The Baptist Memorial Health Care/Mid-South Minority Underserved NCORP is part of Baptist Memorial Healthcare Corporation (BMHCC), a non-for-profit faith-based healthcare system with 22 hospitals, 21 outpatient oncology clinics, 8 radiation facilities, and 19 outpatient infusion centers, providing care for approximately 8000 new cancer patients each year. BMHCC’s service area covers 111 counties, 4.3 million people. This is 44% of the 252 counties and parishes in the Delta Regional Authority, congressionally acknowledged as the most indigent population in the US. BMHCC provides 25% of cancer care in this racially, socioeconomically and culturally diverse region, which has some of the highest volumes of cancer and the most fragile public health infrastructure in the US. Before our NCORP, these patients had no access to clinical trials. In the 4 years since our NCORP began in August 2014, more than 90 patients per year have been enrolled into trials, including 168 patients in 2017/18; 39% of our enrolled patients are racial minorities, 17% reside in rural areas, 13% are uninsured, 21% have Medicaid. Members of our NCORP serve on multiple NCORP taskforces and NCI Steering Committees, including the Cancer Prevention Steering Committee. We have used our unique expertise in establishing Multidisciplinary Care Delivery programs in Breast, Thoracic, Gastrointestinal and Hematologic Oncology to develop Disease-Specific Research Groups that link our NCORP research closely to our clinical oncology care programs. This strategy has accelerated our progress in the past 2 years. Our system-wide implementation of the Electronic Health Record system, EPIC, has enhanced our research ability, especially in Cancer Care Delivery Research. For the new funding cycle, we propose to expand our NCORP research infrastructure across the full extent of BMHCC, with special emphasis on increasing patient recruitment across the state of Mississippi. Using Implementation and Team Science principles and a data-driven approach, our overarching goal is to increase the proportion of BMHCC oncology patients who participate in clinical trials from <3% in 2018 to 10% by 2025. With almost 8000 annual new cancer cases, this would significantly exceed the minimum requirements of the NCORP, to the benefit of our patients, communities and healthcare system, because we believe that ‘the best treatment is a clinical trial.’ Our specific aims are to increase the: 1.) number of active sites from 5 to 16 by 2025, by expanding to all our Mississippi institutions; 2.) proportion of oncology-related providers accruing patients to >90%; 3.) clinical trials activity in urogenital and gynecologic oncology; 4.) average annual patient-enrollment into NCORP trials from 90 to >250. Achieving our goal will help achieve the NCI’s mission of improving the health of this key US population demographic by narrowing a major recognized health disparity: poor access of the large indigent, racial minority and rural populations within the Mississippi Delta region to high quality oncologic care.