re-mission game logore-mission game logo

The Video Game That Started It All

Re-Mission, Hopelab’s first project, was inspired by co-founder, Pam Omidyar’s bold idea to create a video game to help young cancer patients with treatment compliance. This history now drives Hopelab’s mission as a social innovation lab and impact investor, leveraging technology to connect with young people, engaging them as co-creators, and prioritizing research and evidence in all our initiatives.

Re-Mission Box Art - original game from 2006

Re-Mission: From idea to reality

Pam and other original Hopelab staff share the making of Re-Mission.

Re-Mission is based on the vision of Hopelab founder and board chair, Pam Omidyar. Early in her career, Pam worked as a researcher in an immunology lab. As a video game enthusiast, she had the idea that a video game for young people with cancer might play a positive role in helping them fight their disease. Hopelab worked with doctors, nurses, psychologists, cancer experts, video game experts, and young people with cancer to create this groundbreaking game.

Development of the Game

In Re-Mission, players pilot a nanobot named Roxxi as she travels through the bodies of fictional cancer patients destroying cancer cells, battling bacterial infections, and managing the effects of cancer and cancer treatments. Through gameplay, young cancer patients experience what occurs within their bodies as they undergo treatment and deal with side effects. The game addresses the importance of:

  • Compliance with oral chemotherapy regimens and prescribed medications
  • Prompt symptom reporting, even if the symptoms appear unrelated to cancer
  • Proper nutrition to increase the body’s ability to fight cancer
  • Anxiety, nausea, and pain management through breathing and muscle relaxation exercise
child wearing a blue mask looks at a laptop computer
girl wearing a headscarf holds a box saying re-mission
Cancer is power hungry. It's not satisfied with what it's got, it always wants more. I want to see the cancer blown up and vaporized!
Cancer patient, Re-Mission tester
screenshot of a video game with roxxi in foreground

Serious Games —  Designed with Purpose

Re-Mission helped define a popular new subgenre of video games, now referred to as “serious games.” Using design principles, the games encouraged players to carry out activities and learn skills that teach important lessons. In the case of Re-Mission, the games were a fun, interactive way to explain to young cancer patients why they must take oral chemotherapy for years, despite unpleasant side effects. Understanding the needs of patients was pivotal in the design and testing of the game. That co-creation process is a principle Hopelab carries through to our current work in partnership with organizations improving the mental health of underserved populations.


Hopelab conducted a randomized controlled trial to gauge the efficacy of Re-Mission as it relates to compliance with prescribed chemotherapy and antibiotic treatments, cancer-related knowledge, and self-efficacy. The study enrolled 375 cancer patients ages 13-29. Results indicated that playing Re-Mission led to:

  • More consistent treatment adherence
  • Faster rate of increase in cancer knowledge
  • Increase in self-efficacy in young cancer patients

These findings were published in August 2008 in the journal Pediatrics. Results of an fMRI study of Re-Mission showing the impact of the game on neurological processes were presented the same year at the 10th International Congress of the Society of Behavioral Medicine and later published in PLoS One.

Pediatrics, 2008
A Video Game Improves Behavioral Outcomes in Adolescent and Young Adults with Cancer: A Randomized Trial
fMRI Study, PLoS One
Interactivity and Reward-related Neural Activation During a Serious Videogame
fMRI Brain Scan
fMRI images of the brain of a person playing Re-Mission
Picture of PR Newswire and Re-Mission launch in Times Square

Re-Mission Game Distribution

Confident in the game’s clinical effectiveness, Hopelab deployed Re-Mission through a network of partners including Cigna, the Starlight Foundation, and the ESA Foundation. Delivering interventions at scale would not be possible without a devoted network of partners, hospital systems, clinicians, nurses, child life specialists, and caregivers. To date, Hopelab has distributed more than 200,000 copies of Re-Mission in 81 countries. In doing so, we’ve helped 135,000 patients adhere to their cancer treatments and gain a greater sense of personal empowerment over their disease.

Re-Mission 2: Nanobot’s Revenge

Further clinical trials based on Functional Magnetic Resonance Imaging (fMRI), showed an explicit link between the excited states caused by Re-Mission gameplay and susceptibility to retaining knowledge about treatment compliance. A deeper understanding of this research was incorporated into the development of a series of mobile games released in 2012 — Re-Mission 2.

Hopelab’s learnings from our first project would go on to inform much of our future and current work, providing insights into the link between behavioral science and physical health, youth co-creation, the power of partnerships, and investment opportunities.

Minion from Re-Mission 2 Game
Nanobot from Re-Mission 2 Game

Teens looking at laptop

Re-Mission Video Showcase

Straight from the archives, take a trip down memory lane and watch Re-Mission press coverage, game trailers, and hear from young cancer patients and their families who were integral to the development of Re-Mission.

View Showcase