Research Research Programs Biotechnology, Imaging & Drug Development Systems, Pathways & Targets Cancer Control Clinical Research Stern Center for Cancer Clinical Trials and Research Disease-Oriented Teams Protocol Review and Monitoring Committee Research Resources Membership Guidelines Shared Resources Acknowledgement of Grant and Shared Resources Anti-Cancer Challenge Research Anti-Cancer Challenge Pilot Awards Anti-Cancer Challenge Past Awardees Team Funds Centers & Institutes Space Management and Requests Funding Opportunities A1 Bridge Funding Cancer Health Disparity Research and Interventional Studies Collaborative Engine Pilot Projects Cancer Health Disparity Research and Interventional Studies Award Recipients Home Research Funding Opps Cancer Health Disparity Research and Interventional Studies Cancer Health Disparity Research and Interventional Studies Award Recipients 2024 Award Recipients Congratulations to the 2024 award recipients for the inaugural Cancer Health Disparity Research and Interventional Studies funding opportunity! The award is designed to support research projects and investigator-initiated interventional clinical trials that address cancer health disparities in Orange County. Learn more about each project below. Michael A. Hoyt, PhD | Reducing Disparities in the Adverse Impact of Cancer in Young Adult Latino Men Young adult Hispanic/Latino (H/L) men experience higher levels of psychological distress and lower quality-of-life compared to non-Hispanic White (NHW) and Latina cancer survivors [1]. However, young adult H/L men are underserved in supportive cancer care and underrepresented in survivorship research, and often are not offered services in Spanish. As the group that reports the highest levels of adverse cancer impacts, the need to reduce symptom burden and improve quality-of-life is paramount, stems from clear health inequity, and should be understood through the lens of social health determinants (cultural and syndemic factors). Young adulthood is marked by goal attainment and illness experienced as “off time” in the lifespan interrupts goal pursuits. However, no targeted interventions exist to assist young adult H/L men in renegotiating life goals and regulating emotions, and none focus on reducing the burden of morbidity via biobehavioral mechanisms. We developed and pilot-tested Goal-focused Emotion-regulation Therapy (GET) as a novel behavioral intervention developed to enhance self-regulation through improved goal navigation, improved sense of purpose, and enhanced ability to regulate emotions in young adult men with cancer. Building on our extensive preliminary work and responsive to the need for effective, scalable, and culturally tailored interventions, we will randomly allocate 100 young adult male H/L cancer survivors to GET or a time and attention matched comparator (Individual Supportive Listening or ISL) to evaluate primary and secondary outcomes at baseline (T0), post-treatment (T1), and 3-month follow-up (T2). The specific aims are: Aim 1: Determine the efficacy of GET as compared to ISL in improving depressive and anxiety symptoms (primary outcomes) as well as emotion regulation, goal attainment skills, and career confusion (secondary outcomes) in young adult H/L men with cancer. Aim 2: Examine the relative change in salivary markers of distress-relevant biomarkers (i.e., diurnal cortisol parameters) and inflammation (i.e., Interleukin-1-receptor antagonist, Interleukin-6) in young adult H/L men with cancer receiving GET versus ISL. Aim 3: Identify the moderating influence of culturally-relevant processes (i.e., simpatía, machismo) on the impact of GET (vs. ISL). Improving outcomes in H/L survivors has direct implications for addressing the social determinants of health. By 2030, 20% of cancer survivors are expected to be Latinx and young adult H/L cancer survivors are at a critical disadvantage compared with NHW survivors that are underscored by sociodemographic adversities and equitable access to care. Such disparities can be traced to myriad systemic determinants that include lower educational funding, greater exposure to stressors and violence, increased food insecurity, as well as low inclusion in clinical trials. Solutions require the conduct of culturally-focused clinical trials. Hari Keshava, MD | Lung Cancer Screening of Family Members of Patients with Mutation-Driven Lung Cancer Lung Cancer is the leading cause of cancer related death in the United States and the second leading cause of cancer amongst both men and women. Unfortunately, the majority of lung cancer is found when it is has metastasized making it uncurable. When found early, stage I lung cancers are curable with local therapy such as surgical resection. The National Lung Cancer Screening Trial showed that amongst high risk individuals who smoked for over 30 years, a low dose CT scan for screening can help with early detection of lung cancer. Current guidelines for lung cancer screening are for people between 50 – 80 who have smoked at least 20 pack years. However, a large portion of lung cancers develop in patients who have never smoked likely related to a driver mutation. Mutations such as EGFR, RET, MET, and ROS1 mutations have been observed as a cause of lung cancer especially in patients who have never smoked. Additionally, there has been data showing that certain EGFR mutations may be genetically transmissible especially amongst certain cohorts of patients like Asian women. A recent study screening of never smokers in Taiwan, showed a 2.6% lung cancer detection in this patient population with a major risk factor being a first-degree family member with a history of lung cancer. The aim of this study is to screen immediate family members of patients with lung cancer due to a genetic mutation with a low dose chest CT scan to assess if lung cancer can be inherited and if screening family members will help find lung cancer early. Gelareh Sadigh, MD | Addressing Financial and Social Needs Among Patients with Cancer Financial hardship and health-related social needs (HRSNs) (e.g., insecurity about food, housing, transportation, and utilities) are common among patients with cancer, resulting in health disparities in cancer outcomes. Addressing financial hardship and HRSNs can mitigate their damaging health effects, yet screening for them is not the standard clinical practice. There is compelling evidence that out-of-pocket cost (OOPC) communication complemented by financial navigation and counseling delivered by a financial navigator (CostCOM intervention) will decrease financial hardship. However, implementation of this intervention is limited given shortage of financial navigators in many cancer centers. There is also evidence that patients with financial hardship have lower financial health literacy and financial self-efficacy. However, it is not clear whether direct access to local community or national resources and financial education (FinEd intervention) in the absence of financial navigators will meet patient’s needs. We propose a 3-arm pilot randomized controlled trial to assess potential efficacy differences in adherence, financial hardship, financial health literacy, quality of life, and sleep between CostCOM vs. FinEd vs. enhanced usual care (EUC) among 90 newly diagnosed cancer patients (1:1 non-metastatic vs. metastatic) who receive systemic or radiation therapy and are screened positive for financial and social needs. Our multidisciplinary team has experience with all facets of the proposed intervention. CostCOM patients will participate in two remote counseling sessions at baseline, and 3 months, and will receive (1) OOPC communication, individualized, patient-specific education of the anticipated medication OOPC; (2) Financial navigation, real-time professional guidance to identify financial assistance programs that will alleviate costs of care and discuss information to improve insurance coverage; and (3) Financial counseling to address the range of patients’ financial concerns and enroll patients in financial assistance programs. FinEd patients will receive (1) a comprehensive list of local and national resources where patients can self-refer for financial and social needs; and (2) online and paper financial educational materials on topics such as health insurance and health insurance literacy, and navigating price estimator tools. EUC patients will receive usual care enhanced by screening for financial and social needs. Our goals are to compare the efficacy of CostCOM vs. FinEd vs. EUC at 6 months on (1) patient-reported cost-related cancer care nonadherence (defined as self-reported delay, forgo, stop or change in cancer care due to cost concerns), treatment completion and missed appointments (as obtained via medical record); (2) patientreported financial worry, material hardship, health insurance literacy, and quality of life; and (3) patientreported and objectively measured sleep quality using a sleep monitor. The study will support feasibility for a larger trial, and reveal efficacy estimates for potential CostCOM vs. FinEd differences in improving cancer patients’ outcomes and approaches for incorporation into routine clinical practice. Jessica Shiu, MD | Why Do Hispanic Patients Present with Late- Stage Melanoma at a Younger Age? Melanoma, the most lethal of all skin cancers with a disproportionate incidence in our catchment area, tends to present at a younger age and at a later stage in Hispanic patients as compared to Caucasians. Biological or epidemiologic factors that contribute to this difference are currently unknown. Our preliminary studies suggest that the incidence of melanoma in Hispanics in our catchment area has a bimodal distribution, and we have already identified a cohort of 8 Hispanic patients with advanced melanoma at an early age and a matched cohort of 11 Hispanic patients with advanced melanoma presenting at a later age. Here we hypothesize that a combination of biological and epidemiologic factors are associated with melanomas that present at an advanced stage in young Hispanic patients. We combine spatial transcriptomics with a survey-based epidemiological approach to understand factors that distinguish young Hispanic patients (≤45 years old) that present with advanced stage from older Hispanic patients (³ 60 years old) that present at an advanced stage. Once we have identified cellular signatures characteristic of melanomas that present with an advanced stage at a young age, we compare the cellular features of Hispanic melanomas that present at a young age with stage-matched Caucasian melanomas that present at a young (≤45) or older (³60) age. This will be complimented by an epidemiologic study in a sample of self-reported Hispanic individuals diagnosed with melanoma and identified through the UC TriNetX Discovery cohort discovery tool. We will recruit 400 participants to evaluate factors that influence immune functioning (stress, diet, infections) associated with melanoma in n=200 young (≤45) vs those diagnosed with melanoma at an older age (>60). We will perform stratified analysis to also evaluate differences in advanced disease. The survey will include demographic and other established melanoma risk factors to characterize the sample and to account for potential confounders. When completed, we will have identified cellular and epidemiologic characteristics of melanomas that present at an advanced stage in Hispanic patients. Other investigators in our group are pioneering methods to detect melanoma earlier and identify immune reactions against melanoma lesions. Here we collect information on the epidemiology and biology of Hispanic melanomas that present early, with the goal of integrating this information with advanced imaging to improve early detection/intervention for melanoma in Hispanics. These studies will inform the development of a NCI SPORE, NCI P01, and/or NCI HTAN application that focuses on developing integrative approaches to facilitate melanoma early detection and intervention in the Hispanic population.