Abstract: Boron neutron capture therapy (BNCT) has the potential to specififically destroy tumor cells without damaging the tissues infifiltrated by the tumor. BNCT is a binary treatment method based on the combination of two agents that have no effect when applied individually: ¹⁰B and thermal neutrons. Exclusively, the combination of both produces an effect, whose extent depends on the amount of ¹⁰B in the tumor but also on the organs at risk. It is not yet possible to determine the ¹⁰B concentration in a specifific tissue using non-invasive methods. At present, it is only possible to measure the ¹⁰B concentration in blood and to estimate the boron concentration in tissues based on the assumption that there is a fifixed uptake of ¹⁰B from the blood into tissues. On this impre cise assumption, BNCT can hardly be developed further. A therapeutic approach, combining the boron carrier for therapeutic purposes with an imaging tool, might allow us to determine the ¹⁰B concentration in a specifific tissue using a non-invasive method. This review provides an overview of the current clinical protocols and preclinical experiments and results on how innovative drug development for boron delivery systems can also incorporate concurrent imaging. The last section focuses on the importance of proteomics for further optimization of BNCT, a highly precise and personalized therapeutic approach.
Keywords: BNCT; radiation oncology; small molecules; BSH; BPA; PET; quantitative MRI; image registration; cell-penetrating peptides CPP; proteomics