# Cancer research education program (C-REP)

> **NIH NIH P20** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2024 · $73,439

## Abstract

PROJECT SUMMARY
Lung cancer remains one of the most prevalent and deadly cancers in the US. Most lung cancers are not 
diagnosed until after the cancer has already metastasized; stage IV patients have 5-year survival rate of only 
8.2%. While in the past stage IV patients with non-small cell lung cancer (NSCLC), the most common 
histology, were treated with chemotherapy, in recent years novel systemic therapies, such as targeted therapy 
and immunotherapy, have been introduced and have substantially changed the landscape of late stage lung 
cancer outcomes. Early-stage, surgical patients have been shown to benefit from adjuvant targeted therapy as 
well. Targeted therapies work by inhibiting specific molecular pathways, the most commonly targeted of which 
is the epidermal growth factor receptor (EGFR) tyrosine kinase pathway. The anaplastic lymphoma kinase 
(ALK), KRAS, and BRAF pathways are other targetable oncogenic pathways. These novel therapies require 
genetic testing as a basis for treatment to ensure that a druggable target is present, as not all tumors present 
themselves with target mutations. About 30% of NSCLC patients will be eligible. Immunotherapies, specifically 
drugs that inhibit the protein 1–programmed death ligand 1 (PD-1–PD-L1) pathway, can also substantially 
improve survival in a subset of NSCLC patients, but are usually prescribed to only those patients with a high 
PD-1 tumor mutational burden (TMB). Preliminary evidence suggests that utilization of novel target therapies 
and immunotherapy is disproportionately different according to race/ethnicity and socioeconomic status, which 
may partially explain the disparate survival outcomes in these groups of patients. More specifically, Black 
NSCLC patients may be less likely to receive molecular testing compared to White patients, making them less 
likely to access targeted treatments. However, no studies have yet to investigate the prevalence of oncogenic 
panel testing, meaningful for both targeted or immunotherapy treatment, in a population-based dataset such as 
SEER-Medicare, overall and according to race and access to quality care. To address this critical research 
gap, we propose the following aims: Aim 1a) Use SEER-Medicare claims data to investigate the prevalence of 
molecular tests among Black vs White advanced NSCLC patients. Aim 1b) Investigate how NSLC genetic 
testing varies by urban vs rural clinical practice. We hypothesize that molecular testing is significantly less 
likely to be performed among Black and rural NSCLC patients. This project will give important information on 
one of the main reasons for the high mortality observed in minority and minoritized NSCLC patients, while 
offering an opportunity for training in health disparities research, statistical analysis of large datasets, analysis 
and interpretation of genetic data. Thus the proposed aims of this supplement complement well the scope and 
mission of the original parent grant which is to e...

## Key facts

- **NIH application ID:** 11194543
- **Project number:** 3P20CA264076-04S1
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Emma Katherine Tara Benn
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $73,439
- **Award type:** 3
- **Project period:** 2021-09-21 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11194543

## Citation

> US National Institutes of Health, RePORTER application 11194543, Cancer research education program (C-REP) (3P20CA264076-04S1). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/11194543. Licensed CC0.

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