Advances in cold atmospheric plasma therapy for cancer

Cold atmospheric plasma (CAP) has emerged as a promising, non-invasive therapeutic strategy for cancer treatment, leveraging reactive species to selectively induce cancer cell death while sparing healthy tissues. This review summarizes the underlying mechanisms of CAP-mediated anti-cancer effects, including apoptosis, immunogenic cell death, pyroptosis, ferroptosis, necrosis, and modulation of the tumor immune microenvironment. Moreover, we highlight recent advances in CAP-based therapies, including direct CAP treatment and indirect approaches assisted by various delivery methods, encompassing fluids, hydrogels, tubes, and microneedles. Additionally, we survey the clinical efforts of CAP therapy for cancer. Overall, CAP represents a novel and versatile cancer treatment modality with significant translational potential. Continued research into its mechanisms, safety, and optimization strategies will be essential to harness its clinical benefits and expand its application across different cancer types.