Overall Program Summary
This application for Feasibility and Planning Studies of a P20 Specialized Program of Research Excellence
(SPORE) to Investigate Cancer Health Disparities will address racial disparities in metropolitan Detroit, a
uniquely important underserved population where great cancer disparities exist. The application includes two
scientific projects focused on treatment with immune checkpoint inhibitors (ICIs) now being used in the standard
of care setting for lung cancer, an Administrative Core, a Biospecimen Core, a Patient and Community
Engagement Core, and a Developmental Research Program. The decision to use ICIs relies heavily on prior
treatment response and imperfect tumor biomarkers, and immune-related adverse events (irAEs) dictate
continued therapy, and ultimately outcomes, yet little is known about what factors drive disease course in racially
diverse populations. The Overall Aim 1 of this Program is to accelerate translational research to reduce health
disparities in lung cancer outcomes by: a) characterizing race-specific immune profiles with respect to the tumor
environment and host genetic background to determine their contribution to response to ICIs (Project 1); and b)
characterizing patient-reported side effects, quality of life, and irAEs in a racially diverse group of lung cancer
patients and identifying the individual, behavioral, molecular/genetic and disease-specific determinants of these
end points (Project 2). The Overall Aim 2 is to strengthen the existing programmatic structure to encourage
translational research into the biology of cancer health disparities, achieve full P50 SPORE funding, and
ultimately reduce cancer health disparities by: a) expanding our Cancer Biology of Health Disparities initiative,
facilitating use of biospecimens from KCI's racially diverse population, and funding Developmental Research
Projects; b) mentoring investigators in cancer health disparities; and c) expanding our community outreach and
engagement efforts through a robust Patient and Community Engagement Core (PCEC) to support recruitment
and retention of diverse study participants and dissemination of research project progress and findings to
participants and lay audiences. This P20 application will enable clinical, basic and population scientists to
translate relevant, high-impact scientific discoveries in diverse patients to reduce racial disparities in cancer
outcomes, moving towards a more race-inclusive, equity-focused precision medicine approach to cancer
treatment and prevention.