By Woo Kim
What might the future of boron neutron capture therapy (BNCT) look like? A table-top accelerator? A treatment room where only cancer cells are targeted and soft tissue remains unharmed, reminiscent of the medical device in the movie “Elysium” (2013)? Or perhaps an environment filled with automated devices, allowing for high-throughput treatments?
Whatever you imagine, it’s clear that the optimal boron drug is essential for BNCT to be recognized as a groundbreaking or unparalleled treatment in medical history.
The first article in this review, [Andrea Monti Hughes & Naonori Hu “Optimizing Boron Neutron Capture Therapy (BNCT) to Treat Cancer: An Updated Review on the Latest Developments on Boron Compounds and Strategies.” Cancers (Basel). 2023.] provides a comprehensive overview of recent advancements in boron drugs. This article is a valuable read, especially for those new to BNCT or for members of the BNCT community who may not specialize in chemistry. Beyond just boron drug developments, the authors also discuss potential applications for BNCT, offering readers a broader understanding of its potential.
So, with the emergence of new boron drugs, what’s next? How should these drugs be explored and studied? In the age of new drug development, many “sponsor-initiated trials”, often referred to as SITs, have mandated study designs set by regulatory bodies like the FDA, EMA, or PMDA. These bodies review preclinical trial results and approve the components to proceed to human trials, often referred to as “first-in-human” trials, provided the IND-enabling studies are fully supported. Thus, IND-enabling studies are not only a prerequisite but also a minimal requirement.
However, boron drugs for BNCT aren’t just typical drugs. They act as radiation sources, focal points for fission reactions, demanding a deeper understanding of their behavior within tissues which means boron drug may require more studies for its introduction in clinical usage. So, what and how should we investigate regarding these boron drugs in BNCT?
The second article addresses this, [Hattori Y, Andoh T, Kawabata S, et al. “Proposal of recommended experimental protocols for in vitro and in vivo evaluation methods of boron agents for neutron capture therapy.” J Radiat Res. 2023.]. This collaborative review, part of Japanese Society of Neutron Capture Therapy(JSNCT)’s ongoing work, presents a multidisciplinary approach, giving readers a comprehensive overview of the experimental methodologies for future boron drugs.
To truly understand the role of boron drugs in BNCT, it’s essential to also consider the impact of the neutron itself, especially its Relative Biological Effectiveness (RBE). This is even more relevant now with the introduction of accelerators. So, how do we measure the effect of neutrons in today’s BNCT landscape?
Naonori et al. shed light on this in their third article: [Hu N, Suzuki M, et al. “Experimentally determined relative biological effectiveness of cyclotron-based epithermal neutrons designed for clinical BNCT: in vitro study.” J Radiat Res. 2023.]. They offer a thorough look into the RBE of accelerator-based BNCT. It’s worth a read!
BNCT is seeing increased attention with numerous studies and publications from around the world backing its potential. What will the next chapter of BNCT will show?
If you come across an interesting publication or study, don’t hesitate to share it with the BNCT community. We will be glad to publish your review and to include the articles in our repository. Are you involved in BNCT research or have insights that could benefit the community? Just reach out to the Communication Task Force. We’re always looking to spread the word, ensuring nobody misses out on the latest findings.