Mechanisms, challenges, and translational perspectives of cold atmospheric plasma in cancer and wound healing

Cold atmospheric plasma (CAP) generates reactive species at low temperatures, and it has shown promise in oncology, wound healing, and regenerative medicine. Therapeutic mechanisms and translational potential remain unclear across a wide range of biological applications. In this article, a comprehensive assessment of mechanistic, preclinical, and emerging clinical evidence was performed, with a particular emphasis on CAP-mediated biochemical pathways and therapeutic outcomes, focusing on reproducible, mechanism-based studies. CAP modulates apoptosis, immune responses, microbial inactivation, and tissue repair through redox-driven pathways. CAP is selectively cytotoxic toward tumor cells, accelerates wound closure by enhancing angiogenesis and collagen remodeling, and reduces inflammatory signaling in dermatological disorders. CAP has also been shown to modulate cell metabolism and differentiation, enabling applications in tissue engineering and cancer treatment through controlled drug delivery. By integrating CAP with artificial intelligence-guided treatment planning, precision dosing and personalized treatment can be further enhanced. Collectively, current evidence suggests that CAP represents a promising non-invasive therapeutic approach with effects that extend beyond superficial tissue interactions, indicating its potential for applications across a wide range of medical fields. This review identifies CAP-driven biochemical and therapeutic processes and enhances understanding of targeted, multimodal interventions in oncology, wound healing and regenerative medicine.