Therapeutical effects of Cold atmospheric plasma in Head And Neck Cancer and oral hEalth preservation

PIANO NAZIONALE DI RIPRESA E RESILIENZA (PNRR)

Missione 4 - Componente 2 - Investimento 1.1

“Fondo per il Programma Nazionale della Ricerca (PNR) e Progetti di Ricerca di Rilevante Interesse Nazionale (PRIN)” - Finanziato dall’Unione europea – NextGenerationEU

Bando PRIN 2022

D.D. n. 104 del 02.02.2022

Progetto “Therapeutical effects of Cold atmospheric plasma in Head And Neck Cancer and oral hEalth preservation”

Acronimo: C.H.A.N.C.E.

Codice Identificativo Progetto: 2022ATYY5B- CUP: D53D23013380006

Head and Neck cancer (HNC) is the sixth most common type of cancer worldwide with an approximate 5-year survival rate of 50%; this is due to a poor response to standard anti-cancer treatments such as chemotherapy and radiotherapy (RT). Surgery combined with adjuvant radiation therapy and/or chemotherapy is the standard of care, but in the case of squamous cell carcinomas (SCCs), patients often experience notable complications related to disease treatments, while showing high rates of recurrence due to radiation treatment resistance. Moreover, patients undergoing radiation treatment will experience changes of the normal physiology of oral soft and hard tissues, leading to mucositis, periodontal disease, dental caries, and overall alteration of the teeth structure (loss of enamel prism structure, degeneration of odontoblast processes, obliteration of dentinal tubules, and gap formation at the enamel-dentine junction), which further compromises nutrition, speech, and social relations. The potential application of alternative and/or adjuvant therapies (i.e. cold plasma, CAP) for HNC-treatment is highly warranted to reduce the impact of traditional RT on oral health and improve the patients’ survival rate and quality of life. Plasma is defined as the fourth state of matter and it is partially or completely ionized gas that reacts with the environment creating a mixture of active components: electrons, ions, radicals, and energetic photons, all of which can in turn interact with the target. Due to advances in physics and biotechnology, nowadays plasma can be easily generated and used at room temperature, reaching high electron temperatures, but very low gas temperatures associated with weak ionization rates. Recently, CAP has been investigated in several medical applications, such as blood coagulation, wound disinfection and healing, tissue and germicidal irradiation and sterilization, skin rejuvenation, tooth bleaching, material surface modifications and crosslinking, and to selectively eradicate cancer cells, while with lower or irrelevant consequences on normal cells. Despite the promising effects of CAP as anti-cancer cell agent, very little is still known on its application in the HNC therapy field and its effects on cellular responses and oral cavity-related effects. Accordingly, this project is aims at a comprehensive evaluation of CAP biological, biochemical and ultramorphological effects on HNC and normal cell lines and tooth tissues. Specifically, CAP will be applied either as stand-alone therapy or in combination to RT (application of CAP before, as well as after RT will both be evaluated). The effects of these treatment modalities will be compared to the effects of RT alone, as well as no treatment (control), aiming to standardize a protocol to reduce adverse effects of RT and improve HNC susceptibility to treatment, but also to investigate the possibility of the individualization of CAP anti-cancer therapy.