Introduction:
In 2020, Boron Neutron Capture Therapy (BNCT) was officially approved in Japan for the treatment of head and neck tumors, making BNCT the fifth major therapeutic modality following surgery, radiotherapy, chemotherapy, and immunotherapy. In 2025, the Phase I clinical trial of BNCT at Xiamen Hong’ai Hospital completed patient enrollment, and the Phase I trial at Dongguan People’s Hospital officially launched—marking an acceleration of BNCT’s development in China. Its future prospects in China are worth anticipating.
1. BNCT Possesses Both Biological and Physical Targeting Mechanisms
At the forefront of tumor treatment, BNCT is rewriting the rules of traditional radiotherapy with its unique dual-targeting mechanism. This technology functions like a “molecular scalpel” customized for cancer cells, coupling biological targeting with physical targeting to achieve cell-level precision in eliminating malignant tumors.
The treatment begins by injecting a boron-10 (¹⁰B)-containing drug (such as BPA or BSH) into the patient. This drug selectively accumulates in cancer cells while distributing less in normal tissues. Taking BPA (boronophenylalanine), which is widely used in clinical settings, as an example, this drug is molecularly designed to mimic the essential amino acid phenylalanine. Once it enters the human circulatory system, the L-type amino acid transporter proteins—overexpressed on the surface of cancer cells—mistake it for a nutrient and actively transport it inside.
After the drug has accumulated at the tumor site, physicians use a neutron beam to precisely irradiate the tumor area. The neutrons react with boron-10 inside the cancer cells, releasing high-energy alpha particles and lithium ions (⁷Li) with ranges of only 5–9 microns (about the diameter of one cell), destroying the cancer cells from the inside.
This dual-targeting mechanism is precisely the therapeutic advantage of BNCT. For highly sensitive regions like head and neck cancers, neutron beams can penetrate the skull and reach deep lesions, while the boron drugs enriched in the cancer cells ensure that the destructive energy is released with precision. For hypoxic tumor regions resistant to conventional radiotherapy, the dense ionization effect generated by high-energy particles can still effectively kill cancer cells, overcoming the biological limitations of traditional radiation therapy.
In addition to its treatment precision, the mechanism also ensures tissue safety. Although some boron drugs are physiologically distributed in organs like the liver and salivary glands, real-time monitoring systems dynamically regulate neutron flux. Combined with deep-dose control of epithermal neutron beams, energy release can be strictly confined to the target region.
2. BNCT Has Broad Prospects for Indication Expansion
This innovative therapy currently focuses on a major clinical dilemma—locally advanced or recurrent head and neck tumors that cannot be surgically removed. BNCT is opening a new path for these hard-to-treat diseases.
In 2020, Japan was the first to open the door for BNCT’s clinical application, officially including it in the treatment system for recurrent head and neck tumors. In a Japanese study involving 69 patients with head and neck cancers who received BNCT treatment, 57.1% achieved effective local disease control within one year. Some 42.2% remained progression-free, with an overall survival rate of 75.4% and an objective response rate (ORR) as high as 80.5%. According to results published in the Journal of Clinical Oncology, the ORR of PD-1 drug pembrolizumab in treating head and neck cancer is 49%.
Moreover, BNCT is continuously bringing hope to more non-head-and-neck malignancies, such as skin and soft tissue tumors, malignant melanoma, angiosarcoma, and complex cases of locally recurrent breast cancer after radiotherapy. These clinical trials are gradually forming a research network, systematically validating BNCT’s therapeutic effects on various solid tumors and laying a scientific foundation for future clinical applications.
In China, clinical application of this technology is gathering momentum, with a rapidly expanding trial landscape. Indications are extending from hard-to-treat head and neck cancers (e.g., recurrent squamous cell carcinoma and refractory malignant tumors) to intracranial malignancies (e.g., recurrent high-grade meningioma [WHO grades 2 and 3], recurrent glioma, recurrent glioblastoma, and primary brain malignancies).
With the accumulation of more clinical data and the optimization of treatment protocols, BNCT is expected to become an indispensable piece of the tumor treatment puzzle—offering new life-saving options to patients for whom conventional treatments have failed.
3. BNCT Development Accelerates in China
Exploration of BNCT began in 1936, when American chemist H.J. Taylor and physicist G.L. Locher first outlined the theoretical framework for this revolutionary therapy. In 2020, BNCT entered its commercialization era. Japan was the first country to approve the world’s first BNCT device and boron drug for treating head and neck cancers.
In 2014, China built and launched the world’s first nuclear reactor specifically for BNCT treatment (IHNI-1), immediately initiating clinical trials—placing China at the global forefront of this field. Industrialization proceeded in parallel: in 2019, Boron Medical (中硼医疗) successfully achieved large-scale production of multiple batches of boron drug APIs and formulations, providing a material foundation for treatment. In 2021, Boron Medical built China’s first accelerator-based BNCT tumor treatment center, marking a major shift in technical approach. In 2022, China applied accelerator BNCT technology in a hospital environment for the first time. Meanwhile, Zhongsheng Kefu (中生科服) enriched domestic capabilities by introducing Japanese technology and equipment. In 2024, Boron Medical’s independently developed BPA boron drug received the first domestic clinical trial approval, marking a breakthrough in homegrown drug development.
In 2025, BNCT clinical research is flourishing across China. Xiamen Hong’ai Hospital completed trials involving 50 valuable cases, accumulating vital local data. In March, the Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital) announced that its clinical BNCT equipment passed Class III medical device inspection and began patient recruitment for a Phase I trial at the end of April. The equipment was developed by Guoke Neutron Medical Technology Co., Ltd. and is the first domestically developed BNCT clinical device with fully independent intellectual property rights. The hospital is also constructing an ambitious Super BNCT Clinical Research Center, expected to cover 40,000 square meters and house 300 research beds.
4. BNCT May Reshape the Landscape of Tumor Therapy
As the global medical community turns its attention to precision oncology, BNCT is triggering a wave of international competition. Japan, after a decade of development, is leading the way—having built 10 specialized treatment centers nationwide and established a large-scale treatment network. Its 2020 clinical approval for recurrent head and neck tumors signaled the maturity of BNCT technology. Meanwhile, China, as a latecomer, is making a remarkable breakthrough and has become the second country in the world to master core accelerator BNCT technology.
Looking at the domestic market, although BNCT still requires several more years before being officially approved for clinical treatment, the pace of investment has already accelerated dramatically. Currently, there are over 10 BNCT projects in operation, under construction, or planned across China, including: IHNI (Kaibetter), Xiamen Hong’ai Hospital, Qilu Hospital of Shandong University, Gaoxin Campus of Tai’an Central Hospital in Shandong Province, Borong BNCT project, CNNC Changsha Oncology Hospital, Union Hospital of Fujian Medical University (Mazu Health City), Dongguan Hospital of Southern Medical University, Pengbo Bo’ao Boron Neutron Hospital, BNCT Nuclear Medical Health Industry Demonstration Project, and Guangdong Medical University’s Songshan Lake Science City. In Bo’ao, Hainan, commercial BNCT treatment equipment is about to go live, potentially becoming China’s first center to offer routine BNCT treatment.
A dual-engine model of industrialization and clinical research is now taking shape. Medical institutions, research institutes, and innovative enterprises are building a complete industry chain: China Biotechnology Services has introduced advanced Japanese technology to launch commercial projects; companies like Boron Medical are accelerating domestic boron drug development; and treatment centers are springing up nationwide. According to data from medical institutions, future commercial BNCT treatment costs could drop to RMB 100,000–150,000 (approx. USD 13,800–20,700). Previously, BNCT treatment in Japan cost around RMB 200,000 (approx. USD 27,600), while domestic proton and heavy ion therapy typically exceeds RMB 250,000 (approx. USD 34,500).
BNCT currently shows better efficacy than chemotherapy and is significantly cheaper than high-end precision radiotherapies like proton and heavy ion therapy or immunotherapy. Proton and heavy ion therapy are more suitable for specific in-situ cancers, while immunotherapy’s efficacy in treating solid tumors remains under evaluation. In contrast, BNCT has enormous potential for indication expansion. Once officially approved, it may reshape the current tumor treatment landscape in the short to medium term.
5. Conclusion
BNCT combines biological and physical targeting mechanisms. Current clinical trial results show that it has tremendous potential across multiple cancer types. In terms of both efficacy and cost, BNCT may strike an optimal balance, offering broader applicability than high-end radiotherapy like immunotherapy and proton/heavy ion therapy. Although it may still take several years before BNCT is approved for clinical use in China, a significant influx of investment is already flowing into the field. The development of BNCT in China is truly something to look forward to.
[Disclaimer]: The above content reflects analysis of publicly available information, expert insights, and BCC research. It does not constitute investment advice. BCC is not responsible for any losses resulting from reliance on the views expressed herein. Investors should exercise caution.