Recent advances in plasma-based cancer treatments: approaching clinical translation through an intracellular view

Plasma medicine is a multidisciplinary field of research which is combining plasma physics and chemistry with biology and clinical medicine to launch a new cancer treatment modality. It mainly relies on utilizing low temperature plasmas in atmospheric pressure to generate and instill a cocktail of reactive species to selectively target malignant cells for inhibition the cell proliferation and tumor progression. Following a summarized review of primary in vitro and in vivo studies on the antitumor effects of low temperature plasmas, this article briefly outlines the plasma sources which have been developed for cancer therapeutic purposes. Intracellular mechanisms of action and significant pathways behind the anticancer effects of plasma and selectivity toward cancer cells are comprehensively discussed. A thorough understanding of involved mechanisms helps investigators to explicate many disputes including optimal plasma parameters to control the reactive species combination and concentration, transferring plasma to the tumors located in deep, and determining the optimal dose of plasma for specific outcomes in clinical translation. As a novel strategy for cancer therapy in clinical trials, designing low temperature plasma sources which meet the technical requirements of medical devices still needs to improve in efficacy and safety.