Synergistic effects of cold atmospheric plasma and doxorubicin on melanoma: A systematic review and meta-analysis

Melanoma is responsible for the majority of skin cancer deaths, but there are ways to combat this deadly disease. One method is using anti-neoplastic agents, such as Doxorubicin (DOX). Unfortunately, DOX can be toxic and may lead to drug resistance. However, researchers are excited about the potential of Cold Atmospheric Plasma (CAP) treatment cancer cells and overcome drug resistance selectively. To better understand the effectiveness of the combination of CAP and DOX on melanoma cell viability, cytotoxicity, and cell death, we conducted a comprehensive evaluation and meta-analysis in this study. 41 studies out of 121 met our inclusion criteria. The pooled analysis found that CAP and DOX combination had a significant effect on cell viability (ES = 6.75, 95% CI 1.65 to 11.85, and I2 = 71%) and cytotoxicity (ES = 11.71, 95% CI 3.69 to 19.73, and I2 = 56%). however, no statistically significant association was found between cell death with combination treatment. Our studies have confirmed that the combined treatment of CAP and DOX has a synergistic effect on reducing cell viability and increasing cytotoxicity in melanoma cells. These results can assist researchers in selecting more effective treatment methods to address melanoma.