| United
States Patent Application | 20050095197
|
| Kind
Code | A1
|
|
Tuszynski, Jack A.
; et al.
| May 5, 2005
|
Anti-mitotic compound
Abstract
An anti-mitotic compound with a molecular weight of at least 150
grams per mole, a mitotic index factor of at least 10 percent, a
positive magnetic susceptibility of at least 1,000.times.10.sup.-6 cgs,
and a magnetic moment of at least 0.5 bohr magnetrons. The compound
contains at least 7 carbon atoms and at least one inorganic atom with a
positive magnetic susceptibility of at least 200.times.10.sup.-6 cgs.
| Inventors: |
Tuszynski, Jack A.; (Edmonton,
CA)
; Greenwald, Howard J.; (Rochester, NY)
|
| Correspondence
Name and Address: | HOWARD J. GREENWALD P.C.
349 W. COMMERCIAL STREET SUITE 2490
EAST ROCHESTER
NY
14445-2408
US
|
| Serial
No.:
| 878905 |
| Series Code: | 10
|
| Filed: | June 28, 2004 |
| U.S. Current Class: | 424/1.11; 534/11 |
| U.S. Class at Publication: |
424/001.11; 534/011 |
| Intern'l Class: |
A61K 051/00; C07F 005/00 |
Claims
We claim:
1. An anti-mitotic compound with a molecular weight of at least
150 grams per mole, a mitotic index factor of at least 10 percent, a
positive magnetic susceptibility of at least 1,000.times.10.sup.-6 cgs,
and a magnetic moment of at least 0.5 bohr magnetrons, wherein said
compound is comprised of at least 7 carbon atoms and at least one
inorganic atom with a positive magnetic susceptibility of at least
200.times.10.sup.-6 cgs.
2. The anti-mitotic compound as recited in claim 1, wherein
said compound has a mitotic index factor of at least 20 percent.
3. The anti-mitotic compound as recited in claim 1, wherein
said compound has a positive magnetic susceptibility of at least
5,000.times.10 .sup.-6 cgs.
4. The anti-mitotic compound as recited in claim 1, wherein
said compound is comprised of at least 10 carbon atoms.
5. The anti-mitoitc compound as recited in claim 1, wherein
said inorganic atom is radioactive.
6. The anti-mitotic compound as recited in claim 1, wherin said
inorganic atom has a magnetic moment of at least 1.0 bohr magnetron.
7. The anti-mitotic compound as recited in claim 1, wherein
said compound has a mitotic index factor of at least about 50 percent.
8. The anti-mitotic compound as recited in claim 7, wherein
said compound has a positive magnetic susceptibility of at least
10,000.times.10.sup.-6 cgs.
9. The anti-mitotic compound as recited in claim 8, wherein
said inorganic atom has a magnetic moment of at least 2.0 bohr
magnetrons.
10. A composition comprised of the anti-mitotic compound of
claim 1 and a polymeric material.
11. The composition as recited in claim 10, wherein said
polymeric material is absorbable in living tissue.
12. The composition as recited in claim 10, wherein said
polymeric material is selected from the group consisting of a
silicon-containing polymeric material and a hydrocarbon-containing
polymeric material.
13. The composition as recited in claim 10, wherein wherein
said polymeric material is silicone rubber.
14. The composition as recited in claim 13, wherein said
silicone rubber is dimethylpolysiloxane rubber.
15. The composition as recited in claim 13, wherein said
silicone rubber is a biocompatible silicone rubber.
16. The composition as recited in claim 10, wherein said
polymeric material is a synthetic absorbable copolymer formed by
copolymereizing glycolide with trimethylene carbonate.
17. The composition as recited in claim 10, wherein said
polymeric material is selected from the group consisting of polyester,
polytetrafluoroethylene, polyurethane silicone-based material, and
polyamide.
18. The composition as recited in claim 10, wherein said
polymeric material is a copolymer containing carbonate repeat units and
ester repeat units 19. The composition as recited in claim 10, wherein
said polymeric material is collagen.
20. The composition as recited in claim 10, wherein said
polymeric material selected from the group consisting of homopolymers
and copolymers of glycolic acid and lactic acid.
21. The composition as recited in claim 10, wherein said
polymeric material is comprised of a polycarbonate-containing polymer.
22. The composition as recited in claim 10, wherein said
polymeric material is selected from the group consisting of polylactic
acid, polyglycolic acid, copolymers of polylactic acid and polyglycolic
acid, polyamides, and copolyesters of polyamides and polyestes.
23. The composition as recited in claim 10, wherein said
polymeric material is selected from the group consisting of polyesters,
polyamides, polyurethanes, and polyanhydrides.
24. A compositon comprised of a polymeric material and a
compound with a molecular weight of at least 150 grams per mole, a
positive magnetic susceptibility of at least 1,000.times.10.sup.-6 cgs,
and a magnetic moment of at least 0.5 bohr magnetrons, wherein said
compound is comprised of at least 7 carbon atoms and at least one
inorganic atom with a positive magnetic susceptibility of at least
200.times.10.sup.-6 cgs.
25. The composition as recited in claim 10, wherein wherein
said polymeric material is a poly (phosphoester).
26. The composition as recited in claim 10, wherein said
anti-mitotic compound is bound within said polymeric material.
27. The composition as recited in claim 10, wherein a
multiplicity of said anti-mitotic compounds are dispoed within said
polymeric material.
28. The composition as recited in claim 10, wherein said
polymeric material is a polypeptide.
29. The composition as recited in claim 10, wherein said
polymeric material forms a reservoir within which is disposed said
anti-mitotic compound.
30. The composition as recited in claim 29, wherein said
reservoir is formed by a polymer selected from the group consisting of
polyurethanes and its copolymers, silicone and its copolymers, ethylene
vinylacetat, thermoplastic elastomers, polyvinylchloride, polyolefins,
cellulosics, polyamides, polytetrafluoroethylenes, polyesters,
polycarbonates, polysulfones, acrylics, and acrylonitrile butadiene
styrene copolymers.
31. The composition as recited in claim 10, wherein said
polymeric material is a bioabsorbable polymer selected from the group
consisting of poly (L-lactic acid), polycaprolactone, poly
(lactide-co-glycolide), poly (hydroxybutyrate), poly
(hydroxybutyrate-co-valerate), polydioxanone, polyorthoester,
polyanhydride, poly (glycolic acid), poly (D,L-lactic acid), poly
(glycolic acid-co-trimethylene carbonate), polyphosphoester,
polyphosphoester urethane, poly(amino acid), cyanoacruylate,
poly(trimethylene carbonate), poly (iminocarbonate) copoly
(ether-ester), polyalkylene oxalate, polyphosphazenes, and mixtures
thereof.
32. The composition as recited in claim 10, wherein said
polymeric material is a biomolecule.
33. The composition as recited in claim 32, wherein said
biomolecule is selected from the group consisting of fibrin, fibrogen,
cellulose, starch, collagen, and hyaluronic acid.
34. The composition as recited in claim 10, wherein wherein
said polymeric material is selected from the group consisting of
polyolefin, acrylic polymer, acrylic copolymer, vinyl halide polymer,
vinyl halide copolymer, polyvinyl ether, polyvinylidene halide,
polyinylketone, polyvinyl aromatic polymer, copolymers of vinyl
monomer, acrylonitrile-styrene copolymer, ethylene-vinyl acetate
copolymer, polyamide, alkyd resin, polyoxymethylene, polyimide,
polyether, epoxy resin, rayon, rayon-tracetate, cellulose, cellulose
acetate, cellulose butyrate, cellulose acetate butyrate, cellophane,
cellulose nitrate, cellulose propionate, cellulose ether, and
carboxymethyl cellulose.
35. The composition as recited in claim 10, wherein a
heterobifunctional photolytic linker is bonded to said polymeric
material.
36. The composition as recited in claim 35, wherein said
heterobifunctional photolytic linker is bonded to said anti-mitotic
compound.
37. An assembly comprised of the composition of claim 36 and
means for releasing said anti-mitotic compound from said
heterobifuncitonal photolytic linker.
38. The assembly as recited in claim 37, wherein said means for
releasing said anti-mitotic compound from said heterobifunctional
photolytic linker comprises a first coherent laser light source.
39. The composition as recited in claim 10, wherein wherein
said coherent laser light source provides coherent light with a
wavelength of from about 280 to about 400 nanometers.
40. The anti-mitotic compound as recited in claim 1, wherein
said anti-mitotic compound is disposed within a microcapsule.
41. The composition as recited in claim 10, wherein said
polymeric material is a mixture of fibrinogen and thrombin.
42. The therapeutic assembly as recited in claim 10, wherein
said polymeric material is a multi-layered polymeric material.
43. The composition as recited in claim 10, wherein said
polymeric material is a porous polymeric material.
44. The composition as recited in claim 10, wherein said
polymeric material has a thermal processing temperature of less than
about 100 degrees Celsius.,
45. The composition as recited in claim 10, wherein said
polymeric material is comprised of a porosigen.
46. The composition as recited in claim 45, wherein said
porosigen is selected from the group of microgranules of sodium
chloride, lactose, sodium heparin, polyethyelen glycol, polyethylene
oxide/polypropylene oxide copolymer, and mixtures thereof.
47. The composition as recited in claim 10, wherein said
polymeric material is a thermoplastic polymer.
48. The composition as recited in claim 10, wherein said
polymeric material is an elastomeric polymer.
49. The composition as recited in claim 10, wherein said
polymeric material is a controlled release polymer.
50. The composition as recited in claim 10, wherein said
polymeric material is a transparent polymeric material.
51. The composition as recited in claim 10, wherein said
polymeric material is a hydrophobic elastomeric material.
52. The composition as recited in claim 10, wherein said
polymeric material is a hydrophilic polymer.
53. The composition as recited in claim 10, wherein said
polymeric material is a temperature-sensitive polymer.
54. The composition as recited in claim 10, wherein said
polymeric material is a thermogelling polymer.
55. The composition as recited in claim 54, wherein said
thermogelling polymer is selected from the group consisting of
poly(-methyl-N-n-propyla- crlamide),
poly(-methyl-N-n-propylacrylamide), poly(N-n-propylacrylamide),
poly(N-methyl-N-isopropylacrylamide), poly(N-n-propylmethacrylamide),
poly(N-isopropylacrylaminde),; poly(N,n-diethylacrylamide),;
poly(N-isopropylmethacrylamide), poly(N-cyclopropylacrylamide),
poly(N-ethylmethyacrylamide), poly(N-methyl-N-ethylacrylamide),
poly(N-cyclopropylmethacrylamide), and poly(N-ethylacrylamide),
hydroxypropyl cellulose, methyl cellulose, hydroxypropylmethyl
cellulose, and ethylhydroxyethyl cellulose.
Description
Cross-reference to related patent application
[0001] This application claims priority from United States
provisional patent application U.S. Ser. No. 60/516,134, filed on Oct.
31, 2003, the entire disclosure of which is hereby incorporated by
reference into this specification.
[0002] This application is a continuation-in-part of
applicants' U.S. patent application Ser. No. 10/808,618, filed on Mar.
24, 2004, and of applicants' U.S. patent application Ser. No.
10/867,517, filed on Jun. 14, 2004.
FIELD OF THE INVENTION
[0003] An anti-mitotic compound with a mitotic index factor of
at least 10 percent, a positive magnetic susceptibility of at least
1,000.times.10.sup.-6 cgs, and a magnetic moment of at least 0.5 bohr
magnetrons per molecule of said compound.
BACKGROUND OF THE INVENTION
[0004] Tubulin-targeting drugs are well known to those skilled
in the art. They are described, eg., in Chapter 5 of John M. Kirkwood
et al.'s "Current Cancer Therapies," Fourth Edition (Current Medicine,
Inc., Philadelphia, Pa., 2001). At page 95 of such book, it is
disclosed that: "Tubulins have a central role in eukaryotic biology . .
. Microtubules are hollow cylinders comprised of tubulin . . .
Microtubules are also crucial during both mitosis and meiosis,
accurately segregating chromosomes to the two daughter cells by forming
a complex super-structure called the mitotic spindle."
[0005] Drugs that target the tubulin moiety of microtubules,
such as the taxanes, have been used as anti-cancer agents. The taxanes
" . . . target a separate site, binding primarily to the amino-terminal
31 amino acids of the beta-tubulin subunit . . . ," as is disclosed at
page 96 of the Kirwood et al. text. Reference also may be had to an
article by K. H. Downing entitled "Structural basis for the interaction
of tubulin with protein and drugs that affect microtubule function"
(Annu Rev Cell Devel Biol 2000, 16:89-11). These taxanes " . . .
stabilize microtubules against depolymerization by altering the tubulin
rate dissociation constants at both ends . . . " (see page 96 of the
Kirkwood et al. reference).
[0006] A significant problem with prior-art tubulin targeting
drugs is that normal cells, as well as cancer cells, are susceptible to
the drug's effects. The drug thus kills both types of cells; the cure
is often as bad as the disease.
[0007] It is an object of the present invention to provide an
improved class of tubulin-targeting drugs that can be selectively
delivered to cancer cells.
SUMMARY OF THE INVENTION
[0008] In accordance with this invention, there is provided an
anti-mitotic compound with a molecular weight of at least 150 grams per
mole, a mitotic index factor of at least 10 percent, a positive
magnetic susceptibility of at least 1,000.times.10.sup.-6 cgs, and a
magnetic moment of at least 0.5 bohr magnetrons per molecule of said
compound. This compound is comprised of at least 7 carbon atoms and at
least one inorganic atom with a positive magnetic susceptibility of at
least 200.times.10.sup.-6 cgs.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0009] The preferred compound of this invention is an
anti-mitotic compounds. Such anti-mitotic compounds are known to those
skilled in the art. Reference may be had, e.g., to U.S. Pat. Nos.
6,723,858 (estrogenic compounds as anti-mitotic agents), 6,528,676
(estrogenic compounds as anti-mitotic agents), 6,350,777 (anti-mitotic
agents which inhibit tubulin polyumerization), 6,162,930 (anti-mitotic
agents which inhibit tubulin polymerization), 5,892,069 (estrogenic
compounds as anti-mitotic agents), 5,886,025 (anti-mitotic agents which
inhibit tubulin polymerization), 5,661,143 (estrogenic compounds as
anti-mitotic agents), 3,997,506 (anti-mitotic derivatives of
thiocolchicine), and the like. The entire disclosure of each of these
United States patents applications is hereby incorporated by reference
into this specification.
[0010] These prior art anti-mitotic agents may be modified, in
accordance with the process of this invention, to make them "magnetic,"
as that term is defined in this specification. In the next section of
this specification, a process for modifying prior art taxanes to make
them "magnetic" is described.
[0011] Preparation and Use of Magnetic Taxanes
[0012] In this portion of the specification, applicant will
describe the preparation of certain magnetic taxanes that may be used
in one or more of the processes of his invention.
[0013] In one embodiment of the invention, a biologically
active substrate is linked to a magnetic carrier particle. An external
magnetic field may then be used to increase the concentration of a
magnetically linked drug at a predetermined location. 1
[0014] One method for the introduction of a magnetic carrier
particle involves the linking of a drug with a magnetic carrier. While
some naturally occurring drugs inherently carry magnetic particles
(ferrimycin, albomycin, salmycin, etc.), it is more common to generate
a synthetic analog of the target drug and attach the magnetic carrier
through a linker.
[0015] Functionalized Taxanes
[0016] Paclitaxel and docetaxel are members of the taxane
family of compounds. A variety of taxanes have been isolated from the
bark and needles of various yew trees.
[0017] In one embodiment of the invention, such a linker is
covalently attached to at least one of the positions in taxane. 2
[0018] It is well known in the art that the northern hemisphere
of taxanes has been altered without significant impact on the
biological activity of the drug. Reference may be had to Chapter 15 of
Taxane Anticancer Agents, Basic Science and Current Status, edited by
G. George et al., ACS Symposium Series 583, 207.sup.th National Meeting
of the American Chemical Society, San Diego, Calif. (1994).
Specifically the C-7, C-9, and C-10 positions of paclitaxel have been
significantly altered without degrading the biological activity of the
parent compound. Likewise the C-4 position appears to play only a minor
role. The oxetane ring at C-4 to C-5 has been shown to be critical to
biological activity. Likewise, certain functional groups on the C-13
sidechain have been shown to be of particular importance.
[0019] In one embodiment of the invention, a position within
paclitaxel is functionalized to link a magnetic carrier particle. A
number of suitable positions are presented below. It should be
understood that paclitaxel is illustrated in the figures below, but
other taxane analogs may also be employed. 34
[0020] Attachment at C-4
[0021] C-4 taxane analogs have been previously generated in the
art. A wide range of methodologies exist for the introduction of a
variety of substituents at the C-4 position. By way of illustration,
reference may be had to "Synthesis and Biological Evaluation of Novel
C-4 Aziridine-Bearing Paclitaxel Analogs" by S. Chen et al., J. Med.
Chem. 1995, vol 38, pp 2263. 5
[0022] The secondary (C-13) and tertiary (C-1) alcohols of
7-TES baccatin were protected using the procedure of Chen (J. Org.
Chem. 1994, vol 59, p 6156) while simultaneously unmasking the alcohol
at C-4. The resulting product was treated with a chloroformate to yield
the corresponding carboxylate. Removal of the silyl protecting groups
at C-1, C-7, and C-13, followed by selective re-protection of the C-7
position gave the desired activated carboxylate. The compound was then
treated with a suitable nucleophile (in the author's case,
ethanolamine) to produce a C-4 functionalized taxane. The C-13
sidechain was installed using standard lactam methodology.
[0023] This synthetic scheme thus provides access to a variety
of C-4 taxane analogs by simply altering the nucleophile used. In one
embodiment of the instant invention, the nucleophile is selected so as
to allow the attachment of a magnetic carrier to the C-4 position.
[0024] Attachment at C-7
[0025] The C-7 position is readily accessed by the procedures
taught in U.S. Pat. No. 6,610,860. The alcohol at the C-10 position of
10-deacetylbaccatin III was selectively protected. The resulting
product was then allowed to react with an acid halide to produce the
corresponding ester by selectively acylating the C-7 position over the
C-13 alcohol. Standard lactam methodology allowed the installation of
the C-13 sidechain. In another embodiment, baccatin III, as opposed to
its deacylated analog, is used as the starting material. 6
[0026] Other C-7 taxane analogs are disclosed in U.S. Pat. Nos.
6,610,860; 6,359,154; and 6,673,833, the contents of which are hereby
incorporated by reference.
[0027] Attachment at C-9
[0028] It has been established that the C-9 carbonyl of
paclitaxel is relatively chemically inaccessible, although there are
exceptions (see, for example, Tetrahedron Lett. Vol 35, p 4999).
However, scientists gained access to C-9 analogs when
13-acetyl-9-dihydrobaccatin III was isolated from Taxus candidensis
(see J. Nat. Products, 1992, vol 55, p 55 and Tetrahedron Lett. 1992,
vol 33, p 5173). This triol is currently used to provide access to a
variety of such C-9 analogues.
[0029] In chapter 20 of Taxane Anticancer Agents, Basic Science
and Current Status, (edited by G. George et al., ACS Symposium Series
583, 207.sup.th National Meeting of the American Chemical Society, San
Diego, Calif. (1994)) Klein describes a number of C-7/C-9 taxane
analogs. One of routes discussed by Klein begins with the selective
deacylation of 13-acetyl-9-dihydrobaccatin III, followed by the
selective protection of the C7 alcohol as the silyl ether. A standard
lactam coupling introduced the C-13 sidechain. The alcohols at C-7 and
C-9 were sufficiently differentiated to allow a wide range of analogs
to be generated. "In contrast to the sensitivity of the C-9 carbonyl
series under basic conditions, the 9(R)-dihydro system can be treated
directly with strong base in order to alkylate the C-7 and/or the C-9
hydroxyl groups." 7
[0030] One skilled in the art may adapt Klein's general
procedures to install a variety of magnetic carriers at these
positions. Such minor adaptations are routine for those skilled in the
art.
[0031] Attachment at C-7 and C-9
[0032] Klein also describes a procedure wherein
13-acetyl-9-dihydrobaccati- n III is converted to 9-dihydrotaxol.
Reference may be had to "Synthesis of 9-Dihydrotaxol: a Novel Bioactive
Taxane" by L. L. Klein in Tetrahedron Lett. Vol 34, pp 2047-2050. An
intermediate in this synthetic pathway is the dimethylketal of
9-dihydrotaxol. 8
[0033] In one embodiment, the procedure of Klein is followed
with a carbonyl compound other than acetone to bind a wide variety of
groups to the subject ketal. Supplemental discussion of C-9 analogs is
found in "Synthesis of 9-Deoxotaxane Analogs" by L. L. Klein in
Tetrahedron Lett. Vol 35, p 4707 (1994).
[0034] Attachment at C-10
[0035] In one embodiment of the invention, the C-10 position is
functionalized using the procedure disclosed in U.S. Pat. No.
6,638,973. This patent teaches the synthesis of paclitaxel analogs that
vary at the C-10 position. A sample of 10-deacetylbaccatin m was
acylated by treatment with propionic anhydride. The C-13 sidechain was
attached using standard lactam methodology after first performing a
selective protection of the secondary alcohol at the C-7 position. In
one embodiment of the invention, this procedure is adapted to allow
access to a variety of C-10 analogues of paclitaxel. 9
[0036] In one embodiment an anhydride is used as an
electrophile. In another embodiment, an acid halide is used. As would
be apparent to one of ordinary skill in the art, a variety of
electrophiles could be employed. 10
[0037] Siderophores
[0038] In one embodiment, a member of the taxane family of
compounds is attached to a magnetic carrier particle. Suitable carrier
particles include siderophores (both iron and non-iron containing),
nitroxides, as well as other magnetic carriers.
[0039] Sidephores are a class of compounds that act as
chelating agents for various metals. Most organisms use sidephores to
chelate iron (III) although other metals may be exchanged for iron
(see, for example, Exchange of Iron by Gallium in Siderophores by
Emergy, Biochemistry 1986, vol 25, pages 4629-4633). Most of the
siderophores known to date are either catecholates or hydroxamic acids.
11
[0040] Representative examples of catecholate siderophores
include the albomycins, agrobactin, parabactin, enterobactin, and the
like. 12
[0041] Examples of hydroxamic acid-based siderophores include
ferrichrome, ferricrocin, the albomycins, ferrioxamines, rhodotorulic
acid, and the like. Reference may be had to Microbial Iron Chelators as
Drug Delivery Agents by M. J. Miller et al., Acc. Chem. Res. 1993, vol
26, pp 241-249; Structure of Des(diserylglycyl)ferrirhodin, DDF, a
Novel Siderophore from Aspergillus ochraceous by M. A. F. Jalal et al.,
J. Org. Chem. 1985, vol 50, pp 5642-5645; Synthesis and Solution
Structure of Microbial Siderophores by R. J. Bergeron, Chem. Rev. 1984,
vol 84, pp 587-602; and Coordination Chemistry and Microbial Iron
Transport by K. N. Raymond, Acc. Chem. Res., 1979, vol 12, pp 183-190.
The synthesis of a retrohydroxamate analog of ferrichrome is described
by R. K. Olsen et al. in J. Org. Chem. 1985, vol 50, pp 2264-2271. 13
[0042] In "Total Synthesis of Desferrisalmycin" (M. J. Miller
et al. in J. Am. Chem. Soc. 2002, vol 124 pp 15001-15005), a natural
product is synthesized that contains a siderophore. The author states
"siderophores are functionally defined as low molecular mass molecules
which acquire iron (III) from the environment and transport it into
microganisms. Because of the significant roles they play in the active
transport of physiologically essentially iron (III) through microbe
cell members, it is not surprising that siderophores-drug conjugates
are attracting more and more attention from both medicinal chemists and
clinical researchers as novel drug delivery systems in the war against
microbial infections, especially in an area of widespread emergency of
multidrug-resistance (MDR) strains. There have been three families of
compounds identified as natural siderophore-drug conjugates, including
ferrimycin, albomycin, and salmycin." In a related paper, Miller
describes the use of siderophores as drug delivery agents (Acc. Chem.
Res. 1993, vol 26, pp 241-249. Presumably, the siderophore acts as a
"sequestering agents [to] facilitate the active transport of chelated
iron into cells where, by modification, reduction, or siderophore
decomposition, it is released for use by the cell." Miller describes
the process of tethering a drug to a sidrophore to promote the active
transport of the drug across the cell membrane.
[0043] In "The Preparation of a Fully Differentiated
`Multiwarhead` Sidrophore Precursor", by M. J. Miller et al (J. Org.
Chem. 2003, vol 68, pp 191-194) a precursor is disclosed which allows
for a drug to be tethered to a sidrophore. In one embodiment, the route
disclosed by Miller is employed to provide a variety of siderophores of
similar structure. The synthesis of similar hydroxamic acid-based
siderophores is discussed in J. Org. Chem. 2000, vol 65 (Total
Synthesis of the Siderophore Danoxainine by M. J. Miller et al.), pp
4833-4838 and in the J. of Med. Chem. 1991, vol 32, pp 968-978 (by M.
J. Miller et al.).
[0044] A variety of fluorescent labels have been attached to
ferrichrome analogues in "Modular Fluorescent-Labeled Siderophore
Analogues" by A. Shanzer et al. in J. Med. Chem. 1998, vol 41,
1671-1678. The authors have developed a general methodology for such
attachments. 14
[0045] As discussed above, functionalized ferrichrome analogs
have been previous generated, usually using basic amine acids
(glycine). In one embodiment, functionality is introduced using an
alternative amine acid (such as serine) in place of the central glycine
residue. This provides a functional group foothold from which to base a
wide variety of analogs. Using traditional synthetic techniques,
various linkers are utilized so as to increase or decrease the distance
between the magnetic carrier and the drug. 15
[0046] As would be apparent to one of ordinary skill in the
art, the above specified techniques are widely applicable to a variety
of substrates. By way of illustration, and not limitation, a number of
magnetic taxanes are shown below. 1617
[0047] Nitroxides
[0048] Another class of magnetic carriers is the nitroxyl
radicals (also known as nitroxides). Nitroxyl radicals a "persistent"
radials that are unusually stable. A wide variety of nitroxyls are
commercially available. Their paramagnetic nature allows them to be
used as spin labels and spin probes. 18
[0049] In addition to the commercially available nitroxyls,
other paramagnetic radical labels have been generated by acid catalyzed
condensation with 2-Amino-2-methyl-1-propanol followed by oxidation of
the amine. 192021
[0050] One of ordinary skill in the art could use the teachings
of this specification to generate a wide variety of suitable
carrier-drug complexes. The following table represents but a small
sampling of such compounds.
1 22 23 24 25 26 27 28 R1 R2 R3 R4 F1, Y = CH2, H Ac COPh n = 0
to 20 Ac F1, Y = CH2, Ac COPh n = 0 to 20 Ac H F1, Y = CH2, COPh n = 0
to 20 Ac H Ac F1, Y = CH2, n = 0 to 20 H H Ac Boc F1, Y = CH2, H Ac Boc
n = 0 to 20 H F1, Y = CH2, Ac Boc n = 0 to 20 H H F1, Y = CH2, Boc n =
0 to 20 H H Ac F1, Y = CH2, n = 0 to 20 F1, Y = NH or H Ac COPh NR, n =
0 to 20 Ac F1, Y = NH or Ac COPh NR, n = 0 to 20 Ac H F1, Y = NH or
COPh NR, n = 0 to 20 Ac H Ac F1, Y = NH or NR, n = 0 to 20 H H Ac Boc
F1, Y = NH or H Ac Boc NR, n = 0 to 20 H F1, Y = NH or Ac Boc NR, n = 0
to 20 H H F1, Y = NH or Boc NR, n = 0 to 20 H H Ac F1, Y = NH or NR, n
= 0 to 20 N1, n = 0 to 20 H Ac COPh Ac N1, n = 0 to 20 Ac COPh Ac H N1,
n = 0 to 20 COPh Ac H Ac N1, n = 0 to 20 H H Ac Boc N1, n = 0 to 20 H
Ac Boc H N1, n = 0 to 20 Ac Boc H H N1, n = 0 to 20 Boc H H Ac N1, n =
0 to 20 N2, n = 0 to H Ac COPh 20, X = 0 or NH Ac N2, n = 0 to Ac COPh
20, X = 0 or NH Ac H N2, n = 0 to COPh 20, X = 0 or NH Ac H Ac N2, n =
0 to 20, X = 0 or NH H H Ac Boc N2, n = 0 to H Ac Boc 20, X = 0 or NH H
N2, n = 0 to Ac Boc 20, X = 0 or NH H H N2, n = 0 to Boc 20, X = 0 or
NH H H Ac N2, n = 0 to 20, X = 0 or NH N3, n = 0 to H Ac COPh 20, X = 0
or NH Ac N3, n = 0 to Ac COPh 20, X = 0 or NH Ac H N3, n = 0 to COPh
20, X = 0 or NH Ac H Ac N3, n = 0 to 20, X = 0 or NH H H Ac Boc N3, n =
0 to H Ac Boc 20, X = 0 or NH H N3, n = 0 to Ac Boc 20, X = 0 or NH H H
N3, n = 0 to Boc 20, X = 0 or NH H H Ac N3, n = 0 to 20, X = 0 or NH F2
or F3 H Ac COPh Ac F2 or F3 Ac COPh Ac H F2 or F3 COPh Ac H Ac F2 or F3
F2 or F3 H Ac Boc H F2 or F3 Ac Boc H H F2 or F3 Boc H H Ac F2 or F3
[0051] The prior disclosure illustrates how one may modify
prior art taxanes to make them magnetic. As will be apparent to those
skilled in the art, one may similarly modify other modifiable prior art
anti-mitotic compounds to make them magnetic.
[0052] Other modifiable prior art compounds
[0053] Many anti-mitotic compounds that may be modified in
accordance with the process of this invention are described in the
patent literature.
[0054] By way of further illustration, and referring to U.S.
Pat. Nos. 5,504,074, 5,661,143, 5,892,069, 6,528,676, and 6,723,858
(the entire disclosure of each of which is hereby incorporated by
reference into this specification), one may modify estradiol and
estradiol metabolites to make them magnetic in accordance with the
process of this invention. As is disclosed in U.S. Pat. No. 6,723,858
(the entire disclosure of which is hereby incorporated by reference
into this specification, "Cell mitosis is a multi-step process that
includes cell division and replication (Alberts, B. et al. In The Cell,
pp. 652-661 (1989); Stryer, E. Biochemistry (1988)). Mitosis is
characterized by the intracellular movement and segregation of
organelles, including mitotic spindles and chromosomes. Organelle
movement and segregation are facilitated by the polymerization of the
cell protein tubulin. Microtubules are formed from alpha. and B tubulin
polymerization and the hydrolysis of guanosine triphosphate (GTP).
Microtubule formation is important for cell mitosis, cell locomotion,
and the movement of highly specialized cell structures such as cilia
and flagella."
[0055] As is also disclosed in U.S. Pat. No. 6,723,858,
"Microtubules are extremely labile structures that are sensitive to a
variety of chemically unrelated anti-mitotic drugs. For example,
colchicine and nocadazole are anti-mitotic drugs that bind tubulin and
inhibit tubulin polymerization (Stryer, E. Biochemistry (1988)). When
used Cell mitosis is a multi-step process that includes cell division
and replication (Alberts, B. et al. In The Cell, pp. 652-661 (1989);
Stryer, E. Biochemistry (1988)). Mitosis is characterized by the
intracellular movement and segregation of organelles, including mitotic
spindles and chromosomes. Organelle movement and segregation are
facilitated by the polymerization of the cell protein tubulin.
Microtubules are formed from alpha. and .beta. tubulin polymerization
and the hydrolysis of guanosine triphosphate (GTP). Microtubule
formation is important for cell mitosis, cell locomotion, and the
movement of highly specialized cell structures such as cilia and
flagella. Microtubules are extremely labile structures that are
sensitive to a variety of chemically unrelated anti-mitotic drugs. For
example, colchicine and nocadazole are anti-mitotic drugs that bind
tubulin and inhibit tubulin polymerization (Stryer, E. Biochemistry
(1988)). When used alone or in combination with other therapeutic
drugs, colchicine may be used to treat cancer (WO-9303729-A, published
Mar. 4, 1993; J 03240726-A, published Oct. 28, 1991), alter
neuromuscular function, change blood pressure, increase sensitivity to
compounds affecting sympathetic neuron function, depress respiration,
and relieve gout (Physician's Desk Reference, Vol. 47, p. 1487,
(1993))."
[0056] As is also disclosed in U.S. Pat. No. 6,723,858,
"Estradiol and estradiol metabolites such as 2-methoxyestradiol have
been reported to inhibit cell division (Seegers, J. C. et al. J.
Steroid Biochem. 32, 797-809 (1989); Lottering, M-L. et al. Cancer Res.
52, 5926-5923(1992); Spicer, L. J. and Hammond, J. M. Mol. and Cell.
Endo. 64, 119-126 (1989); Rao, P. N. and Engelberg, J. Exp. Cell Res.
48, 71-81 (1967)). However, the activity is variable and depends on a
number of in vitro conditions. For example, estradiol inhibits cell
division and tubulin polymerization in some in vitro settings (Spicer,
L. J. and Hammond, J. M. Mol. and Cell. Endo. 64, 119-126 (1989);
Ravindra, R., J. Indian Sci. 64 (c) (1983)), but not in others
(Lottering, M-L. et al. Cancer Res. 52, 5926-5923 (1992); Ravindra, R.,
J. Indian Sci. 64 (c) (1983)). Estradiol metabolites such as
2-methoxyestradiol will inhibit cell division in selected in vitro
settings depending on whether the cell culture additive phenol red is
present and to what extent cells have been exposed to estrogen.
(Seegers, J. C. et al. Joint NCI-IST Symposium. Biology and Therapy of
Breast Cancer. Sep. 25, Sep. 27, 1989, Genoa, Italy, Abstract A 58).
alone or in combination with other therapeutic drugs, colchicine may be
used to treat cancer (WO-9303729-A, published Mar. 4, 1993; J
03240726-A, published Oct. 28, 1991), alter neuromuscular function,
change blood pressure, increase sensitivity to compounds affecting
sympathetic neuron function, depress respiration, and relieve gout
(Physician's Desk Reference, Vol. 47, p. 1487, (1993)).
[0057] As is also disclosed in U.S. Pat. No. 6,723,858,
estradiol and estradiol metabolites such as 2-methoxyestradiol have
been reported to inhibit cell division (Seegers, J. C. et al. J.
Steroid Biochem. 32, 797-809 (1989); Lottering, M-L. et al. Cancer Res.
52, 5926-5923(1992); Spicer, L. J. and Hammond, J. M. Mol. and Cell.
Endo. 64, 119-126 (1989); Rao, P. N. and Engelberg, J. Exp. Cell Res.
48, 71-81 (1967)). However, the activity is variable and depends on a
number of in vitro conditions. For example, estradiol inhibits cell
division and tubulin polymerization in some in vitro settings (Spicer,
L. J. and Hammond, J. M. Mol. and Cell. Endo. 64, 119-126 (1989);
Ravindra, R., J. Indian Sci. 64 (c) (1983)), but not in others
(Lottering, M-L. et al. Cancer Res. 52, 5926-5923 (1992); Ravindra, R.,
J. Indian Sci. 64 (c) (1983)). Estradiol metabolites such as
2-methoxyestradiol will inhibit cell division in selected in vitro
settings depending on whether the cell culture additive phenol red is
present and to what extent cells have been exposed to estrogen.
(Seegers, J. C. et al. Joint NCI-IST Symposium. Biology and Therapy of
Breast Cancer. Sep. 25, Sep. 27, 1989, Genoa, Italy, Abstract A 58).
[0058] In one preferred embodiment, the modifiable anti-mitotic
agent is an anti-microtubule agent. In one aspect of this embodiment,
and referring to U.S. Pat. No. 6,689,803 at columns 5-6 thereof (the
entire disclosure of which patent is hereby incorporated by reference
into this specification), representative anti-microtubule agents
include, e.g., " . . . taxanes (e.g., paclitaxel and docetaxel),
campothecin, eleutherobin, sarcodictyins, epothilones A and B,
discodermolide, deuterium oxide (D2 O), hexylene glycol
(2-methyl-2,4-pentanediol), tubercidin (7-deazaadenosine), LY290181
(2-amino-4-(3-pyridyl)-4H-naphtho(1,2-b)pyra- n-3-cardonitrile),
aluminum fluoride, ethylene glycol bis-(succinimidylsuccinate), glycine
ethyl ester, nocodazole, cytochalasin B, colchicine, colcemid,
podophyllotoxin, benomyl, oryzalin, majusculamide C, demecolcine,
methyl-2-benzimidazolecarbamate (MBC), LY195448, subtilisin, 1069C85,
steganacin, combretastatin, curacin, estradiol, 2-methoxyestradiol,
flavanol, rotenone, griseofulvin, vinca alkaloids, including
vinblastine and vincristine, maytansinoids and ansamitocins, rhizoxin,
phomopsin A, ustiloxins, dolastatin 10, dolastatin 15, halichondrins
and halistatins, spongistatins, cryptophycins, rhazinilam, betaine,
taurine, isethionate, HO-221, adociasulfate-2, estramustine, monoclonal
anti-idiotypic antibodies, microtubule assembly promoting protein
(taxol-like protein, TALP), cell swelling induced by hypotonic (190
mosmol/L) conditions, insulin (100 nmol/L) or glutamine (10 mmol/L),
dynein binding, gibberelin, XCHO1 (kinesin-like protein),
lysophosphatidic acid, lithium ion, plant cell wall components (e.g.,
poly-L-lysine and extensin), glycerol buffers, Triton X-100 microtubule
stabilizing buffer, microtubule associated proteins (e.g., MAP2, MAP4,
tau, big tau, ensconsin, elongation factor-1-alpha (EF-1.alpha.) and
E-MAP-115), cellular entities (e.g., histone H1, myelin basic protein
and kinetochores), endogenous microtubular structures (e.g., axonemal
structures, plugs and GTP caps), stable tubule only polypeptide (e.g.,
STOP145 and STOP220) and tension from mitotic forces, as well as any
analogues and derivatives of any of the above. Within other
embodiments, the anti-microtubule agent is formulated to further
comprise a polymer."
[0059] The term "anti-microtubule," as used in this
specification (and in the specification of U.S. Pat. No. 6,689,803),
refers to any " . . . protein, peptide, chemical, or other molecule
which impairs the function of microtubules, for example, through the
prevention or stabilization of polymerization. A wide variety of
methods may be utilized to determine the anti-microtubule activity of a
particular compound, including for example, assays described by Smith
et al. (Cancer Lett 79(2):213-219, 1994) and Mooberry et al., (Cancer
Lett. 96(2):261-266, 1995);" see, e.g., lines 13-21 of column 14 of
U.S. Pat. No. 6,689,803. One preferred method, utilizing the
anti-mitotic factor, is described in this specification.
[0060] An extensive listing of anti-microtubule agents is
provided in columns 14, 15, 16, and 17 of U.S. Pat. No. 6,689,803; and
one or more of them may be modified them in accordance with the process
of this invention to make them magnetic. These anti-microtubule agents
include " . . . taxanes (e.g., paclitaxel (discussed in more detail
below) and docetaxel) (Schiff et al., Nature 277: 665-667, 1979; Long
and Fairchild, Cancer Research 54: 4355-4361, 1994; Ringel and Horwitz,
J. Natl. Cancer Inst. 83(4): 288-291, 1991; Pazdur et al., Cancer
Treat. Rev. 19(4): 351-386, 1993), campothecin, eleutherobin (e.g.,
U.S. Pat. No. 5,473,057), sarcodictyins (including sarcodictyin A),
epothilones A and B (Bollag et al., Cancer Research 55: 2325-2333,
1995), discodermolide (ter Haar et al., Biochemistry 35: 243-250,
1996), deuterium oxide (D2 O) (James and Lefebvre, Genetics 130(2):
305-314, 1992; Sollott et al., J. Clin. Invest. 95: 1869-1876, 1995),
hexylene glycol (2-methyl-2,4-pentanediol) (Oka et al., Cell Struct.
Funct. 16(2): 125-134, 1991), tubercidin (7-deazaadenosine) (Mooberry
et al., Cancer Lett. 96(2): 261-266, 1995), LY290181
(2-amino-4-(3-pyridyl)-4H-naphtho(1- ,2-b)pyran-3-cardonitrile) (Panda
et al., J. Biol. Chem. 272(12): 7681-7687, 1997; Wood et al., Mol.
Pharmacol. 52(3): 437-444, 1997), aluminum fluoride (Song et al., J.
Cell. Sci. Suppl. 14: 147-150, 1991), ethylene glycol
bis-(succinimidylsuccinate) (Caplow and Shanks, J. Biol. Chem. 265(15):
8935-8941, 1990), glycine ethyl ester (Mejillano et al., Biochemistry
31(13): 3478-3483, 1992), nocodazole (Ding et al., J. Exp. Med. 171(3):
715-727, 1990; Dotti et al., J. Cell Sci. Suppl. 15: 75-84, 1991; Oka
et al., Cell Struct. Funct. 16(2): 125-134, 1991; Weimer et al., J.
Cell. Biol. 136(1), 71-80, 1997), cytochalasin B (Elinger et al., Biol.
Cell 73(2-3): 131-138, 1991), colchicine and CI 980 (Allen et al., Am.
J. Physiol. 261(4 Pt. 1): L315-L321, 1991; Ding et al., J. Exp. Med.
171(3): 715-727, 1990; Gonzalez et al., Exp. Cell. Res. 192(1): 10-15,
1991; Stargell et al., Mol. Cell. Biol. 12(4): 1443-1450, 1992; Garcia
et al., Antican. Drugs 6(4): 533-544, 1995), colcemid (Barlow et al.,
Cell. Motil. Cytoskeleton 19(1): 9-17, 1991; Meschini et al., J.
Microsc. 176(Pt. 3): 204-210, 1994; Oka et al., Cell Struct. Funct.
16(2): 125-134, 1991), podophyllotoxin (Ding et al., J. Exp. Med.
171(3): 715-727, 1990), benomyl (Hardwick et al., J. Cell. Biol.
131(3): 709-720, 1995; Shero et al., Genes Dev. 5(4): 549-560, 1991),
oryzalin (Stargell et al., Mol. Cell. Biol. 12(4): 1443-1450, 1992),
majusculamide C (Moore, J. Ind. Microbiol. 16(2): 134-143, 1996),
demecolcine (Van Dolah and Ramsdell, J. Cell. Physiol. 166(1): 49-56,
1996; Wiemer et al., J. Cell. Biol. 136(1): 71-80, 1997),
methyl-2-benzimidazolecarbamate (MBC) (Brown et al., J. Cell. Biol.
123(2): 387-403, 1993), LY195448 (Barlow & Cabral, Cell Motil.
Cytoskel. 19: 9-17, 1991), subtilisin (Saoudi et al., J. Cell Sci. 108:
357-367, 1995), 1069C85 (Raynaud et al., Cancer Chemother. Pharmacol.
35: 169-173, 1994), steganacin (Hamel, Med. Res. Rev. 16(2): 207-231,
1996), combretastatins (Hamel, Med. Res. Rev. 16(2): 207-231, 1996),
curacins (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), estradiol
(Aizu-Yokata et al., Carcinogen. 15(9): 1875-1879, 1994),
2-methoxyestradiol (Hamel, Med. Res. Rev. 16(2): 207-231, 1996),
flavanols (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), rotenone
(Hamel, Med. Res. Rev. 16(2): 207-231, 1996), griseofulvin (Hamel, Med.
Res. Rev. 16(2): 207-231; 1996), vinca alkaloids, including vinblastine
and vincristine (Ding et al., J. Exp. Med. 171(3): 715-727, 1990; Dirk
et al., Neurochem. Res. 15(11): 1135-1139, 1990; Hamel, Med. Res. Rev.
16(2): 207-231, 1996; Illinger et al., Biol. Cell 73(2-3): 131-138,
1991; Wiemer et al., J. Cell. Biol. 136(1): 71-80, 1997), maytansinoids
and ansarnitocins (Hamel, Med. Res. Rev. 16(2): 207-231, 1996),
rhizoxin (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), phomopsin A
(Hamel, Med. Res. Rev. 16(2): 207-231, 1996), ustiloxins (Hamel, Med.
Res. Rev. 16(2): 207-231, 1996), dolastatin 10 (Hamel, Med Res. Rev.
16(2): 207-231, 1996), dolastatin 15 (Hamel, Med. Res. Rev. 16(2):
207-231, 1996), halichondrins and halistatins (Hamel, Med. Res. Rev.
16(2): 207-231, 1996), spongistatins (Hamel, Med. Res. Rev. 16(2):
207-231, 1996), cryptophycins (Hamel, Med. Res. Rev. 16(2): 207-231,
1996), rhazinilam (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), betaine
(Hashimoto et al., Zool. Sci. 1: 195-204, 1984), taurine (Hashimoto et
al., Zool. Sci. 1: 195-204, 1984), isethionate (Hashimoto et al., Zool.
Sci. 1: 195-204, 1984), HO-221 (Ando et al., Cancer Chemother.
Pharmacol. 37: 63-69, 1995), adociasulfate-2 (Sakowicz et al., Science
280: 292-295, 1998), estramustine (Panda et al., Proc. Natl. Acad. Sci.
USA 94: 10560-10564, 1997), monoclonal anti-idiotypic antibodies (Leu
et al., Proc. Natl. Acad. Sci. USA 91(22): 10690-10694, 1994),
microtubule assembly promoting protein (taxol-like protein, TALP)
(Hwang et al., Biochem. Biophys. Res. Commun. 208(3): 1174-1180, 1995),
cell swelling induced by hypotonic (190 mosmol/L) conditions, insulin
(100 nmol/L) or glutamine (10 mmol/L) (Haussinger et al., Biochem.
Cell. Biol. 72(1-2): 12-19, 1994), dynein binding (Ohba et al.,
Biochim. Biophys. Acta 1158(3): 323-332, 1993), gibberelin (Mita and
Shibaoka, Protoplasma 119(1/2): 100-109, 1984), XCHO1 kinesin-like
protein) (Yonetani et al., Mol. Biol. Cell 7(suppl): 211A, 1996),
lysophosphatidic acid (Cook et al., Mol. Biol. Cell 6(suppl): 260A,
1995), lithium ion (Bhattacharyya and Wolff, Biochem. Biophys. Res.
Commun. 73(2): 383-390, 1976), plant cell wall components (e.g.,
poly-L-lysine and extensin) (Akashi et al., Planta 182(3): 363-369,
1990), glycerol buffers (Schilstra et al., Biochem. J. 277(Pt. 3):
839-847, 1991; Farrell and Keates, Biochem. Cell. Biol. 68(11):
1256-1261, 1990; Lopez et al., J. Cell. Biochem. 43(3): 281-291, 1990),
Triton X-100 microtubule stabilizing buffer (Brown et al., J. Cell Sci.
104(Pt. 2): 339-352, 1993; Safiejko-Mroczka and Bell, J. Histochem.
Cytochem. 44(6): 641-656, 1996), microtubule associated proteins (e.g.,
MAP2, MAP4, tau, big tau, ensconsin, elongation factor-1-alpha
EF-1.alpha.) and E-MAP-115) (Burgess et al., Cell Motil. Cytoskeleton
20(4): 289-300, 1991; Saoudi et al., J. Cell. Sci. 108(Pt. 1): 357-367,
1995; Bulinski and Bossler, J. Cell. Sci. 107(Pt. 10): 2839-2849, 1994;
Ookata et al., J. Cell Biol. 128(5): 849-862, 1995; Boyne et al., J.
Comp. Neurol. 358(2): 279-293, 1995; Ferreira and Caceres, J. Neurosci.
11(2): 392400, 1991; Thurston et al., Chromosoma 105(1): 20-30, 1996;
Wang et al., Brain Res. Mol. Brain Res. 38(2): 200-208, 1996; Moore and
Cyr, Mol. Biol. Cell 7(suppl): 221-A, 1996; Masson and Kreis, J. Cell
Biol. 123(2), 357-371, 1993), cellular entities (e.g. histone H1,
myelin basic protein and kinetochores) (Saoudi et al., J. Cell. Sci.
108(Pt. 1): 357-367, 1995; Simerly et al., J. Cell Biol. 111(4):
1491-1504, 1990), endogenous microtubular structures (e.g., axonemal
structures, plugs and GTP caps) (Dye et al., Cell Motil. Cytoskeleton
21(3): 171-186, 1992; Azhar and Murphy, Cell Motil. Cytoskeleton 15(3):
156-161, 1990; Walker et al., J. Cell Biol. 114(1): 73-81, 1991;
Drechsel and Kirschner, Curr. Biol. 4(12): 1053-1061, 1994), stable
tubule only polypeptide (e.g., STOP145 and STOP220) (Pirollet et al.,
Biochim. Biophys. Acta 1160(1): 113-119, 1992; Pirollet et al.,
Biochemistry 31(37): 8849-8855, 1992; Bosc et al., Proc. Natl. Acad.
Sci. USA 93(5): 2125-2130, 1996; Margolis et al., EMBO J. 9(12):
4095-4102, 1990) and tension from mitotic forces (Nicklas and Ward, J.
Cell Biol. 126(5): 1241-1253, 1994), as well as any analogues and
derivatives of any of the above. Such compounds can act by either
depolymerizing microtubules (e.g., colchicine and vinblastine), or by
stabilizing microtubule formation (e.g., paclitaxel)."
[0061] U.S. Pat. No. 6,689,803 also discloses (at columns 16
and 17 that, "Within one preferred embodiment of the invention, the
anti-mitotic compound is paclitaxel, a compound which disrupts
microtubule formation by binding to tubulin to form abnormal mitotic
spindles. Briefly, paclitaxel is a highly derivatized diterpenoid (Wani
et al., J. Am. Chem. Soc. 93:2325, 1971) which has been obtained from
the harvested and dried bark of Taxus brevifolia (Pacific Yew) and
Taxomyces Andreanae and Endophytic Fungus of the Pacific Yew (Stierle
et al., Science 60:214-216,-1993). "Paclitaxel" (which should be
understood herein to include prodrugs, analogues and derivatives such
as, for example, TAXOL.RTM., TAXOTERE.RTM., Docetaxel, 10-desacetyl
analogues of paclitaxel and 3'N-desbenzoyl-3'N-t-butoxy carbonyl
analogues of paclitaxel) may be readily prepared utilizing techniques
known to those skilled in the art (see e.g., Schiff et al., Nature
277:665-667, 1979; Long and Fairchild, Cancer Research 54:4355-4361,
1994; Ringel and Horwitz, J. Natl. Cancer Inst. 83(4):288-291, 1991;
Pazdur et al., Cancer Treat. Rev. 19(4):351-386, 1993; WO 94/07882; WO
94/07881; WO 94/07880; WO 94/07876; WO 93/23555; WO 93/10076;
WO94/00156; WO 93/24476; EP 590267; WO 94/20089; U.S. Pat. Nos.
5,294,637; 5,283,253; 5,279,949; 5,274,137; 5,202,448; 5,200,534;
5,229,529; 5,254,580; 5,412,092; 5,395,850; 5,380,751; 5,350,866;
4,857,653; 5,272,171; 5,411,984; 5,248,796; 5,248,796; 5,422,364;
5,300,638; 5,294,637; 5,362,831; 5,440,056; 4,814,470; 5,278,324;
5,352,805; 5,411,984; 5,059,699; 4,942,184; Tetrahedron Letters
35(52):9709-9712, 1994; J. Med. Chem. 35:4230-4237, 1992; J. Med. Chem.
34:992-998, 1991; J. Natural Prod. 57(10):1404-1410, 1994; J. Natural
Prod. 57(11):1580-1583, 1994; J. Am. Chem. Soc. 110:6558-6560, 1988),
or obtained from a variety of commercial sources, including for
example, Sigma Chemical Co., St. Louis, Mo. (T7402--from Taxus
brevifolia)."
[0062] As is also disclosed in U.S. Pat. No. 6,689,893,
"Representative examples of such paclitaxel derivatives or analogues
include 7-deoxy-docetaxol, 7,8-cyclopropataxanes, N-substituted
2-azetidones, 6,7-epoxy paclitaxels, 6,7-modified paclitaxels,
10-desacetoxytaxol, 10-deacetyltaxol (from 10-deacetylbaccatin III),
phosphonooxy and carbonate derivatives of taxol, taxol 2',7-di(sodium
1,2-benzenedicarboxylate,
10-desacetoxy-11,12-dihydrotaxol-10,12(18)-dien- e derivatives,
10-desacetoxytaxol, Protaxol(2'- and/or 7-O-ester derivatives), (2'-
and/or 7-O-carbonate derivatives), asymmetric synthesis of taxol side
chain, fluoro taxols, 9-deoxotaxane, (13-acetyl-9-deoxobaccatine III,
9-deoxotaxol, 7-deoxy-9-deoxotaxol, 10-desacetoxy-7-deoxy-9-deoxotaxol,
Derivatives containing hydrogen or acetyl group and a hydroxy and
tert-butoxycarbonylamino, sulfonated 2'-acryloyltaxol and sulfonated
2'-O-acyl acid taxol derivatives, succinyltaxol,
2'-.gamma.-aminobutyryltaxol formate, 2'-acetyl taxol, 7-acetyl taxol,
7-glycine carbamate taxol, 2'-OH-7-PEG(5000)carbamate taxol, 2'-benzoyl
and 2', 7-dibenzoyl taxol derivatives, other prodrugs (2'-acetyl taxol;
2', 7-diacetyltaxol; 2'succinyltaxol; 2'-(beta-alanyl)-taxol);
2'gamma-aminobutyryltaxol formate; ethylene glycol derivatives of
2'-succinyltaxol; 2'-glutaryltaxol; 2'-(N,N-dimethylglycyl)taxol;
2'-(2-(N,N-dimethylamino)propionyl)taxol; 2'orthocarboxybenzoyl taxol;
2'aliphatic carboxylic acid derivatives of taxol, Prodrugs
{2'(N,N-diethylaminopropionyl)taxol, 2'(N,N-dimethylglycyl)taxol,
7(N,N-dimethylglycyl)taxol, 2', 7-di-(N,N-dimethylglycyl)taxol,
7(N,N-diethylaminopropionyl)taxol,
2',7-di(N,N-diethylaminopropionyl)taxol, 2'-(L-glycyl)taxol,
7-(L-glycyl)taxol, 2',7-di(L-glycyl)taxol, 2'-(L-alanyl)taxol,
7-(L-alanyl)taxol, 2',7-di(L-alanyl)taxol, 2'-(L-leucyl)taxol,
7-(L-leucyl)taxol, 2',7-di(L-leucyl)taxol, 2'-(L-isoleucyl)taxol,
7-(L-isoleucyl)taxol, 2',7-di(L-isoleucyl)taxol, 2'-(L-valyl)taxol,
7-(L-valyl)taxol, 2'7-di(L-valyl)taxol, 2'-(L-phenylalanyl)taxol,
7-(L-phenylalanyl)taxol, 2',7-di(L-phenylalanyl)taxol,
2'-(L-prolyl)taxol, 7-(L-prolyl)taxol, 2',7-di(L-prolyl)taxol,
2'-(L-lysyl)taxol, 7-(L-lysyl)taxol, 2',7-di(L-lysyl)taxol,
2'-(L-glutamyl)taxol, 7-(L-glutamyl)taxol, 2',7-di(L-glutamyl)taxol,
2'-(L-arginyl)taxol, 7-(L-arginyl)taxol, 2',7-di(L-arginyl)taxol},
Taxol analogs with modified phenylisoserine side chains, taxotere,
(N-debenzoyl-N-tert-(butoxycaronyl)-10-deacetyltaxol, and taxanes
(e.g., baccatin III, cephalomannine, 10-deacetylbaccatin III,
brevifoliol, yunantaxusin and taxusin)."
[0063] By way of yet further illustration, one may use one or
more of the anti-mitotic agents disclosed in U.S. Pat. Nos. 6,673,937
(syntheses and methods of use of new antimitotic agents), 6,624,317
(taxoid conjugates as antimitotoic and antitumor agents), 6,593,334
(camptothecin-taxoid conjugates as antimitotic and antitumor agents),
6,593,321 (2-alkoxyestradiiol analogs with antiproliferative and
antimitotic activity), 6,569,870 (fluorinated quinolones as antimitotic
and antitumor agent), 6,528,489 (mycotoxin derivatives as antimitotic
agents), 6,392,055 (synthesis and biological evaluation of analogs of
the antimitotic marine natural product curacin A), 6,127,377 (vinka
alkaloid antimitotic halogenated derivatives), 5,695,950 (method of
screening for antimitotic compounds using the cdc25 tyrosine
phosphatase), 5,620,985 (antimitotic binary alkaloid derivatives from
catharanthus roseus), 5,294,538 (method of screening for antimitotic
compounds using the CDC tyrosine phosphatase), and the like. The entire
disclosure of each of these United States patents is hereby
incorporated by reference into this specification.
[0064] As will be apparent, one or more of the aforementioned
anti-mitotic and/or anti-microtubule agents may be modified to make
them magnetic in accordance with this invention.
[0065] Properties of the Preferred Anti-Mitotic Compounds
[0066] In one preferred embodiment, the compound of this
invention has a mitotic index factor of at least about 10 percent and,
more preferably, at least about 20 percent. In one aspect of this
embodiment, the mitotic index factor is at least about 30 percent. In
another embodiment, the mitotic index factor is at least about 50
percent.
[0067] As is known to those skilled in the art, the mitotic
index is a measure of the extent of mitosis. Reference may be had,
e.g., to U.S. Pat. Nos. 5,262,409 (binary tumor therapy), 5,443,962
(methods of indentifying inhibitors of cdc25 phosphatase), 5,744,300
(methods and reagents for the indentificatioin and regulation of
senescence-related genes), 6,613,318, 6,251,585 (assay and reagents for
indentifying anti-proliferative agents), 6,252,058 (sequences for
targeting metastatic cells), 6,387,642 (method for indentifying a
reagent that modulates Myt1 activity), 6,413,735 (method of screening
for a modulator of angiogenesis), 6,531,479 (anti-cancer compounds),
6,599,694 (method of characterizing potential therapeutics by
determining cell-cell interactions), 6,620,403 (in vivo
chemosensitivity screen for human tumors), 6,699,854 (anti-cancer
compounds), 6,743,576 (database system for predictive cellular
bioinformatics), and the like. The entire disclosure of each of these
United States patents is hereby incorporated by reference into this
specification.
[0068] Reference may also be had, e.g., to U.S. Pat. No.
5,262,409, which discloses that: Determination of mitotic index: For
testing mitotic blockage with nocodazole and taxol, cells were grown a
minimum of 16 hours on polylysinecoated glass coverslips before drug
treatment. Cells were fixed at intervals, stained with antibodies to
detect lamin B, and counterstained with propidium iodide to assay
chromosome condensation. To test cell cycle blocks in interphase, cells
were synchronized in mitosis by addition of nocodazole (Sigma Chemical
Co.) to a final concentration of 0.05 .mu.g/ml from a 1 mg/ml stock in
dimethylsulfoxide. After 12 hours arrest, the mitotic subpopulation was
isolated by shakeoff from the culture plate. After applying cell cycle
blocking drugs and/or 2-AP, cells were fixed at intervals, prepared for
indirect immunofluorescence with anti-tubulin antibodies, and
counterstained with propidium iodide. All data timepoints represent
averages of three counts of greater than 150 cells each. Standard
deviation was never more than 1.5% on the ordinate scale."
[0069] Reference may be had, e.g., to U.S. Pat. No. 6,413,735
which discloses that: "The mitotic index is determined according to
procedures standard in the art. Keram et al., Cancer Genet. Cytogenet.
55:235 (1991). Harvested cells are fixed in methanol:acetic acid (3:1,
v:v), counted, and resuspended at 106 cells/ml in fixative. Ten
microliters of this suspension is placed on a slide, dried, and treated
with Giemsa stain. The cells in metaphase are counted under a light
microscope, and the mitotic index is calculated by dividing the number
of metaphase cells by the total number of cells on the slide.
Statistical analysis of comparisons of mitotic indices is performed
using the 2-sided paired t-test."
[0070] By means of yet further illustration, one may measure
the mitotic index by means of the procedures described in, e.g.,
articles by Keila Torres et al. ("Mechanisms of Taxol-Induced Cell
Death are Concentration Dependent," Cancer Research 58, 3620-3626, Aug.
15, 1998), and Jie-Gung Chen et al. ("Differential Mitosis Responses to
Microtubule-stabilizing and destablilizng Drugs," Cancer Research 62,
1935-1938, Apr. 1, 2002).
[0071] The mitotic index is preferably measured by using the
well-known HeLa cell lines. As is known to those skilled in the art,
HeLa cells are cells that have been derived from a human carcinoma of
the cervix from a patient named Henrietta Lack; the cells have been
maintained in tissued culture since 1953.
[0072] Hela cells are described, e.g., in U.S. Pat. Nos.
5,811,282 (cell lines useful for detection of human immunodeficiency
virus), 5,376,525 (method for the detectioin of mycoplasma), 6,143,512,
6,326,196, 6,365,394 (cell lines and constructs useful in production of
E-1 deleted adenoviruses), 6,440,658 (assay method for determining
effect on aenovirus infection of Hela cells), 6,461,809 (method of
improving infectivity of cells for viruses), 6,596,535, 6,605,426,
6,610,493 (screening compounds for the ability to alter the production
of amyloid-beta-peptide), 6,699,851 (cytotoxic compounds and their
use), and the like; the entire disclosure of each of these United
States patents is hereby incorporated by reference into this
specification. By way of illustration, U.S. Pat. No. 6,440,658 This
patent discloses that, for the experiments described in such patent,
"The HeLa cell line was obtained from the American Type Culture
Collection, Manassas Va."
[0073] In one preferred embodiment, the mitotic index of a
"control cell line" (i.e., one that omits that drug to be tested) and
of a cell line that includes 50 nanomoles of such drug per liter of the
cell line are determined and compared. The "mitotic index factor" is
equal to (Mt-Mc/Mc).times.100, wherein Mc is the mitotic index of the
"control cell line," and Mt is the mitotic index of the cell line that
includes the drug to be tested.
[0074] The compound of this invention preferably has a
molecular weight of at least about 150 grams per mole. In one
embodiment, the molecular weight of such compound is at least 300 grams
per mole. In another embodiment, the molecular weight of such compound
is 400 grams per mole.
[0075] The compound of this invention preferably has a positive
magnetic susceptibility of at least 1,000.times.10.sup.-6
centimeter-gram-seconds (cgs). As is known to those skilled in the art,
magnetic susceptibility is the ratio of the magnetization of a material
to the magnetic filed strength. Reference may be had, e.g., to U.S.
Pat. Nos. 3,614,618 (magnetic susceptibility tester), 3,644,823
(nulling coil apparatus for magnetic susceptibility logging), 3,657,636
(thermally stable coil assembly for magnetic susceptibility logging),
3,665,297 (apparatus for determining magnetic susceptibility in a
controlled chemical and thermal environment), 3,758,847 (method and
system with voltage cancellation for measuring the magnetic
susceptibility of a subsurface earth formation), 3,758,848 (magnetic
susceptibility well logging system), 3,879,658 (apparatus for measuring
magnetic susceptibility), 3,890,563 (magnetic susceptibility logging
apparatus for distinguishing ferromagnetic materials), 3,980,076
(method for measuring externally of the human body magnetic
susceptibility changes), 4,079,730 (apparatus for measuring externally
of the human body magnetic susceptibility changes), 4,277,750
(induction probe for the measurement of magnetic susceptibility),
4,359,399 (taggands with induced magnetic susceptibility), 4,507,613
(method for identifying non-magnetic minerals in earth formations
utilizing magnetic susceptibility measurements), 4,662,359 (use of
magnetic susceptibility probes in the treatment of cancer), 4,701,712
(thermoregulated magnetic susceptibility sensor assembly), 5,233,992
(MRI method for high liver iron measurement using magnetic
susceptibility induced field distortions), 6,208,884 (noninvasive room
temperature instrument to measure magnetic susceptibility variations in
body tissue), 6,321,105 (contrast agents with high magnetic
susceptibility), 6,477,398 (resonant magnetic susceptibility imaging),
and the like. The entire disclosure of each of these United States
patent applications is hereby incorporated by reference into this
specification.
[0076] In one embodiment, the compound of this invention has a
positive magnetic susceptibility of at least 5,000.times.10.sup.-6 cgs.
In another embodiment, such compound has a positive magnetic
susceptibility of at least 10,000.times.10.sup.-6 cgs.
[0077] The compound of this invention is preferably comprised
of at least 7 carbon atoms and, more preferably, at least about 10
carbon atoms. In another embodiment, such compound is comprised of at
least 13 carbon atoms and at least one aromatic ring structure
containing at least one carbon-to-double double bond. In another
embodiment, such compound is comprised of at least 17 carbon atoms.
[0078] The compound of this invention is also preferably
comprised of at least one inorganic atom with a positive magnetic
susceptibility of at least 200.times.10.sup.-6 cgs. Thus, and referring
to the "CRC Handbook of Chemistry and Physics," 63.sup.rd Edition (CRC
Press, Inc., Boca Raton, Fla., 1982-83), the magnetic susceptibility of
elements are described at pages E-118 to E-123. Suitable inorganic
(i.e., non-carbon containing) elements with a positive magnetic
susceptibility greater than about 200.times.10.sup.-6 cgs include,
e.g., cerium (+5,160.times.10.sup.-6 cgs), cobalt
(+11,000.times.10.sup.-6 cgs), dysprosium (+89,600.times.10.sup.-6
cgs), europium (+34,000.times.10.sup.-6 cgs), gadolinium
(+755,000.times.10.sup.-6 cgs), iron (+13,600.times.10.sup.-6 cgs),
manganese (+529.times.10.sup.-6 cgs), palladium (+567.4.times.10.sup.-6
cgs), plutonium (+610.times.10.sup.-6 cgs), praseodymium
(+5010.times.10.sup.-6 cgs), samarium (+2230.times.10.sup.-6 cgs),
technetium (+250.times.10.sup.-6 cgs), thulium (+51,444.times.10.sup.-6
cgs), and the like. In one embodiment, the positive magnetic
susceptibility of such element is preferably greater than about
+500.times.10.sup.-6 cgs and, even more preferably, greater than about
+1,000.times.10.sup.-6 cgs.
[0079] In one preferred atom, the inorganic atom is
radioactive. As is known to those skilled in the art, radioactivity is
a phenomenon characterized by spontaneous disintegration of atomic
nuclei with emission of corpuscular or electromagnetic radiation.
[0080] One preferred class of atoms is the class of radioactive
nuclides. As is known to those skilled in the art, radioactive nuclides
are atoms disintegrate by emission of corpuscular or electromagnetic
radiatons. The rays most commonly emitted are alpha or beta gamma rays.
See, e.g., page F-109 of the aforementioned "CRC Handbook of Chemistry
and Physics."
[0081] Radioactive nuclides are well known and are described,
e.g., in U.S. Pat. Nos. 4,355,179 (radioactive nuclide labeled
propiophenone compounds), 4,625,118 (device for the elution and
metering of a radioactive nuclide), 5,672,876 (method and apparatus for
measuring distribution of radioactive nuclide in a subject), and
6,607,710 (bisphosphonic acid derivative and compound thereof labeled
with radioactive nuclide.). The entire disclosure of each of these
United States patents is hereby incorporated by reference into this
specification.
[0082] Referring again to the aforementioned "CRC Handbook of
Chemistry and Physics," and to pages and in particular to pages
B340-B378 thereof, it will be seen that the inorganic atom may be,
e.g., cobalt 53, cobalt 54, cobalt 55, cobalt 56, cobalt 57, cobalt 58,
cobalt 59, cobalt 60, cobalt 61, cobalt 62, cobalt 63, gadolinium 146,
iron 49, iron 51, iron 52, iron 53, iron 54, iron 57, iron 58, iron 59,
iron 60, iron 61, iron 62, manganese 50, praseodymium 135, samarium
156, and the like.
[0083] The compound of this invention preferably has a magnetic
moment of at least about 0.5 Bohr magnetrons per molecule and, more
preferably, at least about 1.0 Bohr magnetrons per molecule. In one
embodiment, the compound has a magnetic moment of at least about 2 Bohr
magnetrons per molecule.
[0084] As is known to those skilled in the art, a Bohr
magnetron is the amount he/4(pi)mc, wherein he is Plank's constant, e
and m are the charge and mass of the electron, c is the speed of light,
and pi is equal to about 3.14567. Reference may be had, e.g., to U.S.
Pat. Nos. 4,687,331, 4,832,877, 4,849,107, 5,040,373 ("(One Bohr
magnetron is equal to 9.273.times.10.sup.-24 Joules/Tesla"), 5,169,944,
5,323,227 ("duo is a constant known as the Bohr magnetron at
9.274.times.10-21 erg/Gauss"), 5,352,979 6,383,597, 6,725,668,
6,739,137 ("One Bohr magnetron .mu.B is equal to 9.273.times.10-24
Joules/Tesla"), and the like. The entire disclosure of each of these
United States patents is hereby incorporated by reference into this
specification.
[0085] Other Magnetic Compounds
[0086] In another embodiment of this invention, other compounds
which are not necessarily anti-mitotic are made magnetic by a process
comparable to the process described in this specification for making
taxanes magnetic.
[0087] In this embodiment, it is preferred to make "magnetic
derivatives" of drugs and therapeutic agents. These derivative
compounds each preferably have a molecular weight of at least 150 grams
per mole, a positive magnetic susceptibility of at least
1,000.times.10.sup.-6 cgs, and a magnetic moment of at least 0.5 bohr
magnetrons, wherein said compound is comprised of at least 7 carbon
atoms and at least one inorganic atom with a positive magnetic
susceptibility of at least 200.times.10.sup.-6 cgs.
[0088] Some of the preferred "precursors" used to make these
"derivative compounds" are described in the remainder of this section
of the specification.
[0089] The precursor materials may be either proteinaceous or
non-proteinaceous drugs, as they terms are defined in U.S. Pat. No.
5,194,581, the entire disclosure of which is hereby incorporated by
reference into this specification. U.S. Pat. No. 5,194,581 discloses
"The drugs with which can be incorporated in the compositions of the
invention include non-proteinaceous as well as proteinaceous drugs. The
term "non-proteinaceous drugs" encompasses compounds which are
classically referred to as drugs such as, for example, mitomycin C,
daunorubicin, vinblastine, AZT, and hormones. Similar substances are
within the skill of the art. The proteinaceous drugs which can be
incorporated in the compositions of the invention include
immunomodulators and other biological response modifiers. The term
"biological response modifiers" is meant to encompass substances which
are involved in modifying the immune response in such manner as to
enhance the particular desired therapeutic effect, for example, the
destruction of the tumor cells. Examples of immune response modifiers
include such compounds as lymphokines. Examples of lymphokines include
tumor necrosis factor, the interleukins, lymphotoxin, macrophage
activating factor, migration inhibition factor, colony stimulating
factor and the interferons. Interferons which can be incorporated into
the compositions of the invention include alpha-interferon,
beta-interferon, and gamma-interferon and their subtypes. In addition,
peptide or polysaccharide fragments derived from these proteinaceous
drugs, or independently, can also be incorporated. Also, encompassed by
the term "biological response modifiers" are substances generally
referred to as vaccines wherein a foreign substance, usually a
pathogenic organism or some fraction thereof, is used to modify the
host immune response with respect to the pathogen to which the vaccine
relates. Those of skill in the art will know, or can readily ascertain,
other substances which can act as proteinaceous drugs."
[0090] The precursor may be a lectin, as is disclosed in U.S.
Pat. No. 5,176,907, the entire disclosure of which is hereby
incorporated by reference into this specification. This United States
patent discloses "Lectins are proteins, usually isolated from plant
material, which bind to specific sugar moieties. Many lectins are also
able to agglutinate cells and stimulate lymphocytes. Other therapeutic
agents which can be used therapeutically with the biodegradable
compositions of the invention are known, or can be easily ascertained,
by those of ordinary skill in the art."
[0091] The precursor material may be an amorphous water-soluble
pharmaceutical agent, as is disclosed in U.S. Pat. No. 6,117,455, the
entire disclosure of which is hereby incorporated by reference into
this specification. As is disclosed in the abstract of this patent,
there is provided "A sustained-release microcapsule contains an
amorphous water-soluble pharmaceutical agent having a particle size of
from 1 nm-10 .mu.m and a polymer. The microcapsule is produced by
dispersing, in an aqueous phase, a dispersion of from 0.001-90% (w/w)
of an amorphous water-soluble pharmaceutical agent in a solution of a
polymer having a wt. avg. molecular weight of 2,000-800,000 in an
organic solvent to prepare an s/o/w emulsion and subjecting the
emulsion to in-water drying."
[0092] In one embodiment, and referring to U.S. Pat. No.
5,420,105 (the entire disclosure of which is hereby incorporated by
reference into this specification), the precursor material is selected
from the group consisting of an anti-cancer anthracycline antibiotic,
cis-platinum, methotrexate, vinblastine, mitoxanthrone ARA-C,
6-mercaptopurine, 6-mercaptoguanosine, mytomycin C and a steroid.
[0093] By way of further illustration, the precursor material
is selected from the group consisting of antithrombogenic agents,
antiplatelet agents, prostaglandins, thrombolytic drugs,
antiproliferative drugs, antirejection drugs, antimicrobial drugs,
growth factors, and anticalcifying agents.
[0094] By way of yet further illustration, the precursor
material may, e.g., be any one or more of the therapeutic agents
disclosed in column 5 of U.S. Pat. No. 5,464,650. Thus, and referring
to such column 5, "The therapeutic substance used in the present
invention could be virtually any therapeutic substance which possesses
desirable therapeutic characteristics for application to a blood
vessel. This can include both solid substances and liquid substances.
For example, glucocorticoids (e.g. dexamethasone, betamethasone),
heparin, hirudin, tocopherol, angiopeptin, aspirin, ACE inhibitors,
growth factors, oligonucleotides, and, more generally, antiplatelet
agents, anticoagulant agents, antimitotic agents, antioxidants,
antimetabolite agents, and anti-inflammatory agents could be used.
Antiplatelet agents can include drugs such as aspirin and dipyridamole.
Aspirin is classified as an analgesic, antipyretic, anti-inflammatory
and antiplatelet drug. Dypridimole is a drug similar to aspirin in that
it has anti-platelet characteristics. Dypridimole is also classified as
a coronary vasodilator. Anticoagulant agents can include drugs such as
heparin, coumadin, protamine, hirudin and tick anticoagulant protein.
Antimitotic agents and antimetabolite agents can include drugs such as
methotrexate, azathioprine, vincristine, vinblastine, fluorouracil,
adriamycin and mutamycin."
[0095] The precurors material may be one or more of the drugs
disclosed in U.S. Pat. No. 5,599,352, the entire disclosure of which is
hereby incorporated by reference into this specification. As is
disclosed in this patent, "Examples of drugs that are thought to be
useful in the treatment of restenosis are disclosed in published
international patent application WO 91/12779 "Intraluminal Drug Eluting
Prosthesis" which is incorporated herein by reference. Therefore,
useful drugs for treatment of restenosis and drugs that can be
incorporated in the fibrin and used in the present invention can
include drugs such as anticoagulant drugs, antiplatelet drugs,
antimetabolite drugs, anti-inflammatory drugs and antimitotic drugs.
Further, other vasoreactive agents such as nitric oxide releasing
agents could also be used . . . By this method, drugs such as
glucocorticoids (e.g. dexamethasone, betamethasone), heparin, hirudin,
tocopherol, angiopeptin, aspirin, ACE inhibitors, growth factors,
oligonucleotides, and, more generally, antiplatelet agents,
anticoagulant agents, antimitotic agents, antioxidants, antimetabolite
agents, and anti-inflammatory agents can be applied to a stent . . . "
[0096] By way of yet further illustration, and referring to
U.S. Pat. No. 5,605,696 (the entire disclosure of which is hereby
incororporated by reference into this specification), the precursor may
be a "selected therapeutic drug" that may be, g.g., " . . .
anticoagulant antiplatelet or antithrombin agents such as heparin,
D-phe-pro-arg-chloromethylketone (synthetic antithrombin),
dipyridamole, hirudin, recombinant hirudin, thrombin inhibitor
(available from Biogen), or c7E3 (an antiplatelet drug from Centocore);
cytostatic or antiproliferative agents such as angiopeptin (a
somatostatin analogue from Ibsen), angiotensin converting enzyme
inhibitors such as Captopril (available from Squibb), Cilazapril
(available from Hoffman-LaRoche), or Lisinopril (available from Merk);
calcium channel blockers (such as Nifedipine), colchicine, fibroblast
growth factor (FGF) antagonists, fish oil (omega 3-fatty acid), low
molecular weight heparin (available from Wyeth, and Glycomed),
histamine antagonists, Lovastatin (an inhibitor of HMG-CoA reductase, a
cholesterol lowering drug from Merk), methotrexate, monoclonal
antibodies (such as to PDGF receptors), nitroprusside,
phosphodiesterase inhibitors, prostacyclin and prostacyclin analogues,
prostaglandin inhibitor (available from Glaxo), Seramin (a PDGF
antagonist), serotonin blockers, steroids, thioprotease inhibitors, and
triazolopyrimidine (a PDGF antagonist). Other therapeutic drugs which
may be appropriate include alphainterferon and genetically engineered
epithelial cells, for example."
[0097] By way of yet further illustration, and referring to
U.S. Pat. No. 5,700,286 (the entire disclosure of which is hereby
incorporated by reference into this specification), precursor material
may be a therapeutic agent or drug " . . . including, but not limited
to, antiplatelets, antithrombins, cytostatic and antiproliferative
agents, for example, to reduce or prevent restenosis in the vessel
being treated. The therapeutic agent or drug is preferably selected
from the group of therapeutic agents or drugs consisting of sodium
heparin, low molecular weight heparin, hirudin, argatroban, forskolin,
vapiprost, prostacyclin and prostacyclin analogues, dextran,
D-phe-pro-arg-chloromethylketone, dipyridamole, glycoprotein IIb/IIIa
platelet membrane receptor antibody, recombinant hirudin, thrombin
inhibitor, angiopeptin, angiotensin converting enzyme inhibitors, (such
as Captopril, available from Squibb; Cilazapril, available for
Hoffman-La Roche; or Lisinopril, available from Merck) calcium channel
blockers, colchicine, fibroblast growth factor antagonists, fish oil,
omega 3-fatty acid, histamine antagonists, HMG-CoA reductase inhibitor,
methotrexate, monoclonal antibodies, nitroprusside, phosphodiesterase
inhibitors, prostaglandin inhibitor, seramin, serotonin blockers,
steroids, thioprotease inhibitors, triazolopyrimidine and other PDGF
antagonists, alpha-interferon and genetically engineered epithelial
cells, and combinations thereof."
[0098] By way of yet further illustration, and referring to
U.S. Pat. No. 5,900,433 (the entire disclosure of which is hereby
incorporated by reference into this specification), the precursor
material may be a congener of an endothelium-derived bioactive
composition of matter. This congener is discussed in column 7 of the
patent, wherein it is disclosed that "We have discovered that
administration of a congener of an endothelium-derived bioactive agent,
more particularly a nitrovasodilator, representatively the nitric oxide
donor agent sodium nitroprusside, to an extravascular treatment site,
at a therapeutically effective dosage rate, is effective for abolishing
CFR's while reducing or avoiding systemic effects such as supression of
platelet function and bleeding . . . congeners of an
endothelium-derived bioactive agent include prostacyclin, prostaglandin
E1, and a nitrovasodilator agent. Nitrovasodilater agents include
nitric oxide and nitric oxide donor agents, including L-arginine,
sodium nitroprusside and nitroglycycerine."
[0099] By way of yet further illustration, the precursor
material may be heparin. As is disclosed in U.S. Pat. No. 6,120,536
(the entire disclosure of which is hereby incorporated by reference
into this specification), "While heparin is preferred as the
incorporated active material, agents possibly suitable for
incorporation include antithrobotics, anticoagulants, antibiotics,
antiplatelet agents, thorombolytics, antiproliferatives, steroidal and
non-steroidal antinflammatories, agents that inhibit hyperplasia and in
particular restenosis, smooth muscle cell inhibitors, growth factors,
growth factor inhibitors, cell adhesion inhibitors, cell adhesion
promoters and drugs that may enhance the formation of healthy
neointimal tissue, including endothelial cell regeneration."
[0100] By way of yet further illustration, and referring to
U.S. Pat. No. 6,624,138 (the entire disclosure of which is hereby
incorporated by reference into this specification), the precursor
material may be one or more of the drugs described in this patent.
Thus, and referring to columns 9 et seq. of such patent, "Straub et al.
in U.S. Pat. No. 6,395,300 discloses a wide variety of drugs that are
useful in the methods and compositions described herein, entire
contents of which, including a variety of drugs, are incorporated
herein by reference. Drugs contemplated for use in the compositions
described in U.S. Pat. No. 6,395,300 and herein disclosed include the
following categories and examples of drugs and alternative forms of
these drugs such as alternative salt forms, free acid forms, free base
forms, and hydrates: analgesics/antipyretics. (e.g., aspirin,
acetaminophen, ibuprofen, naproxen sodium, buprenorphine, propoxyphene
hydrochloride, propoxyphene napsylate, meperidine hydrochloride,
hydromorphone hydrochloide, morphine, oxycodone, codeine,
dihydrocodeine bitartrate, pentazocine, hydrocodone bitartrate,
levorphanol, diflunisal, trolamine salicylate, nalbuphine
hydrochloride, mefenamic acid, butorphanol, choline salicylate,
butalbital, phenyltoloxamine citrate, diphenhydramine citrate,
methotrimeprazine, cinnamedrine hydrochloride, and meprobamate);
antiasthamatics (e.g., ketotifen and traxanox); antibiotics (e.g.,
neomycin, streptomycin, chloramphenicol, cephalosporin, ampicillin,
penicillin, tetracycline, and ciprofloxacin); antidepressants (e.g.,
nefopam, oxypertine, doxepin, amoxapine, trazodone, amitriptyline,
maprotiline, phenelzine, desipramine, nortriptyline, tranylcypromine,
fluoxetine, doxepin, imipramine, imipramine pamoate, isocarboxazid,
trimipramine, and protriptyline); antidiabetics (e.g., biguanides and
sulfonylurea derivatives); antifungal agents (e.g., griseofulvin,
ketoconazole, itraconizole, amphotericin B, nystatin, and candicidin);
antihypertensive agents (e.g., propanolol, propafenone, oxyprenolol,
nifedipine, reserpine, trimethaphan, phenoxybenzamine, pargyline
hydrochloride, deserpidine, diazoxide, guanethidine monosulfate,
minoxidil, rescinnamine, sodium nitroprusside, rauwolfia serpentina,
alseroxylon, and phentolamine); anti-inflammatories (e.g.,
(non-steroidal) indomethacin, ketoprofen, flurbiprofen, naproxen,
ibuprofen, ramifenazone, piroxicam, (steroidal) cortisone,
dexamethasone, fluazacort, celecoxib, rofecoxib, hydrocortisone,
prednisolone, and prednisone); antineoplastics (e.g., cyclophosphamide,
actinomycin, bleomycin, daunorubicin, doxorubicin, epirubicin,
mitomycin, methotrexate, fluorouracil, carboplatin, carmustine (BCNU),
methyl-CCNU, cisplatin, etoposide, camptothecin and derivatives
thereof, phenesterine, paclitaxel and derivatives thereof, docetaxel
and derivatives thereof, vinblastine, vincristine, tamoxifen, and
piposulfan); antianxiety agents (e.g., lorazepam, buspirone, prazepam,
chlordiazepoxide, oxazepam, clorazepate dipotassium, diazepam,
hydroxyzine pamoate, hydroxyzine hydrochloride, alprazolam, droperidol,
halazepam, chlormezanone, and dantrolene); immunosuppressive agents
(e.g., cyclosporine, azathioprine, mizoribine, and FK506 (tacrolimus));
antimigraine agents (e.g., ergotamine, propanolol, isometheptene
mucate, and dichloralphenazone); sedatives/hypnotics (e.g.,
barbiturates such as pentobarbital, pentobarbital, and secobarbital;
and benzodiazapines such as flurazepam hydrochloride, triazolam, and
midazolam); antianginal agents (e.g., beta-adrenergic blockers; calcium
channel blockers such as nifedipine, and diltiazem; and nitrates such
as nitroglycerin, isosorbide dinitrate, pentearythritol tetranitrate,
and erythrityl tetranitrate); antipsychotic agents (e.g., haloperidol,
loxapine succinate, loxapine hydrochloride, thioridazine, thioridazine
hydrochloride, thiothixene, fluphenazine, fluphenazine decanoate,
fluphenazine enanthate, trifluoperazine, chlorpromazine, perphenazine,
lithium citrate, and prochlorperazine); antimanic agents (e.g., lithium
carbonate); antiarrhythmics (e.g., bretylium tosylate, esmolol,
verapamil, amiodarone, encainide, digoxin, digitoxin, mexiletine,
disopyramide phosphate, procainamide, quinidine sulfate, quinidine
gluconate, quinidine polygalacturonate, flecainide acetate, tocainide,
and lidocaine); antiarthritic agents (e.g., phenylbutazone, sulindac,
penicillanine, salsalate, piroxicam, azathioprine, indomethacin,
meclofenamate, gold sodium thiomalate, ketoprofen, auranofin,
aurothioglucose, and tolmetin sodium); antigout agents (e.g.,
colchicine, and allopurinol); anticoagulants (e.g., heparin, heparin
sodium, and warfarin sodium); thrombolytic agents (e.g., urokinase,
streptokinase, and alteplase); antifibrinolytic agents (e.g.,
aminocaproic acid); hemorheologic agents (e.g., pentoxifylline);
antiplatelet agents (e.g., aspirin); anticonvulsants (e.g., valproic
acid, divalproex sodium, phenyloin, phenyloin sodium, clonazepam,
primidone, phenobarbitol, carbamazepine, amobarbital sodium,
methsuximide, metharbital, mephobarbital, mephenyloin, phensuximide,
paramethadione, ethotoin, phenacemide, secobarbitol sodium, clorazepate
dipotassium, and trimethadione); antiparkinson agents (e.g.,
ethosuximide); antihistamines/antipruritics (e.g., hydroxyzine,
diphenhydramine, chlorpheniramine, brompheniramine maleate,
cyproheptadine hydrochloride, terfenadine, clemastine fumarate,
triprolidine, carbinoxamine, diphenylpyraline, phenindamine, azatadine,
tripelennamine, dexchlorpheniramine maleate, methdilazine; agents
useful for calcium regulation (e.g., calcitonin, and parathyroid
hormone); antibacterial agents (e.g., amikacin sulfate, aztreonam,
chloramphenicol, chloramphenicol palirtate, ciprofloxacin, clindamycin,
clindamycin palmitate, clindamycin phosphate, metronidazole,
metronidazole hydrochloride, gentamicin sulfate, lincomycin
hydrochloride, tobramycin sulfate, vancomycin hydrochloride, polymyxin
B sulfate, colistimethate sodium, and colistin sulfate); antiviral
agents (e.g., interferon alpha, beta or gamma, zidovudine, amantadine
hydrochloride, ribavirin, and acyclovir); antimicrobials (e.g.,
cephalosporins such as cefazolin sodium, cephradine, cefaclor,
cephapirin sodium, ceftizoxime sodium, cefoperazone sodium, cefotetan
disodium, cefuroxime e azotil, cefotaxime sodium, cefadroxil
monohydrate, cephalexin, cephalothin sodium, cephalexin hydrochloride
monohydrate, cefamandole nafate, cefoxitin sodium, cefonicid sodium,
ceforamide, ceftriaxone sodium, ceftazidime, cefadroxil, cephradine,
and cefuroxime sodium; penicillins such as ampicillin, amoxicillin,
penicillin G benzathine, cyclacillin, ampicillin sodium, penicillin G
potassium, penicillin V potassium, piperacillin sodium, oxacillin
sodium, bacampicillin hydrochloride, cloxacillin sodium, ticarcillin
disodium, azlocillin sodium, carbenicillin indanyl sodium, penicillin G
procaine, methicillin sodium, and nafcillin sodium; erythromycins such
as erythromycin ethylsuccinate, erythromycin, erythromycin estolate,
erythromycin lactobionate, erythromycin stearate, and erythromycin
ethylsuccinate; and tetracyclines such as tetracycline hydrochloride,
doxycycline hyclate, and minocycline hydrochloride, azithromycin,
clarithromycin); anti-infectives (e.g., GM-CSF); bronchodilators (e.g.,
sympathomimetics such as epinephrine hydrochloride, metaproterenol
sulfate, terbutaline sulfate, isoetharine, isoetharine mesylate,
isoetharine hydrochloride, albuterol sulfate, albuterol,
bitolterolmesylate, isoproterenol hydrochloride, terbutaline sulfate,
epinephrine bitartrate, metaproterenol sulfate, epinephrine, and
epinephrine bitartrate; anticholinergic agents such as ipratropium
bromide; xanthines such as aminophylline, dyphylline, metaproterenol
sulfate, and aminophylline; mast cell stabilizers such as cromolyn
sodium; inhalant corticosteroids such as beclomethasone dipropionate
(BDP), and beclomethasone dipropionate monohydrate; salbutamol;
ipratropium bromide; budesonide; ketotifen; salmeterol; xinafoate;
terbutaline sulfate; triamcinolone; theophylline; nedocromil sodium;
metaproterenol sulfate; albuterol; flunisolide; fluticasone
proprionate; steroidal compounds and hormones (e.g., androgens such as
danazol, testosterone cypionate, fluoxymesterone, ethyltestosterone,
testosterone enathate, methyltestosterone, fluoxymesterone, and
testosterone cypionate; estrogens such as estradiol, estropipate, and
conjugated estrogens; progestins such as methoxyprogesterone acetate,
and norethindrone acetate; corticosteroids such as triamcinolone,
betamethasone, betamethasone sodium phosphate, dexamethasone,
dexamethasone sodium phosphate, dexamethasone acetate, prednisone,
methylprednisolone acetate suspension, triamcinolone acetonide,
methylprednisolone, prednisolone sodium phosphate, methylprednisolone
sodium succinate, hydrocortisone sodium succinate, triamcinolone
hexacetonide, hydrocortisone, hydrocortisone cypionate, prednisolone,
fludrocortisone acetate, paramethasone acetate, prednisolone tebutate,
prednisolone acetate, prednisolone sodium phosphate, and hydrocortisone
sodium succinate; and thyroid hormones such as levothyroxine sodium);
hypoglycemic agents (e.g., human insulin, purified beef insulin,
purified pork insulin, glyburide, chlorpropamide, glipizide,
tolbutamide, and tolazamide); hypolipidemic agents (e.g., clofibrate,
dextrothyroxine sodium, probucol, pravastitin, atorvastatin,
lovastatin, and niacin); proteins (e.g., DNase, alginase, superoxide
dismutase, and lipase); nucleic acids (e.g., sense or anti-sense
nucleic acids encoding any therapeutically useful protein, including
any of the proteins described herein); agents useful for erythropoiesis
stimulation (e.g., erythropoietin); antiulcer/antireflux agents (e.g.,
famotidine, cimetidine, and ranitidine hydrochloride);
antinauseants/antiemetics (e.g., meclizine hydrochloride, nabilone,
prochlorperazine, dimenhydrinate, promethazine hydrochloride,
thiethylperazine, and scopolamine); as well as other drugs useful in
the compositions and methods described herein include mitotane,
halonitrosoureas, anthrocyclines, ellipticine, ceftriaxone,
ketoconazole, ceftazidime, oxaprozin, albuterol, valacyclovir,
urofollitropin, famciclovir, flutamide, enalapril, mefformin,
itraconazole, buspirone, gabapentin, fosinopril, tramadol, acarbose,
lorazepan, follitropin, glipizide, omeprazole, fluoxetine, lisinopril,
tramsdol, levofloxacin, zafirlukast, interferon, growth hormone,
interleukin, erythropoietin, granulocyte stimulating factor,
nizatidine, bupropion, perindopril, erbumine, adenosine, alendronate,
alprostadil, benazepril, betaxolol, bleomycin sulfate, dexfenfluramine,
diltiazem, fentanyl, flecainid, gemcitabine, glatiramer acetate,
granisetron, lamivudine, mangafodipir trisodium, mesalamine, metoprolol
fumarate, metronidazole, miglitol, moexipril, monteleukast, octreotide
acetate, olopatadine, paricalcitol, somatropin, sumatriptan succinate,
tacrine, verapamil, nabumetone, trovafloxacin, dolasetron, zidovudine,
finasteride, tobramycin, isradipine, tolcapone, enoxaparin,
fluconazole, lansoprazole, terbinafine, pamidronate, didanosine,
diclofenac, cisapride, venlafaxine, troglitazone, fluvastatin,
losartan, imiglucerase, donepezil, olanzapine, valsartan, fexofenadine,
calcitonin, and ipratropium bromide. These drugs are generally
considered to be water soluble." Any of these water-soluble drugs may
be used as precursors in the process of this invention to make a
composition with the desired magnetic properties.
[0101] As is also disclosed in U.S. Pat. No. 6,624,138,
"Preferred drugs useful in the present invention may include albuterol,
adapalene, doxazosin mesylate, mometasone furoate, ursodiol,
amphotericin, enalapril maleate, felodipine, nefazodone hydrochloride,
valrubicin, albendazole, conjugated estrogens, medroxyprogesterone
acetate, nicardipine hydrochloride, zolpidem tartrate, amlodipine
besylate, ethinyl estradiol, omeprazole, rubitecan, amlodipine
besylate/benazepril hydrochloride, etodolac, paroxetine hydrochloride,
paclitaxel, atovaquone, felodipine, podofilox, paricalcitol,
betamethasone dipropionate, fentanyl, pramipexole dihydrochloride,
Vitamin D3 and related analogues, finasteride, quetiapine fumarate,
alprostadil, candesartan, cilexetil, fluconazole, ritonavir, busulfan,
carbamazepine, flumazenil, risperidone, carbemazepine, carbidopa,
levodopa, ganciclovir, saquinavir, amprenavir, carboplatin, glyburide,
sertraline hydrochloride, rofecoxib carvedilol, halobetasolproprionate,
sildenafil citrate, celecoxib, chlorthalidone, imiquimod, simvastatin,
citalopram, ciprofloxacin, irinotecan hydrochloride, sparfloxacin,
efavirenz, cisapride monohydrate, lansoprazole, tamsulosin
hydrochloride, mofafinil, clarithromycin, letrozole, terbinafine
hydrochloride, rosiglitazone maleate, diclofenac sodium, lomefloxacin
hydrochloride, tirofiban hydrochloride, telmisartan, diazapam,
loratadine, toremifene citrate, thalidomide, dinoprostone, mefloquine
hydrochloride, trandolapril, docetaxel, mitoxantrone hydrochloride,
tretinoin, etodolac, triamcinolone acetate, estradiol, ursodiol,
nelfinavir mesylate, indinavir, beclomethasone dipropionate, oxaprozin,
flutamide, famotidine, nifedipine, prednisone, cefuroxime, lorazepam,
digoxin, lovastatin, griseofulvin, naproxen, ibuprofen, isotretinoin,
tamoxifen citrate, nimodipine, amiodarone, and alprazolam. Specific
non-limiting examples of some drugs that fall under the above
categories include paclitaxel, docetaxel and derivatives, epothilones,
nitric oxide release agents, heparin, aspirin, coumadin, PPACK,
hirudin, polypeptide from angiostatin and endostatin, methotrexate,
5-fluorouracil, estradiol, P-selectin Glycoprotein ligand-1 chimera,
abciximab, exochelin, eleutherobin and sarcodictyin, fludarabine,
sirolimus, tranilast, VEGF, transforming growth factor (TGF)-beta,
Insulin-like growth factor (IGF), platelet derived growth factor
(PDGF), fibroblast growth factor (FGF), RGD peptide, beta or gamma ray
emitter (radioactive) agents, and dexamethasone, tacrolimus,
actinomycin-D, batimastat etc." These drugs also may be used in the
process of this invention to make magnetic compositons.
[0102] Guided Delivery of the Compounds of this Invention
[0103] In one preferred embodiment, the magnetic properties of
the anti-mitotic compound of this invention are used in order to
preferentially deliver such compound to a specified site. In another
embodiment, the magnetic properties of the compounds and compositions
of this invention which are not necessarily anti-mitotic but have the
desired magnetic properties also may be used to deliver such compounds
and/or compositions to a desired site.
[0104] Thus, by way of illustration, one may guide delivery of
the compound of this invention with conventional magnetic focusing
means. In one aspect of this embodiment, a magnetic field of a
specified strength is focused onto a desired therapeutic site, such as
a tumor to be treated, whereby the compound is selectively drawn to the
therapeutic site and binds with tubulin moleuces at the site. In one
embodiment, the focused magnetic field has a field strength of at least
about 6 Tesla in order to cause microtubules to move linearly. The
magnetic field may, e.g., be focused for a period of at least about 30
minutes following the administration of the compound of this invention.
[0105] One may use any of the conventional magnetic field
generators known to those skilled in the art to produce such a magnetic
field. Thus, e.g., one may use one or more of the magnetic field
generators disclosed in U.S. Pat. Nos. 6,503,364, 6,377,149 (magnetic
field generator for magnetron plasma generation), 6,353,375
(magnetostatic wave device), 6,340,888 (magnetic field generator for
MRI), 6,336,989, 6,335,617 (device for calibrating a magnetic field
generator), 6,313,632, 6,297,634, 6,275,128, 6,246,066 (magnetic field
generator and charged particle beam irradiator), 6,114,929
(magnetostatic wave device), 6,099,459 (magnetic field generating
device and method of generating and applying a magnetic field),
5,795,212, 6,106,380 (deterministic magnetorheological finishing),
5,839,944 (apparatus for deterministic magnetorheological finishing),
5,971,835 (system for abrasive jet shaping and polishing of a surface
using a magnetorheological fluid), 5,951,369, 6,506,102 (system for
magnetorheological finishing of substrates), 6,267,651, 6,309,285
(magnetic wiper), 5,929,732 and 6,488,615 I(which describe devices and
methods for creating a high intensity magnetic field for magnetically
guiding a anti-mitotic compound to a predetermined site within a
biological organism), and the like. The entire disclosure of each of
these United States patents is hereby incorporated by reference into
this specification.
[0106] The Use of Externally Applied Energy to Affect an
Implanted Medical Device
[0107] The prior art discloses many devices in which an
externally applied electromagnetic field (i.e., a field originating
outside of a biological organism, such as a human body) is generated in
order to influence one or more implantable devices disposed within the
biological organism; these may be used in conjunction with anti-mitotic
compound of this invention. Some of these devices are described below.
[0108] U.S. Pat. No. 3,337,776 describes a device for producing
controllable low frequency magnetic fields; the entire disclosure of
this patent is hereby incorporated by reference into this
specification. Thus, e.g., claim 1 of this patent describes a
biomedical apparatus for the treatment of a subject with controllable
low frequency magnetic fields, comprising solenoid means for creating
the magnetic field. These low-frequency magnetic fields may be used to
affect the anti-mitotic compounds of this invention, and/or tubulin
and/or microtubules and/or other moieties.
[0109] U.S. Pat. No. 3,890,953 also discloses an apparatus for
promoting the growth of bone and other body tissues by the application
of a low frequency alternating magnetic field; the entire disclosure of
this United States patent is hereby incorporated by reference into this
specification. This patent claims "In an electrical apparatus for
promoting the growth of bone and other body tissues by the application
thereto of a low frequency alternating magnetic field, such apparatus
having current generating means and field applicator means, the
improvement wherein the applicator means comprises a flat solenoid coil
having an axis about which the coil is wound and composed of a
plurality of parallel and flexible windings, each said winding having
two adjacent elongate portions and two 180.degree. coil bends joining
said elongate portions together, said coil being flexible in the coil
plane in the region of said elongate portion for being bent into a
U-shape, said coil being bent into such U-shape about an axis parallel
to the coil axis and adapted for connection to a source of low
frequency alternating current." These low-frequency magnetic fields may
be used to affect the anti-mitotic compounds of this invention, and/or
tubulin and/or microtubules and/or other moieties.
[0110] The device of U.S. Pat. No. 3,890,953 is described, in
part, at lines 52 et seq. of column 2, wherein it is disclosed that:
".The apparatus shown diagrammatically in FIG. 1 comprises a AC
generator 10, which supplies low frequency AC at the output terminals
12. The frequency of the AC lies below 150 Hz, for instance between 1
and 50 or 65 Hz. It has been found particularly favorable to use a
frequency range between 5 or 10 and 30 Hz, for example 25 Hz. The half
cycles of the alternating current should have comparatively gently
sloping leading and trailing flanks (rise and fall times of the half
cycles being for example in the order of magnitude of a quarter to an
eighth of the length of a cycle); the AC can thus be a sinusoidal
current with a low non-linear distortion, for example less than 20
percent, or preferably less than 10 percent, or a triangular wave
current."
[0111] U.S. Pat. No. 4,095,588 discloses a "vascular cleansing
device" adapted to " . . . effect motion of the red corpuscles in the
blood stream of a vascular system . . . whereby these red cells may
cleanse the vascular system by scrubbing the walls thereof . . . ;" the
entire disclosure of this United States patent is hereby incorporated
by reference into this specification. This patent claims (in claim 3)
"A means to propel a red corpuscle in a vibratory and rotary fashion,
said means comprising an electronic circuit and magnetic means
including: a source of electrical energy; a variable oscillator
connected to said source; a binary counter means connected to said
oscillator to produce sequential outputs; a plurality of deflection
amplifier means connected to be operable by the outputs of said binary
counter means in a sequential manner, said amplifier means thereby
controlling electrical energy from said source; a plurality of separate
coils connected in separate pairs about an axis in series between said
deflection amplifier means and said source so as to be sequentially
operated in creating an electromagnetic field from one coil to the
other and back again and thence to adjacent separate coils for rotation
of the electromagnetic field from one pair of coils to another; and a
table within the space encircled by said plurality of coils, said table
being located so as to place a person along the axis such that the red
corpuscles of the person's vascular system are within the
electromagnetic field between the coils creating same." The energy used
to affect such red blood corpuscles may also be used affect the
anti-mitotic compounds of this invention, and/or tubulin and/or
microtubules and/or other moieties.
[0112] U.S. Pat. No. 4,323,075 discloses an implantable
defibrillator with a rechargeable power supply; the entire disclosure
of this patent is hereby incorporated by reference into this
specification. Claim 1 of this patent describes "A fully implantable
power supply for use in a fully implantable defibrillator having an
implantable housing, a fibrillation detector for detecting fibrillation
of the heart of a recipient, an energy storage and discharge device for
storing and releasing defibrillation energy into the heart of the
recipient and an inverter for charging the energy storage and discharge
device in response to detection of fibrillation by the fibrillation
detector, the inverter requiring a first level of power to be
operational and the fibrillation detector requiring a second level of
power different from said first level of power to be operational, said
power supply comprising: implantable battery means positioned within
said implantable housing, said battery means including a plurality of
batteries arranged in series, each of said batteries having a pair of
output terminals, each of said batteries producing a distinctly
multilevel voltage across its pair of output terminals, said voltage
being at a first level when the battery is fully charged and dropping
to a second level at some point during the discharge of the battery;
and implantable circuit means positioned within said implantable
housing, said circuit means for creating a first conductive path betwen
said serially-connected batteries and said fibrillation detector to
provide said fibrillation detector with said second level of power, and
for creating a second conductive path between said inverter and said
battery means by placing only the batteries operating at said first
level voltage in said second conductive path, and excluding the
remaining batteries from said second conductive path to provide said
inverter with said first level of power." The power supply of this
patent may be used to power, e.g., one or more magnetic focusing
devices.
[0113] U.S. Pat. No. 4,340,038 discloses an implanted medical
system comprised of magnetic field pick-up means for converting
magnetic energy to electrical energy; the entire disclosure of this
patent is hereby incorporated by reference into this specification. One
may use the electrical energy produced by such pick-up means to affect
the anti-mitotic compounds of this invention, and/or tubulin and/or
microtubules and/or other moieties. Such energy may also be used to
power an implanted magnetic focusing device.
[0114] In column 1 of U.S. Pat. No. 4,340,038, at lines 12 et
seq., it is disclosed that "Many types of implantable devices
incorporate a self-contained transducer for converting magnetic energy
from an externally-located magnetic field generator to energy usable by
the implanted device. In such a system having an implanted device and
an externally-located magnetic field generator for powering the device,
sizing and design of the power transfer system is important. In order
to properly design the power transfer system while at the same time
avoiding overdesign, the distance from the implanted device to the
magnetic field generator must be known. However for some types of
implanted devices the depth of the implanted device in a recipient's
body is variable, and is not known until the time of implantation by a
surgeon. One example of such a device is an intracranial pressure
monitoring device (ICPM) wherein skull thickness varies considerably
between recipients and the device must be located so that it protrudes
slightly below the inner surface of the skull and contacts the dura,
thereby resulting in a variable distance between the top of the
implanted device containing a pick-up coil or transducer and the outer
surface of the skull. One conventional technique for accommodating an
unknown distance between the magnetic field generator and the implanted
device includes increasing the transmission power of the external
magnetic field generator. However this increased power can result in
heating of the implanted device, the excess heat being potentially
hazardous to the recipient. A further technique has been to increase
the diameter of the pick-up coil in the implanted device. However,
physical size constraints imposed on many implanted devices such as the
ICPM are critical; and increasing the diameter of the pick-up coil is
undesirable in that it increases the size of the orifice which must be
formed in the recipient's skull. The concentrator of the present
invention solves the above problems by concentrating magnetic lines of
flux from the magnetic generator at the implanted pick-up coil, the
concentrator being adapted to accommodate distance variations between
the implanted device and the magnetic field generator.`
[0115] Claim 1 of U.S. Pat. No. 4,340,038 describes "In a
system including an implanted device having a magnetic field pick-up
means for converting magnetic energy to electrical energy for
energizing said implanted device, and an external magnetic field
generator located so that magnetic lines of flux generated thereby
intersect said pick-up means, a means for concentrating a portion of
said magnetic lines of flux at said pick-up means comprising a metallic
slug located between said generator and said pick-up means, thereby
concentrating said magnetic lines of flux at said pick-up means. "Claim
5 of this patent further describes the pick-up means as comprising " .
. . a magnetic pick-up coil and said slug is formed in the shape of a
truncated cone and oriented so that a plane defined by the smaller of
said cone end surfaces is adjacent to said substantially parallel to a
plane defined by said magnetic pick-up coil." In one embodiment, such
pick-up means may be located near the site to be treated (such as a
tumor) and may be used to affect the tumor by, e.g., hyperthermia
treatement.
[0116] U.S. Pat. No. 4,361,153 discloses an implantable
telemetry system; the entire disclosure of such United States patent is
hereby incorporated by reference into this specification. Such an
implantable telemetry system, equipped with a multiplicity of sensors,
may be used to report how These the anti-mitotic compounds of this
invention, and/or tubulin and/or microtubules and/or other moieties
respond to applied electromagnetic fields.
[0117] As is disclosed at column 1 of U.S. Pat. No. 4,361,153
(see lines 9 et seq.), "Externally applied oscillating magnetic fields
have been used before with implanted devices. Early inductive cardiac
pacers employed externally generated electromagnetic energy directly as
a power source. A coil inside the implant operated as a secondary
transformer winding and was interconnected with the stimulating
electrodes. More recently, implanted stimulators with rechargeable
(e.g., nickel cadmium) batteries have used magnetic transmission to
couple energy into a secondary winding in the implant to energize a
recharging circuit having suitable rectifier circuitry. Miniature reed
switches have been utilized before for implant communications. They
appear to have been first used to allow the patient to convert from
standby or demand mode to fixed rate pacing with an external magnet.
Later, with the advent of programmable stimulators, reed switches were
rapidly cycled by magnetic pulse transmission to operate pulse
parameter selection circuitry inside the implant. Systems analogous to
conventional two-way radio frequency (RF) and optical communication
system have also been proposed. The increasing versatility of implanted
stimulators demands more complex programming capabilities. While
various systems for transmitting data into the implant have been
proposed, there is a parallel need to develop compatible telemetry
systems for signalling out of the implant. However, the austere energy
budget constraints imposed by long life, battery operated implants rule
out conventional transmitters and analogous systems."
[0118] The solution provided by U.S. Pat. No. 4,361,153 is " .
. . achieved by the use of a resonant impedance modulated transponder
in the implant to modulate the phase of a relatively high energy
reflected magnetic carrier imposed from outside of the body." In
particular, and as is described by claim 1 of this patent, there is
claimed "An apparatus for communicating variable information to an
external device from an electronic stimulator implanted in a living
human patient, comprising an external unit including means for
transmitting a carrier signal, a hermetically sealed fully implantable
enclosure adapted to be implanted at a fixed location in the patient's
body, means within said enclosure for generating stimulator outputs, a
transponder within said enclosure including tuned resonant circuit
means for resonating at the frequency of said carrier signal so as to
re-radiate a signal at the frequency of said carrier signal, and means
for superimposing an information signal on the reflected signal by
altering the resonance of said tuned circuit means in accordance with
an information signal, said superimposing means including a variable
impedance load connected across said tuned circuit and means for
varying the impedance of said load in accordance with an information
signal, said external unit further including pickup means for receiving
the reflected signal from said transponder and means for recovering the
information signal superimposed thereon, said receiving means including
means reponsive to said reflected signal from said transponder for
producing on associated analog output signal, and said recovering means
including phase shift detector means responsive to said analog output
signal for producing an output signal related to the relative phase
angle thereof."
[0119] U.S. Pat. No. 4,408,607 discloses a rechargeable,
implantable capacitive energy source; the entire disclosure of this
patent is hereby incorporated into this specification by reference; and
this source may be used to directly or indirectly supply energy to one
or more of the anti-mitotic compounds of this invention, and/or tubulin
and/or microtubules and/or other moieties. As is disclosed in column 1
of such patent (at lines 12 et seq.), "Medical science has advanced to
the point where it is possible to implant directly within living bodies
electrical devices necessary or advantageous to the welfare of
individual patients. A problem with such devices is how to supply the
electrical energy necessary for their continued operation. The devices
are, of course, designed to require a minimum of electrical energy, so
that extended operation from batteries may be possible. Lithium
batteries and other primary, non-rechargeable cells may be used, but
they are expensive and require replacement of surgical procedures.
Nickel-cadmium and other rechargeable batteries are also available, but
have limited charge-recharge characteristics, require long intervals
for recharging, and release gas during the charging process."
[0120] The solution to this problem is described, e.g., in
claim 1 of the patent, which describes "An electric power supply for
providing electrical energy to an electrically operated medical device
comprising: capacitor means for accommodating an electric charge; first
means providing a regulated source of unidirectional electrical energy;
second means connecting said first means to said capacitor means for
supplying charging current to said capacitor means at a first voltage
which increases with charge in the capacitor means; third means
deriving from said first means a comparison second voltage of constant
magnitude; comparator means operative when said first voltage reaches a
first value to reduce said first voltage to a second, lower value; and
voltage regulator means connected to said capacitor means and medical
device to limit the voltage supplied to the medical device."
[0121] U.S. Pat. No. 4,416,283 discloses a implantable shunted
coil telemetry transponder employed as a magnetic pulse transducer for
receiving externally transmitted data; the entire disclosure of this
United States patent is hereby incorporated by reference into this
specification. This transponder may be used in a manner similar to that
of the aforementioned telemetry system.
[0122] In particular, a programming system for a biomedical
implant is described in claim 1 of U.S. Pat. No. 4,416,283. Such claim
1 discloses "In a programming system for a biomedical implant of the
type wherein an external programmer produces a series of magnetic
impulses which are received and transduced to form a corresponding
electrical pulse input to programmable parameter data registers inside
the implant, wherein the improvement comprises external programming
pulse receiving and transducing circuitry in the implant including a
tuned coil, means responsive to pairs of successive voltage spikes of
opposite polarity magnetically induced across said tuned coil by said
magnetic impulses for forming corresponding binary pulses duplicating
said externally generated magnetic impulses giving rise to said spikes,
and means for outputting said binary pulses to said data registers to
accomplish programming of the implant."
[0123] U.S. Pat. No. 4,871,351 discloses an implantable pump
infusion system; the entire disclosure of this United States patent is
hereby incorporated by reference into this specification. These
implantable pumps are discussed in column 1 of the patent, wherein it
is disclosed that: "Certain human disorders, such as diabetes, require
the injection into the body of prescribed amounts of medication at
prescribed times or in response to particular conditions or events.
Various kinds of infusion pumps have been propounded for infusing drugs
or other chemicals or solutions into the body at continuous rates or
measured dosages. Examples of such known infusion pumps and dispensing
devices are found in U.S. Pat. Nos. 3,731,861; 3,692,027; 3,923,060;
4,003,379; 3,951,147; 4,193,397; 4,221,219 and 4,258,711. Some of the
known pumps are external and inject the drugs or other medication into
the body via a catheter, but the preferred pumps are those which are
fully implantable in the human body." One may use the implantable pumps
of this patent to delivery the anti-mitotic compound of this invention
to a specified site and, thereafter, to "finely focus" such delivery by
means of magnetic focusing means.
[0124] U.S. Pat. No. 4,871,351 also discloses that:
"Implantable pumps have been used in infusion systems such as those
disclosed in U.S. Pat. Nos. 4,077,405; 4,282,872; 4,270,532; 4,360,019
and 4,373,527. Such infusion systems are of the open loop type. That
is, the systems are pre-programmed to deliver a desired rate of
infusion. The rate of infusion may be programmed to vary with time and
the particular patient. A major disadvantage of such open loop systems
is that they are not responsive to the current condition of the
patient, i.e. they do not have feedback information. Thus, an infusion
system of the open loop type may continue dispensing medication
according to its pre-programmed rate or profile when, in fact, it may
not be needed."
[0125] U.S. Pat. No. 4,871,351 also discloses that: "There are
known closed loop infusion systems which are designed to control a
particular condition of the body, e.g. the blood glucose concentration.
Such systems use feedback control continuously, i.e. the patient's
blood is withdrawn via an intravenous catheter and analysed
continuously and a computer output signal is derived from the actual
blood glucose concentration to drive a pump which infuses insulin at a
rate corresponding to the signal. The known closed loop systems suffer
from several disadvantages. First, since they monitor the blood glucose
concentration continuously they are complex and relatively bulky
systems external to the patient, and restrict the movement of the
patient. Such systems are suitable only for hospital bedside
applications for short periods of time and require highly trained
operating staff. Further, some of the known closed loop systems do not
allow for manually input overriding commands. Examples of closed loop
systems are found in U.S. Pat. Nos. 4,055,175; 4,151,845 and
4,245,634."
[0126] U.S. Pat. No. 4,871,351 also discloses that "An
implanted closed loop system with some degree of external control is
disclosed in U.S. Pat. No. 4,146,029. In that system, a sensor (either
implanted or external) is arranged on the body to sense some kind of
physiological, chemical, electrical or other condition at a particular
site and produced data which corresponds to the sensed condition at the
sensed site. This data is fed directly to an implanted microprocessor
controlled medication dispensing device. A predetermined amount of
medication is dispensed in response to the sensed condition according
to a pre-programmed algorithm in the microprocessor control unit. An
extra-corporeal coding pulse transmitter is provided for selecting
between different algorithms in the microprocessor control unit. The
system of U.S. Pat. No. 4,146,029 is suitable for use in treating only
certain ailments such as cardiac conditions. It is unsuitable as a
blood glucose control system for example, since (i) it is not
practicable to measure the blood glucose concentration continuously
with an implanted sensor and (ii) the known system is incapable of
dispensing discrete doses of insulin in response to certain events,
such as meals and exercise. Furthermore, there are several
disadvantages to internal sensors; namely, due to drift, lack of
regular calibration and limited life, internal sensors do not have high
long-term reliability. If an external sensor is used with the system of
U.S. Pat. No. 4,146,029, the output of the sensor must be fed through
the patient's skin to the implanted mechanism. There are inherent
disadvantages to such a system, namely the high risk of infection.
Since the algorithms which control the rate of infusion are programmed
into the implanted unit, it is not possible to upgrade these algorithms
without surgery. The extra-corporeal controller merely selects a
particular one of several medication programs but cannot actually alter
a program."
[0127] U.S. Pat. No. 4,871,351 also discloses that "It is an
object of the present invention to overcome, or substantially
ameliorate the above described disadvantages of the prior art by
providing an implantable open loop medication infusion system with a
feedback control option."
[0128] The solution to this problem is set forth in claim 1 of
U.S. Pat. No. 4,871,351, which describes: "A medical infusion system
intermittently switchable at selected times between an open loop system
without feedback and a closed loop system with feedback, said system
comprising an implantable unit including means for controllably
dispensing medication into a body, an external controller, and an
extra-corporeal sensor; wherein said implantable unit comprises an
implantable transceiver means for communicating with a similar external
transceiver means in said external controller to provide a telemetry
link between said controller and said implantable unit, a first
reservoir means for holding medication liquid, a liquid dispensing
device, a pump connected between said reservoir means and said liquid
dispensing device, and a first electronic control circuit means
connected to said implantable transceiver means and to said pump to
operate said pump; wherein said external controller comprises a second
electronic control circuit means connected with said external
transceiver means, a transducer means for reading said sensor, said
transducer means having an output connected to said second electronic
control circuit means, and a manually operable electric input device
connected to said second electronic control circuit means; wherein said
pump is operable by said first electronic control circuit means to pump
said medication liquid from said first reservoir means to said
liquid-dispensing deive at a first predetermined rate independent of
the output of said extra-corporeal sensor, and wherein said input
device or said transducer means include means which selectively
operable at intermittent times to respectively convey commands or
output of said transducer representing the reading of said sensor to
said second control circuit to instruct said first control circuit via
said telemetry link to modify the operation of said pump."
[0129] U.S. Pat. No. 4,941,461 describes an electrically
actuated inflatable penile erecton device comprised of an implantable
induction coil and an implantable pump; the entire disclosure of this
United States patent is hereby incorporated by reference into this
specification. The device of this patent is described, e.g., in claim 1
of the patent, which discloses "An apparatus for achieving a penile
erection in a human male, comprising: at least one elastomer cylinder
having a root chamber and a pendulous chamber, said elastomer cylinder
adapted to be placed in the corpus carvenosum of the penis; an external
magnetic field generator which can be placed over some section of the
penis which generates an alternating magnetic field; an induction coil
contained within said elastomer cylinder which produces an alternating
electric current when in the proximity of said alternating magnetic
filed which is produced by said external magnetic field generator; and
a fluid pumping means located within said elastomer cylinder, said
pumping means being operated by the electrical power generated in said
induction coil to pump fluid from said root chamber to said pendulous
chamber in order to stiffen said elastomer cylinder for causing the
erect state of the penis."
[0130] U.S. Pat. No. 5,487,760 discloses an implantable signal
transceiver disposed in an artificial heart valve; this transceiver may
be used in the process of this invention in accordance with the
aforementioned telemetry device; and the entire disclosure of this
United States patent is hereby incorporated by reference into this
specification. Claim 1 of this patent describes: "In combination, an
artificial heart valve of the type having a tubular body member,
defining a lumen and pivotally supporting at least one occluder, said
body member having a sewing cuff covering an exterior surface of said
body member; and an electronic sensor module disposed between said
sewing cuff and said exterior surface, wherein said sensor module
incorporates a sensor element for detecting movement of said at least
one occluder between an open and a closed disposition relative to said
lumen and wherein said sensor module further includes a signal
transceiver coupled to said sensor element, and means for energizing
said signal transceiver, and wherein said sensor module includes means
for encapsulating said sensor element, signal transceiver and
energizing means in a moisture-impervious container." As will be
apparent to those skilled in the art, the sensor/transceiver
combination may advantageously be used in conjunction with the
anti-mitotic compound of this invention, and/or microtubules.
[0131] U.S. Pat. No. 5,702,430 discloses an implantable power
supply; the entire disclosure of such patent is hereby incorporated by
reference into this specification. This implantable power supply may be
used to supply power to either the compound of this invention, the
treatment site, and/or one or more other devices from which a specified
energy output is desired.
[0132] Claim 1 of U.S. Pat. No. 5,702,430 describes: "A
surgically implantable power supply comprising battery means for
providing a source of power, charging means for charging the battery
means, enclosure means isolating the battery means from the human body,
gas holding means within the enclosure means for holding gas generated
by the battery means during charging, seal means in the enclosure means
arranged to rapture when the internal gas pressure exceeds a certain
value and inflatable gas container means outside the enclosure means to
receive gas from within the enclosure means when the seal means has
been ruptured."
[0133] Columns 1 through 5 of U.S. Pat. No. 5,702,430 presents
an excellent discussion of "prior art" implantable pump assemblies that
may be used, e.g., to deliver the anti-mitotic compound of this
invention. As is disclosed in such portion of United States patent
5,702,430, "The most widely tested and commonly used implantable blood
pumps employ variable forms of flexible sacks (also spelled sacs) or
diaphragms which are squeezed and released in a cyclical manner to
cause pulsatile ejection of blood. Such pumps are discussed in books or
articles such as Hogness and Antwerp 1991, DeVries et al 1984, and
Farrar et al 1988, and in U.S. Pat. No. 4,994,078 (Jarvik 1991),
4,704,120 (Slonina 1987), 4,936,758 (Coble 1990), and 4,969,864
(Schwarzmann et al 1990). Sack or diaphragm pumps are subject to
fatigue failure of compliant elements and as such are mechanically and
functionally quite different from the pump which is the subject of the
present invention."
[0134] U.S. Pat. No. 5,702,430 also discloses that "An entirely
different class of implantable blood pumps uses rotary pumping
mechanisms. Most rotary pumps can be classified into two categories:
centrifugal pumps and axial pumps. Centrifugal pumps, which include
pumps marketed by Sarns (a subsidiary of the 3M Company) and Biomedicus
(a subsidiary of Medtronic, Eden Prairie, Minn.), direct blood into a
chamber, against a spinning interior wall (which is a smooth disk in
the Medtronic pump). A flow channel is provided so that the centrifugal
force exerted on the blood generates flow."
[0135] U.S. Pat. No. 5,702,430 also discloses that "By
contrast, axial pumps provide blood flow along a cylindrical axis,
which is in a straight (or nearly straight) line with the direction of
the inflow and outflow. Depending on the pumping mechanism used inside
an axial pump, this can in some cases reduce the shearing effects of
the rapid acceleration and deceleration forces generated in centrifugal
pumps. However, the mechanisms used by axial pumps can inflict other
types of stress and damage on blood cells."
[0136] U.S. Pat. No. 5,702,430 also discloses that "Some types
of axial rotary pumps use impeller blades mounted on a center axle,
which is mounted inside a tubular conduit. As the blade assembly spins,
it functions like a fan, or an outboard motor propeller. As used
herein, "impeller" refers to angled vanes (also called blades) which
are constrained inside a flow conduit; an impeller imparts force to a
fluid that flows through the conduit which encloses the impeller. By
contrast, "propeller" usually refers to non-enclosed devices, which
typically are used to propel vehicles such as boats or airplanes."
"Another type of axial blood pump, called the "Haemopump" (sold by
Nimbus) uses a screw-type impeller with a classic screw (also called an
Archimedes screw; also called a helifoil, due to its helical shape and
thin cross-section). Instead of using several relatively small vanes,
the Haemopump screw-type impeller contains a single elongated helix,
comparable to an auger used for drilling or digging holes. In
screw-type axial pumps, the screw spins at very high speed (up to about
10,000 rpm). The entire Haemopump unit is usually less than a
centimeter in diameter. The pump can be passed through a peripheral
artery into the aorta, through the aortic valve, and into the left
ventricle. It is powered by an external motor and drive unit."
[0137] U.S. Pat. No. 5,702,430 also discloses that "Centrifugal
or axial pumps are commonly used in three situations: (1) for brief
support during cardiopulmonary operations, (2) for short-term support
while awaiting recovery of the heart from surgery, or (3) as a bridge
to keep a patient alive while awaiting heart transplantation. However,
rotary pumps generally are not well tolerated for any prolonged period.
Patients who must rely on these units for a substantial length of time
often suffer from strokes, renal (kidney) failure, and other organ
dysfunction. This is due to the fact that rotary devices, which must
operate at relatively high speeds, may impose unacceptably high levels
of turbulent and laminar shear forces on blood cells. These forces can
damage or lyse (break apart) red blood cells. A low blood count
(anemia) may result, and the disgorged contents of lysed blood cells
(which include large quantities of hemoglobin) can cause renal failure
and lead to platelet activation that can cause embolisms and stroke."
[0138] "One of the most important problems in axial rotary
pumps in the prior art involves the gaps that exist between the outer
edges of the blades, and the walls of the flow conduit. These gaps are
the site of severe turbulence and shear stresses, due to two factors.
Since implantable axial pumps operate at very high speed, the outer
edges of the blades move extremely fast and generate high levels of
shear and turbulence. In addition, the gap between the blades and the
wall is usually kept as small as possible to increase pumping
efficiency and to reduce the number of cells that become entrained in
the gap area. This can lead to high-speed compression of blood cells as
they are caught in a narrow gap between the stationary interior wall of
the conduit and the rapidly moving tips or edges of the blades."
[0139] U.S. Pat. No. 5,702,430 also discloses that "An
important factor that needs to be considered in the design and use of
implantable blood pumps is "residual cardiac function," which is
present in the overwhelming majority of patients who would be
candidates for mechanical circulatory assistance. The patient's heart
is still present and still beating, even though, in patients who need
mechanical pumping assistance, its output is not adequate for the
patient's needs. In many patients, residual cardiac functioning often
approaches the level of adequacy required to support the body, as
evidenced by the fact that the patient is still alive when implantation
of an artificial pump must be considered and decided. If cardiac
function drops to a level of severe inadequacy, death quickly becomes
imminent, and the need for immediate intervention to avert death
becomes acute.`"
[0140] U.S. Pat. No. 5,702,430 also discloses that "Most
conventional ventricular assist devices are designed to assume complete
circulatory responsibilities for the ventricle they are "assisting. As
such, there is no need, nor presumably any advantage, for the device to
interact in harmony with the assisted ventricle. Typically, these
devices utilize a "fill-to-empty" mode that, for the most part, results
in emptying of the device in random association with native heart
contraction. This type of interaction between the device and assisted
ventricle ignores the fact that the overwhelming majority of patients
who would be candidates for mechanical assistance have at least some
significant residual cardiac function."
[0141] U.S. Pat. No. 5,702,430 also discloses that "It is
preferable to allow the natural heart, no matter how badly damaged or
diseased it may be, to continue contributing to the required cardiac
output whenever possible so that ventricular hemodynamics are disturbed
as little as possible. This points away from the use of total cardiac
replacements and suggests the use of "assist" devices whenever
possible. However, the use of assist devices also poses a very
difficult problem: in patients suffering from severe heart disease,
temporary or intermittent crises often require artificial pumps to
provide "bridging" support which is sufficient to entirely replace
ventricular pumping capacity for limited periods of time, such as in
the hours or days following a heart attack or cardiac arrest, or during
periods of severe tachycardia or fibrillation."
[0142] U.S. Pat. No. 5,702,430 also discloses that
"Accordingly, an important goal during development of the described
method of pump implantation and use and of the surgically implantable
reciprocating pump was to design a method and a device which could
cover a wide spectrum of requirements by providing two different and
distinct functions. First, an ideal cardiac pumping device should be
able to provide "total" or "complete" pumping support which can keep
the patient alive for brief or even prolonged periods, if the patient's
heart suffers from a period of total failure or severe inadequacy.
Second, in addition to being able to provide total pumping support for
the body during brief periods, the pump should also be able to provide
a limited "assist" function. It should be able to interact with a
beating heart in a cooperative manner, with minimal disruption of the
blood flow generated by the natural heartbeat. If a ventricle is still
functional and able to contribute to cardiac output, as is the case in
the overwhelming majority of clinical applications, then the pump will
assist or augment the residual cardiac output. This allows it to take
advantage of the natural, non-hemolytic pumping action of the heart to
the fullest extent possible; it minimizes red blood cell lysis, it
reduces mechanical stress on the pump, and it allows longer pump life
and longer battery life." "Several types of surgically implantable
blood pumps containing a piston-like member have been developed to
provide a mechanical device for augmenting or even totally replacing
the blood pumping action of a damaged or diseased mammalian heart."
"U.S. Pat. No. 3,842,440 to Karlson discloses an implantable linear
motor prosthetic heart and control system containing a pump having a
piston-like member which is reciprocal within a magnetic field. The
piston-like member includes a compressible chamber in the prosthetic
heart which communicates with the vein or aorta."
[0143] U.S. Pat. No. 5,702,430 also discloses that "U.S. Pat.
Nos. 3,911,897 and 3,911,898 to Leachman, Jr. disclose heart assist
devices controlled in the normal mode of operation to copulsate and
counterpulsate with the heart, respectively, and produce a blood flow
waveform corresponding to the blood flow waveform of the heart being
assisted. The heart assist device is a pump connected serially between
the discharge of a heart ventricle and the vascular system. The pump
may be connected to the aorta between the left ventricle discharge
immediately adjacent the aortic valve and a ligation in the aorta a
short distance from the discharge. This pump has coaxially aligned
cylindrical inlet and discharge pumping chambers of the same diameter
and a reciprocating piston in one chamber fixedly connected with a
reciprocating piston of the other chamber. The piston pump further
includes a passageway leading between the inlet and discharge chambers
and a check valve in the passageway preventing flow from the discharge
chamber into the inlet chamber. There is no flow through the movable
element of the piston."
[0144] U.S. Pat. No. 5,702,430 also discloses that "U.S. Pat.
No. 4,102,610 to Taboada et al. discloses a magnetically operated
constant volume reciprocating pump which can be used as a surgically
implantable heart pump or assist. The reciprocating member is a piston
carrying a tilting-disk type check valve positioned in a cylinder.
While a tilting disk valve results in less turbulence and applied shear
to surrounding fluid than a squeezed flexible sack or rotating
impeller, the shear applied may still be sufficiently excessive so as
to cause damage to red blood cells."
[0145] U.S. Pat. No. 5,702,430 also discloses that "U.S. Pat.
Nos. 4,210,409 and 4,375,941 to Child disclose a pump used to assist
pumping action of the heart having a piston movable in a cylindrical
casing in response to magnetic forces. A tilting-disk type check valve
carried by the piston provides for flow of fluid into the cylindrical
casing and restricts reverse flow. A plurality of longitudinal vanes
integral with the inner wall of the cylindrical casing allow for
limited reverse movement of blood around the piston which may result in
compression and additional shearing of red blood cells. A second fixed
valve is present in the inlet of the valve to prevent reversal of flow
during piston reversal."
[0146] U.S. Pat. No. 5,702,430 also discloses that "U.S. Pat.
No. 4,965,864 to Roth discloses a linear motor using multiple coils and
a reciprocating element containing permanent magnets which is driven by
microprocessor-controlled power semiconductors. A plurality of
permanent magnets is mounted on the reciprocating member. This design
does not provide for self-synchronization of the linear motor in the
event the stroke of the linear motor is greater than twice the pole
pitch on the reciprocating element. During start-up of the motor, or if
magnetic coupling is lost, the reciprocating element may slip from its
synchronous position by any multiple of two times the pole pitch. As a
result, a sensing arrangement must be included in the design to detect
the position of the piston so that the controller will not drive it
into one end of the closed cylinder. In addition, this design having
equal pole pitch and slot pitch results in a "jumpy" motion of the
reciprocating element along its stroke."
[0147] U.S. Pat. No. 5,702,430 also discloses that "In addition
to the piston position sensing arrangement discussed above, the Roth
design may also include a temperature sensor and a pressure sensor as
well as control circuitry responsive to the sensors to produce the
intended piston motion. For applications such as implantable blood
pumps where replacement of failed or malfunctioning sensors requires
open heart surgery, it is unacceptable to have a linear motor drive and
controller that relies on any such sensors. In addition, the Roth
controller circuit uses only NPN transistors thereby restricting
current flow to the motor windings to one direction only.`
[0148] `U.S. Pat. No. 4,541,787 to Delong describes a pump
configuration wherein a piston containing a permanent magnet is driven
in a reciprocating fashion along the length of a cylinder by energizing
a sequence of coils positioned around the outside of the cylinder.
However, the coil and control system configurations disclosed only
allow current to flow through one individual winding at a time. This
does not make effective use of the magnetic flux produced by each pole
of the magnet in the piston. To maximize force applied to the piston in
a given direction, current must flow in one direction in the coils
surrounding the vicinity of the north pole of the permanent magnet
while current flows in the opposite direction in the coils surrounding
the vicinity of the south pole of the permanent magnet. Further, during
starting of the pump disclosed by Delong, if the magnetic piston is not
in the vicinity of the first coil energized, the sequence of coils that
are subsequently energized will ultimately approach and repel the
magnetic piston toward one end of the closed cylinder. Consequently,
the piston must be driven into the end of the closed cylinder before
the magnetic poles created by the external coils can become coupled
with the poles of the magnetic piston in attraction."
[0149] U.S. Pat. No. 5,702,430 also discloses that "U.S. Pat.
No. 4,610,658 to Buchwald et al. discloses an implantable fluid
displacement peritoneovenous shunt system. The system comprises a
magnetically driven pump having a spool piston fitted with a disc flap
valve."
[0150] U.S. Pat. No. 5,702,430 also discloses that "U.S. Pat.
No. 5,089,017 to Young et al. discloses a drive system for artificial
hearts and left ventricular assist devices comprising one or more
implantable pumps driven by external electromagnets. The pump utilizes
working fluid, such as sulfur hexafluoride to apply pneumatic pressure
to increase blood pressure and flow rate."
[0151] U.S. Pat. No. 5,743,854 discloses a device for inducing
and localizing epileptiform activity that is comprised of a direct
current (DC) magnetic field generator, a DC power source, and sensors
adapted to be coupled to a patient's head; this direct current magnetic
field generator may be used in conjunction with the anti-mitotic
compound of this invention and/or an auxiliary device and/or tubulin
and/or microtubules. In one embodiment of the invention, described in
claim 7, the sensors " . . . comprise Foramen Ovale electrodes adapted
to be implanted to sense evoked and natural epileptic firings."
[0152] U.S. Pat. No. 5,803,897discloses a penile prosthesis
system comprised of an implantable pressurized chamber, a reservoir, a
rotary pump, a magnetically responsive rotor, and a rotary magnetic
field generator. Claim 1 of this patent describes: "A penile prosthesis
system comprising: at least one pressurizable chamber including a fluid
port, said chamber adapted to be located within the penis of a patient
for tending to make the penis rigid in response to fluid pressure
within said chamber; a fluid reservoir; a rotary pump adapted to be
implanted within the body of a user, said rotary pump being coupled to
said reservoir and to said chamber, said rotary pump including a
magnetically responsive rotor adapted for rotation in the presence of a
rotating magnetic field, and an impeller for tending to pump fluid at
least from said reservoir to said chamber under the impetus of fluid
pressure, to thereby pressurize said chamber in response to operation
of said pump; and a rotary magnetic field generator for generating a
rotating magnetic field, for, when placed adjacent to the skin of said
user at a location near said rotary pump, rotating said magnetically
responsive rotor in response to said rotating magnetic field, to
thereby tend to pressurize said chamber and to render the penis rigid;
controllable valve means operable in response to motion of said rotor
of said rotary pump, for tending to prevent depressurization of said
chamber when said rotating magnetic field no longer acts on said rotor,
said controllable valve means comprising a unidirectional check valve
located in the fluid path extending between said rotary pump and said
port of said chamber." Such fluid pumping means may be used to
facilitate the delivery of the anti-mitotic compound of this invention.
[0153] U.S. Pat. No. 5,810,015 describes an implantable power
supply that can convert non-electrical energy (such as mechanical,
chemical, thermal, or nuclear energy) into electrical energy; the
entire disclosure of this United States patent is hereby incorporated
by reference into this specification. This power supply may be used to
supply energy to the anti-mitotic compound of this invention and/or to
tubulin and/or to microtubules.
[0154] In column 1 of U.S. Pat. No. 5,810,015, a discussion of
"prior art" rechargeable power supplies is presented. It is disclosed
in this column 1 that: "Modern medical science employs numerous
electrically powered devices which are implanted in a living body. For
example, such devices may be employed to deliver medications, to
support blood circulation as in a cardiac pacemaker or artificial
heart, and the like. Many implantable devices contain batteries which
may be rechargeable by transcutaneous induction of electromagnetic
fields in implanted coils connected to the batteries. Transcutaneous
inductive recharging of batteries in implanted devices is disclosed for
example in U.S. Pat. Nos. 3,923,060; 4,082,097; 4,143,661; 4,665,896;
5,279,292; 5,314,453; 5,372,605, and many others."
[0155] U.S. Pat. No. 5,810,015 also discloses that: "Other
methods for recharging implanted batteries have also been attempted.
For example, U.S. Pat. No. 4,432,363 discloses use of light or heat to
power a solar battery within an implanted device. U.S. Pat. No.
4,661,107 discloses recharging of a pacemaker battery using mechanical
energy created by motion of an implanted heart valve." These "other
methods" may also be used in the process of this invention.
[0156] U.S. Pat. No. 5,810,015 also discloses that: "A number
of implanted devices have been powered without batteries. U.S. Pat.
Nos. 3,486,506 and 3,554,199 disclose generation of electric pulses in
an implanted device by movement of a rotor in response to the patient's
heartbeat. U.S. Pat. No. 3,563,245 discloses a miniaturized power
supply unit which employs mechanical energy of heart muscle
contractions to generate electrical energy for a pacemaker. U.S. Pat.
No. 3,456,134 discloses a piezoelectric converter for electronic
implants in which a piezoelectric crystal is in the form of a weighted
cantilever beam capable of responding to body movement to generate
electric pulses. U.S. Pat. No. 3,659,615 also discloses a piezoelectric
converter which reacts to muscular movement in the area of
implantation. U.S. Pat. No. 4,453,537 discloses a pressure actuated
artificial heart powered by a second implanted device attached to a
body muscle which in turn is stimulated by an electric signal generated
by a pacemaker." These "other devices" may also be used in the process
of this invention.
[0157] U.S. Pat. No. 5,810,015 also discloses that: "In spite
of all these efforts, a need remains for efficient generation of energy
to supply electrically powered implanted devices." The solution
provided by U.S. Pat. No. 5,80,015 is described in claim 1 thereof,
which describes: "An implantable power supply apparatus for supplying
electrical energy to an electrically powered device, comprising: a
power supply unit including: a transcutaneously, invasively
rechargeable non-electrical energy storage device (NESD); an electrical
energy storage device (EESD); and an energy converter coupling said
NESD and said EESD, said converter including means for converting
non-electrical energy stored in said NESD to electrical energy and for
transferring said electrical energy to said EESD, thereby storing said
electrical energy in said EESD." An implantable ultrasound communicaton
system is disclosed in U.S. Pat. No. 5,861,018, the entire disclosure
of which is hereby incorporated by reference into this specification.
As is disclosed in the abstract of this patent, there is disclosed in
such patent "A system for communicating through the skin of a patient,
the system including an internal communication device implanted inside
the body of a patient and an external communication device. The
external communication device includes an external transmitter which
transmits a carrier signal into the body of the patient during
communication from the internal communication device to the external
communication device. The internal communication device includes an
internal modulator which modulates the carrier signal with information
by selectively reflecting the carrier signal or not reflecting the
carrier signal. The external communication device demodulates the
carrier signal by detecting when the carrier signal is reflected and
when the carrier signal is not reflected through the skin of the
patient. When the reflected carrier signal is detected, it is
interpreted as data of a first state, and when the reelected carrier
signal is not detected, it is interpreted as data of a second state.
Accordingly, the internal communication device consumes relatively
little power because the carrier signal used to carry the information
is derived from the external communication device. Further, transfer of
data is also very efficient because the period needed to modulate
information of either the first state or the second state onto the
carrier signal is the same. In one embodiment, the carrier signal
operates in the ultrasound frequency range."
[0158] U.S. Pat. No. 5,861,019, the entire disclosure of which
is hereby incorporated by reference into this specification, discloses
a telemetry system for communications between an external programmer
and an implantable medical device. Claim 1 of this patent describes: "A
telemetry system for communications between an external programmer and
an implantable medical device, comprising: the external programmer
comprising an external telemetry antenna and an external transceiver
for receiving uplink telemetry transmissions and transmitting downlink
telemetry transmission through the external telemetry antenna; the
implantable medical device comprising an implantable medical device
housing, an implantable telemetry antenna and an implantable
transceiver for receiving downlink transmissions and for transmitting
uplink telemetry transmission through the implantable telemetry
antenna, the implantable medical device housing being formed of a
conductive metal and having an exterior housing surface and an interior
housing surface; the implantable medical device housing being formed
with a housing recess extending inwardly from the exterior housing
surface to a predetermined housing recess depth in the predetermined
substrate area of the exterior housing surface for receiving the
dielectric substrate therein; wherein the implantable telemetry antenna
is a conformal microstrip antenna formed as part of the implantable
medical device housing, the microstrip antenna having electrically
conductive ground plane and radiator patch layers separated by a
dielectric substrate, layer the conductive radiator patch layer having
a predetermined thickness and predetermined radiator patch layer
dimensions, the patch layer being formed upon one side of the
dielectric substrate layer."
[0159] "An extensive description of the historical development
of uplink and downlink telemetry transmission formats" is set forth at
columns 2 through 5 of U.S. Pat. No. 5,861,019; such telemetry
transmission formats may be used in conjunction with the anti-mitotic
compound of this invention. As is disclosed in these columns: "An
extensive description of the historical development of uplink and
downlink telemetry transmission formats and is set forth in the
above-referenced '851 and '963 applications and in the following series
of commonly assigned patents all of which are incorporated herein by
reference in their entireties. Commonly assigned U.S. Pat. No.
5,127,404 to Grevious et al. sets forth an improved method of frame
based, pulse position modulated (PPM) of data particularly for uplink
telemetry. The frame-based PPM telemetry format increases bandwidth
well above simple PIM or pulse width modulation (PWM) binary bit stream
transmissions and thereby conserves energy of the implanted medical
device. Commonly assigned U.S. Pat. No. 5,168,871 to Grevious et al.
sets forth an improvement in the telemetry system of the '404 patent
for detecting uplink telemetry RF pulse bursts that are corrupted in a
noisy environment. Commonly assigned U.S. Pat. No. 5,292,343 to
Blanchette et al. sets forth a further improvement in the telemetry
system of the '404 patent employing a hand shake protocol for
maintaining the communications link between the external programmer and
the implanted medical device despite instability in holding the
programmer RF head steady during the transmission. Commonly assigned
U.S. Pat. No. 5,324,315 to Grevious sets forth an improvement in the
uplink telemetry system of the '404 patent for providing feedback to
the programmer to aid in optimally positioning the programmer RF head
over the implanted medical device. Commonly assigned U.S. Pat. No.
5,117,825 to Grevious sets forth an further improvement in the
programmer RF head for regulating the output level of the magnetic H
field of the RF head telemetry antenna using a signal induced in a
sense coil in a feedback loop to control gain of an amplifier driving
the RF head telemetry antenna. Commonly assigned U.S. Pat. No.
5,562,714 to Grevious sets forth a further solution to the regulation
of the output level of the magnetic H field generated by the RF head
telemetry antenna using the sense coil current to directly load the H
field. Commonly assigned U.S. Pat. No. 5,354,319 to Wybomey et al. sets
forth a number of further improvements in the frame based telemetry
system of the '404 patent. Many of these improvements are incorporated
into MEDTRONIC.RTM. Model 9760, 9766 and 9790 programmers. These
improvements and the improvements described in the above-referenced
pending patent applications are directed in general to increasing the
data transmission rate, decreasing current consumption of the battery
power source of the implantable medical device, and increasing
reliability of uplink and downlink telemetry transmissions."
[0160] U.S. Pat. No. 5,810,015 also discloses that: "The
current MEDTRONIC.RTM. telemetry system employing the 175 kHz carrier
frequency limits the upper data transfer rate, depending on bandwidth
and the prevailing signal-to-noise ratio. Using a ferrite core, wire
coil, RF telemetry antenna results in: (1) a very low radiation
efficiency because of feed impedance mismatch and ohmic losses; 2) a
radiation intensity attenuated proportionally to at least the fourth
power of distance (in contrast to other radiation systems which have
radiation intensity attenuated proportionally to square of distance);
and 3) good noise immunity because of the required close distance
between and coupling of the receiver and transmitter RF telemetry
antenna fields."
[0161] U.S. Pat. No. 5,810,015 also discloses that "These
characteristics require that the implantable medical device be
implanted just under the patient's skin and preferably oriented with
the RF telemetry antenna closest to the patient's skin. To ensure that
the data transfer is reliable, it is necessary for the patient to
remain still and for the medical professional to steadily hold the RF
programmer head against the patient's skin over the implanted medical
device for the duration of the transmission. If the telemetry
transmission takes a relatively long number of seconds, there is a
chance that the programmer head will not be held steady. If the uplink
telemetry transmission link is interrupted by a gross movement, it is
necessary to restart and repeat the uplink telemetry transmission. Many
of the above-incorporated, commonly assigned, patents address these
problems."
[0162] U.S. Pat. No. 5,810,015 also discloses that "The ferrite
core, wire coil, RF telemetry antenna is not bio-compatible, and
therefore it must be placed inside the medical device hermetically
sealed housing. The typically conductive medical device housing
adversely attenuates the radiated RF field and limits the data transfer
distance between the programmer head and the implanted medical device
RF telemetry antennas to a few inches."
[0163] U.S. Pat. No. 5,810,015 also discloses that "In U.S.
Pat. Nos. 4,785,827 to Fischer, 4,991,582 to Byers et al., and commonly
assigned 5,470,345 to Hassler et al. (all incorporated herein by
reference in their entireties), the metal can typically used as the
hermetically sealed housing of the implantable medical device is
replaced by a hermetically sealed ceramic container. The wire coil
antenna is still placed inside the container, but the magnetic H field
is less attenuated. It is still necessary to maintain the implanted
medical device and the external programming head in relatively close
proximity to ensure that the H field coupling is maintained between the
respective RF telemetry antennas."
[0164] U.S. Pat. No. 5,810,015 also discloses that: "Attempts
have been made to replace the ferrite core, wire coil, RF telemetry
antenna in the implantable medical device with an antenna that can be
located outside the hermetically sealed enclosure. For example, a
relatively large air core RF telemetry antenna has been embedded into
the thermoplastic header material of the MEDTRONIC.RTM. Prometheus
programmable IPG. It is also suggested that the RF telemetry antenna
may be located in the IPG header in U.S. Pat. No. 5,342,408. The header
area and volume is relatively limited, and body fluid may infiltrate
the header material and the RF telemetry antenna."
[0165] U.S. Pat. No. 5,810,015 also discloses that: "In U.S.
Pat. Nos. 5,058,581 and 5,562,713 to Silvian, incorporated herein by
reference in their entireties, it is proposed that the elongated wire
conductor of one or more medical lead extending away from the implanted
medical device be employed as an RF telemetry antenna. In the
particular examples, the medical lead is a cardiac lead particularly
used to deliver energy to the heart generated by a pulse generator
circuit and to conduct electrical heart signals to a sense amplifier. A
modest increase in the data transmission rate to about 8 Kb/s is
alleged in the '581 and '713 patents using an RF frequency of 10-300
MHz. In these cases, the conductor wire of the medical lead can operate
as a far field radiator to a more remotely located programmer RF
telemetry antenna. Consequently, it is not necessary to maintain a
close spacing between the programmer RF telemetry antenna and the
implanted cardiac lead antenna or for the patient to stay as still as
possible during the telemetry transmission."
[0166] U.S. Pat. No. 5,810,015 also discloses that: "However,
using the medical lead conductor as the RF telemetry antenna has
several disadvantages. The radiating field is maintained by current
flowing in the lead conductor, and the use of the medical lead
conductor during the RF telemetry transmission may conflict with
sensing and stimulation operations. RF radiation losses are high
because the human body medium is lossy at higher RF frequencies. The
elongated lead wire RF telemetry antenna has directional radiation
nulls that depend on the direction that the medical lead extends, which
varies from patient to patient. These considerations both contribute to
the requirement that uplink telemetry transmission energy be set
artificially high to ensure that the radiated RF energy during the RF
uplink telemetry can be detected at the programmer RF telemetry
antenna. Moreover, not all implantable medical devices have lead
conductor wires extending from the device."
[0167] U.S. Pat. No. 5,810,015 also discloses that: "A further
U.S. Pat. No. 4,681,111 to Silvian, incorporated herein by reference in
its entirety, suggests the use of a stub antenna associated with the
header as the implantable medical device RF telemetry antenna for high
carrier frequencies of up to 200 MHz and employing phase shift keying
(PSK) modulation. The elimination of the need for a VCO and a bit rate
on the order of 2-5% of the carrier frequency or 3.3-10 times the
conventional bit rate are alleged."
[0168] U.S. Pat. No. 5,810,015 also discloses that: "At
present, a wide variety of implanted medical devices are commercially
released or proposed for clinical implantation. Such medical devices
include implantable cardiac pacemakers as well as implantable
cardioverter-defibrillators, pacemaker-cardioverter-defibrillators,
drug delivery pumps, cardiomyostimulators, cardiac and other
physiologic monitors, nerve and muscle stimulators, deep brain
stimulators, cochlear implants, artificial hearts, etc. As the
technology advances, implantable medical devices become ever more
complex in possible programmable operating modes, menus of available
operating parameters, and capabilities of monitoring increasing
varieties of physiologic conditions and electrical signals which place
ever increasing demands on the programming system."
[0169] U.S. Pat. No. 5,810,015 also discloses that: "It remains
desirable to minimize the time spent in uplink telemetry and downlink
transmissions both to reduce the likelihood that the telemetry link may
be broken and to reduce current consumption." "Moreover, it is
desirable to eliminate the need to hold the programmer RF telemetry
antenna still and in proximity with the implantable medical device RF
telemetry antenna for the duration of the telemetry transmission. As
will become apparent from the following, the present invention
satisfies these needs."
[0170] The solution to this problem is presented, e.g., in
claim 1 of U.S. Pat. No. 5,861,019. This claim describes "A telemetry
system for communications between an external programmer and an
implantable medical device, comprising: the external programmer
comprising an external telemetry antenna and an external transceiver
for receiving uplink telemetry transmissions and transmitting downlink
telemetry transmission through the external telemetry antenna; the
implantable medical device comprising an implantable medical device
housing, an implantable telemetry antenna and an implantable
transceiver for receiving downlink transmissions and for transmitting
uplink telemetry transmission through the implantable telemetry
antenna, the implantable medical device housing being formed of a
conductive metal and having an exterior housing surface and an interior
housing surface; the implantable medical device housing being formed
with a housing recess extending inwardly from the exterior housing
surface to a predetermined housing recess depth in the predetermined
substrate area of the exterior housing surface for receiving the
dielectric substrate therein; wherein the implantable telemetry antenna
is a conformal microstrip antenna formed as part of the implantable
medical device housing, the microstrip antenna having electrically
conductive ground plane and radiator patch layers separated by a
dielectric substrate, layer the conductive radiator patch layer having
a predetermined thickness and predetermined radiator patch layer
dimensions, the patch layer being formed upon one side of the
dielectric substrate layer."
[0171] U.S. Pat. No. 5,945,762, the entire disclosure of which
is hereby incorporated by reference into this specification, discloses
an external transmitter adapted to magnetically excite an implanted
receiver coil; such an implanted receiver coil may be disposed near,
e.g., the anti-mitotic compound of this invention and/or other devices
and/or tubulin and/or microtubules. Claim 1 of this patent describes
"An external transmitter adapted for magnetically exciting an implanted
receiver coil, causing an electrical current to flow in the implanted
receiver coil, comprising: (a) a support; (b) a magnetic field
generator that is mounted to the support; and (c) a prime mover that is
drivingly coupled to an element of the magnetic field generator to
cause said element of the magnetic field generator to reciprocate, in a
reciprocal motion, said reciprocal motion of said element of the
magnetic field generator producing a varying magnetic field that is
adapted to induce an electrical current to flow in the implanted
receiver coil."
[0172] U.S. Pat. No. 5,954,758, the entire disclosure of which
is hereby incorporated by reference into this specification, claims an
implantable electrical stimulator comprised of an implantable radio
frequency receiving coil, an implantable power supply, an implantable
input signal generator, an implantable decoder, and an implantable
electrical stimulator. Claim 1 of this patent describes "A system for
transcutaneously telemetering position signals out of a human body and
for controlling a functional electrical stimulator implanted in said
human body, said system comprising: an implantable radio frequency
receiving coil for receiving a transcutaneous radio frequency signal;
an implantable power supply connected to said radio frequency receiving
coil, said power supply converting received transcutaneous radio
frequency signals into electromotive power; an implantable input signal
generator electrically powered by said implantable power supply for
generating at least one analog input movement signal to indicate
voluntary bodily movement along an axis; an implantable encoder having
an input operatively connected with said implantable input signal
generator for encoding said movement signal into output data in a
preselected data format; an impedance altering means connected with
said encoder and said implantable radio frequency signal receiving coil
to selectively change an impedance of said implantable radio frequency
signal receiving coil; an external radio frequency signal transmit coil
inductively coupled with said implantable radio frequency signal
receiving coil, such that impedance changes in said implantable radio
frequency signal receiving coil are sensed by said external radio
frequency signal transmit coil to establish a sensed modulated movement
signal in said external transmit coil; an external control system
electrically connected to said external radio frequency transmit coil
for monitoring said sensed modulated movement signal in said external
radio frequency transmit coil, said external control system including:
a demodulator for recovering the output data of said encoder from the
sensed modulated ovement signal of said external transmit coil, a pulse
width algorithm means for applying a preselected pulse width algorithm
to the recovered output data to derive a first pulse width, an
amplitude algorithm means for applying an amplitude algorithm to the
recovered output data to derive a first amplitude therefrom, an
interpulse interval algorithm means for applying an interpulse
algorithm to the recovered output data to derive a first interpulse
interval therefrom; and, a stimulation pulse train signal generator for
generating a stimulus pulse train signal which has the first pulse
width and the first pulse amplitude; an implantable functional
electrical stimulator for receiving said stimulation pulse train signal
from said stimulation pulse train signal generator and generating
stimulation pulses with the first pulse width, the first pulse
amplitude, and separated by the first interpulse interval; and, at
least one electrode operatively connected with the functional
electrical stimulator for applying said stimulation pulses to muscle
tissue of said human body."
[0173] U.S. Pat. No. 6,006,133, the entire disclosure of which
is hereby incorporated by reference into this specification, describes
an implantable medical device comprised of a hermetically sealed
housing." Such a hermetically sealed housing may be used to contain,
e.g., the anti-mitotic compound of this invention.
[0174] U.S. Pat. No. 6,083,166, the entire disclosure of which
is hereby incorporated by reference into this specification, discloses
an ultrasound transmitter for use with a surgical device. This
ultrasound transmitter may be used, e.g., to affect the anti-mitotic
compound of this invention and/or tubulin and/or microtubules.
[0175] U.S. Pat. No. 6,152,882, the entire disclosure of which
is hereby incorporated by reference into this specification, discloses
an implantable electroporation unit, an implantable proble electrode,
an implantable reference electrode, and an an amplifier unit; this
electroporation unit may be used to treat, e.g., cancer cells in
conjunction with the anti-mitotic compound of this invention. Claim 35
of this patent describes: "Apparatus for measurement of monophasic
action potentials from an excitable tissue including a plurality of
cells, the apparatus comprising: at least one probe electrode placeable
adjacent to or in contact with a portion of said excitable tissue; at
least one reference electrode placeable proximate said at least one
probe electrode; an electroporating unit electrically connected to said
at least one probe electrode and said at least one reference electrode
for controllably applying to at least some of said cells subjacent said
at least one probe electrode electrical current pulses suitable for
causing electroporation of cell membranes of said at least some of said
cells; and an amplifier unit electrically connected to said at least
one probe electrode and to said at least one reference electrode for
providing an output signal representing the potential difference
between said probe electrode and said reference electrode."
[0176] U.S. Pat. No. 6,169,925, the entire disclosure of which
is hereby incorporated by reference into this specification, describes
a transceiver for use in communication with an implantable medical
device. Claim 1 of this patent describes: "An external device for use
in communication with an implantable medical device, comprising: a
device controller; a housing; an antenna array mounted to the housing;
an RF transceiver operating at defined frequency, coupled to the
antenna array; means for encoding signals to be transmitted to the
implantable device, coupled to an input of the transceiver; means for
decoding signals received from the implantable device, coupled to an
output of the transceiver; and means for displaying the decoded signals
received from the implantable device; wherein the antenna array
comprises two antennas spaced a fraction of the wavelength of the
defined frequency from one another, each antenna comprising two antenna
elements mounted to the housing and located orthogonal to one another;
and wherein the device controller includes means for selecting which of
the two antennas is coupled to the transceiver." Such a transceiver, in
combination with an implantable sensor, may be used in conjunction with
the anti-mitotic compound of this invention and/or tubulin and/or
microtubules and/or one or more other implanted devices.
[0177] U.S. Pat. No. 6,185,452, the entire disclosure of which
is hereby incorporated by reference into this specification, claims a
device for stimulating internal tissue, wherein such device is
comprised of: "a sealed elongate housing configured for implantation in
said patient's body, said housing having an axial dimension of less
than 60 mm and a lateral dimension of less than 6 mm; power consuming
circuitry carried by said housing including at least one electrode
extending externally of said housing, said power consuming circuitry
including a capacitor and pulse control circuitry for controlling (1)
the charging of said capacitor and (2) the discharging of said
capacitor to produce a current pulse through said electrode; a battery
disposed in said housing electrically connected to said power consuming
circuitry for powering said pulse control circuitry and charging said
capacitor, said battery having a capacity of at least one
microwatt-hour; an internal coil and a charging circuit disposed in
said housing for supplying a charging current to said battery; an
external coil adapted to be mounted outside of said patient's body; and
means for energizing said external coil to generate an alternating
magnetic field for supplying energy to said charging circuit via said
internal coil." Such capacitative discharge energy may be used to
affect either the anti-mitotic compound of this invention and/or
tubulin and/or microtubules.
[0178] U.S. Pat. No. 6,235,024, the entire disclosure of which
is hereby incorporated by reference into this specification, discloses
an implantable high frequency energy generator; such high-frequency
energy may be used to affect either the anti-mitotic compound of this
invention, tubulin, microtubules, and/or one or more other implanted
devices. Claim 1 of this patent describes: "A catheter system
comprising: an elongate catheter tubing having a distal section, a
distal end, a proximal end, and at least one lumen extending between
the distal end and the proximal end; a handle attached to the proximal
end of said elongate catheter tubing, wherein the handle has a cavity;
an ablation element mounted at the distal section of the elongate
catheter tubing, the ablation element having a wall with an outer
surface and an inner surface, wherein the outer surface is covered with
an outer member made of a first electrically conductive material and
the inner surface is covered with an inner member made of a second
electrically conductive material, and wherein the wall comprises an
ultrasound transducer; an electrical conducting means having a first
and a second electrical wires, wherein the first electrical wire is
coupled to the outer member and the second electrical wire is coupled
to the inner member of the ablation element; and a high frequency
energy generator means for providing a radiofrequency energy to the
ablation element through a first electrical wire of the electrical
conducting means."
[0179] An implantable light-generating apparatus is described
in claim 16 of U.S. Pat. No. 6,363,279, the entire disclosure of which
is hereby incorporated by reference into this specification. In one
embodiment, the compound of this invention is comprised of a photolytic
linker which is caused to disassociate upon being exposed to specified
light energy. As is disclosed in such claim 16, this patent provides a
"Heart control apparatus, comprising circuitry for generating a
non-excitatory stimulus, and stimulus application devices for applying
to a heart or to a portion thereof said non-excitatory stimulus,
wherein the circuitry for generating a non-excitatory stimulus
generates a stimulus which is unable to generate a propagating action
potential and wherein said circuitry comprises a light-generating
apparatus for generating light."
[0180] An implantable ultrasound probe is described in claim 1
of U.S. Pat. No. 6,421,565, the entire disclosure of which is hereby
incorporated by reference into this specification. Such ultrasound may
be used, e.g., to treat the microtubules of cancer cells; and this
treatment may be combined, e.g., with the anti-mitotic compounds of
this invention.
[0181] Claim 1 of U.S. Pat. No. 6,421,565 describes: "An
implantable cardiac monitoring device comprising: an A-mode ultrasound
probe adapted for implantation in a right ventricle of a heart, said
ultrasound probe emitting an ultrasound signal and receiving at least
one echo of said ultrasound signal from at least one cardiac segment of
the left ventricle; a unit connected to said ultrasound probe for
identifying a time difference between emission of said ultrasound
signal and reception of said echo and, from said time difference,
determining a position of said cardiac segment, said cardiac segment
having a position which, at least when reflecting said ultrasound
signal, is correlated to cardiac performance, and said unit deriving an
indication of said cardiac performance from said position of said
cardiac segment."
[0182] An implantable stent that contains a tube and several
optical emitters located on the inner surface of the tube is disclosed
in U.S. Pat. No. 6,488,704, the entire disclosure of which is hereby
incorporated by reference into this specification. One may use one or
more of the implantable devices described in U.S. Pat. No. 6,488,704
together with the anti-mitotic compound of this invention and/or
tubulin and/or microtubules and/or another in vivo device.
[0183] Claim 1 of U.S. Pat. No. 6,488,704 describes "1. An
implantable stent which comprises: (a) a tube comprising an inner
surface and an outer surface, and (b) a multiplicity of optical
radiation emitting means adapted to emit radiation with a wavelength
from about 30 nanometers to about 30 millimeters, and a multiplicity of
optical radiation detecting means adapted to detect radiation with a
wavelength of from about 30 nanometers to about 30 millimeters, wherein
said optical radiation emitting means and said optical radiation
detecting means are disposed on the inside surface of said tube."
[0184] Many other implantable devices and configurations are
described in the claims of U.S. Pat. No. 6,488,704. These devices and
configurations may be used in conjunction with the anti-mitotic
compound of this invention, and/or tubulin, and/or microtubules, and/or
other auxiliary, implanted deivce.
[0185] Thus, e.g., claim 2 of U.S. Pat. No. 6,488,704 discloses
that the " . . . implantable stent is comprised of a flexible casing
with an inner surface and an outer surface." Claim 3 of such patent
discloses that the case may be " . . . comprised of fluoropolymer."
Claim 4 of such patent discloses that the casing may be " . . .
optically impermeable."
[0186] Thus, e.g., claim 10 of U.S. Pat. No. 6,488,704
discloses an embodiment in which an implantable stent contains " . . .
telemetry means for transmitting a signal to a receiver located
external to said implantable stent." The telemetry means may be adapted
to receive " . . . a signal from a transmitter located external to said
implantable stent (see claim 11); and such signal may be a
radio-frequency signal (see claims 12 and 13). The implantable stent
may also comprise " . . . telemetry means for transmitting a signal to
a receiver located external to said implantable stent"(see claim 22),
and/or " . . . telemetry means for receiving a signal from a
transmitter located external to said implantable stent" (see claim 23),
and/or " . . . a controller operatively connected to said means for
transmitting a signal to said receiver, and operatively connected to
said means for receiving a signal from said transmitter" (see claim
24).
[0187] Thus, e.g., claim 14 of U.S. Pat. No. 6,488,704
describes an implantable stent that contains a waveguide array. The
waveguide array may contain " . . . a flexible optical waveguide
device" (see claim 15), and/or " . . . means for transmitting optical
energy in a specified configuration" (see claim 16), and/or " . . . a
waveguide interface for receiving said optical energy transmitted in
said specified configuration by said waveguide array" (see claim 17),
and/or " . . . means for filtering specified optical frequencies" (see
claim 18). The implantable stent may be comprised of " . . . means for
receiving optical energy from said waveguide array" (see claim 19),
and/or " . . . means for processing said optical energy received from
waveguide array" (see claim 20). The implantable stent may comprise " .
. . means for processing said radiation emitted by said optical
radiation emitting means adapted with a wavelength from about 30
nanometers to about 30 millimeters" (see claim 21).
[0188] The implantable stent of U.S. Pat. No. 6,488,404 may be
comprised of implantable laser devices. Thus, e.g., and referring again
to U.S. Pat. No. 6,488,704, the implantable stent may be comprised of "
. . . a multiplicity of vertical cavity surface emitting lasers and
photodetectors arranged in a monolithic configuration" (see claim 27),
wherein " . . . said monolithic configuration further comprises a
multiplicity of optical drivers operatively connected to said vertical
cavity surface emitting lasers" (see claim 28) and/or wherein " . . .
said vertical cavity surface emitting lasers each comprise a
multiplicity of distributed Bragg reflector layers" (see claim 29),
and/or wherein " . . . each of said photodetectors comprises a
multiplicity of distributed Bragg reflector layers" (see claim 30),
and/or wherein " . . . each of said vertical cavity surface emitting
lasers is comprised of an emission layer disposed between a first
distributed Bragg reflector layer and a second distributed Bragg
reflector layer" (see claim 31), and/or wherein " . . . said emission
layer is comprised of a multiplicity of quantum well structures" (see
claim 32), and/or wherein " . . . each of said photodetectors is
comprised of an absorption layer disposed between a first distributed
Bragg reflector layer and a second distributed Bragg reflector layer"
(see claim 33), and/or wherein " . . . each of said vertical cavity
surface emitting lasers and photodetectors is disposed on a separate
semiconductor substrate" (see claim 34), and/or wherein " . . . said
semiconductor substrate comprises gallium arsenide." These devices may
advantageously be used in the process of this invention.
[0189] Referring again to U.S. Pat. No. 6,488,704, the entire
disclosure of which is hereby incorporated by reference into this
specification, the implantable stent may be comprised of an arithmetic
unit (see claim 37 of such patent), and such arithmetic unit may be " .
. . comprised of means for receiving signals from said optical
radiation detecting means" (see claim 38), and/or " . . . means for
calculating the concentration of components in an analyte disposed
within said implantable stent (see claim 39). In one embodiment, "said
means for calculating the concentration of components in said analyte
calculates concentrations of said components in said analyte based upon
optimum optical path lengths for different wavelengths and values of
transmitted light (see claim 40).
[0190] Referring again to U.S. Pat. No. 6,488,704, the
implantable stent may contain a power supply (see claim 41 thereof)
which may contain a battery (see claim 42) which, in one embodiment, is
a lithium-iodine battery (see claim 43).
[0191] U.S. Pat. No. 6,585,763, the entire disclosure of which
is hereby incorporated by reference into this specification, describes
in its claim 1 " . . . a vascular graft comprising: a biocompatible
material formed into a shape having a longitudinal axis to enclose a
lumen disposed along said longitudinal axis of said shape, said lumen
positioned to convey fluid through said vascular graft; a first
transducer coupled to a wall of said vascular graft; and an implantable
circuit for receiving electromagnetic signals, said implantable circuit
coupled to said first transducer, said first transducer configured to
receive a first energy from said circuit to emit a second energy having
one or more frequencies and power levels to alter said biological
activity of said medication in said localized area of said body
subsequent to implantation of said first transducer in said body near
said localized area." One may use the means for " . . . altering said
biological activity of said medication . . . " in the process of this
invention. The transducer may be selected from the group consisting of
" . . . an ultrasonic transducer, a plurality of light sources, an
electric field transducer, an electromagnetic transducer, and a
resistive heating transducer" (see claim 2), it may comprise a coil
(see claim 3), it may comprise " . . . a regular solid including
piezoelectric material, and wherein a first resonance frequency, being
of said one or more frequencies, is determined by a first dimension of
said regular solid and a second resonance frequency, being of said one
or more frequencies, is determined by a second dimension of said
regular solid and further including a first electrode coupled to said
regular solid and a second electrode coupled to said regular solid"
(see claim 4).
[0192] U.S. Pat. No. 6,605,089, the entire disclosure of which
is hereby incorporated by reference into this specification, discloses
an implantable bone growth promoting device. Claim 1 of this patent
describes "A device for placement into and between at least two
adjacent bone masses to promote bone growth therebetween, said device
comprising: an implant having opposed first and second surfaces for
placement between and in contact with the adjacent bone masses, a
mid-longitudinal axis, and a hollow chamber between said first and
second surfaces, said hollow chamber being adapted to hold bone growth
promoting material, said hollow chamber being along at least a portion
of the mid-longitudinal axis of said implant, each of said first and
second surfaces having at least one opening in communication with said
hollow chamber into which bone from the adjacent bone masses grows; and
an energizer for energizing said implant, said energizer being sized
and configured to promote bone growth from adjacent bone mass to
adjacent bone mass through said first and second surfaces and through
at least a portion of said hollow chamber at the mid-longitudinal
axis." The implant may have a coil wrapped around it (see claim 6), a
portion of the coil may be " . . . in the form of an external thread on
at least a portion of said first and second surfaces of said implant"
(see claim 7), the "external thread" may be energized by the
"energizer" (claim 8) by conducting " . . . electromagnetic energy to
said interior space . . . " of the energizer (claim 9). One may use
such "energizer" in the process of this invention.
[0193] Referring again to U.S. Pat. No. 6,605,089, and to the
implant claimed therein, the implant may contain " . . . a power supply
delivering an electric charge" (see claim 14), and it may comprise " .
. . a first portion that is electrically conductive for delivering said
electrical charge to at least a portion of the adjacent bone masses and
said energizer delivers negative electrical charge to said first
portion of said implant" (see claim 15). Additionally, the implant may
also contain " . . . a controller for controlling the delivery of said
electric charge" that is disposed within the implant (see claim 18),
that " . . . includes one of a wave form generator and a voltage
generator" (see claim 19), and that " . . . provides for the delivery
of one of an alternating current, a direct current, and a sinusoidal
current" (see claim 21).
[0194] U.S. Pat. No. 6,641,520, the entire disclosure of which
is hereby incorporated by reference into this specification, discloses
a magnetic field generator for providing a static or direct current
magnetic field generator.; the magnetic field generator described in
this patent may be used in conjunction the anti-mitotic compound and/or
tubulin and/or microtubules. In column 1 of this patent, some "prior
art" magnetic field generators were described; and they also may be so
used. It was stated in such column 1 that: "There has recently been an
increased interest in therapeutic application of magnetic fields. There
have also been earlier efforts of others in this area. The recent
efforts, as well as those earlier made, can be categorized into three
general types, based on the mechanism for generating and applying the
magnetic field. The first type were what could be generally referred to
as systemic applications. These were large, tubular mechanisms which
could accommodate a human body within them. A patient or recipient
could thus be subjected to magnetic therapy through their entire body.
These systems were large, cumbersome and relatively immobile. Examples
of this type of therapeutic systems included U.S. Pat. Nos. 1,418,903;
4,095,588; 5,084,003; 5,160,591; and 5,437,600. A second type of system
was that of magnetic therapeutic applicator systems in the form of
flexible panels, belts or collars, containing either electromagnets or
permanent magnets. These applicator systems could be placed on or about
portion of the recipient's body to allow application of the magnetic
therapy. Because of their close proximity to the recipients body,
considerations limited the amount and time duration of application of
magnetic therapy. Examples of this type system were U.S. Pat. Nos.
4,757,804; 5,084,003 and 5,344,384. The third type of system was that
of a cylindrical or toroidal magnetic field generator, often small and
portable, into which a treatment recipient could place a limb to
receive electromagnetic therapy. Because of size and other limitations,
the magnetic field strength generated in this type system was usually
relatively low. Also, the magnetic field was a time varying one.
Electrical current applied to cause the magnetic field was time
varying, whether in the form of simple alternating current waveforms or
a waveform composed of a series of time-spaced pulses."
[0195] The magnetic field generator claimed in U.S. Pat. No.
6,641,520 comprised " . . . a magnetic field generating coil composed
of a wound wire coil generating the static magnetic field in response
to electrical power; a mounting member having the coil mounted thereon
and having an opening therethrough of a size to permit insertion of a
limb of the recipient in order to receive electromagnetic therapy from
the magnetic field coil; an electrical power supply furnishing power to
the magnetic field coil to cause the coil to generate a static
electromagnetic field within the opening of the mounting member for
application to the recipient's limb; a level control mechanism
providing a reference signal representing a specified electromagnetic
field strength set point for regulating the power furnished to the
magnetic field coil; a field strength sensor detecting the static
electromagnetic field strength generated by the magnetic field coil and
forming a field strength signal representing the detected
electromagnetic field strength in the opening in the mounting member; a
control signal generator receiving the field strength signal from the
field strength sensor and the reference signal from the level control
mechanism representing a specified electromagnetic field strength set
point; and the control signal generator forming a signal to regulate
the power flowing from the electrical power supply to the magnetic
field coil."
[0196] An implantable sensor is disclosed in U.S. Pat. No.
6,491,639, the entire disclosure of which is hereby incorporated by
reference into this specification; this sensor also may be used in
conjunction with the anti-mitotic compound of this invention, and/or
tubulin, and/or microtubules. Claim 1 of such patent describes: "An
implantable medical device including a sensor for use in detecting the
hemodynamic status of a patient comprising: a hermetic device housing
enclosing device electronics for receiving and processing data; and
said device housing including at least one recess and a sensor
positioned in said at least one recess." Claim 10 of such patent
describes "10. An implantable medical device including a hemodynamic
sensor for monitoring arterial pulse amplitude comprising: a device
housing; a transducer comprising a light source and a light detector
positioned exterior to said device housing responsive to variations in
arterial pulse amplitude; and wherein said light detector receives
light originating from said light source and reflected from arterial
vasculature of a patient and generates a signal which is indicative of
variations in the reflected light caused by the expansion and
contraction of said arterial vasculature. "Claim 14 of such patent
describes: "14. An implantable medical device including a hemodynamic
sensor for monitoring arterial pulse amplitude comprising: a device
housing; and an ultrasound transducer associated with said device
housing responsive to variations in arterial pulse amplitude." Claim 15
of such patent describes: "15. An implantable medical device including
a hemodynamic sensor for monitoring arterial pulse amplitude
comprising: a device housing; and a transducer associated with said
device housing responsive to variations in arterial pulse amplitude,
said device housing having at least one substantially planar face and
said transducer is positioned on said planar face." Claim 17 of such
patent describes " . . . an implantable pulse generator . . . `
[0197] U.S. Pat. No. 6,663,555, the entire disclosure of which
is incorporated by reference into this specification, also claims a
magnetic field generator; this magnetic field generator may be used in
conjunction with the anti-mitotic compound of this invention and/or
tubulin and/or microtubules. Claim 1 of this patent describes: "A
magnet keeper-shield assembly for housing a magnet, said magnet
keeper-shield assembly comprising: a keeper-shield comprising a
material substantially permeable to a magnetic flux; a cavity in the
keeper-shield, said cavity comprising an inner side wall and a base,
and said cavity being adapted to accept a magnet having a front and a
bottom face; an actuator extending through the base; a plurality of
springs extending through the base, said springs operative to exert a
force in a range from about 175 pounds to about 225 pounds on the
bottom face of the magnet in a retracted position, and wherein said
magnet produces at least about 118 gauss at a distance of about 10 cm
from the front face in the extended position and produces at most about
5 gauss at a distance less than or equal to about 22 cm from the front
face in the retracted position."
[0198] Published United States patent application
US2002/0182738 discloses an implantable flow cytometer; the entire
disclosure of this published United States patent application is hereby
incorporated by reference into this specification. Claim 1 of this
patent describes "A flow cytometer comprising means for sampling
cellular material within a body, means for marking cells within said
bodily fluid with a marker to produce marked cells, means for analyzing
said marked cells, a first means for removing said marker from said
marked cells, a second means for removing said marker from said marked
cells, means for sorting said cells within said bodily fluid to produce
sorted cells, and means for maintaining said sorted cells cells in a
viable state."
[0199] Referring again to published United States patent
application US 2002/0182738, the implantable flow cytometer may contain
" . . . a first control valve operatively connected to said first means
for removing said marker from said marked cells and to said second
means for removing said marker from said marked cells . . . " (see
claim 3), a controller connected to the first control valve (claim 4),
a second control valve (claim 5), a third control valve (claim 6), a
dye separator (claims 7 and 8), an analyzer for testing blood purity
(claim 9), etc.
[0200] A similar flow cytometer is disclosed in published
United States patent application US 2003/0036718, the entire disclosure
of which is also hereby incorporated by reference into this
specification.
[0201] Published United States patent application US
2003/0036776, the entire disclosure of which is hereby incorporated by
reference into this specification, discloses an MRI-compatible
implantable device. Claim 1 of this patent describes "A cardiac assist
device comprising means for connecting said cardiac assist device to a
heart, means for furnishing electrical impulses from said cardiac
assist device to said heart, means for ceasing the furnishing of said
electrical impulses to said heart, means for receiving pulsed radio
frequency fields, means for transmitting and receiving optical signals,
and means for protecting said heart and said cardiac assist device from
currents induced by said pulsed radio frequency fields, wherein said
cardiac assist device contains a control circuit comprised of a
parallel resonant frequency circuit and means for activating said
parallel resonant frequency circuit." The " . . . means for activating
said parallel resonant circuit . . . " may contain " . . . comprise
optical means (see claim 2) such as an optical switch (claim 3)
comprised of " . . . a pin type diode . . . " (claim 4) and connected
to an optical fiber (claim 5). The optical switch may be " . . .
activated by light from a light source . . . " (claim 6), and it may be
located with a biological organism (claim 7). The light source may be
located within the biological organism (claim 9), and it may provide "
. . . light with a wavelength of from about 750 to about 850 nanometers
. . . "
[0202] Polymeric Carriers and/or Delivery Systems
[0203] The anti-mitotic compound of this invention may be used
in conjunction with prior art polymeric carriers and/or delivery
systems comprised of polymeric material. In one embodiment, the
polymeric material 14 is preferably comprised of one or more
anti-mitotic compounds that are adapted to be released from the
polymeric material wherein the polymeric material is disposed within a
biological organism. The polymeric material may be, e.g., any of the
drug eluting polymers known to those skilled in the art.
[0204] By way of illustration, and referring to U.S. Pat. No.
3,279,996 (the entire disclosure of which is hereby incorporated by
reference into this specification), the polymeric material may be
silicone rubber. This patent claims "An implantate for releasing a drug
in the tissues of a living organism comprising a drug enclosed in a
capsule of silicone rubber, . . . said drug being soluble in and
capable of diffusing through said silicone rubber to the outer surface
of said capsule . . . " One may use, as the anti-mitotic compound a
material that is soluble in and capable of diffusing through the
polymeric material.
[0205] At column 1 of U.S. Pat. No. 3,279,996, other "carrier
agents" which may be used as polymeric material are also disclosed,
including " . . . beeswax, peanut oil, stearates, etc." Any of these
"carrier agents" may be used as the polymeric material.
[0206] By way of further illustration, and as is disclosed in
U.S. Pat. No. 4,191,741 (the entire disclosure of which is hereby
incorporated by reference into this specification), one may use
dimethylpolsiloxane rubber as the polymeric material. This patent
claims "A solid, cylindrical, subcutaneous implant for improving the
rate of weight gain of ruminant animals which comprises (a) a
biocompatible inert core having a diameter of from about 2 to about 10
mm. and (b) a biocompatible coating having a thickness of from about
0.2 to about 1 mm., the composition of said coating comprising from
about 5 to about 40 percent by weight of estradiol and from about 95 to
about 60 percent by weight of a dimethylpolysiloxane rubber."
[0207] In column 1 of U.S. Pat. No. 4,191,741, other materials
which may be used as the polymeric material are disclosed. Thus, it is
stated in such patent that "Long et al. U.S. Pat. No. 3,279,996
describes an implant for releasing a drug in the tissues of a living
organism comprising the drug enclosed in a capsule formed of silicone
rubber. The drug migrates through the silicone rubber wall and is
slowly released into the living tissues. A number of biocompatible
silicone rubbers are described in the Long et al. patent. When a drug
delivery system such as that described in U.S. Pat. No. 3,279,996 is
used in an effort to administer estradiol to a ruminant animal a number
of problems are encountered. For example, an excess of the drug is
generally required in the hollow cavity of the implant. Also, it is
difficult to achieve a constant rate of administration of the drug over
a long time period such as from 200 to 400 days as would be necessary
for the daily administration of estradiol to a growing beef animal.
Katz et al. U.S. Pat. No. 4,096,239 describes an implant pellet
containing estradiol or estradiol benzoate which has an inert spherical
core and a uniform coating comprising a carrier and the drug. The
coating containing the drug must be both biocompatible and biosoluble,
i.e., the coating must dissolve in the body fluids which act upon the
pellet when it is implanted in the body. The rate at which the coating
dissolves determines the rate at which the drug is released.
Representative carriers for use in the coating material include
cholesterol, solid polyethylene glycols, high molecular weight fatty
acids and alcohols, biosoluble waxes, cellulose derivatives and solid
polyvinyl pyrrolidone." The polymeric material used with the
anti-mitotic compound is, in one embodiment, both biocompatible and
biosoluble.
[0208] By way of yet further illustration, and referring to
U.S. Pat. No. 4,429,080 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be a synthetic absorbable copolymer formed by
copolymerizing glycolide with trimethylene carbonate.
[0209] By way of yet further illustration, and referring to
U.S. Pat. No. 4,581,028 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be selected from the group consisting of polyester (such
as Dacron), polytetrafluoroethylene, polyurethane silicone-based
material, and polyamide. The polymeric material of this patent is
comprised " . . . of at least one antimicrobial agent selected from the
group consisting of the metal salts of sulfonamides." In one
embodiment, the polymeric material is comprised of an antimicrobial
agent.
[0210] By way of yet further illustration, and referring to
U.S. Pat. No. 4,481,353, (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be the bioresorbable polyester disclosed in such patent.
U.S. Pat. No. 4,481,353 claims "A bioresorbable polyester in which
monomeric subunits are arranged randomly in the polyester molecules,
said polyester comprising the condensation reaction product of a Krebs
Cycle dicarboxylic acid or isomer or anhydride thereof, chosen for the
group consisting of succinic acid, fumaric acid, oxaloacetic acid,
L-malic acid, and D-malic acid, a diol having 2, 4, 6, or 8 carbon
atoms, and an alpha-hydroxy carboxylic acid chosen from the group
consisting of glycolic acid, L-lactic acid and D-lactic acid."
[0211] By way of yet further illustration, and referring to
U.S. Pat. No. 4,846,844 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be a silicone polymer matrix in which an anabolic agent
(such as an anabolic steroid, or estradiol) is disposed. This patent
claims "An implant adapted for the controlled release of an anabolic
agent, said implant comprising a silicone polymer matrix, an anabolic
agent in said polymer matrix, and an antimicrobial coating, wherein the
coating comprises a first-applied non-vulcanizing silicone fluid and a
subsequently applied antimicrobial agent in contact with said fluid."
[0212] By way of yet further illustration, and referring to
U.S. Pat. No. 4,916,193 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be a copolymer containing carbonate repeat units and ester
repeat units (see, e.g., claim 1 of the patent). As disclosed in column
2 of the patent, it may also be "collagen," "homopolymers and
copolymers of glycolic acid and lactic acid," "alpha-hydroxy carboxylic
acids in conjunction with Krebs cycle dicarboxylic acids and aliphatic
diols," "polycarbonate-containing polymers," and "high molecular weight
fiber-forming crystalline copolymers of lactide and glycolide." Thus,
it is disclosed in such column 2 that: "Various polymers have been
proposed for use in the fabrication of bioresorbable medical devices.
Examples of absorbable materials used in nerve repair include collagen
as disclosed by D. G. Kline and G. J. Hayes, "The Use of a Resorbable
Wrapper for Peripheral Nerve Repair, Experimental Studies in
Chimpanzees", J. Neurosurgery 21, 737 (1964). Artandi et al., U.S. Pat.
No. 3,272,204 (1966) reports the use of collagen protheses that are
reinforced with nonabsorbable fabrics. These articles are intended to
be placed permanently in a human body. However, one of the
disadvantages inherent with collagenous materials, whether utilized
alone or in conjunction with biodurable materials, is their potential
antigenicity. Other biodegradable polymers of particular interest for
medical implantation purposes are homopolymers and copolymers of
glycolic acid and lactic acid. A nerve cuff in the form of a smooth,
rigid tube has been fabricated from a copolymer of lactic and glycolic
acids [The Hand; 10 (3) 259 (1978)]. European patent application No.
118-458-A discloses biodegradable materials used in organ protheses or
artificial skin based on poly-L-lactic acid and/or poly-DL-lactic acid
and polyester or polyether urethanes. U.S. Pat. No. 4,481,353 discloses
bioresorbable polyester polymers, and composites containing these
polymers, that are also made up of alpha-hydroxy carboxylic acids, in
conjunction with Krebs cycle dicarboxylic acids and aliphatic diols.
These polyesters are useful in fabricating nerve guidance channels as
well as other surgical articles such as sutures and ligatures. U.S.
Pat. Nos. 4,243,775 and 4,429,080 disclose the use of
polycarbonate-containing polymers in certain medical applications,
especially sutures, ligatures and haemostatic devices. However, this
disclosure is clearly limited only to "AB" and "ABA" type block
copolymers where only the "B" block contains poly(trimethylene
carbonate) or a random copolymer of glycolide with trimethylene
carbonate and the "A" block is necessarily limited to glycolide. In the
copolymers of this patent, the dominant portion of the polymer is the
glycolide component. U.S. Pat. No. 4,157,437 discloses high molecular
weight, fiber-forming crystalline copolymers of lactide and glycolide
which are disclosed as useful in the preparation of absorbable surgical
sutures. The copolymers of this patent contain from about 50 to 75 wt.
% of recurring units derived from glycolide."
[0213] By way of further illustration, and referring to U.S.
Pat. No. 5,176,907 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be the poly-phosphoester-urethane) described and claimed
in claim 1 of such patent. Furthermore, the polymeric material may be
one or more of the biodegradable polymers discussed in columns 1 and 2
of such patent. As is disclosed in such columns 1 and 2: "Polymers have
been used as carriers of therapeutic agents to effect a localized and
sustained release (Controlled Drug Delivery, Vol. I and II, Bruck, S.
D., (ed.), CRC Press, Boca Raton, Fla., 1983; Leong, et al., Adv. Drug
Delivery Review, 1:199, 1987). These anti-mitotic compounddelivery
systems simulate infusion and offer the potential of enhanced
therapeutic efficacy and reduced systemic toxicity." The polymeric
material may be such a poly-phosphoester-urethan- e.
[0214] U.S. Pat. No. 5,176,907 also discloses "For a
non-biodegradable matrix, the steps leading to release of the
anti-mitotic compoundare water diffusion into the matrix, dissolution
of the therapeutic agent, and out-diffusion of the anti-mitotic
compound through the channels of the matrix. As a consequence, the mean
residence time of the anti-mitotic compoundexisting in the soluble
state is longer for a non-biodegradable matrix than for a biodegradable
matrix where a long passage through the channels is no longer required.
Since many pharmaceuticals have short half-lives it is likely that the
anti-mitotic compound is decomposed or inactivated inside the
non-biodegradable matrix before it can be released. This issue is
particularly significant for many bio-macromolecules and smaller
polypeptides, since these molecules are generally unstable in buffer
and have low permeability through polymers. In fact, in a
non-biodegradable matrix, many bio-macromolecules will aggregate and
precipitate, clogging the channels necessary for diffusion out of the
carrier matrix. This problem is largely alleviated by using a
biodegradable matrix which allows controlled release of the therapeutic
agent. Biodegradable polymers differ from non-biodegradable polymers in
that they are consumed or biodegraded during therapy. This usually
involves breakdown of the polymer to its monomeric subunits, which
should be biocompatible with the surrounding tissue. The life of a
biodegradable polymer in vivo depends on its molecular weight and
degree of cross-linking; the greater the molecular weight and degree of
crosslinking, the longer the life. The most highly investigated
biodegradable polymers are polylactic acid (PLA), polyglycolic acid
(PGA), polyglycolic acid (PGA), copolymers of PLA and PGA, polyamides,
and copolymers of polyamides and polyesters. PLA, sometimes referred to
as polylactide, undergoes hydrolytic de-esterification to lactic acid,
a normal product of muscle metabolism. PGA is chemically related to PLA
and is commonly used for absorbable surgical sutures, as is the PLA/PGA
copolymer. However, the use of PGA in controlled-release implants has
been limited due to its low solubility in common solvents and
subsequent difficulty in fabrication of devices." The polymeric
material 14 may be a biodegradable polymeric material.
[0215] U.S. Pat. No. 5,176,907 also discloses "An advantage of
a biodegradable material is the elimination of the need for surgical
removal after it has fulfilled its mission. The appeal of such a
material is more than simply for convenience. From a technical
standpoint, a material which biodegrades gradually and is excreted over
time can offer many unique advantages."
[0216] U.S. Pat. No. 5,176,907 also discloses "A biodegradable
thereapeutic agent delivery system has several additional advantages:
1) the therapeutic agent release rate is amenable to control through
variation of the matrix composition; 2) implantation can be done at
sites difficult or impossible for retrieval; 3) delivery of unstable
therapeutic agents is more practical. This last point is of particular
importance in light of the advances in molecular biology and genetic
engineering which have lead to the commercial availability of many
potent bio-macromolecules. The short in vivo half-lives and low GI
tract absorption of these polypeptides render them totally unsuitable
for conventional oral or intravenous administration. Also, because
these substances are often unstable in buffer, such polypeptides cannot
be effectively delivered by pumping devices."
[0217] U.S. Pat. No. 5,176,907 also discloses "In its simplest
form, a biodegradable therapeutic agent delivery system consist of a
dispersion of the drug solutes in a polymer matrix. The therapeutic
agent is released as the polymeric matrix decomposes, or biodegrades
into soluble products which are excreted from the body. Several classes
of synthetic polymers, including polyesters (Pitt, et al., in
Controlled Release of Bioactive Materials, R. Baker, Ed., Academic
Press, New York, 1980); polyamides (Sidman, et al., Journal of Membrane
Science, 7:227, 1979); polyurethanes (Maser, et al., Journal of Polymer
Science, Polymer Symposium, 66:259, 1979); polyorthoesters (Heller, et
al., Polymer Engineering Science, 21:727, 1981); and polyanhydrides
(Leong, et al., Biomaterials, 7:364, 1986) have been studied for this
purpose." The "therapeutic agent" used in this (and other) patents may
be the anti-mitotic compound of this invention.
[0218] By way of yet further illustration, and referring to
U.S. Pat. No. 5,194,581 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may the poly (phosphoester) compositions described in such
patent.
[0219] The polymeric material may be in the form of
microcapsules within which the anti-mitotic compound of this invention
is disposed. Thus, one may use microcapusels such as, e.g., the
microcapsule described in U.S. Pat. No. 6,117,455, the entire
disclosure of which is hereby incorporated by reference into this
specification. As is disclosed in the abstract of this patent, there is
provided "A sustained-release microcapsule contains an amorphous
water-soluble pharmaceutical agent having a particle size of from 1
nm-10 .mu.m and a polymer. The microcapsule is produced by dispersing,
in an aqueous phase, a dispersion of from 0.001-90% (w/w) of an
amorphous water-soluble pharmaceutical agent in a solution of a polymer
having a wt. avg. molecular weight of 2,000-800,000 in an organic
solvent to prepare an s/o/w emulsion and subjecting the emulsion to
in-water drying."
[0220] In one embodiment, disclosed in U.S. Pat. No. 5,484,584
(the entire disclosure of which is hereby incorporated by reference
into this specification), a poly (benzyl-L-glutamate) microsphere is
disclosed (see, e.g., claim 10); the anti-mitotic compound of this
invention may be disposed within and/or on the surface of such
microsphere. As is disclosed in the abstract of this patent, "The
present invention relates to a highly efficient method of preparing
modified microcapsules exhibiting selective targeting. These
microcapsules are suitable for encapsulation surface attachment of
therapeutic and diagnostic agents. In one aspect of the invention,
surface charge of the polymeric material is altered by conjugation of
an amino acid ester to the providing improved targeting of encapsulated
agents to specific tissue cells. Examples include encapsulation of
radiodiagnostic agents in 1 .mu.m capsules to provide improved
opacification and encapsulation of cytotoxic agents in 100 .mu.m
capsules for chemoembolization procedures. The microcapsules are
suitable for attachment of a wide range of targeting agents, including
antibodies, steroids and drugs, which may be attached to the
microcapsule polymer before or after formation of suitably sized
microcapsules. The invention also includes microcapsules surface
modified with hydroxyl groups. Various agents such as estrone may be
attached to the microcapsules and effectively targeted to selected
organs."
[0221] The release rate of the anti-mitotic compound from the
polymeric material may be varied in, e.g., the manner suggested in
column 6 of U.S. Pat. No. 5,194,581, the entire disclosure of which is
hereby incorporated by reference into this specification. As is
disclosed in such column 6, "A wide range of degradation rates can be
obtained by adjusting the hydrophobicities of the backbones of the
polymers and yet the biodegradability is assured. This can be achieved
by varying the functional groups R or R'. The combination of a
hydrophobic backbone and a hydrophilic linkage also leads to
heterogeneous degradation as cleavage is encouraged, but water
penetration is resisted." As is disclosed at column 9 of such patent,
"The rate of biodegradation of the poly(phosphoester) compositions of
the invention may also be controlled by varying the hydrophobicity of
the polymer. The mechanism of predictable degradation preferably relies
on either group R' in the poly(phosphoester) backbone being hydrophobic
for example, an aromatic structure, or, alternatively, if the group R'
is not hydrophobic, for example an aliphatic group, then the group R is
preferably aromatic. The rates of degradation for each
poly(phosphoester) composition are generally predictable and constant
at a single pH. This permits the compositions to be introduced into the
individual at a variety of tissue sites. This is especially valuable in
that a wide variety of compositions and devices to meet different, but
specific, applications may be composed and configured to meet specific
demands, dimensions, and shapes--each of which offers individual, but
different, predictable periods for degradation. When the composition of
the invention is used for long term delivery of a anti-mitotic compound
a relatively hydrophobic backbone matrix, for example, containing
bisphenol A, is preferred. It is possible to enhance the degradation
rate of the poly(phosphoester) or shorten the functional life of the
device, by introducing hydrophilic or polar groups, into the backbone
matrix. Further, the introduction of methylene groups into the backbone
matrix will usually increase the flexibility of the backbone and
decrease the crystallinity of the polymer. Conversely, to obtain a more
rigid backbone matrix, for example, when used orthopedically, an
aromatic structure, such as a diphenyl group, can be incorporated into
the matrix. Also, the poly(phosphoester) can be crosslinked, for
example, using 1,3,5-trihydroxybenzene or (CH2 OH)4 C, to enhance the
modulus of the polymer. Similar considerations hold for the structure
of the side chain (R)."
[0222] ,By way of yet further illustration, and referring to
U.S. Pat. No. 5,252,713 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be a polypeptide comprising at least one drug-binding
domain that non-covalently binds a drug. The means of identifying and
isolating such a polypeptide is described at columns 5-7 of the patent,
wherein it is disclosed that: "The process of isolating a polymeric
carrier from a drug-binding, large molecular weight protein begins with
the identification of a large protein that can non-covalently bind the
drug of interest. Examples of such protein/drug pairs are shown in
Table I. The drugs in the Table (other than the steroids) are
anti-cancer drugs . . . "
[0223] As is also disclosed in U.S. Pat. No. 5,252,713, "Other
drug-binding proteins may be identified by appropriate analytical
procedures, including Western blotting of large proteins or protein
fragments and subsequent incubation with a detectable form of drug.
Alternative procedures include combining a drug and a protein in a
solution, followed by size exclusion HPLC gel filtration, thin-layer
chromatography (TLC), or other analytical procedures that can
discriminate between free and protein-bound drug. Detection of drug
binding can be accomplished by using radiolabeled, fluorescent, or
colored drugs and appropriate detection methods. Equilibrium dialysis
with labeled drug may be used. Alternative methods include monitoring
the fluorescence change that occurs upon binding of certain drugs
(e.g., anthracyclines or analogs thereof, which should be fluorescent)
. . . ". In one detection method, drug and protein are mixed, and an
aliquot of this solution (not exceeding 5% of the column volume of an
HPLC column, such as a Bio-sil TSK-250 7.5.times.30 cm column) is
loaded onto the HPLC column. The flow rate is 1 ml/min. The drug bound
to protein will elute first, in a separate peak, followed by free drug,
eluting at a position characteristic of its molecular weight. If the
drug is doxorubicin, both a 280-nm as well as a 495-nm adsorptive peak
will correspond to the elution position of the protein if interaction
occurs. The elution peaks for other drugs will indicate whether drug
binding occurs . . . "
[0224] As is also disclosed in U.S. Pat. No. 5,252,713,
"Knowledge of the chemical structure of a particular drug (i.e.,
whether chemically reactive functional groups are present) allows one
to predict whether covalent binding of the drug to a given protein can
occur. Additional methods for determining whether drug binding is
covalent or non-covalent include incubating the drug with the protein,
followed by dialysis or subjecting the protein to denaturing
conditions. Release of the drug from the drug-binding protein during
these procedures indicates that the drug was non-covalently bound.
Usually, a dissociation constant of about 10-15 M or less indicates
covalent or extremely tight non-covalent binding . . . "
[0225] As is also disclosed in U.S. Pat. No. 5,252,713, "During
dialysis, non-covalently bound drug molecules are released over time
from the protein and pass through a dialysis membrane, whereas
covalently bound drug molecules are retained on the protein. An
equilibrium constant of about 10-5 M indicates non-covalent binding.
Alternatively, the protein may be subjected to denaturing conditions;
e.g., by gel electrophoresis on a denaturing (SDS) gel or on a gel
filtration column in the presence of a strong denaturant such as 6M
guanidine. Covalently bound drug molecules remain bound to the
denatured protein, whereas non-covalently bound drug molecules are
released and migrate separately from the protein on the gel and are not
retained with the protein on the column."
[0226] As is also disclosed in U.S. Pat. No. 5,252,713, "Once a
protein that can non-covalently bind a particular drug of interest is
identified, the drug-binding domain is identified and isolated from the
protein by any suitable means. Protein domains are portions of proteins
having a particular function or activity (in this case, non-covalent
binding of drug molecules). The present invention provides a process
for producing a polymeric carrier, comprising the steps of generating
peptide fragments of a protein that is capable of non-covalently
binding a drug and identifying a drug-binding peptide fragment, which
is a peptide fragment containing a drug-binding domain capable of
non-covalently binding the drug, for use as the polymeric carrier."
[0227] As is also disclosed in U.S. Pat. No. 5,252,713, "One
method for identifying the drug-binding domain begins with digesting or
partially digesting the protein with a proteolytic enzyme or specific
chemicals to produce peptide fragments. Examples of useful proteolytic
enzymes include lys-C-endoprotease, arg-C-endoprotease, V8 protease,
endoprolidase, trypsin, and chymotrypsin. Examples of chemicals used
for protein digestion include cyanogen bromide (cleaves at methionine
residues), hydroxylamine (cleaves the Asn-Gly bond), dilute acetic acid
(cleaves the Asp-Pro bond), and iodosobenzoic acid (cleaves at the
tryptophane residue). In some cases, better results may be achieved by
denaturing the protein (to unfold it), either before or after
fragmentation."
[0228] As is also disclosed in U.S. Pat. No. 5,252,713, "The
fragments may be separated by such procedures as high pressure liquid
chromatography (HPLC) or gel electrophoresis. The smallest peptide
fragment capable of drug binding is identified using a suitable
drug-binding analysis procedure, such as one of those described above.
One such procedure involves SDS-PAGE gel electrophoresis to separate
protein fragments, followed by Western blotting on nitrocellulose, and
incubation with a colored drug like adriamycin. The fragments that have
bound the drug will appear red. Scans at 495 nm with a laser
densitometer may then be used to analyze (quantify) the level of drug
binding."
[0229] As is also disclosed in U.S. Pat. No. 5,252,713,
"Preferably, the smallest peptide fragment capable of non-covalent drug
binding is used. It may occasionally be advisable, however, to use a
larger fragment, such as when the smallest fragment has only a
low-affinity drug-binding domain."
[0230] As is also disclosed in U.S. Pat. No. 5,252,713, "The
amino acid sequence of the peptide fragment containing the drug-binding
domain is elucidated. The purified fragment containing the drug-binding
region is denatured in 6M guanidine hydrochloride, reduced and
carboxymethylated by the method of Crestfield et al., J. Biol. Chem.
238:622, 1963. As little as 20 to 50 picomoles of each peptide fragment
can be analyzed by automated Edman degradation using a gas-phase or
liquidpulsed protein sequencer (commercially available from Applied
Biosystems, Inc.). If the peptide fragment is longer than 30 amino
acids, it will most likely have to be fragmented as above and the amino
acid sequence patched together from sequences of overlapping
fragments."
[0231] As is also disclosed in U.S. Pat. No. 5,252,713, "Once
the amino acid sequence of the desired peptide fragment has been
determined, the polymeric carriers can be made by either one of two
types of synthesis. The first type of synthesis comprises the
preparation of each peptide chain with a peptide synthesizer (e.g.,
commercially available from Applied Biosystems). The second method
utilizes recombinant DNA procedures." The polymeric material 14 may
comprise one or more of the polymeric carriers described in U.S. Pat.
No. 5,252,713.
[0232] As is also disclosed in U.S. Pat. No. 5,252,713,
"Peptide amides can be made using 4-methylbenzhydrylamine-derivatized,
cross-linked polystyrene-1% divinylbenzene resin and peptide acids made
using PAM (phenylacetamidomethyl) resin (Stewart et al., "Solid Phase
Peptide Synthesis," Pierce Chemical Company, Rockford, Ill., 1984). The
synthesis can be accomplished either using a commercially available
synthesizer, such as the Applied Biosystems 430A, or manually using the
procedure of Merrifield et al., Biochemistry 21:5020-31, 1982; or
Houghten, PNAS 82:5131-35, 1985. The side chain protecting groups are
removed using the Tam-Merrifield low-high HF procedure (Tam et al., J.
Am. Chem. Soc. 105:6442-55, 1983). The peptide can be extracted with
20% acetic acid, lyophilized, and purified by reversed-phase HPLC on a
Vydac C-4 Analytical Column using a linear gradient of 100% water to
100% acetonitrile-0.1% trifluoroacetic acid in 50 minutes. The peptide
is analyzed using PTC-amino acid analysis (Heinrikson et al., Anal.
Biochem. 136:65-74, 1984). After gas-phase hydrolysis (Meltzer et al.,
Anal. Biochem. 160: 356-61, 1987), sequences are confirmed using the
Edman degradation or fast atom bombardment mass spectroscopy. After
synthesis, the polymeric carriers can be tested for drug binding using
size-exclusion HPLC, as described above, or any of the other analytical
methods listed above."
[0233] The polymeric carriers of U.S. Pat. No. 5,252,713 may be
used with the anti-mitotic compounds of this invention. As is also
disclosed in U.S. Pat. No. 5,252,713, "The polymeric carriers of the
present invention preferably comprise more than one drug-binding
domain. A polypeptide comprising several drug-binding domains may be
synthesized. Alternatively, several of the synthesized drug-binding
peptides may be joined together using bifunctional cross-linkers, as
described below." The polymeric material in one embodiment, comprises
more than one drug-binding domain.
[0234] By way of yet further illustration, and referring to
U.S. Pat. No. 5,420,105 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may form a conjugate with a ligand. Thus, and referring to
claim 1 of such patent, such conjugate may be "A ligand or an
anti-ligand/polymeric carrier/drug conjugate comprising a ligand
consisting of biotin or an anti-ligand selected from the group
consisting of avidin and streptavidin, which ligand or anti-ligand is
covalently bound to a polymeric carrier that comprises at least one
drug-binding domain derived from a drug-binding protein, and at least
one drug non-covalently bound to the polymeric carrier, wherein the
polymeric carrier does not comprise an entire drug-binding protein, but
is derived from a drug-binding domain of said drug-binding protein
which derivative non-covalently binds a drug which is non-covalently
bound by an entire naturally occurring drug-binding protein, and
wherein the molecular weight of the polymeric carrier is less than
about 60,000 daltons, and wherein said drug is selected from the group
consisting of an anti-cancer anthracycline antibiotic, cis-platinum,
methotrexate, vinblastine, mitoxanthrone ARA-C, 6-mercaptopurine,
6-mercaptoguanosine, mytomycin C and a steroid."
[0235] The polymeric material form comprise a reservoir (see
U.S. Pat. No. 5,447,724) for the anti-mitotic compound(s). Such a
reservoir may be constructed in accordance with the procedure described
in U.S. Pat. No. 5,447,724, which claims "A medical device at least a
portion of which comprises: a body insertable into a patient, said body
having an exposed surface which is adapted for exposure to tissue of a
patient and constructed to release, at a predetermined rate,
therapeutic agent to inhibit adverse physiological reaction of said
tissue to the presence of the body of said medical device, said
therapeutic agent selected from the group consisting of
antithrombogenic agents, antiplatelet agents, prostaglandins,
thrombolytic drugs, antiproliferative drugs, antirejection drugs,
antimicrobial drugs, growth factors, and anticalcifying agents, at said
exposed surface, said body including: an outer polymer metering layer,
and an internal polymer layer underlying and supporting said outer
polymer metering layer and in intimate contact therewith, said internal
polymer layer defining a reservoir for said therapeutic agent, said
reservoir formed by a polymer selected from the group consisting of
polyurethanes and its copolymers, silicone and its copolymers, ethylene
vinylacetate, thermoplastic elastomers, polyvinylchloride, polyolefins,
cellulosics, polyamides, polytetrafluoroethylenes, polyesters,
polycarbonates, polysulfones, acrylics, and acrylonitrile butadiene
styrene copolymers, said outer polymer metering layer having a stable,
substantially uniform, predetermined thickness covering the underlying
reservoir so that no portion of the reservoir is directly exposed to
body fluids and incorporating a distribution of an elutable component
which, upon exposure to body fluid, elutes from said outer polymer
metering layer to form a predetermined porous network capable of
exposing said anti-mitotic compound in said reservoir in said internal
polymer layer to said body fluid, said elutable component is selected
from the group consisting of polyethylene oxide, polyethylene glycol,
polyethylene oxide/polypropylene oxide copolymers,
polyhydroxyethylmethacrylate, polyvinylpyrollidone, polyacrylamide and
its copolymers, liposomes, albumin, dextran, proteins, peptides,
polysaccharides, polylactides, polygalactides, polyanhydrides,
polyorthoesters and their copolymers, and soluble cellulosics, said
reservoir defined by said internal polymer layer incorporating said
therapeutic agent in a manner that permits substantially free outward
release of said therapeutic agent from said reservoir into said porous
network of said outer polymer metering layer as said elutable component
elutes from said polymer metering layer, said predetermined thickness
and the concentration and particle size of said elutable component
being selected to enable said outer polymer metering layer to meter the
rate of outward migration of the thereapuetic agent from said internal
reservoir layer through said outer polymer metering layer, said outer
polymer metering layer and said internal polymer layer, in combination,
enabling prolonged controlled release, at said predetermined rate, of
said therapeutic agent at an effective dosage level from said exposed
surface of said body of said medical device to the tissue of said
patient to inhibit adverse reaction of the patient to the prolonged
presence of said body of said medical device in said patient."
[0236] U.S. Pat. No. 5,447,724 also discloses the preparation
of the "reservoir" in e.g., in columns 8 and 9 of the patent, wherein
it is disclosed that: "A particular advantage of the time-release
polymers of the invention is the manufacture of coated articles, i.e.,
medical instruments. Referring now to FIG. 3, the article to be coated
such as a catheter 50 may be mounted on a mandrel or wire 60 and
aligned with the preformed apertures 62 (slightly larger than the
catheter diameter) in the teflon bottom piece 63 of a boat 64 that
includes a mixture 66 of polymer at ambient temperature, e.g.,
25.degree. C. To form the reservoir portion, the mixture may include,
for example, nine parts solvent, e.g. tetrahydrofuran (THF), and one
part Pellthane.RTM. polyurethane polymer which includes the desired
proportion of ground sodium heparin particles. The boat may be moved in
a downward fashion as indicated by arrow 67 to produce a coating 68 on
the exterior of catheter 50. After a short (e.g., 15 minutes) drying
period, additional coats may be added as desired. After coating, the
catheter 50 is allowed to air dry at ambient temperature for about two
hours to allow complete solvent evaporation and/or polymerization to
form the reservoir portion. For formation of the surface-layer the boat
64 is cleaned of the reservoir portion mixture and filled with a
mixture including a solvent, e.g. THF (9 parts) and Pellthane.RTM. (1
part) having the desired amount of elutable component. The boat is
moved over the catheter and dried, as discussed above to form the
surface-layer. Subsequent coats may also be formed. An advantage of the
dipping method and apparatus described with regard to FIG. 3 is that
highly uniform coating thickness may be achieved since each portion of
the substrate is successively in contact with the mixture for the same
period of time and further, no deformation of the substrate occurs.
Generally, for faster rates of movement of the boat 64, thicker layers
are formed since the polymer gels along the catheter surfaces upon
evaporation of the solvent, rather than collects in the boat as happens
with slower boat motion. For thin layers, e.g., on the order of a few
mils, using a fairly volatile solvent such as THF, the dipping speed is
generally between 26 to 28 cm/min for the reservoir portion and around
21 cm/min for the outer layer for catheters in the range of 7 to 10 F.
The thickness of the coatings may be calculated by subtracting the
weight of the coated catheter from the weight of the uncoated catheter,
dividing by the calculated surface area of the uncoated substrate and
dividing by the known density of the coating. The solvent may be any
solvent that solubilizes the polymer and preferably is a more volatile
solvent that evaporates rapidly at ambient temperature or with mild
heating. The solvent evaporation rate and boat speed are selected to
avoid substantial solubilizing of the catheter substrate or degradation
of a prior applied coating so that boundaries between layers are
formed."
[0237] By way of yet further illustration, and referring to
U.S. Pat. No. 5,464,650 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be one or ore of the polymeric materials discussed at
columns 4 and 5 of such patent. Referring to such columns 4 and 5, it
is disclosed that: "The polymer chosen must be a polymer that is
biocompatible and minimizes irritation to the vessel wall when the
stent is implanted. The polymer may be either a biostable or a
bioabsorbable polymer depending on the desired rate of release or the
desired degree of polymer stability, but a bioabsorbable polymer is
probably more desirable since, unlike a biostable polymer, it will not
be present long after implantation to cause any adverse, chronic local
response. Bioabsorbable polymers that could be used include
poly(L-lactic acid), polycaprolactone, poly(lactide-co-glycolide),
poly(hydroxybutyrate), poly(hydroxybutyrate-co-valerate),
polydioxanone, polyorthoester, polyanhydride, poly(glycolic acid),
poly(D,L-lactic acid), poly(glycolic acid-co-trimethylene carbonate),
polyphosphoester, polyphosphoester urethane, poly(amino acids),
cyanoacrylates, poly(trimethylene carbonate), poly(iminocarbonate),
copoly(ether-esters) (e.g. PEO/PLA), polyalkylene oxalates,
polyphosphazenes and biomolecules such as fibrin, fibrinogen,
cellulose, starch, collagen and hyaluronic acid. Also, biostable
polymers with a relatively low chronic tissue response such as
polyurethanes, silicones, and polyesters could be used and other
polymers could also be used if they can be dissolved and cured or
polymerized on the stent such as polyolefins, polyisobutylene and
ethylene-alphaolefin copolymers; acrylic polymers and copolymers, vinyl
halide polymers and copolymers, such as polyvinyl chloride; polyvinyl
ethers, such as polyvinyl methyl ether; polyvinylidene halides, such as
polyvinylidene fluoride and polyvinylidene chloride; polyacrylonitrile,
polyvinyl ketones; polyvinyl aromatics, such as polystyrene, polyvinyl
esters, such as polyvinyl acetate; copolymers of vinyl monomers with
each other and olefins, such as ethylene-methyl methacrylate
copolymers, acrylonitrile-styrene copolymers, ABS resins, and
ethylene-vinyl acetate copolymers; polyamides, such as Nylon 66 and
polycaprolactam; alkyd resins; polycarbonates; polyoxymethylenes;
polyimides; polyethers; epoxy resins, polyurethanes; rayon;
rayon-triacetate; cellulose, cellulose acetate, cellulose butyrate;
cellulose acetate butyrate; cellophane; cellulose nitrate; cellulose
propionate; cellulose ethers; and carboxymethyl cellulose. The ratio of
therapeutic substance to polymer in the solution will depend on the
efficacy of the polymer in securing the therapeutic substance onto the
stent and the rate at which the coating is to release the therapeutic
substance to the tissue of the blood vessel. More polymer may be needed
if it has relatively poor efficacy in retaining the therapeutic
substance on the stent and more polymer may be needed in order to
provide an elution matrix that limits the elution of a very soluble
therapeutic substance. A wide ratio of therapeutic substance to polymer
could therefore be appropriate and could range from about 10:1 to about
1:100."
[0238] By way of yet further illustration, and referring to
U.S. Pat. No. 5,470,307 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may a synthetic or natural polymer, such as polyamide,
polyester, polyolefin (polypropylene or polyethylene), polyurethane,
latex, acrylamide, methacrylate, polyvinylchloride, polysuflone, and
the like; see, e.g., column 11 of the patent.
[0239] In one embodiment, the polymeric material is bound to
the anti-mitotic compound by one or more photosensitive linkers. The
process of preparing and binding these photosensitive linkers is
described in columns 8-9 of U.S. Pat. No. 5,470,307, wherein it is
disclosed that: "The process of fabricating a catheter 10 having a
desired therapeutic agent 20 connected thereto and then controllably
and selectively releasing that therapeutic agent 20 at a remote site
within a patient may be summarized in five steps. 1. Formation of
Substrate. The substrate layer 16 is formed on or applied to the
surface 14 of the catheter body 12, and subsequently or simultaneously
prepared for coupling to the linker layer 18. This is accomplished by
modifying the substrate layer 16 to expose or add groups such as
carboxyls, amines, hydroxyls, or sulflhydryls. In some cases, this may
be followed by customizing the substrate layer 16 with an extender 22
that will change the functionality, for example by adding a maleimide
group that will accept a Michael's addition of a sulfhydryl at one end
of a bifunctional photolytic linker 18. The extent of this
derivitization is measured by adding group-specific probes (such as 1
pyrenyl diazomethane for carboxyls, 1 pyrene butyl hydrazine for
amines, or Edman's reagent for sulfhydryls Molecular Probes, Inc. of
Eugene, Oreg. or Pierce Chemical of Rockford, Ill.) or other
fluorescent dyes that may be measured optically or by flow cytometry.
The substrate layer 16 can be built up to increase its capacity by
several methods, examples of which are discussed below."
[0240] As is also dislosed in United Sttes patent 5,470,307,
"2. Selection of Photolytic Release Mechanism. A heterobifunctional
photolytic linker 18 suitable for the selected therapeutic agent d20
and designed to couple readily to the functionality of the substrate
layer 16 is prepared, and may be connected to the substrate layer 16.
Alternately, the photolinker 18 may first be bonded to the therapeutic
agent 20, with the combined complex of the therapeutic agent 20 and
photolytic linker 18 together being connected to the substrate layer
16. 3. Selection of the Therapeutic Agent. Selection of the appropriate
therapeutic agent 20 for a particular clinical application will depend
upon the prevailing medical practice. One representative example
described below for current use in PTCA and PTA procedures involves the
amine terminal end of a twelve amino acid peptide analogue of hirudin
being coupled to a chloro carbonyl group on the photolytic linker 18.
Another representative example is provided below where the therapeutic
agent 20 is a nucleotide such as an antisense oligodeoxynucleotide
where a terminal phosphate is bonded by means of a diazoethane located
on the photolytic linker 18. A third representative example involves
the platelet inhibitor dipyridamole (persantin) that is attached
through an alkyl hydroxyl by means of a diazo ethane on the photolytic
linker 18. 4. Fabrication of the Linker-Agent Complex and Attachment to
the Substrate. The photolytic linker 18 or the photolytic linker 18
with the therapeutic agent 20 attached are connected to the substrate
layer 16 to complete the catheter 10. A representative example is a
photolytic linker 18 having a sulfhydryl disposed on the non-photolytic
end for attachment to the substrate layer 16, in which case the
coupling will occur readily in a neutral buffer solution to a
maleimide-modified substrate layer 16 on the catheter 10. Once the
therapeutic agent 20 has been attached to the catheter 10, it is
necessary that the catheter 10 be handled in a manner that prevents
damage to the substrate layer 16, photolytic linker layer 18, and
therapeutic agent 20, which may include subsequent sterilization,
protection from ambient light, heat, moisture, and other environmental
conditions that would adversely affect the operation or integrity of
the drug-delivery catheter system 10 when used to accomplish a specific
medical procedure on a patient."
[0241] In the process of U.S. Pat. No. 5,470,307, the linker is
preferably bound to the polymeric material through a modified
functional group. The preparation of such modified functional groups is
discussed at columns 10-13 of such patent, wherein it is disclosed
that: "Most polymers including those discussed herein can be made of
materials which have modifiable functional groups or can be treated to
expose such groups. Polyamide (nylon) can be modified by acid treatment
to produce exposed amines and carboxyls. Polyethylene terephthalate
(PET, Dacron.RTM.) is a polyester and can be chemically treated to
expose hydroxyls and carboxyls. Polystyrene has an exposed phenyl group
that can be derivitized. Polyethylene and polypropylene (collectively
referred to as polyolefins) have simple carbon backbones which can be
derivitized by treatment with chromic and nitric acids to produce
carboxyl functionality, photocoupling with suitably modified
benzophenones, or by plasma grafting of selected monomers to produce
the desired chemical functionality. For example, grafting of acrylic
acid will produce a surface with a high concentration of carboxyl
groups, whereas thiophene or 1,6 diaminocyclohexane will produce a
surface containing sulfhydryls or amines, respectively. The surface
functionality can be modified after grafting of a monomer by addition
of other functional groups. For example, a carboxyl surface can be
changed to an amine by coupling 1,6 diamino hexane, or to a sulfhydryl
surface by coupling mercapto ethyl amine."
[0242] As is also disclosed in United Sttes patent 5,470,307,
"Acrylic acid can be polymerized onto latex, polypropylene,
polysulfone, and polyethylene terephthalate (PET) surfaces by plasma
treatment. When measured by toluidine blue dye binding, these surfaces
show intense modification. On polypropylene microporous surfaces
modified by acrylic acid, as much as 50 nanomoles of dye binding per
cm2 of external surface area can be found to represent carboxylated
surface area. Protein can be linked to such surfaces using carbonyl
diimidazole (CDI) in tetrahydrofuran as a coupling system, with a
resultant concentration of one nanomole or more per cm2 of external
surface. For a 50,000 Dalton protein, this corresponds to 50 .mu.g per
cm2, which is far above the concentration expected with simple plating
on the surface. Such concentrations of a anti-mitotic compound20 on the
angioplasty (PTCA) balloon of a catheter 10, when released, would
produce a high concentration of that therapeutic agent 20 at the site
of an expanded coronary artery. However, plasma-modified surfaces are
difficult to control and leave other oxygenated carbons that may cause
undesired secondary reactions."
[0243] As is also disclosed in U.S. Pat. No. 5,470,307, "In the
case of balloon dilation catheters 10, creating a catheter body 12
capable of supporting a substrate layer 16 with enhanced surface area
can be done by several means known to the art including altering
conditions during balloon spinning, doping with appropriate monomers,
applying secondary coatings such as polyethylene oxide hydrogel,
branched polylysines, or one of the various Starburst..TM. dendrimers
offered by the Aldrich Chemical Company of Milwaukee, Wis."
[0244] As is also disclosed in U.S. Pat. No. 5,470,307, "The
most likely materials for the substrate layer 16 in the case of a
dilation balloon catheter 10 or similar apparatus are shown in FIGS.
1a-1g, including synthetic or natural polymers such as polyamide,
polyester, polyolefin (polypropylene or polyethylene), polyurethane,
and latex. For solid support catheter bodies 12, usable plastics might
include acrylamides, methacrylates, urethanes, polyvinylchloride,
polysulfone, or other materials such as glass or quartz, which are all
for the most part derivitizable." In one embodiment, depicted in FIG.
1A, the photosensitive linker is bonded to a plastic container 12.
[0245] As is also disclosed in U.S. Pat. No. 5,470,307,
"Referring to the polymers shown in FIGS. 1a-1g, polyamide (nylon) is
treated with 3-5M hydrochloric acid to expose amines and carboxyl
groups using conventional procedures developed for enzyme coupling to
nylon tubing. A further description of this process may be obtained
from Inman, D. J. and Hormby, W. E., The Iramobilization of Enzymes on
Nylon Structures and their Use in Automated Analysis, Biochem. J.
129:255-262 (1972) and Daka, N. J. and Laidler, Flow kinetics of
lactate dehydrogenase chemically attached to nylon tubing, K. J., Can.
J. Biochem. 56:774-779 (1978). This process will release primary amines
and carboxyls. The primary amine group can be used directly, or
succinimidyl 4 (p-maleimidophenyl) butyrate (SMBP) can be coupled to
the amine function leaving free the maleimide to couple with a
sulfhydryl on several of the photolytic linkers 18 described below and
acting as an extender 22. If needed, the carboxyl released can also be
converted to an amine by first protecting the amines with BOC groups
and then coupling a diamine to the carboxyl by means of carbonyl
diimidazole (CDI)." The polymeric material 14, and/or the container 12,
may comprise or consist essentially of nylon.
[0246] As is also disclosed in U.S. Pat. No. 5,470,307,
"Polyester (Dacron.RTM.) can be functionalized using 0.01N NaOH in 10%
ethanol to release hydroxyl and carboxyl groups in the manner described
by Blassberger, D. et al, Chemically Modified Polyesters as Supports
for Enzyme Iramobilization: Isocyanide, Acylhydrazine, and Aminoaryl
derivatives of Poly(ethylene Terephthalate), Biotechnol. and Bioeng.
20:309-315 (1978). A diamine is added directly to the etched surface
using CDI and then reacted with SMBP to yield the same maleimide
reacting group to accept the photolytic linker 18." The polymeric
material 14, and/or the container 12, may comprise or consist
essentially of polyester."
[0247] As is also disclosed in U.S. Pat. No. 5,470,307,
"Polystyrene can be modified many ways, however perhaps the most useful
process is chloromethylation, as originally described by Merrifield, R.
B., Solid Phase Synthesis. I. The Synthesis of a Tetrapeptide, J. Am.
Chem Soc. 85:2149-2154 (1963), and later discussed by Atherton, E. and
Sheppard, R. C., Solid Phase Peptide Synthesis: A Practical Approach,
pp. 13-23, (IRL Press 1989). The chlorine can be modified to an amine
by reaction with anhydrous ammonia." The polymeric material may be
comprised of or consist essentially of polystyrene.
[0248] As is also disclosed in U.S. Pat. No. 5,470,307,
"Polyolefins (polypropylene or polyethylene) require different
approaches because they contain primarily a carbon backbone offering no
native functional groups. One suitable approach is to add carboxyls to
the surface by oxidizing with chromic acid followed by nitric acid as
described by Ngo, T. T. et al., Kinetics of acetylcholinesterase
immobilized on polyethylene tubing, Can. J. Biochem. 57:1200-1203
(1979). These carboxyls are then converted to amines by reacting
successively with thionyl chloride and ethylene diamine. The surface is
then reacted with SMBP to produce a maleimide that will react with the
sulflhydryl on the photolytic linker 18." The polymeric material may be
comprised of or consist essentially of polyolefin material.
[0249] As is also disclosed in U.S. Pat. No. 5,470,307, "A more
direct method is to react the polyolefin surfaces with benzophenone
4-maleimide as described by Odom, O. W. et al, Relaxation Time,
Interthiol Distance, and Mechanism of Action of Ribosomal Protein S1,
Arch. Biochem Biophys. 230:178-193 (1984), to produce the required
group for the sulfhydryl addition to the photolytic linker 18. The
benzophenone then links to the polyolefin through exposure to
ultraviolet (uv) light. Other methods to derivitize the polyolefin
surface include the use of radio frequency glow discharge (RFGD)--also
known as plasma discharge--in several different manners to produce an
in-depth coating to provide functional groups as well as increasing the
effective surface area. Polyethylene oxide (PEO) can be crosslinked to
the surface, or polyethylene glycol (PEG) can also be used and the mesh
varied by the size of the PEO or PEG. This is discussed more fully by
Sheu, M. S., et al., A glow discharge treatment to immobilize
poly(ethylene oxide)/poly(propylene oxide) surfactants for wettable and
non-fouling biomaterials, J. Adhes. Sci. Tech., 6:995-1009 (1992) and
Yasuda, H., Plasma Polymerization, (Academic Press, Inc. 1985). Exposed
hydroxyls can be activated by tresylation, also known as trifluoroethyl
sulfonyl chloride activation, in the manner described by Nielson, K.
and Mosbach, K., Tresyl Chloride-Activated Supports for Enzyme
Immobilization (and related articles), Meth. Enzym., 135:65-170 (1987).
The function can be converted to amines by addition of ethylene diamine
or other aliphatic diamines, and then the usual addition of SMBP will
give the required maleimide. Another suitable method is to use RFGD to
polymerize acrylic acid or other monomers on the surface of the
polyolefin. This surface consisting of carboxyls and other carbonyls is
derivitizable with CDI and a diamine to give an amine surface which
then can react with SMBP."
[0250] Referring again to the process described in U.S. Pat.
No. 5,470,307, photolytic linkers can be conjugated to the functional
groups on substrate layers to form linker-agent complexes. As is
disclosed in columns 13-14 of such patent, "Once a particular
functionality for the substrate layer 16 has been determined, the
appropriate strategy for coupling the photolytic linker 18 can be
selected and employed. Several such strategies are set out in the
examples which follow. As with selecting a method to expose a
functional group on the surface 14 of the substrate layer 16, it is
understood that selection of the appropriate strategy for coupling the
photolytic linker 18 will depend upon various considerations including
the chemical functionality of the substrate layer 16, the particular
therapeutic agent 20 to be used, the chemical and physical factors
affecting the rate and equilibrium of the particular photolytic release
mechanism, the need to minimize any deleterious side-effects that might
result (such as the production of antagonistic or harmful chemical
biproducts, secondary chemical reactions with adjunct medical
instruments including other portions of the catheter 10, unclean
leaving groups or other impurities), and the solubility of the material
used to fabricate the catheter body 12 or substrate layer 16 in various
solvents. More limited strategies are available for the coupling of a
2-nitrophenyl photolytic linker 18. If the active site is 1-ethyl
hydrazine used in most caging applications, then the complementary
functionality on the therapeutic agent 20 will be a carboxyl, hydroxyl,
or phosphate available on many pharmaceutical drugs. If a bromomethyl
group is built into the photolytic linker 18, it can accept either a
carboxyl or one of many other functional groups, or be converted to an
amine which can then be further derivitized. In such a case, the
leaving group might not be clean and care must be taken when adopting
this strategy for a particular anti-mitotic compound20. Other
strategies include building in an oxycarbonyl in the 1-ethyl position,
which can form an urethane with an amine in the anti-mitotic
compound20. In this case, the photolytic process evolves CO2."
[0251] Referring again to U.S. Pat. No. 5,470,307, after the
photolytic linker construct has been prepared, it may be contacted with
a coherent laser light source to release the therapeutic agent. Thus,
as is disclosed in column 9 of U.S. Pat. No. 5,470,307, "use of a
coherent laser light source 26 will be preferable in many applications
because the use of one or more discrete wavelengths of light energy
that can be tuned or adjusted to the particular photolytic reaction
occurring in the photolytic linker 18 will necessitate only the minimum
power (wattage) level necessary to accomplish a desired release of the
anti-mitotic compound20. As discussed above, coherent or laser light
sources 26 are currently used in a variety of medical procedures
including diagnostic and interventional treatment, and the wide
availability of laser sources 26 and the potential for redundant use of
the same laser source 26 in photolytic release of the therapeutic agent
20 as well as related procedures provides a significant advantage. In
addition, multiple releases of different therapeutic agents 20 or
multiple-step reactions can be accomplished using coherent light of
different wavelengths, intermediate linkages to dye filters may be
utilized to screen out or block transmission of light energy at unused
or antagonistic wavelengths (particularly cytotoxic or cytogenic
wavelengths), and secondary emitters may be utilized to optimize the
light energy at the principle wavelength of the laser source 26. In
other applications, it may be suitable to use a light source 26 such as
a flash lamp operatively connected to the portion of the body 12 of the
catheter 10 on which the substrate 16, photolytic linker layer 18, and
anti-mitotic compound20 are disposed. One example would be a mercury
flash lamp capable of producing long-wave ultra-violet (uv) radiation
within or across the 300-400 nanometer wavelength spectrum. When using
either a coherent laser light source 26 or an alternate source 26 such
as a flash lamp, it is generally preferred that the light energy be
transmitted through at least a portion of the body 12 of the catheter
10 such that the light energy traverses a path through the substrate
layer 16 to the photolytic linker layer 18 in order to maximize the
proportion of light energy transmitted to the photolytic linker layer
18 and provide the greatest uniformity and reproducibility in the
amount of light energy (photons) reaching the photolytic linker layer
18 from a specified direction and nature. Optimal uniformity and
reproducibility in exposure of the photolyric linker layer 18 permits
advanced techniques such as variable release of the anti-mitotic
compound20 dependent upon the controlled quantity of light energy
incident on the substrate layer 16 and photolytic linker layer 18."
[0252] As is also disclosed in U.S. Pat. No. 5,470,307, "The
art pertaining to the transmission of light energy through fiber optic
conduits 28 or other suitable transmission or production means to the
remote biophysical site is extensively developed. For a fiber optic
device, the fiber optic conduit 28 material must be selected to
accommodate the wavelengths needed to achieve release of the
anti-mitotic compound20 which will for almost all applications be
within the range of 280-400 nanometers. Suitable fiber optic materials,
connections, and light energy sources 26 may be selected from those
currently available and utilized within the biomedical field. While
fiber optic conduit 28 materials may be selected to optimize
transmission of light energy at certain selected wavelengths for
desired application, the construction of a catheter 10 including fiber
optic conduit 28 materials capable of adequate transmission throughout
the range of the range of 280-400 nanometers is preferred, since this
catheter 10 would be usable with the full compliment of photolytic
release mechanisms and therapeutic agents 10. Fabrication of the
catheter 10 will therefore depend more upon considerations involving
the biomedical application or procedure by which the catheter 10 will
be introduced or implanted in the patient, and any adjunct capabilities
which the catheter 10 must possess."
[0253] By way of yet further illustration, and referring to
U.S. Pat. No. 5,599,352 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material can comprise fibrin. As is disclosed in column 4 of such
patent, "The present invention provides a stent comprising fibrin. The
term "fibrin" herein means the naturally occurring polymer of
fibrinogen that arises during blood coagulation. Blood coagulation
generally requires the participation of several plasma protein
coagulation factors: factors XII, XI, IX, X, VIII, VII, V, XIII,
prothrombin, and fibrinogen, in addition to tissue factor (factor III),
kallikrein, high molecular weight kininogen, Ca+2, and phospholipid.
The final event is the formation of an insoluble, cross-linked polymer,
fibrin, generated by the action of thrombin on fibrinogen. Fibrinogen
has three pairs of polypeptide chains (ALPHA 2--BETA 2--GAMMA 2)
covalently linked by disulfide bonds with a total molecular weight of
about 340,000. Fibrinogen is converted to fibrin through proteolysis by
thrombin. An activation peptide, fibrinopeptide A (human) is cleaved
from the amino-terminus of each ALPHA chain; fibrinopeptide B (human)
from the amino-terminus of each BETA chain. The resulting monomer
spontaneously polymerizes to a fibrin gel. Further stabilization of the
fibrin polymer to an insoluble, mechanically strong form, requires
cross-linking by factor XIII. Factor XIII is converted to XIIIa by
thrombin in the presence of Ca+2. XIIIa cross-links the GAMMA chains of
fibrin by transglutaminase activity, forming EPSILON-(GAMMA-glutamyl)
lysine cross-links. The ALPHA chains of fibrin also may be secondarily
cross-linked by transamidation."
[0254] As is also disclosed in U.S. Pat. No. 5,599,352, "Since
fibrin blood clots are naturally subject to fibrinolysis as part of the
body's repair mechanism, implanted fibrin can be rapidly biodegraded.
Plasminogen is a circulating plasma protein that is adsorbed onto the
surface of the fibrin polymer. The adsorbed plasminogen is converted to
plasmin by plasminogen activator released from the vascular
endothelium. The plasmin will then break down the fibrin into a
collection of soluble peptide fragments."
[0255] As is also disclosed in U.S. Pat. No. 5,599,352,
"Methods for making fibrin and forming it into implantable devices are
well known as set forth in the following patents and published
applications which are hereby incorporated by reference. In U.S. Pat.
No. 4,548,736 issued to Muller et al., fibrin is clotted by contacting
fibrinogen with a fibrinogen-coagulating protein such as thrombin,
reptilase or ancrod. Preferably, the fibrin in the fibrin-containing
stent of the present invention has Factor XIII and calcium present
during clotting, as described in U.S. Pat. No. 3,523,807 issued to
Gerendas, or as described in published European Patent Application
0366564, in order to improve the mechanical properties and biostability
of the implanted device. Also preferably, the fibrinogen and thrombin
used to make fibrin in the present invention are from the same animal
or human species as that in which the stent of the present invention
will be implanted in order to avoid cross-species immune reactions. The
resulting fibrin can also be subjected to heat treatment at about
150.degree. C. for 2 hours in order to reduce or eliminate
antigenicity. In the Muller patent, the fibrin product is in the form
of a fine fibrin film produced by casting the combined fibrinogen and
thrombin in a film and then removing moisture from the film osmotically
through a moisture permeable membrane. In the European Patent
Application 0366564, a substrate (preferably having high porosity or
high affinity for either thrombin or fibrinogen) is contacted with a
fibrinogen solution and with a thrombin solution. The result is a
fibrin layer formed by polymerization of fibrinogen on the surface of
the device. Multiple layers of fibrin applied by this method could
provide a fibrin layer of any desired thickness. Or, as in the Gerendas
patent, the fibrin can first be clotted and then ground into a powder
which is mixed with water and stamped into a desired shape in a heated
mold. Increased stability can also be achieved in the shaped fibrin by
contacting the fibrin with a fixing agent such as glutaraldehyde or
formaldehyde. These and other methods known by those skilled in the art
for making and forming fibrin may be used in the present invention."
[0256] As is also disclosed in U.S. Pat. No. 5,599,352,
"Preferably, the fibrinogen used to make the fibrin is a bacteria-free
and virus-free fibrinogen such as that described in U.S. Pat. No.
4,540,573 to Neurath et al which is hereby incorporated by reference.
The fibrinogen is used in solution with a concentration between about
10 and 50 mg/ml and with a pH of about 5.8-9.0 and with an ionic
strength of about 0.05 to 0.45. The fibrinogen solution also typically
contains proteins and enzymes such as albumin, fibronectin (0-300 .mu.g
per ml fibrinogen), Factor XIII (0-20 .mu.g per ml fibrinogen),
plasminogen (0-210 .mu.g per ml fibrinogen), antiplasmin (0-61 .mu.g
per ml fibrinogen) and Antithrombin II (0-150 .mu.g per ml fibrinogen).
The thrombin solution added to make the fibrin is typically at a
concentration of 1 to 120 NIH units/ml with a preferred concentration
of calcium ions between about 0.02 and 0.2M."
[0257] As is also disclosed in U.S. Pat. No. 5,599,352,
"Polymeric materials can also be intermixed in a blend or co-polymer
with the fibrin to produce a material with the desired properties of
fibrin with improved structural strength. For example, the polyurethane
material described in the article by Soldani et at., "Bioartificial
Polymeric Materials Obtained from Blends of Synthetic Polymers with
Fibrin and Collagen" International Journal of Artificial Organs, Vol.
14, No. 5, 1991, which is incorporated herein by reference, could be
sprayed onto a suitable stent structure. Suitable polymers could also
be biodegradable polymers such as polyphosphate ester,
polyhydroxybutyrate valerate, polyhydroxybutyrate-co-hydroxyvalerate
and the like . . . " The polymeric material 14 may be, e.g., a blend of
fibrin and another polymeric material.
[0258] As is also disclosed in U.S. Pat. No. 5,599,352, "The
shape for the fibrin can be provided by molding processes. For example,
the mixture can be formed into a stent having essentially the same
shape as the stent shown in U.S. Pat. No. 4,886,062 issued to Wiktor.
Unlike the method for making the stent disclosed in Wiktor which is
wound from a wire, the stent made with fibrin can be directly molded
into the desired open-ended tubular shape."
[0259] As is also disclosed in U.S. Pat. No. 5,599,352, "In
U.S. Pat. No. 4,548,736 issued to Muller et al., a dense fibrin
composition is disclosed which can be a bioabsorbable matrix for
delivery of drugs to a patient. Such a fibrin composition can also be
used in the present invention by incorporating a drug or other
therapeutic substance useful in diagnosis or treatment of body lumens
to the fibrin provided on the stent. The drug, fibrin and stent can
then be delivered to the portion of the body lumen to be treated where
the drug may elute to affect the course of restenosis in surrounding
luminal tissue. Examples of drugs that are thought to be useful in the
treatment of restenosis are disclosed in published international patent
application WO 91/12779 "Intraluminal Drug Eluting Prosthesis" which is
incorporated herein by reference. Therefore, useful drugs for treatment
of restenosis and drugs that can be incorporated in the fibrin and used
in the present invention can include drugs such as anticoagulant drugs,
antiplatelet drugs, antimetabolite drugs, anti-inflammatory drugs and
antimitotic drugs. Further, other vasoreactive agents such as nitric
oxide releasing agents could also be used. Such therapeutic substances
can also be microencapsulated prior to their inclusion in the fibrin.
The micro-capsules then control the rate at which the therapeutic
substance is provided to the blood stream or the body lumen. This
avoids the necessity for dehydrating the fibrin as set forth in Muller
et al., since a dense fibrin structure would not be required to contain
the therapeutic substance and limit the rate of delivery from the
fibrin. For example, a suitable fibrin matrix for drug delivery can be
made by adjusting the pH of the fibrinogen to below about pH 6.7 in a
saline solution to prevent precipitation (e.g., NACl, CaCl, etc.),
adding the microcapsules, treating the fibrinogen with thrombin and
mechanically compressing the resulting fibrin into a thin film. The
microcapsules which are suitable for use in this invention are well
known. For example, the disclosures of U.S. Pat. Nos. 4,897,268,
4,675,189; 4,542,025; 4,530,840; 4,389,330; 4,622,244; 4,464,317; and
4,943,449 could be used and are incorporated herein by reference.
Alternatively, in a method similar to that disclosed in U.S. Pat. No.
4,548,736 issued to Muller et al., a dense fibrin composition suitable
for drug delivery can be made without the use of microcapsules by
adding the drug directly to the fibrin followed by compression of the
fibrin into a sufficiently dense matrix that a desired elution rate for
the drug is achieved. In yet another method for incorporating drugs
which allows the drug to elute at a controlled rate, a solution which
includes a solvent, a polymer dissolved in the solvent and a
therapeutic drug dispersed in the solvent is applied to the structural
elements of the stent and then the solvent is evaporated. Fibrin can
then be added over the coated structural elements in an adherent layer.
The inclusion of a polymer in intimate contact with a drug on the
underlying stent structure allows the drug to be retained on the stent
in a resilient matrix during expansion of the stent and also slows the
administration of drug following implantation. The method can be
applied whether the stent has a metallic or polymeric surface. The
method is also an extremely simple method since it can be applied by
simply immersing the stent into the solution or by spraying the
solution onto the stent. The amount of drug to be included on the stent
can be readily controlled by applying multiple thin coats of the
solution while allowing it to dry between coats. The overall coating
should be thin enough so that it will not significantly increase the
profile of the stent for intravascular delivery by catheter. It is
therefore preferably less than about 0.002 inch thick and most
preferably less than 0.001 inch thick. The adhesion of the coating and
the rate at which the drug is delivered can be controlled by the
selection of an appropriate bioabsorbable or biostable polymer and by
the ratio of drug to polymer in the solution. By this method, drugs
such as glucocorticoids (e.g. dexamethasone, betamethasone), heparin,
hirudin, tocopherol, angiopeptin, aspirin, ACE inhibitors, growth
factors, oligonucleotides, and, more generally, antiplatelet agents,
anticoagulant agents, antimitotic agents, antioxidants, antimetabolite
agents, and anti-inflamrnatory agents can be applied to a stent,
retained on a stent during expansion of the stent and elute the drug at
a controlled rate. The release rate can be further controlled by
varying the ratio of drug to polymer in the multiple layers. For
example, a higher drug-to-polymer ratio in the outer layers than in the
inner layers would result in a higher early dose which would decrease
over time. Examples of some suitable combinations of polymer, solvent
and therapeutic substance are set forth in Table 1 below . . . "
[0260] At column 7 of U.S. Pat. No. 5,599,352, some polymers
that can be mixed with the fibrin are discussed. It is disclosed that:
"The polymer used can be a bioabsorbable or biostable polymer. Suitable
bioabsorbable polymers include poly(L-lactic acid),
poly(lactide-co-glycolide) and poly(hydroxybutyrate-co-valerate).
Suitable biostable polymers include silicones, polyurethanes,
polyesters, vinyl homopolymers and copolymers, acrylate homopolymers
and copolymers, polyethers and cellulosics. A typical ratio of drug to
dissolved polymer in the solution can vary widely (e.g. in the range of
about 10:1 to 1:100). The fibrin is applied by molding a polymerization
mixture of fibrinogen and thrombin onto the composite as described
herein." The polymeric material 14 may be, e.g., a blend of fibrin and
a bioabsorbable and/or biostable polymer.
[0261] By way of yet further illustration, and referring to
U.S. Pat. No. 5,605,696, the polymeric material can be a multi-layered
polymeric material, and/or a porous polymeric material. Thus, e.g., and
as is disclosed in claim 25 of such patent, "A polymeric material
containing a therapeutic drug for application to an intravascular stent
for carrying and delivering said therapeutic drug within a blood vessel
in which said intravascular stent is placed, comprising: a polymeric
material having a thermal processing temperature no greater than about
100.degree. C.; particles of a therapeutic drug incorporated in said
polymeric material; and a porosigen uniformly dispersed in said
polymeric material, said porosigen being selected from the group
consisting of sodium chloride, lactose, sodium heparin, polyethylene
glycol, copolymers of polyethylene oxide and polypropylene oxide, and
mixtures thereof." The "porsigen" is described at columns 4 and 5 of
the patent, wherein it is disclosed that: "porosigen can also be
incorporated in the drug loaded polymer by adding the porosigen to the
polymer along with the therapeutic drug to form a porous, drug loaded
polymeric membrane. A porosigen is defined herein for purposes of this
application as any moiety, such as microgranules of sodium chloride,
lactose, or sodium heparin, for example, which will dissolve or
otherwise be degraded when immersed in body fluids to leave behind a
porous network in the polymeric material. The pores left by such
porosigens can typically be a large as 10 microns. The pores formed by
porosigens such as polyethylene glycol (PEG), polyethylene
oxide/polypropylene oxide (PEO/PPO) copolymers, for example, can also
be smaller than one micron, although other similar materials which form
phase separations from the continuous drug loaded polymeric matrix and
can later be leached out by body fluids can also be suitable for
forming pores smaller than one micron. While it is currently preferred
to apply the polymeric material to the structure of a stent while the
therapeutic drug and porosigen material are contained within the
polymeric material, to allow the porosigen to be dissolved or degraded
by body fluids when the stent is placed in a blood vessel,
alternatively the porosigen can be dissolved and removed from the
polymeric material to form pores in the polymeric material prior to
placement of the polymeric material combined with the stent within a
blood vessel. If desired, a rate-controlling membrane can also be
applied over the drug loaded polymer, to limit the release rate of the
therapeutic drug. Such a rate-controlling membrane can be useful for
delivery of water soluble substances where a nonporous polymer film
would completely prevent diffusion of the drug. The rate-controlling
membrane can be added by applying a coating from a solution, or a
lamination, as described previously. The rate-controlling membrane
applied over the polymeric material can be formed to include a uniform
dispersion of a porosigen in the rate-controlling membrane, and the
porosigen in the rate-controlling membrane can be dissolved to leave
pores in the rate-controlling membrane typically as large as 10
microns, or as small as 1 micron, for example, although the pores can
also be smaller than 1 micron. The porosigen in the rate-controlling
membrane can be, for example, sodium chloride, lactose, sodium heparin,
polyethylene glycol, polyethylene oxide/polypropylene oxide copolymers,
and mixtures thereof." The polymeric material 14 may comprise a
multiplicity of layers of polymeric material.
[0262] By way of yet further illustration, and referring to
U.S. Pat. No. 5,700,286 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be either a thermoplastic or an elastomeric polymer. Thus,
and referring to columns 5 and 6 of such patent, "The polymeric
material is preferably selected from thermoplastic and elastomeric
polymers. In one currently preferred embodiment the polymeric material
can be a material available under the trade name "C-Flex" from Concept
Polymer Technologies of Largo, Fla. In another currently preferred
embodiment, the polymeric material can be ethylene vinyl acetate (EVA);
and in yet another currently preferred embodiment, the polymeric
material can be a material available under the trade name "BIOSPAN."
Other suitable polymeric materials include latexes, urethanes,
polysiloxanes, and modified styrene-ethylenelbutylene-styrene block
copolymers (SEBS) and their associated families, as well as
elastomeric, bioabsorbable, linear aliphatic polyesters. The polymeric
material can typically have a thickness in the range of about 0.002 to
about 0.020 inches, for example. The polymeric material is preferably
bioabsorbable, and is preferably loaded or coated with a anti-mitotic
compounder drug, including, but not limited to, antiplatelets,
antithrombins, cytostatic and antiproliferative agents, for example, to
reduce or prevent restenosis in the vessel being treated."
[0263] By way of yet further illustration, and referring to
U.S. Pat. No. 6,004,346 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be a bioabsorbable polymer. Thus, and referring to column
7 of such patent, "controlled release, via a bioabsorbable polymer,
offers to maintain the drug level within the desired therapeutic range
for the duration of the treatment. In the case of stents, the
prosthesis materials will maintain vessel support for at least two
weeks or until incorporated into the vessel wall even with
bioabsorbable, biodegradable polymer constructions."
[0264] As is also disclosed in U.S. Pat. No. 6,004,346,
"Several polymeric compounds that are known to be bioabsorbable and
hypothetically have the ability to be drug impregnated may be useful in
prosthesis formation herein. These compounds include: poly-1-lactic
acid/polyglycolic acid, polyanhydride, and polyphosphate ester. A brief
description of each is given below."
[0265] As is also disclosed in U.S. Pat. No. 6,004,346,
"Poly-1-lactic acid/polyglycolic acid has been used for many years in
the area of bioabsorbable sutures. It is currently available in many
forms, i.e., crystals, fibers, blocks, plates, etc. . . . "
[0266] As is also disclosed in U.S. Pat. No. 6,004,346,
"Another compound which could be used are the polyanhydrides. They are
currently being used with several chemotherapy drugs for the treatment
of cancerous tumors. These drugs are compounded into the polymer which
is molded into a cube-like structure and surgically implanted at the
tumor site . . . "
[0267] As is also disclosed in U.S. Pat. No. 6,004,346, "The
compound which is preferred is a polyphosphate ester. Polyphosphate
ester is a compound such as that disclosed in U.S. Pat. Nos. 5,176,907;
5,194,581; and 5,656,765 issued to Leong which are incorporated herein
by reference. Similar to the polyanhydrides, polyphoshate ester is
being researched for the sole purpose of drug delivery. Unlike the
polyanhydrides, the polyphosphate esters have high molecular weights
(600,000 average), yielding attractive mechanical properties. This high
molecular weight leads to transparency, and film and fiber properties.
It has also been observed that the phosphorous-carbon-oxygen
plasticizing effect, which lowers the glass transition temperature,
makes the polymer desirable for fabrication."
[0268] As is also disclosed in U.S. Pat. No. 6,004,346, "The
basic structure of polyphosphate ester monomer is shown below . . .
where P corresponds to Phosphorous, O corresponds to Oxygen, and R and
R1 are functional groups. Reaction with water leads to the breakdown of
this compound into monomeric phosphates (phosphoric acid) and diols
(see below). [Figure] It is the hydrolytic instability of the
phosphorous ester bond which makes this polymer attractive for
controlled drug release applications. A wide range of controllable
degradation rates can be obtained by adjusting the hydrophobicities of
the backbones of the polymers and yet assure biodegradability. he
functional side groups allow for the chemical linkage of drug molecules
to the polymer . . . he drug may also be incorporated into the backbone
of the polymer."
[0269] By way of further illustration, and referring to U.S.
Pat. No. 6,120,536 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may comprise a hydrophobic elastomeric material incorporating
an amount of anti-mitotic compound therein for timed release. Some of
these elastomeric materials are described at columns 5 and 6 of such
patent, wherein it is disclosed that: "The elastomeric materials that
form the stent coating underlayers should possess certain properties.
Preferably the layers should be of suitable hydrophobic biostable
elastomeric materials which do not degrade. Surface layer material
should minimize tissue rejection and tissue inflammation and permit
encapsulation by tissue adjacent the stent implantation site. Exposed
material is designed to reduce clotting tendencies in blood contacted
and the surface is preferably modified accordingly. Thus, underlayers
of the above materials are preferably provided with a fluorosilicone
outer coating layer which may or may not contain imbedded bioactive
material, such as heparin. Alternatively, the outer coating may consist
essentially of polyethylene glycol (PEG), polysaccharides,
phospholipids, or combinations of the foregoing."
[0270] As is also disclosed in U.S. Pat. No. 6,120,536,
"Polymers generally suitable for the undercoats or underlayers include
silicones (e.g., polysiloxanes and substituted polysiloxanes),
polyurethanes, thermoplastic elastomers in general, ethylene vinyl
acetate copolymers, polyolefin elastomers, polyamide elastomers, and
EPDM rubbers. The above-referenced materials are considered hydrophobic
with respect to the contemplated environment of the invention. Surface
layer materials include fluorosilicones and polyethylene glycol (PEG),
polysaccharides, phospholipids, and combinations of the foregoing."
[0271] As is also disclosed in U.S. Pat. No. 6,120,536,
"Various combinations of polymer coating materials can be coordinated
with biologically active species of interest to produce desired effects
when coated on stents to be implanted in accordance with the invention.
Loadings of therapeutic materials may vary. The mechanism of
incorporation of the biologically active species into the surface
coating and egress mechanism depend both on the nature of the surface
coating polymer and the material to be incorporated. The mechanism of
release also depends on the mode of incorporation. The material may
elute via interparticle paths or be administered via transport or
diffusion through the encapsulating material itself."
[0272] By way of yet further illustration, and referring to
U.S. Pat. No. 6,159,488 (the entire disclosure of which is hereby
incorporated by reference into this specification), the polymeric
material may be a biopolymer that is non-degradable and is insoluble in
biological mediums. Thus, and as is disclosed at column 8 of this
patent, "The polymer carrier can be any pharmaceutically acceptable
biopolymer that is non-degradable and insoluble in biological mediums,
has good stability in a biological environment, has a good adherence to
the selected stent, is flexible, and that can be applied as coating to
the surface of a stent, either from an organic solvent, or by a melt
process. The hydrophilicity or hydrophobicity of the polymer carrier
will determine the release rate of halofuginone from the stent surface
. . . . The coating may include other antiproliferative agents, such as
heparin, steroids and non-steroidal anti-inflammatory agents. To
improve the blood compatibility of the coated stent, a hydrophilic
coating such as hydromer-hydrophilic polyurethane can be applied. A
material for delivering a biologically active compound comprising a
solid carrier material having dissolved and/or dispersed therein at
least two biologically active compounds, each of said at least two
biologically active compounds having a biologically active nucleus
which is common to each of the biologically active compounds, and the
at least two biologically active compounds having maximum solubility
levels in a single solvent which differ from each other by at least 10%
by weight; wherein said solid carrier comprises a biocompatible
polymeric material."
[0273] By way of yet further illustration, and referring to
claim 1 of U.S. Pat. No. 6,168,801 (the entire disclosure of which is
hereby incorporated by reference into this specification), the
polymeric material may comprise "A material for delivering a
biologically active compound comprising a solid carrier material having
dissolved and/or dispersed therein at least two biologically active
compounds, each of said at least two biologically active compounds
having a biologically active nucleus which is common to each of the
biologically active compounds, and the at least two biologically active
compounds having maximum solubility levels in a single solvent which
differ from each other by at least 10% by weight; wherein said solid
carrier comprises a biocompatible polymeric material."
[0274] The device of U.S. Pat. No. 6,168,801 preferably
comprises at least two forms of a biologically active ingredient in a
single polymeric matrix. Thus, and as is disclosed at column 6 of the
patent, "It is contemplated in the practice of the present invention
that the combination of the at least two forms of the biologically
active ingredient or medically active ingredient in at least a single
polymeric carrier can provide release of the active ingredient nucleus
common to the at least two forms. The release of the active nucleus can
be accomplished by, for example, enzymatic hydrolysis of the forms upon
release from the carrier device. Further, the combination of the at
least two forms of the biologically active ingredient or medically
active ingredient in at least a single polymeric carrier can provide
net active ingredient release characterized by the at least simple
combination of the two matrix forms described above. This point is
illustrated in FIG. 1 which compares the in vitro release of
dexamethasone from matrices containing various fractions of two forms
of the synthetic steroid dexamethasone, dexamethasone sodium phosphate
(DSP; hydrophilic) and dexamethasone acetate (DA; hydrophobic). It is
easy to see from these results that the release of dexamethasone
acetate (specifically, 100% DA) is slower than all other matrices
tested containing some degree or loading of dexamethasone sodium
phosphate (hydrophilic). Still further, the resulting active ingredient
release from the combined form matrix should be at least more rapid in
the early stages of release than the slow single active ingredient
component alone. Further still, the cumulative active ingredient
release from the combined form matrix should be at least greater in the
chronic stages than the fast single active ingredient component. Once
again from FIG. 1, the two test matrices containing the greatest amount
of dexamethasone sodium phosphate (specifically, 100% DSP, and 75%
DSP/25% DA) began to slow in release as pointed out at points "A" and
"B". And further still, the optimal therapeutic release can be designed
through appropriate combination of the at least two active biological
or medical ingredients in the polymeric carrier material. If as in this
example, rapid initial release as well as continuous long term release
is desired to achieve a therapeutic goal, the matrix composed of 50%
DSP/50% DA would be selected."
[0275] By way of yet further illustration, and referring to
claim 1 of U.S. Pat. No. 6,395,300 (the entire disclosure of which is
hereby incorporated by reference into this specification), the
polymeric material may be a porous polymeric matrix made by a process
comprising the steps of: "a) dissolving a drug in a volatile organic
solvent to form a drug solution, (b) combining at least one volatile
pore forming agent with the volatile organic drug solution to form an
emulsion, suspension, or second solution, and (c) removing the volatile
organic solvent and volatile pore forming agent from the emulsion,
suspension, or second solution to yield the porous matrix comprising
drug, wherein the porous matrix comprising drug has a tap density of
less than or equal to 1.0 g/mL or a total surface area of greater than
or equal to 0.2 m2/g."
[0276] The anti-mitotic compound may be derived from an
anti-microtuble agent. As is disclosed in U.S. Pat. No. 6,689,803 (at
columns 5-6), representative anti-microtubule agents include, e.g., " .
. . taxanes (e.g., paclitaxel and docetaxel), campothecin,
eleutherobin, sarcodictyins, epothilones A and B, discodermolide,
deuterium oxide (D2 O), hexylene glycol (2-methyl-2,4-pentanediol),
tubercidin (7-deazaadenosine), LY290181
(2-amino-4-(3-pyridyl)-4H-naphtho(1,2-b)pyra- n-3-cardonitrile),
aluminum fluoride, ethylene glycol bis-(succinimidylsuccinate), glycine
ethyl ester, nocodazole, cytochalasin B, colchicine, colcemid,
podophyllotoxin, benomyl, oryzalin, majusculamide C, demecolcine,
methyl-2-benzimidazolecarbamate (MBC), LY195448, subtilisin, 1069C85,
steganacin, combretastatin, curacin, estradiol, 2-methoxyestradiol,
flavanol, rotenone, griseofulvin, vinca alkaloids, including
vinblastine and vincristine, maytansinoids and ansamitocins, rhizoxin,
phomopsin A, ustiloxins, dolastatin 10, dolastatin 15, halichondrins
and halistatins, spongistatins, cryptophycins, rhazinilam, betaine,
taurine, isethionate, HO-221, adociasulfate-2, estramustine, monoclonal
anti-idiotypic antibodies, microtubule assembly promoting protein
(taxol-like protein, TALP), cell swelling induced by hypotonic (190
mosmol/L) conditions, insulin (100 nmol/L) or glutamine (10 mmol/L),
dynein binding, gibberelin, XCHO1 (kinesin-like protein),
lysophosphatidic acid, lithium ion, plant cell wall components (e.g.,
poly-L-lysine and extensin), glycerol buffers, Triton X-100 microtubule
stabilizing buffer, microtubule associated proteins (e.g., MAP2, MAP4,
tau, big tau, ensconsin, elongation factor-1-alpha (EF-1.alpha.) and
E-MAP-115), cellular entities (e.g., histone H1, myelin basic protein
and kinetochores), endogenous microtubular structures (e.g., axonemal
structures, plugs and GTP caps), stable tubule only polypeptide (e.g.,
STOP145 and STOP220) and tension from mitotic forces, as well as any
analogues and derivatives of any of the above. Within other
embodiments, the anti-microtubule agent is formulated to further
comprise a polymer."
[0277] The term "anti-micrtubule," as used in this
specification (and in the specification of U.S. Pat. No. 6,689,803),
refers to any " . . . protein, peptide, chemical, or other molecule
which impairs the function of microtubules, for example, through the
prevention or stabilization of polymerization. A wide variety of
methods may be utilized to determine the anti-microtubule activity of a
particular compound, including for example, assays described by Smith
et al. (Cancer Lett 79(2):213-219, 1994) and Mooberry et al., (Cancer
Lett. 96(2):261-266, 1995);" see, e.g., lines 13-21 of column 14 of
U.S. Pat. No. 6,689,803.
[0278] An extensive listing of anti-microtubule agents is
provided in columns 14, 15, 16, and 17 of U.S. Pat. No. 6,689,803; and
one or more of them may be disposed within the polymeric material
together with and/or instead of the anti-mitotic compound of this
invention. In one embodiment, these prior art anti-microtubule agents
are made magnetic in accordance with the process described earlier in
this specification.
[0279] These prior art anti-microtubule agents, which may be
used to prepare the anti-mitotic compounds of this invention, include "
. . . taxanes (e.g., paclitaxel (discussed in more detail below) and
docetaxel) (Schiff et al., Nature 277: 665-667, 1979; Long and
Fairchild, Cancer Research 54: 4355-4361, 1994; Ringel and Horwitz, J.
Natl. Cancer Inst. 83(4): 288-291, 1991; Pazdur et al., Cancer Treat.
Rev. 19(4): 351-386, 1993), campothecin, eleutherobin (e.g., U.S. Pat.
No. 5,473,057), sarcodictyins (including sarcodictyin A), epothilones A
and B (Bollag et al., Cancer Research 55: 2325-2333, 1995),
discodermolide (ter Haar et al., Biochemistry 35: 243-250, 1996),
deuterium oxide (D2 O) (James and Lefebvre, Genetics 130(2): 305-314,
1992; Sollott et al., J. Clin. Invest. 95: 1869-1876, 1995), hexylene
glycol (2-methyl-2,4-pentanediol) (Oka et al., Cell Struct. Funct.
16(2): 125-134, 1991), tubercidin (7-deazaadenosine) (Mooberry et al.,
Cancer Lett. 96(2): 261-266, 1995), LY290181
(2-amino-4-(3-pyridyl)-4H-naphtho(1,2-b)pyran-3-cardonitrile) (Panda et
al., J. Biol. Chem. 272(12): 7681-7687, 1997; Wood et al., Mol.
Pharmacol. 52(3): 437-444, 1997), aluminum fluoride (Song et al., J.
Cell. Sci. Suppl. 14: 147-150, 1991), ethylene glycol
bis-(succinimidylsuccinate) (Caplow and Shanks, J. Biol. Chem. 265(15):
8935-8941, 1990), glycine ethyl ester (Mejillano et al., Biochemistry
31(13): 3478-3483, 1992), nocodazole (Ding et al., J. Exp. Med. 171(3):
715-727, 1990; Dotti et al., J. Cell Sci. Suppl. 15: 75-84, 1991; Oka
et al., Cell Struct. Funct. 16(2): 125-134, 1991; Weimeret al., J.
Cell. Biol. 136(1), 71-80, 1997), cytochalasin B (Illinger et al.,
Biol. Cell 73(2-3): 131-138, 1991), colchicine and CI 980 (Allen et
al., Am. J. Physiol. 261(4 Pt. 1): L315-L321, 1991; Ding et al., J.
Exp. Med. 171(3): 715-727, 1990; Gonzalez et al., Exp. Cell. Res.
192(1): 10-15, 1991; Stargell et al., Mol. Cell. Biol. 12(4):
1443-1450, 1992; Garcia et al., Antican. Drugs 6(4): 533-544, 1995),
colcemid (Barlow et al., Cell. Motil. Cytoskeleton 19(1): 9-17, 1991;
Meschini et al., J. Microsc. 176(Pt. 3): 204-210, 1994; Oka et al.,
Cell Struct. Funct. 16(2): 125-134, 1991), podophyllotoxin (Ding et
al., J. Exp. Med. 171(3): 715-727, 1990), benomyl (Hardwick et al., J.
Cell. Biol. 131(3): 709-720, 1995; Shero et al., Genes Dev. 5(4):
549-560, 1991), oryzalin (Stargell et al., Mol. Cell. Biol. 12(4):
1443-1450, 1992), majusculamide C (Moore, J. Ind. Microbiol. 16(2):
134-143, 1996), demecolcine (Van Dolah and Ramsdell, J. Cell. Physiol.
166(1): 49-56, 1996; Wiemer et al., J. Cell. Biol. 136(1): 71-80,
1997), methyl-2-benzimidazolecarbamate (MBC) (Brown et al., J. Cell.
Biol. 123(2): 387-403, 1993), LY195448 (Barlow & Cabral, Cell
Motil. Cytoskel. 19: 9-17, 1991), subtilisin (Saoudi et al., J. Cell
Sci. 108: 357-367, 1995), 1069C85 (Raynaud et al., Cancer Chemother.
Pharmacol. 35: 169-173, 1994), steganacin (Hamel, Med. Res. Rev. 16(2):
207-231, 1996), combretastatins (Hamel, Med. Res. Rev. 16(2): 207-231,
1996), curacins (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), estradiol
(Aizu-Yokata et al., Carcinogen. 15(9): 1875-1879, 1994),
2-methoxyestradiol (Hamel, Med. Res. Rev. 16(2): 207-231, 1996),
flavanols (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), rotenone
(Hamel, Med. Res. Rev. 16(2): 207-231, 1996), griseofulvin (Hamel, Med.
Res. Rev. 16(2): 207-231; 1996), vinca alkaloids, including vinblastine
and vincristine (Ding et al., J. Exp. Med. 171(3): 715-727, 1990; Dirk
et al., Neurochem. Res. 15(11): 1135-1139, 1990; Hamel, Med. Res. Rev.
16(2): 207-231, 1996; Illinger et al., Biol. Cell 73(2-3): 131-138,
1991; Wiemer et al., J. Cell. Biol. 136(1): 71-80, 1997), maytansinoids
and ansamitocins (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), rhizoxin
(Hamel, Med. Res. Rev. 16(2): 207-231, 1996), phomopsin A (Hamel, Med.
Res. Rev. 16(2): 207-231, 1996), ustiloxins (Hamel, Med. Res. Rev.
16(2): 207-231, 1996), dolastatin 10 (Hamel, Med Res. Rev. 16(2):
207-231, 1996), dolastatin 15 (Hamel, Med. Res. Rev. 16(2): 207-231,
1996), halichondrins and halistatins (Hamel, Med. Res. Rev. 16(2):
207-231, 1996), spongistatins (Hamel, Med. Res. Rev. 16(2): 207-231,
1996), cryptophycins (Hamel, Med. Res. Rev. 16(2): 207-231, 1996),
rhazinilam (Hamel, Med. Res. Rev. 16(2): 207-231, 1996), betaine
(Hashimoto et al., Zool. Sci. 1: 195-204, 1984), taurine (Hashimoto et
al., Zool. Sci. 1: 195-204, 1984), isethionate (Hashimoto et al., Zool.
Sci. 1: 195-204, 1984), HO-221 (Ando et al., Cancer Chemother.
Pharmacol. 37: 63-69, 1995), adociasulfate-2 (Sakowicz et al., Science
280: 292-295, 1998), estramustine (Panda et al., Proc. Natl. Acad. Sci.
USA 94: 10560-10564, 1997), monoclonal anti-idiotypic antibodies (Leu
et al., Proc. Natl. Acad. Sci. USA 91(22): 10690-10694, 1994),
microtubule assembly promoting protein (taxol-like protein, TALP)
(Hwang et al., Biochem. Biophys. Res. Commun. 208(3): 1174-1180, 1995),
cell swelling induced by hypotonic (190 mosmol/L) conditions, insulin
(100 nmol/L) or glutamine (10 mmol/L) (Haussinger et al., Biochem.
Cell. Biol. 72(1-2): 12-19, 1994), dynein binding (Ohba et al.,
Biochim. Biophys. Acta 1158(3): 323-332, 1993), gibberelin (Mita and
Shibaoka, Protoplasma 119(1/2): 100-109, 1984), XCHO1 kinesin-like
protein) (Yonetani et al., Mol. Biol. Cell 7(suppl): 211A, 1996),
lysophosphatidic acid (Cook et al., Mol. Biol. Cell 6(suppl): 260A,
1995), lithium ion (Bhattacharyya and Wolff, Biochem. Biophys. Res.
Commun. 73(2): 383-390, 1976), plant cell wall components (e.g.,
poly-L-lysine and extensin) (Akashi et al., Planta 182(3): 363-369,
1990), glycerol buffers (Schilstra et al., Biochem. J. 277(Pt. 3):
839-847, 1991; Farrell and Keates, Biochem. Cell. Biol. 68(11):
1256-1261, 1990; Lopez et al., J. Cell. Biochem. 43(3): 281-291, 1990),
Triton X-100 microtubule stabilizing buffer (Brown et al., J. Cell Sci.
104(Pt. 2): 339-352, 1993; Safiejko-Mroczka and Bell, J. Histochem.
Cytochem. 44(6): 641-656, 1996), microtubule associated proteins (e.g.,
MAP2, MAP4, tau, big tau, ensconsin, elongation factor-1-alpha
EF-1.alpha.) and E-MAP-115) (Burgess et al., Cell Motil. Cytoskeleton
20(4): 289-300, 1991; Saoudi et al., J. Cell. Sci. 108(Pt. 1): 357-367,
1995; Bulinski and Bossler, J. Cell. Sci. 107(Pt. 10): 2839-2849, 1994;
Ookata et al., J. Cell Biol. 128(5): 849-862, 1995; Boyne et al., J.
Comp. Neurol. 358(2): 279-293, 1995; Ferreira and Caceres, J. Neurosci.
11(2): 392400, 1991; Thurston et al., Chromosoma 105(1): 20-30, 1996;
Wang et al., Brain Res. Mol. Brain Res. 38(2): 200-208, 1996; Moore and
Cyr, Mol. Biol. Cell 7(suppl): 221-A, 1996; Masson and Kreis, J. Cell
Biol. 123(2), 357-371, 1993), cellular entities (e.g. histone H1,
myelin basic protein and kinetochores) (Saoudi et al., J. Cell. Sci.
108(Pt. 1): 357-367, 1995; Simerly et al., J. Cell Biol. 111(4):
1491-1504, 1990), endogenous microtubular structures (e.g., axonemal
structures, plugs and GTP caps) (Dye et al., Cell Motil. Cytoskeleton
21(3): 171-186, 1992; Azhar and Murphy, Cell Motil. Cytoskeleton 15(3):
156-161, 1990; Walker et al., J. Cell Biol. 114(1): 73-81, 1991;
Drechsel and Kirschner, Curr. Biol. 4(12): 1053-1061, 1994), stable
tubule only polypeptide (e.g., STOP145 and STOP220) (Pirollet et al.,
Biochim. Biophys. Acta 1160(1): 113-119, 1992; Pirollet et al.,
Biochemistry 31(37): 8849-8855, 1992; Bosc et al., Proc. Natl. Acad.
Sci. USA 93(5): 2125-2130, 1996; Margolis et al., EMBO J. 9(12):
4095-4102, 1990) and tension from mitotic forces (Nicklas and Ward, J.
Cell Biol. 126(5): 1241-1253, 1994), as well as any analogues and
derivatives of any of the above. Such compounds can act by either
depolymerizing microtubules (e.g., colchicine and vinblastine), or by
stabilizing microtubule formation (e.g., paclitaxel)."
[0280] U.S. Pat. No. 6,689,803 also discloses (at columns 16
and 17 that, "Within one preferred embodiment of the invention, the
therapeutic agent is is paclitaxel, a compound which disrupts
microtubule formation by binding to tubulin to form abnormal mitotic
spindles. Briefly, paclitaxel is a highly derivatized diterpenoid (Wani
et al., J. Am. Chem. Soc. 93:2325, 1971) which has been obtained from
the harvested and dried bark of Taxus brevifolia (Pacific Yew) and
Taxomyces Andreanae and Endophytic Fungus of the Pacific Yew (Stierle
et al., Science 60:214-216,-1993). "Paclitaxel" (which should be
understood herein to include prodrugs, analogues and derivatives such
as, for example, TAXOL.RTM., TAXOTERE.RTM., Docetaxel, 10-desacetyl
analogues of paclitaxel and 3'N-desbenzoyl-3'N-t-butoxy carbonyl
analogues of paclitaxel) may be readily prepared utilizing techniques
known to those skilled in the art (see e.g., Schiff et al., Nature
277:665-667, 1979; Long and Fairchild, Cancer Research 54:4355-4361,
1994; Ringel and Horwitz, J. Natl. Cancer Inst. 83(4):288-291, 1991;
Pazdur et al., Cancer Treat. Rev. 19(4):351-386, 1993; WO 94/07882; WO
94/07881; WO 94/07880; WO 94/07876; WO 93/23555; WO 93/10076;
WO94/00156; WO 93/24476; EP 590267; WO 94/20089; U.S. Pat. Nos.
5,294,637; 5,283,253; 5,279,949; 5,274,137; 5,202,448; 5,200,534;
5,229,529; 5,254,580; 5,412,092; 5,395,850; 5,380,751; 5,350,866;
4,857,653; 5,272,171; 5,411,984; 5,248,796; 5,248,796; 5,422,364;
5,300,638; 5,294,637; 5,362,831; 5,440,056; 4,814,470; 5,278,324;
5,352,805; 5,411,984; 5,059,699; 4,942,184; Tetrahedron Letters
35(52):9709-9712, 1994; J. Med. Chem. 35:42304237, 1992; J. Med. Chem.
34:992-998, 1991; J. Natural Prod. 57(10):1404-1410, 1994; J. Natural
Prod. 57(11):1580-1583, 1994; J. Am. Chem. Soc. 110:6558-6560, 1988),
or obtained from a variety of commercial sources, including for
example, Sigma Chemical Co., St. Louis, Mo. (T7402--from Taxus
brevifolia)."
[0281] As is also disclosed in U.S. Pat. No. 6,689,893,
"Representative examples of such paclitaxel derivatives or analogues
include 7-deoxy-docetaxol, 7,8-cyclopropataxanes, N-substituted
2-azetidones, 6,7-epoxy paclitaxels, 6,7-modified paclitaxels,
10-desacetoxytaxol, 10-deacetyltaxol (from 10-deacetylbaccatin III),
phosphonooxy and carbonate derivatives of taxol, taxol 2',7-di(sodium
1,2-benzenedicarboxylate,
10-desacetoxy-11,12-dihydrotaxol-10,12(18)-dien- e derivatives,
10-desacetoxytaxol, Protaxol(2'- and/or 7-O-ester derivatives), (2'-
and/or 7-O-carbonate derivatives), asymmetric synthesis of taxol side
chain, fluoro taxols, 9-deoxotaxane, (13-acetyl-9-deoxobaccatine III,
9-deoxotaxol, 7-deoxy-9-deoxotaxol, 10-desacetoxy-7-deoxy-9-deoxotaxol,
Derivatives containing hydrogen or acetyl group and a hydroxy and
tert-butoxycarbonylamino, sulfonated 2'-acryloyltaxol and sulfonated
2'-O-acyl acid taxol derivatives, succinyltaxol,
2'-.gamma.-aminobutyryltaxol formate, 2'-acetyl taxol, 7-acetyl taxol,
7-glycine carbamate taxol, 2'-OH-7-PEG(5000)carbamate taxol, 2'-benzoyl
and 2',7-dibenzoyl taxol derivatives, other prodrugs (2'-acetyl taxol;
2',7-diacetyltaxol; 2'succinyltaxol; 2'-(beta-alanyl)-taxol);
2'gamma-aminobutyryltaxol formate; ethylene glycol derivatives of
2'-succinyltaxol; 2'-glutaryltaxol; 2'-(N,N-dimethylglycyl)taxol;
2'-(2-(N,N-dimethylamino)propionyl)taxol; 2'orthocarboxybenzoyl taxol;
2'aliphatic carboxylic acid derivatives of taxol, Prodrugs
{2'(N,N-diethylaminopropionyl)taxol, 2'(N,N-dimethylglycyl)taxol,
7(N,N-dimethylglycyl)taxol, 2',7-di-(N,N-dimethylglycyl)taxol,
7(N,N-diethylaminopropionyl)taxol,
2',7-di(N,N-diethylaminopropionyl)taxol, 2'-(L-glycyl)taxol,
7-(L-glycyl)taxol, 2',7-di(L-glycyl)taxol, 2'-(L-alanyl)taxol,
7-(L-alanyl)taxol, 2',7-di(L-alanyl)taxol, 2'-(L-leucyl)taxol,
7-(L-leucyl)taxol, 2',7-di(L-leucyl)taxol, 2'-(L-isoleucyl)taxol,
7-(L-isoleucyl)taxol, 2',7-di(L-isoleucyl)taxol, 2'-(L-valyl)taxol,
7-(L-valyl)taxol, 2'7-di(L-valyl)taxol, 2'-(L-phenylalanyl)taxol,
7-(L-phenylalanyl)taxol, 2',7-di(L-phenylalanyl)taxol,
2'-(L-prolyl)taxol, 7-(L-prolyl)taxol, 2',7-di(L-prolyl)taxol,
2'-(L-lysyl)taxol, 7-(L-lysyl)taxol, 2',7-di(L-lysyl)taxol,
2'-(L-glutamyl)taxol, 7-(L-glutamyl)taxol, 2',7-di(L-glutamyl)taxol,
2'-(L-arginyl)taxol, 7-(L-arginyl)taxol, 2',7-di(L-arginyl)taxol},
Taxol analogs with modified phenylisoserine side chains, taxotere,
(N-debenzoyl-N-tert-(butoxycaronyl)-10-deacetyltaxol, and taxanes
(e.g., baccatin III, cephalomannine, 10-deacetylbaccatin III,
brevifoliol, yunantaxusin and taxusin)."
[0282] At columns 17, 18, 19, and 20 of U.S. Pat. No.
6,689,803, several "polymeric carriers" are described. One or more of
these "polymeric carriers" may be used as the polymeric material. Thus,
and referring to columns 17-20 of such United States patent, " . . . a
wide variety of polymeric carriers may be utilized to contain and/or
deliver one or more of the therapeutic agents discussed above,
including for example both biodegradable and non-biodegradable
compositions. Representative examples of biodegradable compositions
include albumin, collagen, gelatin, hyaluronic acid, starch, cellulose
(methylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose,
hydroxyethylcellulose, carboxymethylcellulose, cellulose acetate
phthalate, cellulose acetate succinate, hydroxypropylmethylcellulose
phthalate), casein, dextrans, polysaccharides, fibrinogen, poly(D,L
lactide), poly(D,L-lactide-co-glycolide), poly(glycolide),
poly(hydroxybutyrate), poly(alkylcarbonate) and poly(orthoesters),
polyesters, poly(hydroxyvaleric acid), polydioxanone, poly(ethylene
terephthalate), poly(malic acid), poly(tartronic acid), polyanhydrides,
polyphosphazenes, poly(amino acids) and their copolymers (see
generally, Illum, L., Davids, S. S. (eds.) "Polymers in Controlled Drug
Delivery" Wright, Bristol, 1987; Arshady, J. Controlled Release 17:
1-22, 1991; Pitt, Int. J. Phar. 59:173-196, 1990; Holland et al., J.
Controlled Release 4:155-0180, 1986). Representative examples of
nondegradable polymers include poly(ethylene-vinyl acetate) ("EVA")
copolymers, silicone rubber, acrylic polymers (polyacrylic acid,
polymethylacrylic acid, polymethylmethacrylate, polyalkylcynoacrylate),
polyethylene, polyproplene, polyamides (nylon 6,6), polyurethane,
poly(ester urethanes), poly(ether urethanes), poly(ester-urea),
polyethers (poly(ethylene oxide), poly(propylene oxide), Pluronics and
poly(tetramethylene glycol)), silicone rubbers and vinyl polymers
(polyvinylpyrrolidone, poly(vinyl alcohol), poly(vinyl acetate
phthalate). Polymers may also be developed which are either anionic
(e.g. alginate, carrageenin, carboxymethyl cellulose and poly(acrylic
acid), or cationic (e.g., chitosan, poly-L-lysine, polyethylenimine,
and poly (allyl amine)) (see generally, Dunn et al., J. Applied Polymer
Sci. 50:353-365, 1993; Cascone et al., J. Materials Sci.: Materials in
Medicine 5:770-774, 1994; Shiraishi et al., Biol. Pharm. Bull. 16(11):
1164-1168, 1993; Thacharodi and Rao, Int'l J. Pharm. 120:115-118, 1995;
Miyazaki et al., Int'l J. Pharm. 118:257-263, 1995). Particularly
preferred polymeric carriers include poly(ethylenevinyl acetate), poly
(D,L-lactic acid) oligomers and polymers, poly (L-lactic acid)
oligomers and polymers, poly (glycolic acid), copolymers of lactic acid
and glycolic acid, poly (caprolactone), poly (valerolactone),
polyanhydrides, copolymers of poly (caprolactone) or poly (lactic acid)
with a polyethylene glycol (e.g., MePEG), and blends thereof."
[0283] As is also disclosed in U.S. Pat. No. 6,689,893,
"Polymeric carriers can be fashioned in a variety of forms, with
desired release characteristics and/or with specific desired
properties. For example, polymeric carriers may be fashioned to release
a anti-mitotic compoundupon exposure to a specific triggering event
such as pH (see e.g., Heller et al., "Chemically Self-Regulated Drug
Delivery Systems," in Polymers in Medicine III, Elsevier Science
Publishers B. V., Amsterdam, 1988, pp. 175-188; Kang et al., J. Applied
Polymer Sci. 48:343-354, 1993; Dong et al., J. Controlled Release
19:171-178, 1992; Dong and Hoffmnan, J. Controlled Release 15:141-152,
1991; Kim et al., J. Controlled Release 28:143-152, 1994; Cornejo-Bravo
et al., J. Controlled Release 33:223-229, 1995; Wu and Lee, Pharm. Res.
10(10): 1544-1547, 1993; Serres et al., Pharm. Res. 13(2):196-201,
1996; Peppas, "Fundamentals of pH-- and Temperature-Sensitive Delivery
Systems," in Gurny et al. (eds.), Pulsatile Drug Delivery,
Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart, 1993, pp. 41-55;
Doelker, "Cellulose Derivatives," 1993, in Peppas and Langer (eds.),
Biopolymers I, Springer-Verlag, Berlin). Representative examples of
pH-sensitive polymers include poly(acrylic acid) and its derivatives
(including for example, homopolymers such as poly(aminocarboxylic
acid); poly(acrylic acid); poly(methyl acrylic acid), copolymers of
such homopolymers, and copolymers of poly(acrylic acid) and
acrylmonomers such as those discussed above. Other pH sensitive
polymers include polysaccharides such as cellulose acetate phthalate;
hydroxypropylmethylcellulose phthalate; hydroxypropylmethylcellulose
acetate succinate; cellulose acetate trimellilate; and chitosan. Yet
other pH sensitive polymers include any mixture of a pH sensitive
polymer and a water soluble polymer."
[0284] As is also disclosed in U.S. Pat. No. 6,689,893,
"Likewise, polymeric carriers can be fashioned which are temperature
sensitive (see e.g., Chen et al., "Novel Hydrogels of a
Temperature-Sensitive Pluronic Grafted to a Bioadhesive Polyacrylic
Acid Backbone for Vaginal Drug Delivery," in Proceed. Intern. Symp.
Control. Rel. Bioact. Mater. 22:167-168, Controlled Release Society,
Inc., 1995; Okano, "Molecular Design of Stimuli-Responsive Hydrogels
for Temporal Controlled Drug Delivery," in Proceed. Intern. Symp.
Control. Rel. Bioact. Mater. 22:111-112, Controlled Release Society,
Inc., 1995; Johnston et al., Pharm. Res. 9(3):425-433, 1992; Tung,
Int'l J. Pharm. 107:85-90, 1994; Harsh and Gehrke, J. Controlled
Release 17:175-186, 1991; Bae et al., Pharm. Res. 8(4):531-537, 1991;
Dinarvand and D'Emanuele, J. Controlled Release 36:221-227, 1995; Yu
and Grainger, "Novel Thermo-sensitive Amphiphilic Gels: Poly
N-isopropylacrylamide-co-sodium acrylate-co-n-N-alkylacrylamide Network
Synthesis and Physicochemical Characterization," Dept. of Chemical
& Biological Sci., Oregon Graduate Institute of Science &
Technology, Beaverton, Oreg., pp. 820-821; Zhou and Smid, "Physical
Hydrogels of Associative Star Polymers," Polymer Research Institute,
Dept. of Chemistry, College of Environmental Science and Forestry,
State Univ. of New York, Syracuse, N.Y., pp. 822-823; Hoffman et al.,
"Characterizing Pore Sizes and Water `Structure` in Stimuli-Responsive
Hydrogels," Center for Bioengineering, Univ. of Washington, Seattle,
Wash., p. 828; Yu and Grainger, "Thermo-sensitive Swelling Behavior in
Crosslinked N-isopropylacrylamide Networks: Cationic, Anionic and
Ampholytic Hydrogels," Dept. of Chemical & Biological Sci., Oregon
Graduate Institute of Science & Technology, Beaverton, Oreg., pp.
829-830; Kim et al., Pharm. Res. 9(3):283-290, 1992; Bae et al., Pharm.
Res. 8(5):624-628, 1991; Kono et al., J. Controlled Release 30:69-75,
1994; Yoshida et al., J. Controlled Release 32:97-102. 1994; Okano et
al., J. Controlled Release 36:125-133, 1995; Chun and Kim, J.
Controlled Release 38:39-47, 1996; D'Emanuele and Dinarvand, Int'l J.
Pharm. 118:237-242, 1995; Katono et al., J. Controlled Release
16:215-228, 1991; Hoffman, "Thermally Reversible Hydrogels Containing
Biologically Active Species," in Migliaresi et al. (eds.), Polymers in
Medicine III, Elsevier Science Publishers B. V., Amsterdam, 1988, pp.
161-167; Hoffman, "Applications of Thermally Reversible Polymers and
Hydrogels in Therapeutics and Diagnostics," in Third International
Symposium on Recent Advances in Drug Delivery Systems, Salt Lake City,
Utah, Feb. 24-27, 1987, pp. 297-305; Gutowska et al., J. Controlled
Release 22:95-104, 1992; Palasis and Gehrke, J. Controlled Release
18:1-12, 1992; Paavola et al., Pharm. Res. 12(12):1997-2002, 1995)."
[0285] As is also disclosed in U.S. Pat. No. 6,689,893,
"Representative examples of thermogelling polymers, and their gelatin
temperature (LCST (.degree. C.)) include homopolymers such as
poly(-methyl-N-n-propylacryla- mide), 19.8; poly(N-n-propylacrylamide),
21.5; poly(N-methyl-N-isopropylac- rylamide), 22.3;
poly(N-n-propylmethacrylamide), 28.0; poly(N-isopropylacrylamide),
30.9; poly(N,n-diethylacrylamide), 32.0;
poly(N-isopropylmethacrylamide), 44.0; poly(N-cyclopropylacrylamide),
45.5; poly(N-ethylmethyacrylamide), 50.0;
poly(N-methyl-N-ethylacrylamide- ), 56.0;
poly(N-cyclopropylmethacrylamide), 59.0; poly(N-ethylacrylamide), 72.0.
Moreover thermogelling polymers may be made by preparing copolymers
between (among) monomers of the above, or by combining such
homopolymers with other water soluble polymers such as acrylmonomers
(e.g., acrylic acid and derivatives thereof such as methylacrylic acid,
acrylate and derivatives thereof such as butyl methacrylate,
acrylamide, and N-n-butyl acrylamide)."
[0286] As is also disclosed in U.S. Pat. No. 6,689,893, "Other
representative examples of thermogelling polymers include cellulose
ether derivatives such as hydroxypropyl cellulose, 41.degree. C.;
methyl cellulose, 55.degree. C.; hydroxypropylmethyl cellulose,
66.degree. C.; and ethylhydroxyethyl cellulose, and Pluronics such as
F-127, 10-15.degree. C.; L-122, 19.degree. C.; L-92, 26.degree. C.;
L-81, 20.degree. C.; and L-61, 24.degree. C."
[0287] As is also disclosed in U.S. Pat. No. 6,689,893,
"Preferably, therapeutic compositions of the present invention are
fashioned in a manner appropriate to the intended use. Within certain
aspects of the present invention, the therapeutic composition should be
biocompatible, and release one or more therapeutic agents over a period
of several days to months. For example, "quick release" or "burst"
therapeutic compositions are provided that release greater than 10%,
20%, or 25% (w/v) of a therapeutic agent (e.g., paclitaxel) over a
period of 7 to 10 days. Such "quick release" compositions should,
within certain embodiments, be capable of releasing chemotherapeutic
levels (where applicable) of a desired agent. Within other embodiments,
"low release" therapeutic compositions are provided that release less
than 1% (w/v) of a therapeutic agent a period of 7 to 10 days. Further,
therapeutic compositions of the present invention should preferably be
stable for several months and capable of being produced and maintained
under sterile conditions."
[0288] In one preferred embodiment, the anti-mitotic compound
is disposed on or in a drug-eluting polymer that is adapted to elute
the anti-mitotic compound at a specified rate. These polymers are well
known and are often used in conjunction with drug-eluting stents.
Reference may be had, e.g., to U.S. Pat. Nos. 6,702,850 (multi-coated
drug-eluting stent), 6,671,562 (high impedance drug eluting cardiac
lead), 6,206,914, 6,004,346 (intralumenl drug eluting prosthesis),
5,997,468, 5,871,535 (intralumenal drug eluting prosthesis), 5,851,231,
5,851,217, 5,725,567, 5,697,967 (drug eluting stent), 5,599,352 (method
of making a drug elting stent), 5,591,227 (drug eluting stent),
5,545,208 (intralumenal drug eluting prosthesis), 5,217,028 (bipolar
cardiac lead with drug eluting device), 4,953,564 (screw-in drug
eluting lead), and the like. The entire disclosure of each of these
United States patents is hereby incorporated by referenc into this
specification.
[0289] Although preferred embodiments have been depicted and
described in detail herein, it will be apparent to those skilled in the
relevant art that various modifications, additons, substitutions, and
the like can be made without departing from the spirit of the
invention, and these are thus considered to be within the scope of the
invnetino as defined in the claims which follow.