# Radical oncology: what could change the war by 2035

Source: https://onco.cc/roadmaps/frontier-2035/  
OnCo record `frontier-2035` (Roadmap). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Radical oncology is a horizon map of the wilder ideas in cancer, sorted by how close they are to mattering, with the reason each one might never arrive.

## Summary

Most of what is celebrated as a breakthrough is an incremental gain on an existing modality. This roadmap collects the ideas that would change the shape of treatment rather than its slope: therapies that read DNA directly, living drugs, radiation delivered in milliseconds, and detection that runs continuously rather than annually.

The grouping is by horizon, from technologies already producing randomised data to ideas with no human evidence at all. Placement reflects the state of evidence in September 2026, not company timelines. Several steps will not happen: the failure record of hypoxia-activated prodrugs, metabolic therapy, and matrix-softening agents is a reminder that a clean mechanism is not a clinical benefit.

## Fields

- Kind: Roadmap
- Last checked: 2026-09-08

## Connected records

- fronts: [Cell Therapy](https://onco.cc/fronts/cell-therapy/), [Drug Discovery Platforms](https://onco.cc/fronts/drug-discovery/), [Early Detection & Screening](https://onco.cc/fronts/early-detection/), [Radiation Therapy](https://onco.cc/fronts/radiation/)
- technologies: [Alpha-emitter nanogenerators and daughter trapping](https://onco.cc/technologies/alpha-nanogenerators/), [Antibody-oligonucleotide conjugates](https://onco.cc/technologies/antibody-oligonucleotide-conjugates/), [Auger-electron therapy](https://onco.cc/technologies/auger-electron-therapy/), [Bacteriophage-based tumour delivery](https://onco.cc/technologies/phage-delivery/), [Breath and volatile-organic-compound detection](https://onco.cc/technologies/breath-vocs/), [Cachexia-directed therapy (GDF-15 blockade)](https://onco.cc/technologies/cachexia-therapy/), [CAR-T against stroma: fibroblasts and myeloid cells](https://onco.cc/technologies/stroma-directed-car/), [Chronotherapy: timing treatment to the body clock](https://onco.cc/technologies/chronotherapy/), [Continuous and near-continuous ctDNA monitoring](https://onco.cc/technologies/continuous-ctdna-monitoring/), [De novo designed protein binders](https://onco.cc/technologies/de-novo-protein-design/), [Digital twins and virtual control arms](https://onco.cc/technologies/digital-twins-trials/), [DNA origami nanorobots](https://onco.cc/technologies/dna-origami-nanorobots/), [Engineered bacteria as living cancer drugs](https://onco.cc/technologies/engineered-bacteria-therapy/), [Engineered exosomes as drug carriers](https://onco.cc/technologies/exosome-therapeutics/), [Epigenetic editing (durable gene silencing)](https://onco.cc/technologies/epigenetic-editing/), [Histotripsy as an immune primer](https://onco.cc/technologies/histotripsy-immune-priming/), [Hypoxia-activated prodrugs](https://onco.cc/technologies/hypoxia-activated-therapy/), [In situ vaccination](https://onco.cc/technologies/in-situ-vaccination/), [In vivo base and prime editing for cancer](https://onco.cc/technologies/in-vivo-gene-editing-cancer/), [Lattice and GRID radiotherapy](https://onco.cc/technologies/lattice-radiotherapy/), [Logic-gated therapeutics (AND, NOT gates)](https://onco.cc/technologies/logic-gated-therapeutics/), [Magnetic nanoparticle hyperthermia](https://onco.cc/technologies/magnetic-nanoparticle-hyperthermia/), [Metabolic therapy: starving the tumour of a nutrient](https://onco.cc/technologies/metabolic-therapy/), [Microbiome modulation to unlock immunotherapy](https://onco.cc/technologies/microbiome-modulation-io/), [Molecular glue discovery platforms](https://onco.cc/technologies/molecular-glue-platforms/), [N-of-1 and rapid platform trials](https://onco.cc/technologies/n-of-1-platforms/), [Organoid-guided therapy at scale](https://onco.cc/technologies/organoid-guided-therapy-scale/), [Photothermal (plasmonic) nanoparticle ablation](https://onco.cc/technologies/photothermal-nanoparticles/), [Programmable DNA-targeting therapeutics](https://onco.cc/technologies/programmable-dna-targeting-therapeutics/), [Proton arc therapy](https://onco.cc/technologies/proton-arc-therapy/), [Quantum-dot and molecular ultrasound imaging agents](https://onco.cc/technologies/quantum-dot-imaging/), [Radiodynamic therapy and radiosensitising nanoparticles](https://onco.cc/technologies/radiodynamic-therapy/), [Radioligand plus DNA-repair inhibitor combinations](https://onco.cc/technologies/radionuclide-parp-combination/), [Self-amplifying and circular RNA therapeutics](https://onco.cc/technologies/self-amplifying-rna/), [Senolytics and senescence-directed therapy](https://onco.cc/technologies/senescence-targeting/), [Sonodynamic therapy](https://onco.cc/technologies/sonodynamic-therapy/), [Spatial-omics-guided treatment selection](https://onco.cc/technologies/spatial-omics-guided-therapy/), [Systematic drug repurposing](https://onco.cc/technologies/drug-repurposing/), [Targeting the tumour's own microbes](https://onco.cc/technologies/tumour-microbiome-targeting/), [Targeting tumour mechanics and pressure](https://onco.cc/technologies/mechanobiology-therapy/), [Total-body PET for screening and ultra-low-dose imaging](https://onco.cc/technologies/total-body-pet-screening/), [Trained innate immunity](https://onco.cc/technologies/trained-innate-immunity/), [Very-high-energy electron therapy](https://onco.cc/technologies/vhee-radiotherapy/)
- pathways: [Cancer neuroscience (nerve-tumour signalling)](https://onco.cc/pathways/cancer-neuroscience/)
- roadmaps: [Devices and physical therapies roadmap: heat and light → electric fields and focused sound → drug-releasing implants](https://onco.cc/roadmaps/devices-roadmap/), [Epigenetic therapy roadmap: loosening silenced genes → mutation-specific enzymes → editing the epigenome](https://onco.cc/roadmaps/epigenetics-roadmap/), [Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH](https://onco.cc/roadmaps/radiation-roadmap/)

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