Chapter 6 │ Page 211 a potential key element in explaining NTP’s multifaceted e ects. Solidifying these hypotheses, while also deepening our understanding of the dual role of gap junctions in cancer, could not only help interpret the observations from the preceding research chapters, but also more broadly, guide the rational design of more e ective combination therapies, improve agent delivery, and optimize treatment timing and regimens in the future. A final important consideration is the technical advancements and standardization of plasma devices to boost clinical implementation. Given NTP’s potential as a powerful adjuvant or even salvage therapy for advanced cancer patients, two major challenges need to be addressed. First, uniformity across plasma devices is essential. Studies have demonstrated that the concentration and composition of the generated species play a crucial role in their biological e ect, meaning that without a consistent dosing strategy, treatment regimens cannot be reliably established nor repeated [14, 78]. Therefore, future work must focus on developing standardization protocols, ensuring that each NTP treatment delivers the same species profile to achieve consistent therapeutic e ects. Second, an important technical obstacle is NTP’s limitations in accessibility to tumors with a deeper location. While its e icacy against a broad range of solid tumor types can be assessed in a laboratory setting, clinical application is currently restricted to superficial and easily accessible malignancies such as melanoma and HNSCC. If more studies validate NTP’s e ectiveness against a wide range of cancers, innovative delivery methods need to be developed. One intermediate approach could be an intraoperative NTP application, whereby tumor margins are treated after surgical resection, although this would be a one-time application. Ideally, future technological progress should focus on expanding minimally invasive solutions, such as endoscopic plasma delivery systems, enabling safe and e ective treatment of tumors in deeper anatomical locations. Addressing these technical and
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