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(12) United States Patent (10) Patent No.: US 9,687,493 B2 Weglicki Et Al US009687493B2 (12) United States Patent (10) Patent No.: US 9,687,493 B2 Weglicki et al. (45) Date of Patent: *Jun. 27, 2017 (54) USE OF NK-1 RECEPTOR ANTAGONISTS ionized Mg, Mg metabolism and electrolytes in serum of human FOR TREATING HYPOMAGNESEMLA, volunteers.” Journal of the American College of Nutrition, 1994; NEUROGENIC INFLAMMATION, AND 13(5): 447-454. CARDAC DYSFUNCTIONASSOCATED Barbagallo et al., “Magnesium homeostasis and aging.” Magnesium WITH EGFR-BLOCKING DRUGS Research, 2009; 22(4): 235-246. Cao et al., “Methionine Sulfoxide reductase B1 (MSrB1) recovers TRPM6 channel activity during oxidative stress.” Journal of Bio (71) Applicant: THE GEORGE WASHINGTON logical Chemistry, Aug. 20, 2010; 285(34):26081-7. UNIVERSITY, Washington, DC (US) Chen et al., “Mechanisms of cardiac dysfunction associated with tyrosine kinase inhibitor cancer therapeutics.” Circulation, 2008; (72) Inventors: William B. Weglicki, Potomac, MD 117: 84-95. (US); Iu Tong Mak, Gaithersburg, MD Dehlin et al., “Substance P acting via the neurokinin-1 receptor regulates adverse myocardial remodeling in a rat model of hyper (US) tension.” International Journal of Cardiology, 2013 12; 168(5):4643-51. (73) Assignee: THE GEORGE WASHINGTON Dimke et al., “Effects of the EGFR Inhibitor Erlotinib on Magne UNIVERSITY, Washington, DC (US) sium Handling.” Journal of the American Society of Nephrology, Aug. 2010; 21 (8): 1309-16. doi:10.1681/ASN. 2009111153. Epub (*) Notice: Subject to any disclaimer, the term of this Jul. 1, 2010. patent is extended or adjusted under 35 Doherty et al., “Multi-parameter in vitro toxicity testing of crizotinib, Sunitinib, erlotinib, and nilotinib in human U.S.C. 154(b) by 0 days. cardiomyocytes.” Toxicology and Applied Pharmacology, Oct. 1, This patent is Subject to a terminal dis 2013; 272(1):245-55. doi:10.1016/j.taap.2013.04.027. Epub May claimer. 21, 2013. Fletcher et al., “EGFR inhibition induces proinflammatory cytokines via NOX4 in HNSCC.” Molecular Cancer Research, Dec. (21) Appl. No.: 15/278,192 2013; 11(12): 1574-84. doi: 10.1158/1541-7786.MCR-13-0187. Epub Sep. 18, 2013. (22) Filed: Sep. 28, 2016 Garrett et al., “Cetuximab in the treatment of patients with colorectal cancer.” Expert Opinion on Biological Therapy, 2011; 11: (65) Prior Publication Data 937-949. Gill et al., “NADPH oxidases in the kidney.” Antioxidants and US 2017/OO14420 A1 Jan. 19, 2017 Redox Signaling, 2006; 8:1597-1607; 23. Groenestege et al., “Impaired basolateral sorting of pro-EGF causes isolated recessive renal hypomagnesemia.” Journal of Clinical Related U.S. Application Data Investigation, 2007: 117: 2260-2267. Hahn et al., “Cancer therapy-induced cardiotoxicity: basic mecha (63) Continuation of application No. 14/735,396, filed on nisms and potential cardioprotective therapies.” Journal of the Jun. 10, 2015, now Pat. No. 9,474,761. American Heart Association, Apr. 22, 2014:3(2):e()00665. doi:10. 1161 JAHA113.00.0665. Hasinoff, B.B., “The cardiotoxicity and myocyte damage caused by (60) Provisional application No. 62/010, 198, filed on Jun. Small molecule anticancer tyrosine kinase inhibitors is correlated 10, 2014. with lack of target specificity.” Toxicology and Applied Pharma cology, 2010:244(2): 190-195. (51) Int. Cl. Ho et al., “Human monocytes and macrophages express Substance A 6LX 3/5.377 (2006.01) P and neurokinin-1 receptor.” Journal of Immunology, 1997; 159:5654-5660. A6 IK3I/00 (2006.01) Imai et al., “Comparing antibody and Small-molecule therapies for A6 IK 3/4035 (2006.01) cancer.” Nature Reviews. Cancer. Sep. 2006;6(9):714-27. Review. A6 IK3I/444 (2006.01) International Cosmetic Ingredient Dictionary and Handbook, eds. A6 IK 3/4985 (2006.01) Wenninger and McEwen, pp. 1656-1661, 1626, 1654-1655, 1673 A6 IK 3/495 (2006.01) 1686 and 1693-1697 (The Cosmetic, Toiletry, and Fragrance Assoc. (52) U.S. Cl. Washington, D.C., 7th Edition, 1997). CPC .......... A6 IK3I/5377 (2013.01); A61 K3I/00 Janjigian et al., “Phase I/II trial of cetuximab and erlotinib in (2013.01); A61K 31/4035 (2013.01); A61 K patients with lung adenocarcinoma and acquired resistance to 3 1/444 (2013.01); A61K 31/495 (2013.01); erlotinib.” Clinical Cancer Research, Apr. 15, 2011;17(8): 2521-7. A61K 31/4985 (2013.01) Epub Jan. 19, 2011. (58) Field of Classification Search (Continued) None Primary Examiner — Brian J Davis See application file for complete search history. (74) Attorney, Agent, or Firm — Cooley LLP (56) References Cited (57) ABSTRACT The present disclosure provides methods for alleviating or U.S. PATENT DOCUMENTS preventing the negative physiological side effects associated with the administration of EGFR blocking therapeutics. The 9,474,761 B2 * 10/2016 Weglicki ............ A61K 31,5377 disclosure provides, inter alia, methods for treating or pre venting: hypomagnesemia, cardiac dysfunction, and skin OTHER PUBLICATIONS lesions, which are induced by EGFR blocking drugs, by Altura et al., “Comparative effects of a Mg-enriched diet and administering an NK-1 receptor antagonist. different orally administered magnesium oxide preparations on 18 Claims, 10 Drawing Sheets US 9,687,493 B2 Page 2 (56) References Cited Saif M.W., “Management of hypomagnesemia in cancer patients receiving chemotherapy.” Journal of Supportive Oncology, May Jun. 2008;6(5):243-8. OTHER PUBLICATIONS Sawyers C. “Targeted cancer therapy.” Nature, 432:294-297, 2004. Schettino et al. “Erlotinib: an EGF receptor tyrosine kinase inhibitor Kramer et al., “Dietary Mg-intake influence circulating pro-inflam in non-Small-cell lung cancer treatment.” Expert Review of Respi matory neuropeptide levels and loss of myocardial tolerance to ratory Medicine, Apr. 2008:2(2):167-78. doi:10.1586/17476348.2. postischemic stress.” Experimental Biology and Medicine, 2003; 2,167. 228:665-673. Kramer et al., “Neurogenic inflammation and cardiac dysfunction Tejpar et al., “Magnesium wasting associated with epidermal due to hypomagnesemia.” American Journal of the Medical Sci growth-factor receptor-targeting antibodies in colorectal cancer: a ences, 2009; 338(1):22-27. prospective study.” The Lancet. Oncology, 2007, 8:387-394. Ledeganck et al., “The TRPM6/EGF pathway is downregulated in Thebault S et al., “EGF increases TRPM6 activity and surface a rat model of cisplatin nephrotoxicity.” PLoS One, expression.” Journal of the American Society of Nephrology, Jan. 2013;8(2):e57016. doi: 10.1371/journal.pone.0057016. Epub Feb. 2009:20(1):78-85. Epub Dec. 10, 2008. 15, 2013. Van Angelen et al., “Cisplatin-induced injury of the renal distal Lockhart et al., “The epidermal growth factor receptor as a target for convoluted tubule is associated with hypomagnesaemia in mice.” colorectal cancer therapy.” Seminars in Oncology, 2005; 32: 52-60. Mak et al., “Loss of neutral Endopeptidase activity contributes to Nephrology Dialysis Transplant, 2013; 28:879-89. neutrophil activation and cardiac dysfunction during chronic Vickers et al., “Association of hypomagnesemia with inferior Sur hypomagnesemia: Protection by Substance P receptor blockade.” vival in a phase III, randomized study of cetuximab plus best Experimental and Clinical Cardiology, 2011;16(4): 121-124. supportive care versus best supportive care alone: NCIC CTG/ Mak et al., “EGFR-TKI, erlotinib, causes hypomagnesemia, oxida AGITG CO. 17.” Annals of Oncology, Apr. 2013; 24(4):953-60. tive stress, and cardiac dysfunction: attenuation by NK-1 receptor Weglicki WB, et al., “Neutral endopeptidase inhibition enhances blockade.” Journal of Cardiovascular Pharmacology, Jan. 2015; Substance P mediated inflammation due to hypomagnesemia.” Mag 65(1):54-61. nesium Research, 2009; 22:1-7. Mak et al., “Suppression of neutrophil and endothelial activation by Weglicki et al., “Pathobiology of magnesium deficiency: A Substance P receptor blockade in the Mg-deficient rat.” Magnesium cytokine/neurogenic inflammation hypothesis.” American Journal Research, 2003; 16(2):91-97. of Physiology, 1992; 263: R734-R737. Mak, et al., “Mg Supplementation Attenuates Ritonavir-induced Weglicki et al., “The EGFR tyrosine kinase inhibitor tyrphostin Hyperlipidemia, Oxidative Stress and Cardiac Dysfunction in AG-1478 causes hypomagnesemia and cardiac dysfunction.” Cana Rats.” American Journal of Physiology: Regulatory, Integrative and dian Journal of Physiology of Pharmacology, 2012; 90(8): 1145-9. Comparative Physiology, 2013: 305: R1102-R1111. Weglicki et al., “The role of Magnesium Deficiency in Cardiovas Mak, et al., “AZT-Induced cardiovascular toxicity—attenuation by cular and Intestinal Inflammation.” Magnesium Research, 2012; Mg-Supplementation.” Cardiovascular Toxicology, 2009; 9(2):78 23(4): S199-206. 85. Weglicki et al., “Role of free radicals and substance P in magnesium McCutcheon's Detergents and Emulsifiers, North American Edi deficiency.” Cardiovascular Research, 1996:31:677-682. tion, pp. 317-324 (1986). Yang B et al., “Tyrosine kinase inhibitor (TKI)-induced cardiotoxic Metro, et al., “Epidermal growth factor receptor (EGFR) targeted ity: approaches to narrow the gaps between preclinical safety therapies in non-small cell lung cancer (NSCLC).” Rev Recent Clin evaluation and clinical outcome.” Journal of Applied Toxicology, Trials. Jan. 2006;1(1): 1-13. Dec. 2012; 32(12):945-51. doi: 10.1002/jat.2813. Epub Sep. 10, Nistala et al., “Redox control of renal function and hypertension.” 2012. Review. Antioxidants and Redox Signaling, Dec. 2008; 10(12):2047-89. doi: Vincenzi et al., "Aprepitant for Erlotinib-Induced Pruritus.” New 10.1089, arS2008.2034. England Journal of Medicine,
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