Boron-10 carriers and their applications in boron neutron capture therapy

Boron neutron capture therapy (BNCT) has emerged as a promising therapeutic modality in cancer treatment, demonstrating the ability to selectively eliminate cancer cells through the ¹⁰B(n,α)⁷Li nuclear reaction with minimal side effects on normal tissues. As a binary, target-specific therapeutic modality for malignancies, BNCT critically depends on novel boron delivery carriers that exhibit high tumor affinity and prolonged intratumoral retention. Although several boron carriers have received Food and Drug Administration approval for clinical investigation, leading carriers such as L-p-boronophenylalanine (BPA) and sodium borocaptate (BSH) continue to require high infusion doses and exhibit limited tumor selectivity and affinity, short systemic half-lives, and limited in vivo stability. These challenges have stimulated extensive global research into novel boron-10 carriers and innovative carrier platforms, including amino acids, sugars, porphyrin derivatives, nucleotides, and a variety of nanocarrier systems. This review provides a systematic classification of high-abundance boron-10 carriers, critically examines radio-boron research, and evaluates the potential integration of BNCT into clinical diagnostics and advanced cancer treatment protocols. By detailing the current status of novel boron-10 carriers, this review further aims to elucidate critical challenges and opportunities in BNCT drug development, ultimately providing a theoretical foundation for next-generation BNCT interventions.