Synthesis and optimization of novel α-phenylglycinamides as selective TRPM8 antagonists.

Transient receptor potential melastatin 8 (TRPM8) is activated by innocuous cold and chemical substances, and antagonists of this channel have been considered to be effective for pain and urinary diseases. N-(3-aminopropyl)-2-{[(3-methylphenyl)methyl]oxy}-N-(2-thienylmethyl)benzamide hydrochloride (AMTB), a TRPM8 antagonist, was proposed to be effective for overactive bladder and painful bladder syndrome; however, there is a potential risk of low blood pressure. We report herein the synthesis and structure-activity relationships of novel phenylglycine derivatives that led to the identification of KPR-2579 (20l), a TRPM8 selective antagonist. KPR-2579 reduced the number of icilin-induced wet-dog shakes and rhythmic bladder contraction in rats, with no negative cardiovascular effects at the effective dose.

O-Glycosylation of 4-(Substituted benzyl)-1,2-dihydro-3H-pyrazol-3-one Derivatives with 2,3,4,6-Tetra-O-acyl-α-D-glucopyranosyl Bromide via N1-Acetylation of the Pyrazole Ring.

A practical preparation of 4-(substituted benzyl)-3-(2,3,4,6-tetra-O-acyl-ß-D-glucopyranosyloxy)-1H-pyrazole derivative 2 is described. O-Glycosylation of 4-(substituted benzyl)-1,2-dihydro-3H-pyrazol-3-one derivative 3 was facilitated by introduction of electron-withdrawing substituents, such as an acetyl group, at the N1-position of the pyrazole ring. 1-Acetyl-4-(substituted benzyl)-1,2-dihydro-3H-pyrazol-3-one 10 reacted with 2,3,4,6-tetra-O-acyl-α-D-glucopyranosyl bromide 5 in the presence of potassium carbonate in acetonitrile to provide the 1-acetyl-4-(substituted benzyl)-3-(2,3,4,6-tetra-O-acyl-ß-D-glucopyranosyloxy)-1H-pyrazole derivative 11 in high yield. When 2,3,4,6-tetra-O-pivaloyl-α-D-glucopyranosyl bromide (5b) was used as a glycosyl donor, the resulting O-glycosylated product 11 was N1-deacetylated in the presence of potassium bicarbonate in methanol without unfavorable deprotection of the glycosyl moiety to provide 2 in excellent yield. The synthetic intermediate 2b of Remogliflozin etabonate (1b) was synthesized using this strategy.

Patients preferences in chemotherapy for advanced non-small-cell lung cancer.

OBJECTIVE: To determine how Japanese patients with lung cancer weigh potential survival, chemotherapy response rate, and symptom relief against the potential toxicity of different treatments in cancer chemotherapy. METHODS AND PATIENTS: We used a questionnaire describing a hypothetical situation about stage IV non-small-cell lung cancer. Seventy-three patients with lung cancer who had received chemotherapy and 120 patients with other respiratory disease as the control group were asked to rate the minimal benefit that would make two hypothetical treatments acceptable. For "chance of cure," "response but not cure," and "symptom relief," the subjects could give answers from 1% to 100% and for prolonging life could give answers from 1 to 60 months. RESULTS: Patients with lung cancer were significantly more likely than were patients with other respiratory diseases to accept either intensive or less-intensive treatments for a potentially small benefit for "chance of cure," "response but not cure," and "symptom relief". The degree of survival advantage that patients require before accepting cancer treatment with its associated toxicity varied widely. If their lives were prolonged 3 months, 19% and 21% of patients with lung cancer would choose to receive intensive and less-intensive treatment, respectively. When the chance of symptom relief was 70%, 73% of patients with lung cancer were willing to choose intensive chemotherapy. Factor associated with patients' choice of chemotherapy in both groups was age. CONCLUSION: Oncologists must consider the substantial range of attitudes to chemotherapy among patients when making treatment decisions and they must give patients the opportunity to be included in this process.