Jim Foote, Co-Founder and CEO, First Ascent Biomedical

May 2026 — In an interview with Invest:, Jim Foote, co-founder and CEO of First Ascent Biomedical, discussed how functional precision medicine is changing cancer treatment by shifting the focus from population averages to individualized care. “If we know genetically we’re all different, why would we accept that everybody’s cancer is being treated based on a law of averages?” Foote said.

What inspired the creation of First Ascent Biomedical, and what problem were you determined to solve?

Most of us believe, before you hear the word cancer, that the system has it all figured out. We hear about all the advances and all the money going into diagnosing and treating cancer. But when you hear that word and it is related to you or someone you love, you instantly get pulled into a world where you realize that the way we are treating cancer today is largely based on averages.

Cancer treatment is often based on data from groups of patients who hopefully look similar and whose cancers respond in similar ways. But genetically there is only one of each of us. There is only one you, one me. If we know genetically we’re all different, why would we accept that everybody’s cancer is being treated based on a law of average?

What First Ascent Biomedical does is take the opposite approach. A hospital takes a biopsy from the patient’s tumor, and we use technology that allows us to test hundreds of drugs directly against that patient’s living cancer cells. We combine that data with genomics and artificial intelligence, and we provide the results back to the physician. That information helps the doctor make better decisions about which drugs work for that specific patient.

We can typically do that in about 10 days. It gives the physician information based on how that individual cancer responds to treatment rather than relying on averages. This is particularly important for patients whose cancers have come back after the standard of care or for patients with rare cancers where physicians are not certain what treatment path to follow.

The inspiration behind the company is also very personal for me. I lost my son to cancer. He was diagnosed at 15 and passed away at 17. I had spent my entire career in technology solving complex problems, and when my son was diagnosed, I realized that doctors did not have the same type of decision-making tools that executives in technology companies use every day.

After losing my son, I knew this was a solvable problem. That became the basis and the inspiration for moving forward with this company.

How does your approach differ from traditional precision medicine that relies primarily on genetics?

Genetics helps identify biomarkers in a tumor. Once a biomarker is identified, doctors try to map a drug that targets that specific biomarker. That approach has helped improve outcomes in some cases.

However, even when a biomarker is identified and a drug exists that targets it, the treatment only works about 10% of the time. So while genetics is valuable, it does not always predict how the cancer will actually respond to the drug.

What we do is take that one step further. If genetics identifies a biomarker and suggests a drug that might work, we test that drug directly on the patient’s cancer cells to see whether it actually works.

In other words, we move from “try and hope” to “test and treat.” Functional precision medicine provides the final validation step by showing whether the drug actually works on that patient’s cancer.

Precision medicine is typically DNA and RNA sequencing, identifying biomarkers, and mapping drugs to those biomarkers. Functional precision medicine bridges the final gap by answering the question: functionally, does that drug actually work on the patient’s cancer?

What challenges do biotechnology startups face when bringing new technologies into clinical practice?

One of the biggest challenges is credibility. There are many companies that claim they have new approaches to cancer treatment, so physicians are naturally skeptical — and they should be. Doctors cannot simply accept every new technology without strong evidence.

The first question people should ask is whether the technology has been prospectively validated. Prospective validation means guiding treatment for patients and then measuring the outcomes going forward. That is different from retrospective analysis, where someone looks back at existing data and tries to predict what might have happened.

The second important factor is whether the results have been published in peer-reviewed journals. Journals such as Nature Medicine, The New England Journal of Medicine, and The Lancet have rigorous peer-review processes. Experts review the data before it is published, which helps validate the results.

Other key questions include how many drugs can be tested and how quickly the results can be delivered. When patients and physicians ask those questions, the number of companies that can meet those standards becomes very small.

At First Ascent Biomedical, we took the opposite approach from many companies. We first validated the technology prospectively, then published the clinical results, and only after that did we open a laboratory so the platform could be made available to patients. Having that data and evidence available helps build trust with physicians.

For example, we conducted a pediatric cancer study funded by the National Institutes of Health (NIH). It was designed as a five-year study, but we enrolled all the patients within one year. Patients were recruited from 24 hospitals across the country and treated at Nicklaus Children’s Hospital in Miami under Dr. Maggie Fader, who is one of the world’s leading experts in using this technology to guide treatment.

Children with very serious cancers who were not expected to survive are still here today and doing well. Those kinds of outcomes help demonstrate the real impact of the technology.

How can functional precision medicine help reduce healthcare costs while improving outcomes for patients?

Cancer care is extremely expensive, and much of that spending occurs during treatments that ultimately do not work. For example, a patient might receive treatment for eight months only to find that the drug was ineffective and that the cancer has returned.

During that time, patients often experience significant side effects and complications. Treatments can suppress the immune system and lead to infections that require hospitalization. A single neutropenia event — an infection caused by a severely weakened immune system — can cost a hospital about $40,000.

The question becomes: why treat a patient for eight months only to discover that the drug never worked?

Functional precision medicine helps address that problem by identifying treatments that are more likely to work before they are given to the patient.

One example involves a pediatric patient named Logan who had leukemia that returned after treatment. Logan enrolled in one of our studies. Using our platform, doctors identified the drugs that would put his leukemia into remission. At the same time, we identified another drug that was part of the standard treatment but would have had no effect on his cancer and would have caused permanent damage to his heart.

The doctors removed that drug from his treatment plan. Logan’s leukemia went into remission, he received a bone marrow transplant, and today he is a healthy 11-year-old playing soccer and living the life of a normal child.

That is the power of functional precision medicine — not only improving outcomes but also avoiding unnecessary toxicity and long-term damage from treatments that are unlikely to help.

How do you expect cancer treatment to evolve over the next five years as technology and biology continue to converge?

Several technological trends are making this type of medicine more accessible. The cost of genome sequencing has dropped dramatically. What once cost around $10,000 can now be done for less than $1,000.

Cloud computing costs have also decreased, and robotics is improving laboratory efficiency. In our own lab, robotics allows processes that used to take five hours — such as applying drugs to cancer cells for testing — to be completed in about five minutes with higher precision.

As these technologies continue to advance and converge, they will make functional precision medicine more affordable and more accessible.

The next major step is integrating these tools directly into clinical workflows so they become part of the standard process rather than something used only after other treatments fail.

Ultimately, the goal is to give physicians better insight so they can make better decisions for patients. We are not redefining biology. We are using technology to help doctors understand how each individual patient’s cancer behaves and to guide treatment decisions based on that information.