title: Low temperature plasmas as emerging cancer therapeutics: the state of play and thoughts for the future.
abstract: The field of plasma medicine has seen substantial advances over the last decade, with applications developed for bacterial sterilisation, wound healing and cancer treatment. Low temperature plasmas (LTPs) are particularly suited for medical purposes since they are operated in the laboratory at atmospheric pressure and room temperature, providing a rich source of reactive oxygen and nitrogen species (RONS). A great deal of research has been conducted into the role of reactive species in both the growth and treatment of cancer, where long-established radio- and chemo-therapies exploit their ability to induce potent cytopathic effects. In addition to producing a plethora of RONS, LTPs can also create strong electroporative fields. From an application perspective, it has been shown that LTPs can be applied precisely to a small target area. On this basis, LTPs have been proposed as a promising future strategy to accurately and effectively control and eradicate tumours. This review aims to evaluate the current state of the literature in the field of plasma oncology and highlight the potential for the use of LTPs in combination therapy. We also present novel data on the effect of LTPs on cancer stem cells, and speculatively outline how LTPs could circumvent treatment resistance encountered with existing therapeutics.
authors.affiliation: Department of Physics, York Plasma Institute, University of York, Heslington, UK.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Hirst
authors.affiliation: YCR Cancer Research Unit, Department of Biology, University of York, Heslington, UK.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Frame
authors.affiliation: University College London, London, UK.
authors.forename: Manit
authors.initials: M
authors.lastname: Arya
authors.affiliation: YCR Cancer Research Unit, Department of Biology, University of York, Heslington, UK.
authors.forename: Norman J
authors.initials: NJ
authors.lastname: Maitland
authors.affiliation: Department of Physics, York Plasma Institute, University of York, Heslington, UK. deborah.oconnell@york.ac.uk.
authors.forename: Deborah
authors.initials: D
authors.lastname: O'Connell
mesh_terms: D000818:Animals; D003080:Cold Temperature; D017679:Cryotherapy; D006801:Humans; D009369:Neoplasms / Q000473:pathology / Q000628:therapy*; D058626:Plasma Gases / Q000627:therapeutic use*; D026361:Reactive Nitrogen Species / Q000378:metabolism; D017382:Reactive Oxygen Species / Q000378:metabolism
chemical_list: D058626:Plasma Gases; D026361:Reactive Nitrogen Species; D017382:Reactive Oxygen Species
keywords: Cancer stem cells; Combination therapy; Focal therapy; Low temperature plasma; Reactive species