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    Oligometastatic breast cancer can be cured?
    (Churchill Livingstone, 2019) Gündüz, Şeyda; Özdoğan, Mustafa; Yıldız, Akın; İlkgül, Özer; Kargı, Ayşegül; Kaya, Vacide Selin; Özozan, Ömer Vefik
    The aim of this study was to assess to efficacy curative intent to oligometastatic disease (OMBC) and compared with the locally advanced breast cancer (LABC).
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    Pembrolizumab for advanced urothelial carcinoma: exploratory ctDNA biomarker analyses of the KEYNOTE-361 phase 3 trial
    (Nature portfolio, 2024) Powles, Thomas; Chang, Yen-Hwa; Yamamoto, Yoshiaki; Munoz, Jose; Reyes-Cosmelli, Felipe; Peer, Avivit; Cohen, Graham; Yu, Evan Y.; Lorch, Anja; Bavle, Abhishek; Moreno, Blanca Homet; Markensohn, Julia; Edmondson, Mackenzie; Chen, Cai; Cristescu, Razvan; Pena, Carol; Lunceford, Jared; Gündüz, Şeyda
    Circulating tumor DNA (ctDNA) is emerging as a potential biomarker in early-stage urothelial cancer, but its utility in metastatic disease remains unknown. In the phase 3 KEYNOTE-361 study, pembrolizumab with and without chemotherapy was compared with chemotherapy alone in patients with metastatic urothelial cancer. The study did not meet prespecified efficacy thresholds for statistical significance. To identify potential biomarkers of response, we retrospectively evaluated the association of pre- and posttreatment ctDNA with clinical outcomes in a subset of patients who received pembrolizumab (n = 130) or chemotherapy (n = 130) in KEYNOTE-361. Baseline ctDNA was associated with best overall response (BOR; P = 0.009), progression-free survival (P < 0.001) and overall survival (OS; P < 0.001) for pembrolizumab but not for chemotherapy (all; P > 0.05). Chemotherapy induced larger ctDNA decreases from baseline to treatment cycle 2 than pembrolizumab; however, change with pembrolizumab (n = 87) was more associated with BOR (P = 4.39 x 10(-5)) and OS (P = 7.07 x 10(-5)) than chemotherapy (n = 102; BOR: P = 1.01 x 10(-4); OS: P = 0.018). Tumor tissue-informed versions of ctDNA change metrics were most associated with clinical outcomes but did not show a statistically significant independent value for explaining OS beyond radiographic change by RECIST v.1.1 when jointly modeled (pembrolizumab P = 0.364; chemotherapy P = 0.823). These results suggest distinct patterns in early ctDNA changes with immunotherapy and chemotherapy and differences in their association with long-term outcomes, which provide preliminary insights into the utility of liquid biopsies for treatment monitoring in metastatic urothelial cancer. Clinical trial registration: NCT02853305.
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    Percutaneous delivery of oncogel for targeted liver tumor ablation and controlled release of therapeutics
    (John wiley and sons inc, 2024) Albadawi, Hassan; Zhang, Zefu; Keum, Hyeongseop; Çevik, Enes; Nagalo, Bolni M.; Gündüz, Şeyda; Kita, Hirohito; Oklu, Rahmi
    Advanced-stage liver cancers are associated with poor prognosis and have limited treatment options, often leading the patient to hospice care. Percutaneous intratumoral injection of anticancer agents has emerged as a potential alternative to systemic therapy to overcome tumor barriers, increase bioavailability, potentiate immunotherapy, and avoid systemic toxicity, which advanced-stage cancer patients cannot tolerate. Here, an injectable OncoGel (OG) comprising of a nanocomposite hydrogel loaded with an ionic liquid (IL) is developed for achieving a predictable and uniform tumor ablation and long-term slow release of anticancer agents into the ablation zone. Rigorous mechanical, physiochemical, drug release, cytotoxicity experiments, and ex vivo human tissue testing identify an injectable version of the OG with bactericidal properties against highly resistant bacteria. Intratumoral injection of OG loaded with Nivolumab (Nivo) and doxorubicin (Dox) into highly malignant tumor models in mice, rats, and rabbits demonstrates enhanced survival and tumor regression associated with robust tissue ablation and drug distribution throughout the tumor. Mass cytometry and proteomic studies in a mouse model of colorectal cancer that often metastasizes to the liver indicate an enhanced anticancer immune response following the intratumoral injection of OG. OG may augment immunotherapy and potentially improve outcomes in liver cancer patients.
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    Prostate tissue ablation and drug delivery by an image-guided injectable ionic liquid in ex vivo and in vivo models
    (American association advancement science, 2024) Demirlenk, Yusuf M.; Albadawi, Hassan; Zhang, Zefu; Atar, Dila; Çevik, Enes; Keum, Hyeongseop; Kim, Jinjoo; Rehman, Suliman; Gündüz, Şeyda; Graf, Erin; Mayer, Joseph L.; Dos Santos, Pedro R.; Oklu, Rahmi
    Benign prostatic hyperplasia and prostate cancer are often associated with lower urinary tract symptoms, which can severely affect patient quality of life. To address this challenge, we developed and optimized an injectable compound, prostate ablation and drug delivery agent (PADA), for percutaneous prostate tissue ablation and concurrently delivered therapeutic agents. PADA is an ionic liquid composed of choline and geranic acid mixed with anticancer therapeutics and a contrast agent. The PADA formulation was optimized for mechanical properties compatible with hand injection, diffusion capability, cytotoxicity against prostate cells, and visibility of an x-ray contrast agent. PADA also exhibited antibacterial properties against highly resistant clinically isolated bacteria in vitro. Ultrasound-guided injection, dispersion of PADA in the tissue, and tissue ablation were tested ex vivo in healthy porcine, canine, and human prostates and in freshly resected human tumors. In vivo testing was conducted in a murine subcutaneous tumor model and in the canine prostate. In all models, PADA decreased the number of viable cells in the region of dispersion and supported the delivery of nivolumab throughout a portion of the tissue. In canine survival experiments, there were no adverse events and no impact on urination. The injection approach was easy to perform under ultrasound guidance and produced a localized effect with a favorable safety profile. These findings suggest that PADA is a promising therapeutic prostate ablation strategy to treat lower urinary tract symptoms.