A roadmap for treating “incurable” cancers

The future is brighter for patients with “incurable” cancers, such as end-stage head and neck cancers and invasive glioblastomas. Boron neutron capture therapy (BNCT) relies on the nuclear reaction between boron-10 and thermal neutrons to generate destructive alpha particles that travel only a cell’s length, enabling tumor treatment while largely sparing adjacent healthy tissue.

Xu et al. conducted a review of BNCT, including its physical principles, delivery agents, clinical outcomes, and future immunotherapies. They found that while the therapy’s neutron sources are mature, its boron drugs currently present a bottleneck.

“BNCT is experiencing a true paradigm shift,” said author Bing Yuan. “We are moving away from massive, expensive nuclear reactors to compact, hospital-friendly accelerator-based neutron sources, positioning BNCT to become a mainstream therapy.”

The researchers began by establishing the physical principles of the boron-neutron reaction and the crucial shift to accelerator-based neutron sources. They then categorized the evolution of boron drugs from simple molecules to peptide platforms and evaluated clinical outcomes from trials with head and neck cancers and glioblastomas. Finally, they discussed how BNCT could be combined with immunotherapy.

The review revealed that boron delivery drugs must not simply achieve high boron concentrations in tumor cells, but also be present close to the nucleus. The review also showed how BNCT has high potential for priming the body for immunotherapy.

Based on their findings, the researchers are now developing targeted boron delivery systems.

“By perfecting BNCT, we are pushing the absolute boundaries of precision oncology,” said Yuan. “I feel a strong sense of responsibility and excitement to develop the ‘smart software’ that will unlock its full life-saving potential.”

Source: “Recent advances and challenges in boron neutron capture therapy for cancer treatment,” by Xiaoyan Xu, Yushuang Wei, Kai Yang, Jianqiang Liu, and Bing Yuan, Biophysics Reviews (2026). The article can be accessed at https://doi.org/10.1063/5.0342433 .