g., squamous cell carcinoma), malignant melanoma, peritoneal cancer, gastric cancer, hepatic cancer, colorectal cancer, gallbladder cancer, bone cancer, pancreatic cancer, tongue cancer, esophageal cancer, brain tumor, brain stem glioma, a metastases thereof, and leukemia.