Empathy and Action: Transforming Childhood Cancer Treatment Through Advocacy

Jim Foote never set out to start a biotech company. But in the wake of his son’s death from childhood cancer, statistics became personal—and unacceptable.

“Most people don’t realize that one in five children diagnosed with cancer will die,” said Foote, co-founder of First Ascent, a Florida-based company focused on transforming pediatric oncology. “And my son was one of those one in five.”

What began as hope gradually unraveled into heartbreak. After eight months of aggressive chemotherapy, the family received the devastating news that the cancer was no longer responding. “We thought we were going to beat it just like everybody else,” Foote recalled. “The doctors came back and said, ‘Jim, we’ve given it the best we’ve got. It didn’t work.’”

That moment of resignation didn’t end the story. It sparked a new one.

In 2018, Foote co-founded First Ascent with a singular mission: to improve how pediatric cancer is understood and treated—by personalizing it. The company rejects the longstanding paradigm of adapting adult therapies for children, focusing instead on the unique biology of pediatric tumors. “Children aren’t meant to get cancer,” Foote said. “Pediatric cancers are biologically different than adults, but most drugs are developed for adults and then adapted for children.”

At the heart of First Ascent’s model is functional precision medicine. Using a fresh biopsy from a child’s tumor, the company’s lab rapidly tests hundreds of FDA-approved drugs—both cancer-specific and non-oncology compounds—to see which ones show the most promise against that child’s unique cancer profile. Within roughly 10 days, physicians receive a report outlining which treatments may have the best chance of success.

Foote sees this as a necessary evolution in cancer care, one that moves away from a “one-size-fits-most” approach. “We figure out which drugs work specifically for them,” he explained, noting that a tumor’s responsiveness is often dictated not just by cancer type but by the molecular fingerprint of the patient’s DNA and RNA. “Treatment shouldn't be based on averages. It should be based on the individual.”

The potential impact is vast. Childhood cancer survival rates have dramatically improved—from 10% in the 1970s to about 85% today, according to the Children’s Cancer Group Cure Search. But the rate of diagnosis has remained largely unchanged for nearly two decades, and relapse remains a life-threatening hurdle for many families.

“You know, there are 611,000 Americans that will die of cancer in 2025 — and tens of thousands of children,” Foote said. “We can have an impact on that.”

And for some families, that impact has been nothing short of transformative. Foote recounted the story of one child who had already been placed in hospice care when their physician turned to First Ascent’s platform. After following the lab’s recommendations, the child not only left hospice, but returned to school and rejoined their football team.

Stories like that fuel the company’s work—and Foote’s own healing. “I wish my son had been one of those stories,” he said. “But now, more children are getting the chance he never had.”

In a field often bound by protocol and precedent, First Ascent is betting on individuality—and on the belief that behind every data point is a child worth fighting for.