Published
What if a simple test could save millions of lives by catching cancer early? What if we could develop radiotherapy technology to enable one low-cost curative treatment effective for all cancers? What if we could adapt cancer treatments as tumors mutate and change?
There are far too many unanswered questions in cancer detection, treatment, and care. But the answers aren't out of reach. These are the investments ARPA-H is making now, on behalf of every American who has heard the words "you have cancer," and every American whose loved ones have been given such a prognosis.
Cancer remains the second leading cause of death in the United States. Despite decades of scientific progress, the path from a promising discovery in the lab to a treatment that actually reaches patients is still brutally long, expensive, and uncertain. Too many people are diagnosed too late. Too many tumors outsmart the treatments designed to fight them. Too many children face a disease that the medical system cannot address on their terms.
ARPA-H was created to change that, not by funding more of the same research, but by making investments that traditional ventures won't, on timelines that the standard system cannot achieve.
What ARPA-H does differently
Basic knowledge of cancer mechanisms alone does not save lives — delivery does. ARPA-H exists in the space between what we know is possible and what actually reaches patients. We fund the hardest part, which is turning a breakthrough into something a doctor can use, a patient can access, and a health system can sustain.
Across our cancer portfolio, we are attacking the disease at every stage — before diagnosis, in the operating room, through treatment, and inside the data systems that connect it all.
You can't treat what you can't detect
Nearly 60% of diagnosed cancers — including brain, pancreatic, and ovarian cancer — have no recommended screening test. By the time most of these cancers are found, they have already advanced to a stage where treatment options are limited and survival rates are low.
That is not an acceptable status quo. Early detection is where lives are saved, and it is one of the spaces where ARPA-H is investing.
POSEIDON (Platform Optimizing SynBio for Early Intervention and Detection in Oncology) is building what doesn't yet exist: a simple, at-home test that can accurately detect more than 30 cancers, as early as Stage I, when tumors are small and outcomes are best. The program brings together experts in synthetic biology, oncology, medical devices, and large-scale cancer data to create test kits that any American could use, on their own schedule, long before symptoms appear. Detection is step one. But knowing cancer is there is only valuable if the tools exist to act on it.
Treating early and completely
For many solid tumors, surgery is the first and best option. To succeed, a surgeon must see clearly, identify exactly where a tumor ends and healthy tissue begins, and confirm that nothing malignant is left behind.
Today, surgeons rely on judgment developed over years, and even the most experienced hands leave microscopic cancer cells behind in a significant percentage of operations. Those cells become recurrences. Recurrences become advanced disease.
PSI (Precision Surgical Interventions) is changing what surgeons can see, through real-time visualization tools that illuminate tumor edges and critical anatomy during surgery, giving surgeons a clear map of what to remove and what to preserve. The goal is complete removal, the first time. Less guesswork in the operating room will mean fewer recurrences, fewer second surgeries, and more patients who leave the hospital cancer-free.
When cancer fights back
Even when treatment works, cancer often finds a way around it, as tumors mutate or develop resistance to treatment. A therapy that was working in January may stop working by April — and without a way to detect that shift and respond, patients lose precious time on continued treatments that are no longer effective.
ADAPT (Advanced Analysis for Precision Cancer Therapy) is building the tools to detect resistance before it defeats treatment. By tracking how a tumor is changing in near-real time, ADAPT aims to give oncologists the information they need to switch strategies fast — adjusting treatment as the disease evolves rather than waiting for clinical failure to make the decision for them. For patients with metastatic, advanced, or treatment-resistant cancer, speed could mean survival.
1-CURE (One Comprehensive Universal Radiotherapy for Everyone) is pursuing a different kind of breakthrough: a single, low-cost radiotherapy approach designed to be curative across cancer types. The vision is a treatment powerful enough to work broadly and affordable enough to reach every patient who needs it, not just those at major academic medical centers with the latest technology and the best insurance.
Cancer doesn't spare children
Childhood cancer is the leading cause of death by disease in American children. Yet treatment approaches have often been adapted from adult therapies rather than designed around pediatric biology — when in fact, kids need therapies built for how their cancers actually behave.
PCX (Pediatric Cancer eXchange) is built on a different premise: that children deserve cancer medicine built for their biology. The PCX project is developing precision approaches designed specifically for pediatric patients, recognizing that a disease that strikes a six-year-old is not the same disease that strikes a sixty-year-old, even when the tumor type looks the same.
The infrastructure that connects it all
Better detection, smarter surgery, adaptive treatments, and pediatric precision medicine all depend on something most people never see: the data systems that make it possible to learn from every patient, every clinical trial, and every outcome.
The ARPA-H BDF Toolbox (Biomedical Data Fabric Toolbox) is building the connective data network of cancer research. It creates shared data infrastructure that lets researchers, clinicians, and program teams’ access, integrate, and learn from cancer data at a scale that individual programs cannot achieve alone. Every insight from POSEIDON, PSI, ADAPT, 1-CURE, and PCX becomes more powerful when it feeds into a system that is learning continuously. The BDF Toolbox is not a program that treats cancer. It is the platform that makes these programs smarter.
The long view
ARPA-H's cancer portfolio is not a collection of isolated investments. It is a coordinated attack on the disease at every stage of its progression — from the moment a tumor begins to form, through the point where a patient needs surgery, through the treatment decisions that follow, and through the data systems that connect every piece of the picture.
ARPA-H is not here to underwrite research publications. We are here to produce cures and to make sure those cures reach every American who needs them, regardless of where they live, what they earn, or what insurance they carry.
The science to change cancer's trajectory exists. The question has always been whether we have the will and the infrastructure to get it to patients on the timeline they deserve.
At ARPA-H, that is the only question we are trying to answer.