This Sunday, a group of 42 athletes will gather in Las Vegas to compete in a somewhat unusual sporting competition. Participants in the inaugural Enhanced Games are being encouraged to take performance-enhancing drugs. The goal is to “push the boundaries of human performance.”

The games’ organizers have said that competitors will only be taking substances that have been approved by the US Food and Drug Administration, and that they are all being medically monitored and supervised. But they have also said they expect to see world records broken—and are offering substantial prizes to athletes who succeed in doing so.

As you might expect, the event is generating a mix of curiosity, excitement, and condemnation from various quarters. To me, it feels like very much a reflection of where we are today—an era of peptide-crazed looksmaxxing in which consumers are being encouraged to get thinner than ever, optimize for longevity, and have their “best baby.” It’s 2026, and if you’re not enhancing, what are you even doing?

So, these games. They’ll feature competitions in four categories: swimming, track and field, weightlifting, and strongman (which also involves lifting weights). Many of the competitors already hold national and world records, and some are Olympic medalists. They’ve been paid a salary and will compete for prizes from a $25 million pot. The money has been a major draw for at least some of the athletes.

Another draw is the opportunity to openly experiment with drugs that might boost their performance. In the world of elite sport, every microsecond and every millimeter counts. Athletes—most of whom arguably have genetics on their side already—follow meticulous diet, training, and recovery protocols and wear specially designed gear that allows them to reach for those performance bests.

But within most sporting communities, there are limits. The World Anti-Doping Agency—an international outfit that fights the use of drugs in sports—maintains a lengthy list of “non-approved substances” that are banned in international sporting events. It features many anabolic steroids (which can build muscle), hormones (such as those that stimulate testosterone production or increase the ability of blood to carry oxygen), growth factors (which can stimulate muscle growth and repair, among other things), and more.

Some of these substances have been FDA approved to treat health disorders. And that means they can be used by participants in the Enhanced Games, according to the organization’s rules.

I’ll briefly point out the obvious here—just because a drug has been approved by the FDA doesn’t mean it’s totally safe for everyone and anyone. The risks associated with use of anabolic steroids, for example, include high blood pressure, acne, depression, and liver tumors. Growth hormone use can cause weak muscles, affect vision, and even lead to diabetes.

“Technological doping,” or using improved equipment to gain advantage, has also been supported by the games’ organizers. Last year, participating swimmer Kristian Gkolomeev was reported to have broken a record in a 50-meter freestyle time trial while wearing a polyurethane “super” swimsuit. Such suits have been banned for use in the Olympics since a slew of record-breaking performances in 2008 and 2009. Back then, the swimming governing body ruled that they gave athletes an unfair advantage. But hey, this is the Enhanced Games, where the word “unfair” seems to have a completely different meaning.

Can we expect more records to be broken on Sunday? Maybe. In addition to prize money for winning an event, any athlete who manages to beat a record stands to win up to $1 million, the sum also awarded to Gkolomeev last year following his time trial. But those performances won’t be recognized by official sporting bodies.

Plenty of concerns have been raised about these games. Some argue that they are unsafe and promote risky drug use. Others see them as a “clown show,” and a slap in the face to “clean” athletes who train hard without the use of prohibited drugs. World Athletics president Sebastian Coe has said that anyone who takes part is “moronic,” and World Aquatics, which oversees international competitions in water sports, has banned Enhanced Games participants from its events and activities.

But. The games—and the participating athletes—will still get a huge amount of attention. As a result, so will performance-enhancing drugs. Enhanced, the company behind the games, also runs an online store. There, you can buy a $52 T-shirt emblazoned with the message “I am Enhanced.”

There is also a range of prescription drugs on offer, including peptides “to support recovery, vitality, and longevity.” One of these is a growth hormone that the FDA approved in 1997 for the treatment of children with “growth failure.” The compounded version offered on the Enhanced website, which is not FDA approved, is marketed for longevity, supporting deep sleep and “overall wellness and vitality.” (“Marketed” is the key word here. The drug has, again, not been approved for that purpose.)

It all fits very well with the zeitgeist. Sure, we don’t yet have any drugs that are designed to extend human lifespan. But the search for anti-aging drugs is getting more attention—and funding—than ever. People, particularly women, are seemingly not allowed to visibly age anymore—we have filters and facelifts for that now. The idea that “death is wrong” is gaining acceptance.

And self-experimentation is rife. “Biohacking” was shortlisted for Collins Dictionary’s Word of the Year in 2025. Peptides are everywhere, despite all the unknowns surrounding their safety and effectiveness. So are longevity clinics, despite the fact that most are selling unproven treatments. US states like Montana are making it easier for people to get hold of unapproved “therapies.”

Companies are even offering would-be parents the option to choose the potential future children expected to live longest. Yep—you can supposedly optimize your embryos now, too.

In this climate, the Enhanced Games don’t feel so radical. They feel entirely fitting for our era of questionable optimization despite the risks —an era when, apparently, being human is no longer enough.

Is it the Department of Defense or the Department of War? The Gulf of Mexico or the Gulf of America? A vaccine—or an “individualized neoantigen treatment”?

That’s the Trump-era vocabulary paradox facing Moderna, the covid-19 shot maker whose plans for next-generation mRNA vaccines against flus and emerging pathogens have been dashed by vaccine skeptics in the federal government. Canceled contracts and unfriendly regulators have pushed the Massachusetts-based biotech firm to a breaking point. Last year, Robert F. Kennedy Jr., head of the Department of Health and Human Services, zeroed in on mRNA, unwinding support for dozens of projects—including a $776 million award to Moderna for a bird flu vaccine. By January, the company was warning it might have to stop late-stage programs to develop vaccines against infections altogether.

That raises the stakes for a second area of Moderna’s research. In a partnership with Merck, it’s been using its mRNA technology to destroy tumors through a very, very promising technique known as a cancer vacc—

“It’s not a vaccine,” a spokesperson for Merck jumped in before the V-word could leave my mouth. “It’s an individualized neoantigen therapy.”

Oh, but it is a vaccine. And here’s how it works. Moderna sequences a patient’s cancer cells to find the ugliest, most peculiar molecules on their surface. Then it packages the genetic code for those same molecules, called neoantigens, into a shot. The patient’s immune system has its orders: Kill any cells with those yucky surface markers.

Mechanistically, it’s similar to the covid-19 vaccines. What’s different, of course, is that the patient is being immunized against a cancer, not a virus.

And it looks like a possible breakthrough. This year, Moderna and Merck showed that such shots halved the chance that patients with the deadliest form of skin cancer would die from a recurrence after surgery.

In its formal communications, like regulatory filings, Moderna hasn’t called the shot a cancer vaccine since 2023. That’s when it partnered up with Merck and rebranded the tech as individualized neoantigen therapy, or INT. Moderna’s CEO said at the time that the renaming was to “better describe the goal of the program.” (BioNTech, the European vaccine maker that’s also working in cancer, has shifted its language too, moving from “neoantigen vaccine” in 2021 to “mRNA cancer immunotherapies” in its latest report.)

The logic of casting it as a therapy is that patients already have cancer—so it’s a treatment as opposed to a preventive measure. But it’s no secret what the other goal is: to distance important innovation from vaccine fearmongering, which has been inflamed by high-ranking US officials. “Vaccines are maybe a dirty word nowadays, but we still believe in the science and harnessing our immune system to not only fight infections, but hopefully to also fight … cancers,” Kyle Holen, head of Moderna’s cancer program, said last summer during BIO 2025, a big biotech event in Boston.

Not everyone is happy with the word games. Take Ryan Sullivan, a physician at Massachusetts General Hospital who has enrolled patients in Moderna’s trials. He says the change raises questions over whether trial volunteers are being properly informed. “There is some concern that there will be patients who decline to treat their cancer because it is a vaccine,” Sullivan told me. “But I also felt it was important, as many of my colleagues did, that you have to call it what it is.”

But is it worth going to the mat for a word? Lillian Siu, a medical oncologist at the Princess Margaret Cancer Centre, in Toronto, who has played a role in safety testing for the new shots, watches US politics from a distance. She believes name change is acceptable “if it allows the research to continue.”

Holen told me the doctors complaining to Moderna were basically motivated by a desire to defend vaccines—which are, of course, among the greatest public health interventions of all time. They wanted the company to stand strong. 

But that’s not what’s happening. When Moderna’s latest results were published in February, the paper’s main text didn’t use the word “vaccine” at all. It was only in the footnotes that you could see the term—in the titles of old papers and patents.

All this could be a sign that Kennedy’s strategy is working. His agencies often appear to make mRNA vaccines a focus of people’s worries, impede their reach, devalue them for companies, and sideline their defenders. 

Still, Moderna’s strategy may be working too. So far, at least, the government hasn’t had much to say about the company’s cancer vacc— I mean, its individualized neoantigen therapy.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.