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The technology mainly relies on the emittance of various reactive oxygen and nitrogen species (ROS\/RNS) that are tumor\u2010toxic at high concentrations. Moreover, malignant melanoma has a metabolic dimension that can be targeted by mild starvation. To this end, we investigated the combined effect of starvation and CAP treatment on melanoma in vitro and in vivo. In vitro, starvation+CAP led to cell morphology changes, decreased metabolic activity and increased lipid peroxidation accompanied by apoptosis and DNA fragmentation in murine B16 melanoma cells but not murine non\u2010malignant L929 fibroblasts. This was paralleled by increased apoptosis (<jats:italic>Bax<\/jats:italic>, <jats:italic>Bcl\u20102<\/jats:italic> and <jats:italic>Caspase\u20103<\/jats:italic>) and autophagy (<jats:italic>Lc3<\/jats:italic> and <jats:italic>Atg5<\/jats:italic>)\u2010related gene expression. In vivo, starvation reduced tumor burden. Combination with CAP treatment augmented this effect significantly, albeit there was no difference of combination treatment to CAP exposure alone. Interestingly, there was an overall greater increase of <jats:italic>Lc3<\/jats:italic> and <jats:italic>Atg5<\/jats:italic> in the tumor tissue compared to CAP exposure alone, while starvation\u2010induced autophagy\u2010related gene expression was similar to in the combination group. These data collectively suggest that CAP\u2010derived ROS\/RNS treatment and autophagy\u2010induction augment antitumor effects in malignant melanoma in vitro and in vivo.<\/jats:p>","DOI":"10.1111\/exd.14544","type":"journal-article","created":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T01:54:25Z","timestamp":1645235665000},"page":"1016-1028","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Cold atmospheric pressure plasma treatment combined with starvation increases autophagy and apoptosis in melanoma in\u00a0vitro and in vivo"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1406-9028","authenticated-orcid":false,"given":"Monireh","family":"Golpour","sequence":"first","affiliation":[{"name":"Molecular and Cell Biology Research Center Student Research Committee Faculty of Medicine Mazandaran University of Medical Science  Sari 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