Physical and chemical enhancement of cancer cell death induced by cold atmospheric plasma

Cold atmospheric plasma (CAP) has gained increasing attention for its anticancer potential. CAP anticancer application is unique for its selective targeting of cancer cells than normal cells. These CAP effects are directly related to producing reactive oxygen species (ROS) and reactive nitrogen species in air and liquid environment. The ROS producing ability can vary greatly depending on the CAP source. CAP-induced an enormous amount of ROS in the liquid phase. However, incorporating extracellular ROS into the cells seems limited to the ROS in the liquid phase. It poses a crucial challenge to CAP clinical applications. This short review describes the potential strategies that allow the incorporation of CAPinduced ROS to enhance cancer cell death. Further, the possible combination of CAP with hyperthermia and redox modulating agent sulfasalazine (SSZ) is explained.