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Yura Y, Fujita Y, Hamada M. Ultrasound Combination to Improve the Efficacy of Current Boron Neutron Capture Therapy for Head and Neck Cancer. Cancers (Basel) 2024; 16:2770. [PMID: 39123497 PMCID: PMC11311392 DOI: 10.3390/cancers16152770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
Boron neutron capture therapy (BNCT) is radiotherapy in which a nuclear reaction between boron-10 (10B) in tumor cells and neutrons produces alpha particles and recoiling 7Li nuclei with an extremely short range, leading to the destruction of the tumor cells. Although the neutron source has traditionally been a nuclear reactor, accelerators to generate neutron beams have been developed and commercialized. Therefore, this treatment will become more widespread. Recurrent head and neck cancer (HNC) close to the body surface is considered a candidate for BNCT using the boron compound boronophenylalanine (BPA) and has been found to be highly responsive to this treatment. However, some cases recur early after the completion of the treatment, which needs to be addressed. Ultrasound is a highly safe diagnostic method. Ultrasound with microbubbles is expected to promote the uptake of BPA into tumor cells. Ultrasound also has the ability to improve the sensitivity of tumor cells to radiotherapy. In addition, high-intensity focused ultrasound may improve the efficacy of BNCT via its thermal and mechanical effects. This review is not systematic but outlines the current status of BPA-based BNCT and proposes plans to reduce the recurrence rate of HNC after BNCT in combination with ultrasound.
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Affiliation(s)
- Yoshiaki Yura
- Department of Oral & Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka 565-0871, Japan;
| | - Yusei Fujita
- Department of Oral and Maxillofacial Surgery, Rinku General Medical Center, Izumisano, Osaka 598-8577, Japan;
| | - Masakazu Hamada
- Department of Oral & Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka 565-0871, Japan;
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Shen S, Wang S, Zhou D, Wu X, Gao M, Wu J, Yang Y, Pan X, Wang N. A clinician's perspective on boron neutron capture therapy: promising advances, ongoing trials, and future outlook. Int J Radiat Biol 2024; 100:1126-1142. [PMID: 38986056 DOI: 10.1080/09553002.2024.2373746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/15/2024] [Accepted: 06/13/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE This comprehensive review aims to provide a unique clinical perspective on the latest advances and ongoing boron neutron capture therapy (BNCT) trials for various cancers. METHODS We critically analyzed clinical data from BNCT trials for head and neck cancer, glioblastoma, melanoma, meningioma, breast cancer, and liver tumors. We investigated differences in tumor responses and normal tissue toxicities among trials and discussed potential contributing factors. We also identified the limitations of early BNCT trials and proposed strategies to optimize future trial design. RESULTS BNCT has shown promising results in treating head and neck cancer, with high response rates and improved survival in patients with recurrent disease. In glioblastoma, BNCT combined with surgery and chemotherapy has demonstrated survival benefits compared to standard treatments. BNCT has also been successfully used for recurrent high-grade meningiomas and shows potential for melanomas, extramammary Paget's disease, and liver tumors. However, differences in tumor responses and toxicities were observed among trials, potentially attributable to variations in treatment protocols, patient characteristics, and evaluation methods. CONCLUSIONS BNCT is a promising targeted radiotherapy for various cancers. Further optimization and well-designed randomized controlled trials are needed to establish its efficacy and safety. Future studies should focus on standardizing treatment protocols and addressing limitations to guide clinical decision-making and research priorities.
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Affiliation(s)
- Shumin Shen
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Shanghu Wang
- Department of Radiotherapy, Anhui Chest Hospital, Hefei, China
| | - Dachen Zhou
- Department of General Surgery, The Second Hospital of Anhui Medical University, Hefei, China
| | - Xiuwei Wu
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Mingzhu Gao
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Jinjin Wu
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Yucai Yang
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Xiaoxi Pan
- Department of Nuclear Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Nianfei Wang
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
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Barth RF, Gupta N, Kawabata S. Evaluation of sodium borocaptate (BSH) and boronophenylalanine (BPA) as boron delivery agents for neutron capture therapy (NCT) of cancer: an update and a guide for the future clinical evaluation of new boron delivery agents for NCT. Cancer Commun (Lond) 2024. [PMID: 38973634 DOI: 10.1002/cac2.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/24/2024] [Accepted: 06/13/2024] [Indexed: 07/09/2024] Open
Abstract
Boron neutron capture therapy (BNCT) is a cancer treatment modality based on the nuclear capture and fission reactions that occur when boron-10, a stable isotope, is irradiated with neutrons of the appropriate energy to produce boron-11 in an unstable form, which undergoes instantaneous nuclear fission to produce high-energy, tumoricidal alpha particles. The primary purpose of this review is to provide an update on the first drug used clinically, sodium borocaptate (BSH), by the Japanese neurosurgeon Hiroshi Hatanaka to treat patients with brain tumors and the second drug, boronophenylalanine (BPA), which first was used clinically by the Japanese dermatologist Yutaka Mishima to treat patients with cutaneous melanomas. Subsequently, BPA has become the primary drug used as a boron delivery agent to treat patients with several types of cancers, specifically brain tumors and recurrent tumors of the head and neck region. The focus of this review will be on the initial studies that were carried out to define the pharmacokinetics and pharmacodynamics of BSH and BPA and their biodistribution in tumor and normal tissues following administration to patients with high-grade gliomas and their subsequent clinical use to treat patients with high-grade gliomas. First, we will summarize the studies that were carried out in Japan with BSH and subsequently at our own institution, The Ohio State University, and those of several other groups. Second, we will describe studies carried out in Japan with BPA and then in the United States that have led to its use as the primary drug that is being used clinically for BNCT. Third, although there have been intense efforts to develop new and better boron delivery agents for BNCT, none of these have yet been evaluated clinically. The present report will provide a guide to the future clinical evaluation of new boron delivery agents prior to their clinical use for BNCT.
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Affiliation(s)
- Rolf F Barth
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Nilendu Gupta
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA
| | - Shinji Kawabata
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
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4
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Takeno S, Yoshino Y, Aihara T, Higashino M, Kanai Y, Hu N, Kakino R, Kawata R, Nihei K, Ono K. Preliminary outcomes of boron neutron capture therapy for head and neck cancers as a treatment covered by public health insurance system in Japan: Real-world experiences over a 2-year period. Cancer Med 2024; 13:e7250. [PMID: 38826090 PMCID: PMC11145025 DOI: 10.1002/cam4.7250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/16/2024] [Accepted: 04/28/2024] [Indexed: 06/04/2024] Open
Abstract
PURPOSE Since June 2020, boron neutron capture therapy (BNCT) has been a health care service covered by health insurance in Japan to treat locally advanced or recurrent unresectable head and neck cancers. Therefore, we aimed to assess the clinical outcomes of BNCT as a health insurance treatment and explore its role among the standard treatment modalities for head and neck cancers. MATERIALS AND METHODS We retrospectively analyzed data from patients who were treated using BNCT at Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, between June 2020 and May 2022. We assessed objective response rates based on the Response Evaluation Criteria in Solid Tumors version 1.1, and adverse events based on the Common Terminology Criteria for Adverse Events, version 5.0. Additionally, we conducted a survival analysis and explored the factors that contributed to the treatment results. RESULTS Sixty-nine patients (72 treatments) were included in the study, with a median observation period of 15 months. The objective response rate was 80.5%, and the 1-year locoregional control, progression-free survival, and overall survival rates were 57.1% (95% confidence interval [CI]: 43.9%-68.3%), 42.2% (95% CI: 30.1%-53.8%), and 75.4% (95% CI: 62.5%-84.5%), respectively. Locoregional control was significantly longer in patients with earlier TNM staging and no history of chemotherapy. CONCLUSIONS BNCT may be an effective treatment option for locally advanced or recurrent unresectable head and neck cancers with no other definitive therapies. If definitive surgery or radiation therapy are not feasible, BNCT should be considered at early disease stages.
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Affiliation(s)
- Satoshi Takeno
- Department of Radiation OncologyOsaka Medical and Pharmaceutical UniversityOsakaJapan
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Yuki Yoshino
- Department of Radiation OncologyOsaka Medical and Pharmaceutical UniversityOsakaJapan
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Teruhito Aihara
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
- Department of Otorhinolaryngology – Head and Neck SurgeryOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Masaaki Higashino
- Department of Otorhinolaryngology – Head and Neck SurgeryOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Yasukazu Kanai
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
- BNCT Joint Clinical InstituteOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Naonori Hu
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
- Institute for Integrated Radiation and Nuclear ScienceKyoto UniversityOsakaJapan
| | - Ryo Kakino
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Ryo Kawata
- Department of Otorhinolaryngology – Head and Neck SurgeryOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Keiji Nihei
- Department of Radiation OncologyOsaka Medical and Pharmaceutical UniversityOsakaJapan
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Koji Ono
- Kansai BNCT Medical CenterOsaka Medical and Pharmaceutical UniversityOsakaJapan
- BNCT Joint Clinical InstituteOsaka Medical and Pharmaceutical UniversityOsakaJapan
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5
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Hirose K, Sato M. Clinical Results and Prognostic Factors in Boron Neutron Capture Therapy for Recurrent Squamous Cell Carcinoma of the Head and Neck Under the Japan National Health Insurance System: A Retrospective Study of the Initial 47 Patients. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00466-8. [PMID: 38580084 DOI: 10.1016/j.ijrobp.2024.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/13/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024]
Abstract
PURPOSE Recurrent head and neck cancer presents a therapeutic challenge because of cumulative toxicity from initial radiation therapy, limiting reirradiation options. Boron neutron capture therapy (BNCT) offers a promising alternative, selectively delivering a radical dose to tumors while sparing adjacent normal tissue. This study investigates the initial clinical outcomes and prognostic factors associated with BNCT for recurrent squamous cell carcinoma of the head and neck. METHODS AND MATERIALS This retrospective analysis investigated the initial 47 patients treated with BNCT between May 2020 and February 2021 in Japan. All patients had received radiation therapy with a median dose of 70 Gy (range, 44-176) before BNCT. Median tumor size was 11 cm3 (range, 1-117 cm3), with 23% of tumors larger than 30 cm3, and 87% of patients had prior systemic therapy. The most common prescribed dose to the pharyngeal mucosa was 15 Gy-Eq (36%), followed by 18 Gy-Eq (34%). The minimum dose given to tumor was 27.4 Gy-Eq (range, 13.3-45.2). In 23 patients, 18F-fluoro-borono-phenylalanine positron emission tomography was performed within 1 week before BNCT, and the tumor-to-blood 10B ratio was 3.5 (range, 2.0-8.7). RESULTS Efficacy analysis revealed a 51% complete response rate and a 74% overall response rate. Disease-free survival rates at 1 and 2 years were 34.6% and 26.6%, respectively. Overall survival rates at 1 and 2 years were 86.1% and 66.5%, respectively. Multivariate analysis revealed that, among the patient characteristics, whether the lesion was mucosal had a significant effect on achieving complete response. CONCLUSIONS This study provided valuable insights into the early integration of BNCT into routine clinical practice, highlighting its efficacy and safety. Technical improvements are needed to ensure precise dose administration. Ongoing prospective studies, such as the phase II REBIVAL study, will further elucidate the role of BNCT in recurrent head and neck cancer.
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Affiliation(s)
- Katsumi Hirose
- Department of Radiation Oncology, Southern Tohoku BNCT Research Center, Koriyama, Fukushima, Japan; Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
| | - Mariko Sato
- Department of Radiation Oncology, Southern Tohoku BNCT Research Center, Koriyama, Fukushima, Japan; Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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6
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Postuma I, Magni C, Marcaccio B, Fatemi S, Vercesi V, Ciocca M, Magro G, Orlandi E, Vischioni B, Ronchi S, Liu YH, Han Y, Geng C, González SJ, Bortolussi S. Using the photon isoeffective dose formalism to compare and combine BNCT and CIRT in a head and neck tumour. Sci Rep 2024; 14:418. [PMID: 38172585 PMCID: PMC10764928 DOI: 10.1038/s41598-023-50522-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Boron Neutron Capture Therapy (BNCT) is a radiotherapy technique based on the enrichment of tumour cells with suitable 10-boron concentration and on subsequent neutron irradiation. Low-energy neutron irradiation produces a localized deposition of radiation dose caused by boron neutron capture reactions. Boron is vehiculated into tumour cells via proper borated formulations, able to accumulate in the malignancy more than in normal tissues. The neutron capture releases two high-LET charged particles (i.e., an alpha particle and a lithium ion), losing their energy in a distance comparable to the average dimension of one cell. Thus BNCT is selective at the cell level and characterized by high biological effectiveness. As the radiation field is due to the interaction of neutrons with the components of biological tissues and with boron, the dosimetry requires a formalism to express the absorbed dose into photon-equivalent units. This work analyzes a clinical case of an adenoid cystic carcinoma treated with carbon-ion radiotherapy (CIRT), located close to optic nerve and deep-seated as a practical example of how to apply the formalism of BNCT photon isoeffective dose and how to evaluate the BNCT dose distribution against CIRT. The example allows presenting different dosimetrical and radiobiological quantities and drawing conclusions on the potential of BNCT stemming on the clinical result of the CIRT. The patient received CIRT with a dose constraint on the optic nerve, affecting the peripheral part of the Planning Target Volume (PTV). After the treatment, the tumour recurred in this low-dose region. BNCT was simulated for the primary tumour, with the goal to calculate the dose distribution in isoeffective units and a Tumour Control Probability (TCP) to be compared with the one of the original treatment. BNCT was then evaluated for the recurrence in the underdosed region which was not optimally covered by charged particles due to the proximity of the optic nerve. Finally, a combined treatment consisting in BNCT and carbon ion therapy was considered to show the consistency and the potential of the model. For the primary tumour, the photon isoeffective dose distribution due to BNCT was evaluated and the resulted TCP was higher than that obtained for the CIRT. The formalism produced values that are consistent with those of carbon-ion. For the recurrence, BNCT dosimetry produces a similar TCP than that of primary tumour. A combined treatment was finally simulated, showing a TCP comparable to the BNCT-alone with overall dosimetric advantage in the most peripheral parts of the treatment volume. Isoeffective dose formalism is a robust tool to analyze BNCT dosimetry and to compare it with the photon-equivalent dose calculated for carbon-ion treatment. This study introduces for the first time the possibility to combine the dosimetry obtained by two different treatment modalities, showing the potential of exploiting the cellular targeting of BNCT combined with the precision of charged particles in delivering an homogeneous dose distribution in deep-seated tumours.
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Affiliation(s)
- Ian Postuma
- National Institute of Nuclear Physics, INFN, Unit of Pavia, Pavia, 27100, Italy
| | - Chiara Magni
- National Institute of Nuclear Physics, INFN, Unit of Pavia, Pavia, 27100, Italy
- Department of Physics, University of Pavia, Pavia, 27100, Italy
| | - Barbara Marcaccio
- National Institute of Nuclear Physics, INFN, Unit of Pavia, Pavia, 27100, Italy
- Department of Physics, University of Pavia, Pavia, 27100, Italy
- National University of San Martín, Dan Beninson Institute, Buenos Aires, Argentina
| | - Setareh Fatemi
- National Institute of Nuclear Physics, INFN, Unit of Pavia, Pavia, 27100, Italy
| | - Valerio Vercesi
- National Institute of Nuclear Physics, INFN, Unit of Pavia, Pavia, 27100, Italy
| | - Mario Ciocca
- National Institute of Nuclear Physics, INFN, Unit of Pavia, Pavia, 27100, Italy
- National Centre for Oncological Hadrontherapy, CNAO, Pavia, 27100, Italy
| | - Giuseppe Magro
- National Centre for Oncological Hadrontherapy, CNAO, Pavia, 27100, Italy
| | - Ester Orlandi
- National Centre for Oncological Hadrontherapy, CNAO, Pavia, 27100, Italy
| | - Barbara Vischioni
- National Centre for Oncological Hadrontherapy, CNAO, Pavia, 27100, Italy
| | - Sara Ronchi
- National Centre for Oncological Hadrontherapy, CNAO, Pavia, 27100, Italy
| | - Yuan-Hao Liu
- Neuboron Medtech Ltd, Nanjing, China
- Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, NUAA, Nanjing, China
| | - Yang Han
- Department of Physics, University of Pavia, Pavia, 27100, Italy
- Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, NUAA, Nanjing, China
| | - Changran Geng
- Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, NUAA, Nanjing, China
| | - Sara Josefina González
- National University of San Martín, Dan Beninson Institute, Buenos Aires, Argentina
- National Atomic Energy Commission, CNEA, Buenos Aires, Argentina
- National Scientific and Technical Research Council, CONICET, Buenos Aires, Argentina
| | - Silva Bortolussi
- National Institute of Nuclear Physics, INFN, Unit of Pavia, Pavia, 27100, Italy.
- Department of Physics, University of Pavia, Pavia, 27100, Italy.
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Kashihara T, Mori T, Nakaichi T, Nakamura S, Ito K, Kurihara H, Kusumoto M, Itami J, Yoshimoto S, Igaki H. Correlation between L-amino acid transporter 1 expression and 4-borono-2- 18 F-fluoro-phenylalanine accumulation in humans. Cancer Med 2023; 12:20564-20572. [PMID: 37881128 PMCID: PMC10660410 DOI: 10.1002/cam4.6635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/04/2023] [Accepted: 09/30/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND The correlation between L-type amino acid transporter 1 (LAT1) expression and 4-borono-2-18 F-fluoro-phenylalanine (18 F-FBPA) accumulation in humans remains unclear. This study aimed to investigate the correlation between LAT1 expression in tumor tissues and 18 F-FBPA accumulation in patients with head and neck cancer who participated in a clinical trial of 18 F-FBPA positron emission tomography (PET). METHODS Altogether, 28 patients with head and neck cancer who participated in a clinical trial of 18 F-FBPA PET at our institution between March 2012 and January 2018 were included. Correlations between standardized uptake values (SUVs); the maximum SUV (SUVmax ), the mean SUV within a 1 cm3 sphere centered at a single point, that is, the SUVmax (SUVpeak ), the minimum SUV (SUVmin ), and the intensity of LAT1 expression (maximum and minimum LAT1 expressions) were investigated. RESULTS Weak correlations were identified between SUVmax and LAT1 maximum score, SUVmin and LAT1 maximum score, and SUVmin and LAT1 minimum score (ρ = 0.427, 0.362, and 0.330, respectively). SUVmax and LAT1 minimum score, SUVpeak and LAT1 maximum score, and SUVpeak and LAT1 minimum score demonstrated moderate correlations (ρ = 0.535, 0.556, and 0.661, respectively). Boron neutron capture therapy (BNCT) was performed in 2 of the 4 patients with discrepancies between 18 F-FBPA accumulation and intensity of LAT1 expression, and the intensity of LAT1 expression was a better predictor of treatment response. CONCLUSION 18 F-FBPA accumulation and the intensity of LAT1 expression demonstrated a moderate correlation; however, LAT1 expression may be a better predictor of treatment response of BNCT in patients with discrepancies.
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Affiliation(s)
- Tairo Kashihara
- Department of Radiation OncologyNational Cancer Center HospitalTokyoJapan
- Division of Research and Development for Boron Neutron Capture TherapyNational Cancer Center Exploratory Oncology Research & Clinical Trial CenterTokyoJapan
| | - Taisuke Mori
- Department of Pathology and Clinical LaboratoriesNational Cancer Center HospitalTokyoJapan
| | - Tetsu Nakaichi
- Division of Research and Development for Boron Neutron Capture TherapyNational Cancer Center Exploratory Oncology Research & Clinical Trial CenterTokyoJapan
- Department of Medical PhysicsNational Cancer Center HospitalTokyoJapan
| | - Satoshi Nakamura
- Division of Research and Development for Boron Neutron Capture TherapyNational Cancer Center Exploratory Oncology Research & Clinical Trial CenterTokyoJapan
- Department of Medical PhysicsNational Cancer Center HospitalTokyoJapan
| | - Kimiteru Ito
- Department of Diagnostic RadiologyNational Cancer Center HospitalTokyoJapan
| | - Hiroaki Kurihara
- Department of Diagnostic RadiologyNational Cancer Center HospitalTokyoJapan
- Department of Diagnostic and Interventional RadiologyKanagawa Cancer CenterYokohamaJapan
| | - Masahiko Kusumoto
- Department of Diagnostic RadiologyNational Cancer Center HospitalTokyoJapan
| | - Jun Itami
- Department of Radiation OncologyNational Cancer Center HospitalTokyoJapan
- Shin‐Matsudo Accuracy Radiation Therapy CenterShin‐Matsudo Central General HospitalChibaJapan
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgical OncologyNational Cancer Center HospitalTokyoJapan
| | - Hiroshi Igaki
- Department of Radiation OncologyNational Cancer Center HospitalTokyoJapan
- Division of Research and Development for Boron Neutron Capture TherapyNational Cancer Center Exploratory Oncology Research & Clinical Trial CenterTokyoJapan
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Chang CH, Chen CJ, Yu CF, Tsai HY, Chen FH, Chiang CS. Targeting M-MDSCs enhances the therapeutic effect of BNCT in the 4-NQO-induced murine head and neck squamous cell carcinoma model. Front Oncol 2023; 13:1263873. [PMID: 37886177 PMCID: PMC10598372 DOI: 10.3389/fonc.2023.1263873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023] Open
Abstract
Purpose Malignant head and neck squamous cell carcinoma (HNSCC) is characterized by a poor prognosis and resistance to conventional radiotherapy. Infiltrating myeloid-derived suppressive cells (MDSCs) is prominent in HNSCC and is linked to immune suppression and tumor aggressiveness. This study aimed to investigate the impact of boron neutron capture therapy (BNCT) on the MDSCs in the tumor microenvironment and peripheral blood and to explore the potential for MDSCs depletion combined with BNCT to reactivate antitumor immunity. Methods and materials Carcinogen, 4-NQO, -induced oral tumors were irradiated with a total physical dose of 2 Gy BNCT in Tsing Hua Open Reactor (THOR). Flow cytometry and immunohistochemistry accessed the dynamics of peripheral MDSCs and infiltrated MDSCs within the tumor microenvironment. Mice were injected with an inhibitor of CSF-1 receptor (CSF-1R), PLX3397, to determine whether modulating M-MDSCs could affect mice survival after BNCT. Results Peripheral CD11b+Ly6ChighLy6G- monocytic-MDSCs (M-MDSCs), but not CD11b+Ly6CloLy6Ghigh polymorphonuclear-MDSCs (PMN-MDSCs), increased as tumor progression. After BNCT treatment, there were temporarily decreased and persistent increases of M-MDSCs thereafter, either in peripheral blood or in tumors. The administration of PLX-3397 hindered BNCT-caused M-MDSCs infiltration, prolonged mice survival, and activated tumor immunity by decreasing tumor-associated macrophages (TAMs) and increasing CD8+ T cells. Conclusion M-MDSCs were recruited into 4-NQO-induced tumors after BNCT, and their number was also increased in peripheral blood. Assessment of M-MDSCs levels in peripheral blood could be an index to determine the optimal intervention window. Their temporal alteration suggests an association with tumor recurrence after BNCT, making M-MDSCs a potential intervention target. Our preliminary results showed that PLX-3397 had strong M-MDSCs, TAMs, and TIL (tumor-infiltrating lymphocyte) modulating effects that could synergize tumor control when combined with BNCT.
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Affiliation(s)
- Chun-Hsiang Chang
- Department of Biomedical Engineering and Environment Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Chi-Jui Chen
- Department of Biomedical Engineering and Environment Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Ching-Fang Yu
- Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Hui-Yu Tsai
- Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Fang-Hsin Chen
- Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Chi-Shiun Chiang
- Department of Biomedical Engineering and Environment Sciences, National Tsing Hua University, Hsinchu, Taiwan
- Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan
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9
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Zhang X, Lin Y, Hosmane NS, Zhu Y. Nanostructured boron agents for boron neutron capture therapy: a review of recent patents. MEDICAL REVIEW (2021) 2023; 3:425-443. [PMID: 38283251 PMCID: PMC10811353 DOI: 10.1515/mr-2023-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/16/2023] [Indexed: 01/30/2024]
Abstract
Boron neutron capture therapy (BNCT) is a potential radiation therapy modality for cancer, and tumor-targeted stable boron-10 (10B) delivery agents are an important component of BNCT. Currently, two low-molecular-weight boron-containing compounds, sodium mercaptoundecahydro-closo-dodecaborate (BSH) and boronophenylalanine (BPA), are mainly used in BNCT. Although both have suboptimal tumor selectivity, they have shown some therapeutic benefit in patients with high-grade glioma and several other tumors. To improve the efficacy of BNCT, great efforts have been devoted for the development of new boron delivery agents with better uptake and favorable pharmacokinetic profiles. This article reviews the application and research progress of boron nanomaterials as boron carriers in boron neutron capture therapy and hopes to stimulate people's interest in nanomaterial-based delivery agents by summarizing various kinds of boron nanomaterial patents disclosed in the past decade.
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Affiliation(s)
- Xiyin Zhang
- Shenzhen HEC Industrial Development Co., Ltd., Shenzhen, Guangdong Province, China
| | - Yusheng Lin
- Shenzhen HEC Industrial Development Co., Ltd., Shenzhen, Guangdong Province, China
| | - Narayan S. Hosmane
- Department of Chemistry and Biochemistry, Northern Illinois University, DeKalb, IL, USA
| | - Yinghuai Zhu
- Sunshine Lake Pharma Co. Ltd, Dongguan, Guangdong Province, China
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10
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Gordon K, Smyk D, Gulidov I, Golubev K, Fatkhudinov T. An Overview of Head and Neck Tumor Reirradiation: What Has Been Achieved So Far? Cancers (Basel) 2023; 15:4409. [PMID: 37686685 PMCID: PMC10486419 DOI: 10.3390/cancers15174409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
The recurrence rate of head and neck cancers (HNCs) after initial treatment may reach 70%, and poor prognosis is reported in most cases. Curative options for recurrent HNCs mainly depend on the treatment history and the recurrent tumor localization. Reirradiation for HNCs is effective and has been included in most guidelines. However, the option remains clinically challenging due to high incidence of severe toxicity, especially in cases of quick infield recurrence. Recent technical advances in radiation therapy (RT) provide the means for upgrade in reirradiation protocols. While the majority of hospitals stay focused on conventional and widely accessible modulated RTs, the particle therapy options emerge as tolerable and providing further treatment opportunities for recurrent HNCs. Still, the progress is impeded by high heterogeneity of the data and the lack of large-scale prospective studies. This review aimed to summarize the outcomes of reirradiation for HNCs in the clinical perspective.
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Affiliation(s)
- Konstantin Gordon
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
- Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklaya Street 8, 117198 Moscow, Russia;
| | - Daniil Smyk
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
- Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklaya Street 8, 117198 Moscow, Russia;
| | - Igor Gulidov
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
| | - Kirill Golubev
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
| | - Timur Fatkhudinov
- Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklaya Street 8, 117198 Moscow, Russia;
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11
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Monti Hughes A, Hu N. Optimizing Boron Neutron Capture Therapy (BNCT) to Treat Cancer: An Updated Review on the Latest Developments on Boron Compounds and Strategies. Cancers (Basel) 2023; 15:4091. [PMID: 37627119 PMCID: PMC10452654 DOI: 10.3390/cancers15164091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Boron neutron capture therapy (BNCT) is a tumor-selective particle radiotherapy. It combines preferential boron accumulation in tumors and neutron irradiation. The recent initiation of BNCT clinical trials employing hospital-based accelerators rather than nuclear reactors as the neutron source will conceivably pave the way for new and more numerous clinical trials, leading up to much-needed randomized trials. In this context, it would be interesting to consider the implementation of new boron compounds and strategies that will significantly optimize BNCT. With this aim in mind, we analyzed, in this review, those articles published between 2020 and 2023 reporting new boron compounds and strategies that were proved therapeutically useful in in vitro and/or in vivo radiobiological studies, a critical step for translation to a clinical setting. We also explored new pathologies that could potentially be treated with BNCT and newly developed theranostic boron agents. All these radiobiological advances intend to solve those limitations and questions that arise during patient treatment in the clinical field, with BNCT and other therapies. In this sense, active communication between clinicians, radiobiologists, and all disciplines will improve BNCT for cancer patients, in a cost- and time-effective way.
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Affiliation(s)
- Andrea Monti Hughes
- Radiation Pathology Division, Department Radiobiology, National Atomic Energy Commission, San Martín, Buenos Aires B1650KNA, Argentina
- National Scientific and Technical Research Council, Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
| | - Naonori Hu
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan;
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Osaka 590-0494, Japan
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12
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Leyva JA, Munévar E. Current status and development of neutron radiation for biophysical applications in Colombia. Biophys Rev 2023; 15:531-538. [PMID: 37681110 PMCID: PMC10480130 DOI: 10.1007/s12551-023-01079-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/13/2023] [Indexed: 09/09/2023] Open
Abstract
In Colombia, medical physics started formally about 3 decades ago. Two master's programs in medical physics initiated activities at two different universities. In particular, the master's program at the Pontificia Universidad Javeriana has been underway since 2012, and taking into account its projections, a team was established in 2015 in collaboration with the Universidad Distrital Francisco José de Caldas to conduct basic research on cancer treatment using neutron capture therapy (NCT). The primary goal of our initiative is to create the infrastructure required to adapt new technologies in our universities in the future. The long-term objective is to use neutron radiation to study not only NCT but also biomolecules, membranes, and materials. This will require the commissioning of an actual nuclear facility. Our group has been exclusively focused on carrying out calculations with GEANT4 because of its characteristics as open-source software, its accessibility, and its ample worldwide use and validation in the particle physics, nuclear physics, and medical physics communities. In this work, we present some results of our preliminary design for the ion accelerator column of a compact neutron generator. Also, we present the characterization of the kinematical and dose distributions of boron neutron capture processes using Geant4.
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Affiliation(s)
- J. Alfonso Leyva
- Departamento de Física, Pontificia Universidad Javeriana, Cra. 7 No 40-62, Bogotá, 110231 Cundinamarca Colombia
| | - Edwin Munévar
- Proyecto Curricular de Licenciatura en Física, Universidad Distrital Francisco José de Caldas, Cra. 3 No 26A-40, Bogotá, 110311 Cundinamarca Colombia
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13
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Al-Bader AR, Agapito J, Pan M. Perceptions of Canadian Radiation Oncologists, Medical Physicists, and Radiation Trainees about the Feasibility and Need of Boron Neutron Capture Therapy (BNCT) in Canada: A National Survey. Cancers (Basel) 2023; 15:3626. [PMID: 37509287 PMCID: PMC10377324 DOI: 10.3390/cancers15143626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Boron Neutron Capture Therapy (BNCT) is an emerging radiotherapy. There are ongoing efforts to develop a Canadian accelerator-based BNCT center. However, it remains unclear how Canadian radiation oncologists (RO), medical physicists (MP), and their trainees perceive BNCT and its impact on radiation oncology as a discipline. METHODS A survey was created to explore the knowledge of BNCT, its clinical role, and the support for Canadian research. It was distributed through the Canadian Association of Radiation Oncology (CARO) and the Canadian Organization of Medical Physicists (COMP). RESULTS We received 118 valid responses from all 10 provinces, from 70 RO (59.3%) and 48 MP (40.7%), including 9 residents. Most knew of BNCT and its indications (60.2%). Although many were unaware of the reasons behind early failures (44.1%), common reasons were a lack of clinical trials and an inaccessibility of neutron sources (42.4%) as well as reactor unsuitability (34.7%). Additionally, 90.6% showed definite (66.9%) or possible (23.7%) support for Canadian BNCT research, while 89% indicated a definite (56.8%) or possible (32.2%) willingness for BNCT referrals. CONCLUSIONS Most ROs and MPs supported Canadian BNCT research and would refer patients. However, limited awareness and a lack of experiences remain a challenge. Educational sessions are needed to realize this innovative cancer treatment in Canada.
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Affiliation(s)
- Al-Retage Al-Bader
- Schulich School of Medicine and Dentistry, University of Western Ontario, Windsor, ON N9B 2Y9, Canada
| | - John Agapito
- Windsor Regional Hospital, 1995 Lens Ave, Windsor, ON N8W 1L9, Canada
- Department of Physics, University of Windsor, Windsor, ON N9B 3P4, Canada
| | - Ming Pan
- Schulich School of Medicine and Dentistry, University of Western Ontario, Windsor, ON N9B 2Y9, Canada
- Windsor Regional Hospital, 1995 Lens Ave, Windsor, ON N8W 1L9, Canada
- Department of Physics, University of Windsor, Windsor, ON N9B 3P4, Canada
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14
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Oloo SO, Smith KM, Vicente MDGH. Multi-Functional Boron-Delivery Agents for Boron Neutron Capture Therapy of Cancers. Cancers (Basel) 2023; 15:3277. [PMID: 37444386 DOI: 10.3390/cancers15133277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/03/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Boron neutron capture therapy (BNCT) is a binary cancer treatment that involves the irradiation of 10B-containing tumors with low-energy neutrons (thermal or epithermal). The alpha particles and recoiling Li nuclei that are produced in the 10B-capture nuclear reaction are high-linear-energy transfer particles that destroy boron-loaded tumor cells; therefore, BNCT has the potential to be a localized therapeutic modality. Two boron-delivery agents have been used in clinical trials of BNCT in patients with malignant brain tumors, cutaneous melanoma, or recurrent tumors of the head and neck region, demonstrating the potential of BNCT in the treatment of difficult cancers. A variety of potentially highly effective boron-delivery agents have been synthesized in the past four decades and tested in cells and animal models. These include boron-containing nucleosides, peptides, proteins, polyamines, porphyrins, liposomes, monoclonal antibodies, and nanoparticles of various types. The most promising agents are multi-functional boronated molecules and nanoparticles functionalized with tumor cell-targeting moieties that increase their tumor selectivity and contain a radiolabel or fluorophore to allow quantification of 10B-biodistribution and treatment planning. This review discusses multi-functional boron agents reported in the last decade, but their full potential can only be ascertained after their evaluation in BNCT clinical trials.
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Affiliation(s)
- Sebastian O Oloo
- Department of Chemistry, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Kevin M Smith
- Department of Chemistry, Louisiana State University, Baton Rouge, LA 70803, USA
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15
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Wang LW, Liu YWH, Chu PY, Liu HM, Peir JJ, Lin KH, Huang WS, Lo WL, Lee JC, Lin TY, Liu YM, Yen SH. Boron Neutron Capture Therapy Followed by Image-Guided Intensity-Modulated Radiotherapy for Locally Recurrent Head and Neck Cancer: A Prospective Phase I/II Trial. Cancers (Basel) 2023; 15:2762. [PMID: 37345099 DOI: 10.3390/cancers15102762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND This trial investigated the efficacy and safety of salvage boron neutron capture therapy (BNCT) combined with image-guided intensity-modulated radiotherapy (IG-IMRT) for recurrent head and neck cancer after prior radiotherapy (RT). METHODS BNCT was administered using an intravenous boronophenylalanine-fructose complex (500 mg/kg) in a single fraction; multifractionated IG-IMRT was administered 28 days after BNCT. For BNCT, the mucosa served as the dose-limiting organ. For IG-IMRT, the clinical target volume (CTV) and the planning target volume (PTV) were generated according to the post-BNCT gross tumor volume (GTV) with chosen margins. RESULTS This trial enrolled 14 patients, and 12 patients received combined treatment. The median BNCT average dose for the GTV was 21.6 Gy-Eq, and the median IG-IMRT dose for the PTV was 46.8 Gy/26 fractions. After a median (range) follow-up period of 11.8 (3.6 to 53.2) months, five patients had a complete response and four had a partial response. One patient had grade 4 laryngeal edema; another patient had a grade 4 hemorrhage. Most tumor progression occurred within or adjacent to the CTV. The 1-year overall survival and local progression-free survival rates were 56% and 21%, respectively. CONCLUSION Despite the high response rate (64%) of this trial, there was a high incidence of in-field and marginal failure with this approach. Future studies combining BNCT with modalities other than radiation may be tried.
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Affiliation(s)
- Ling-Wei Wang
- Department of Heavy Ion and Radiation Oncology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
- School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Section 2, Li-Nong Street, Taipei 112304, Taiwan
| | - Yen-Wan Hsueh Liu
- Heron Neutron Medical Corporation, No. 66-2, Shengyi 5th Road, Zhubei City 30261, Taiwan
| | - Pen-Yuan Chu
- School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Section 2, Li-Nong Street, Taipei 112304, Taiwan
- Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
| | - Hong-Ming Liu
- Nuclear Science and Technology Development Center, National Tsing Hua University, No. 101, Sect 2, Kuang Fu Road, Hsinchu 30013, Taiwan
| | - Jinn-Jer Peir
- Nuclear Science and Technology Development Center, National Tsing Hua University, No. 101, Sect 2, Kuang Fu Road, Hsinchu 30013, Taiwan
| | - Ko-Han Lin
- School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Section 2, Li-Nong Street, Taipei 112304, Taiwan
- Department of Nuclear Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
| | - Wen-Sheng Huang
- Department of Nuclear Medicine, Cheng Hsin General Hospital, No. 45, Cheng Hsin Street, Taipei 11220, Taiwan
| | - Wen-Liang Lo
- Department of Stomatology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
- School of Dentistry, National Yang-Ming Chiao Tung University, No. 155, Section 2, Li-Nong Street, Taipei 112304, Taiwan
| | - Jia-Cheng Lee
- Department of Heavy Ion and Radiation Oncology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
| | - Tzung-Yi Lin
- Heron Neutron Medical Corporation, No. 66-2, Shengyi 5th Road, Zhubei City 30261, Taiwan
| | - Yu-Ming Liu
- Department of Heavy Ion and Radiation Oncology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
- School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Section 2, Li-Nong Street, Taipei 112304, Taiwan
| | - Sang-Hue Yen
- Division of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, No. 111, Section 3, Shing-Long Road, Taipei 116, Taiwan
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16
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Olaiz N, Monti Hughes A, Pozzi ECC, Thorp S, Curotto P, Trivillin VA, Ramos PS, Palmieri MA, Marshall G, Schwint AE, Garabalino MA. Enhancement in the Therapeutic Efficacy of In Vivo BNCT Mediated by GB-10 with Electroporation in a Model of Oral Cancer. Cells 2023; 12:cells12091241. [PMID: 37174642 PMCID: PMC10177359 DOI: 10.3390/cells12091241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Boron neutron capture therapy (BNCT) combines preferential tumor uptake of 10B compounds and neutron irradiation. Electroporation induces an increase in the permeability of the cell membrane. We previously demonstrated the optimization of boron biodistribution and microdistribution employing electroporation (EP) and decahydrodecaborate (GB-10) as the boron carrier in a hamster cheek pouch oral cancer model. The aim of the present study was to evaluate if EP could improve tumor control without enhancing the radiotoxicity of BNCT in vivo mediated by GB-10 with EP 10 min after GB-10 administration. Following cancerization, tumor-bearing hamster cheek pouches were treated with GB-10/BNCT or GB-10/BNCT + EP. Irradiations were carried out at the RA-3 Reactor. The tumor response and degree of mucositis in precancerous tissue surrounding tumors were evaluated for one month post-BNCT. The overall tumor response (partial remission (PR) + complete remission (CR)) increased significantly for protocol GB-10/BNCT + EP (92%) vs. GB-10/BNCT (48%). A statistically significant increase in the CR was observed for protocol GB-10/BNCT + EP (46%) vs. GB-10/BNCT (6%). For both protocols, the radiotoxicity (mucositis) was reversible and slight/moderate. Based on these results, we concluded that electroporation improved the therapeutic efficacy of GB-10/BNCT in vivo in the hamster cheek pouch oral cancer model without increasing the radiotoxicity.
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Affiliation(s)
- Nahuel Olaiz
- Departamento de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires (UBA), Pabellón I, Ciudad Universitaria, Buenos Aires C1428EHA, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2270, Buenos Aires C1425FQD, Argentina
| | - Andrea Monti Hughes
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2270, Buenos Aires C1425FQD, Argentina
- Departamento Radiobiología, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Constituyentes (CAC), Av. General Paz 1499, San Martín, Buenos Aires B1650KNA, Argentina
| | - Emiliano C C Pozzi
- Departamento de Reactores de Investigación y Producción, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Ezeiza (CAE), Camino Real Presbítero González y Aragón 15, Buenos Aires B1802AYA, Argentina
| | - Silvia Thorp
- Sub-Gerencia Instrumentación y Control, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Ezeiza (CAE), Camino Real Presbítero González y Aragón 15, Buenos Aires B1802AYA, Argentina
| | - Paula Curotto
- Departamento de Reactores de Investigación y Producción, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Ezeiza (CAE), Camino Real Presbítero González y Aragón 15, Buenos Aires B1802AYA, Argentina
| | - Verónica A Trivillin
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2270, Buenos Aires C1425FQD, Argentina
- Departamento Radiobiología, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Constituyentes (CAC), Av. General Paz 1499, San Martín, Buenos Aires B1650KNA, Argentina
| | - Paula S Ramos
- Departamento Radiobiología, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Constituyentes (CAC), Av. General Paz 1499, San Martín, Buenos Aires B1650KNA, Argentina
| | - Mónica A Palmieri
- Departamento de Biodiversidad y Biología Experimental, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires (UBA), Pabellón II, Ciudad Universitaria, Buenos Aires C1428EHA, Argentina
| | - Guillermo Marshall
- Departamento de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires (UBA), Pabellón I, Ciudad Universitaria, Buenos Aires C1428EHA, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2270, Buenos Aires C1425FQD, Argentina
| | - Amanda E Schwint
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2270, Buenos Aires C1425FQD, Argentina
- Departamento Radiobiología, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Constituyentes (CAC), Av. General Paz 1499, San Martín, Buenos Aires B1650KNA, Argentina
| | - Marcela A Garabalino
- Departamento Radiobiología, Comisión Nacional de Energía Atómica (CNEA), Centro Atómico Constituyentes (CAC), Av. General Paz 1499, San Martín, Buenos Aires B1650KNA, Argentina
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Kanygin V, Zaboronok A, Kichigin A, Petrova E, Guselnikova T, Kozlov A, Lukichev D, Mathis BJ, Taskaev S. Gadolinium Neutron Capture Therapy for Cats and Dogs with Spontaneous Tumors Using Gd-DTPA. Vet Sci 2023; 10:vetsci10040274. [PMID: 37104429 PMCID: PMC10142813 DOI: 10.3390/vetsci10040274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023] Open
Abstract
We conducted a clinical veterinary study on neutron capture therapy (NCT) at a neutron-producing accelerator with seven incurable pets with spontaneous tumors and gadolinium as a neutron capture agent (gadolinium neutron capture therapy, or GdNCT). Gadolinium-containing dimeglumine gadopentetate, or Gd-DTPA (Magnevist®, 0.6 mL/kg b.w.), was used. We observed mild and reversible toxicity related to the treatment. However, no significant tumor regression in response to the treatment was observed. In most cases, there was continued tumor growth. Overall clinical improvement after treatment was only temporary. The use of Gd-DTPA for NCT had no significant effects on the life expectancy and quality of life of animals with spontaneous tumors. Further experiments using more advanced gadolinium compounds are needed to improve the effect of GdNCT so that it can become an alternative to boron neutron capture therapy. Such studies are also necessary for further NCT implementation in clinical practice as well as in veterinary medicine.
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Affiliation(s)
- Vladimir Kanygin
- Budker Institute of Nuclear Physics, Siberian Branch of Russian Academy of Sciences, ave. Lavrentiev, 11, 630090 Novosibirsk, Russia
- Laboratory of Nuclear and Innovative Medicine, Department of Physics, Novosibirsk State University, Pirogov str., 1, 630090 Novosibirsk, Russia
| | - Alexander Zaboronok
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba 305-8575, Ibaraki, Japan
| | - Aleksandr Kichigin
- Budker Institute of Nuclear Physics, Siberian Branch of Russian Academy of Sciences, ave. Lavrentiev, 11, 630090 Novosibirsk, Russia
- Laboratory of Nuclear and Innovative Medicine, Department of Physics, Novosibirsk State University, Pirogov str., 1, 630090 Novosibirsk, Russia
| | - Elena Petrova
- Veterinary Clinic “Best”, Frunze str., 57, 630005 Novosibirsk, Russia
| | - Tatyana Guselnikova
- Laboratory of Nuclear and Innovative Medicine, Department of Physics, Novosibirsk State University, Pirogov str., 1, 630090 Novosibirsk, Russia
- Nikolaev Institute of Inorganic Chemistry, Siberian Branch of Russian Academy of Sciences, ave. Lavrentiev, 3, 630090 Novosibirsk, Russia
| | - Andrey Kozlov
- Clinical Hospital “Avicenna”, Uritskogo str., 2, 630007 Novosibirsk, Russia
| | - Dmitriy Lukichev
- Laboratory of Nuclear and Innovative Medicine, Department of Physics, Novosibirsk State University, Pirogov str., 1, 630090 Novosibirsk, Russia
| | - Bryan J. Mathis
- International Medical Center, University of Tsukuba Hospital, Amakubo 2-1-1, Tsukuba 305-8576, Ibaraki, Japan
| | - Sergey Taskaev
- Budker Institute of Nuclear Physics, Siberian Branch of Russian Academy of Sciences, ave. Lavrentiev, 11, 630090 Novosibirsk, Russia
- Laboratory of Nuclear and Innovative Medicine, Department of Physics, Novosibirsk State University, Pirogov str., 1, 630090 Novosibirsk, Russia
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18
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Wittig A, Sauerwein WAG. Strategic Clinical Trial Design for Boron Neutron Capture Therapy. Cancer Biother Radiopharm 2023; 38:195-200. [PMID: 37023401 DOI: 10.1089/cbr.2022.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Boron neutron capture therapy (BNCT) involves infusion of cancer patients with a tumor-seeking, boron-loaded compound and irradiation by a beam of neutrons, with an energy range of 1 eV-10 keV. Neutron capture in the 10B atoms results in an effective lethal radiation dose to the tumor cells, while sparing the healthy tissue. Recently available accelerator-based irradiation facilities facilitate developing BNCT to a treatment modality. However, the binary principle of BNCT, together with other points, is challenging in designing clinical trials that allow a timely and safe introduction of this innovative targeted modality into clinical practice. We propose a methodological framework to work toward a systematic, coordinated, and internationally accepted and evidence-based approach.
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Affiliation(s)
- Andrea Wittig
- Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Wolfgang A G Sauerwein
- Deutsche Gesellschaft für Bor-Neutroneneinfangtherapie (DGBNCT), Essen, Germany
- BNCT Global GmbH, Essen, Germany
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19
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Terada S, Tsunetoh S, Tanaka Y, Tanaka T, Kashiwagi H, Takata T, Kawabata S, Suzuki M, Ohmichi M. Boron uptake of boronophenylalanine and the effect of boron neutron capture therapy in cervical cancer cells. Appl Radiat Isot 2023; 197:110792. [PMID: 37062147 DOI: 10.1016/j.apradiso.2023.110792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 06/13/2022] [Accepted: 03/26/2023] [Indexed: 04/05/2023]
Abstract
There are few studies about boron neutron capture therapy (BNCT) for cervical cancer. The present study evaluated the biodistribution of boronophenylalanine (BPA) and the effect of BNCT on cervical cancer cell lines. BPA exposure and neutron irradiation of cervical cancer cell lines resulted in decreased survival fraction compared to irradiation only. In vivo cervical cancer tumor boron concentration was highest at 2.5 h after BPA intraperitoneal administration, and higher than in the other organs. BNCT may be effective against cervical carcinoma.
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20
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Mechetin GV, Zharkov DO. DNA Damage Response and Repair in Boron Neutron Capture Therapy. Genes (Basel) 2023; 14:127. [PMID: 36672868 PMCID: PMC9859301 DOI: 10.3390/genes14010127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Boron neutron capture therapy (BNCT) is an approach to the radiotherapy of solid tumors that was first outlined in the 1930s but has attracted considerable attention recently with the advent of a new generation of neutron sources. In BNCT, tumor cells accumulate 10B atoms that react with epithermal neutrons, producing energetic α particles and 7Li atoms that damage the cell's genome. The damage inflicted by BNCT appears not to be easily repairable and is thus lethal for the cell; however, the molecular events underlying the action of BNCT remain largely unaddressed. In this review, the chemistry of DNA damage during BNCT is outlined, the major mechanisms of DNA break sensing and repair are summarized, and the specifics of the repair of BNCT-induced DNA lesions are discussed.
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Affiliation(s)
- Grigory V. Mechetin
- Department of Natural Sciences, Novosibirsk State University, 2 Pirogova St., 630090 Novosibirsk, Russia
- Siberian Branch of the Russian Academy of Sciences Institute of Chemical Biology and Fundamental Medicine, 8 Lavrentieva Ave., 630090 Novosibirsk, Russia
| | - Dmitry O. Zharkov
- Department of Natural Sciences, Novosibirsk State University, 2 Pirogova St., 630090 Novosibirsk, Russia
- Siberian Branch of the Russian Academy of Sciences Institute of Chemical Biology and Fundamental Medicine, 8 Lavrentieva Ave., 630090 Novosibirsk, Russia
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21
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Matsubayashi N, Hu N, Takata T, Sasaki A, Mukawa T, Suga K, Sakurai Y, Tanaka H. Characteristics of optically stimulated luminescent dosimeter of beryllium oxide in BNCT irradiation field. RADIAT MEAS 2023. [DOI: 10.1016/j.radmeas.2023.106900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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22
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Porra L, Wendland L, Seppälä T, Koivunoro H, Revitzer H, Tervonen J, Kankaanranta L, Anttonen A, Tenhunen M, Joensuu H. From Nuclear Reactor-Based to Proton Accelerator-Based Therapy: The Finnish Boron Neutron Capture Therapy Experience. Cancer Biother Radiopharm 2022; 38:184-191. [PMID: 36269660 DOI: 10.1089/cbr.2022.0059] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The authors review the results of 249 patients treated with boron neutron capture therapy (BNCT) at the Helsinki University Hospital, Helsinki, Finland, from May 1999 to January 2012 with neutrons obtained from a nuclear reactor source (FiR 1) and using l-boronophenylalanine-fructose (l-BPA-F) as the boron delivery agent. They also describe a new hospital BNCT facility that hosts a proton accelerator-based neutron source for BNCT. Most of the patients treated with nuclear reactor-derived neutrons had either inoperable, locally recurrent head and neck cancer or malignant glioma. In general, l-BPA-F-mediated BNCT was relatively well tolerated with adverse events usually similar to those of conventional radiotherapy. Twenty-eight (96.6%) out of the evaluable 29 patients with head and neck cancer and treated within a clinical trial either responded to BNCT or had tumor growth stabilization for at least 5 months, suggesting efficacy of BNCT in the treatment of this patient population. The new accelerator-based BNCT facility houses a nuBeam neutron source that consists of an electrostatic Cockcroft-Walton-type proton accelerator and a lithium target that converts the proton beam to neutrons. The proton beam energy is 2.6 MeV operating with a current of 30 mA. Treatment planning is based on Monte Carlo simulation and the RayStation treatment planning system. Patient positioning is performed with a 6-axis robotic image-guided system, and in-room imaging is done with a rail-mounted computed tomography scanner. Under normal circumstances, the personnel can enter the treatment room almost immediately after shutting down the proton beam, which improves the unit capacity. ClinicalTrials.gov ID: NCT00114790.
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Affiliation(s)
- Liisa Porra
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Lauri Wendland
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tiina Seppälä
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Hannu Revitzer
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Tervonen
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leena Kankaanranta
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anu Anttonen
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mikko Tenhunen
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Heikki Joensuu
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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23
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Cheng X, Li F, Liang L. Boron Neutron Capture Therapy: Clinical Application and Research Progress. Curr Oncol 2022; 29:7868-7886. [PMID: 36290899 PMCID: PMC9601095 DOI: 10.3390/curroncol29100622] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Boron neutron capture therapy (BNCT) is a binary modality that is used to treat a variety of malignancies, using neutrons to irradiate boron-10 (10B) nuclei that have entered tumor cells to produce highly linear energy transfer (LET) alpha particles and recoil 7Li nuclei (10B [n, α] 7Li). Therefore, the most important part in BNCT is to selectively deliver a large number of 10B to tumor cells and only a small amount to normal tissue. So far, BNCT has been used in more than 2000 cases worldwide, and the efficacy of BNCT in the treatment of head and neck cancer, malignant meningioma, melanoma and hepatocellular carcinoma has been confirmed. We collected and collated clinical studies of second-generation boron delivery agents. The combination of different drugs, the mode of administration, and the combination of multiple treatments have an important impact on patient survival. We summarized the critical issues that must be addressed, with the hope that the next generation of boron delivery agents will overcome these challenges.
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Affiliation(s)
- Xiang Cheng
- Oncology Department, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei Economic and Technological Development Zone, Hefei 230601, China
| | - Fanfan Li
- Oncology Department, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei Economic and Technological Development Zone, Hefei 230601, China
- Correspondence: (F.L.); (L.L.); Tel.: +86-13855137365 (F.L.); +86-15905602477 (L.L.)
| | - Lizhen Liang
- Hefei Comprehensive National Science Center, Institute of Energy, Building 9, Binhu Excellence City Phase I, 16 Huayuan Avenue, Baohe District, Hefei 230031, China
- Correspondence: (F.L.); (L.L.); Tel.: +86-13855137365 (F.L.); +86-15905602477 (L.L.)
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24
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Kondo N. DNA damage and biological responses induced by Boron Neutron Capture Therapy (BNCT). Enzymes 2022; 51:65-78. [PMID: 36336409 DOI: 10.1016/bs.enz.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Boron Neutron Capture Therapy (BNCT) is a tumor cell selective high LET (linear energy transfer) particle beam therapy. The patient is administrated a boron (10B) compound via intravenous injection or infusion, and when 10B is sufficiently accumulated in the tumor, neutron beams containing epithermal neutrons as the main component are irradiated. Epithermal neutrons lose energy in the body and become thermal neutrons. The captured 10B undergoes a (n, α) reaction with thermal neutrons, and the resulting α particles and 7Li nuclei have short ranges of 9-10μm and 4-5μm, respectively, and do not reach the surrounding cells in normal tissues. Therefore, these high LET-heavy charged particles can selectively kill cancer cells. The cell-killing effect of these heavy charged particles is thought to be triggered by DNA damage. It is known that DNA damage caused by heavy charged particles is more serious and difficult to repair than DNA damage caused by Low LET radiation such as X-rays and γ-rays. This review focuses on DNA damage, e.g., DNA strand breaks and DNA damage repair caused by BNCT and describes the resulting biological response.
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Affiliation(s)
- Natsuko Kondo
- Particle Radiation Oncology Research Center, Institute for Integrated Radiation and Nuclear Science, Kyoto University, Osaka, Japan.
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Kondo N, Masutani M, Imamichi S, Matsumoto Y, Nakai K. Strategies for Preclinical Studies Evaluating the Biological Effects of an Accelerator-Based Boron Neutron Capture Therapy System. Cancer Biother Radiopharm 2022; 38:173-183. [PMID: 36154293 DOI: 10.1089/cbr.2022.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This review discusses the strategies of preclinical studies intended for accelerator-based (AB)-boron neutron capture therapy (BNCT) clinical trials, which were presented at the National Cancer Institute (NCI) Workshop on Neutron Capture Therapy held from April 20 to 22, 2022. Clinical studies of BNCT have been conducted worldwide using reactor neutron sources, with most targeting malignant brain tumors, melanoma, or head and neck cancer. Recently, small accelerator-based neutron sources that can be installed in hospitals have been developed. AB-BNCT clinical trials for recurrent malignant glioma, head and neck cancers, high-grade meningioma, melanoma, and angiosarcoma have all been conducted in Japan. The necessary methods, equipment, and facilities for preclinical studies to evaluate the biological effects of AB-BNCT systems in terms of safety and efficacy are described, with reference to two examples from Japan. The first is the National Cancer Center, which is equipped with a vertical downward neutron beam, and the other is the University of Tsukuba, which has a horizontal neutron beam. The preclinical studies discussed include cell-based assays to evaluate cytotoxicity and genotoxicity, in vivo cytotoxicity and efficacy of BNCT, and radioactivation measurements.
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Affiliation(s)
- Natsuko Kondo
- Particle Radiation Oncology Center, Institute for Integrated Radiation and Nuclear Science, Kyoto University, Asashiro-Nishi, Osaka, Japan
| | - Mitsuko Masutani
- Department of Molecular and Genomic Biomedicine School of Medicine, Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Central Radioisotope Division, National Cancer Center Research Institute, Tokyo, Japan.,Division of BNCT, EPOC, National Cancer Center, Tokyo, Japan
| | - Shoji Imamichi
- Department of Molecular and Genomic Biomedicine School of Medicine, Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Central Radioisotope Division, National Cancer Center Research Institute, Tokyo, Japan.,Division of BNCT, EPOC, National Cancer Center, Tokyo, Japan
| | - Yoshitaka Matsumoto
- Department of Radiation Oncology, Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kei Nakai
- Department of Radiation Oncology, Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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26
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Monti Hughes A, Schwint AE. Animal Tumor Models for Boron Neutron Capture Therapy Studies (Excluding Central Nervous System Solid Tumors). Cancer Biother Radiopharm 2022. [PMID: 36130136 DOI: 10.1089/cbr.2022.0054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Translational research in adequate experimental models is necessary to optimize boron neutron capture therapy (BNCT) for different pathologies. Multiple radiobiological in vivo studies have been performed in a wide variety of animal models, studying multiple boron compounds, routes of compound administration, and a range of administration strategies. Animal models are useful for the study of the stability and potential toxicity of new boron compounds or delivery systems, BNCT theranostic strategies, the evaluation of biomarkers to monitor BNCT therapeutic and adverse effects, and to study the BNCT immune response by the host against tumor cells. This article will mention examples of these studies, highlighting the importance of experimental animal models for the advancement of BNCT. Animal models are essential to design novel, safe, and effective clinical BNCT protocols for existing or new targets for BNCT.
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Affiliation(s)
- Andrea Monti Hughes
- Departamento de Radiobiología, Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Amanda E Schwint
- Departamento de Radiobiología, Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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27
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Seo IH, Lee J, Na D, Kyung H, Yang J, Lee S, Jeon SJ, Choi JW, Lee KY, Yi J, Han J, Yoo M, Kim SH. The Anti-Tumor Effect of Boron Neutron Capture Therapy in Glioblastoma Subcutaneous Xenograft Model Using the Proton Linear Accelerator-Based BNCT System in Korea. Life (Basel) 2022; 12:life12081264. [PMID: 36013445 PMCID: PMC9410173 DOI: 10.3390/life12081264] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 04/08/2023] Open
Abstract
Boron neutron capture therapy (BNCT) is a radiation therapy that selectively kills cancer cells and is being actively researched and developed around the world. In Korea, development of the proton linear accelerator-based BNCT system has completed development, and its anti-cancer effect in the U-87 MG subcutaneous xenograft model has been evaluated. To evaluate the efficacy of BNCT, we measured 10B-enriched boronophenylalanine (BPA) uptake in U-87 MG, FaDu, and SAS cells and evaluated cell viability by clonogenic assays. In addition, the boron concentration in the tumor, blood, and skin on the U-87 MG xenograft model was measured, and the tumor volume was measured for 4 weeks after BNCT. In vitro, the intracellular boron concentration was highest in the order of SAS, FaDu, and U-87 MG, and cell survival fractions decreased depending on the BPA treatment concentration and neutron irradiation dose. In vivo, the tumor volume was significantly decreased in the BNCT group compared to the control group. This study confirmed the anti-cancer effect of BNCT in the U-87 MG subcutaneous xenograft model. It is expected that the proton linear accelerator-based BNCT system developed in Korea will be a new option for radiation therapy for cancer treatment.
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Affiliation(s)
| | - Jeongwoo Lee
- A-BNCT Center, Dawonmedax, Incheon 21988, Korea
- Department of Pharmacy, ERICA Campus, Hanyang University, Ansan 15588, Korea
| | - Dasom Na
- A-BNCT Center, Dawonmedax, Incheon 21988, Korea
| | | | - Jieun Yang
- A-BNCT Center, Dawonmedax, Incheon 21988, Korea
| | | | | | | | | | - Jungyu Yi
- A-BNCT Center, Dawonmedax, Incheon 21988, Korea
- Department of Nuclear Engineering, Hanyang University, Seoul 04763, Korea
| | - Jaehwan Han
- A-BNCT Center, Dawonmedax, Incheon 21988, Korea
| | | | - Se Hyun Kim
- A-BNCT Center, Dawonmedax, Incheon 21988, Korea
- Correspondence: ; Tel.: +82-2-6251-4468
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Hu N, Tanaka H, Kakino R, Yoshikawa S, Miyao M, Akita K, Aihara T, Nihei K, Ono K. Improvement in the neutron beam collimation for application in boron neutron capture therapy of the head and neck region. Sci Rep 2022; 12:13778. [PMID: 35962034 PMCID: PMC9374716 DOI: 10.1038/s41598-022-17974-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/03/2022] [Indexed: 12/03/2022] Open
Abstract
In June 2020, the Japanese government approved boron neutron capture therapy for the treatment of head and neck cancer. The treatment is usually performed in a single fraction, with the neutron irradiation time being approximately 30–60 min. As neutrons scatter in air and loses its intensity, it is preferable to bring the patient as close to the beam port as possible to shorten the irradiation time. However, this can be a challenge, especially for patients with head and neck cancer, as the shoulders are an obstacle to a clean positioning. In this study, a novel neutron collimation system for an accelerator based neutron source was designed to allow for a more comfortable treatment, without compromising the irradiation time. Experimental measurements confirmed the simulation results and showed the new collimator can reduce the irradiation time by approximately 60% (under the same condition where the distance between the source and the patient surface was kept the same). The dose delivered to the surrounding healthy tissue was reduced with the new collimator, showing a 25% decrease in the D50 of the mucosal membrane. Overall, the use of the newly designed collimator will allow for a more comfortable treatment of the head and neck region, reduce the treatment time, and reduce the dose delivered to the surrounding healthy tissue.
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Affiliation(s)
- Naonori Hu
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan. .,Institute for Integrated Radiation and Nuclear Science, Kyoto University, Osaka, Japan.
| | - Hiroki Tanaka
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Osaka, Japan
| | - Ryo Kakino
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Syuushi Yoshikawa
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Mamoru Miyao
- Central Department of Radiology, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
| | - Kazuhiko Akita
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Teruhito Aihara
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Keiji Nihei
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.,Department of Radiation Oncology, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
| | - Koji Ono
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Monti Hughes A, Goldfinger JA, Palmieri MA, Ramos P, Santa Cruz IS, De Leo L, Garabalino MA, Thorp SI, Curotto P, Pozzi ECC, Kawai K, Sato S, Itoiz ME, Trivillin VA, Guidobono JS, Nakamura H, Schwint AE. Boron Neutron Capture Therapy (BNCT) Mediated by Maleimide-Functionalized Closo-Dodecaborate Albumin Conjugates (MID:BSA) for Oral Cancer: Biodistribution Studies and In Vivo BNCT in the Hamster Cheek Pouch Oral Cancer Model. LIFE (BASEL, SWITZERLAND) 2022; 12:life12071082. [PMID: 35888170 PMCID: PMC9323568 DOI: 10.3390/life12071082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 12/12/2022]
Abstract
Background: BNCT (Boron Neutron Capture Therapy) is a tumor-selective particle radiotherapy that combines preferential boron accumulation in tumors and neutron irradiation. Although p-boronophenylalanine (BPA) has been clinically used, new boron compounds are needed for the advancement of BNCT. Based on previous studies in colon tumor-bearing mice, in this study, we evaluated MID:BSA (maleimide-functionalized closo-dodecaborate conjugated to bovine serum albumin) biodistribution and MID:BSA/BNCT therapeutic effect on tumors and associated radiotoxicity in the hamster cheek pouch oral cancer model. Methods: Biodistribution studies were performed at 30 mg B/kg and 15 mg B/kg (12 h and 19 h post-administration). MID:BSA/BNCT (15 mg B/kg, 19 h) was performed at three different absorbed doses to precancerous tissue. Results: MID:BSA 30 mg B/kg protocol induced high BSA toxicity. MID:BSA 15 mg B/kg injected at a slow rate was well-tolerated and reached therapeutically useful boron concentration values in the tumor and tumor/normal tissue ratios. The 19 h protocol exhibited significantly lower boron concentration values in blood. MID:BSA/BNCT exhibited a significant tumor response vs. the control group with no significant radiotoxicity. Conclusions: MID:BSA/BNCT would be therapeutically useful to treat oral cancer. BSA toxicity is a consideration when injecting a compound conjugated to BSA and depends on the animal model studied.
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Affiliation(s)
- Andrea Monti Hughes
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
- National Scientific and Technical Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
- Correspondence: or ; Tel.: +54-9-11-41689832 or +54-11-6772-7927
| | - Jessica A. Goldfinger
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
| | - Mónica A. Palmieri
- Biodiversity and Experimental Biology Department, School of Exact and Natural Sciences, University of Buenos Aires, Av. Int. Güiraldes 2160, 4° piso, Pab. II, Ciudad Autónoma de Buenos Aires C1428EGA, Argentina;
| | - Paula Ramos
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
| | - Iara S. Santa Cruz
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
| | - Luciana De Leo
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
| | - Marcela A. Garabalino
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
| | - Silvia I. Thorp
- Department of Instrumentation and Control, National Atomic Energy Commission, Presbítero Juan González y Aragon, 15, Ezeiza, Buenos Aires B1802AYA, Argentina;
| | - Paula Curotto
- Department of Research and Production Reactors, National Atomic Energy Commission, Presbítero Juan González y Aragon, 15, Ezeiza, Buenos Aires B1802AYA, Argentina; (P.C.); (E.C.C.P.)
| | - Emiliano C. C. Pozzi
- Department of Research and Production Reactors, National Atomic Energy Commission, Presbítero Juan González y Aragon, 15, Ezeiza, Buenos Aires B1802AYA, Argentina; (P.C.); (E.C.C.P.)
| | - Kazuki Kawai
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama 226-8503, Japan; (K.K.); (S.S.); (H.N.)
| | - Shinichi Sato
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama 226-8503, Japan; (K.K.); (S.S.); (H.N.)
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 226-8503, Japan
| | - María E. Itoiz
- Department of Oral Pathology, Faculty of Dentistry, University of Buenos Aires, M.T. de Alvear 2142, Ciudad Autónoma de Buenos Aires C1122AAH, Argentina;
| | - Verónica A. Trivillin
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
- National Scientific and Technical Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
| | - Juan S. Guidobono
- Buenos Aires Institute of Ecology, Genetics and Evolution (IEGEBA), CONICET, UBA, Intendente Güiraldes 2160, Ciudad Universitaria, Ciudad Autónoma de Buenos Aires C1428EGA, Argentina;
| | - Hiroyuki Nakamura
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama 226-8503, Japan; (K.K.); (S.S.); (H.N.)
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 226-8503, Japan
| | - Amanda E. Schwint
- Department of Radiobiology, National Atomic Energy Commission, Av. General Paz 1499, San Martin, Buenos Aires B1650KNA, Argentina; (J.A.G.); (P.R.); (I.S.S.C.); (L.D.L.); (M.A.G.); (V.A.T.); or (A.E.S.)
- National Scientific and Technical Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
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Komori S, Hirose K, Sato M, Takeuchi A, Kato R, Motoyanagi T, Harada T, Yamazaki Y, Harada M, Narita Y, Kato T, Takai Y. Dosimetric effect of set-up error in accelerator-based boron neutron capture therapy for head and neck cancer. JOURNAL OF RADIATION RESEARCH 2022; 63:684-695. [PMID: 35482434 PMCID: PMC9303597 DOI: 10.1093/jrr/rrac017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/31/2022] [Indexed: 05/12/2023]
Abstract
The dosimetric effect of set-up error in boron neutron capture therapy (BNCT) for head and neck cancer remains unclear. In this study, we analyzed the tendency of dose error by treatment location when simulating the set-up error of patients. We also determined the tolerance level of the set-up error in BNCT for head and neck cancer. As a method, the distal direction was shifted with an interval of 2.5 mm, from 0.0 mm to +20.0 mm and compared with the dose at the reference position. Similarly, the horizontal direction and vertical direction were shifted, with an interval of 5.0 mm, from -20.0 mm to +20.0 mm. In addition, cases with 3.0 mm and 5.0 mm simultaneous shifts in all directions were analyzed as the worst-case scenario. The dose metrics of the minimum dose of the tumor and the maximum dose of the mucosa were evaluated. From unidirectional set-up error analysis, in most cases, the set-up errors with dose errors within ±5% were Δdistal < +2.5 mm, Δhorizontal < ±5.0 mm and Δvertical < ±5.0 mm. In the simulation of 3.0 mm shifts in all directions, the errors in the minimum tumor dose and maximum mucosal dose were -3.6% ±1.4% (range, -5.4% to -0.6%) and 2% ±1.4% (range, 0.4% to 4.5%), respectively. From these results, if the set-up error was within ±3.0 mm in each direction, the dose errors of the tumor and mucosa could be suppressed within approximately ±5%, which is suggested as a tolerance level.
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Affiliation(s)
- Shinya Komori
- Corresponding author. Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan, ; Tel: +81-24-934-5330; Fax: +81-24-934-5423
| | - Katsumi Hirose
- Department of Radiation Oncology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
- Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Mariko Sato
- Department of Radiation Oncology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
- Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Akihiko Takeuchi
- Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
| | - Ryohei Kato
- Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
| | - Tomoaki Motoyanagi
- Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
| | - Takaomi Harada
- Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
| | - Yuhei Yamazaki
- Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
| | - Mayumi Harada
- Department of Radiation Oncology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
| | - Yuki Narita
- Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
| | - Takahiro Kato
- Department of Radiation Physics and Technology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
- School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima, Fukushima, 960-8516, Japan
| | - Yoshihiro Takai
- Department of Radiation Oncology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, Fukushima, 963-8052, Japan
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Jin WH, Seldon C, Butkus M, Sauerwein W, Giap HB. A Review of Boron Neutron Capture Therapy: Its History and Current Challenges. Int J Part Ther 2022; 9:71-82. [PMID: 35774489 PMCID: PMC9238127 DOI: 10.14338/ijpt-22-00002.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Mechanism of Action External beam, whether with photons or particles, remains as the most common type of radiation therapy. The main drawback is that radiation deposits dose in healthy tissue before reaching its target. Boron neutron capture therapy (BNCT) is based on the nuclear capture and fission reactions that occur when 10B is irradiated with low-energy (0.0025 eV) thermal neutrons. The resulting 10B(n,α)7Li capture reaction produces high linear energy transfer (LET) α particles, helium nuclei (4He), and recoiling lithium-7 (7Li) atoms. The short range (5-9 μm) of the α particles limits the destructive effects within the boron-containing cells. In theory, BNCT can selectively destroy malignant cells while sparing adjacent normal tissue at the cellular levels by delivering a single fraction of radiation with high LET particles. History BNCT has been around for many decades. Early studies were promising for patients with malignant brain tumors, recurrent tumors of the head and neck, and cutaneous melanomas; however, there were certain limitations to its widespread adoption and use. Current Limitations and Prospects Recently, BNCT re-emerged owing to several developments: (1) small footprint accelerator-based neutron sources; (2) high specificity third-generation boron carriers based on monoclonal antibodies, nanoparticles, among others; and (3) treatment planning software and patient positioning devices that optimize treatment delivery and consistency.
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Affiliation(s)
- Will H Jin
- Department of Radiation Oncology, Jackson Memorial Hospital/Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, USA
| | - Crystal Seldon
- Department of Radiation Oncology, Jackson Memorial Hospital/Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, USA
| | - Michael Butkus
- Department of Radiation Oncology, Jackson Memorial Hospital/Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, USA
| | - Wolfgang Sauerwein
- Deutsche Gesellschaft für Bor-Neutroneneinfangtherapie (DGBNCT), Universitätsklinikum Essen, Essen, Germany
| | - Huan B Giap
- Department of Radiation Oncology, Nancy N. and J. C. Lewis Cancer & Research Pavilion, Savannah, GA, USA
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32
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Kato R, Hirose K, Kato T, Motoyanagi T, Arai K, Harada T, Takeuchi A, Yamazaki Y, Narita Y, Komori S, Sato M, Takai Y. Dosimetric effects of the ipsilateral shoulder position variations in the sitting-positioned boron neutron capture therapy for lower neck tumor. Appl Radiat Isot 2022; 188:110397. [DOI: 10.1016/j.apradiso.2022.110397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/07/2022] [Accepted: 07/27/2022] [Indexed: 11/02/2022]
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33
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Clinical Viability of Boron Neutron Capture Therapy for Personalized Radiation Treatment. Cancers (Basel) 2022; 14:cancers14122865. [PMID: 35740531 PMCID: PMC9221296 DOI: 10.3390/cancers14122865] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Usually, for dose planning in radiotherapy, the tumor is delimited as a volume on the image of the patient together with other clinical considerations based on populational evidence. However, the same prescription dose can provide different results, depending on the patient. Unfortunately, the biological aspects of the tumor are hardly considered in dose planning. Boron Neutron Capture Radiotherapy enables targeted treatment by incorporating boron-10 at the cellular level and irradiating with neutrons of a certain energy so that they produce nuclear reactions locally and almost exclusively damage the tumor cell. This technique is not new, but modern neutron generators and more efficient boron carriers have reactivated the clinical interest of this technique in the pursuit of more precise treatments. In this work, we review the latest technological facilities and future possibilities for the clinical implementation of BNCT and for turning it into a personalized therapy. Abstract Boron Neutron Capture Therapy (BNCT) is a promising binary disease-targeted therapy, as neutrons preferentially kill cells labeled with boron (10B), which makes it a precision medicine treatment modality that provides a therapeutic effect exclusively on patient-specific tumor spread. Contrary to what is usual in radiotherapy, BNCT proposes cell-tailored treatment planning rather than to the tumor mass. The success of BNCT depends mainly on the sufficient spatial biodistribution of 10B located around or within neoplastic cells to produce a high-dose gradient between the tumor and healthy tissue. However, it is not yet possible to precisely determine the concentration of 10B in a specific tissue in real-time using non-invasive methods. Critical issues remain to be resolved if BNCT is to become a valuable, minimally invasive, and efficient treatment. In addition, functional imaging technologies, such as PET, can be applied to determine biological information that can be used for the combined-modality radiotherapy protocol for each specific patient. Regardless, not only imaging methods but also proteomics and gene expression methods will facilitate BNCT becoming a modality of personalized medicine. This work provides an overview of the fundamental principles, recent advances, and future directions of BNCT as cell-targeted cancer therapy for personalized radiation treatment.
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Hirose K, Sato M, Kato T, Takayama K, Suzuki M, Yamaguchi H, Seto I, Kikuchi Y, Murakami M, Takai Y. Profile analysis of adverse events after boron neutron capture therapy for head and neck cancer: a sub-analysis of the JHN002 study. JOURNAL OF RADIATION RESEARCH 2022; 63:393-401. [PMID: 35388879 PMCID: PMC9124626 DOI: 10.1093/jrr/rrac012] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/27/2022] [Indexed: 06/14/2023]
Abstract
The purpose of this study was to outline the course and profile of adverse events specific to boron neutron capture therapy (BNCT) for head and neck cancer. This was a sub-analysis of the phase II JHN002 trial. Patients received 400 mg/kg borofalan(10B), followed by neutron irradiation. The course of adverse events after BNCT was documented in the JHN002 Look Up study. Patients were grouped into face/front (FF), face/lateral (FL) and neck (N) beam groups according to the point of skin incidence of the epithermal neutron beam axis, and the profile of adverse events dependent on beam incidence position was examined. The courses of adverse events in eight recurrent squamous cell carcinoma (R-SCC) and 13 recurrent or locally advanced non-SCC cases were analyzed. Median interval to complete recovery was 23 days (interquartile range (IQR), 14-48 days) for oral mucositis, 40 days (IQR, 24-56 days) for dermatitis, 58 days (IQR, 53-80 days) for dysgeusia and 156 days (IQR, 82-163 days) for alopecia. In the FF beam group, parotitis (P = 0.007) was less frequent, while oral mucositis (P = 0.032), fatigue (P = 0.002), conjunctivitis (P = 0.001), epistaxis (P = 0.001) and abdominal discomfort (P = 0.029) tended to be more frequent than in the FL and N beam groups. Courses and irradiation site-specific profiles of adverse events in BNCT for head and neck cancer were identified. This profile may be useful for considering interventions to prevent exacerbation of treatment-related adverse events on BNCT.
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Affiliation(s)
- Katsumi Hirose
- Corresponding author. Katsumi Hirose, Southern Tohoku BNCT Research Center, 7–10 Yatsuyamada, Koriyama, 963-8052 Japan. Tel: +81-24-934-5330;
| | - Mariko Sato
- Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, 963-8052, Japan
- Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Takahiro Kato
- Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, 963-8052, Japan
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, 963-8052, Japan
- School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima, 960-8516, Japan
| | - Kanako Takayama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, 963-8052, Japan
| | - Motohisa Suzuki
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, 963-8052, Japan
| | - Hisashi Yamaguchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, 963-8052, Japan
| | - Ichiro Seto
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, 963-8052, Japan
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, 963-8052, Japan
| | - Masao Murakami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, 963-8052, Japan
| | - Yoshihiro Takai
- Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, Koriyama, 963-8052, Japan
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35
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Bernardini GFP, Bortolussi S, Koivunoro H, Provenzano L, Ferrari C, Cansolino L, Postuma I, Carando DG, Kankaanranta L, Joensuu H, González SJ. Comparison of Photon Isoeffective Dose Models Based on In Vitro and In Vivo Radiobiological Experiments for Head and Neck Cancer Treated with BNCT. Radiat Res 2022; 198:134-144. [PMID: 35504003 DOI: 10.1667/rade-21-00234.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/22/2022] [Indexed: 11/03/2022]
Abstract
Boron neutron capture therapy (BNCT) is a treatment modality for cancer that involves radiations of different qualities. A formalism that proved suitable to compute doses in photon-equivalent units is the photon isoeffective dose model. This study addresses the question whether considering in vitro or in vivo radiobiological studies to determine the parameters involved in photon isoeffective dose calculations affects the consistency of the model predictions. The analysis is focused on head and neck squamous cell carcinomas (HNSCC), a main target that proved to respond to BNCT. The photon isoeffective dose model for HNSCC with parameters from in vitro studies using the primary human cell line UT-SCC-16A was introduced and compared to the one previously reported with parameters from an in vivo oral cancer model in rodents. Both models were first compared in a simple scenario by means of tumor dose and control probability calculations. Then, the clinical impact of the different dose models was assessed from the analysis of a group of squamous cell carcinomas (SCC) patients treated with BNCT. Traditional dose calculations using the relative biological effectiveness factors derived from the SCC cell line were also analyzed. Predictions of tumor control from the evaluated models were compared to the patients' outcome. The quantification of the biological effectiveness of the different radiations revealed that relative biological effectiveness/compound biological effectiveness (RBE/CBE) factors for the SCC cell line are up to 20% higher than those assumed in clinical BNCT, highlighting the importance of using experimental data intimately linked to the tumor type to derive the model's parameters. The comparison of the different models showed that photon isoeffective doses based on in vitro data are generally greater than those from in vivo data (∼8-16% for total tumor absorbed doses of 10-15 Gy). However, the predictive power of the two models was not affected by these differences: both models fulfilled conditions to guarantee a good predictive performance and gave predictions statistically compatible with the clinical outcome. On the other hand, doses computed with the traditional model were substantially larger than those obtained with both photon isoeffective models. Moreover, the traditional model is statistically rejected, which reinforces the assertion that its inconsistencies are intrinsic and not due to the use of RBE/CBE factors obtained for a tumor type different from HN cancer. The results suggest that the nature of the radiobiological data would not affect the consistency of the photon isoeffective dose model in the studied cases of SCC head and neck cancer treated with BPA-based BNCT.
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Affiliation(s)
| | - Silva Bortolussi
- Department of Physics, University of Pavia, Italy.,National Institute of Nuclear Physics (INFN), Unit of Pavia, Italy
| | - Hanna Koivunoro
- Neutron Therapeutics, Helsinki, Finland.,Department of Oncology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Cinzia Ferrari
- National Institute of Nuclear Physics (INFN), Unit of Pavia, Italy.,Department of Clinic-Surgical Sciences, Experimental Surgery Laboratory, University of Pavia, Italy
| | - Laura Cansolino
- National Institute of Nuclear Physics (INFN), Unit of Pavia, Italy.,Department of Clinic-Surgical Sciences, Experimental Surgery Laboratory, University of Pavia, Italy
| | - Ian Postuma
- National Institute of Nuclear Physics (INFN), Unit of Pavia, Italy
| | - Daniel Germán Carando
- Depto. de Matemática, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires (UBA), Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Leena Kankaanranta
- Department of Oncology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Heikki Joensuu
- Department of Oncology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sara Josefina González
- Comisión Nacional de Energía Atómica (CNEA), Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
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36
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Sahu U, Barth RF, Otani Y, McCormack R, Kaur B. Rat and Mouse Brain Tumor Models for Experimental Neuro-Oncology Research. J Neuropathol Exp Neurol 2022; 81:312-329. [PMID: 35446393 PMCID: PMC9113334 DOI: 10.1093/jnen/nlac021] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Rodent brain tumor models have been useful for developing effective therapies for glioblastomas (GBMs). In this review, we first discuss the 3 most commonly used rat brain tumor models, the C6, 9L, and F98 gliomas, which are all induced by repeated injections of nitrosourea to adult rats. The C6 glioma arose in an outbred Wistar rat and its potential to evoke an alloimmune response is a serious limitation. The 9L gliosarcoma arose in a Fischer rat and is strongly immunogenic, which must be taken into consideration when using it for therapy studies. The F98 glioma may be the best of the 3 but it does not fully recapitulate human GBMs because it is weakly immunogenic. Next, we discuss a number of mouse models. The first are human patient-derived xenograft gliomas in immunodeficient mice. These have failed to reproduce the tumor-host interactions and microenvironment of human GBMs. Genetically engineered mouse models recapitulate the molecular alterations of GBMs in an immunocompetent environment and “humanized” mouse models repopulate with human immune cells. While the latter are rarely isogenic, expensive to produce, and challenging to use, they represent an important advance. The advantages and limitations of each of these brain tumor models are discussed. This information will assist investigators in selecting the most appropriate model for the specific focus of their research.
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Affiliation(s)
- Upasana Sahu
- From the Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rolf F Barth
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Yoshihiro Otani
- From the Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ryan McCormack
- From the Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Balveen Kaur
- From the Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
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37
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Wang S, Zhang Z, Miao L, Li Y. Boron Neutron Capture Therapy: Current Status and Challenges. Front Oncol 2022; 12:788770. [PMID: 35433432 PMCID: PMC9009440 DOI: 10.3389/fonc.2022.788770] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
Boron neutron capture therapy (BNCT) is a re-emerging therapy with the ability to selectively kill tumor cells. After the boron delivery agents enter the tumor tissue and enrich the tumor cells, the thermal neutrons trigger the fission of the boron atoms, leading to the release of boron atoms and then leading to the release of the α particles (4He) and recoil lithium particles (7Li), along with the production of large amounts of energy in the narrow region. With the advantages of targeted therapy and low toxicity, BNCT has become a unique method in the field of radiotherapy. Since the beginning of the last century, BNCT has been emerging worldwide and gradually developed into a technology for the treatment of glioblastoma multiforme, head and neck cancer, malignant melanoma, and other cancers. At present, how to develop and innovate more efficient boron delivery agents and establish a more accurate boron-dose measurement system have become the problem faced by the development of BNCT. We discuss the use of boron delivery agents over the past several decades and the corresponding clinical trials and preclinical outcomes. Furthermore, the discussion brings recommendations on the future of boron delivery agents and this therapy.
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Affiliation(s)
- Song Wang
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Zhengchao Zhang
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Lele Miao
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Yumin Li
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
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38
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Importance of radiobiological studies for the advancement of boron neutron capture therapy (BNCT). Expert Rev Mol Med 2022; 24:e14. [PMID: 35357286 DOI: 10.1017/erm.2022.7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Boron neutron capture therapy (BNCT) is a tumour selective particle radiotherapy, based on the administration of boron carriers incorporated preferentially by tumour cells, followed by irradiation with a thermal or epithermal neutron beam. BNCT clinical results to date show therapeutic efficacy, associated with an improvement in patient quality of life and prolonged survival. Translational research in adequate experimental models is necessary to optimise BNCT for different pathologies. This review recapitulates some examples of BNCT radiobiological studies for different pathologies and clinical scenarios, strategies to optimise boron targeting, enhance BNCT therapeutic effect and minimise radiotoxicity. It also describes the radiobiological mechanisms induced by BNCT, and the importance of the detection of biomarkers to monitor and predict the therapeutic efficacy and toxicity of BNCT alone or combined with other strategies. Besides, there is a brief comment on the introduction of accelerator-based neutron sources in BNCT. These sources would expand the clinical BNCT services to more patients, and would help to make BNCT a standard treatment modality for various types of cancer. Radiobiological BNCT studies have been of utmost importance to make progress in BNCT, being essential to design novel, safe and effective clinical BNCT protocols.
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39
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Key biological mechanisms involved in high-LET radiation therapies with a focus on DNA damage and repair. Expert Rev Mol Med 2022; 24:e15. [PMID: 35357290 DOI: 10.1017/erm.2022.6] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
DNA damage and repair studies are at the core of the radiation biology field and represent also the fundamental principles informing radiation therapy (RT). DNA damage levels are a function of radiation dose, whereas the type of damage and biological effects such as DNA damage complexity, depend on radiation quality that is linear energy transfer (LET). Both levels and types of DNA damage determine cell fate, which can include necrosis, apoptosis, senescence or autophagy. Herein, we present an overview of current RT modalities in the light of DNA damage and repair with emphasis on medium to high-LET radiation. Proton radiation is discussed along with its new adaptation of FLASH RT. RT based on α-particles includes brachytherapy and nuclear-RT, that is proton-boron capture therapy (PBCT) and boron-neutron capture therapy (BNCT). We also discuss carbon ion therapy along with combinatorial immune-based therapies and high-LET RT. For each RT modality, we summarise relevant DNA damage studies. Finally, we provide an update of the role of DNA repair in high-LET RT and we explore the biological responses triggered by differential LET and dose.
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40
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Takahara K, Miyatake SI, Azuma H, Shiroki R. Boron neutron capture therapy for urological cancers. Int J Urol 2022; 29:610-616. [PMID: 35240726 DOI: 10.1111/iju.14855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/21/2022] [Indexed: 01/18/2023]
Abstract
Boron neutron capture therapy is based on a nuclear reaction between the nonradioactive isotope boron-10 and either low-energy thermal neutrons or high-energy epithermal neutrons, which generate high linear energy transfer α particles and a recoiled lithium nucleus (7 Li) that selectively destroys the DNA helix in tumor cells. Boron neutron capture therapy is an emerging procedure aimed at improving the therapeutic ratio for the traditional treatment of various malignancies, which has been studied clinically in a variety of diseases, including glioblastoma, head and neck cancer, cutaneous melanoma, hepatocellular carcinoma, lung cancer, and extramammary Paget's disease. However, boron neutron capture therapy has not been clinically performed for urological cancers, excluding genital extramammary Paget's disease that appeared at the scrotum to penis area. In this review, we aimed to provide an updated summary of the current clinical literature of patients treated with boron neutron capture therapy and to focus on the future prospects of boron neutron capture therapy for urological cancers.
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Affiliation(s)
- Kiyoshi Takahara
- Department of Urology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Shin-Ichi Miyatake
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.,Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ryoichi Shiroki
- Department of Urology, School of Medicine, Fujita Health University, Aichi, Japan
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41
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Räty A, Tanhua-Tyrkkö M, Kotiluoto P, Kekki T. Validation and Optimization of Activity Estimates of the FiR 1 TRIGA Research Reactor Biological Shield Concrete. NUCL SCI ENG 2022. [DOI: 10.1080/00295639.2021.2011671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Antti Räty
- VTT Technical Research Centre of Finland, Espoo, Finland
| | | | | | - Tommi Kekki
- VTT Technical Research Centre of Finland, Espoo, Finland
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42
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Kanygin V, Kichigin A, Zaboronok A, Kasatova A, Petrova E, Tsygankova A, Zavjalov E, Mathis BJ, Taskaev S. In Vivo Accelerator-Based Boron Neutron Capture Therapy for Spontaneous Tumors in Large Animals: Case Series. BIOLOGY 2022; 11:138. [PMID: 35053138 PMCID: PMC8773183 DOI: 10.3390/biology11010138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 11/29/2022]
Abstract
(1) Background: accelerator-based neutron sources are a new frontier for BNCT but many technical issues remain. We aimed to study such issues and results in larger-animal BNCT (cats and dogs) with naturally occurring, malignant tumors in different locations as an intermediate step in translating current research into clinical practice. (2) Methods: 10 pet cats and dogs with incurable, malignant tumors that had no treatment alternatives were included in this study. A tandem accelerator with vacuum insulation was used as a neutron source. As a boron-containing agent, 10B-enriched sodium borocaptate (BSH) was used at a dose of 100 mg/kg. Animal condition as well as tumor progression/regression were monitored. (3) Results: regression of tumors in response to treatment, improvements in the overall clinical picture, and an increase in the estimated duration and quality of life were observed. Treatment-related toxicity was mild and reversible. (4) Conclusions: our study contributes to preparations for human BNCT clinical trials and suggests utility for veterinary oncology.
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Affiliation(s)
- Vladimir Kanygin
- Laboratory of Medical and Biological Problems of BNCT, Department of Physics, Novosibirsk State University, 1 Pirogov Str., 630090 Novosibirsk, Russia; (V.K.); (A.K.); (A.T.); (E.Z.)
| | - Aleksandr Kichigin
- Laboratory of Medical and Biological Problems of BNCT, Department of Physics, Novosibirsk State University, 1 Pirogov Str., 630090 Novosibirsk, Russia; (V.K.); (A.K.); (A.T.); (E.Z.)
| | - Alexander Zaboronok
- Laboratory of Medical and Biological Problems of BNCT, Department of Physics, Novosibirsk State University, 1 Pirogov Str., 630090 Novosibirsk, Russia; (V.K.); (A.K.); (A.T.); (E.Z.)
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Anna Kasatova
- Budker Institute of Nuclear Physics, Siberian Branch of Russian Academy of Sciences, 11, Acad. Lavrentieva Ave., 630090 Novosibirsk, Russia; (A.K.); (S.T.)
| | - Elena Petrova
- Veterinary Clinic “Best”, 57 Frunze Str., 630005 Novosibirsk, Russia;
| | - Alphiya Tsygankova
- Laboratory of Medical and Biological Problems of BNCT, Department of Physics, Novosibirsk State University, 1 Pirogov Str., 630090 Novosibirsk, Russia; (V.K.); (A.K.); (A.T.); (E.Z.)
- Nikolaev Institute of Inorganic Chemistry SB RAS, 3, Acad. Lavrentieva Ave., 630090 Novosibirsk, Russia
| | - Evgenii Zavjalov
- Laboratory of Medical and Biological Problems of BNCT, Department of Physics, Novosibirsk State University, 1 Pirogov Str., 630090 Novosibirsk, Russia; (V.K.); (A.K.); (A.T.); (E.Z.)
- Center for Genetic Resources of Laboratory Animals, Institute of Cytology and Genetics SB RAS, 10, Acad. Lavrentieva Ave., 630090 Novosibirsk, Russia
| | - Bryan J. Mathis
- International Medical Center, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba 305-8576, Ibaraki, Japan;
| | - Sergey Taskaev
- Budker Institute of Nuclear Physics, Siberian Branch of Russian Academy of Sciences, 11, Acad. Lavrentieva Ave., 630090 Novosibirsk, Russia; (A.K.); (S.T.)
- Laboratory of BNCT, Department of Physics, Novosibirsk State University, 1 Pirogov Str., 630090 Novosibirsk, Russia
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Loap P, Vischioni B, Bonora M, Ingargiola R, Ronchi S, Vitolo V, Barcellini A, Goanta L, De Marzi L, Dendale R, Pacelli R, Locati L, Calugaru V, Mammar H, Cavalieri S, Kirova Y, Orlandi E. Biological Rationale and Clinical Evidence of Carbon Ion Radiation Therapy for Adenoid Cystic Carcinoma: A Narrative Review. Front Oncol 2021; 11:789079. [PMID: 34917512 PMCID: PMC8668942 DOI: 10.3389/fonc.2021.789079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/15/2021] [Indexed: 12/13/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare, basaloid, epithelial tumor, arising mostly from salivary glands. Radiation therapy can be employed as a single modality for unresectable tumors, in an adjuvant setting after uncomplete resection, in case of high-risk pathological features, or for recurrent tumors. Due to ACC intrinsic radioresistance, high linear energy transfer (LET) radiotherapy techniques have been evaluated for ACC irradiation: while fast neutron therapy has now been abandoned due to toxicity concerns, charged particle beams such as protons and carbon ions are at present the beams used for hadron therapy. Carbon ion radiation therapy (CIRT) is currently increasingly used for ACC irradiation. The aim of this review is to describe the immunological, molecular and clinicopathological bases that support ACC treatment with CIRT, as well as to expose the current clinical evidence that reveal the advantages of using CIRT for treating ACC.
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Affiliation(s)
- Pierre Loap
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.,Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Barbara Vischioni
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Maria Bonora
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Rossana Ingargiola
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Sara Ronchi
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Viviana Vitolo
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Amelia Barcellini
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Lucia Goanta
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli, Italy
| | - Ludovic De Marzi
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France.,Institut Curie, PSL Research University, University Paris Saclay, INSERM LITO, Orsay, France
| | - Remi Dendale
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli, Italy
| | - Laura Locati
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Valentin Calugaru
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Hamid Mammar
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Stefano Cavalieri
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Youlia Kirova
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Ester Orlandi
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
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Xu J, Wang J, Wei Q. Boron neutron capture therapy in clinical application:Progress and prospect. CHINESE SCIENCE BULLETIN-CHINESE 2021. [DOI: 10.1360/tb-2021-0907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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45
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He H, Li J, Jiang P, Tian S, Wang H, Fan R, Liu J, Yang Y, Liu Z, Wang J. The basis and advances in clinical application of boron neutron capture therapy. Radiat Oncol 2021; 16:216. [PMID: 34743756 PMCID: PMC8573925 DOI: 10.1186/s13014-021-01939-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/25/2021] [Indexed: 12/31/2022] Open
Abstract
Boron neutron capture therapy (BNCT) was first proposed as early as 1936, and research on BNCT has progressed relatively slowly but steadily. BNCT is a potentially useful tool for cancer treatment that selectively damages cancer cells while sparing normal tissue. BNCT is based on the nuclear reaction that occurs when 10B capture low-energy thermal neutrons to yield high-linear energy transfer (LET) α particles and recoiling 7Li nuclei. A large number of 10B atoms have to be localized within the tumor cells for BNCT to be effective, and an adequate number of thermal neutrons need to be absorbed by the 10B atoms to generate lethal 10B (n, α)7Li reactions. Effective boron neutron capture therapy cannot be achieved without appropriate boron carriers. Improvement in boron delivery and the development of the best dosing paradigms for both boronophenylalanine (BPA) and sodium borocaptate (BSH) are of major importance, yet these still have not been optimized. Here, we present a review of this treatment modality from the perspectives of radiation oncology, biology, and physics. This manuscript provides a brief introduction of the mechanism of cancer-cell-selective killing by BNCT, radiobiological factors, and progress in the development of boron carriers and neutron sources as well as the results of clinical study.
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Affiliation(s)
- Huifang He
- Department of Radiotherapy, Peking University International Hospital, Beijing, China
| | - Jiyuan Li
- College of Chemistry and Molecular Engineering, Peking University, Beijing, 100871, China
| | - Ping Jiang
- Department of Radiotherapy, Peking University 3rd Hospital, Beijing, 100191, China
| | - Suqing Tian
- Department of Radiotherapy, Peking University 3rd Hospital, Beijing, 100191, China
| | - Hao Wang
- Department of Radiotherapy, Peking University 3rd Hospital, Beijing, 100191, China
| | - Ruitai Fan
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Junqi Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuyan Yang
- Department of Radiotherapy, Peking University International Hospital, Beijing, China
| | - Zhibo Liu
- College of Chemistry and Molecular Engineering, Peking University, Beijing, 100871, China.
| | - Junjie Wang
- Department of Radiotherapy, Peking University 3rd Hospital, Beijing, 100191, China.
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Dose-Dependent Suppression of Human Glioblastoma Xenograft Growth by Accelerator-Based Boron Neutron Capture Therapy with Simultaneous Use of Two Boron-Containing Compounds. BIOLOGY 2021; 10:biology10111124. [PMID: 34827117 PMCID: PMC8615214 DOI: 10.3390/biology10111124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/21/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022]
Abstract
Simple Summary Accelerator-based boron neutron capture therapy (BNCT) has opened up new perspectives in increasing cancer treatment efficacy, including malignant brain tumors and particularly glioblastoma. We studied dosimetry control optimization, neutron beam parameter adjustment, and two boron compound combinations (along with single and double irradiation regimens) to assess safety and increase therapy efficacy, using a U87MG xenotransplant immunodeficient mouse model. In two sets of experiments, we achieved increases in tumor-growth inhibition (to 80–83%), a neutron capture therapy ratio of 2:1 (two times higher neutron capture therapy efficacy than neutron irradiation without boron), and increases in animal life expectancy, from 9 to 107 days, by treatment parameter adjustment. These results will contribute to the development of clinical-trial protocols for accelerator-based BNCT and further innovations in this cancer treatment method. Abstract (1) Background: Developments in accelerator-based neutron sources moved boron neutron capture therapy (BNCT) to the next phase, where new neutron radiation parameters had to be studied for the treatment of cancers, including brain tumors. We aimed to further improve accelerator-BNCT efficacy by optimizing dosimetry control, beam parameters, and combinations of boronophenylalanine (BPA) and sodium borocaptate (BSH) administration in U87MG xenograft-bearing immunodeficient mice with two different tumor locations. (2) Methods: The study included two sets of experiments. In Experiment #1, BPA only and single or double irradiation in higher doses were used, while, in Experiment #2, BPA and BSH combinations and single or double irradiation with dosage adjustment were analyzed. Mice without treatment or irradiation after BPA or BPA+BSH injection were used as controls. (3) Results: Irradiation parameter adjustment and BPA and BSH combination led to 80–83% tumor-growth inhibition index scores, irradiation:BNCT ratios of 1:2, and increases in animal life expectancy from 9 to 107 days. (4) Conclusions: Adjustments in dosimetry control, calculation of irradiation doses, and combined use of two 10B compounds allowed for BNCT optimization that will be useful in the development of clinical-trial protocols for accelerator-based BNCT.
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Chiang CW, Chien YC, Yu WJ, Ho CY, Wang CY, Wang TW, Chiang CS, Keng PY. Polymer-Coated Nanoparticles for Therapeutic and Diagnostic Non- 10B Enriched Polymer-Coated Boron Carbon Oxynitride (BCNO) Nanoparticles as Potent BNCT Drug. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:2936. [PMID: 34835699 PMCID: PMC8618246 DOI: 10.3390/nano11112936] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022]
Abstract
Boron neutron capture therapy (BNCT) is a powerful and selective anti-cancer therapy utilizing 10B-enriched boron drugs. However, clinical advancement of BCNT is hampered by the insufficient loading of B-10 drugs throughout the solid tumor. Furthermore, the preparation of boron drugs for BNCT relies on the use of the costly B-10 enriched precursor. To overcome these challenges, polymer-coated boron carbon oxynitride (BCNO) nanoparticles, with ~30% of boron, were developed with enhanced biocompatibility, cell uptake, and tumoricidal effect via BNCT. Using the ALTS1C1 cancer cell line, the IC50 of the PEG@BCNO, bare, PEI@BCNO were determined to be 0.3 mg/mL, 0.1 mg/mL, and 0.05 mg/mL, respectively. As a proof-of-concept, the engineered non-10B enriched polymer-coated BCNO exhibited excellent anti-tumor effect via BNCT due to their high boron content per nanoparticle and due to the enhanced cellular internalization and retention compared to small molecular 10B-BPA drug. The astrocytoma ALTS1C1 cells treated with bare, polyethyleneimine-, and polyethylene glycol-coated BCNO exhibited an acute cell death of 24, 37, and 43%, respectively, upon 30 min of neutron irradiation compared to the negligible cell death in PBS-treated and non-irradiated cells. The radical approach proposed in this study addresses the expensive and complex issues of B-10 isotope enrichment process; thus, enabling the preparation of boron drugs at a significantly lower cost, which will facilitate the development of boron drugs for BNCT.
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Affiliation(s)
- Chen-Wei Chiang
- Department of Material Science and Engineering, National Tsing Hua University, Hsinchu City 300, Taiwan; (C.-W.C.); (Y.-C.C.); (C.-Y.H.); (C.-Y.W.); (T.-W.W.)
| | - Yun-Chen Chien
- Department of Material Science and Engineering, National Tsing Hua University, Hsinchu City 300, Taiwan; (C.-W.C.); (Y.-C.C.); (C.-Y.H.); (C.-Y.W.); (T.-W.W.)
| | - Wen-Jui Yu
- Department of Biomedical Engineering and Environmental Science, National Tsing Hua University, Hsinchu City 300, Taiwan; (W.-J.Y.); (C.-S.C.)
| | - Chia-Yu Ho
- Department of Material Science and Engineering, National Tsing Hua University, Hsinchu City 300, Taiwan; (C.-W.C.); (Y.-C.C.); (C.-Y.H.); (C.-Y.W.); (T.-W.W.)
| | - Chih-Yi Wang
- Department of Material Science and Engineering, National Tsing Hua University, Hsinchu City 300, Taiwan; (C.-W.C.); (Y.-C.C.); (C.-Y.H.); (C.-Y.W.); (T.-W.W.)
| | - Tzu-Wei Wang
- Department of Material Science and Engineering, National Tsing Hua University, Hsinchu City 300, Taiwan; (C.-W.C.); (Y.-C.C.); (C.-Y.H.); (C.-Y.W.); (T.-W.W.)
| | - Chi-Shiun Chiang
- Department of Biomedical Engineering and Environmental Science, National Tsing Hua University, Hsinchu City 300, Taiwan; (W.-J.Y.); (C.-S.C.)
| | - Pei-Yuin Keng
- Department of Material Science and Engineering, National Tsing Hua University, Hsinchu City 300, Taiwan; (C.-W.C.); (Y.-C.C.); (C.-Y.H.); (C.-Y.W.); (T.-W.W.)
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Popova T, Dymova MA, Koroleva LS, Zakharova OD, Lisitskiy VA, Raskolupova VI, Sycheva T, Taskaev S, Silnikov VN, Godovikova TS. Homocystamide Conjugates of Human Serum Albumin as a Platform to Prepare Bimodal Multidrug Delivery Systems for Boron Neutron Capture Therapy. Molecules 2021; 26:molecules26216537. [PMID: 34770947 PMCID: PMC8586956 DOI: 10.3390/molecules26216537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
Boron neutron capture therapy is a unique form of adjuvant cancer therapy for various malignancies including malignant gliomas. The conjugation of boron compounds and human serum albumin (HSA)-a carrier protein with a long plasma half-life-is expected to extend systemic circulation of the boron compounds and increase their accumulation in human glioma cells. We report on the synthesis of fluorophore-labeled homocystamide conjugates of human serum albumin and their use in thiol-'click' chemistry to prepare novel multimodal boronated albumin-based theranostic agents, which could be accumulated in tumor cells. The novelty of this work involves the development of the synthesis methodology of albumin conjugates for the imaging-guided boron neutron capture therapy combination. Herein, we suggest using thenoyltrifluoroacetone as a part of an anticancer theranostic construct: approximately 5.4 molecules of thenoyltrifluoroacetone were bound to each albumin. Along with its beneficial properties as a chemotherapeutic agent, thenoyltrifluoroacetone is a promising magnetic resonance imaging agent. The conjugation of bimodal HSA with undecahydro-closo-dodecaborate only slightly reduced human glioma cell line viability in the absence of irradiation (~30 μM of boronated albumin) but allowed for neutron capture and decreased tumor cell survival under epithermal neutron flux. The simultaneous presence of undecahydro-closo-dodecaborate and labeled amino acid residues (fluorophore dye and fluorine atoms) in the obtained HSA conjugate makes it a promising candidate for the combination imaging-guided boron neutron capture therapy.
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Affiliation(s)
- Tatyana Popova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
- Faculty of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Maya A Dymova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
| | - Ludmila S Koroleva
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
| | - Olga D Zakharova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
| | - Vladimir A Lisitskiy
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
| | - Valeria I Raskolupova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
- Faculty of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Tatiana Sycheva
- Budker Institute of Nuclear Physics, SB RAS, 630090 Novosibirsk, Russia
| | - Sergei Taskaev
- Faculty of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
- Budker Institute of Nuclear Physics, SB RAS, 630090 Novosibirsk, Russia
| | - Vladimir N Silnikov
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
| | - Tatyana S Godovikova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, 630090 Novosibirsk, Russia
- Faculty of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
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Response of Normal Tissues to Boron Neutron Capture Therapy (BNCT) with 10B-Borocaptate Sodium (BSH) and 10B-Paraboronophenylalanine (BPA). Cells 2021; 10:cells10112883. [PMID: 34831105 PMCID: PMC8616460 DOI: 10.3390/cells10112883] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 02/07/2023] Open
Abstract
Boron neutron capture therapy (BNCT) is a cancer-selective radiotherapy that utilizes the cancer targeting 10B-compound. Cancer cells that take up the compound are substantially damaged by the high liner energy transfer (LET) particles emitted mainly from the 10B(n, α7Li reaction. BNCT can minimize the dose to normal tissues, but it must be performed within the tolerable range of normal tissues. Therefore, it is important to evaluate the response of normal tissues to BNCT. Since BNCT yields a mixture of high and low LET radiations that make it difficult to understand the radiobiological basis of BNCT, it is important to evaluate the relative biological effectiveness (RBE) and compound biological effectiveness (CBE) factors for assessing the responses of normal tissues to BNCT. BSH and BPA are the only 10B-compounds that can be used for clinical BNCT. Their biological behavior and cancer targeting mechanisms are different; therefore, they affect the CBE values differently. In this review, we present the RBE and CBE values of BPA or BSH for normal tissue damage by BNCT irradiation. The skin, brain (spinal cord), mucosa, lung, and liver are included as normal tissues. The CBE values of BPA and BSH for tumor control are also discussed.
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50
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Song S, Gao P, Sun L, Kang D, Kongsted J, Poongavanam V, Zhan P, Liu X. Recent developments in the medicinal chemistry of single boron atom-containing compounds. Acta Pharm Sin B 2021; 11:3035-3059. [PMID: 34729302 PMCID: PMC8546671 DOI: 10.1016/j.apsb.2021.01.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/25/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022] Open
Abstract
Various boron-containing drugs have been approved for clinical use over the past two decades, and more are currently in clinical trials. The increasing interest in boron-containing compounds is due to their unique binding properties to biological targets; for example, boron substitution can be used to modulate biological activity, pharmacokinetic properties, and drug resistance. In this perspective, we aim to comprehensively review the current status of boron compounds in drug discovery, focusing especially on progress from 2015 to December 2020. We classify these compounds into groups showing anticancer, antibacterial, antiviral, antiparasitic and other activities, and discuss the biological targets associated with each activity, as well as potential future developments.
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Key Words
- ACTs, artemisinin combination therapies
- ADCs, Acinetobacter-derived cephalosporinases
- AML, acute myeloid leukemia
- AMT, aminopterin
- BLs, β-lactamases
- BNCT, boron neutron capture therapy
- BNNPs, boron nitride nanoparticles
- BNNTs, boron nitride nanotubes
- Boron-containing compounds
- CEs, carboxylesterases
- CIA, collagen-induced arthritis
- COVID-19, coronavirus disease 2019
- ClpP, casein protease P
- Covalent inhibitors
- GSH, glutathione
- HADC1, class I histone deacetylase
- HBV, hepatitis B virus
- HCV, hepatitis C virus
- HIV, human immunodeficiency virus
- LeuRS, leucyl-tRNA synthetase
- Linker components
- MBLs, metal β-lactamases
- MDR-TB, multidrug-resistant tuberculosis
- MERS, Middle East respiratory syndrome
- MIDA, N-methyliminodiacetic acid
- MM, multiple myeloma
- MTX, methotrexate
- Mcl-1, myeloid cell leukemia 1
- Mtb, Mycobacterium tuberculosis
- NA, neuraminidase
- NS5B, non-nucleoside polymerase
- OBORT, oxaborole tRNA capture
- OPs, organophosphate
- PBA, phenylboronic acid
- PDB, Protein Data Bank
- PPI, protein–protein interaction
- Prodrug
- QM, quinone methide
- RA, rheumatoid arthritis
- ROS, reactive oxygen species
- SARS-CoV-2, syndrome coronavirus 2
- SBLs, serine β-lactamases
- SERD, selective estrogen receptor downregulator
- SHA, salicyl hydroxamic acid
- SaClpP, Staphylococcus aureus caseinolytic protease P
- TB, tuberculosis
- TTR, transthyretin
- U4CR, Ugi 4-component reaction
- cUTI, complex urinary tract infection
- dCTPase, dCTPase pyrophosphatase
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Affiliation(s)
- Shu Song
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University, Ji'nan 250012, China
| | - Ping Gao
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University, Ji'nan 250012, China
| | - Lin Sun
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University, Ji'nan 250012, China
| | - Dongwei Kang
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University, Ji'nan 250012, China
| | - Jacob Kongsted
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense M. DK-5230, Denmark
| | - Vasanthanathan Poongavanam
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense M. DK-5230, Denmark
- Corresponding authors. Tel./fax: +86 531 88380270.
| | - Peng Zhan
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University, Ji'nan 250012, China
- Corresponding authors. Tel./fax: +86 531 88380270.
| | - Xinyong Liu
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University, Ji'nan 250012, China
- Corresponding authors. Tel./fax: +86 531 88380270.
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