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Is Cold Atmospheric Plasma Selective for Breast Tumor Cells? A Systematic Review.

Inês Pinheiro1,2, Catarina Almeida-Ferreira1,2,3,4, Carlos Miguel Marto1,2,4,5,6,7

  • 1Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.

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Cold atmospheric plasma (CAP) and plasma-activated solutions (PAS) show promise in selectively targeting breast cancer cells in vitro. Further research is needed to standardize methods and confirm findings.

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Area of Science:

  • Biomedical Engineering
  • Oncology
  • Plasma Physics

Background:

  • Breast cancer (BC) is a leading cause of cancer death globally.
  • Current BC treatments lack tumor cell selectivity.
  • Cold atmospheric plasma (CAP) is an emerging cancer therapy.

Purpose of the Study:

  • To systematically review in vitro studies on CAP/plasma-activated solutions (PAS) selectivity for breast cancer (BC) cell lines.
  • To explore potential mechanisms of CAP/PAS selectivity in BC treatment.

Main Methods:

  • Systematic review of 4 databases (PubMed, Embase, Web of Science, Cochrane).
  • Inclusion of 32 in vitro studies using BC cell lines (e.g., MDA-MB-231) and non-malignant cells (e.g., MCF-10A).
  • Analysis of various cell viability, proliferation, and migration assays (MTT, MTS, SRB, trypan blue, clonogenic, resazurin, luciferin, annexin-V/propidium iodide, ROS, scratch assays).

Main Results:

  • CAP and PAS demonstrated reduced viability in BC cells with less impact on non-malignant cells, indicating partial selectivity.
  • Elevated reactive oxygen species (ROS) levels in cancer cells may contribute to CAP/PAS selectivity.
  • Treatments reduced BC cell migration and enhanced efficacy of other therapies.
  • Heterogeneity in experimental protocols precluded meta-analysis.

Conclusions:

  • In vitro studies suggest CAP/PAS exhibit partial selectivity for breast cancer cells.
  • The precise mechanisms and consistency of selectivity require further investigation.
  • Standardization of experimental methods is crucial for future research and clinical translation.