{"entity":{"id":"idea-moon-supportive-care-arpa","kind":"idea","name":"An ARPA-style programme to develop supportive-care drugs nobody else will","aka":[],"tldr":"A supportive-care ARPA would be a well-funded, milestone-driven agency that develops drugs for nausea, nerve damage, mouth sores, fatigue and brain fog from cancer treatment, which the market has largely ignored.","summary":"Supportive-care drug development has stalled: the last major antiemetic class (NK1 antagonists) is over twenty years old, there is no approved preventive for chemotherapy-induced neuropathy, and fatigue and cognitive impairment have no pharmacological standard. The proposal is a dedicated programme (public or philanthropic, ARPA-H style) funding target discovery, repurposing screens and pragmatic trials of supportive-care agents, with pull incentives (advance purchase, priority review vouchers) for approvals.","asOf":"2026-09-08","links":[{"label":"ARPA-H","url":"https://arpa-h.gov/"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol","b-cachexia-supportive"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A ten-year, well-funded programme delivers at least three new approved supportive-care agents and measurably reduces dose reductions and discontinuations for toxicity across common regimens.","rationale":"Supportive-care drugs are generics-priced and off-patent-adjacent, so private investment is weak although the population is enormous and the endpoints are fast. Focused public programmes have succeeded where markets failed (antibiotics, neglected diseases).","test":"Fund a first cohort of five programmes (neuropathy prevention, mucositis, cachexia, fatigue, cognition) with 3-year go/no-go milestones; success is two reaching phase 3 with positive phase 2 signals.","maturity":"speculative","actor":"philanthropy","cost":"large","horizonYears":6},"route":"/ideas/idea-moon-supportive-care-arpa/","neighbours":{"bottleneck":[{"id":"b-cachexia-supportive","kind":"bottleneck","name":"Cachexia, toxicity and the limits of the patient","route":"/bottlenecks/b-cachexia-supportive/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"idea":[{"id":"idea-rejuv-survivorship-platform-trial","kind":"idea","name":"Give survivorship interventions a shared control arm","route":"/ideas/idea-rejuv-survivorship-platform-trial/"}],"roadmap":[{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}