Cold atmospheric plasma for the ablative treatment of neuroblastoma

Background: Recent breakthroughs have allowed for production of plasma at room temperature. Cold atmospheric plasma (CAP) may offer the capability of delivering reactive oxygen species directly into tissues, representing a novel modality for targeted cancer therapy. We studied helium-based CAP's effect on neuroblastoma, both in-vitro and in an in-vivo murine model. Methods: Mouse neuroblastoma cultures were treated with CAP for 0, 30, 60, and 120 s and assayed for apoptotic and metabolic activity immediately and at 24 and 48 h post-treatment. Five-millimeter tumors were ablated with a single transdermal CAP treatment, and tumor volume and mouse survival were measured. Results: CAP decreased metabolic activity, induced apoptosis, and reduced viability of cancer cells in proportion to both duration of exposure and time post-treatment. In-vivo, a single treatment ablated tumors and eventual tumor growth was decelerated. Furthermore, survival nearly doubled, with median survival of 15 vs. 28 days (p < 0.001). Conclusions: Our findings demonstrate the sensitivity of neuroblastoma to CAP treatment, both in-vitro and in an in-vivo mouse model of established tumor. While further investigation is necessary to establish the mechanism and optimize the treatment protocol, these initial observations establish cold atmospheric plasma as a potentially useful ablative therapy in neuroblastoma.