Rethinking Precision Oncology in the Age of Functional Data

Contributed Commentary by Jim Foote, First Ascent Biomedical 

December 11, 2025 | Few words strike fear into our hearts more than “cancer.” For me, it was October 19, when I heard, “Jim, Trey has cancer.” In an instant, I was thrust into a world I didn’t understand, filled with unfamiliar terms and life-or-death decisions. My son was fighting cancer, and I was given the most complex problem of my life. 

After eight months of grueling chemotherapy, surgery confirmed the tumor was dead. We thought we had won. But three months later, the oncologist delivered devastating news: “The standard of care has failed, and the cancer has returned.” In that moment, I realized the system’s limitations. With all our tools and technology, one in three cancer patients still dies. I knew this was a solvable problem. 

Ending the Era of ‘Try and Hope’ in Cancer Treatment 

Historically, cancer treatment has relied on a one-size-fits-all approach known as the Standard of Care, where patients are treated based on population averages. But cancer is not a single disease; it’s thousands of distinct conditions, each driven by unique biology. Two patients with the same diagnosis may respond entirely differently to the same therapy. 

Functional Precision Medicine (FPM) changes this paradigm. By directly testing a patient’s live tumor cells against hundreds of FDA-approved drugs, FPM identifies what works for that individual. Combined with AI, it delivers actionable results in days, replacing uncertainty with evidence-based care. 

The New Era of Functional Precision Medicine 

That’s where FPM comes in. Biology is the universe: vast, complex, and full of unknowns. Genomics is the telescope, revealing patterns and structures. Artificial intelligence (AI) is the navigation system, interpreting data and guiding the mission. FPM is the spacecraft, uniting these tools to turn discovery into direction and data into life-saving outcomes. 

FPM directly tests a patient’s living tumor cells to see which drugs actually kill the cancer. Instead of relying on population data, oncologists receive real-time results tailored to the patient’s unique biology. AI processes this data, uncovering the most effective treatments within days. 

Most medical AI systems rely on generalized data from thousands of patients, producing averages rather than personalized insights. FPM flips this model. Each patient becomes their own control, with AI analyzing their tumor’s live-cell data, genomic profile, and drug responses. It’s not about more data; it’s about the right data, tailored to the individual. 

The Human Equation 

Technology alone doesn’t heal people, but it can give doctors and patients the right information at the right time to make better decisions faster. For patients, FPM means fewer failed therapies, fewer side effects, and less time lost to uncertainty. For physicians, it replaces intuition with actionable data. For healthcare systems, it reduces cost and waste by focusing on treatments that truly help. Most importantly, it gives families something no algorithm can quantify: time. 

When families tell me, “You didn’t just give us treatment options, you gave us clarity,” that’s what this work is about. FPM isn’t just precision science. It’s emotional precision. When you can see what works, hope stops being abstract. It becomes evidence. 

Scaling Precision, Together 

Imagine an oncology ecosystem where physicians know which drugs will work before treatment begins, hospitals move from biopsy to treatment in days, and insurers approve therapies faster with validated data. FPM makes this possible, but it requires collaboration across hospitals, payers, innovators, and regulators to scale. This isn’t about replacing clinicians with machines. It’s about equipping them with tools that combine biology, data, and AI to move from “try and hope” to “test and treat.” When that happens, oncology becomes not just more precise but more human. 

Redefining Cancer Care 

For too long, we’ve fought cancer with blunt tools and best guesses. Now, by uniting the patient’s unique biology, genomics, and AI, we can fight with precision. The future of oncology won’t be defined by the biggest datasets but by the right data, those that close the feedback loop between biology and computation. The next leap in cancer care won’t come from more generalized intelligence but from deeply personal insight, powered by AI that learns from life itself. The future of oncology isn’t about hope without evidence; it’s about evidence that creates hope. 

Jim Foote is the CEO and Co-Founder of First Ascent Biomedical, a company developing AI-driven Functional Precision Medicine platforms to personalize cancer care. A lifelong technologist and entrepreneur, Jim began his career building data and decision systems before focusing on healthcare after losing his son, Trey, to cancer. His mission is to ensure every child facing cancer has access to data-driven, individualized treatment options. He can be reached out at jfoote@firstascentbio.com and his LinkedIn.