The Texas Pediatric NCORP is a consortium of five independent COG institutions serving South, West, and Central Texas. Its catchment area spans 113 counties and over 140,000 square miles, encompassing a diverse mix of rural and urban communities. Population density varies widely—from 15.4 to 122.6 people per square mile—and many families must travel long distances to access care. These geographic and demographic variabilities present significant challenges to the consistent delivery of complex cancer treatments for children, adolescents and your adults across the region. The overarching goals of the Texas Pediatric NCORP therefore are to: Improve the outcome, both quantitative and qualitative, of children, adolescents and young adults (AYAs) diagnosed with cancer through enrollment on clinical trials (therapeutic, cancer control and biology) closer to home. This includes: 1) Promoting enrollment of pediatric cancer patients on increasingly complex clinical trials; 2) Increasing participation of AYAs in the NCTN and NCORP clinical trials through targeted activities; and 3) Supporting the participation of patients and families by providing easily understandable study-related materials. Consolidate the Texas Pediatric NCORP’s involvement in the Cancer Care Delivery Research (CCDR) arena by: 1) Proposing new COG and cross-network CCDR studies in the arena of genetic counseling, implementation of innovative treatment modalities and other proposals addressing cancer care delivery to the heterogenous population residing in the catchment area; 2) On-going participation in study committees and COG CCDR leadership; and 3) Leveraging the NCTN to maintain a cross-network portfolio of active studies that meet our population’s needs. Maintain and retain a cadre of trained Clinical Research Associates (CRAs) to support participation of children and AYAs with cancer in the increasingly complex NCTN and NCORP clinical trials portfolio. This will involve promoting, supporting and engaging CRAs in the research base committees (COG and others) and collaborative projects with other NCORP institutions.