Laser-Assisted Delivery Of Cold Atmospheric Plasma In Unresectable Cutaneous Metastasis In Melanoma Patients

Abstract

According to the World Health Organization, the incidence of melanoma is increasing faster than that of any other major cancer in the world. Melanoma is the fifth most common cancer in the United States, posing a substantial health and economic burden. Treatment of early and multiple cutaneous unresectable metastasis in melanoma patients is a major therapeutic problem. Cold atmospheric plasma (CAP) contains electrons, charged particles, radicals, various excited molecules, UV photons, and transient electric fields. These various compositional elements have the potential either to enhance cellular activity, or to disrupt it. In particular, based on this unique composition, CAP could offer a minimally-invasive surgical approach allowing for specific cancer cell or tumor tissue removal without influencing healthy cells. Topical application of treatment agents is a basic principle of dermatological therapy. However, the effective barrier function of the skin significantly impairs the bioavailability of most topical drugs. Fractional ablative lasers represent an innovative strategy to overcome the epidermal barrier in a standardized, contact-free manner. The bioavailability of topical agents can be significantly enhanced using laser-assisted delivery. Ablative fractional laser resurfacing creates vertical channels that might assist the delivery of topically applied cold plasma into cutaneous melanoma metastasis. For lesions refractory to elective treatments, the laser-assisted drug delivery technique combined with cold atmospheric plasma may present a new potential option. We report on a pilot study showing a proof of concept for enhancing topical cold atmospheric plasma permeation into depth by ablative fractional laser technique.