The present invention provides MEL-18, which is a biomarker for human epidermal growth factor receptor2 (HER2)-positive cancer and anti-HER2 therapy, and a use thereof. According to the present invention, MEL-18 is a prognostic factor or predictor for a response of subjects to an anti-HER2-targeted drug in HER2-POSITIVE cancer and may be used in companion diagnostics for HER2-targeted drugs in subjects with HER2-positive cancer. Therefore, HER2-positive cancer may be more effectively treated by overcoming resistance to HER2 therapeutic agents and enhancing therapeutic efficacy by determining whether ADAM10/17 inhibitors are administered or co-administered with HER2-targeted drugs.

A method for treating a neurodegenerative disease is provided. The method for treating a neurodegenerative disease includes administering, to a subject in need thereof, one or more of a small molecule glycogen synthase (GYS) inhibitor, an antisense oligonucleotide targeting glycogen synthase, an antibody-enzyme fusion compound targeting polyglucosan bodies (PGBs), or combinations thereof.

A method for treating a neurodegenerative disease is provided. The method for treating a neurodegenerative disease includes administering, to a subject in need thereof, one or more of a small molecule glycogen synthase (GYS) inhibitor, an antisense oligonucleotide targeting glycogen synthase, an antibody-enzyme fusion compound targeting polyglucosan bodies (PGBs), or combinations thereof.

Cancer stem cells are responsible for tumor recurrence, distant metastasis and drug-resistance, in the vast majority of cancer patients. There exists an urgent need to identify new mitochondrial inhibitor drugs that can target and eradicate CSCs, and companion diagnostics to identify candidates for mitochondrial inhibition therapy. In 3D mammospheres, 25 mitochondrial-related proteins were over 100-fold over-expressed in a large collection of transcriptional profiling data from ER(+) breast cancer patients. These 25 proteins may be used to derive short gene signatures to predict the likelihood of distant metastasis and tumor recurrence. For example, the 4-gene signature of ACLY, VDAC3, HADH2, and COX6B1 may be used for predicting the likelihood of distant metastasis, with a hazard ratio of 1.91-fold (P=2.2e−08). A pharmaceutically effective amount of a mitochondrial inhibitor may be administered to a candidate having elevated expression of the genes in a gene signature. Five example mitochondrial inhibitors showed preferential and selective inhibition of tumor cell metastasis, without causing significant toxicity. Mechanistically, all five mitochondrial inhibitors have been previously shown to induce ATP-depletion in cancer cells. Gene signatures composed of 6-9 large mitochondrial ribosomal proteins also show prognostic value in predicting distant metastasis, tumor recurrence, and Tamoxifen resistance, in both ER(+) and ER(−) breast cancer patients. The disclosed gene signatures may be used as companion diagnostics to assess which patients may benefit most from mitochondrial inhibition therapy.

Cancer stem cells are responsible for tumor recurrence, distant metastasis and drug-resistance, in the vast majority of cancer patients. There exists an urgent need to identify new mitochondrial inhibitor drugs that can target and eradicate CSCs, and companion diagnostics to identify candidates for mitochondrial inhibition therapy. In 3D mammospheres, 25 mitochondrial-related proteins were over 100-fold over-expressed in a large collection of transcriptional profiling data from ER(+) breast cancer patients. These 25 proteins may be used to derive short gene signatures to predict the likelihood of distant metastasis and tumor recurrence. For example, the 4-gene signature of ACLY, VDAC3, HADH2, and COX6B1 may be used for predicting the likelihood of distant metastasis, with a hazard ratio of 1.91-fold (P=2.2e−08). A pharmaceutically effective amount of a mitochondrial inhibitor may be administered to a candidate having elevated expression of the genes in a gene signature. Five example mitochondrial inhibitors showed preferential and selective inhibition of tumor cell metastasis, without causing significant toxicity. Mechanistically, all five mitochondrial inhibitors have been previously shown to induce ATP-depletion in cancer cells. Gene signatures composed of 6-9 large mitochondrial ribosomal proteins also show prognostic value in predicting distant metastasis, tumor recurrence, and Tamoxifen resistance, in both ER(+) and ER(−) breast cancer patients. The disclosed gene signatures may be used as companion diagnostics to assess which patients may benefit most from mitochondrial inhibition therapy.

The invention is directed to substituted piperidine derivatives. Specifically, the invention is directed to compounds according to Formula IIII:

##STR00001##

wherein A, B, X, Y, L.sup.1, L.sup.2, L.sup.3, R.sup.1, R.sup.2, R.sup.3, R.sup.4 R.sup.5, R.sup.6, R.sup.9, z.sup.2, z.sup.4, z.sup.5, and z.sup.6 are as defined herein, and salts thereof.

The compounds of the invention are inhibitors of the ATF4 pathway and can be useful in the treatment of cancer, pre-cancerous syndromes and diseases associated with activated unfolded protein response pathways, such as Alzheimer’s disease, spinal cord injury, traumatic brain injury, ischemic stroke, stroke, diabetes, Parkinson disease, Huntington’s disease, Creutzfeldt-Jakob Disease, and related prion diseases, progressive supranuclear palsy, amyotrophic lateral sclerosis, myocardial infarction, cardiovascular disease, inflammation, fibrosis, chronic and acute diseases of the liver, chronic and acute diseases of the lung, chronic and acute diseases of the kidney, chronic traumatic encephalopathy (CTE), neurodegeneration, dementia, cognitive impairment, atherosclerosis, ocular diseases, arrhythmias, in organ transplantation and in the transportation of organs for transplantation. Accordingly, the invention is further directed to pharmaceutical compositions comprising a compound of the invention. The invention is still further directed to methods of inhibiting the ATF4 pathway and treatment of disorders associated therewith using a compound of the invention or a pharmaceutical composition comprising a compound of the invention.

The invention is directed to substituted piperidine derivatives. Specifically, the invention is directed to compounds according to Formula IIII:

##STR00001##

wherein A, B, X, Y, L.sup.1, L.sup.2, L.sup.3, R.sup.1, R.sup.2, R.sup.3, R.sup.4 R.sup.5, R.sup.6, R.sup.9, z.sup.2, z.sup.4, z.sup.5, and z.sup.6 are as defined herein, and salts thereof.

The compounds of the invention are inhibitors of the ATF4 pathway and can be useful in the treatment of cancer, pre-cancerous syndromes and diseases associated with activated unfolded protein response pathways, such as Alzheimer’s disease, spinal cord injury, traumatic brain injury, ischemic stroke, stroke, diabetes, Parkinson disease, Huntington’s disease, Creutzfeldt-Jakob Disease, and related prion diseases, progressive supranuclear palsy, amyotrophic lateral sclerosis, myocardial infarction, cardiovascular disease, inflammation, fibrosis, chronic and acute diseases of the liver, chronic and acute diseases of the lung, chronic and acute diseases of the kidney, chronic traumatic encephalopathy (CTE), neurodegeneration, dementia, cognitive impairment, atherosclerosis, ocular diseases, arrhythmias, in organ transplantation and in the transportation of organs for transplantation. Accordingly, the invention is further directed to pharmaceutical compositions comprising a compound of the invention. The invention is still further directed to methods of inhibiting the ATF4 pathway and treatment of disorders associated therewith using a compound of the invention or a pharmaceutical composition comprising a compound of the invention.

Cis-tetrahydro-spiro(cyclohexane-1,1′-pyrido[3,4-b]indole)-4-amine compounds which act on the nociceptin/ORL-1 receptor system as well as on the μ-opioid receptor system and which are distinguished in particular by selective effectiveness in the treatment of chronic pain, such as inflammatory pain, visceral pain, tumour pain, and neuropathic pain, without at the same time developing pronounced effectiveness against acute, nociceptive pain.

Cis-tetrahydro-spiro(cyclohexane-1,1′-pyrido[3,4-b]indole)-4-amine compounds which act on the nociceptin/ORL-1 receptor system as well as on the μ-opioid receptor system and which are distinguished in particular by selective effectiveness in the treatment of chronic pain, such as inflammatory pain, visceral pain, tumour pain, and neuropathic pain, without at the same time developing pronounced effectiveness against acute, nociceptive pain.

The present invention relates to a combination product and its use in therapy.