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WO 2018/175301 Al 27 September 2018 (27.09.2018) W !P O PCT

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WO 2018/175301 Al 27 September 2018 (27.09.2018) W !P O PCT (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization III International Bureau (10) International Publication Number (43) International Publication Date WO 2018/175301 Al 27 September 2018 (27.09.2018) W !P O PCT (51) International Patent Classification: MAINERO, Valentina; 30699 Russell Ranch Road, Suite A 61K 47/60 (20 17.0 1) A61P 17/00 (2006 .0 1) 140, Westlake Village, CA 91362 (US). HARRIS, Todd, A61P 11/00 (2006.01) A61P 27/02 (2006.01) James; 30699 Russell Ranch Road, Suite 140, Westlake A61P 1/00 (2006.01) Village, CA 91362 (US). RAVA ROSSA, Luisa, Bertari- one; 30699 Russell Ranch Road, Suite 140, Westlake V il (21) International Application Number: lage, CA 91362 (US). PCT/US20 18/023 108 (74) Agent: CHRISTENSEN, Michael, R.; Knobbe, Martens, (22) International Filing Date: Olson & Bear, LLP , 2040 Main Street, 14th Floor, Irvine, 19 March 2018 (19.03.2018) CA 92614 (US). (25) Filing Language: English (81) Designated States (unless otherwise indicated, for every (26) Publication Language: English kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, (30) Priority Data: CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, DO, 62/473,982 20 March 20 17 (20.03 .20 17) US DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, 62/501,568 04 May 20 17 (04.05 .2017) US HR, HU, ID, IL, IN, IR, IS, JO, JP, KE, KG, KH, KN, KP, 62/590,1 19 22 November 2017 (22. 11.20 17) US KR, KW, KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, (71) Applicant: SIENNA BIOPHARMACEUTICALS, INC. MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, [US/US]; 30699 Russell Ranch Road, Suite 140, Westlake OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, Village, CA 91362 (US). SC, SD, SE, SG, SK, SL, SM, ST, SV, SY,TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (72) Inventors: TRAVERSA, Silvio; 30699 Russell Ranch Road, Suite 140, Westlake Village, CA 91362 (US). (54) Title: POLYMER CONJUGATE OF MONTESANIB WITH REDUCED EXPOSURE CT103 FIG. 4 1 100µΜ 30µ Μ 10µ Μ DMSO Motesanib Disphosphate 10nM (57) Abstract: Disclosed herein are polymer conjugates, such as SNA- 103, comprising an active agent linked to a polymer, wherein 00 the active agent comprises an inhibitor, antagonist, or inverse agonist of a vascular endothelial growth factor receptor (VEGFR), such o as montesanib. The disclosed polymer conjugates reduce exposure of the active agent at non-target sites. [Continued on nextpage] WO 2018/175301 Al Illlll II lllll lllll lllll ill III III lllll ll lllll lllll Hill llll III llll llll (84) Designated States (unless otherwise indicated, for every kind of regional protection available): ARIPO (BW, GH, GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, LV, MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, SM, TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, GW, KM, ML, MR, NE, SN, TD, TG). Published: — with international search report (Art. 21(3)) — before the expiration of the time limit for amending the claims and to be republished in the event of receipt of amendments (Rule 48.2(h)) POLYMER CONJUGATE OF MONTESANIB WITH REDUCED EXPOSURE CROSS REFERENCE TO RELATED APPLICATIONS [0001] This application claims priority to US provisional patent application Serial No. 62/473,982 filed March 20, 201 7 , and claims priority to US provisional patent application Serial No. 62/501 ,568 filed May 4 , 201 7 , and claims priority to US provisional patent application Serial No. 62/590, 119 filed November 22, 201 7 . Each of these applications is incorporated by reference in their entirety herein. FIELD [0002] Disclosed herein are polymer conjugates, comprising active agents linked to polymers, and therapeutic uses thereof. More particularly, a polymer conjugate of montesanib, which exhibits reduced exposure to non-target sites, and inhibits Vascular Endothelial Growth Factor Receptors (VEGFR) mediators of various pathological conditions is described. BACKGROUND [0003] Inhibitors of (VEGFR) , such as montesanib, have been described for possible therapeutic use in the prevention, alleviation and treatment of kinase-associated pathologies. However, such compounds are associated with broad specificity, as well as undesirable and toxic effects. Accordingly, strategies to render these VEGFR inhibitors more specific and less toxic are needed. SUMMARY OF EMBODIMENTS [0004] In several embodiments, a polymer conjugate (such as SNA-1 03) is provided having the following structure: [0005] Effective delivery of pharmacologically active agents may be hindered by unwanted exposure of those agents to non-desired locations (such as the systemic circulation and/or lymphatic system). For example, topical agents useful in treating various skin disorders may result in toxic side effects because of systemic exposure. One issue with delivering compositions comprising one or more active agents topically (or non-topically) is the concern that such agents need to be delivered in an amount and at a location sufficient to have a therapeutic effect. At the same time however, exposure (e.g., absorption or longevity of the composition in the systemic circulation, lymphatic system, or other non-targeted sites) may not be desirable for multiple reasons, including, but not limited to, safety reasons. There remains an unmet need for compounds with reduced exposure at non-target sites that result in a clinically therapeutic effect. [0006] In several embodiments of the invention, the compositions described herein are both therapeutically efficacious and minimize non-target (e.g., systemic or bloodstream) exposure. In some embodiments, the active agents are PEGylated or otherwise coupled to large molecules, and surprisingly, are effective in crossing biological membranes such that the active agents are effectively delivered to the target location. Although inflammatory skin conditions are disclosed in several embodiments, other embodiments are used to treat non-dermal inflammation, as well as other several conditions (e.g., those conditions that would benefit from treatment with reduced exposure at non-target sites). For example, in some embodiments, the compositions and technology described herein are used in the gastrointestinal and pulmonary systems. Ophthalmic treatments are provided in some embodiments. In yet other embodiments, compositions for treating joints are provided. Treatment of the nose and ear are provided in other embodiments. Inflammatory and non-inflammatory conditions are contemplated herein. [0007] Reduced exposure compounds and compositions are provided in several embodiments. "Reduced exposure" compounds are those compounds that, when delivered to a target location, are formulated to act at the target location with reduced exposure (e.g., entry and/or longevity) in non-target sites. Exposure is reduced as compared to active agents not formulated according to the embodiments described herein. As a non-limiting example, a PEGylated topical dermal active agent has reduced exposure to the bloodstream as compared to the active agent alone. Reduced exposure compounds include topical compounds that can be delivered to body surfaces and cavities such as the skin, eyes, ears, nose, mouth, vagina, rectum, etc., as well as oral (e.g., enteric coated) compounds for oral delivery that treat the gastrointestinal system (e.g., the Gl lining), inhalants that treat the lungs, injections for joints, and other modes of delivery that target one location with the goal of reducing exposure to a non-desired site. Non-desired target sites include, for example, the systemic system, the lymphatic system, non-target tissue, etc. "Reduced exposure compositions" comprise or consist essentially of one or more "reduced exposure compounds." [0008] Reduced exposure topical compositions are provided in many embodiments. In some embodiments, a reduced exposure composition is delivered orally, e.g. , for treatment of the gastrointestinal system. The active agent remains in the lining of the gastrointestinal tract and is able to achieve pharmacological specificity. Because the active agent is conjugated with PEG or another molecule as described herein, the active agent is absorbed more slowly into the non-target site (e.g. , the systemic circulation and/or lymphatic system). In some cases, less or none of the active agent is absorbed into the non-target site (e.g. , systemic circulation and/or lymphatic system). Further, once the composition enters the systemic circulation and/or lymphatic system, clearance (e.g. , by the kidney) occurs at a much faster rate. One or more of the advantages of (i) reduced absorption into the non-target site (e.g. , systemic circulation and/or lymphatic system), (ii) slower absorption into the non-target site (e.g. , systemic circulation and/or lymphatic system) , and (iii) faster clearance rates from the non-target site (e.g. , systemic circulation and/or lymphatic system) are also achieved when using the compositions (formulated according to the methods described herein) for treating the eye (e.g. , via eye drops), the lungs (e.g. , via inhalants), the skin (e.g. , via dermal topicals) , joints (e.g. , via injectables), nasal passageways, and the ear (such as the ear canal and other structures). Vaginal and rectal tissues are treated in some embodiments via, for example suppositories. [0009] In several embodiments, there is provided in a reduced exposure composition, a polymer conjugate comprising a warhead (e.g. , at least one active agent) linked to a polymer, wherein the warhead comprises an inhibitor, antagonist, or inverse agonist of, for example, a vascular endothelial growth factor receptor (VEGFR).
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