OnCo
ideasIdea

Milestone prizes for first-in-class mechanisms reaching human proof of concept

Pay a fixed prize, of tens of millions, to the first team to show that a completely new way of attacking cancer works in patients, so that the riskiest early bets are rewarded even before a product exists.

A prize schedule for pre-specified novel target classes or mechanisms (for example a direct MYC inhibitor, a mutant p53 reactivator with objective responses, a therapy for dormant disseminated cells, a therapy that reverses cachexia) awarded at demonstrated human proof of concept: confirmed objective responses or biomarker-validated target engagement in a phase 1/2 trial with pre-registered criteria. The prize is paid regardless of commercial path, so academic and non-profit developers qualify. It complements, rather than replaces, market rewards, which arrive too late and too uncertainly for truly novel biology.

Hypothesis
Announcing prizes of $25 to $100 million for named first-in-class milestones raises the proportion of phase 1 oncology trials testing novel mechanisms (rather than known classes) in the named areas by at least a third within five years.
Rationale
The share of oncology pipeline assets that are follow-on rather than first-in-class has grown; analyses show dozens of PD-1 antibodies and TROP2 ADCs in development. Prizes that reward the discovery step have precedent in the Breakthrough Prize and DARPA Grand Challenges, and milestone prizes reduce the risk premium that makes investors avoid novel targets.
What would test it
Run three prizes for three years and compare novel-mechanism trial starts in the prize areas with matched areas; also survey developers on whether the prize changed their portfolio decisions.
Maturity
speculative
Who has to act
philanthropy
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks

Connected

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Pages like this

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targets

2
KRASTP53

pathways

2
p53 / RB / cell-cycle checkpointRAS / RAF / MEK / ERK (MAPK)

ideas

3
A billion-dollar prize for the first durable cure of a lethal metastatic cancerAn open-science consortium on the undruggable drivers, open until a candidateGovernment reinsurance for phase 2 failures of first-in-class cancer drugs

bottlenecks

2
Incentives reward me-too drugs and marginal gainsThe undruggable drivers