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WO2014093960A1 - Compositions et méthodes de traitement de maladie - Google Patents

Compositions et méthodes de traitement de maladie Download PDF

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Publication number
WO2014093960A1
WO2014093960A1 PCT/US2013/075259 US2013075259W WO2014093960A1 WO 2014093960 A1 WO2014093960 A1 WO 2014093960A1 US 2013075259 W US2013075259 W US 2013075259W WO 2014093960 A1 WO2014093960 A1 WO 2014093960A1
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WIPO (PCT)
Prior art keywords
ioalkyl
ioalkenyl
ioalkynyl
cycloc3
aryl
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PCT/US2013/075259
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English (en)
Inventor
Weizhong Cai
Itzhak D. Goldberg
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Angion Biomedica Corp.
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Publication of WO2014093960A1 publication Critical patent/WO2014093960A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/045—Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
    • A61K31/07—Retinol compounds, e.g. vitamin A
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents

Definitions

  • fibrosis Numerous diseases and conditions responsible for significant morbidity as well as mortality have as an underlying disease mechanism the inappropriate or excessive production of fibrous connective tissue, a process generally known as fibrosis.
  • diseases and conditions include by way of non-limiting examples, fibrotic liver disease, cirrhosis, cardiac fibrosis and lung fibrosis including idiopathic pulmonary fibrosis.
  • numerous other conditions and diseases exhibit a fibrotic component, including but not limited to hepatic ischemia-reperfusion injury, cerebral infarction, chronic obstructive pulmonary diseases including emphysema, pancreatic fibrosis, ischemic heart disease, heart failure and renal disease including renal fibrosis.
  • fibrosis is among the conditions that can affect the appearance and elastic properties of the skin, and conditions such as wrinkling, sagging, thickening, thinning, and other adverse features of photoaging and chronoaging that while not life threatening are desirous of being ameliorated.
  • Diseases and other conditions that affect the skin such as psoriasis, ichthyosis, and acne are also in need of effective treatments.
  • dysproliferative diseases including cancer are also major diseases with significant impact to the patients as well as the health care system.
  • a method for treating fibrotic conditions and diseases and cancer and other dysproliferative diseases comprising administering to a subject in need there of a therapeutically effective amount of a synergistic composition comprising a retinol or a pharmaceutically acceptable ester, salt or prodrug thereof, and a CYP26 inhibitor, or a pharmaceutically acceptable ester, salt or prodrug thereof; wherein said therapeutically effective amount suppresses fibrosis or growth of dysproliferative cells in vivo.
  • a synergistic composition provides benefit to the subject greater than the effect of either component separately or greater than the sum of each of their effects when administered in the absence of the other.
  • compositions, and effects of their use show an enhancement or potentiation effect, whereby one or both of the components are present at concentrations or dosages that have no effect alone, but when combined with the other, show an effect.
  • the retinol and the CYP26 inhibitor can be administered in the same composition or route of administration, or separately, provided that the synergistic benefit to the patient or subject of the two compounds is achieved. Routes of administration such as topical, parenteral and oral are among non- limiting examples.
  • a method for treating acne, psoriasis, ichthyosis, skin photoaging, skin chronoaging, skin wrinkling, skin sagging, skin thickening, skin thinning or a dysproliferative disease in subject in need thereof comprising administering to the subject a therapeutically effective amount the composition of claim 1, wherein said therapeutically effective amounts treat acne, psoriasis, ichthyosis, skin photoaging, skin chronoaging, skin wrinkling, skin sagging, skin thickening, skin thinning or dysproliferative disease.
  • compositions and formulations thereof described herein are therapeutically beneficial when administered at a time after the onset of the acute disease or acute condition or time of injury.
  • administration at least 3 hours after onset is beneficial.
  • administration at least 24 hours after onset is beneficial.
  • administration at least 1-3 weeks after onset is beneficial.
  • methods are provided for treating an acute disease or condition wherein the composition is administered at a time after the onset or induction of the disease or condition.
  • temporal separation of the induction, onset, recurrence or recrudescence of a disease or injury, and the optimal effective response to an antifibrotic or antidysproliferative composition provides guidance to the timing of administration of a composition of the invention or a composition of formulation thereof.
  • a disease, condition or injury can be prevented by prophylactic administration of a composition embodied herein prior to the injury, exposure, or other anticipated sustaining of pathology.
  • the methods and synergistic compositions of the invention are useful in the treatment of dysproliferative diseases including cancer, psoriasis, rheumatoid arthritis, and other inflammatory joint and skin diseases.
  • the compositions are useful in the treatment of prostate cancer.
  • the invention herein is directed to synergistic compositions and methods of their use for the treatment of fibrosis, cancer and other dysproliferative diseases.
  • a therapeutically effective amount of a synergistic combined preparation comprising a retinol, or a pharmaceutically acceptable ester, salt or prodrug thereof; and a CYP26 inhibitor, or a pharmaceutically acceptable ester, salt or prodrug thereof; wherein said therapeutically effective amount suppresses fibrosis or the growth of dysproliferative cells in vivo.
  • compositions have anti-fibrotic activities and thus are useful for the prevention, treatment or lessening of the severity of a condition or disease associated with or characterized by increased, excessive or inappropriate fibrosis.
  • compositions and pharmaceutical formulations have anti-dysproliferative activities and thus are useful for the prevention, treatment or lessening of the severity of a condition or disease associated with or characterized by increased, excessive or inappropriate proliferation, such as cancer.
  • the invention provides methods for the use of any of the compositions disclosed herein for treating or lessening the severity of a disease or condition associated with inappropriate fibrosis.
  • the method is for treating or lessening the severity of a disease or condition selected from fibrotic liver disease, cirrhosis, cardiac fibrosis and lung fibrosis including idiopathic pulmonary fibrosis; hepatic ischemia-rep erfusion injury, cerebral infarction, chronic obstructive pulmonary diseases including emphysema, pancreatic fibrosis, ischemic heart disease, heart failure and renal disease including renal fibrosis, fibrotic liver disease, hepatic ischemia-reperfusion injury, cerebral infarction, ischemic heart disease, and renal disease or lung (pulmonary) fibrosis.
  • the method is for treating or lessening the severity of a disease or condition selected from liver fibrosis associated with hepatitis C, hepatitis B, delta hepatitis, chronic alcoholism, non-alcoholic steatohepatitis, extrahepatic obstructions (stones in the bile duct), cholangiopathies (primary biliary cirrhosis and sclerosing cholangitis), autoimmune liver disease, and inherited metabolic disorders (Wilson's disease, hemochromatosis, and alpha- 1 antitrypsin deficiency); damaged and/or ischemic organs, transplants or grafts; ischemia/reperfusion injury; stroke; cerebrovascular disease; myocardial ischemia; atherosclerosis; renal failure; renal fibrosis or idiopathic pulmonary fibrosis.
  • a disease or condition selected from liver fibrosis associated with hepatitis C, hepatitis B, delta hepatitis
  • the method is for the treatment of wounds for acceleration of healing; vascularization of a damaged and/or ischemic organ, transplant or graft; amelioration of ischemia/reperfusion injury in the brain, heart, liver, kidney, and other tissues and organs; normalization of myocardial perfusion as a consequence of chronic cardiac ischemia or myocardial infarction; development or augmentation of collateral vessel development after vascular occlusion or to ischemic tissues or organs; fibrotic diseases; hepatic disease including fibrosis and cirrhosis; lung fibrosis; radiocontrast nephropathy; fibrosis secondary to renal obstruction; renal trauma and transplantation; renal failure secondary to chronic diabetes and/or hypertension; amytrophic lateral sclerosis, muscular dystrophy, scleroderma, chronic obstructive pulmonary disease, emphysema, diabetes mellitus, multiple sclerosis, trauma to the central nervous system, and hereditary neurodegenerative disorders
  • compositions of the invention are useful in the treatment of dysproliferative diseases including cancer, psoriasis, rheumatoid arthritis, and other inflammatory joint and skin diseases.
  • the compositions are useful in the treatment of prostate cancer.
  • the compositions are useful in the treatment of breast cancer.
  • synergistic compositions of the invention are useful for prevention and treatment of other cancerous and precancerous conditions, including, for example, premalignant and malignant hyperproliferative diseases such as cancers of the breast, ovary, germ cell, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, as well as metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes, and in the treatment of Kaposi's sarcoma.
  • premalignant and malignant hyperproliferative diseases such as cancers of the breast, ovary, germ cell, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, as well as metaplasias, dysplasias, neoplasias
  • inventive synergistic compositions can also be used as agents to treat diseases of the eye, including, for example, proliferative vitreoretinopathy, retinal detachment, comeopathies such as dry eye, as well as in the treatment and prevention of various cardiovascular diseases, including, without limitation, diseases associated with lipid metabolism such as dyslipidemias, prevention of post-angioplasty restenosis and as an agent to increase the level of circulation tissue plasminogen activator.
  • compositions are also useful in treating type II non-insulin dependent diabetes mellitus (NIDDM).
  • NIDDM non-insulin dependent diabetes mellitus
  • the present invention is also directed to treatment of non-malignant tumors and other disorders involving inappropriate cell or tissue growth by administering a therapeutically effective amount of a composition of the invention.
  • the invention is useful for the treatment of arteriovenous (AV) malformations, particularly in intracranial sites.
  • AV arteriovenous
  • the invention may also be used to treat psoriasis, a dermato logic condition that is characterized by inflammation and vascular proliferation; benign prostatic hypertrophy, a condition associated with inflammation and possibly vascular proliferation; and cutaneous fungal infections. Treatment of other hyperproliferative disorders is also contemplated.
  • the agents may also be used topically to remove warts, birthmarks, moles, nevi, skin tags, lipomas, angiomas including hemangiomas, and other cutaneous lesions for cosmetic or other purposes.
  • the invention is also directed to treatment of conditions and diseases that affect the skin.
  • Skin is subject to deterioration through dermato logical disorders, environmental abuse such as wind, air conditioning, central heating, or through the normal ageing process (chronoaging), which may be accelerated by exposure of skin to sun (photoaging).
  • chronoaging normal ageing process
  • photoaging photoaging
  • consumers are increasingly seeking "anti-ageing" products that reverse, treat or delay the visible signs of chronoaging and photoaging skin such as wrinkles, lines, sagging, hyperpigmentation and age spots.
  • compositions and pharmaceutical formulations comprising a retinol and a CYP26 inhibitor are useful for such conditions, in particular when one or both are administered via the topical route, concurrently or at different times.
  • diseases and other conditions also affect the skin that the compositions embodied herein can benefit.
  • Diseases including acne and psoriasis are examples.
  • Ichthyosis refers to a group of skin disorders characterized by the presence of excessive amounts of dry surface scales. This disease manifests itself within the first year of life and is clinically characterized by thickened dry, scaly skin, keratosis pilaris, tightening and cracking of the skin and many white fish- like scales.
  • compositions of the invention are also directed to the treatment of the various types of ichthyoses.
  • Retinols useful for the methods and compositions of the invention include, but are not limited to, retinol and retinyl esters.
  • the invention is directed to a combination of a foregoing mentioned retinol, and an agent or compound that inhibits the activity of cytochrome P450 (CYP) enzymes.
  • this component of the composition embodied herein inhibits CYP26.
  • the CYP26 inhibitor is selected from talarozole or liarozole.
  • the CYP26 inhibitor is a compound of formula (I)
  • G 1 , R 1 , R 2 , R 3 , X, R 6a , R 6b , Y, R 5a , R 4a , Z, R 5b , R 4b , Q 1 , nl, n2, n3 and n4 are as described generally and in classes and subclasses herein, tautomers thereof, Z and E isomers thereof, syn and anti isomers thereof, optically pure isomers thereof, pharmaceutically acceptable salts thereof, and pharmaceutical compositions thereof.
  • the CYP26 inhibitor is a compound of formula (I-A)
  • the CYP26 inhibitor is a compound of formula (I-B)
  • G 1 , R 2 , R 3 , X, R 4b , R 5b , Z, n2 and n3 are as described generally and in classes and subclasses herein, tautomers thereof, Z and E isomers thereof, optically pure isomers thereof, and pharmaceutical compositions thereof.
  • the CYP26 inhibitor is a compound of formula (II)
  • Ri and R 2 are as described generally and in classes and subclasses herein, tautomers thereof, Z and E isomers thereof, optically pure isomers thereof, and pharmaceutical compositions thereof.
  • the CYP26 inhibitor is a compound of formula (III):
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, tetrazolyl, thiazole, 3-pyridinyl or 4- pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 is hydrogen, Co-ealkyl, -OR 7 , -SR 7 , or -NR 7 R 8 ;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl, Ci-ioalkylthioC 2 -ioalkynyl, cycloC3-8alkyl, cycloC3-salkenyl, cycloC3-8alkylci-ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC
  • R 6a , R 6b , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl,
  • -NR 778 R 888 substituents; or hetaryl-Co-ioalkyl, hetaryl-C 2 -ioalkenyl, or hetaryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 77 , Ci-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, haloCi-ioalkyl, haloC 2 -ioalkenyl, haloC 2 -ioalkynyl, -COOH, Ci_ 4 alkoxycarbonyl, -CONR 778 R 888 , -S0 2 NR 778 R 888 or -NR 778 R 888 substituents; or mono
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-8alkyl, cycloCs-salkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenyl
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy,
  • the CYP26 inhibitor is a compound of formula (IV):
  • the CYP26 inhibitor is a compound of formula (IV -A):
  • a compound is represented by Formula (IV), or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein Y is -NR 6b CO-, and the other variables are as described above.
  • the CYP26 inhibitor is a compound of formula (V):
  • the CYP26 inhibitor is a compound of formula (V-A):
  • a compound is represented by Formula (V), or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein Y is oxygen, and the other variables are as described above.
  • the CYP26 inhibitor is a compound of formula (VI):
  • the CYP26 inhibitor is a compound of formula (VI-A):
  • a compound is represented by Formula (VI), or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein Y is aryl or heteroaryl, and the other variables are as described above.
  • the CYP26 inhibitor is a compound of formula (VII):
  • B is aryl or heteroaryl which is optionally substituted with one or more independent halo, -OR 77 -SR 77 , -NR 77 R 88 (R 98 ) réelle 7 , -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthio
  • a compound is represented by Formula (VII), or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein Y is as described below and the other variables are as described above.
  • the CYP26 inhibitor is a compound of formula (VIII):
  • the CYP26 inhibitor is a compound selected from among compounds described in US Patent 7,265,143, which is incorporated herein by reference in its entirety.
  • the CYP26 inhibitor is a compound of formula (IX):
  • R d and R p are optional naphthyl group substituents
  • R Het is imidazolyl, triazolyl or pyridyl
  • R c is Ci-4 alkyl substituted by a group selected from: hydroxy, amino, amido, carboxy, Ci- 7 alkyl ester, C5-7 aryl-C 1-2 alkyl ester, sulfonamino, sulfinamino, hydroxamino and tetrazolyl.
  • the compound of formula (IX) can be formula (IX-A) or formula (IX-B):
  • R c is Ci-4 alkyl substituted by a group selected from: hydroxy, amino, amido, carboxy, Ci_ 7 alkyl ester, C5-7 aryl-C 1-2 alkyl ester, sulfonamino, sulfinamino, hydroxamino and tetrazolyl; and
  • R d and R p are optionally selected from, but not limited to, C 1-7 alkyl, C3- 2 o heterocyclyl, C 5 - 2 o aryl, halo, hydroxy, ether, nitro, cyano, acyl, ester, amido, amino, acylamido, ureido, acyloxy, thiol, thioether, sulfoxide, sulfonyl, thioamido, sulfonamino, sulfinamino and hydroxamino.
  • the CYP26 inhibitor is a compound described in PCT/GB2009/001533, published as WO2009/153566 on December 23, 2009, incorporated herein by reference in its entirety.
  • the CYP26 inhibitor is a compound described in Pautus et al., (2006), Synthesis and CYP26A1 inhibitory activity of l-[benzofuran-2-yl-(4-alkyl/aryl- phenyl)-methyl]-lH-triazoles. Bioorg Med Chem. 2006 Jun 1; 14(11):3643-53. Epub 2006 Feb 3; Gomaa et al., (2011) Small molecule inhibitors of retinoic acid 4-hydroxylase (CYP26): synthesis and biological evaluation of imidazole methyl 3-(4-(aryl-2- ylamino)phenyl)propanoates, Med Chem.
  • the retinol and the CYP26 inhibitor can be administered in the same composition, or separately, provided that the synergistic benefit to the patient of the two compounds is achieved.
  • one inhibitor may administered parenterally and the other orally.
  • One or both may be administered topically.
  • the frequency of administration may depend on the pharmacokinetics of each component such that the synergistic activity can be optimized without necessarily requiring simultaneous administration or administration by the same routes.
  • synergistic compositions of the invention are useful for prevention and treatment of other cancerous and precancerous conditions, including, for example, premalignant and malignant hyperproliferative diseases such as cancers of the breast, ovary, germ cell, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, as well as metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes, and in the treatment of Kaposi's sarcoma.
  • premalignant and malignant hyperproliferative diseases such as cancers of the breast, ovary, germ cell, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, as well as metaplasias, dysplasias, neoplasias
  • compositions are useful in the treatment of breast cancer. In one embodiment the compositions are useful in the treatment of ovarian cancer.
  • the synergistic compositions of the invention are useful in the treatment of dysproliferative diseases including cancer, psoriasis, rheumatoid arthritis, and other inflammatory joint and skin diseases.
  • the compositions are useful in the treatment of prostate cancer.
  • the present invention is also directed to treatment of non-malignant tumors and other disorders involving inappropriate cell or tissue growth by administering a therapeutically effective amount of a synergistic composition of the invention.
  • the invention is useful for the treatment of arteriovenous (AV) malformations, particularly in intracranial sites.
  • AV arteriovenous
  • the invention may also be used to treat psoriasis, a dermatologic condition that is characterized by inflammation and vascular proliferation; benign prostatic hypertrophy, a condition associated with inflammation and possibly vascular proliferation; and cutaneous fungal infections. Treatment of other hyperproliferative disorders is also contemplated.
  • the agents may also be used topically to remove warts, birthmarks, moles, nevi, skin tags, lipomas, angiomas including hemangiomas, and other cutaneous lesions for cosmetic or other purposes.
  • compositions described above comprising a retinol and a CYP26 inhibitor are useful for the treatment of a dysproliferative disease.
  • a method is provided for treating a dysproliferative disease in a subject in need thereof comprising administering to the subject an effective amount of a composition comprising a retinol and a CYP26 inhibitor.
  • the retinol is, by way of non-limiting example, selected from among those compounds and agents described herein above.
  • the CYP26 inhibitor is, by way of non-limiting example, a compound as described above.
  • a method for treating dysproliferative diseases including cancer, psoriasis, rheumatoid arthritis, and other inflammatory joint, skin diseases and undesirable cosmetic features of the skin.
  • a method is provided for the treatment of prostate cancer.
  • a method is provided for the treatment of breast cancer.
  • methods described here are provided for prevention and treatment of other cancerous and precancerous conditions, including, for example, premalignant and malignant hyperproliferative diseases such as cancers of the breast, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes, and in the treatment of Kaposi's sarcoma.
  • premalignant and malignant hyperproliferative diseases such as cancers of the breast, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes, and in the treatment
  • methods are provided to treat diseases of the eye, including, for example, proliferative vitreoretinopathy, retinal detachment, comeopathies such as dry eye, as well as in the treatment and prevention of various cardiovascular diseases, including, without limitation, diseases associated with lipid metabolism such as dyslipidemias, prevention of post-angioplasty restenosis and as an agent to increase the level of circulation tissue plasminogen activator.
  • Other methods embodied herein include the prevention and treatment of conditions and diseases associated with human papilloma virus (HPV), including warts, various inflammatory diseases such as pulmonary fibrosis, ileitis, colitis and Crohn's disease, neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease and stroke, improper pituitary function, including insufficient production of growth hormone, modulation of apoptosis, including both the induction of apoptosis, restoration of hair growth, including combination therapies with the present compositions and other agents such as minoxidil, diseases associated with the immune systems, including use of the present compositions as immunosuppressant and immunostimulants, modulation of organ transplant rejection and facilitation of wound healing, including modulation of chelosis.
  • Synergistic compositions embodied herein are also useful in treating type II non-insulin dependent diabetes mellitus (NIDDM).
  • NIDDM non-insulin dependent diabetes mellitus
  • hetarylthioCi_4alkyl has a heteroaryl group connected through a thio sulfur to a C 1-4 alkyl that connects to the chemical species bearing the substituent.
  • Co-4alkyl is used to mean an alkyl having 0-4 carbons — that is, 0, 1, 2, 3, or 4 carbons in a straight or branched configuration.
  • An alkyl having no carbon is hydrogen when the alkyl is a terminal group.
  • An alkyl having no carbon is a direct bond when the alkyl is a bridging (connecting) group.
  • alkyl includes both branched and straight chain alkyl groups. Typical alkyl groups are methyl, ethyl, n-propyl, isopropyl (iPr), n-butyl, sec-butyl, isobutyl, tert-butyl, n-pentyl, isopentyl, n-hexyl, n-heptyl, isooctyl, nonyl, decyl, undecyl, dodecyl, tetradecyl, hexadecyl, octadecyl, eicosyl and the like.
  • halo or halogen refers to fluoro, chloro, bromo or iodo.
  • haloalkyl refers to an alkyl group substituted with one or more halo groups, for example chloromethyl, 2-bromoethyl, 3-iodopropyl, trifluoromethyl, perfluoropropyl, 8-chlorononyl and the like.
  • cycloalkyl or “saturated ring” refers to a cyclic aliphatic ring structure, optionally substituted with alkyl, hydroxy and halo, such as cyclopropyl, methylcyclopropyl, cyclobutyl, cyclopentyl, 2-hydroxycyclopentyl , cyclohexyl, 4-chlorocyclohexyl, cycloheptyl, cyclooctyl and the like.
  • bicycloalkyl refers to two cycloalkyl rings fused together and the term “bridged bicycloalkyl” refers to two rings joined together forming a bridged structure, for example bicyclo[3.2.1]octane, bicyclo[2.2.1]heptane, bicyclo[2.2.2]octane and the like.
  • alkylcarbonyloxyalkyl refers to an ester moiety, for example acetoxymethyl, n-butyryloxyethyl and the like.
  • alkynylcarbonyl refers to an alkynylketo functionality, for example propynoyl and the like.
  • hydroxyalkyl refers to an alkyl group substituted with one or more hydroxy groups, for example hydroxymethyl, 2,3-dihydroxybutyl and the like.
  • alkylsulfonylalkyl refers to an alkyl group substituted with an alkylsulfonyl moiety, for example mesylmethyl, isopropylsulfonylethyl and the like.
  • alkylsulfonyl refers to a sulfonyl moiety substituted with an alkyl group, for example mesyl, n-propylsulfonyl and the like.
  • acetylaminoalkyl refers to an alkyl group substituted with an amide moiety, for example acetylaminomethyl and the like.
  • acetylaminoalkenyl refers to an alkenyl group substituted with an amide moiety, for example 2-(acetylamino)vinyl and the like.
  • alkenyl refers to an ethylenically unsaturated hydrocarbon group, straight or branched chain, having 1 or 2 ethylenic bonds, for example vinyl, allyl, 1-butenyl, 2-butenyl, isopropenyl, 2-pentenyl and the like.
  • haloalkenyl refers to an alkenyl group substituted with one or more halo groups.
  • the term "unsaturated ring” refers to a substituted or unsubstituted “cycloalkenyl” or a phenyl group.
  • cycloalkenyl refers to a cyclic aliphatic ring structure, optionally substituted with alkyl, hydroxy and halo, having 1 or 2 ethylenic bonds such as methylcyclopropenyl, trifluoromethylcyclopropenyl, cyclopentenyl, cyclohexenyl, 1 ,4-cyclohexadienyl and the like.
  • alkynyl refers to an unsaturated hydrocarbon group, straight or branched, having 1 or 2 acetylenic bonds, for example ethynyl, propargyl and the like.
  • haloalkynyl refers to an alkynyl group substituted with one or more halo groups.
  • alkylcarbonyl refers to an alkylketo functionality, for example acetyl, n-butyryl and the like.
  • alkenylcarbonyl refers to an alkenylketo functionality, for example, propenoyl and the like.
  • aryl refers to phenyl or naphthyl which may be optionally substituted.
  • Typical aryl groups include, but are not limited to, phenyl, 4-chlorophenyl, 4-fluorophenyl, 4-bromophenyl, 3-chlorophenyl, 3 -fluorophenyl, 3-nitrophenyl, 3-(trifluoromethyl)phenyl, 2-methoxyphenyl, 2-methylphenyl, 3-methyphenyl, 4-methylphenyl, 4-ethylphenyl, 2-methyl-3methoxyphenyl, 2,4-dibromophenyl, 3,5-difluorophenyl, 3,5-dimethylphenyl, 2,4,6-trichlorophenyl, 4-methoxyphenyl, naphthyl, 2-chloronaphthyl, 2,4-dimethoxyphenyl, 4-(trifluoromethyl)phenyl and 2-iodo-4-
  • heterocyclic unsaturated ring refers to a substituted or unsubstituted "heteroaryl” or a heteroaliphatic ring structure having 1 or 2 ethylenic bonds such as dihydropyridine, tetrahydropyridine, dihydropyrrole, dihydroimidazole and the like.
  • heteroaryl refers to a substituted or unsubstituted 3-10 membered unsaturated ring containing one, two, three or four heteroatoms, preferably one or two heteroatoms independently selected from oxygen, nitrogen and sulfur or to a bicyclic unsaturated ring system containing up to 10 atoms including at least one heteroatom selected from oxygen, nitrogen and sulfur.
  • heteroaryls include, but are not limited to, 2-pyridinyl (synonym: 2-pyridyl), 3-pyridinyl (synonym: 3-pyridyl) or 4-pyridinyl (synonym: 4-pyridyl), pyrazinyl, 2-, 4-, or 5-pyrimidinyl, pyridazinyl, triazolyl, tetrazolyl, imidazolyl, 2- or 3-thienyl, 2- or 3-furyl, pyrrolyl, oxazolyl, isoxazolyl, thiazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, quinolyl, isoquinolyl, benzimidazolyl, benzotriazolyl, benzofuranyl, and benzothienyl.
  • the heterocyclic ring may be optionally substituted with up to two substituents.
  • aryl-alkyl or "arylalkyl” are used to describe a group wherein the alkyl chain can be branched or straight chain with the aryl portion, as defined hereinbefore, forming a bridging portion of the aryl-alkyl moiety.
  • aryl-alkyl groups include, but are not limited to, optionally substituted benzyl, phenethyl, phenpropyl and phenbutyl such as 4-chlorobenzyl, 2,4-dibromobenzyl, 2-methylbenzyl, 2-(3-fluorophenyl)ethyl, 2-(4-methylphenyl)ethyl, 2-(4-(trifluoromethyl)phenyl)ethyl, 2-(2-methoxyphenyl)ethyl, 2- (3-nitrophenyl)ethyl, 2-(2,4-dichlorophenyl)ethyl, 2-(3,5-dimethoxyphenyl)ethyl, 3 -phenylpropyl, 3 -(3 -chlorophenyl)propyl, 3 -(2-methylphenyl)propyl, 3 -(4-methoxyphenyl)propyl, 3 -(4-(trifluor
  • aryl-cycloalkyl or "arylcycloalkyl” are used to describe a group wherein the aryl group is attached to a cycloalkyl group, for example phenylcyclopentyl and the like.
  • aryl-alkenyl or "arylalkenyl” are used to describe a group wherein the alkenyl chain can be branched or straight chain with the aryl portion, as defined hereinbefore, forming a bridging portion of the aralkenyl moiety, for example styryl (2-phenylvinyl), phenpropenyl and the like.
  • aryl-alkynyl or "arylalkynyl” are used to describe a group wherein the alkynyl chain can be branched or straight chain with the aryl portion, as defined hereinbefore, forming a bridging portion of the aryl-alkynyl moiety, for example 3 -phenyl- 1-propynyl and the like.
  • aryl-oxy or "aryloxy” are used to describe a terminal aryl group attached to a bridging oxygen atom. Typical aryl-oxy groups include phenoxy, 3,4-dichlorophenoxy and the like. [0079] The terms “aryl-oxyalkyl” or “aryloxyalkyl” are used to describe a group wherein an alkyl group is substituted with an aryl-oxy group, for example pentafluorophenoxymethyl and the like.
  • hetaryl-oxy or “heteroaryl-oxy” or “hetaryloxy” or “heteroaryloxy” are used to describe a terminal hetaryl group attached to a bridging oxygen atom.
  • Typical hetaryl-oxy groups include 4,6-dimethoxypyrimidin-2-yloxy and the like.
  • heteroarylalkyl or “heteroarylalkyl” or “hetaryl-alkyl” or “heteroaryl-alkyl” are used to describe a group wherein the alkyl chain can be branched or straight chain with the heteroaryl portion, as defined hereinbefore, forming a bridging portion of the heteroaralkyl moiety, for example 3-furylmethyl, thienyl, furfuryl and the like.
  • heteroarylalkenyl or “heteroarylalkenyl” or “hetaryl-alkenyl” or “heteroaryl-alkenyl” are used to describe a group wherein the alkenyl chain can be branched or straight chain with the heteroaryl portion, as defined hereinbefore, forming a bridging portion of the heteroaralkenyl moiety, for example 3-(4-pyridyl)-l-propenyl.
  • heteroarylalkynyl or “heteroarylalkynyl” or “hetaryl-alkynyl” or “heteroaryl-alkynyl” are used to describe a group wherein the alkynyl chain can be branched or straight chain with the heteroaryl portion, as defined hereinbefore, forming a bridging portion of the heteroaralkynyl moiety, for example 4-(2-thienyl)-l-butynyl.
  • heterocyclyl or “heterocyclic saturated ring” refers to a substituted or unsubstituted 3-10 membered saturated ring containing one, two or three heteroatoms, preferably one or two heteroatoms independently selected from oxygen, nitrogen and sulfur or to a bicyclic ring system containing up to 10 atoms including at least one heteroatom selected from oxygen, nitrogen and sulfur wherein the ring containing the heteroatom is saturated.
  • heterocyclyls include, but are not limited to, tetrahydrofuranyl, tetrahydrofuryl, pyrrolidinyl, piperidinyl, 4-pyranyl, tetrahydropyranyl, thiolanyl, morpholinyl, piperazinyl, dioxolanyl, dioxanyl, indolinyl and 5-methyl-6-chromanyl.
  • the term "monoheterocyclic” refers to a single heterocyclic ring structure, while “polyheterocyclic” refers to more than one ring fused together to form a heterocyclic structure.
  • heterocyclylalkyl or “heterocyclyl-alkyl” are used to describe a group wherein the alkyl chain can be branched or straight chain with the heterocyclyl portion, as defined hereinabove, forming a bridging portion of the heterocyclylalkyl moiety, for example 3-piperidinylmethyl and the like.
  • heterocyclylalkenyl or “heterocyclyl-alkenyl” are used to describe a group wherein the alkenyl chain can be branched or straight chain with the heterocyclyl portion, as defined hereinbefore, forming a bridging portion of the heterocyclylalkenyl moiety, for example 2-morpholinyl-l-propenyl.
  • heterocyclylalkynyl or “heterocyclyl-alkynyl” are used to describe a group wherein the alkynyl chain can be branched or straight chain with the heterocyclyl portion, as defined hereinbefore, forming a bridging portion of the heterocyclylalkynyl moiety, for example 2-pyrrolidinyl-l-butynyl.
  • carboxylalkyl includes both branched and straight chain alkyl groups as defined hereinbefore attached to a carboxyl (-COOH) group.
  • carboxylalkenyl includes both branched and straight chain alkenyl groups as defined hereinbefore attached to a carboxyl (-COOH) group.
  • carboxylalkynyl includes both branched and straight chain alkynyl groups as defined hereinbefore attached to a carboxyl (-COOH) group.
  • carboxylcycloalkyl refers to a carboxyl (-COOH) group attached to a cyclic aliphatic ring structure as defined hereinbefore.
  • carboxylcycloalkenyl refers to a carboxyl (-COOH) group attached to a cyclic aliphatic ring structure having 1 or 2 ethylenic bonds as defined hereinbefore.
  • cycloalkylalkyl or "cycloalkyl-alkyl” refer to a cycloalkyl group as defined hereinbefore attached to an alkyl group, for example cyclopropylmethyl, cyclohexylethyl and the like.
  • cycloalkylalkenyl or “cycloalkyl-alkenyl” refer to a cycloalkyl group as defined hereinbefore attached to an alkenyl group, for example cyclohexylvinyl, cycloheptylallyl and the like.
  • cycloalkylalkynyl or “cycloalkyl-alkynyl” refer to a cycloalkyl group as defined hereinbefore attached to an alkynyl group, for example cyclopropylpropargyl, 4-cyclopentyl-2-butynyl and the like.
  • cycloalkenyl alkyl or "cycloalkenyl-alkyl” refer to a cycloalkenyl group as defined hereinbefore attached to an alkyl group, for example 2(cyclopenten-l-yl)ethyl and the like.
  • cycloalkenylalkenyl or “cycloalkenyl-alkenyl” refer to a cycloalkenyl group as defined hereinbefore attached to an alkenyl group, for example l-(cyclohexen-3-yl)allyl and the like.
  • cycloalkenylalkynyl or “cycloalkenyl-alkynyl” refer to a cycloalkenyl group as defined hereinbefore attached to an alkynyl group, for example l-(cyclohexen-3-yl)propargyl and the like.
  • carboxylcycloalkylalkyl refers to a carboxyl (-COOH) group attached to the cycloalkyl ring portion of a cycloalkylalkyl group as defined hereinbefore.
  • carboxylcycloalkylalkenyl refers to a carboxyl (-COOH) group attached to the cycloalkyl ring portion of a cycloalkylalkenyl group as defined hereinbefore.
  • carboxylcycloalkylalkynyl refers to a carboxyl (-COOH) group attached to the cycloalkyl ring portion of a cycloalkylalkynyl group as defined hereinbefore.
  • carboxylcycloalkenylalkyl refers to a carboxyl (-COOH) group attached to the cycloalkenyl ring portion of a cycloalkenylalkyl group as defined hereinbefore.
  • carboxylcycloalkenylalkenyl refers to a carboxyl (-COOH) group attached to the cycloalkenyl ring portion of a cycloalkenylalkenyl group as defined hereinbefore.
  • carboxylcycloalkenylalkynyl refers to a carboxyl (-COOH) group attached to the cycloalkenyl ring portion of a cycloalkenylalkynyl group as defined hereinbefore.
  • alkoxy includes both branched and straight chain terminal alkyl groups attached to a bridging oxygen atom. Typical alkoxy groups include methoxy, ethoxy, n-propoxy, isopropoxy, tert-butoxy and the like.
  • haloalkoxy refers to an alkoxy group substituted with one or more halo groups, for example chloromethoxy, trifluoromethoxy, difluoromethoxy, perfluoroisobutoxy and the like.
  • alkoxyalkoxyalkyl refers to an alkyl group substituted with an alkoxy moiety which is in turn substituted with a second alkoxy moiety, for example methoxymethoxymethyl, isopropoxymethoxyethyl and the like.
  • alkylthio includes both branched and straight chain alkyl groups attached to a bridging sulfur atom, for example methylthio.
  • haloalkylthio refers to an alkylthio group substituted with one or more halo groups, for example trifluoromethylthio.
  • alkoxyalkyl refers to an alkyl group substituted with an alkoxy group, for example isopropoxymethyl.
  • alkoxyalkenyl refers to an alkenyl group substituted with an alkoxy group, for example 3-methoxyallyl.
  • alkoxyalkynyl refers to an alkynyl group substituted with an alkoxy group, for example 3-methoxypropargyl.
  • alkoxycarbonylalkyl refers to a straight chain or branched alkyl substituted with an alkoxycarbonyl, for example ethoxycarbonylmethyl,
  • alkoxycarbonylalkenyl refers to a straight chain or branched alkenyl as defined hereinbefore substituted with an alkoxycarbonyl, for example 4-(ethoxycarbonyl)-2-butenyl and the like.
  • alkoxycarbonylalkynyl refers to a straight chain or branched alkynyl as defined hereinbefore substituted with an alkoxycarbonyl, for example 4-(ethoxycarbonyl)-2-butynyl and the like.
  • haloalkoxyalkyl refers to a straight chain or branched alkyl as defined hereinbefore substituted with a haloalkoxy, for example 2-chloroethoxymethyl, trifluoromethoxymethyl and the like.
  • haloalkoxyalkenyl refers to a straight chain or branched alkenyl as defined hereinbefore substituted with a haloalkoxy, for example 4-(chloromethoxy)-2-butenyl and the like.
  • haloalkoxyalkynyl refers to a straight chain or branched alkynyl as defined hereinbefore substituted with a haloalkoxy, for example 4-(2-fluoroethoxy)-2-butynyl and the like.
  • alkylthioalkyl refers to a straight chain or branched alkyl as defined hereinbefore substituted with an alkylthio group, for example methylthiomethyl,
  • alkylthioalkenyl refers to a straight chain or branched alkenyl as defined hereinbefore substituted with an alkylthio group, for example
  • alkylthioalkynyl refers to a straight chain or branched alkynyl as defined hereinbefore substituted with an alkylthio group, for example 4-(ethylthio)-2-butynyl and the like.
  • haloalkylthioalkyl refers to a straight chain or branched alkyl as defined hereinbefore substituted with an haloalkylthio group, for example 2-chloroethylthiomethyl, trifluoromethylthiomethyl and the like.
  • haloalkylthioalkenyl refers to a straight chain or branched alkenyl as defined hereinbefore substituted with an haloalkylthio group, for example 4-(chloromethylthio)-2-butenyl and the like.
  • haloalkylthioalkynyl refers to a straight chain or branched alkynyl as defined hereinbefore substituted
  • dialkoxyphosphorylalkyl refers to two straight chain or branched alkoxy groups as defined hereinbefore attached to a pentavalent phosphorous atom, containing an oxo substituent, which is in turn attached to an alkyl, for example diethoxyphosphorylmethyl.
  • oligomer refers to a low-molecular weight polymer, whose number average molecular weight is typically less than about 5000 g/mol, and whose degree of polymerization (average number of monomer units per chain) is greater than one and typically equal to or less than about 50.
  • Compounds described herein may contain one or more asymmetric centers and may thus give rise to diastereomers and optical isomers.
  • the present invention includes all such possible diastereomers as well as their racemic mixtures, their substantially pure resolved enantiomers, all possible geometric isomers, and pharmaceutically acceptable salts thereof.
  • the above Formula (I) is shown without a definitive stereochemistry at certain positions.
  • the present invention includes all stereoisomers of compounds and formulas described herein, and pharmaceutically acceptable salts thereof. Further, mixtures of stereoisomers as well as isolated specific stereoisomers are also included.
  • the products of such procedures can be a mixture of stereoisomers.
  • both the syn and anti isomers involving the X and G 1 substituent show activity. Furthermore, it is preferable that there be dual chiral centers at the X and G 1 attachment positions, if G 1 is not hydrogen.
  • the invention encompasses a pharmaceutical composition for the treatment of disease by inhibiting the cytochrome retmoic acid 4-hydroxylase enzyme (CYP26).
  • salts refers to salts prepared from pharmaceutically acceptable non-toxic bases or acids.
  • the compound of the present invention is acidic, its corresponding salt can be conveniently prepared from pharmaceutically acceptable non-toxic bases, including inorganic bases and organic bases.
  • Salts derived from such inorganic bases include aluminum, ammonium, calcium, copper (ic and ous), ferric, ferrous, lithium, magnesium, manganese (ic and ous), potassium, sodium, zinc and the like salts. Particularly preferred are the ammonium, calcium, magnesium, potassium and sodium slats.
  • Salts derived from pharmaceutically acceptable organic non-toxic bases include salts of primary, secondary, and tertiary amines, as well as cyclic amines and substituted amines such as naturally occurring and synthesized substituted amines.
  • Other pharmaceutically acceptable organic non-toxic bases from which salts can be formed include ion exchange resins such as, for example, arginine, betaine, caffeine, choline, ⁇ ', ⁇ '-dibenzylethylenediamine, diethylamine, 2-diethylaminoethanol,
  • a compound comprising the composition of the present invention is basic, its corresponding salt can be conveniently prepared from pharmaceutically acceptable non-toxic acids, including inorganic and organic acids.
  • acids include, for example, acetic, benzenesulfonic, benzoic, camphorsulfonic, citric, ethanesulfonic, formic, fumaric, gluconic, glutamic, hydrobromic, hydrochloric, isethionic, lactic, maleic, malic, mandelic, methanesulfonic, mucic, nitric, pamoic, pantothenic, phosphoric, succinic, sulfuric, tartaric, p-toluenesulfonic acid and the like.
  • compositions of the present invention comprise a compound represented by Formula (I) (or E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or a pharmaceutically acceptable salt thereof) as an active ingredient, a pharmaceutically acceptable carrier and optionally other therapeutic ingredients or adjuvants.
  • compositions include compositions suitable for oral, rectal, topical, and parenteral (including subcutaneous, intramuscular, and intravenous) administration, although the most suitable route in any given case will depend on the particular host, and nature and severity of the conditions for which the active ingredient is being administered.
  • the pharmaceutical compositions may be conveniently presented in unit dosage form and prepared by any of the methods well known in the art of pharmacy.
  • pharmaceutically acceptable derivative denotes any pharmaceutically acceptable salt, ester, or salt of such ester, of a compound, or any other adduct or derivative which, upon administration to a patient, is capable of providing (directly or indirectly) a compound as otherwise described herein, or a metabolite or residue thereof.
  • Pharmaceutically acceptable derivatives thus include among others pro-drugs.
  • a pro-drug is a derivative of a compound, usually with significantly reduced pharmacological activity, which contains an additional moiety, which is susceptible to removal in vivo yielding the parent molecule as the pharmacologically active species.
  • pro-drug is an ester, which is cleaved in vivo to yield a compound of interest.
  • Another example is an N-methyl derivative of a compound, which is susceptible to oxidative metabolism resulting in N-demethylation.
  • Pro-drugs of a variety of compounds, and materials and methods for derivatizing the parent compounds to create the pro-drugs, are known and may be adapted to the present invention. Certain exemplary pharmaceutical compositions and pharmaceutically acceptable derivatives will be discussed in more detail herein below.
  • tautomerization refers to the phenomenon wherein a proton of one atom of a molecule shifts to another atom. See, Jerry March, Advanced Organic Chemistry: Reactions, Mechanisms and Structures, Fourth Edition, John Wiley & Sons, pages 69-74 (1992).
  • tautomer refers to the compounds produced by the proton shift.
  • the present invention encompasses the tautomeric moieties like pyrazoles, pyridones and enols, etc.
  • geometrical isomers refers to cis-trans isomerism, syn-anti or E/Z isomerism based on the Cahn-Ingold-Prelog system. See March's Advanced Organic Chemistry: Reactions, Mechanisms and Structures, Sixth Edition, Wiley-Interscience, pages 182-195 (2007).
  • geometrical isomers refers to compounds having double bond with an E or Z configuration or cis-trans isomers of monocyclic or fused ring systems.
  • protecting group By the term “protecting group”, as used herein, it is meant that a particular functional moiety, e.g., O, S, or N, is temporarily blocked so that a reaction can be carried out selectively at another reactive site in a multifunctional compound.
  • a protecting group reacts selectively in good yield to give a protected substrate that is stable to the projected reactions; the protecting group must be selectively removed in good yield by readily available, preferably nontoxic reagents that do not attack the other functional groups; the protecting group forms an easily separable derivative (more preferably without the generation of new stereogenic centers); and the protecting group has a minimum of additional functionality to avoid further sites of reaction.
  • oxygen, sulfur, nitrogen and carbon protecting groups may be utilized.
  • oxygen protecting groups include, but are not limited to methyl ethers, substituted methyl ethers (e.g. , MOM (methoxymethyl ether), MTM (methylthiomethyl ether), BOM (benzyloxymethyl ether), PMBM or MPM (p-methoxybenzyloxymethyl ether), to name a few), substituted ethyl ethers, substituted benzyl ethers, silyl ethers (e.g., TMS (trimethylsilyl ether), TES (triethylsilylether), TIPS (triisopropylsilyl ether), TBDMS (t-butyldimethylsilyl ether), tribenzyl silyl ether, TBDPS (t-butyldiphenyl silyl ether), to name a few), esters (e.g., formate, acetate, benzoate (Bz) of methyl ethers, substituted methyl ethers (e.g. ,
  • nitrogen protecting groups are utilized. These nitrogen protecting groups include, but are not limited to, carbamates (including methyl, ethyl and substituted ethyl carbamates (e.g., Troc), to name a few) amides, cyclic imide derivatives, N-Alkyl and N-Aryl amines, imine derivatives, and enamine derivatives, to name a few. Certain other exemplary protecting groups are detailed herein, however, it will be appreciated that the present invention is not intended to be limited to these protecting groups; rather, a variety of additional equivalent protecting groups can be readily identified using the above criteria and utilized in the present invention. Additionally, a variety of protecting groups are described in "Protective Groups in Organic Synthesis" Third Ed.
  • the term "isolated" when applied to the compounds comprising the compositions of the present invention refers to such compounds that are (i) separated from at least some components with which they are associated in nature or when they are made and/or (ii) produced, prepared or manufactured by the hand of man.
  • biological sample includes, without limitation, cell cultures or extracts thereof; biopsied material obtained from an animal (e.g., mammal) or extracts thereof; and blood, saliva, urine, feces, semen, tears, or other body fluids or extracts thereof; or purified versions thereof.
  • biological sample refers to any solid or fluid sample obtained from, excreted by or secreted by any living organism, including single-celled micro organisms (such as bacteria and yeasts) and multicellular organisms (such as plants and animals, for instance a vertebrate or a mammal, and in particular a healthy or apparently healthy human subject or a human patient affected by a condition or disease to be diagnosed or investigated).
  • the biological sample can be in any form, including a solid material such as a tissue, cells, a cell pellet, a cell extract, cell homogenates, or cell fractions; or a biopsy, or a biological fluid.
  • the biological fluid may be obtained from any site (e.g. blood, saliva (or a mouth wash containing buccal cells), tears, plasma, serum, urine, bile, seminal fluid, cerebrospinal fluid, amniotic fluid, peritoneal fluid, and pleural fluid, or cells therefrom, aqueous or vitreous humor, or any bodily secretion), a transudate, an exudate (e.g. fluid obtained from an abscess or any other site of infection or inflammation), or fluid obtained from a joint (e.g.
  • the biological sample can be obtained from any organ or tissue (including a biopsy or autopsy specimen) or may comprise cells (whether primary cells or cultured cells) or medium conditioned by any cell, tissue or organ.
  • Biological samples may also include sections of tissues such as frozen sections taken for histological purposes.
  • Biological samples also include mixtures of biological molecules including proteins, lipids, carbohydrates and nucleic acids generated by partial or complete fractionation of cell or tissue homogenates.
  • biological samples may be from any animal, plant, bacteria, virus, yeast, etc.
  • the term animal refers to humans as well as non-human animals, at any stage of development, including, for example, mammals, birds, reptiles, amphibians, fish, worms and single cells. Cell cultures and live tissue samples are considered to be pluralities of animals.
  • the non-human animal is a mammal (e.g., a rodent, a mouse, a rat, a rabbit, a monkey, a dog, a cat, a sheep, cattle, a primate, or a pig).
  • An animal may be a transgenic animal or a human clone.
  • the biological sample may be subjected to preliminary processing, including preliminary separation techniques. DETAILED DESCRIPTION OF CERTAIN PREFERRED EMBODIMENTS
  • the invention herein is directed in one embodiment to compositions and methods for treating fibrotic conditions and diseases, and cancer and other dysproliferative diseases.
  • the method comprises administering to a subject in need there of a therapeutically effective amount of a synergistic composition comprising a retinol, or a pharmaceutically acceptable ester, salt or prodrug thereof; and a CYP26 inhibitor, or a pharmaceutically acceptable ester, salt or prodrug thereof; wherein said therapeutically effective amount suppresses fibrosis or the growth of dysproliferative cells in vivo.
  • a synergistic composition provides benefit to the subject which benefit is greater than the effect of either component separately or the sum of their effects when administered in the absence of the other.
  • the retinol and the CYP26 inhibitor can be administered in the same composition, or separately, provided that the synergistic benefit to the patient of the two compounds is achieved.
  • one compound may administered parenterally and the other orally; or one or both topically.
  • the frequency of administration may depend on the pharmacokinetics of each component such that the synergistic activity can be optimized without necessarily requiring simultaneous administration or administration by the same routes.
  • compositions, and benefits of their use show an enhancement or potentiation effect, whereby one or both of the components are present at concentrations or dosages that have no effect alone, but when combined with the other, show an effect.
  • the CYP26 inhibitor can be present at a concentration or dose that if alone does not show any positive effect on the disease or condition being treated, and the retinol is present at a concentration or dose with a small effect if administered alone.
  • the combination of CYP26 inhibitor and retinol increases the effect of the retinol, the combination shows potentiation or enhancement of the effect.
  • the CYP26 inhibitor can be present at a concentration or dose that shows a small positive effect on the disease or condition being treated if administered alone, and the retinol is present at a concentration or dose without any effect if administered alone.
  • the combination of CYP26 inhibitor and retinol increase the positive effect on the disease or condition, the combination shows potentiation or enhancement of the effect.
  • both the CYP26 inhibitor and the retinol are present in the combination at concentrations or doses wherein either one administered alone would have no positive effect on the disease or condition, but the combination shows a benefit.
  • the synergistic effects, the enhancement effects and the potentiation effects are fully embodied in the disclosure herein.
  • the retinol and the CYP26 inhibitor can be administered in the same composition or route of administration, or separately, provided that the synergistic, enhancement or potentiation of benefit to the patient or subject of the two compounds is achieved. Routes of administration such as topical, parenteral and oral are among non-limiting examples.
  • a composition comprising a combination of a retinol and a CYP26 inhibitor, wherein said combination is effective to suppress fibrosis or the growth of dysproliferative cells in vivo.
  • the composition is a synergistic combination.
  • the effectiveness to suppress fibrosis or the growth of dysproliferative cells in vivo of the combination is greater than the combined effectiviness of the retinol and the CYP26 inhibitor if each is administered alone.
  • the CYP26 inhibitor enhances or potentiates the effect of the retinol to suppress fibrosis or the growth of dysproliferative cells in vivo.
  • the retinol enhances or potentiates the effect of the CYP26 inhibitor to suppress fibrosis or the growth of dysproliferative cells in vivo.
  • a method is provided to suppress fibrosis or the growth of dysproliferative cells in vivo by administering a combination of a retinol and a CYP26 inhibitor, wherein said combination is effective to suppress fibrosis or the growth of dysproliferative cells in vivo.
  • the composition used for the aforementioned method is a synergistic combination.
  • the effectiveness to suppress fibrosis or the growth of dysproliferative cells in vivo of the combination is greater than the effectiviness of the retinol and the CYP26 inhibitor if each is administered alone.
  • the CYP26 inhibitor enhances or potentiates the effect of the retinol to suppress fibrosis or the growth of dysproliferative cells in vivo.
  • the retinol enhances or potentiates the effect of the CYP26 inhibitor to suppress fibrosis or the growth of dysproliferative cells in vivo.
  • a method for treating acne, psoriasis, ichthyosis, skin photoaging, skin chronoaging, skin wrinkling, skin sagging, skin thickening, skin thinning or a dysproliferative disease in subject in need thereof comprising
  • composition of claim 1 wherein said therapeutically effective amounts treat acne, psoriasis, ichthyosis, skin photoaging, skin chronoaging, skin wrinkling, skin sagging, skin thickening, skin thinning or dysproliferative disease.
  • the methods of treatment and the compositions of the invention are useful for prevention and treatment of cancerous and precancerous conditions, including, for example, premalignant and malignant hyperproliferative diseases such as cancers of the breast, ovary, germ cell, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, as well as metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes, and in the treatment of Kaposi's sarcoma.
  • the methods and compositions are useful in the treatment of breast cancer.
  • the methods and compositions are useful in the treatment of ovarian cancer. In another embodiment the methods and compositions are useful in the treatment of HER2 expressing cancers. In another embodiment the methods and compositions are useful in the treatment of HER2 expressing breast cancer. In another embodiment the methods and compositions are useful in the treatment of HER2 expressing ovarian cancer.
  • the synergistic compositions of the invention are useful in the treatment of dysproliferative diseases including cancer, psoriasis, rheumatoid arthritis, and other inflammatory joint and skin diseases.
  • the compositions are useful in the treatment of prostate cancer.
  • the present invention is also directed to methods of treatment of non-malignant tumors and other disorders involving inappropriate cell or tissue growth by administering a therapeutically effective amount of a synergistic composition of the invention.
  • the invention is useful for the treatment of arteriovenous (AV) malformations, particularly in intracranial sites.
  • AV arteriovenous
  • the invention may also be used to treat psoriasis, a dermatologic condition that is characterized by inflammation and vascular proliferation; benign prostatic hypertrophy, a condition associated with inflammation and possibly vascular proliferation; and cutaneous fungal infections. Treatment of other hyperproliferative disorders is also contemplated.
  • the agents may also be used topically to remove warts, birthmarks, moles, nevi, skin tags, lipomas, angiomas including hemangiomas, and other cutaneous lesions for cosmetic or other purposes.
  • the compositions described herein are also useful for treatment of skin. Skin is subject to deterioration through dermato logical disorders, environmental abuse such as wind, air conditioning, central heating, or through the normal ageing process (chronoaging), which may be accelerated by exposure of skin to sun (photoaging).
  • chronoaging normal ageing process
  • photoaging photoaging
  • compositions and pharmaceutical formulation comprising a retinol and a CYP26 inhibitor are useful for such conditions, in particular when one or both are administered via the topical route, concurrently or at different times.
  • Ichthyosis refers to a group of skin disorders characterized by the presence of excessive amounts of dry surface scales. This disease manifests itself within the first year of life and is clinically characterized by thickened dry, scaly skin, keratosis pilaris, tightening and cracking of the skin and many white fish-like scales. There are common and rare forms including inherited and acquired forms of ichthyosis, and an estimated total of about 1.24 million afflicted individuals in the US population. The compositions of the invention are also directed to the treatment of these various types of ichthyosis and related diseases.
  • methods described here are provided for prevention and treatment of other cancerous and precancerous conditions, including, for example, premalignant and malignant hyperproliferative diseases such as cancers of the breast, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes, and in the treatment of Kaposi's sarcoma.
  • premalignant and malignant hyperproliferative diseases such as cancers of the breast, skin, prostate, colon, bladder, cervix, uterus, stomach, lung, esophagus, blood and lymphatic system, larynx, oral cavity, metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes, and in the treatment
  • methods are provided to treat diseases of the eye, including, for example, proliferative vitreoretinopathy, retinal detachment, comeopathies such as dry eye, as well as in the treatment and prevention of various cardiovascular diseases, including, without limitation, diseases associated with lipid metabolism such as dyslipidemias, prevention of post-angioplasty restenosis and as an agent to increase the level of circulation tissue plasminogen activator.
  • Other methods embodied herein include the prevention and treatment of conditions and diseases associated with human papilloma virus (HPV), including warts, various inflammatory diseases such as pulmonary fibrosis, ileitis, colitis and Crohn's disease, neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease and stroke, improper pituitary function, including insufficient production of growth hormone, modulation of apoptosis, including both the induction of apoptosis, restoration of hair growth, including combination therapies with the present compositions and other agents such as minoxidil, diseases associated with the immune systems, including use of the present compositions as immunosuppressant and immunostimulants, modulation of organ transplant rejection and facilitation of wound healing, including modulation of chelosis.
  • Synergistic compositions embodied herein are also useful in treating type II non-insulin dependent diabetes mellitus (NIDDM).
  • NIDDM non-insulin dependent diabetes mellitus
  • the methods of treatment and synergistic compositions of the invention comprise a retinol.
  • Retinols useful for the methods and compositions of the invention include, but are not limited to, retinol and retinyl esters.
  • Retinol ((2E,4E,6E,8E)-3,7- dimethyl-9-(2,6,6-trimethylcyclohex-l-enyl)nona-2,4,6,8-tetraen-l-ol) is one of the animal forms of vitamin A. It is a diterpenoid and an alcohol. It is convertible to other forms of vitamin A, and the retinyl ester derivative of the alcohol serves as the storage form of the vitamin in animals.
  • retinol typically requires retinal synthesis through reduction of a pentadiene derivative and subsequent acidification/hydrolysis of the resulting isomer to produce retinol.
  • Pure retinol is extremely sensitive to oxidization and is prepared and transported at low temperatures and oxygen free atmospheres.
  • retinol is stabilized as the ester derivatives retinyl acetate or retinyl palmitate.
  • Synthetic retinol is marketed under the following trade names: Aeon, Afaxin, Agiolan, Alphalin, Anatola, Aoral, Apexol, Apostavit, Atav, Avibon, Avita, Avitol, Axerol, Dohyfral A, Epiteliol, Nio-A-Let, Prepalin, Testavol, Vaflol, Vi-Alpha, Vitpex, Vogan, and Vogan-Neu. Any and all of the foregoing retinols are embraced by the teachings herein.
  • the synergistic composition also comprises a CYP26 inhibitor.
  • CYP26 inhibitors inhibit the activity of the cytochrome P450 (CYP) enzyme retinoic acid 4- hydroxylase. Numerous compounds and agents are known to inhibit CYP26 and any of these, single or in combination, are useful in the synergistic composition of the invention.
  • CYP26 inhibitors include, by way of example, compounds described in PCT/US2011/038695, published as WO2011/153192, and in PCT/US2010/02175, published as WO2011/016863, both of which are incorporated herein by reference in their entireties. These and other non-limiting examples of such CYP26 inhibitors are described below.
  • the CYP26 inhibitor is talarozole (RAMBAZOLE), having the chemical name N-(2-benzothioazolyl)-N-[4-[2-ethyl-l-(l,2,4-triazo-l- yl)butyl]phenyl]amine. Its use as a CYP26 inhibitor is described in Stoppie et al. (2000) J Pharmacol Exp Ther. Apr;293(l):304; Ocaya et al. (2007) Arterioscler Thromb Vase Biol. Jul;27(7): 1542; Pavez Lorie et al. (2009) Br J Dermatol. Jan;160(l):26; Armstrong et al.
  • the CYP26 inhibitor is liarazole (5-[(3- chlorophenyl)- 1 h-imidazol- 1 -ylmethyl] - 1 h-benzimidazole).
  • CYP26 inhibitor useful for the methods and synergistic compositions is represented by formula (I):
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, tetrazolyl, thiazole, or pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 is a Co-ealkyl, -OR 7 , -SR 7 , or -NR 7 R 8 ;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, Ci_ loalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 _ioalkenyl, Ci-ioalkylthioC 2 _ioalkynyl, cycloC3- ealkyl, cycloC3-8alkenyl, cycloC3-8alkylCi-ioalkyl, cycloC3-8alkenylCi-ioalkyl, cycloC3- 8alkylC 2 _ioalkenyl, cycloC3-8alkenylCi-ioalkyl, cycl
  • G 1 is -OR 72 , -SR 72 , -NR 72 R 82 (R 9 )n5, or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n s, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83
  • Z is-aryl-, -arylalkyl-, -aryloxy-, -oxyaryl-, -arylalkenyl-, -alkenylaryl-, -hetaryl-, - hetarylalkyl-, -alkylhetaryl-, -hetarylalkenyl-, -alkenylhetaryl-, or -aryl-, any of which is optionally substituted with R 68 ;
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ loalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 _ loalkynyl, Ci-ioalkylthioCi-ioalkyl, Cl-10alkylthioC 2 _ioalkenyl, CnoalkylthioC 2 - loalkynyl, cycloC3-8alkyl, cycloC3-8alkenyl, cycloC3-8alkylCl-10alkyl, cycloC3- 8alkenylCi_ioalkyl, cycloC3-8alkylC 2 _ioalkenyl, cycloC3-8alken
  • R 6a , R 6b , R 66 , R 67 , R 68 , and R 69 are each independently halo, -OR -SH, - NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co- loalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci_ ioalkoxyC 2 -ioalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 -ioalkenyl, C 0- ioalkylthioC 2 -ioal
  • NR 778 R 888 su b s tituents; or hetaryl-Co-ioalkyl, hetaryl-C 2 -loalkenyl, or hetaryl-C 2 - loalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR, Ci-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, haloCi-ioalkyl, haloC 2 - loalkenyl, haloC 2 -ioalkynyl, -COOH, Ci_ 4 alkoxycarbonyl, -CONR 778 R 888 , -S0 2 NR 778 R 888 or -NR 778 R 888 substituents; or mono (Ci-6alkyl)aminoCi- 6 alkyl, di(Ci-6alkyl)aminoCi
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C 2 - loalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci_ioalkoxyC2- loalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci_ioalkylthioC2- loalkynyl, cycloC3-8alkyl, cycloC3-salkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3- 8alkenylCi_ioalkyl, cycloC3-8alkylC2-ioalkenyl, cycloC3-8alkenylC
  • the compound is represented by Formula I, or a pharmaceutically acceptable salt thereof, wherein X is an optionally substituted imidazolyl or optionally substituted triazolyl, and the other variables are as described above.
  • a compound is represented by Formula I, or a pharmaceutically acceptable salt thereof, wherein X is a substituted imidazolyl or substituted triazolyl; R 1 is hydrogen; and the other variables are as described above.
  • the compound is represented by Formula I, or a pharmaceutically acceptable salt thereof, wherein Y is oxygen, and the other variables are as described above.
  • the CYP26 inhibitor is represented by Formula IA:
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, tetrazolyl, thiazole, or pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 2 and R 3 are each independently Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi- loalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, Ci_ ioalkylthioC 2 _ioalkenyl, Ci-ioalkylthioC 2 _ioalkynyl, cycloC3-8alkyl, cycloC3-8alkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkeny
  • G 1 is -OR 72 , -SR 72 , -NR 72 R 82 (R 9 )n5, or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or
  • Z is-aryl-, -arylalkyl-, -aryloxy-, -oxyaryl-, -arylalkenyl-, -alkenylaryl-, -hetaryl-, - hetarylalkyl-, -alkylhetaryl-, -hetarylalkenyl-, -alkenylhetaryl-, or -aryl-, any of which is optionally substituted with R 68 ;
  • R 4b and R 5b are each independently Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci_ loalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, Ci-ioalkylthioCi- loalkyl, Cl-10alkylthioC2-ioalkenyl, CnoalkylthioC2-ioalkynyl, cycloC3-8alkyl, cycloC3-8alkenyl, cycloC3-8alkylCl-10alkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3- 8alkylC2-ioalkenyl, cycloC3-8alkenylC2-ioalkenyl, cycloC3-8alkylC2-ioalkyn
  • R 66 , R 67 , R 68 , and R 69 are each independently -OR 78 , -NR 77 R 88 (R 98 ) n7 , -CO2R 78 , - CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 -ioalkenyl, C 2 - loalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynyl, Ci_ loalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Co-ioalkylthioC2-ioalkynyl, cycloC3- 8alkyl, cycloC3-salken
  • R O ⁇ r , r , oJ, R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C 2 - loalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 - loalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 -ioalkenyl, Ci_ioalkyl
  • n2, n3, n4, n5, n6, and n7 are each independently equal to 0, 1 or 2.
  • the CYP26 inhibitor is represented by Formula 1-B:
  • X is substituted imidazolyl
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci_ loalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi- loalkyl, Ci-ioalkylthioC 2 _ioalkenyl, Ci-ioalkylthioC 2 _ioalkynyl, cycloC3-8alkyl, cycloC3- 8 alkenyl, cycloC3- 8 alkylCi_ioalkyl, cycloC3- 8 alkenylCi_ioalkyl, cycloC3- 8 alkenylCi_ioalkyl, cycloC3- 8 alkylC 2 _ loalkenyl, cycloC
  • G 1 is -OR 72 , -SR 72 , -NR 72 R 82 (R 9 )n5, or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n s, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83
  • Z is-aryl-, -arylalkyl-, -aryloxy-, -oxyaryl-, -arylalkenyl-, -alkenylaryl-, -hetaryl-, - hetarylalkyl-, -alkylhetaryl-, -hetarylalkenyl-, -alkenylhetaryl-, or -aryl-, any of which is optionally substituted with R 68 ;
  • R and R are each independently Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci_ loalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, Ci-ioalkylthioCi- loalkyl, Cl-10alkylthioC 2 -ioalkenyl, Cno
  • R 67 , R 68 , and R 69 are each independently -OR 78 , -NR 77 R 88 (R 98 ) n7 , -C0 2 R 78 , - CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 -ioalkenyl, C 2 - loalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, Ci_ loalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 -ioalkenyl, Co-ioalkylthioC 2 -ioalkynyl, cycloC3- 8alkyl, cycloC3
  • R O ⁇ r , r , , oJ, R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C 2 - loalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 - loalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 -ioalkenyl, Ci_io
  • the compounds of the present invention include compounds represented by
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents; or 2) wherein X is imidazolyl or triazolyl; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents, and Q 1 is -C0 2 H or -C0 2 R 75 ; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Co-io alkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent
  • X is imidazolyl or triazolyl
  • R ! is hydrogen
  • R 2 and R 3 are each independently C 0- loalkyl
  • G 1 is -NR 72 R 82 ; or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR
  • R 1 , R 2 and R 3 are each independently Co- loalkyl;
  • G 1 is -NR 72 R 82 ; or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83 substituents; Y is oxygen; Q 1 is Co-ealkyl, -C0 2 R
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Co- loalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent hal
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Cio- oalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Cio- oalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent
  • R 1 , R 2 and R 3 are each independently Co-ioalkyl; Y is oxygen; Q 1 is Co-ealkyl, CO2R 75 , or -CoNR 75 R 85 ; R 4a , R 4b , R 5a , and R 5b are each independently a Co-ioalkyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 77 -S0 2 NR 77 R 87 or -NR 77 R 87 substituents; or R 4a with R 5a , or R with R taken together with the respective carbon atom to which they are attached, form a 3-10 membered saturated or unsaturated ring, wherein said ring is optionally substituted with R 69 ; or R 4a with R 5a , or R 4
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 is Co-ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is - NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached; or G 1 and R 3 taken together with the carbon atom to which they are attached form
  • ⁇ is the carbon to which they are attached, any of which is optionally substituted by 1-10 independent R substituents;
  • X is imidazole; or 22) wherein X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 is Co ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 63 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 63 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • R , and R 6a and R 6b are each independently halo, -OR 78 , -NR 78 R 88 (R 98 ) n7 , -CO2R 78 , - CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , or Co-ioalkyl; and R 2 is hydrogen; and G 1 and R 3 taken together with the carbon atom to which they are attached form
  • ⁇ is the carbon to which they are attached or G 1 and R 3 taken
  • n2, n3, and n4 are each 1 and Z is aryl; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 63 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached or G 1 and R 3 taken
  • n2 is 1; n3 and n4 are each 0; and Z is aryl; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 63 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached or G 1 and R 3 taken
  • n2 is the carbon to which they are attached, any of which is optionally substituted by i_io independent R 67 substituents; and n2, n3, and n4 are each 1 and Z is aryl; and n3 is 0; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 63 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached or G 1 and R 3 taken
  • n2 is the carbon to which they are attached, any of which is optionally substituted by i_io independent R67 substituents; and n2, n3, and n4 are each 1 and Z is aryl; and n3 is 0; or
  • X is imidazolyl or triazolyl;
  • R 1 is hydrogen;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83
  • X is imidazolyl or triazolyl
  • R L is hydrogen
  • G 1 is -NR 72 R 82
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83 substituents
  • X is imidazolyl or triazolyl;
  • R 1 is hydrogen;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is- NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached, or G 1 and R 3 taken together with the
  • ⁇ is the carbon to which they are attached, any of which is optionally substituted by 1-10 independent R substituents; nl and n2 are each 1 ; and Z is aryl; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is- NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached or G 1 and R 3 taken together with the
  • nl and n2 are each 1; n3 and n4 are each 0; and Z is aryl; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is- NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached or G 1 and R 3 taken together with the
  • nl and n2 are each 1; Z is aryl; and Q 1 is -C0 2 R 75 ; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 and R 3 are each independently Co-ioalkyl;
  • G 1 is- NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo,
  • ⁇ is the carbon to which they are attached or G 1 and R 3 taken together with the
  • nl and n2 are each 1 ; Z is aryl; and Q 1 is-C0 2 H; and wherein, in each case, the other variables are as defined above for Formula I.
  • the CYP26 inhibitor compounds useful in the compositions of the present invention include, by way of non-limiting examples: methyl 3-((6-(2-(dimethylamino)-l-(lH- imidazol- 1 -yl)propyl)naphthalen-2-yl)oxy)-2,2-dimethylpropanoate; methyl 2-(((6-(2- (dimethylamino)- 1 -( 1 H-imidazol- 1 -yl)propyl)naphthalen-2-yl)oxy)methyl)-2-ethylbutanoate; ethyl 1 -(((6-(2-(dimethylamino)- 1 -(1 H-imidazol- 1 -yl)propyl)naphthalen-2- yl)oxy)methyl)cyclopropanecarboxylate; ethyl 1 -(((6-(2-(dimethylamino)- 1 -( 1
  • the CYP26 inhibitor is represented by formula (II)
  • Ri is an optionally substituted azole, sulfur, oxygen, nitrogen, pyridyl, acetylinic, cyclopropyl-amine, ester, oxime, cyano, amino, azido, cyclopropylamino, oxirane, aziridine, thiirane, thiol, alkylthiol, -OR 4 wherein R 4 is hydrogen or an alkyl group, cyclopropylether, an oxygen containing group that forms, together with the 4-position carbon, an oxirane group; -NR 5 R 6 , where R 5 and R 6 are independently selected from the group consisting of hydrogen and alkyl groups, or R 5 and R 6 may together form a ring; and
  • R 2 is selected from the group consisting of hydroxyl, aminophenol, -OR3 and an azole group, wherein R3 is selected from the group consisting of alkyl, aryl and heterocyclic groups.
  • Ri is selected from the group consisting of sulfur containing groups, oxygen containing groups, nitrogen containing groups, acetylinic, ester groups, oxime and aziridine; and R 2 is selected from the group consisting of hydroxyl, aminophenol, -OR3 and azole groups, wherein R3 is selected from the group consisting of alkyl, aryl and heterocyclic groups.
  • Ri is optionally substituted azole, sulfur, oxygen, nitrogen, pyridyl, acetylinic, cyclopropyl-amine, esters, oxime, cyano, oxirane or aziridine; and R 2 is hydroxyl, an aminophenol, an ester, or an azole.
  • Ri may be a sulfur containing group.
  • sulfur containing groups include thiirane, thiol and alkylthiol derivatives.
  • alkylthiol derivatives include Ci to Cio alkyl thiols.
  • Ri may be an oxygen containing group.
  • oxygen containing groups include -OR 4 , where R 4 is hydrogen or an alkyl group (preferably a 1-10 carbon alkyl, more preferably methyl or ethyl), cyclopropylether or an oxygen containing group that forms, together with the 4-position carbon, an oxirane group.
  • Ri may be a nitrogen containing group.
  • nitrogen containing groups include the formula-NR 5 R 6 , where R 5 and R 6 are independently selected from the group consisting of hydrogen and alkyl groups (preferably a 1-10 carbon alkyl, more preferably methyl or ethyl), or R 5 and R 6 may together form a ring.
  • R 5 and R 6 are independently selected from the group consisting of hydrogen and alkyl groups (preferably a 1-10 carbon alkyl, more preferably methyl or ethyl), or R 5 and R 6 may together form a ring.
  • the ring formed by R 5 and R 6 is an imidazolyl ring or a triazole ring.
  • Preferable azole substituent groups include imidazoles and triazoles. More preferably, the azole substituent groups include IH imidazole- 1-yl, IH 1,2,4-triazol-l-yl and 4H-l,2,4-triazol-4-yl.
  • Ri may be a cyano, amino, azido, cyclopropylamino, or Ri is a nitrogen containing group that forms, together with the 4-position carbon, an aziridine group or an oxime group.
  • Ri may also be a pyridyl group or an allylic azole group, preferably methyleneazolyl.
  • Ri of an ester includes substituent groups that contain an ester moiety, including substituent groups attached via an ester moiety.
  • R 2 may be preferably selected from the group consisting of hydroxyl, aminophenol, -OR 3 and azole groups, wherein R 3 is selected from the group consisting of alkyl, aryl and heterocyclic groups, more preferably, hydroxyl or -OCH3 (methoxy).
  • alkyl substituents for the above identified substituent groups include substituted and unsubstituted alkyl groups, branched and straight chain and cyclo alkyl groups, such as cyclopropyl.
  • aryl includes a phenyl or naphthyl ring.
  • Non-limiting examples of CYP26 inhibitors of formula (II) useful compositions and methods for the purposes described herein include: ( ⁇ )-4-(lH-imidazol-l- yl)-methyl retinoate, ( ⁇ )-4-(lH-imidazole-l-yl)retinoic acid, ( ⁇ )-4-(lH-l,2,4-triazol-l-yl) methyl retinoate, ( ⁇ )-4-(4H- 1 ,2,4-triazole-4-yl) methyl retinoate, ( ⁇ )-4-(lH- 1 ,2,4-triazol- 1 -yl) retinoic acid, and ( ⁇ )-4- (4H-l,2,4-triazol-4-yl) retinoic acid.
  • compositions herein comprising such compounds may be in the form of an individual enantiomer, diastereomer or geometric isomer, or may be in the form of a mixture of stereoisomers.
  • the compounds of the invention are enantiopure compounds. In certain other embodiments, mixtures of stereoisomers or diastereomers are provided.
  • certain compounds, as described herein may have one or more double bonds that can exist as either the Z or E isomer, unless otherwise indicated.
  • the invention additionally encompasses the compounds as individual isomers substantially free of other isomers and alternatively, as mixtures of various isomers, e.g., racemic mixtures of stereoisomers.
  • this invention also encompasses pharmaceutically acceptable derivatives of these compounds and compositions comprising one or more compounds of the invention and one or more pharmaceutically acceptable excipients or additives.
  • the CYP26 inhibitor of the synergistic composition is represented by formula (III)
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, tetrazolyl, thiazole, 3-pyridinyl or 4- pyridinyl, any of which is optionally substituted with one or more independent R substituents;
  • R 1 is hydrogen, Co-ealkyl, -OR 7 , -SR 7 , or -NR 7 R 8 ;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl, Ci-ioalkylthioC 2 -ioalkynyl, cycloC3-8alkyl, cycloC3-8alkenyl, cycloC3-8alkylCnoalkyl, cycloC3-8alkenylCi-ioalkylC2-ioalkenyl, cycloC3-8alkeny
  • R 6a , R 6b , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci_ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Co-ioalkylthioC2-ioalkynyl, cycloC3-
  • -NR 778 R 888 substituents; or hetaryl-Co-ioalkyl, hetaryl-C 2 -ioalkenyl, or hetaryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 77 , Ci-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, haloCi-ioalkyl, haloC 2 -ioalkenyl, haloC 2 -ioalkynyl, -COOH, Ci- 4 alkoxycarbonyl, -CONR 778 R 888 , -S0 2 NR 778 R 888 or -NR 778 R 888 substituents; or mono
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-salkyl, cycloC3-8alkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenyl
  • nl, n2, n3, n4, n5, n6, and n7 are each independently equal to 0, 1 or 2.
  • a compound is represented by Formula (III), or a pharmaceutically acceptable salt thereof, wherein X is an optionally substituted imidazolyl, optionally substituted triazolyl, optionally substituted 3-pyridinyl, optionally substituted 4-pyridinyl and the other variables are as described above.
  • a compound is represented by Formula (III), or a pharmaceutically acceptable salt thereof, wherein X is a substituted imidazolyl, substituted 3- pyridinyl, substituted 4-pyridinyl or substituted triazolyl; R 1 is hydrogen; and the other variables are as described above.
  • Non-limiting examples of compounds of Formula (III) include 3-(((6-(-2- (Dimethylamino)- 1 -( 1 H-imidazol- 1 -yl)butyl)benzo [d]thiazol-2-yl)amino)methyl)benzoic acid; 3-((6-(-2-(Dimethylamino)-l-(lH-imidazol-l-yl)butyl)benzo[d]thiazol-2-yl)amino)-2,2- dimethylpropanoic acid; 3 -((6-(-2-(Dimethylamino)- 1 -( 1 H-imidazol- 1 - yl)butyl)benzo[d]thiazol-2-yl)a
  • the CYP26 inhibitor of the synergistic composition is represented by Formula (IV):
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, tetrazolyl, thiazole, 3-pyridinyl or 4- pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl,
  • R 6a , R 6b , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 -ioalkenyl, Co-ioalkylthioC 2 -io
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-salkyl, cycloC3-8alkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-salkyl
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S02N(Co-4alkyl)(Co-4alkyl) or -N(C 0-4 alkyl) (C 0-4 alkyl) substituents; aryl-Co-ioalkyl, aryl-C2-ioalkenyl, or aryl-C2-ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -0(Co-4alkyl), Ci-ioalkyl, C2-
  • CYP26 inhibitors useful in the synergistic composition are represented by Formula (IV-A):
  • X is optionally substituted imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i-6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-i-i
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl,
  • R 6a , R 6b , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 ,
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 _ioalkenyl, Ci-ioalkylthioC 2 -ioalkynyl, cycloC3-8alkyl, cycloCs-salkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalky
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 N(Co-4alkyl)(Co-4alkyl) or -N(C 0-4 alkyl) (C 0-4 alkyl) substituents; aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 _ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -0(Co-4alkyl), Ci-ioalkyl
  • a compound is represented by Formula (I), or an E or
  • CYP26 inhibitors comprising the synergistic composition are represented by Formula (V):
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, tetrazolyl, thiazole, 3-pyridinyl or 4- pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC2-ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-8alkyl, cycloC3-salkenyl, cycloC3-8alkylCnoalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylC2-ioalkenyl, cycloC3-8alkenylC2-
  • -NR 77 R 87 substituents; or hetaryl-Co-ioalkyl, hetaryl-C2-ioalkenyl, or hetaryl-C2-ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 77 , Ci-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, haloCi-ioalkyl, haloC2-ioalkenyl, haloC2-ioalkynyl, -COOH, Ci_ 4 alkoxycarbonyl, -CONR 77 R 87 , -S0 2 NR 77 R 87 or -NR 77 R 87 substituents; or mono
  • R 5a , or R 4b with R 5b , or R 4c with R 5C taken together with the respective carbon atom to which they are attached, form a carbonyl or 3-10 membered saturated or unsaturated monocyclic or polycyclic ring, wherein said ring is optionally substituted with R 69 ; or R 4a with R 5a , or R 4b with R 5b , or R 4c with R 5c , taken together with the respective carbon atom to which they are attached, form a 3-10 membered saturated or unsaturated monoheterocyclic or polyheterocyclic ring, wherein said ring is optionally substituted with R 69 ;
  • R 6a , R 6b , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 , -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci_ioalkoxyC2-ioalkenyl,
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl,
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S02N(Co-4alkyl)(Co-4alkyl) or -N(C 0-4 alkyl) (C 0-4 alkyl) substituents; aryl-Co-ioalkyl, aryl-C 2 -ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -0(Co-4alkyl), Ci-ioalky
  • CYP26 inhibitors comprising the synergistic composition are represented by Formula (V-A):
  • V-A or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, and wherein:
  • X is optionally substituted imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl,
  • Ci-ioalkoxyCi-ioalkyl Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • G 1 is hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl, Ci-ioalkylthioC 2 -ioalkynyl, cycloC3-8alkyl, cycloC3-salkenyl, cycloC3-8alkylCnoalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkylC 2 _ioalkenyl, cycloC3
  • Ci-ioalkyl Ci-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, haloCi-ioalkyl, haloC 2 _ioalkenyl, haloC 2 -ioalkynyl, -COOH, Ci_ 4 alkoxycarbonyl, -CONR 77 R 87 , -S0 2 NR 77 R 87 or -NR 77 R 87 substituents; or hetaryl-Co-ioalkyl, hetaryl-C 2 _ioalkenyl, or hetaryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 77 , Ci-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, haloCi-ioalkyl
  • R 6a , R 6b , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 , -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl,
  • -NR 778 R 888 substituents; or hetaryl-Co-ioalkyl, hetaryl-C 2 -ioalkenyl, or hetaryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 778 , Ci-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, haloCi-ioalkyl, haloC 2 -ioalkenyl, haloC 2 -ioalkynyl, -COOH, Ci_ 4 alkoxycarbonyl, -CONR 778 R 888 , -S0 2 NR 778 R 888 or -NR 778 R 888 substituents; or mono
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-8alkyl, cycloCs-salkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenyl
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy,
  • nl, n2, n3, n5, and n7 are each independently equal to 0, 1 or 2.
  • a compound is represented by Formula (I), or an E or
  • Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein Y is oxygen, and the other variables are as described above.
  • CYP26 inhibitors comprising the synergistic composition are represented by Formula (VI):
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, tetrazolyl, thiazole, 3-pyridinyl or 4- pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl, Ci-ioalkylthioC 2 -ioalkynyl, cycloC3-8alkyl, cycloC3-8alkenyl, cycloC3-8alkylCnoalkyl, cycloC3-8alkenylCi-ioalkylC2-ioalkenyl, cycloC3-8alkeny
  • R 6a , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 , -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci_ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Co-ioalkylthioC2-ioalkynyl, cycloC3-salky
  • -NR 778 R 888 substituents; or hetaryl-Co-ioalkyl, hetaryl-C 2 -ioalkenyl, or hetaryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 778 , Ci-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, haloCi-ioalkyl, haloC 2 -ioalkenyl, haloC 2 -ioalkynyl, -COOH, Ci- 4 alkoxycarbonyl, -CONR 778 R 888 , -S0 2 NR 778 R 888 or -NR 778 R 888 substituents; or mono
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-salkyl, cycloC3-8alkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenyl
  • CYP26 inhibitors comprising the synergistic composition are represented by Formula (VI -A):
  • VI-A or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, and wherein;
  • X is optionally substituted imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkoxycarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i-6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 -ioalkenyl, or aryl-C2-ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-ioalkyl
  • G 1 is hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl,
  • R 6a , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 , -SH, -NR 77 R 88 (R 98 ) réelle7, -C0 2 R 78 , -CONR 78 R 88 , -N0 2 , -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 -ioalkenyl, C 2 -ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, Ci-ioalkylthioCi-ioalkyl, Ci-ioalkylthioC 2 -ioalkenyl, Co-ioalkylthioC 2 -i
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-salkyl, cycloC3-8alkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-salkyl
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S02N(Co-4alkyl)(Co-4alkyl) or -N(C 0-4 alkyl) (C 0-4 alkyl) substituents; aryl-Co-ioalkyl, aryl-C2-ioalkenyl, or aryl-C2-ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -0(Co-4alkyl), Ci-ioalkyl, C2-
  • Ci_ 4 alkoxycarbonyl -CON(Co- 4 alkyl)(C 0 -ioalkyl), -S0 2 N(Co-4alkyl)(Co- 4 alkyl) or -N(Co-4alkyl)(Co-4alkyl) substituents; or hetaryl-Co-ioalkyl, hetaryl-C2-ioalkenyl, or hetaryl-C2-ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -0(Co-4alkyl), Ci-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, haloCi-ioalkyl, haloC2-ioalkenyl, haloC2-ioalkynyl, -COOH, Ci-4alkoxycarbonyl,
  • a compound is represented by Formula (I), or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein Y is aryl or heteroaryl, and the other variables are as described above.
  • CYP26 inhibitors comprising the synergistic composition are represented by Formula (VII):
  • X is an unsaturated heterocycle selected from pyrrolyl, pyrazolyl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, tetrazolyl, thiazole, 3-pyridinyl or 4- pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 is hydrogen, Co-ealkyl, -OR 7 , -SR 7 , or -NR 7 R 8 ;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • B is aryl or heteroaryl which is optionally substituted with one or more independent halo, -OR 77 -SR 77 , -NR 77 R 88 (R 98 ) friendship 7 , -C0 2 R 78 , -CONR 78 R 88 , -N0 2 , -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC 2 -ioalkenyl, Ci-ioalkylthioC 2 -ioalkynyl, cycloC3-8alkyl, cycloC3-salkenyl, cycloC3-8alkylCnoalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkylC 2 _ioalkenyl, cycloC3
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-salkyl, cycloC3-8alkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenyl
  • CYP26 inhibitors comprising the synergistic composition are represented by Formula (VII- A):
  • VII-A or an E or Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein:
  • X is optionally substituted imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, 3- pyridinyl or 4-pyridinyl;
  • R 1 is hydrogen, Co-ealkyl, -OR 7 , -SR 7 , or -NR 7 R 8 ;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 is hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, -OR 72 , -SR 72 , -NR 72 R 82 (R 9 ) réelle 5 , or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5, R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • B is aryl or heteroaryl which is optionally substituted with one or more independent halo, -OR 77 -SR 77 , -NR 77 R 88 (R 98 ) friendship 7 , -C0 2 R 78 , -CONR 78 R 88 , -N0 2 , -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl,
  • R 4a , R 4b , R 4c , R 5a , R 5b and R 5c are each independently hydrogen, Co-ioalkyl, C 2 _ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 -ioalkenyl, Ci-ioalkoxyC2-ioalkynyl, CuoalkylthioCi-ioalkyl, CnoalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-8alkyl, cycloC3-salkenyl, cycloC3-8alkylCnoalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylC2-ioalkenyl, cycloC3-8alkenylC2-
  • -NR 77 R 87 substituents; or hetaryl-Co-ioalkyl, hetaryl-C2-ioalkenyl, or hetaryl-C2-ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 77 , Ci-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, haloCi-ioalkyl, haloC2-ioalkenyl, haloC2-ioalkynyl, -COOH, Ci_ 4 alkoxycarbonyl, -CONR 77 R 87 , -S0 2 NR 77 R 87 or -NR 77 R 87 substituents; or mono
  • R 5a , or R 4b with R 5b , or R 4c with R 5C taken together with the respective carbon atom to which they are attached, form a carbonyl or 3-10 membered saturated or unsaturated monocyclic or polycyclic ring, wherein said ring is optionally substituted with R 69 ; or R 4a with R 5a , or R 4b with R 5b , or R 4c with R 5c , taken together with the respective carbon atom to which they are attached, form a 3-10 membered saturated or unsaturated monoheterocyclic or polyheterocyclic ring, wherein said ring is optionally substituted with R 69 ;
  • R 6a , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 , -SH, -NR 77 R 88 (R 98 ) admir7, -CO2R 78 , -CONR 78 R 88 , -NO2, -CN, -S(0) foi 7 R 78 , -S0 2 NR 78 R 88 , Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci_ioalkoxyC2-ioalkenyl,
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl,
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S02N(Co-4alkyl)(Co-4alkyl) or -N(C 0-4 alkyl) (C 0-4 alkyl) substituents; aryl-Co-ioalkyl, aryl-C 2 -ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -0(Co-4alkyl), Ci-ioalky
  • a compound is represented by Formula (I), or an E or
  • Z isomer thereof, syn or anti isomer thereof, an optically pure isomer thereof, or pharmaceutically acceptable salt thereof, wherein Y is as described below and the other variables are as described above.
  • CYP26 inhibitors comprising the synergistic composition are represented by Formula (VIII):
  • X is optionally substituted imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, 3- pyridinyl or 4-pyridinyl;
  • R 1 is hydrogen, Co-ealkyl, -OR 7 , -SR 7 , or -NR 7 R 8 ;
  • R 2 and R 3 are each independently hydrogen, Co-ioalkyl, C 2 -ioalkenyl, C 2 _ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC 2 _ioalkenyl, Ci-ioalkoxyC 2 -ioalkynyl,
  • Ci-ioalkynylcarbonyl Ci-ioalkoxycarbonyl, Ci-ioalkoxycarbonylCi-ioalkyl, monoC i_6alkylaminocarbonyl, diC i_6aminocarbonyl, mono(aryl)aminocarbonyl, di(aryl)aminocarbonyl, or Cnoalkyl(aryl)aminocarbonyl, any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 71 R 81 , or -NR 71 R 81 substituents; or aryl-Co-ioalkyl, aryl-C 2 _ioalkenyl, or aryl-C 2 -ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -OR 71 , Ci-
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, any of which is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or in the case of -NR 72 R 82 (R 9 ) n 5,
  • R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83 substituents;
  • R 6a , R 66 , R 67 , R 68 , and R 69 are each independently hydrogen, halo, -OR 77 , -SH,
  • R 86 , R 87 , R 88 , R 888 , R 9 , R 95 and R 98 are each independently hydrogen, Co-ioalkyl, C2-ioalkenyl, C2-ioalkynyl, Ci-ioalkoxyCi-ioalkyl, Ci-ioalkoxyC2-ioalkenyl, Ci-ioalkoxyC2-ioalkynmyl, Ci-ioalkylthioCi-ioalkyl, Ci_ioalkylthioC2-ioalkenyl, Ci-ioalkylthioC2-ioalkynyl, cycloC3-salkyl, cycloC3-8alkenyl, cycloC3-8alkylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenylCi_ioalkyl, cycloC3-8alkenyl
  • Ci-ioalkyl (aryl)aminocarbonyl any of which is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S02N(Co-4alkyl)(Co-4alkyl) or -N(Co-4alkyl) (Co-4alkyl) substituents; aryl-Co-ioalkyl, aryl-C2-ioalkenyl, or aryl-C2-ioalkynyl, any of which is optionally substituted with one or more independent halo, cyano, nitro, -0(Co-4alkyl), Ci-ioalkyl, C2-ioalken
  • the compounds of the present invention include compounds represented by Formula (VIII) above, or a pharmaceutically acceptable salt thereof, and
  • X is hetaryl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl, 3-pyridinyl or 4-pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents; or
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents, and Q 1 is -C0 2 H or -C0 2 R 75 ; or 4) wherein Y is nitrogen; or
  • Y is -NHCO-; and X is hetaryl, imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents; or
  • Y is -NHCO-; and X is imidazolyl, or triazolyl; n3, n2 and n4 are 0; or
  • Y is -NHCO-; and X is imidazolyl, or triazolyl; n2 is 0; and Q 1 is -CO2H or -CO2R 75 ; or
  • Y is -NHCO-; and X is imidazolyl, or triazolyl; n3 is 0; and Q 1 is -CO2H or -CO2R 75 ; or
  • Y is optionally substituted phenyl and X is hetaryl, imidazolyl, triazolyl, benzimidazolyl, benzotriazolyl,, 3-pyridinyl or 4-pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents; or
  • Y is optionally substituted phenyl and X is imidazolyl or triazolyl; or 25) wherein Y is phenyl substituted with halogen or CF3; and X is imidazolyl or triazolyl; or
  • Y is phenyl substituted with halogen or CF3; and X is imidazolyl or triazolyl; nl, n2 and n3 are 0; and Q 1 is -CO2H or -CO2R 75 ; or
  • Y is phenyl and X is 3-pyridinyl or 4-pyridinyl; n2 and n3 are 0; G 1 is hydrogen; G 1 is hydrogen; and Q 1 is -CO2H or -CO2R 75 ; or
  • Y is phenyl and X is imidazolyl or triazolyl; nl and n2 are 0; and Q 1 is -CO2H or -CO2R 75 ; or
  • Y is phenyl and X is imidazolyl or triazolyl; nl and n2 are 0; G 1 is hydrogen; and Q 1 is -CO2H or -CO2R 75 ; or
  • R 1 , R 2 and R 3 are each independently Co- loalkyl;
  • G 1 is -NR 72 R 82 ; or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83 substituents; Y is NH; Q 1 is Co-ealkyl, -C0 2
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Co- loalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent hal
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Co- loalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent hal
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Co- loalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent hal
  • X is hetaryl, imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently hydrogen or Co-io alkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, where
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 , R 2 and R 3 are each independently Co- loalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent hal
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R 66 substituents;
  • R 1 is Co-ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy
  • ⁇ is the carbon to which they are attached; or G 1 and R 3 taken together with the carbon atom to which they are attached form
  • ⁇ is the carbon to which they are attached, any of which is optionally substituted by 1-10 independent R 67 substituents; or
  • R 1 is Co-ioalkyl
  • G 1 is -NR 72 R 82 ; or G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 63 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more
  • X is hetaryl, imidazolyl, or triazolyl, any of which is optionally substituted with one or more independent R66 substituents;
  • R 1 is Co-ioalkyl;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 63 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy,
  • X is imidazolyl or triazolyl
  • R 1 is hydrogen
  • G 1 is -NR 72 R 82
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83 substituents;
  • X is imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl;
  • R 1 is hydrogen;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR
  • X is imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl;
  • R 1 is hydrogen;
  • G 1 is hydrogen; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or
  • X is imidazolyl, triazolyl, 3-pyridinyl or 4-pyridinyl;
  • R 1 is hydrogen;
  • G 1 is hydrogen; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR
  • X is imidazolyl or triazolyl;
  • R 1 is hydrogen;
  • G 1 is -NR 72 R 82 ; or
  • G 1 and R 3 taken together with the carbon atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent R 67 and an N heteroatom of the heterocyclic saturated ring or heterocyclic unsaturated ring optionally is substituted with an R 72 substituent; or R 72 and R 82 taken together with the nitrogen atom to which they are attached form a 3-10 membered saturated ring, unsaturated ring, heterocyclic saturated ring, or heterocyclic unsaturated ring, wherein said ring is optionally substituted with one or more independent halo, cyano, hydroxy, nitro, Ci-ioalkoxy, -S0 2 NR 73 R 83 or -NR 73 R 83
  • the CYP26 inhibitor is a compound of formula (IX):
  • R d and R p are optional naphthyl group substituents
  • R Het is imidazolyl, triazolyl or pyridyl
  • R c is Ci-4 alkyl substituted by a group selected from: hydroxy, amino, amido, carboxy, Ci- 7 alkyl ester, C5-7 aryl-C 1-2 alkyl ester, sulfonamino, sulfinamino, hydroxamino and tetrazolyl.
  • the compound of formula (IX) can be formula (IX- A) or formula (IX-B):
  • R c is Ci-4 alkyl substituted by a group selected from: hydroxy, amino, amido, carboxy, Ci_ 7 alkyl ester, C5-7 aryl-C 1-2 alkyl ester, sulfonamino, sulfinamino, hydroxamino and tetrazolyl; and R d and R p are optionally selected from, but not limited to, C 1-7 alkyl, C3-20 heterocyclyl, C5-20 aryl, halo, hydroxy, ether, nitro, cyano, acyl, ester, amido, amino, acylamido, ureido, acyloxy, thiol, thioether, sulfoxide, sulfonyl, thioamido, sulfonamino, sulfinamino and hydroxamino.
  • Particular compounds of interest in formula (IX) include 3-imidazol-l-yl-2 ,2- dimethyl-3-[4-(naphthalen-2-ylamino)-phenyl]-propionic acid methyl ester, methyl anti-3- ( 1 H- 1 -imidazolyl)-3 - [4-(2-naphthylamino)phenyl] -2-methylpropanoate; methyl syn-3 -( 1 H- 1 - imidazolyl)-3 - [4-(2-naphthylamino)phenyl] -2-methylpropanoate; methyl 3 -( 1 H-imidazol- 1 - yl)-2,3-dimethyl-3-((4-naphthalene-2-yloxy)phenyl)propanoate; methyl 2,2-dimethyl-3-(4- (naphthalen-2-ylamino)phenyl)-3-(lH-l,2,4-
  • each of the CYP26 inhibitor compounds described herein and each of the classes and subclasses of compounds described above may be substituted as described generally herein, or may be substituted according to any one or more of the subclasses described above and herein.
  • inventive compounds and pharmaceutical compositions thereof may be in the form of an individual enantiomer, diastereomer or geometric isomer, or may be in the form of a mixture of stereoisomers.
  • the compounds of the invention are enantiopure compounds.
  • mixtures of stereoisomers or diastereomers are provided.
  • certain compounds, as described herein may have one or more double bonds that can exist as either the Z or E isomer, unless otherwise indicated.
  • the invention additionally encompasses the compounds as individual isomers substantially free of other isomers and alternatively, as mixtures of various isomers, e.g., racemic mixtures of stereoisomers.
  • this invention also encompasses pharmaceutically acceptable derivatives of these compounds and compositions comprising one or more compounds of the invention and one or more pharmaceutically acceptable excipients or additives.
  • Compounds comprising synergistic compositions of the invention may be prepared by crystallization of compound of formula (I) - (IX) under different conditions and may exist as one or a combination of polymorphs of compound of general formula (I) - (IX) forming part of this invention.
  • different polymorphs may be identified and/or prepared using different solvents, or different mixtures of solvents for recrystallization; by performing crystallizations at different temperatures; or by using various modes of cooling, ranging from very fast to very slow cooling during crystallizations.
  • Polymorphs may also be obtained by heating or melting the compound followed by gradual or fast cooling.
  • the presence of polymorphs may be determined by solid probe NMR spectroscopy, IR spectroscopy, differential scanning calorimetry, powder X-ray diffractogram and/or other techniques.
  • inventive compounds their derivatives, their tautomeric and geometrical isomeric forms, their stereoisomers, their polymorphs, their pharmaceutically acceptable salts their pharmaceutically acceptable solvates and pharmaceutically acceptable compositions containing them.
  • Tautomeric forms of compounds of the present invention include, pyrazoles, pyridones and enols, etc.
  • geometrical isomers include E/Z isomers of compounds having double bonds and cis-trans isomers of monocyclic or fused ring systems, etc. 2) Pharmaceutical Compositions
  • a synergistic composition in practice, comprise administering a retinol and a CYP26 inhibitor to a subject in need thereof to provide benefit to the subject more than is achievable by either inhibitor when administered in the absence of the other. Therefore, a synergistic composition can comprise both inhibitors in the same composition or separately for simultaneous administration, or in other embodiments, each inhibitor can be administered to the subject to achieve its maximal pharmacological activity, which in the presence of the pharmacological activity of the other inhibitor, provides a synergistic benefit.
  • One or more of the retinol compounds described herein, or another as generally known to one of ordinary skill in the art, or one or more of the CYP26 inhibitor compounds represented by Formulas (I)-(IX) or another as generally known to one of skill in the art, or pharmaceutically acceptable salts thereof, in accordance with this invention can be combined as the active ingredient in intimate admixture with a pharmaceutical carrier according to conventional pharmaceutical compounding techniques. At least one of each of the two compounds can be combined together; in other embodiments, two (or more) forms or retinol and two (or more) CYP26 inhibtors can be present in the combination heren or used for the methods herein.
  • the carrier may take a wide variety of forms depending on the pharmacokinetics of the each compound and form of preparation desired for administration, e.g., oral or parenteral (including intravenous).
  • the pharmaceutical compositions of the present invention can be presented as discrete units suitable for oral administration such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient.
  • the compositions can be presented as a powder, as granules, as a solution, as a suspension in an aqueous liquid, as a non-aqueous liquid, as an oil-in-water emulsion, or as a water-in-oil liquid emulsion.
  • the inhibitor compound, or a pharmaceutically acceptable salt thereof may also be administered by controlled release means and/or delivery devices.
  • the compositions may be prepared by any of the methods of pharmacy. In general, such methods include a step of bringing into association the active ingredient with the carrier that constitutes one or more necessary ingredients. In general, the compositions are prepared by uniformly and intimately admixing the active ingredient with liquid carriers or finely divided solid carriers or both. The product can then be conveniently shaped into the desired presentation.
  • compositions of this invention may include a pharmaceutically acceptable carrier and a compound or a pharmaceutically acceptable salt of an inhibitor herein.
  • Compounds or pharmaceutically acceptable salts thereof can also be included in pharmaceutical compositions in combination with one or more other therapeutically active compounds.
  • the pharmaceutical carrier employed can be, for example, a solid, liquid, or gas.
  • solid carriers include lactose, terra alba, sucrose, talc, gelatin, agar, pectin, acacia, magnesium stearate, and stearic acid.
  • liquid carriers are sugar syrup, peanut oil, olive oil, and water.
  • gaseous carriers include carbon dioxide and nitrogen.
  • any convenient pharmaceutical media may be employed.
  • water, glycols, oils, alcohols, flavoring agents, preservatives, coloring agents, and the like may be used to form oral liquid preparations such as suspensions, elixirs and solutions; while carriers such as starches, sugars, microcrystalline cellulose, diluents, granulating agents, lubricants, binders, disintegrating agents, and the like may be used to form oral solid preparations such as powders, capsules and tablets. Because of their ease of administration, tablets and capsules are the preferred oral dosage units whereby solid pharmaceutical carriers are employed.
  • tablets may be coated by standard aqueous or nonaqueous techniques.
  • a tablet containing the composition of this invention may be prepared by compression or molding, optionally with one or more accessory ingredients or adjuvants.
  • Compressed tablets may be prepared by compressing, in a suitable machine, the active ingredient in a free-flowing form such as powder or granules, optionally mixed with a binder, lubricant, inert diluent, surface active or dispersing agent. Molded tablets may be made by molding in a suitable machine, a mixture of the powdered compound moistened with an inert liquid diluent.
  • Each tablet preferably contains from about 0.05mg to about 5g of each active ingredient and each cachet or capsule preferably containing from about 0.05mg to about 5g of each active ingredient, when present in the same composition of formulation.
  • the retinol and the CYP26 inhibitor can be present in different compositions or formulation, but administered at the same time or at different times provided a synergistic effect is achieved.
  • a formulation intended for the oral administration to humans may contain from about 0.5mg to about 5g of each active agent, compounded with an appropriate and convenient amount of carrier material which may vary from about 5 to about 95 percent of the total composition.
  • Unit dosage forms will generally contain between from about lmg to about 2g of each active ingredient, typically 25mg, 50mg, lOOmg, 200mg, 300mg, 400mg, 500mg, 600mg, 800mg, or lOOOmg.
  • compositions of the present invention suitable for parenteral administration may be prepared as solutions or suspensions of the active compounds in water or buffer solution.
  • a suitable surfactant can be included such as, for example, hydroxypropylcellulose.
  • Dispersions can also be prepared in glycerol, liquid polyethylene glycols, and mixtures thereof in oils. Further, a preservative can be included to prevent the detrimental growth of microorganisms.
  • Pharmaceutical compositions of the present invention suitable for injectable use include sterile aqueous solutions or dispersions. Furthermore, the compositions can be in the form of sterile powders for the extemporaneous preparation of such sterile injectable solutions or dispersions.
  • the final injectable form must be sterile and must be effectively fluid for easy syringability.
  • the pharmaceutical compositions must be stable under the conditions of manufacture and storage; thus, preferably should be preserved against the contaminating action of microorganisms such as bacteria and fungi.
  • the carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (e.g., glycerol, propylene glycol and liquid polyethylene glycol), vegetable oils, and suitable mixtures thereof.
  • Pharmaceutical compositions of the present invention can be in a form suitable for topical use such as, for example, an aerosol, cream, ointment, lotion, dusting powder, or the like.
  • compositions can be in a form suitable for use in transdermal devices.
  • These formulations may be prepared, utilizing a retinol and CYP inhibitor such as those described herein, or a pharmaceutically acceptable salt thereof, via conventional processing methods.
  • a cream or ointment is prepared by admixing hydrophilic material and water, together with about 5wt% to about 10wt% of each of the compounds, to produce a cream or ointment having a desired consistency.
  • compositions of this invention can be in a form suitable for rectal administration wherein the carrier is a solid. It is preferable that the mixture forms unit dose suppositories. Suitable carriers include cocoa butter and other materials commonly used in the art. The suppositories may be conveniently formed by first admixing the composition with the softened or melted carrier(s) followed by chilling and shaping in molds. [00215] In addition to the aforementioned carrier ingredients, the pharmaceutical formulations described above may include, as appropriate, one or more additional carrier ingredients such as diluents, buffers, flavoring agents, binders, surface-active agents, thickeners, lubricants, preservatives (including anti-oxidants) and the like. Furthermore, other adjuvants can be included to render the formulation isotonic with the blood of the intended recipient. Compositions containing the compounds described herein, or pharmaceutically acceptable salts thereof, may also be prepared in powder or liquid concentrate form.
  • dosage levels on the order of from about O.Olmg/kg to about 1
  • 50mg/kg of body weight per day of each component are useful in the treatment of the above indicated conditions, or alternatively about 0.5mg to about 7g per patient per day ofeach component.
  • dermatological diseases and cancers may be effectively treated by the administration of from about 0.01 to 50mg of the compounds per kilogram of body weight per day, or alternatively about 0.5mg to about 3.5g per patient per day.
  • the specific dose level of the retinol and CYP inhibitor for any particular patient will depend upon a variety of factors including the age, body weight, general health, sex, diet, time of administration, route of administration, rate of excretion, drug combination and the severity of the particular disease undergoing therapy.
  • compositions which comprise any one or more of each of the compounds described herein (or a prodrug, pharmaceutically acceptable salt or other pharmaceutically acceptable derivative thereof), and optionally comprise a pharmaceutically acceptable carrier.
  • these compositions optionally further comprise one or more additional therapeutic agents.
  • a compound of this invention may be administered to a patient in need thereof in combination with the administration of one or more other therapeutic agents.
  • additional therapeutic agents for conjoint administration or inclusion in a pharmaceutical composition with a compound of this invention may be an approved agent to treat the same or related indication, or it may be any one of a number of agents undergoing approval in the Food and Drug Administration that ultimately obtain approval for the treatment of any disorder related to fibrosis.
  • a pharmaceutically acceptable derivative includes, but is not limited to, pharmaceutically acceptable salts, esters, salts of such esters, or a pro-drug or other adduct or derivative of a compound of this invention which upon administration to a patient in need is capable of providing, directly or indirectly, a compound as otherwise described herein, or a metabolite or residue thereof.
  • the term "pharmaceutically acceptable salt” refers to those salts which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio.
  • Pharmaceutically acceptable salts of amines, carboxylic acids, and other types of compounds are well known in the art. For example, S.M. Berge, et al. describe pharmaceutically acceptable salts in detail in J. Pharmaceutical Sciences, 66: 1-19 (1977), incorporated herein by reference.
  • suitable pharmaceutically acceptable salts thereof may, include metal salts such as alkali metal salts, e.g. sodium or potassium salts; and alkaline earth metal salts, e.g. calcium or magnesium salts.
  • Examples of pharmaceutically acceptable, nontoxic acid addition salts are salts of an amino group formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid or with organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid
  • organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • salts include adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptonate, glycerophosphate, gluconate, hernisulfate, heptanoate, hexanoate, hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate, pamoate, pectinate,
  • alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like.
  • Further pharmaceutically acceptable salts include, when appropriate, nontoxic ammonium, quaternary ammonium, and amine cations formed using counterions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, loweralkyl sulfonate and aryl sulfonate.
  • ester refers to esters that hydrolyze in vivo and include those that break down readily in the human body to leave the parent compound or a salt thereof.
  • suitable ester groups include, for example, those derived from pharmaceutically acceptable aliphatic carboxylic acids, particularly alkanoic, alkenoic, cycloalkanoic and alkanedioic acids, in which each alkyl or alkenyl moiety advantageously has not more than 6 carbon atoms.
  • esters include formates, acetates, propionates, butyrates, acrylates and ethylsuccinates.
  • esters of retinols include acetate and palmitate, suh that in some embodiments, longer alkyl or alkenyl moieties may be appropriate.
  • prodrugs refers to those prodrugs of the compounds of the present invention which are, within the scope of sound medical judgment, suitable for use in contact with the issues of humans and lower animals with undue toxicity, irritation, allergic response, and the like, commensurate with a reasonable benefit/risk ratio, and effective for their intended use, as well as the zwitterionic forms, where possible, of the compounds of the invention.
  • prodrug refers to compounds that are rapidly transformed in vivo to yield the parent compound of the above formula, for example by hydrolysis in blood, or N-demethylation of a compound of the invention where R 1 is methyl.
  • the pharmaceutical compositions of the present invention additionally comprise a pharmaceutically acceptable carrier, which, as used herein, includes any and all solvents, diluents, or other liquid vehicle, dispersion or suspension aids, surface active agents, isotonic agents, thickening or emulsifying agents, preservatives, solid binders, lubricants and the like, as suited to the particular dosage form desired.
  • a pharmaceutically acceptable carrier includes any and all solvents, diluents, or other liquid vehicle, dispersion or suspension aids, surface active agents, isotonic agents, thickening or emulsifying agents, preservatives, solid binders, lubricants and the like, as suited to the particular dosage form desired.
  • Remington's Pharmaceutical Sciences, Sixteenth Edition, E. W. Martin (Mack Publishing Co., Easton, Pa., 1980) discloses various carriers used in formulating pharmaceutical compositions and known techniques for the preparation thereof.
  • any conventional carrier medium is incompatible with the compounds of the invention, such as by producing any undesirable biological effect or otherwise interacting in a deleterious manner with any other component(s) of the pharmaceutical composition, its use is contemplated to be within the scope of this invention.
  • materials which can serve as pharmaceutically acceptable carriers include, but are not limited to, sugars such as lactose, glucose and sucrose; starches such as corn starch and potato starch; cellulose and its derivatives such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; powdered tragacanth; malt; gelatine; talc; excipients such as cocoa butter and suppository waxes; oils such as peanut oil, cottonseed oil; safflower oil, sesame oil; olive oil; corn oil and soybean oil; glycols; such as propylene glycol; esters such as ethyl oleate and ethyl laurate; agar; buffering agents such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogenfree water; isotonic saline; Ringer's solution; ethyl alcohol, and phosphate buffer solutions, as well as other non-toxic compatible lubricants such as sodium
  • Liquid dosage forms for oral administration include, but are not limited to, pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs.
  • the liquid dosage forms may contain inert diluents commonly used in the art such as, for example, water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, dimethylformamide, oils (in particular, cottonseed, groundnut (peanut), corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofurfuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof.
  • inert diluents such as, for example, water or other solvents, so
  • liquid compositions or liquid formulations comprising compounds of the invention are provided that have increased solubility as compared to compounds of the invention dissolved in aqueous buffer such as phosphate -buffered saline.
  • aqueous buffer such as phosphate -buffered saline.
  • such liquid compositions with increased solubility are provided by a composition comprising polyethylene glycol, polysorbate or a combination thereof.
  • the polyethylene glycol is polyethylene glycol 300.
  • the polysorbate is polysorbate 80.
  • the polyethylene glycol is present at about 40% to about 60% (v/v).
  • the polysorbate is present at about 5% to about 15% (v/v).
  • the polyethylene glycol is present at about 50% (v/v).
  • the polysorbate is present at about 10% (v/v).
  • the polyethylene glycol is present at 50%> (v/v) together with polysorbate 80 at 10% (v/v).
  • the balance of the solution can be a saline solution, a buffer or a buffered saline solution, such as phosphate -buffered saline.
  • the pH of the solution can be from about pH 5 to about pH 9, and in other embodiments, about from pH 6 to about pH 8.
  • the pH of the buffer is 7.4.
  • the compound of the invention is soluble at a concentration higher than in buffer alone, and can be present at about 0.8 to about 10 milligrams per milliliter of solution, or even higher.
  • compositions offer the preparation of convenient dosing solutions of practical volumes for single dose administration, by any route, in particular a parenteral route.
  • the route is intravenous, subcutaneous or intraperitoneal.
  • Such compositions with a higher solubility permit achievement of more elevated blood concentrations that provide efficacy when the threshold Cmax (maximal blood concentration after administration) should be achieved for optimal efficacy.
  • Injectable preparations for example, sterile injectable aqueous or oleaginous suspensions may be formulated according to the known art using suitable dispersing or wetting agents and suspending agents.
  • the sterile injectable preparation may also be a sterile injectable solution, suspension or emulsion in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol.
  • the acceptable vehicles and solvents that may be employed are water, Ringer's solution, U.S. P. and isotonic sodium chloride solution.
  • sterile, fixed oils are conventionally employed as a solvent or suspending medium.
  • any bland fixed oil can be employed including synthetic mono- or diglycerides.
  • fatty acids such as oleic acid are used in the preparation of injectables.
  • the injectable formulations can be sterilized, for example, by filtration through a bacterial-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable medium prior to use.
  • the rate of drug release can be controlled.
  • biodegradable polymers include poly(orthoesters) and poly(anhydrides).
  • Depot injectable formulations are also prepared by entrapping the drug in liposomes or microemulsions which are compatible with body tissues.
  • compositions for rectal or vaginal administration are preferably suppositories which can be prepared by mixing the compounds of this invention with suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.
  • suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.
  • Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules.
  • the active compound is mixed with at least one inert, pharmaceutically acceptable excipient or carrier such as sodium citrate or dicalcium phosphate and/or a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl
  • the dosage form may also comprise buffering agents.
  • Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.
  • the solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art. They may optionally contain opacifying agents and can also be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner.
  • embedding compositions examples include polymeric substances and waxes. Solid compositions of a similar type may also be employed as fillers in soft and hard- filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polethylene glycols and the like.
  • solid dosage forms of compounds embodied herein are provided.
  • such solid dosage forms have improved oral bioavailability.
  • a formulation is prepared in a solid formulation comprising about 20% (w/w) of each of the compounds of the invention, about 10-20% (w/w) GLUCIRE® 44/14, about 10-20%) (w/w) vitamin E succinate (TPS), 0 to about 60%> polyethylene glycol 400, 0 to about 40% Lubrizol, 0 to about 15% Cremophor RH 40 (w/w), and about 1% (w/w) BHT.
  • Formulations containing Cremophor RH 20 are liquid at room temperature but waxy solids at 4 C.
  • the active compounds can also be in micro-encapsulated form with one or more excipients as noted above, the two components separately or together.
  • the solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings, release controlling coatings and other coatings well known in the pharmaceutical formulating art.
  • the active compound may be admixed with at least one inert diluent such as sucrose, lactose and starch.
  • Such dosage forms may also comprise, as in normal practice, additional substances other than inert diluents, e.g., tableting lubricants and other tableting aids such as magnesium stearate and micro crystalline cellulose.
  • the dosage forms may also comprise buffering agents. They may optionally contain opacifying agents and can also be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner. Examples of embedding compositions that can be used include polymeric substances and waxes. [00233] In other embodiments solid dosage forms are provided. In certain embodiments, such solid dosage forms provide a higher than about a 20% oral bioavailability of each component.
  • compounds in the compositions of the invention can be co-precipitated with one or more agents such as mannitol, a combination of mannitol and lactobionic acid, a combination of mannitol and gluconic acid, a combination of mannitol and methanesulfonic acid, a combination of micro crystalline cellulose and oleic acid or a combination of pregelatinized starch and oleic acid.
  • agents to aid in preparing formulations compsising the retinol and CY inhibitor are merely illustrative and non-limiting.
  • the present invention encompasses pharmaceutically acceptable topical formulations of inventive compounds.
  • pharmaceutically acceptable topical formulation means any formulation which is pharmaceutically acceptable for intradermal administration of a compound of the invention by application of the formulation to the epidermis.
  • the topical formulation comprises a carrier system.
  • Pharmaceutically effective carriers include, but are not limited to, solvents (e.g., alcohols, poly alcohols, water), creams, lotions, ointments, oils, plasters, liposomes, powders, emulsions, microemulsions, and buffered solutions (e.g., hypotonic or buffered saline) or any other carrier known in the art for topically administering pharmaceuticals.
  • solvents e.g., alcohols, poly alcohols, water
  • creams e.g., lotions, ointments, oils, plasters, liposomes, powders, emulsions, microemulsions, and buffered solutions (e.g., hypotonic or buffered saline) or any other carrier known in the art for topically administering pharmaceuticals.
  • buffered solutions e.g., hypotonic or buffered saline
  • the topical formulations of the invention may comprise excipients.
  • Any pharmaceutically acceptable excipient known in the art may be used to prepare the inventive pharmaceutically acceptable topical formulations.
  • excipients that can be included in the topical formulations of the invention include, but are not limited to, preservatives, antioxidants, moisturizers, emollients, buffering agents, solubilizing agents, other penetration agents, skin protectants, surfactants, and propellants, and/or additional therapeutic agents used in combination to the inventive compound.
  • Suitable preservatives include, but are not limited to, alcohols, quaternary amines, organic acids, parabens, and phenols.
  • Suitable antioxidants include, but are not limited to, ascorbic acid and its esters, sodium bisulfite, butylated hydroxytoluene, butylated hydroxyanisole, tocopherols, and chelating agents like EDTA and citric acid.
  • Suitable moisturizers include, but are not limited to, glycerine, sorbitol, polyethylene glycols, urea, and propylene glycol.
  • Suitable buffering agents for use with the invention include, but are not limited to, citric, hydrochloric, and lactic acid buffers.
  • Suitable solubilizing agents include, but are not limited to, quaternary ammonium chlorides, cyclodextrins, benzyl benzoate, lecithin, and polysorbates.
  • Suitable skin protectants that can be used in the topical formulations of the invention include, but are not limited to, vitamin E oil, allatoin, dimethicone, glycerin, petrolatum, and zinc oxide.
  • the pharmaceutically acceptable topical formulations of the invention comprise at least the retinol and CYP inhibitor and a penetration enhancing agent.
  • the choice of topical formulation will depend or several factors, including the condition to be treated, the physicochemical characteristics of the inventive compound and other excipients present, their stability in the formulation, available manufacturing equipment, and costs constraints.
  • penetration enhancing agent means an agent capable of transporting a pharmacologically active compound through the stratum corneum and into the epidermis or dermis, preferably, with little or no systemic absorption. A wide variety of compounds have been evaluated as to their effectiveness in enhancing the rate of penetration of drugs through the skin.
  • penetration agents for use with the invention include, but are not limited to, triglycerides ⁇ e.g., soybean oil), aloe compositions ⁇ e.g., aloe-vera gel), ethyl alcohol, isopropyl alcohol, octolyphenylpolyethylene glycol, oleic acid, polyethylene glycol 400, propylene glycol, N-decylmethylsulfoxide, fatty acid esters ⁇ e.g., isopropyl myristate, methyl laurate, glycerol monooleate, and propylene glycol monooleate) and N-methyl pyrrolidone.
  • triglycerides ⁇ e.g., soybean oil
  • aloe compositions ⁇ e.g., aloe-vera gel
  • ethyl alcohol isopropyl alcohol
  • octolyphenylpolyethylene glycol oleic acid
  • polyethylene glycol 400 propylene glycol
  • the compositions may be in the form of ointments, pastes, creams, lotions, gels, powders, solutions, sprays, inhalants or patches.
  • formulations of the compositions according to the invention are creams, which may further contain saturated or unsaturated fatty acids such as stearic acid, palmitic acid, oleic acid, palmito-oleic acid, cetyl or oleyl alcohols, stearic acid being particularly preferred.
  • Creams of the invention may also contain a non-ionic surfactant, for example, polyoxy-40-stearate.
  • the active components are admixed under sterile conditions with a pharmaceutically acceptable carrier and any needed preservatives or buffers as may be required.
  • Ophthalmic formulation, eardrops, and eye drops are also contemplated as being within the scope of this invention.
  • Formulations for intraocular administration are also included.
  • the present invention contemplates the use of transdermal patches, which have the added advantage of providing controlled delivery of a compound to the body. Such dosage forms are made by dissolving or dispensing the compound in the proper medium.
  • penetration enhancing agents can also be used to increase the flux of the compound across the skin. The rate can be controlled by either providing a rate controlling membrane or by dispersing the compound in a polymer matrix or gel.
  • the pharmaceutical compositions of the present invention further comprise one or more additional therapeutically active ingredients (e.g., anti-inflammatory and/or palliative).
  • additional therapeutically active ingredients e.g., anti-inflammatory and/or palliative.
  • palliative refers to treatment that is focused on the relief of symptoms of a disease and/or side effects of a therapeutic regimen, but is not curative.
  • palliative treatment encompasses painkillers, antinausea medications and anti-sickness drugs.
  • the retinol and the CYP26 inhibitor can be administered in the same composition, or in other embodiments, separately, provided that the synergistic benefit to the patient of the two compounds is achieved.
  • one inhibitor may administered parenterally and the other orally.
  • the frequency of administration may depend on the pharmacokinetics of each component such that the synergistic activity can be optimized without necessarily requiring simultaneous administration or administration by the same routes.
  • the dose level of each of the retinol and CYP inhibitor in the composition or method of treatment will be present to provide the synergistic effect of the combination. Determination of the amount of each component will be readily determinable by one of skill in the art.
  • the method involves the administration of a therapeutically effective amount of the synergistic composition or a pharmaceutically acceptable derivative thereof to a subject (including, but not limited to a human or animal) in need of it.
  • a subject including, but not limited to a human or animal
  • Subjects for which the benefits of the compounds of the invention are intended for administration include, in addition to humans, livestock, domesticated, zoo and companion animals.
  • the pharmaceutical compositions of this invention can be administered to humans and other animals orally, rectally, parenterally, intracisternally, intravaginally, intraperitoneally, subcutaneously, intradermally, intra-ocularly, topically (as by powders, ointments, or drops), buccally, as an oral or nasal spray, or the like, depending on the severity of the disease or disorder being treated.
  • each of the compounds in the compositions of the invention may be administered at dosage levels of about 0.001 mg/kg to about 50 mg/kg, preferably from about 0.1 mg/kg to about 10 mg/kg for parenteral administration, or preferably from about 1 mg/kg to about 50 mg/kg, more preferably from about 10 mg/kg to about 50 mg/kg for oral administration, of subject body weight per day, one or more times a day, to obtain the desired therapeutic effect. It will also be appreciated that dosages smaller than 0.001 mg/kg or greater than 50 mg/kg (for example 50-100 mg/kg) can be administered to a subject. In certain embodiments, compounds are administered orally or parenterally.
  • CYP26 inhibitor and a retinol do not have to be administered simultaneously or by the same route of administration, but the treatment in one embodiment is beneficial synergistically over the effects of one agent administered without the other.
  • the retinol can be administered topically and the CYP26 inhibitor orally; or the retinol orally and the CYP26 inhibitor topically.
  • compositions comprising one or more compounds of the invention may also contain other compounds or agents for which co-administration with the compound(s) of the invention is therapeutically advantageous.
  • pharmaceutical agents are used in the treatment of the diseases and disorders for which the compounds of the invention are also beneficial, any may be formulated together for administration.
  • Synergistic formulations are also embraced herein, where the combination of at least one compound of the invention and at least one other compounds act more beneficially than when each is given alone.
  • Non-limiting examples of pharmaceutical agents that may be combined therapeutically with compounds of the invention include (non-limiting examples of diseases or conditions treated with such combination are indicated in parentheses): antivirals and antifibrotics, such as interferon alpha (hepatitis B, and hepatitis C), combination of interferon alpha and ribavirin (hepatitis C), Lamivudine (hepatitis B), Adefovir dipivoxil (hepatitis B), interferon gamma (idiopathic pulmonary fibrosis, liver fibrosis, and fibrosis in other organs); anticoagulants, e.g., heparin and warfarin (ischemic stroke); antiplatelets e.g., aspirin, ticlopidine and clopidogrel (ischemic stroke); other growth factors involved in regeneration, e.g., VEGF and FGF and mimetics of these growth factors; antiapoptotic agents; and motility and morphogenic agents.
  • the present invention relates to a kit for conveniently and effectively carrying out the methods in accordance with the present invention.
  • the pharmaceutical pack or kit comprises one or more containers filled with one or more of the ingredients of the pharmaceutical compositions of the invention.
  • kits are especially suited for the delivery of solid oral forms such as tablets or capsules.
  • Such a kit preferably includes a number of unit dosages, and may also include a card having the dosages oriented in the order of their intended use.
  • a memory aid can be provided, for example in the form of numbers, letters, or other markings or with a calendar insert, designating the days in the treatment schedule in which the dosages can be administered.
  • placebo dosages, or calcium dietary supplements can be included to provide a kit in which a dosage is taken every day.
  • Optionally associated with such container(s) can be a notice in the form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceutical products, which notice reflects approval by the agency of manufacture, use or sale for human administration.
  • Retinol or a retinyl ester can be obtained as described above.
  • CYP26 inhibitors can be obtained following the guidance of PCT/US2011/038695, published as WO2011/153192, and in PCT/US2010/02175, published as WO2011/016863; talarozole (RAMBAZOLE), having the chemical name N-(2-benzothioazolyl)-N-[4-[2-ethyl-l-(l,2,4- triazo- 1 -yl)butyl]phenyl] amine; 1 - [benzofuran-2-yl-(4-alkyl/ aryl-phenyl)-methyl] - 1 H- triazoles, methyl 3-(4-(aryl-2-ylamino)phenyl)propanoates 3-(lH-imidazol- and triazol-l-yl)- 2,2-dimethyl-3-[4-(naphthalen-2-ylamino
  • CYP26 inhibitors include ( ⁇ )-4-(lH-imidazol-l-yl)-methyl retinoate, ( ⁇ )-4-(lH-imidazole-l-yl)retinoic acid, ( ⁇ )-4-(lH- 1 ,2,4-triazol- 1 -yl) methyl retinoate, ( ⁇ )-4-(4H- 1 ,2,4-triazole-4-yl) methyl retinoate, ( ⁇ )-4-(lH-l,2,4-triazol-l-yl) retinoic acid, and ( ⁇ )-4- (4H-l,2,4-triazol-4-yl) retinoic acid.
  • compositions and methods of the invention can be conducted in any number of models of fibrosis and dysproliferation.
  • the rhino mouse model can be used to evaluate the combinations on adverse histological changes in the skin, in accordance with the methods described by Sakuta et al, Eur. J. Dermatol. 2005; 15(6):459- 64, and Mezick et al., J. Invest. Dermatol. 1984; 83: 110-113; and on vaginal keratinization in estrogen-stimulated rats, in accordance with Stoppie et al., J. Pharmacol. Exp. Ther. 2000; 293 :304-312.
  • Compounds of the invention can be shown to reduce adverse effects in the skin and other organs.
  • mice treated with 0.25, 1 or 2 mg/mL CYP26 inhibitor had an increased thickness of 10.5, 13.2 and 30 micrometers, respectively.
  • Mice treated with 0.25 or 1 mg/mL retinol had an increased thickness of 24.1 and 35 micrometers, respectively.
  • mice treated with a combination of 1 mg/mL CYP26 inhibitor and 0.25 mg/mL retinol had a mean thickness increase of 49 micrometers, and mice treated with a combination of 0.25 mg/mL CYP26 inhibitor and 1 mg/mL retinol had a mean thickness increase of 53 micrometers.

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Abstract

L'invention concerne des méthodes de traitement de maladies et d'états fibrogènes, ainsi que du cancer et d'autres maladies de prolifération anormale par l'administration à un sujet qui en a besoin d'une quantité thérapeutiquement efficace d'une composition comportant un rétinol, ou un ester, un sel ou un promédicament de qualité pharmaceutique de celui-ci ; un inhibiteur de CYP26, ou un ester, un sel ou un promédicament de qualité pharmaceutique de celui-ci, ladite quantité thérapeutiquement efficace inhibant la fibrose ou la croissance de cellules à mauvaise prolifération in vivo. L'invention concerne également des compositions comportant une combinaison d'un rétinol, ou d'un ester, d'un sel ou d'un promédicament de qualité pharmaceutique de celui-ci ; d'un inhibiteur de CYP26 ou d'un ester, d'un sel ou d'un promédicament de qualité pharmaceutique de celui-ci.
PCT/US2013/075259 2012-12-16 2013-12-16 Compositions et méthodes de traitement de maladie WO2014093960A1 (fr)

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Publication number Priority date Publication date Assignee Title
WO2016025424A1 (fr) * 2014-08-11 2016-02-18 Angion Biomedica Corporation Inhibiteurs de cytochrome p450 et leurs utilisations
US10851095B2 (en) 2014-12-31 2020-12-01 Angion Biomedica Corp. Methods and agents for treating disease

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WO2009153566A1 (fr) * 2008-06-17 2009-12-23 Cancer Research Technology Limited Inhibiteurs de cyp26
WO2011016863A2 (fr) * 2009-08-05 2011-02-10 Angion Biomedica Corp. Procédés et utilisations d'inhibiteurs du cytochrome p450
WO2011153192A2 (fr) * 2010-06-01 2011-12-08 Angion Biomedica Corp. Inhibiteurs des cytochromes p450 et leurs utilisations

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US20030162823A1 (en) * 2000-07-11 2003-08-28 University Of Maryland Novel C-4 substituted retinoids
WO2009153566A1 (fr) * 2008-06-17 2009-12-23 Cancer Research Technology Limited Inhibiteurs de cyp26
WO2011016863A2 (fr) * 2009-08-05 2011-02-10 Angion Biomedica Corp. Procédés et utilisations d'inhibiteurs du cytochrome p450
WO2011153192A2 (fr) * 2010-06-01 2011-12-08 Angion Biomedica Corp. Inhibiteurs des cytochromes p450 et leurs utilisations

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016025424A1 (fr) * 2014-08-11 2016-02-18 Angion Biomedica Corporation Inhibiteurs de cytochrome p450 et leurs utilisations
CN107074841A (zh) * 2014-08-11 2017-08-18 安吉恩生物医药公司 细胞色素p450抑制剂及其用途
JP2017524010A (ja) * 2014-08-11 2017-08-24 アンジオン バイオメディカ コーポレーション チトクロームｐ４５０阻害剤およびその使用
AU2015301891B2 (en) * 2014-08-11 2019-12-05 Angion Biomedica Corporation Cytochrome P450 inhibitors and uses thereof
US10556893B2 (en) 2014-08-11 2020-02-11 Angion Biomedica Corp. Cytochrome P450 inhibitors and uses thereof
CN107074841B (zh) * 2014-08-11 2021-03-26 安吉恩生物医药公司 细胞色素p450抑制剂及其用途
CN112961149A (zh) * 2014-08-11 2021-06-15 安吉恩生物医药公司 细胞色素p450抑制剂及其用途
US11459319B2 (en) 2014-08-11 2022-10-04 Angion Biomedica Corp. Cytochrome P450 inhibitors and uses thereof
US10851095B2 (en) 2014-12-31 2020-12-01 Angion Biomedica Corp. Methods and agents for treating disease
US11434234B2 (en) 2014-12-31 2022-09-06 Angion Biomedica Corp. Methods and agents for treating disease

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