Cure First to More Than Double PARIS Test Capacity, Expanding Functional Precision Medicine Access for Patients With Difficult-to-Treat Cancers
Cure First, a Seattle-based 501(c)(3) nonprofit organization focused on expanding access to functional precision medicine for patients with difficult-to-treat cancers, has announced plans to more than double its testing capacity over the next year. The expansion is expected to enable the organization to provide its PARIS Test to more than 240 patients annually while adding scientific staff to support increasing demand from oncologists and cancer research institutions.
The planned expansion comes amid growing interest in functional precision medicine as a complementary approach to cancer treatment selection. While conventional precision oncology frequently relies on genomic profiling to identify mutations and other molecular characteristics that may guide therapy, functional precision medicine evaluates how a patient’s living tumor cells respond to different treatments in laboratory settings. This approach may provide additional information when DNA-based biomarkers do not identify a clear treatment option, particularly for patients with rare, advanced, treatment-resistant, or metastatic cancers.
Cure First aims to make this type of testing more accessible to patients who have limited treatment options. The organization is expanding its laboratory operations and strengthening collaborations with oncologists and research institutions to support additional clinical studies and generate evidence on how functional testing can inform treatment decisions.
“We built Cure First on the mission to advance the research needed to bring functional precision medicine to every cancer patient,” said Carla Grandori, MD, PhD, Founder, President and Scientific Director of Cure First. “Now we’re seeing that need grow and we’re building the capacity to meet it. We’re scaling our lab and partnering with leading oncologists and institutions to advance the clinical research needed to build the evidence that will make functional testing part of the future standard of care.”
The organization expects the additional capacity to help address the growing need for individualized treatment strategies in oncology. However, broader adoption of functional precision medicine will depend on continued clinical research, validation of testing methods, and evidence demonstrating how the approach can improve treatment decisions and patient outcomes.
Growing Institutional Interest in Functional Precision Medicine
Functional precision medicine has attracted increasing attention as researchers and clinicians explore ways to supplement genomic information with direct measurements of tumor responses to treatment.
Traditional molecular profiling can identify genetic alterations associated with cancer development or progression. In some cases, these findings help clinicians select therapies targeting specific mutations or molecular pathways. However, not every tumor contains an actionable alteration, and genomic results do not always predict whether a particular treatment will produce a meaningful response in an individual patient.
Tumors can also exhibit biological complexity that extends beyond their DNA sequence. Different cancer cells within the same tumor may behave differently, while interactions among cellular pathways can influence sensitivity or resistance to treatment. These factors can complicate treatment selection, especially when patients have advanced disease and limited time to evaluate additional options.
Functional precision medicine seeks to address some of these limitations by assessing the effects of candidate treatments on patient-derived tumor models. Rather than relying exclusively on molecular characteristics to predict therapeutic activity, the approach examines how tumor cells respond when exposed to selected treatments under laboratory conditions.
Cure First’s PARIS Test is designed to provide functional data that oncologists can consider alongside other clinical information when evaluating treatment options. The organization focuses on patients with rare, treatment-resistant, late-stage, or metastatic cancers, for whom standard treatment approaches may have been unsuccessful or may offer limited benefit.
The broader clinical and research community has also shown growing interest in the field. According to Cure First, the American Society of Clinical Oncology issued a clinical notice during the summer supporting the advancement of modern functional precision medicine to improve outcomes for patients with cancer. The notice cited technological advances reported by the Society for Functional Precision Medicine.
In addition, National Cancer Institute Director Anthony Letai, MD, PhD, who founded the Society for Functional Precision Medicine in 2017, has identified functional precision medicine as a priority research opportunity in the institute’s Fiscal Year 2028 Professional Judgment Budget.
These developments reflect increasing institutional attention to the potential role of functional testing in oncology research. They do not, however, establish that functional precision medicine is appropriate for every cancer or that all testing strategies have demonstrated clinical benefit. Continued prospective studies will be important for determining which patients are most likely to benefit and how results should be incorporated into treatment decisions.
PARIS Test Research Demonstrates Potential Beyond DNA-Based Biomarkers
A new study published in Cancer Research Communications, authored by Cure First scientific leadership and clinical collaborators, has examined how the PARIS Test can help guide treatment selection in late-stage biliary tract cancer beyond information provided by DNA-based biomarkers.
Biliary tract cancers arise in structures associated with the production, storage, and transportation of bile. These malignancies can be challenging to treat, particularly when diagnosed at an advanced stage or when disease progresses despite available therapies.
Although genomic testing can identify potentially actionable alterations in some biliary tract cancers, molecular findings may not always provide a clear treatment recommendation. In such circumstances, additional approaches that evaluate the functional response of tumor cells to potential therapies may offer complementary information.
The study illustrates how functional testing can be used to investigate treatment options when conventional biomarker-based strategies provide limited guidance. By assessing drug responses in patient-derived tumor models, the PARIS Test may help identify treatments warranting further clinical consideration.
The findings contribute to a growing body of research exploring the use of functional precision medicine in difficult-to-treat cancers. Nevertheless, laboratory responses do not automatically translate into clinical responses, and prospective studies are needed to determine how reliably test results predict outcomes in patients.
The research also supports Cure First’s plans to expand its testing capacity while continuing to work with clinical collaborators. As more patients gain access to functional testing, the organization aims to support additional research into the test’s feasibility, clinical utility, and potential role in individualized cancer care.
Published Cases Highlight Potential Clinical Applications
Cure First has also pointed to published case reports describing patients who received PARIS-guided treatment and subsequently experienced meaningful clinical outcomes.
One case, published in JCO Precision Oncology, described a patient with metastatic pancreatic cancer who achieved a complete remission lasting three years after conventional treatment options had been exhausted.
Another case, published in Nature Precision Oncology, involved a patient with a rare form of ovarian cancer who was entering hospice care. Following treatment guided by the PARIS Test, the patient reportedly achieved a remission lasting more than two years.
These cases illustrate why researchers are investigating functional precision medicine for patients who have exhausted standard treatment options. They also demonstrate the potential value of studying treatment responses in individual patient-derived tumor models when conventional approaches have not identified an effective path forward.
However, individual case reports cannot establish how frequently similar outcomes may occur across a broader patient population. They also cannot independently demonstrate that functional testing was solely responsible for the observed outcomes or determine whether the same approach would be effective in other patients.
Larger studies, particularly prospective clinical trials, are necessary to evaluate the reproducibility of test-guided treatment decisions and determine whether they improve outcomes compared with existing approaches.
Despite these limitations, the published cases have contributed to interest in the potential clinical applications of functional testing and the need for further investigation.
University of Washington Oncologist Plans Further Research in Rare Ovarian Cancer
Elizabeth Swisher, MD, Professor of Gynecologic Oncology at the University of Washington, highlighted the potential importance of functional testing for patients with rare and difficult-to-treat ovarian cancers.
“For this patient, we were running out of options when functional testing indicated a clear path forward. I am now writing a 21-case cohort study and it is my hope to be able to start a clinical study soon for this rare and difficult-to-treat ovarian cancer,” Swisher said.
She also expressed enthusiasm about using the PARIS Test through Cure First’s PROSPERITY study to evaluate the approach prospectively and determine where it may best inform clinical care.
Her planned 21-case cohort study reflects an effort to build additional evidence beyond individual patient experiences. Examining multiple cases could help researchers better characterize how functional testing is used in this rare cancer setting and identify questions that warrant further investigation.
A prospective clinical study could provide additional insight into how test results influence treatment selection and whether the resulting treatment decisions are associated with meaningful patient outcomes.
For rare cancers, evidence generation can be particularly challenging because relatively few patients may be eligible for a given study. Collaboration among specialists, research institutions, and organizations providing functional testing may therefore be important for advancing the field.
The PROSPERITY study represents one avenue through which Cure First aims to support clinical research and help determine how functional precision medicine can be incorporated into treatment strategies.
The ultimate objective is to establish where functional testing provides useful additional information, which patients may benefit most, and how clinicians can interpret laboratory findings alongside genomic results, disease characteristics, prior treatments, and other clinical considerations.
From Tumor Models to a Broader Cancer Testing Program
The PARIS Test originated from research pioneered by Grandori at Fred Hutchinson Cancer Center and was subsequently developed into a pan-cancer test at SEngine Precision Medicine.
According to Cure First, the test has been deployed in 1,300 patient-derived tumor models covering more than 40 cancer types. More than one-third of the samples have supported research studies intended to demonstrate feasibility and clinical utility.
Patient-derived tumor models allow researchers to investigate the biological characteristics of an individual’s cancer outside the body. In functional testing, these models can be exposed to selected therapies to observe how the tumor cells respond under laboratory conditions.
Such information may help generate hypotheses about treatment sensitivity and provide additional evidence for clinicians considering potential therapeutic options.
The approach is particularly relevant to cancers for which treatment selection remains difficult, including rare malignancies and tumors that have progressed despite multiple therapies. In these situations, genomic findings alone may not identify a suitable option, or several potential treatments may require further evaluation.
Nevertheless, translating laboratory findings into clinical decisions involves important considerations. The conditions under which tumor models are grown and tested may not fully reproduce the biological environment of a tumor inside the patient. Drug exposure, interactions with the immune system, tumor heterogeneity, and other factors can influence clinical outcomes.
Functional testing should therefore be interpreted as a potential source of complementary evidence rather than a guarantee that a selected treatment will work.
Cure First’s research strategy focuses on providing functional data to oncologists treating patients with rare, resistant, late-stage, and metastatic cancers while supporting studies that can clarify the clinical value of the technology.
Expanded Laboratory Capacity and Scientific Hiring
To meet rising demand, Cure First plans to more than double its testing capacity over the next year and provide the PARIS Test to more than 240 patients annually. The organization also plans to hire additional scientific personnel and expand laboratory operations.
Increasing capacity is expected to help the nonprofit accommodate more patients and support collaborations with oncologists and institutions conducting research into functional precision medicine.
The expansion also reflects the operational requirements associated with providing individualized tumor testing. Each patient-derived sample must be handled and evaluated through laboratory processes designed to generate interpretable information for clinical or research use.
Additional scientific staff could help the organization manage increased testing volumes while supporting continued research and collaboration. Scaling operations may also create opportunities to expand the number of cases contributing to studies that evaluate the feasibility and clinical utility of functional testing.
However, the anticipated expansion alone does not establish that testing will improve outcomes for every patient. Its broader impact will depend on the quality of the resulting data, how clinicians use the information, and the findings of ongoing and future clinical research.
Grandori said Cure First intends to combine expanded laboratory operations with stronger clinical partnerships to build the evidence needed for wider adoption.
This approach links the organization’s immediate goal of increasing patient access with its longer-term objective of demonstrating where functional precision medicine can make a meaningful contribution to cancer care.
Nonprofit Funding Supports Patient Access
As a 501(c)(3) nonprofit organization, Cure First relies on philanthropic support to maintain access to the PARIS Test for patients who may benefit from functional precision medicine.
According to the organization, the test is not currently covered by most insurance companies. As a result, donations from individuals and corporations, including employer matching-gift programs, play an important role in supporting its work.
Limited insurance coverage can create financial barriers for patients who are already facing the costs and challenges associated with advanced cancer. For a nonprofit focused on expanding access, philanthropic funding can help sustain testing availability while the evidence base and reimbursement landscape continue to develop.
Donations also support the organization’s broader research mission, which includes collaborating with oncologists and institutions to investigate the clinical utility of functional testing.
Cure First encourages individuals and organizations interested in supporting its work or learning more about the PARIS Test to visit its website at www.cure-first.org.
Advancing Functional Precision Medicine in Cancer Care
Cure First’s planned expansion comes at a time of growing interest in approaches that combine genomic information with functional assessments of tumor response.
The organization aims to increase annual PARIS Test capacity to more than 240 patients, hire additional scientific staff, and strengthen clinical research partnerships. Its efforts are supported by published studies and case reports that illustrate potential applications of functional testing in challenging cancer settings, although further evidence is needed to establish its broader clinical value.
The recent study in Cancer Research Communications, the reported cases involving metastatic pancreatic and rare ovarian cancers, and the planned research led by clinical collaborators underscore the importance of continued investigation into individualized treatment selection.
As the field develops, prospective clinical studies will be essential to determine whether functional testing can reliably guide therapy choices, improve patient outcomes, and identify the cancer types and clinical circumstances in which it offers the greatest value.
Through expanded laboratory capacity, scientific hiring, and philanthropic support, Cure First intends to help more patients access functional precision medicine while advancing the research needed to evaluate its role in future oncology care.
About the PARIS Test
Offered through Cure First, the PARIS Test was developed over more than a decade, beginning with early research at Fred Hutch and later advanced by SEngine Precision Medicine. The platform combines advanced organoid models with ultra-precise, acoustic robotics to deliver tiny amounts of many drugs to a patient’s live cancer cells ex vivo, and quickly measures how an individual tumor responds. Custom-built software analyzes the results and produces a personalized ranking of drugs, from exceptional response to non-response. Doctors select drugs from the PARIS Test menu based also on the genomic features and clinical condition of each patient.
The PARIS Test is available in all 50 states from Cure First’s CLIA-certified lab in Bothell, Washington, and is optimized for all solid-tumor cancers.
About Cure First
Cure First is a Seattle-based nonprofit advancing functional precision medicine for patients with hard-to-treat cancers. Through stewardship of the Bothell, WA, laboratory and leadership in functional genomics and drug sensitivity testing, Cure First ensures patients and oncologists worldwide can access actionable insights that improve outcomes and extend lives.