as used herein , the term “ breast cancer patient ” is a patient having breast cancer and being treated by the disease . as used herein , the term “ bone metastasis ”, includes , but is not limited to , the spread of a cancer to a new part of the body is called metastasis . bone is one of the most common site of metastatic spread . many people with cancer ( except for those with non - melanoma skin cancer ) develop bone metastasis at some point in the course of their disease . breast , prostate , lung , kidney and thyroid cancers and some blood cancers ( e . g . multiple myeloma ) are most likely to spread to bones . as used herein , the term “ hypercalcemia ”, includes , but is not limited to , a disorder in which the level of calcium in the blood is too high . hypercalcemia is the most common life - threatening disorder associated with cancer . as used herein , the term “ bone resorption ” includes , but is not limited to , the process of bone breakdown and the release of bone minerals ( calcium , magnesium , phosphate and by - products of collagens ) from bone fluid to the blood . as used herein , the term “ osteoclasts ”, includes , but is not limited to , the following description . bone resorption is the unique function of the osteoclasts , which are specialized , macrophage polykaryon ( multi - nucleated cells ) that contain numerous mitochondria and lysosomes . the osteoclast possesses a specialized cytoskeleton that upon src kinase signaling permits it to establish an isolated microenvironment between itself and bone , wherein matrix degradation occurs by a process involving proton transport . osteoclastogenesis — the formation of osteoclasts . osteoclastogenesis is principally regulated by macrophage colony - stimulating factor ( csf - 1 ), rank ligand , and osteoprotegerin . unless otherwise specified , all chemicals and reagents were obtained from sigma ( st . louis , mo .). sterile buffers and solutions were obtained from invitrogen ( carlsbad , calif .). sterile tissue culture ware was obtained from fisher scientific co . ( hanover park , ill .). dmem ( cat # 11995 - 040 ) and fetal bovine serum ( fbs ) ( cat # 16140 - 071 ) were obtained from invitrogen ( carlsbad , calif .). mcsf - 1 ( cat # 416 - ml ) and receptor activator for nuclear kappab ( rank ) ligand ( cat # 462 - tr ) cytokines were purchased from r & amp ; d systems , inc ( minneapolis , minn .). acid phosphatase , leukocyte staining kit ( cat # 387 - a ) was purchased from sigma ( st . louis , mo .) parathyroid hormone human 1 - 34 ( pth ) ( cat # p3796 ) and thyrocalcitonin ( cat # t3660 ) were purchased from sigma ( st . louis , mo .). zometa ( ndc # 0078 - 0387 - 25 ) was purchased from novartis pharmaceuticals ( east hanover , n . j .). alzet ® mini pumps ( cat # 1007d ) were purchased from durect corporation ( cupertino , calif .). isoflurane ( ndc # 10019 - 773 - 60 ) was purchased from baxter pharmaceuticals ( deerfield , ill .). female cdf - 1 mice , 5 - 6 weeks of age , were obtained from harlan sprague - dawley co ( indianapolis , ind . ), and maintained in an ammonia - free environment in a defined and pathogen - free colony . animals were quarantined for approximately 3 weeks prior to their use for tumor propagation and drug efficacy testing . male sprague - dawley rats ( 175 - 200 gram body weight ) were received thyroparathyroidectomized ( tptx ) from taconic ( germantown , n . y .) and were delivered to the animal facility two days post surgery . tptx rats were quarantined for approximately 13 days prior to their use . animals were provided with food and water ad libitum . all studies were performed in accordance with bristol - myers squibb ( bms ) and the american association for accreditation of laboratory animal care ( aaalac ). for oral ( po ) administration , bms - 354825 was dissolved in 80 mm citrate buffer . the volume of administration for bms - 354825 was 0 . 01 ml / gm for mice and 0 . 005 ml / gm for rats . for subcutaneous ( sc ) administration , zometa was diluted in citrate buffer and administered at 0 . 005 ml / gm for rats . thyrocalcitonin was diluted in 5 % dextrose and administered at 1 ug / rat . bone marrow was harvested by flushing the femur and tibia bones of cdf - 1 mice with pbs followed by washing twice with pbs and resuspending in dmem with 10 % fbs ( 1 - 2 × 10 6 cells / m , 10 ml ). cells were then seeded in 24 - well plates ( 2 × 10 6 cells / well / ml ) and were cultured for 6 - 9 days in dmem media supplemented with the cytokines : 10 ng / ml recombinant mouse m - csf - 1 and 100 ng / ml recombinant mouse rank ligand to induce osteoclast development . culture medium was replaced every two days till day 5 and there was no medium replacing between day 6 and day 9 . bms - 354825 was typically dosed on day 5 . on days 5 , 7 , and 9 , cell viability and number of trap positive cells were determined using the acid phosphatase leukocyte staining kit . the bone marrow cells were washed with pbs and stained according to the protocol recommended by the vendor . trap positive cells and osteoclasts were counted using an inverted microscope . male sprague - dawley tptx rats with basal serum calcium levels around 7 - 8 mg / dl were randomly assigned to the experimental groups . alzet ® mini - pumps containing a resorption stimulus ( pth : infusion rate of 0 . 3 μg / hr ) were implanted subcutaneously . in brief , rats were anesthetized with isoflurane ( 5 % of oxygen ), the skin of the flank area was disinfected with a topical disinfectant . following a small incision , a subcutaneous pouch was made with a sterile pair of blunt scissors , a mini - pump was inserted and the incision was closed with a wound clip . upon drug administration , 500 μl of blood was sampled at the indicated time points by retro - orbital bleeding , the serum was collected and frozen at − 80 ° c . levels of serum calcium and drug were analyzed accordingly . the serum levels of drug were analyzed by high performance liquid chromatography / mass spectrometry ( hplc / ms ). in brief , serum samples ( 50 μl ) were de - proteinized with three volumes of acetonitrile containing 5 μg / ml of bms - 357990 , wherein bms - 357990 is the compound of formula ( ii ) below , as an internal standard ( is ). after centrifugation to remove precipitated proteins , 5 μl of the supernatant was analyzed by hplc / ms . the hplc column was a phenomenex prodigy c18 - ods3 column ( 2 mm × 50 mm , 3 μm particles ) maintained at 60 ° c . with a flow rate of 0 . 5 ml / min . the mobile phase consisted of 5 mm ammonium formate ph 3 . 75 ( a ) and acetonitrile ( b ). the initial mobile phase composition was 87 . 5 % of a / 12 . 5 % of b . after sample injection , the mobile phase was changed to 37 . 5 % of a / 62 . 5 % of b over 2 minutes , and was held at that composition for an additional 1 . 5 minutes . the hplc was interfaced to a finnigan lcq advantage ion - trap mass spectrometer operated in the positive ion electrospray and full ms / ms mode . for bms - 354825 , fragmentation of m / z 488 yielded a daughter ion for quantitation at m / z 401 . for the internal standard , m / z 444 was fragmented to yield a daughter ion at m / z 303 . the retention times for bms - 354825 and the is were 3 . 10 and 2 . 75 min , respectively . the standard curve ranged from 0 . 004 μm to 16 μm and was fitted with a quadratic regression weighted by reciprocal concentration ( 1 /×). the limit of quantitation ( loq ) for the purposes of this assay was 0 . 004 μm . quality control ( qc ) samples at two levels in the range of the standard curve were used to accept individual analytical sets . pk data analysis was performed by noncompartmental method using kinetica ( v4 . 0 . 2 , innaphase corporation , philadelphia , pa .). the maximum plasma concentration ( c max ) and the time reaching c max ( t max ) were determined by visually inspecting the profiles of plasma level of drug vs . time . the half life of plasma drug elimination ( t 1 / 2 ) was the ratio of 0 . 693 to the slope obtained by log - linear regression of the terminal phase of the drug plasma profile . the area under the plasma drug concentration curve ( auc ) was estimated by the trapezoidal rule . the serum levels of calcium of tptx rats were quantitated by a photometric assay with the roche hitachi 917 ( h9 17 ) automated chemistry analyzer ( indianapolis , ind .). in this method , calcium reacts with o - cresolphthalein complexone in the presence of 8 - hydroxyquinoline to form a purple chromophore . the color intensity of the purple complex is directly proportional to the calcium concentration and is measured photometrically on the analyzer . this method is capable of quantifying 0 . 2 - 18 . 2 mg / dl of serum calcium . for samples & gt ; 18 . 2 mg / dl the samples must be diluted in saline and the value multiplied by the appropriate factor . bms - 354825 is a potent and selective inhibitor of src kinase with a biochemical ic 50 of 0 . 8 nm . it also has been found to strongly inhibit csf - 1r ( 89 % of control at 10 nm ). therefore , bms - 354825 , targeting both src and csf - 1r kinases , is an novel method for the treatment of tumor bone metastasis as well as related bone resorption and hypercalcemia . it has been demonstrated that addition of m - csf to murine bone marrow progenitors stimulates proliferation and initiates differentiation toward the myeloid pathway . differentiation to osteoclasts then occurs in the presence of osteoclast differentiation factor or rank ligand ( buckley and fraser buckley , k . a . and w . d . fraser ( 2002 ). “ receptor activator for nuclear factor kappab ligand and osteoprotegerin : regulators of bone physiology and immune responses / potential therapeutic agents and biochemical markers .” ann clin biochem 39 ( pt 6 ): 551 - 6 .). to establish the cell culture model of osteoclasts , bone marrow cells were freshly harvested from the tibia and femur bones of mice and were seeded in 24 - wells plates containing dmem medium supplemented with 20 ng / ml m - csf and 100 ng / ml rank ligand , which are the conditions commonly used in murine bone marrow culturing conditions ( murray , l . j ., t . j . abrams , et al . ( 2003 ). “ su11248 inhibits tumor growth and csf - 1r - dependent osteolysis in an experimental breast cancer bone metastasis model .” clin exp metastasis 20 ( 8 ): 757 - 66 .). the formation of osteoclasts was monitored by trap staining for 9 days . no significant trap positive staining cells were observed in the early phase of osteoclast development , i . e . between days 1 and 3 . starting from day 5 , trap positive staining cells were observed , and the multi - nucleated trap positive staining osteoclasts ( with ≧ 3 nuclei ) were clearly detected on day 7 and became most abundant by day 9 . no multi - nucleated trap positive staining osteoclasts were observed in control cells being cultured in the absence of csf and rank ligand . inhibition of osteoclast formation by bms - 354825 in bone marrow cell culture to explore the inhibition of osteoclast development , various concentrations of bms - 354825 was dosed on day 5 post cell seeding , bone marrow cells were cultured up to 9 days . bms - 354825 significantly reduced the number of the trap positive staining osteoclasts . it appeared that bms - 354825 was able to potently inhibit the development of osteoclasts over the entire culture period . ( fig1 ) the inhibition of osteoclast development by bms - 354825 was quantitated by counting the number of the trap positive staining osteoclasts with multiple nuclei (≧ 3 ). it was observed that , in the absence of bms - 354825 , the number of osteoclasts in mda - mb - 231 condition media was greater than that in dmem medium supplemented with csf / rank ligand , indicating a greater stimulation of osteoclast development by condition medium ( fig2 a ). it is speculated that condition medium could contain more kinds and / or higher levels of cytokines / growth factors secreted by tumor cells , which in turn result in a stronger stimulatory effect on osteoclast development . when dosed with bms - 354825 , the number of osteoclasts was significantly reduced for both culturing conditions ( fig2 a ). the inhibitory effect of bms - 354825 on osteoclast development was further titrated in bone marrow cells cultured in dmem media supplemented with m - csf / rnak ligand . bms - 354825 was dosed on day 5 post seeding , the formation of osteoclasts was inhibited dose dependently ( fig2 b ). the value of ic 50 , the drug concentration required to inhibit 50 % of osteoclast formation , was estimated to be 4 . 4 nm . this value was comparable to the inhibitory potency of bone resorption by bms - 354825 ( ic 50 of 2 nm ). it suggests that bms - 354825 is able to inhibit bone resorption likely through the inhibition of osteoclast development and function . overall , the current data demonstrated that bms - 354825 was able to inhibit the development of osteoclasts in mouse bone marrow cell culture in vitro , which could consequently inhibit bone resorption mediated through the osteoclastogenesis pathway . we are currently exploring the mechanistic link between the inhibition of osteoclast development and the potential target inhibition by bms - 354825 , i . e . src and / or csf - 1r kinase in osteoclasts . malignancy related hypercalcemia has been strongly linked with bone resorption mediated by stimulation of native osteoclast formation and activity . bms - 354825 was therefore further tested in thyroid parathyroidectomized ( tptx ) rats , a commonly used animal model to evaluate bone resorption ( fisher , j . e ., m . p . caulfield , et al . ( 1993 ). “ inhibition of osteoclastic bone resorption in vivo by echistatin , an “ arginyl - glycyl - aspartyl ” ( rgd )- containing protein .” endocrinology 132 ( 3 ): 1411 - 3 . engleman , v . w ., g . a . nickols , et al . ( 1997 ). “ a peptidomimetic antagonist of the alpha ( v ) beta3 integrin inhibits bone resorption in vitro and prevents osteoporosis in vivo .” j clin invest 99 ( 9 ): 2284 - 92 . lark , m . w ., g . b . stroup , et al . ( 1999 ). “ design and characterization of orally active arg - gly - asp peptidomimetic vitronectin receptor antagonist sb 265123 for prevention of bone loss in osteoporosis .” j pharmacol exp ther 291 ( 2 ): 612 - 7 .). in this model , the thyroid and parathyroid are surgically removed to induce hypocalcemia , then subsequent infusion with pth stimulates the osteoclast - mediated calcemic response . in the present study , tptx rats with basal calcium levels from 7 - 8 mg / dl , were implanted subcutaneously with osmotic alzet pumps containing pth . upon initiation of pth infusion to induce hypercalcemia , tptx rats were administered bms - 354825 at 30 , 15 , and 5 mpk po ( qd × 1 ). a dose dependent inhibition of serum calcium levels was observed ( data not shown ). calcitonin , a drug currently being used to manage hypercalcemia clinically , was used as a reference compound at 5 iu / dose sc , and showed an inhibition of serum calcium levels , see discussion below . a study demonstrated that bms - 354825 administered orally rapidly inhibited the serum levels of calcium at 30 mpk ( qd × 1 ) as well as at 15 mpk ( 2qd × 1 ), while 30 mg / kg at qd appeared more effective to inhibit serum calcium levels than 15 mg / kg at 2qd . nonetheless , the inhibition appeared to recover with time , but the serum calcium levels of tptx rats treated with bms - 354825 were still significantly below those of the control rats on day 3 post drug administration ( fig3 ). in the same experiment , calcitonin at 5 iu / dose sc also provided a rapid inhibition of serum calcium levels , but the inhibition was reversed rapidly . there was essentially no significant difference in serum calcium levels between the calcitonin treated and the control rats on day 3 ( fig3 ). this experiment demonstrated that bms - 354825 was able to inhibit the induction of hypercalcemia by pth more effectively than calcitonin . with a multiple treatment schedule , bms - 354825 was compared side by side with zometa ®, a new generation of bisphosphonates , which has demonstrated clinical benefits in breast cancer patients with bone metastases ( rosen , l . s ., d . gordon , et al . ( 2003 ). “ zoledronic acid versus placebo in the treatment of skeletal metastases in patients with lung cancer and other solid tumors : a phase iii , double - blind , randomized trial — the zoledronic acid lung cancer and other solid tumors study group .” j clin oncol 21 ( 16 ): 3150 - 7 ). in this experiment , tptx rats were infused with pth for 24 hr prior to drug treatment and hypercalcemia was shown to be induced , based on the measurement of serum levels of calcium ranged from 14 - 15 mg / dl ( fig4 ). bms - 354825 was then administered at dose levels of 30 , 15 , and 5 mg / kg / dose po ( qd × 5 ) while zometa ® was administered at 0 . 4 mg / kg / dose sc ( qd × 5 ). once again , bms - 354825 demonstrated a rapid inhibition of serum calcium levels within 3 hr . in contrast , zometa did not produce any appreciable inhibition until 24 hr post drug administration . the degree of inhibition of serum calcium levels by bms - 354825 at 15 mg / kg / dose was comparable to that by zometa between 24 hr and 72 hr ( the end of study ) post drug administration , while bms - 354825 at 30 mg / kg / dose showed more robust inhibition through the entire period of experiment . by 72 hr , the inhibition of serum calcium levels by zometa appeared similar to that by bms - 354825 at 5 mg / kg / dose which was the dose level appearing less effective with initial dosing . due to the fact that osmotic pump works less efficiently after day 4 , we intended not to include the data of calcium levels thereafter . overall , this study demonstrated that bms - 354825 was able to inhibit the progression of hypercalcemia induced by pth , dose - dependently . at the current once daily treatment regimen , bms - 354825 at 30 mg / kg / dose po appeared more effective than zometa at 0 . 4 mg / kg / dose sc , while at 15 and 5 mg / kg / dose , bms - 354825 produced comparable inhibitory effect compared to zometa at 0 . 4 mg / kg / dose with a multiple treatment schedule . to fully characterize the relationship between the pk and the pd effect of bms - 354825 , the pk was determined in tptx rats in conjunction with evaluation of inhibition of serum calcium levels at 5 , 15 , and 30 mg / kg / dose . the rat blood was collected at 0 , 2 , 4 , 7 , and 24 hours on both day 1 and day 5 and the plasma levels of bms - 354825 were analyzed by hplc / ms ( fig5 ). the pk parameters were derived and listed in table 1 . following oral administration , bms - 354825 was rapidly absorbed with t max of 2 hr for all three oral doses , which was consistent with previous pk studies in rodents conducted in house . the plasma level of bms - 354825 stayed higher at 24 hr than at 7 hr at 30 mg / kg which was also observed in previous pk studies in rats and was probably due to enterohepatic recycling . the exposure parameters , c max and auc 0 - 24 hr , appeared dose dependent on day 1 for 5 , 15 , and 30 mg / kg , respectively . on day 5 , both c max and auc 0 - 24 hr , were less than those on day 1 , which was also observed in previous toxicity study in rats . the decrease of systemic exposure was probably attributable to gi lesion caused by bms - 354825 . the plasma levels of bms - 354825 apparently correlated with the serum levels of calcium in tptx rats at both 15 and 30 mg / kg / dose ( fig6 ). the maximum inhibition of serum calcium levels was achieved at 4 hr post drug administration , implying that the peak drug level in bone was probably several hours later than in plasma . alternatively , the inhibition of serum calcium levels was a consequence of inhibition of bone resorption by bms - 354825 , which could result in a delay between pk and pd effects . this kind of indirect pd response with several hour delay between c max and e max has been observed in previous studies in mice bearing tumor xenografts treated with bms - 354825 ( luo , f . r ., z . yang , et al . ( 2005 ). identification and validation of a pharmacodynamic biomarker assessing target exposure and drug efficacy for the potent pansrc kinase inhibitor bms - 354825 . aacr 96th annual meeting . luo , f . r ., z . yang , et al . ( 2004 ). pharmacokinetics - and pharmacodynamics - guided optimization of the dose and treatment schedule for the dual src / abl inhibitor bms - 354825t . ash 46th annual meeting .). fetal rat long bones were prepared and cultured as described previously . ( feyen j h m , cardinaux f , gamse r , bruns c , azria m , and trechsel u . n - terminal truncation of salmon calcitonin leads to calcitonin antagonist . structure activity relationship of n - terminally truncated salmon calcitonin fragments in vitro and in vivo . biochemistry and biophysiology research communication 1992 ; 187 : 8 - 13 .) briefly , pregnant sprague dawley rats were injected subcutaneously with 200 μci 45 ca on day 18 of gestation . the following day , radii and ulnae were dissected free from muscle and connective tissue . the cartilaginous ends of the bones were removed and the calcified diaphyses were cultured in 0 . 5 ml bgj medium supplemented with 1 mg / ml bovine serum albumin ( bsa , fraction v ) in 24 - well tissue culture plates in a co 2 incubator at 37 ° c . overnight to reduce free exchangeable calcium . next , medium was replaced and the bone explants were maintained in culture for 5 days in the presence or absence of the compounds to be tested . on day 2 , a 100 μl aliquot was taken from the medium and the medium was replaced with fresh medium with or without treatments . on day 5 another 100 μl aliquot was taken from the medium . residual 45 ca was extracted from the bone explants by incubation in 200 μl 5 % ( w / v ) trichloroacetic acid ( tca ) for 24 hours and subsequently neutralized using 200 μl of 1n naoh . the amount of radioactive calcium was determined using a beckman liquid scintillation counter . bone resorption was expressed as the percentage 45 ca released by day 5 of total amount of 45 ca originally incorporated in bone explants . thyro - parathyroidectomy ( tptx ) surgery was performed on male sprague - dawley rats ( 200 gram body weight ) as described previously . 4 thyro - parathyroidectomized ( tptx ) rats with serum calcium values of 5 - 8 mg / dl were used for the study ( normal reference range is 10 - 12 mg / dl ). on the day of the study ( 48 hours post - surgery ), blood was collected from the tail vein under isoflurane anesthesia , and alzet mini - pumps ( delivering 1 μl / hr ) containing 0 . 3 μg / ml of parathyroid hormone ( pth ) were implanted subcutaneously . immediately following implantation of the pumps , the animals were dosed ip with vehicle , 5 iu salmon calcitonin or bms - 354825 at 3 & amp ; 10 mg / kg . blood was collected at 3 , 6 & amp ; 24 hours after dosing and analyzed for serum calcium levels . in vitro bone resorption assay : the results show that bms - 354825 is a potent inhibitor of bone resorption in vitro . pth ( 10 − 8 m ) stimulates bone resorption approximately 4 - fold . bms - 354825 inhibits pth - stimulated release of 45 ca dose - dependently with an apparent ic 50 of 2 nm . at 5 nm bms 354825 completely blocks pth - stimulated bone resorption ( see fig7 ). serum calcium in thyro - parathyroidectomized rats : results show that bms - 354825 is a potent inhibitor of bone resorption . compared to vehicle treated animals , all treatments significantly prevented the pth stimulated increase in serum calcium through the time course of this study . due to high variability , the 3 hour time point in the 3 mg / kg bms - 354825 treated group was not significant . after 24 hours serum calcium levels of animals treated with bms - 354825 at 10 mg / kg are significantly lower than both vehicle and calcitonin ( see fig8 and table 2 ).
the present disclosure is directed to a method of treating bone metastasis , hypercalcemia , and / or bone resorption comprising administering to a patient in need thereof a therapeutically effective amount of a compound of formula or pharmaceutically acceptable salt , hydrate or solvate thereof .