ETCTN Early Drug Development Opportunity Leadership program administrative supplement to Cancer Center Support Grant

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This application is being submitted in response to the EDDOP Leadership Program via the mechanism PA-20- 272, “Administrative Supplements to Existing NIH Grants and Cooperative Agreements (Parent Admin Supp Clinical Trial Optional).” The Karmanos Cancer Institute (KCI), founded in 1943, is a not-for-profit, cancer-only research and patient care organization in partnership with Wayne State University (WSU) in Michigan. The designation by the NCI as a Comprehensive Cancer Center was achieved in 1978. KCI operates its wholly-owned, free-standing, cancer hospital and ambulatory clinics (KCC) in Detroit and in Farmington Hills, a suburban location. As a member of McLaren Health Care (MHC), a not-for profit health care corporation, KCI is also responsible for cancer research, quality of care, and cancer care operations in all facilities owned and operated by MHC. Our catchment area covers 46 of Michigan's 83 counties with a population of 6.7 million people. This catchment area is home to 95% of our patients, and KCI sees one-third of all new cancer patients in the catchment area. The Southeast region of our catchment area includes the metropolitan Detroit, defined as a tri-county area (Wayne, Oakland, Macomb) and home to 3.86 million residents. The city of Detroit is the largest city in the state (672,000 residents). Detroit is a resource-challenged area, with a median household income of $27,838 and 37.9% of residents living below poverty level, compared to 16.7% in the state of Michigan. The majority of census tracts in the city of Detroit are medically underserved areas based on HRSA definitions. About 79% of Detroit residents identify as African American, a group that disproportionately carries KCI catchment area's cancer burden. In 2018, KCI physicians saw approximately 12,000 new cancer patients (including approximately 8,000 analytic cases), with approximately 15% representing minority groups. The annual number of new cancer cases in these 46 counties is approximately 39,000 and has not changed significantly since 2014. In FY19, our minority accrual to interventional treatment protocols was 24.2%. We have a long standing scientific and patient care commitment to the African American population of southeastern Michigan, as exemplified in the broad array of studies focused on molecular, therapeutic, and social disparities. This application profiles the strengths and successes of our four scientific Programs, Tumor Biology and Microenvironment (TBM, 01), Molecular Imaging (MI, 02), Molecular Therapeutics (MT, 03), and Population Studies and Disparities Research (PSDR, 04). The research efforts of these Programs is supported by nine Shared Resources (Cores), including one developing Core.