Cold atmospheric plasma therapy for lung cancer: mechanistic and therapeutic approach

Cold atmospheric plasma (CAP) has gained increasing attention as redox-based therapeutic strategies for lung cancer. Reactive oxygen and nitrogen species produced by plasma particularly impair intracellular redox equilibrium, mitochondrial integrity and stress responsive signalling, leading to cytotoxicity that is particular to cancer. This review highlights recent mechanistic and translational research revealing that, depending on plasma delivery mode, exposure parameters, and tumour intrinsic redox capacity, CAP induce lung cancer cell death through several regulated pathways including apoptosis and ferroptosis. Beyond cell death, this plasma treatment also decreases epithelial-mesenchymal transition and metastatic behaviour while actively reprogramming oncogenic signalling. Significantly data from immune-inclusive and three-dimensional tumour models emphasizes how important tumour architecture, extracellular matrix and immune control are in determining plasma response. Current research supports the development of CAP as adaptable redox-modulating treatments that can target lung cancer through cytotoxic and signalling based pathways.