Cold atmospheric plasma conveys selectivity on triple negative breast cancer cells both in vitro and in vivo.

Breast cancers are heterogeneous, with the triple negative subtype being the most aggressive and lack of effective therapy. Cold atmospheric plasma has become a promising onco-therapeutic approach as demonstrated by many pre-clinical studies. We found from both in vitro and in vivo experiments that plasma-activated medium could selectively induce the apoptosis, inhibit the proliferation and migration of triple negative breast cancers rather than the other subtypes. We propose that it is the accelerated genome mutation rate, hyper-activated MAPK/JNK and NF-kB pathways of triple negative breast cancers that make them more vulnerable to plasma treatment than non-triple negative tumors, and MAPK/JNK and NF-κB signalings in response to reactive oxygen species generated by plasma that play deterministic roles in this differential therapeutic response. Our work contributes in establishing a correlation between plasma efficacy and cancer subtypes, which facilitates the clinical translation of plasma as a precision medicinal approach.