PROJECT SUMMARY The principal investigator (PI), Dr. Supriya Mohile, of this K24 renewal proposal leads an independently funded patient-oriented geriatric oncology research program at the University of Rochester Wilmot Cancer Institute. Over the last K24 funding period, Dr. Mohile completed two large multi-site cluster-randomized trials that evaluated whether geriatric assessment and management (GAM) improves outcomes of older patients with advanced cancer. GAM, a validated patient-centered approach for assessing health status, identifies older patients with cancer who are at risk of adverse outcomes and guides management for cancer treatment and for aging-related conditions. Both trials demonstrated, for the first time, that a GAM intervention improves patient- centered outcomes (communication and patient/caregiver satisfaction) and clinical outcomes (treatment toxicity, falls, and polypharmacy). Integrally involved in this research, mentees at the University of Rochester and through the Cancer and Aging Research Group (CARG) have utilized data from the GAM trials to successfully compete for their own career development and independent awards. Of the ten early career scientists that Dr. Mohile currently mentors at the University of Rochester, eight are women and four identify as underrepresented in medicine. Mentees have received over 20 grants and have published over 80 manuscripts with Dr. Mohile. Dr. Mohile is currently a primary mentor or co-mentor on seven career development awards. Further, over the last K24 funding period, Dr. Mohile successfully competed for three new R-level awards as PI from the Patient Centered Outcomes Research and the National Institutes of Health to evaluate strategies for implementing GAM in oncology practices and to expand understanding about cancer treatment tolerability in older adults. The original K24 allowed Dr. Mohile and her mentees to enhance skills in communication research; the renewal will allow them to learn about implementation science and leadership with expert consultants at the University of Rochester and in CARG. The overarching aims of this proposal are: 1) to develop and evaluate implementation strategies for GAM in oncology practices; and 2) to examine treatment tolerability in older patients with advanced cancer and aging-related conditions starting a new high-risk cancer treatment regimen. This research will have a positive impact by providing information on pragmatic mechanisms for implementing GAM in oncology care. Importantly, this proposal will allow for the career development of mentees pursuing patient-oriented research focused on geriatric oncology, an understudied field. Through funded research, an endowment from the Wilmot Cancer Institute, and the NIA-funded CARG (MPI: Mohile), Dr. Mohile has the resources to continue to foster the careers of investigators interested in geriatric oncology research across the academic career trajectory. The renewal of this K24 Award will enable Dr. ...