Administration of carboline derivatives useful in the treatment of cancer and other diseases

#The present invention relates to compounds for inhibiting the expression of VEGF post-transcriptionally or for inhibiting angiogenesis, and compositions, methods, and kits for the administration or use of such compounds.

#Aberrant angiogenesis plays a critical role in the pathogenesis of numerous diseases, including malignant, ischemic, inflammatory and immune disorders (Carmeliet, Nat. Med., 9(6):653-60 (2003), Ferrara, Semin. Oncol., 29(6 Suppl 16):10-4 (2002)). The best-known of these disorders are cancer, exudative macular degeneration and diabetic retinopathy (DR), the last two of which are leading cause of blindness in the United States (Witmer et al., Prog. Retin Eye Res., 22(1): 1-29 (2003), Clark et al., Nat. Rev. Drug Discovery, 2:448-459 (2003)). During the last decade our understanding of the molecular basis of angiogenesis has grown considerably. Numerous cytokines and growth factors that stimulate angiogenesis, such as VEGF, FGF-2, PDGF, IGF-1, TGF, TNF-α, G-CSF have been identified (Ferrara et al., Nat. Med., 5(12):1359-64 (1999), Kerbel et al., Nat. Rev. Cancer, 2(10):727-39 (2002), Rofstad et al., Cancer Res., 60(17):4932-8 (2000)). Among these growth factors, Vascular Endothelial Growth Factor (VEGF) plays a central role in angiogenesis (Ferrara, Semin. Oncol., 29(6 Suppl 16): 10-4 (2002)).

#VEGF, also known as VEGF-A, was initially identified for its ability to induce vascular permeability and to promote vascular endothelial cell proliferation (Leung et al., Science, 246:1306-1309 (1989), Plouet et al., EMBO J., 8:3801-3806 (1989), Connolly et al., J. Biol. Chem., 264:20017-20024 (1989)). VEGF is encoded by a single gene that gives rise to four isoforms by alternative splicing (Tischer et al., J. Biol. Chem., 266:11947-11954 (1991)). All four isoforms share the same unusually long and GC rich 5′-UTR, as well as a 3′-UTR that includes multiple RNA stability determinants. The receptors VEGFR-2 (also known as KDR or Flk-1) and VEGFR-1 (previously known as Flt1) recognize the dimeric form of VEGF (Ortega et al., Front. Biosci., 4:D141-52 (1999), Sato et al., Annals of New York Academy of Science, 902:201-207, (2000)). The highly specific VEGFR-2 receptor is expressed on endothelial cells. VEGF binding to the VEGFR-2 receptor activates the receptor's tyrosine kinase activity, leading to endothelial cell proliferation, differentiation and primitive vessel formation (Shalaby et al., Nature, 376:62-66, (1995)). VEGFR-1 inhibits endothelial cell growth either by acting as a decoy or by suppressing signaling pathways through VEGFR-2 (Fong et al., Nature, 376:66-70 (1995)).

#FIG. 1 illustrates inhibition of lung cancer tumor growth by compound #10.

#FIG. 2 illustrates inhibition of Ewing's sarcoma and neuroblastoma tumor growth by compound #10.

#FIG. 3 illustrates inhibition of fibrosarcoma tumor growth by compound #10.

#Aberrant up-regulation of Vascular Endothelial Growth Factor (VEGF), a key factor for angiogenesis, is an important contributor to the pathogenesis of disease states such as cancer, diabetic retinopathy, rheumatoid arthritis, psoriasis, atherosclerosis, chronic inflammation, other chronic inflammation-related diseases and disorders, obesity, or exudative macular degeneration. In accordance with the present invention, compounds that inhibit the expression of VEGF post-transcriptionally have been identified, and methods for their use provided. The compounds of the invention have nanomolar to sub-nanomolar activity for the inhibition of VEGF expression.

#A. Compounds of the Invention

#In one aspect of the invention, compounds are provided which are useful in the inhibition of VEGF production, in the inhibition of angiogenesis, and/or in the treatment of cancer, diabetic retinopathy or exudative macular degeneration. In certain embodiments, the compounds of the invention specifically inhibit VEGF production, while in other embodiments, the compounds of the invention inhibit VEGF expression as well as that of other angiogenesis factors such as FGF-2. In this regard, pan-angiogenic inhibitor may be preferred in methods of inhibiting tumor growth, while VEGF specific inhibitors may be preferred for the treatment of ocular neovascular disorders (Eyetech Study Group, 22(2):143-52 (2002)).