The present invention relates to arylating agents, in particular phenylating agents, which are suitable as therapeutic compounds, especially in the treatment of cancer and disease caused by viral infections (eg retrovirus infections such as HIV. As shown by studies reported herein, the compounds of the invention show marked anti-tumour activity and in AIDS and pre-AIDS therapy show the capacity to regress Kaposi's sarcoma, improve CD4 count in humans, increase the level of various blood parameters in murine patient models and to achieve weight gain and general patient condition by action against HIV and/or its effects (eg opportunistic disease).

According to the invention, there is provided a compound of the following general formula for use in the treatment of prophylaxis or therapy of neoplasm or viral infection such as HIV-infection:-

wherein X] and X ₂ are, each independently, hydrogen or chloro and wherein X ₃ and X ₄ are, each independently, hydrogen or nitro, provided that at least two of X _h X ₂ , X ₃ and X ₄ are other than hydrogen, or a salt or ester thereof (eg a salt wherein -COOH is substituted by -COOR in which R is optionally substituted amino).

Conveniently, X, is chloro, X ₂ is chloro or hydrogen, X ₃ is nitro and X ₄ is nitro or hydrogen. The following are preferred compounds :-

2, 4-dichloro-3, 5-dinitrobenzoic acid 4-chloro-3, 5-dinitrobenzoic acid

2-chloro-3, 5-dinitrobenzoic acid 2-chloro-5-nitrobenzoic acid 2, 5-dichlorobenzoic acid 2, 4-dinitrobenzoic acid 3, 5-dinitrobenzoic acid

2, 5-dichloro-4-nitrobenzoic acid 2, 4-dichloro-5-nitrobenzoic acid

2, 6-dichloro-4-nitrobenzoic acid

3, 5-dichloro-4-nitrobenzoic acid 4-chloro-3 -nitrobenzoic acid

2-chloro-4-nitrobenzoic acid 3, 4-dichlorobenzoic acid

Since treatment in accordance with the invention is by what is believed to be an arylating mechanism, use is typically at relatively high concentrations and, consequently, doses. Generally, the recommended dosage is lmg/kg body weight to 30mg/kg body weight per day for 5 days weekly.

The compounds of the invention may be prepared by known process techniques for preparing benzene substituted compounds. Such techniques are described in various standard texts, for example, "Organic Syntheses" 1963 Collective Volume 4, pages 364 to 366, by Harry P Schultz and published by John Wiley and Sons Inc. Post- preparation sterilization may be required, at least following formulation of the compounds into pharmaceutical composition form.

The compounds of the invention may be formulated for use as pharmaceutical compositions (eg for iv, ip, oral or sc administration) comprising at least one active compound and a diluent or carrier. Thus, the invention includes a pharmaceutical composition, which composition comprises a compound according to the invention and a pharmaceutically-acceptable diluent or carrier (eg aqueous).

Such a composition may be in bulk form or, more preferably, unit dosage form. Thus, for example, the composition may be formulated as a tablet, capsule, powder, solution or suspension. Soft gel capsules may be especially convenient. The composition may be a liposomal formulation or administered in a slow sustained release delivery system.

Compositions in accordance with the invention may be prepared using the active compounds defined herein in accordance with conventional pharmaceutical practice. The diluents, excipients or carriers which may be used are well known in the formulation art and the form chosen for any particular regimen will depend on the given context and the physician's choice.

Thus, for example, as illustrated below the compounds of the invention may be administered in solution in sterile deionised water. Also, if necessary, solution may be facilitated using dimethyl sulphoxide (DMSO) or alternatively an alcohol, a glycol or a vegetable oil. The compounds are most favourably administered in corn oil or as a solution in DMSO/sterile water. In the case of the use according to the invention of sodium salts of the active compounds, the active ingredient is preferably administered as an aqueous solution.

In using a compound of the invention, dosage guidance can be taken from animal studies such as that described below. In such studies doses of from about 50mg/kg typically up to about lOOOmg/kg (eg up to about 400mg/kg, conveniently about 200mg/kg or less). Thus it is to be expected that a typical dosage for humans will be from about 5mg/kg upwards (eg up to about 20mg/kg). The concentration and dose are to be sufficient to bring an arylating mechanism into play. For intravenous administration the active compound will be dissolved or dispersed in an aqueous or other injectable liquid bearing in mind the aforementioned requirements of dosage. Typically, concentration will be 250mg/ml or less. Patient tolerance was found to be of a higher order for concentrations below that threshold although concentrations of more than 250mg/ml may be used. Typically, a preferred concentration is less than lOOmg/ml, with concentrations below 50mg/ml (eg 40mg/ml) being preferred. For

oral administration, enteric coated tablets will often be preferred. Maximum strength will be less than 500mg and preferably 400mg or less. Thus, for example, a range of strengths for oral administration (whether in tablet or other solid form) will be lOOmg, 200mg or 400mg. Patients who are subject to oral administration will generally fast for 8 hours prior to first dose with the fast continuing for 4 hours after first dose. Free access to fluid will generally be allowed during this fasting period. Intravenous treatment will generally take place by administration very slowly over a period, typically a period of approximately 20 minutes or more. Administration will typically be by catheter, for example a catheter left in situ after flashing with 2ml of saline. Of course, the catheter will in practice then be used for taking blood samples for pharmacokinetic measurements and removed prior to the patient's departure from the clinic.

As shown by the results reported in Table 6 below, 2-chloro-5-nitrobenzoic acid shows considerable anti-tumour activity in vivo. This could not be supported in vitro and it appears some compounds according to the invention require activation in the patient's liver. This and some other compounds may also be immunomodulators.

The following animal study illustrates the remarkable activity of compounds of the invention.

ANIMAL STUDIES

The in vivo anti-tumour responses of various compounds according to the invention were assessed against the ascitic tumours, MAC15A murine colon adenocarcinoma and various solid tumour models. The MAC 15 A ascites tumour cells were transplanted into male NMR1 mice by ip innoculation at a cell density of 1 x 10 cells in 200μl buffer (Table 1). The solid tumour models included the MAC13 and MAC 16 murine colon adenocarcinomas, the B16 Fl murine melanoma and the M5076 reticulum cell sarcoma.

Treatment commenced 3 days after ip transplant or, in the case of solid tumours such as MAC 13 and MAC 16, treatment commenced when average tumour volumes reached 40mm ³ .

The animals were located in both cases into groups of 5 to 8 animals.

The animals were sacrificed after 12 days or when tumours ulcerated, tumour volume exceeded 1000mm or loss of body weight exceeded 50%.

Except where otherwise stated, the compounds used were dissolved in DMSO and diluted in sterile distilled water, at appropriate concentrations before administration in a solvent volume of 200μl. Anti-tumour responses were obtained by comparing the median survival times or tumour growth inhibition against solvent controls. The results obtained are as shown in Tables 1 to 6 below.

Preparation

Preparation of dosage solutions is exemplified as follows:-

Subjects: No : 10 animals

Weight: 22g

Dosage: 50mg/kg weight per animal per day thus 1. lmg per mouse per day

Total Mass Dosage: 55mg active ingredient (referred to 5 day treatment regime)

Total Formulation: 10ml solvent plus 55mg for divisior. into 50 doses of 1. lmg dissolves in 200μl solvent

T/C%

T/C% is determined as follows:-

5 Animal Survival Test Control

T days C days

T/C% = T X 100

C

0

Example

Animal Survival Test Control

443 days 100 days ς

T/C% = 443 X 100 = = 443

100

A figure of 158 or above indicates performance justifying clinical trial. 0

Conclusions

The effect of a group of compounds on the growth rate of a number of experimental tumours has been evaluated in vivo and the following findings were noted:- 5

1. Structure-activity relationships against the MAC15A murine colon adenocarcinoma, in the female NMRI mice showed maximal activity on a split-dose schedule and when the halogen was maximally activated for nucleophilic attack.

0 2. Against the M5076 reticulum cell sarcoma, 2, 4-dichloro-3, 5-dinitrobenzoic acid showed activity on a split-dose schedule down to 25mg kg body weight by both ip and sc routes. Both the amide and the methyl ester showed 10-fold increase in

toxicity and were without anti-tumour activity. The acid also effectively inhibited growth of B16 murine melanoma and the MAC 16 murine colon adenocarcinoma.

It is concluded that this group of compounds show a wide spectrum of activity against murine models.

TABLE 1

Anti-tumour activity against MAC15A (murine adenocarcinoma colon). 5 animals per group. Dose lOOmg kg ^"1 ip per day.

Code Compound Schedule T/C% ^a

(days)

C4 4-chloro-3, 5-dinitrobenzoic acid 1,2,3,4,5 271

Cl 2, 4-dichloro-3, 5-dinotrobenzoic acid 1,2 243

C12 2, 5-dichlorobenzoic acid 1,2,3,4,5 171

C28 2, 4-dinitrobenzoic acid 1,2,3,4,5 100

C29 3, 5-dinitrobenzoic acid 1,2,3,4,5 100

a = median, T-test group, C-solvent control

TABLE 2

Anti-tumour activity against M5076-reticulum cell sarcoma 16 days after im transplant.7 animals per group. Drugs dissolved in corn oil. Dosage is per day.

Compound Dose Route Schedule % Tumour Weight

(mg/kg) (days) Inhibition

2,4BA 75 ^a ip 1,4,6,9 79, 88 50 ip 1,4,6,9 57 25 ip 1,2,4,6,9 75 75 sc 1,4,5,7,9 66

50 sc 1,2,4,5,6, 7, 9 16

25 sc 1,2,4,5,6, 7, 9 63

2,4BM 1.0 ^a ip 1,2,3,4,5, 6, 7, 8, 9 41

0.5 ip 1,2,3,4,5, 6, 7, 8, 9 39

0.25 ip 1,2,3,4,5, 6, 7, 8, 9 42

a = Maximum tolerated dose b = Two independent experiments; 4 animals had no tumour in the second experiment

2, 4 BA = 2, 4-dichloro-3, 5-dinitrobenzoic acid (Cl)

2,4 BM = 2, 4-dichloro-3, 5-dinitrobenzoic acid methyl ester (C3)

% Tumour Weight Inhibition:

Treated Control

Agm Bgm Tumour weight % inhibition = B-A X 100

B

TABLE 3

Anti-tumour activity against B16F1 -murine melanoma 12 days after sc transplant. 6 animals per group. Drugs dissolves in com oil. Dosage is per day.

Compound Dose Route Schedule % Tumour Weight

(mg/kg) (days) Inhibition

2,4BA 75 ^a ip 1,5 71,81 ^b

50 ip 1,5 45, 56 ^b

25 ip 1,5 13

75 sc 1,3,5 30

50 sc 1,3,5 9

25 sc 1,3,5 22

4BA 100 ip 1,5 39

75 ip 1,5 41

50 ip 1,5 10

4BM 2.5 ^a ip 1,3 67

1.25 ip 1,2,3 43

a = Maximum tolerated dose b = Two independent experiments

2, 4 BA = 2, 4-dichloro-3, 5-dinitrobenzoic acid (Cl)

4BA = 4-chloro-3, 5-dinitrobenzoic acid (C4)

4 BM = 4-chloro-3, 5-dinitrobenzoic acid methyl ester (C6)

TABLE 4 Anti-tumour activity against MAC 13 murine colon adenocarcinoma 12 days after im transplant. Drugs dissolved in com oil. Dosage is per day.

Compound Dose Route Schedule % Tumour Weight

(mg/kg) (days) inhibition

2, 4 BA 75 ^a ip 1, 4, 5 45

2, 4 BA 50 ip 1, 2, 3, 4, 5, 6, 7, 8, 9 39

2, 4 BA graph ¹ ip graph ¹ graph ¹

2 BA graph ² ip graph ² graph ²

a = Maximum tolerated dose

2, 4 BA = 2, 4-dichloro-3, 5-dinitrobenzoic acid ¹ (Cl)

2 BA = 2-chloro-5-nitrobenzoic acid (C17)

(1: see Figure 2 of the drawings; 2: see figure 3 of the drawings)

TABLE 5 Anti-tumour activity against MAC 16, murine colon adenocarcinoma sc transplanted on day 11 after the beginning of treatment with 2, 4-dichloro-3, 5-dinitrobenzoic acid (2, 4 BA; Cl). Drug dissolved in corn oil. The tumour volumes were at least 40mm at the beginning of the treatment. 6 animals per group. Dosage is per day.

Compound Dose Route Schedule % Tumour Weight

(mg/kg) (days) Inhibition

2, 4 BA 75 ^a ip 1, 2, 5, 8 88 50 ip 1, 2, 4, 5, 8 91

a = Maximum tolerated dose

TABLE 6

Anti-tumour activity of C17 against B16 murine melanoma 12 days after sc transplant on female C57/black mice. 6 animals per group. Dosage is per day and is ip.

Code Compound Dose Schedule % Tumour Weight

(mg/kg) (days) Inhibition

C17 2-chloro-5- 700 1, 2, 3, 4, 5, 6 62 nitrobenzoic acid

Anti-tumour activity and toxicity studies have additionally been completed for the following compounds with broadly satisfactory results :-

C22 2, 5-dichloro-4-nitrobenzoic acid

C23 2, 4-dichloro-5-nitrobenzoic acid

C24 2, 6-dichloro-4-nitrobenzoic acid

C26 2-hydroxy-5-nitrobenzoic acid

C27 3, 5-dichloro-4-nitrobenzoic acid

In addition, the following primary assay was used to investigate the anti-viral activity of compounds in accordance with the invention.

Primary Assay

(i) Acute Infection Assay. High titre virus stocks of the human immunodeficiency virus HIV-I _RP were grown in H9 cells with RM1 1640 (Flow laboratories) supplemented with 10% fetal calf serum, penicillin (lOOIU/ml). Cell debris was removed by low speed centrifugation, and the supernatant stored at -70°C until required. In a typical assay C8166 T-lymphoblastoid CD4+ cells were incubated with _, 10xTCID50 HIV-1 _RF at 37°C for 90 minutes and then washed three times with

phosphate buffered saline (PBS). Cell aliquots (2 x 10 ) were resuspended in 1.5ml growth medium in 6ml tubes, and active compounds in log dilutions [200μM to 0.2μM] were added immediately. 20mM stock solutions of each compound were made up in 70% alcohol. The compounds were stored as a powder and made up freshly in distilled water before each experiment or were stored as a 90 mM stock solution in 70% alcohol. The final concentration of alcohol in the tissue culture medium was 1%. The cells were then incubated at 37°C in 5% CO ₂ . At 72 hours post-infection 200μl of supernatant was taken from each culture and assayed for HIV (Kingchington et al, 1989, Robert et al 1990) using an antigen capture ELISA which recognizes all the core proteins equally (Coulter Electronics, Luton, UK). The following controls were used: supernatants taken from uninfected and infected cells, infected cells treated with AZT (Roche Products UK Ltd) and ddC (Roche) and RO31-8959 (Roche) an inhibitor of HIV proteinase. The IC ₅₀ activities of 8959, AZT and ddC in infected cells were 1, 10, 20 nM and 200nM respectively (accompanying Figure 2). The ELISA plates were read with a spectrophotometer. Compounds were tested in duplicate at each concentration, and the data shown is the average of at least two assays. This assay assesses the activity of compounds by measuring their inhibition of HIV core antigen levels.

(ii) Chronically Infected Cell Assay. Chronically infected cells (H9rf) were washed three times to remove extracellular virus and incubated with the active compounds (200-0.2 μM) for four days. HIV-1 antigen in the supernatant was then measured using an ELISA.

To test for compound toxicity, uninfected H9 cells were incubated with the compounds for four days. Supernatants were discarded and the cells resuspended in 200μl pg growth medium containing ^l4 C protein hydrolysate. After 6 hours the cells were harvested and the ¹⁴ C incorporation measured.

(iii) Toxicity Assay.. To test for compound toxicity, aliquots of 2 x 10 ⁵ of uninfected cells were cultured with the compounds in the same dilutions for 72 hours. The cells were then washed with PBSA and resuspended in 200μl of growth medium

containing C protein hydrolysate. After 12, hours the cells were harvested and the C incorporation measured. Uninfected, untreated cells were used as controls. Toxicity is expressed as inhibition of uptake of C protein hydrolysate.

The results of these assays are summarized in Table 7 below. The 1C ₅₀ is the drug concentration that causes a 50% reduction in HIV core antigen levels as detected by the Coulter P24 antigen assay and is determined by doubling dilutions of supernatant taken from tubes containing untreated acutely infected cells. The CD ₅₀ is the concentration of drug that causes a 50% inhibition of cells as measured by ¹⁴ C protein hydrolysate uptake. The therapeutic index (TI) is determined by dividing the CD ₅₀ by the IC ₅₀ .

TABLE 7

Code Compound IC _S0 CD ₅₀ TI

C4 4-chloro-3, 5-dinitrobenzoic acid 30μm 70μm 2.33

Following the same methodology, more extensive assays were performed as reported in Tables 8 below.

TABLE 8.1

STRUCTURE ACTIVITY RELATIONSHIP AGAINST HIV VIRUS

CODE COMPOUNDS

Cl 2, 4-dichloro-3, 5-dinitrobenzoic acid

C3 2, 4-dichloro-3, 5-dinitrobenzoic acid methyl ester

C4 4-chloro-3, 5-dinitrobenzoic acid

C6 4-chloro-3, 5-dinitrobenzoic acid methyl ester

C7 2-chloro-3, 5-dinitrobenzoic acid

C8 2-chloro-3, 5-dinitrobenzoic acid methyl ester

C9 4-chloro-3-nitrobenzoic acid

CIO 2-chloro-4-nitrobenzoic acid

Cl l 3, 4-dichlorobenzoic acid

C12 2, 5-dichlorobenzoic acid

C17 2-chloro-5-nitrobenzoic acid

TABLE 8.2

IC50 CC50 SI

(Antiviral) (Toxicity) (Selectivity Index)

Against HIV-I IIIB

Cl 5 70 14

36 70 2

33 70 2

35 60 2

Average 27 70 3

Cl 10 30 3

•

2.5 20 8

Against HIV-IRF

Cl 7 60 8.5 56

16 56 3.5

Average 11.5 57 5

Against Chronicallv infected cells

Cl 16 30 2

16 95 6

Average 16 63

Against HIV- 1-ΪΪIF .

C2 2 70 35

C3 0.3 7 23

C4 40 100 2.5

30 70 2.3

Average 35 85 2.4

C5 5 50 10

C6 5 60 12

C7 23 150 6

5 >200 >10

Average 22 >175 8

C7 >1 35 >35

10 30 3

C8 10 60 5

C9 >200 >200

CIO >200 >200

Cl l >200 >200

C12 >200 >200

Against HTV-T TTTB

C17 >1 >1000 >1000

5 >1000 >200

Patient Tests

A pilot study was conducted for safety, pharmacokinetics and preliminary activity of C17 in patients with HIV-1 infection and HIV-related Kaposi's sarcoma. In the pilot study, 10 patients were enrolled but only 6 were eligible for evaluation. These patients were positive for serum antibody to HIV-1 as determined by both enzyme- linked immunosorbent assay (ELISA) and Western Blot. These patients had WHO Clinical Stage 2 to 3 for HIV infection and disease and fulfilled the inclusion and exclusion criteria as per the Clinical Trial Protocol. Their CD4 ranged from 0.072 to 0.812 x 10 ³ cells/mm ³ (normal range 1.0 x 1.3 x 10 ³ cells/mm ³ ). Patient 6 had AIDS- related Kaposi's sarcoma confirmed on histology.

C17 was prepared for intravenous administration under GMP (good manufacturing practice) in strength of 40 mg/ml following the method set forth below for producing a 250mg/ml solution, additional water being added at Step 7:-

Method of Preparation

1. ^• To 275ml water for injection add 266.4ml 4N sodium hydroxide solution and mix.

2. Add with stirring 182.5g of active compound.

3. Add additional 4N sodium hydroxide if needed to obtain solution.

4. Filter solution through a Sterivex GV 0.22μm filter.

5. Dilute to approximately 680ml with water for injection. 6. Adjust to pH 7.2-7.6 with hydrochloric acid.

7. Make-up to 730ml water for injection. Adjust pH if necessary.

8. Transfer solution to aseptic room and filter through Sterivex GV 0.22μm filter into injection vials. Seal with rubber stoppers and aluminium closures.

9. Effect terminal sterilization by autoclave.

The patients received lOmg/kg body weight/day of C17 by deep intramuscular injection daily for 5 days weekly. The CD4 counts were estimated before and at about 2 weeks after the beginning of the therapy.

The CD4 counts in all 6 patients showed an increase which was associated with clinical improvements in patient general condition including weight gain and a marked decrease in opportunistic infections and diaorrhea. Patient observations are shown in Tables 9 below.

In the case of Patient 6, the sarcoma lesions disappeared.

Murine Haematology

Preliminary data on the administration of C17 in mice and rats showed increases in red blood cell count, haemoglobin concentration, macrophage count, white blood cell count (WBC), lymphocyte count and haematocrii _s rITC) on day 7 when maximum tolerated dose (MTD) was given by 5 consecutive daily intravenous injections. These values returned to normal on day 14. The MTD values were 950mg and 900mg/kg body weight/day respectively in mouse and rat. The data are reported in Figures 4 to 11.

TABLE 9.0 ( Summarizing Tables 9.1 to 9.6)

PATIENTS 1 TO 6 IMMUNOLOGY:-

PATIENT 1

Before After Before After Before After Before After Before After Before After

Lymphocytes x I 10Λ3 mm -3 2.1 2.0 2.0 1.9 0.9 1.1 1.8 2.0 2.8 3.1 2.1 1.9

CD4 % 19 38 18 27 8 17 6 22 29 33 18 23

CD4 ABS/mm ³ 0.399 0.760 0.360 0.513 0.072 0.187 0.108 0.440 0.812 1.023 0.378 0.437

CD8 ABS/mm ³ 0.567 0.840 0.940 0.874 0.270 0.682 1.350 1.260 1.456 1.550 1.218 0.931

CD4/CD8 0.70 0.90 0.38 0.59 0.27 0.27 0.08 0.35 0.56 0.66 0.31 0.47

TABLE 9.1 PATIENT 1 IMMUNOLOGY:-

DAY 1 20

Lymphocytes x 10 ³ mm ^"3 2.1 2.0

CD4 % 19 38

CD4 ABS/mm ³ 0.399 0.760

CD8 ABS/mm ³ 0.567 0.840

CD4/CD8 0.70 0.90

TABLE 9.2 PATIENT 2 IMMUNOLOGY:-

DAY 1 14

Lymphocytes x 10 ³ mm ^'3 2.0 1.9

CD4 % 18 27

CD4 ABS/mm ³ 0.360 0.513

CD8 ABS/mm ³ 0.940 0.874

CD4/CD8 0.38 0.59

TABLE 9.3 PATIENT 3 IMMUNOLOGY-

DAY 1 20

Lymphocytes x 10 ³ mm ^"3 0.9 1.1

CD4 % 8 17

CD4 ABS/mm ³ 0.072 0.187

CD8 ABS/mm ³ 0.270 0.682

CD4/CD8 0.27 0.27

TABLE 9.4 PATIENT 4 IMMUNOLOGY:-

DAY 1 14

Lymphocytes x 10 ³ mm ^"3 1.8 2.0

CD4 % 6 22

CD4 ABS/mm ³ 0.108 0.440

CD8 ABS/mm ³ 1.350 1.260

CD4/CD8 0.08 0.35

TABLE 9.5 PATIENT 5 IMMUNOLOGY:-

DAY 1 21

Lymphocytes x 10 ³ mm ^"3 2.8 3.1

CD4 % 29 33

CD4 ABS/mm ³ 0.812 1.023

CD8 ABS/mm ³ 1.456 1.550

CD4/CD8 0.56 0.66

TABLE 9.6

PATIENT 6 IMMUNOLOGY:-

DAY 1 34

Lymphocytes x 10 ³ mm ^"3 2.1 1.9

CD4 % 18 23

CD4 ABS/mm ³ 0.378 0.437

CD8 ABS/mm ³ 1.218 0.931

CD4/CD8 0.31 0.47