Cure
Overview
From AI-driven diagnostics to next-generation targeted therapies, these startups are redefining how cancer is understood, matched, and treated at the molecular level.
Cancer treatment has long operated on a model of educated guesswork: standard protocols applied broadly, then adjusted when they failed. Precision oncology is dismantling that model. By mapping the molecular drivers that make each patient's cancer grow and matching those findings to therapies engineered to exploit them, oncologists are moving from generalized treatment toward something far more precise.
A new generation of targeted therapies, including bispecific antibodies, antibody-drug conjugates, and radioligand therapies, has expanded the toolkit well beyond conventional chemotherapy. Where earlier treatments worked by flooding the body with agents slightly more toxic to cancer cells than to healthy ones, these newer approaches attach therapeutic payloads directly to targeting molecules, concentrating their effects at the tumor while reducing collateral damage.
Steven Paulson, MD, President and CEO of Texas Oncology, one of the largest community oncology practices in the United States, has watched that evolution play out across hundreds of thousands of patients. "Targeted therapy is really the promise that you are going to be truly in a situation where you have a lock and a key," Paulson told Cure in an exclusive interview. "A specific key that fits that lock so that the cancer gets shut down." The result is a different set of tradeoffs: new side effect profiles to learn and new genomic distinctions to master, but for many people with cancer, meaningfully better quality of life alongside extended survival.
Molecular testing is the foundation on which all of this rests. Without knowing which mutations, deletions, amplifications, or fusions are present in a tumor, even the most precisely engineered therapy cannot be appropriately deployed. Community oncology practices have moved aggressively to close that gap, building infrastructure to ensure molecular profiling is initiated early and that results reach physicians in a form they can act on.
William Oh, MD, Chief of Hematology and Medical Oncology at Yale Cancer Center, said the next hurdle is not access to information but the ability to act on it. "How does the average doctor track the molecular changes that are driving the cancer? I think AI is going to play an increasing role in helping clinicians do that matching," Oh said. The challenge is no longer just getting the data. It is making sense of it.
Artificial intelligence (AI) is beginning to take on the work of pattern recognition at scale, helping physicians identify which people may benefit from newly approved indications, normalizing the inconsistent ways laboratories report molecular findings, and surfacing relevant clinical trial options that might otherwise go unnoticed. Embedded in electronic health records and practice management systems, these tools are quietly reshaping the daily workflow of cancer care.
Every person with cancer deserves a treatment strategy built around the specific biology of their disease, not the average biology of everyone who shares their diagnosis. The companies profiled here are among those building the tools, therapies, and data infrastructure to make that possible.
The list spans a range of approaches, from novel biomarker-driven small molecules and next-generation cell therapies to AI-powered diagnostics and first-in-class bispecific antibodies. While hundreds of companies are working in this space, these 12 stand out for their clinical momentum, platform depth, or potential to change how oncologists make treatment decisions.
Adcentrx Therapeutics
Sector: Antibody-drug conjugate (ADC) therapeutics for cancer
HQ: San Diego, CA
Year Founded: 2021
Origin Story: Founded by Hui Li, PhD, to develop the i-Conjugation platform addressing limitations of conventional ADCs, including linker instability, narrow therapeutic windows, and off-target toxicity.
Key Leaders: Hui Li, PhD, President and CEO
Number of Employees: ~30
Stage: Series A
Financial Snapshot: Undisclosed; two active IND programs
Key Products: ADRX-0706, a Nectin-4 ADC in Phase 1a/b trials (NCT06036121) for advanced solid tumors including cervical cancer. ADRX-0405, a STEAP1 ADC in Phase 1a/b targeting metastatic castration-resistant prostate cancer, gastric cancer, and NSCLC.
Recent Highlights: In May 2025, the FDA granted Fast Track designation to ADRX-0706 for locally advanced or metastatic squamous cell cervical cancer. In July 2025, ADRX-0405 received Orphan Drug Designation for gastric cancer. Interim Phase 1a data presented at ASCO 2025 showed a differentiated safety and pharmacokinetic profile for ADRX-0706, including lower rates of peripheral neuropathy compared with other Nectin-4 ADCs.
EvolveImmune Therapeutics
Sector: Immuno-oncology; T cell engager platform
HQ: Branford, CT
Year Founded: 2019
Origin Story: Developed to create a new generation of T cell engagers beyond conventional CD3-targeting approaches. The EVOLVE platform integrates CD2 co-stimulation to sustain anti-tumor T cell activity, particularly in immunosuppressed tumor environments.
Key Leaders: Stephen Bloch, MD, CEO; Jay Fine, PhD, President of Research and Development
Number of Employees: ~50
Stage: Pre-clinical / IND-stage
Financial Snapshot: $65 million upfront from AbbVie (October 2024); potential $1.4 billion in option fees and milestones plus tiered royalties
Notable Investors: Pfizer Ventures, Bristol Myers Squibb, Takeda Ventures, Solasta Ventures, Yonjin Ventures, Elm Street Ventures
Key Products: EVOLVE platform, proprietary T cell engager technology with integrated CD2 co-stimulation. Lead candidates: EVOLVE104 (ULBP2/5/6, solid tumors) and EVOLVE205 (CD20, blood cancers).
Recent Highlights: October 2024, AbbVie and EvolveImmune announced a collaboration and option-to-license agreement. November 2024, preclinical and translational data for EVOLVE104 and EVOLVE205 were presented at SITC Annual Meeting. In-human trials for EVOLVE104 initiated in 2025.
Guardant Health
Sector: Liquid biopsy; precision oncology diagnostics
HQ: Palo Alto, CA
Year Founded: 2012
Origin Story: Co-founded by Helmy Eltoukhy and AmirAli Talasaz, who developed techniques to detect tumor DNA fragments in the blood, offering a less invasive alternative to tissue biopsies. The U.S. IPO in 2018 raised $237.5 million.
Key Leaders: Helmy Eltoukhy, Chairman and Co-CEO; AmirAli Talasaz, Co-CEO; Craig Eagle, MD, Chief Medical Officer; Darya Chudova, Chief Technology Officer
Number of Employees: 1,000 - 2,000
Stage: Public
Financial Snapshot: The company's market cap was $11.96 Billion as of March 2026.
Key Products: Guardant360 CDx, FDA-approved comprehensive genomic profiling for advanced solid tumors with results in under 7 days. Guardant Reveal, a blood-based test using methylation analysis for MRD detection, recurrence monitoring, and therapy response assessment.
Recent Highlights: In 2025, Guardant expanded Reveal to monitor therapy response across all therapy classes in advanced cancer. Palmetto GBA granted coverage for CRC surveillance. At ASCO 2025, a Stage III colon cancer cohort (2,000+ patients, 6.1-year median follow-up) demonstrated Reveal’s prognostic utility for disease-free and overall survival.
IDEAYA Biosciences
Sector: Precision oncology; synthetic lethality therapeutics
HQ: San Francisco, CA
Year Founded: 2015
Origin Story: Founded by Yujiro Hata to exploit genetic vulnerabilities in cancer cells absent in normal cells, pairing drug discovery with biomarker identification to select patients most likely to benefit.
Key Leaders: Yujiro S. Hata, CEO and Founder; Darrin Beaupre, MD, Chief Medical Officer; Michael White, PhD, Chief Scientific Officer; Theodora Ross, MD, Chief Development Officer; Paul Barsanti, PhD, Chief Technology Officer
Number of Employees: ~145
Stage: Public
Financial Snapshot: The company's market cap was $3.05 Billion as of March 2026.
Key Products: IDE397 (MAT2A inhibitor, MTAP-deleted tumors), IDE161 (PARG inhibitor, HRD-positive cancers), Darovasertib/IDE196 (PKC inhibitor, uveal melanoma with GNAQ/GNA11 mutations).
Recent Highlights: July 2024, IDE397 Phase 2 monotherapy showed approximately 39% ORR and 94% disease control in 18 evaluable patients. September 2025, combination data with Gilead’s Trodelvy showed 57% ORR in late-line MTAP-deleted urothelial cancer. No drug-related serious adverse events observed at 30 mg once-daily expansion dose.
Immunai
Sector: AI-powered immune profiling for oncology drug development
HQ: New York, NY
Year Founded: 2018
Origin Story: Founded to decode the human immune system at single-cell resolution using genomics and machine learning to accelerate drug development.
Key Leaders: Noam Solomon, PhD, CEO; Mikael Dolsten, MD, PhD, Board of Directors
Number of Employees: ~192
Stage: Series B
Financial Snapshot: AstraZeneca committed $18 million in 2024; multi-year collaboration expanded October 2025.
Notable Investors: 8VC, Alexandria Venture Investments, Koch Disruptive Technologies, Piedmont Capital Investments, Catalio Capital Investments, Andreessen Horowitz, TLV Partners, Pfizer Ventures
Key Products: IDE (Immune Drug Engine) and AMICA platforms integrate single-cell genomics and machine learning across 300,000+ patient samples to identify immune drivers, biomarkers, and therapeutic hypotheses.
Recent Highlights: September 2024, AstraZeneca committed $18 million for trial optimization. October 2025, multi-year agreement expanded collaboration. August 2025, launched the Grand Collaboration Initiative for Single-Cell Immune Profiling, offering free sequencing for up to 1,000 non-commercial academic samples.
Iovance Biotherapeutics
Sector: TIL (tumor-infiltrating lymphocyte) cell therapy for solid tumors
HQ: San Carlos, CA
Year Founded: 2007
Origin Story: Built on NCI research on TIL therapy in the late 1980s by Steven Rosenberg, MD; aims to translate this into a scalable therapy.
Key Leaders: Frederick Vogt, PhD, Interim CEO and President; Friedrich Graf Finckenstein, MD, Chief Scientific Officer; Igor Bilinsky, PhD, Chief Operating Officer
Number of Employees: ~975
Stage: Public
Financial Snapshot: The company's market cap was $2.20 Billion as of March 2026.
Key Products: AMTAGVI (lifileucel), FDA-approved TIL therapy for solid tumors, administered as a single intravenous infusion for unresectable or metastatic melanoma.
Recent Highlights: February 2024, FDA granted accelerated approval based on a 31.5% ORR in Phase 2 C-144-01 trial (n=73). Median duration of response not reached. Over 30 U.S. treatment centers approved for sample collection and administration. Confirmatory Phase 3 TILVANCE-301 trial ongoing.
Natera
Sector: Cell-free DNA testing; molecular residual disease (MRD) monitoring
HQ: Austin, TX
Year Founded: 2004
Origin Story: Founded to integrate personalized genetic testing into oncology, women’s health, and organ transplant monitoring. Signatera tracks patient-specific tumor mutations in blood over time.
Key Leaders: Steve Chapman, CEO; Eric Evans, PhD, Chief Scientific Officer; Rishi Cacker, Chief Technology Officer; John Ryan, PhD, Chief Laboratory Officer
Number of Employees: ~2,670
Stage: Public
Financial Snapshot: The company's market cap was $28.89 Billion as of March 2026.
Key Products: Signatera, tumor-informed ctDNA assay for MRD detection, recurrence monitoring, and treatment response assessment. Validated in 125+ publications; >300,000 patients tested.
Recent Highlights: ASCO 2025, Signatera Genome assay: 94% longitudinal sensitivity, 100% specificity across five cancer types. 2025 clinical MRD volume grew 52% to approximately 769,700 tests. Tissue-free MRD assay using methylation technology launched for colorectal cancer.
PathAI
Sector: AI-powered pathology for cancer diagnostics and drug development
HQ: Boston, MA
Year Founded: 2016
Origin Story: Founded to apply deep learning to pathology, detecting patterns missed by human analysis to improve patient outcomes.
Key Leaders: Andy Beck, MD, CEO and Co-Founder; Eric Walk, MD, Chief Medical Officer
Number of Employees: ~270
Stage: Late-stage private (Series D)
Financial Snapshot: Raised >$255 million; 2024 strategic partnership with Quest included $100 million acquisition of PathAI's lab
Notable Investors: Hercules Capital, Biospring Partners, Brightwing Capital; Camford Capital; D1 Capital Partners
Key Products: AISight Dx, FDA-cleared (2025) digital pathology platform with PCCP; PathExplore IOP and IHC Explore for single-cell and spatial tumor profiling; AIM-MASH AI Assist, first AI tool qualified by FDA and EMA for MASH trials.
Recent Highlights: In 2025, Labcorp rolled out AISight Dx nationwide. Launched Precision Pathology Network, first global network of digital pathology labs. AIM-MASH AI Assist qualified by EMA.
Relay Therapeutics
Sector: Computational small molecule drug discovery for cancer
HQ: Cambridge, MA
Year Founded: 2016
Origin Story: Founded to leverage protein motion, not just structure, for drug design. Dynamo platform combines simulations and experiments to reveal hidden binding sites.
Key Leaders: Sanjiv Patel, MD, President and CEO; Don Bergstrom, MD, President, R&D; Imogen Price, PhD, COO, R&D; Pete Rahmer, Chief Corporate Development Officer; Tom Catinazzo, CFO
Number of Employees: ~200
Stage: Public
Financial Snapshot: The company's market cap was $1.89 Billion as of March 2026.
Key Products: Zovegalisib (RLY-2608), allosteric, pan-mutant PI3Kα inhibitor targeting mutant PI3Kα while sparing wild-type.
Recent Highlights: Mid-2025, Phase 3 ReDiscover-2 trial initiated for PI3Kα-mutated HR+/HER2- advanced breast cancer. SABCS 2025, Phase 1b data: 10.3-month median PFS, 39% ORR, consistent across ESR1 mutation and prior SERD exposure.
Summit Therapeutics
Sector: Bispecific antibody therapeutics
HQ: Miami, Florida
Year Founded: 2003
Origin Story: Refocused pipeline around ivonescimab, a bispecific antibody targeting PD-1 and VEGF, licensed from Akeso Inc. in China for global rights.
Key Leaders: Bob Duggan, Executive Chairman; Manoussos Perros, PhD, CEO
Number of Employees: ~265
Stage: Public
Financial Snapshot: The company's market cap was $12.66 Billion as of March 2026.
Key Products: Ivonescimab (SMT112), bispecific PD-1/VEGF antibody with cooperative binding to enhance tumor selectivity and reduce systemic toxicity.
Recent Highlights: At IASLC 2025, the Phase 3 HARMONi trial reported an overall survival trend favoring ivonescimab versus chemotherapy in patients with EGFR-mutated NSCLC (nominal p=0.0332). In North American participants, the OS hazard ratio was 0.70. Globally, more than 2,800 patients have received ivonescimab in clinical studies. The drug received approval in China in May 2024.
Tempus AI
Sector: AI-powered precision medicine data platform for oncology
HQ: Chicago, IL
Year Founded: 2015
Origin Story: Founded by Eric Lefkofsky to structure and analyze oncology molecular and clinical data to improve patient care and research.
Key Leaders: Eric Lefkofsky, Founder and CEO
Number of Employees: ~3,800
Stage: Public
Financial Snapshot: The company's market cap was $9.43 Billion as of March 2026.
Key Products: Oncology real-world database integrating de-identified patient records, including genomic, transcriptomic, imaging, and clinical text data. TIME Trial Network supports Phase 1 trial acceleration. AI tools convert unstructured clinical text into analysis-ready data.
Recent Highlights: April 2025, Tempus AI, AstraZeneca, and Pathos AI announced multi-year collaboration to build a multimodal foundation model for drug discovery, biological insights, and therapeutics development.
Xilio Therapeutics
Sector: Tumor-activated immuno-oncology therapies
HQ: Waltham, MA
Year Founded: 2016
Origin Story: Developed tumor-activation technology to unmask drug activity selectively in tumors, separating efficacy from systemic toxicity.
Key Leaders: René Russo, PharmD, President and CEO; Uli Bialucha, PhD, Chief Scientific Officer; Katarina Luptakova, MD, Chief Medical Officer
Number of Employees: ~100
Stage: Public
Financial Snapshot: The company’s market cap was $39.68 Million as of March 2026.
Key Products: Vilastobart (Fc-enhanced anti-CTLA-4, Phase 1/2 with atezolizumab), XTX301 (tumor-activated IL-12, Phase 1), masked T cell engagers ATACR (bispecific) and SEECR (trispecific) targeting PSMA, CLDN18.2, STEAP1.
Recent Highlights: Feb 2025, collaboration with AbbVie announced, disclosing three wholly-owned masked T cell engager programs. In January 2025, early Phase 2 data for vilastobart in combination with atezolizumab in MSS colorectal cancer showed measurable clinical activity.
