Abstract A090: Community partnerships expand access to tumor molecular profiling
Authors: Reynolds Thomas , Jack Kellie , Kemeny Margaret , Bulone Linda , Gonsky Jason , Kampel Lewis J. , Hyman David , Solit David B. , Conklin Claire , McMillan Shadai , DeSimone Nicole , Galle Jesse , Naupari Sandy , Brown Carol L. 
Published: September 2020

Abstract
Background: In oncology, the promise of precision medicine relies fundamentally on the identification of genetic mutations that can be targeted therapeutically. Tumor molecular profiling is becoming standard of care for many cancers, however, not all cancer patients have access to genetic testing of their tumors. Lack of access to tumor molecular profiling for underrepresented minority (URM) patients contributes to cancer health disparities faced by URMs on two fronts. First, genomic profiling may provide real-time information that can alter a patient’s course of treatment, if actionable mutations are identified. Second, lack of understanding of genomic differences based on racial and ethnic ancestry may lead to ineffective treatments for URMs. Community partnerships provide one way to improve access to tumor molecular profiling for URMs. Objective: Memorial Sloan Kettering Cancer Center’s (MSKCC) Cancer Health Equity Research Program (CHERP) partners with community hospitals/centers (Kings County Hospital, Queens Cancer Center and the Ralph Lauren Cancer Center) to increase access to MSK-IMPACT™ (Integrated Mutation Profiling of Actionable Cancer Targets). MSK-IMPACT™ is a targeted tumor sequencing test used to detect gene mutations and other genetic aberrations in cancer. MSKCC staff work on-site at CHERP partner sites to assist in patient accrual, specimen collection, and specimen shipping to MSKCC. By collaborating with community sites, whose populations are predominantly URMs, MSKCC increases the diversity of the IMPACT biobank while also providing cutting-edge treatment and prevention options to patients based on IMPACT results. Results: Since opening IMPACTED (IMPACT to End Disparities) at our CHERP partner sites in 2016, 391 patients have consented to have their tumor sequenced (as of June 2019). Consistent with the aims of CHERP, the IMPACTED cohort is diverse, including 60% Black, 12% Asian, 20% other/unknown and 25% Hispanic. Two hundred fifty-six patients have had samples successfully sequenced using MSK-IMPACT™, 43% of which had at least one actionable alteration identified. Additionally, 14 patients have had positive germline results, revealing mutations that were not identified prior to their participation on IMPACT. Discussion: MSKCC’s partnerships with several community cancer providers had led to the successful enrollment of almost 400 URMs onto MSKCC’s MSK-IMPACT™ study, which seeks to identify the molecular drivers of a patient’s cancer. Providing access to tumor molecular profiling is a necessary first step to addressing cancer disparities experiences by URMs. However, access alone is not sufficient. Challenges still remain in finding appropriate treatment options, including clinical trials, when mutations are identified and in getting patients access to treatments when they are available. Working closely with our community partners will help us to address these challenges and decrease cancer disparities experiences by URMs.
Citation Format: Thomas Reynolds, Kellie Jack, Margaret Kemeny, Linda Bulone, Jason Gonsky, Lewis J. Kampel, David Hyman, David B. Solit, Claire Conklin, Shadai McMillan, Nicole DeSimone, Jesse Galle, Sandy Naupari, Carol L. Brown. Community partnerships expand access to tumor molecular profiling [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A090.