Clinical Research
Expanding the Clinical Application of BNCT to Difficult-to-Treat Abdominal Cancers
At the Fujita Health University BNCT Research Center, we are preparing investigator-initiated clinical studies and industry-sponsored clinical trials aimed at expanding the application of Boron Neutron Capture Therapy (BNCT) to difficult-to-treat abdominal cancers, including pancreatic cancer, biliary tract cancer, and liver cancer.
To date, BNCT has been used primarily for recurrent or otherwise difficult-to-treat head and neck cancers, where it has become an established treatment option for selected patients. Our goal is to extend this innovative therapy to deep-seated abdominal tumors, where curative treatment remains a major clinical challenge. Achieving this represents one of the most important frontiers in BNCT research worldwide.
To date, BNCT has been used primarily for recurrent or otherwise difficult-to-treat head and neck cancers, where it has become an established treatment option for selected patients. Our goal is to extend this innovative therapy to deep-seated abdominal tumors, where curative treatment remains a major clinical challenge. Achieving this represents one of the most important frontiers in BNCT research worldwide.
A key component of this effort is ^18F-BPA positron emission tomography (F-BPA PET), an advanced molecular imaging technique. Because the effectiveness of BNCT depends on the selective accumulation of boron in tumor cells while minimizing uptake by normal tissues, accurate pre-treatment evaluation is essential. F-BPA PET enables visualization of boron distribution before treatment, allowing clinicians to assess whether BNCT can be delivered safely and effectively for each individual patient. This personalized approach reflects the principles of theranostics, which integrates diagnostic imaging and targeted therapy to optimize patient care.
Beyond evaluating boron distribution, we are also developing new strategies to improve the therapeutic efficacy of BNCT. One of the greatest challenges in treating deep-seated abdominal tumors with the currently available boron compound boronophenylalanine (BPA) is improving the tumor-to-normal tissue boron uptake ratio (T/N ratio).
Because abdominal tumors are often located adjacent to highly radiosensitive organs such as the intestine, excessive boron uptake by normal tissues limits the neutron irradiation time that can be delivered safely. As a result, it becomes difficult to achieve an adequate therapeutic dose in tumors located deep within the body. Increasing the T/N ratio—by maximizing boron accumulation in tumors while minimizing uptake in surrounding normal tissues—is therefore a critical prerequisite for expanding the clinical application of BNCT to abdominal cancers.
To address this challenge, we are investigating the unique biological characteristics of cancer cells, including amino acid transport systems such as the L-type amino acid transporter 1 (LAT1). By optimizing boron drug administration protocols and developing novel therapeutic strategies that exploit tumor-specific biology, we aim to substantially improve the T/N ratio. Achieving this goal would allow longer and safer neutron irradiation, enabling effective treatment of deep-seated tumors while protecting surrounding healthy organs.
Successfully expanding BNCT to abdominal malignancies requires expertise that extends far beyond a single discipline. Our clinical research program is therefore conducted through close collaboration with specialists across Fujita Health University Hospital, including the Departments of Gastroenterology, Diagnostic Pathology, and Radiology, together with the Theranostics Center.
Because abdominal tumors are often located adjacent to highly radiosensitive organs such as the intestine, excessive boron uptake by normal tissues limits the neutron irradiation time that can be delivered safely. As a result, it becomes difficult to achieve an adequate therapeutic dose in tumors located deep within the body. Increasing the T/N ratio—by maximizing boron accumulation in tumors while minimizing uptake in surrounding normal tissues—is therefore a critical prerequisite for expanding the clinical application of BNCT to abdominal cancers.
To address this challenge, we are investigating the unique biological characteristics of cancer cells, including amino acid transport systems such as the L-type amino acid transporter 1 (LAT1). By optimizing boron drug administration protocols and developing novel therapeutic strategies that exploit tumor-specific biology, we aim to substantially improve the T/N ratio. Achieving this goal would allow longer and safer neutron irradiation, enabling effective treatment of deep-seated tumors while protecting surrounding healthy organs.
Successfully expanding BNCT to abdominal malignancies requires expertise that extends far beyond a single discipline. Our clinical research program is therefore conducted through close collaboration with specialists across Fujita Health University Hospital, including the Departments of Gastroenterology, Diagnostic Pathology, and Radiology, together with the Theranostics Center.
Accurate clinical evaluation by gastroenterologists, detailed pathological analyses, and advanced molecular imaging performed by radiologists and theranostics specialists are integrated into a multidisciplinary framework that supports safe, rigorous, and high-quality clinical research.
Our objective extends beyond generating clinical data. Through these investigator-initiated studies, we seek to establish the scientific and clinical foundation for the safe and effective use of BNCT in abdominal cancers, paving the way for full-scale clinical trials planned for 2028 and, ultimately, the establishment of BNCT as a new standard treatment option.
Our objective extends beyond generating clinical data. Through these investigator-initiated studies, we seek to establish the scientific and clinical foundation for the safe and effective use of BNCT in abdominal cancers, paving the way for full-scale clinical trials planned for 2028 and, ultimately, the establishment of BNCT as a new standard treatment option.
By bringing together expertise from across the university, we are committed to advancing innovative cancer therapies and creating new treatment opportunities for patients facing some of the most challenging forms of cancer.