OVERALL: PROJECT SUMMARY As a National Cancer Institute (NCI)-Designated Cancer Center for the past 45 years, Wake Forest Baptist Comprehensive Cancer Center (WFBCCC) has been a leader in basic, translational, clinical, and population- based cancer research. WFBCCC addresses the significant cancer burden within a 58-county region, predominantly rural Appalachian regions within central and western North Carolina, southwestern Virginia, and southern West Virginia. The WFBCCC Director Boris Pasche, MD, PhD and his leadership team have built a robust, transdisciplinary center that includes 140 scientists. Innovative, high-impact research is driven by WFBCCC’s four research Programs: Cancer Prevention and Control, Cancer Genetics and Metabolism, Signaling and Biotechnology, and Neuro-Oncology. The rapid pace of discovery and movement toward effective translational research is supported by nine Shared Resources. WFBCCC successfully leverages its NCI- Designated Cancer Center status to harness, expand, and improve the Center’s research capabilities to decrease the cancer burden throughout its catchment area. Through its three-decade history as a research base for the NCI’s Community Clinical Oncology Research Program, WFBCCC is one of the nation’s leading institutions driving innovative cancer control and cancer care delivery interventions across the US. During the current project period, WFBCCC invested in the recruitment of 47 new cancer-focused faculty contributing to an annual base of cancer-relevant, peer-reviewed research of $29.4M (excluding training and career development awards), of which $16.5M is from the NCI. These are 49% and 57% increases, respectively, from the previous renewal. In addition, accrual to all interventional trials has increased more than 5-fold this project period. In 2020, the Center recruited 12,507 individuals to cancer-focused interventional studies, the highest annual recruitment to interventional studies in the history of WFBCCC. In addition, WFBCCC has made significant progress in recruiting racial/ethnic minorities and individuals residing in rural communities to participate in research. In 2020, 23.2% of all interventional clinical trial participants were racial/ethnic minorities, and nearly 23% of all individuals recruited were from rural communities federally designated as medically underserved. This success is a result of many years of progressive, WFBCCC-led community outreach, engagement, and education, which continue within the WFBCCC Office of Cancer Health Equity. Also committed to training the next generation of diverse cancer physicians and biomedical and biobehavioral scientists, the WFBCCC has developed a comprehensive cancer education and training pipeline for learners across the entire educational continuum. Going forward, the WFBCCC will be guided by its 2021-2026 Strategic Plan – developed from thoughtful internal and external evaluations incorporating scientific and community perspectives – to ensur...