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Background. Racial disparities among clinical trial participants present a challenge to assess whether trial results can be generalized into patients representing diverse races and ethnicities. The objective of this study is to evaluate the impact of race and ethnicity on treatment response in advanced non-small cell lung cancer (aNSCLC) patients treated with PD-1 or PD-L1 inhibitors through analysis of real-world data (RWD). Materials and Methods. A retrospective cohort study of 11,138 lung cancer patients treated at hospitals within the Mount Sinai Health System was performed. Patients with confirmed aNSCLC who received anti-PD1/PD-L1 treatment were analyzed for clinical outcomes. Our cohort included 249 aNSCLC patients who began nivolumab, pembrolizumab, or atezolizumab treatment between November 2014 and December 2018. Time-to-treatment discontinuation (TTD) and overall survival (OS) were the analyzed clinical endpoints. Results. After a median follow-up of 14.8 months, median TTD was 7.8 months (95% confidence interval 5.4not estimable [NE]) in 75 African American patients vs. 4.6 (2.4 -7.2) in 110 White patients (hazard ratio [HR] 0.63). Median OS was not reached (18.4 -NE) in African Americans vs. 11.6 months (9.7 -NE) in Whites (HR 0.58). Multivariable cox regression conducted with potential confounders confirmed longer TTD (adjusted HR 0.65) and OS (adjusted HR 0.60) in African American vs. White patients. Similar real-world response rate (42.6% vs. 43.5%) and disease control rate (59.6% vs. 56.5%) were observed in the African American and White patient populations. Further investigation revealed the African American group had lower incidence (14.7%) of putative hyperprogressive diseases (HPD) upon anti-PD1/PD-L1 treatment than the White patient group (24.5%). Conclusions. Analysis of RWD showed longer TTD and OS in African American aNSCLC patients treated with anti-PD1/PD-L1 inhibitors. Lower incidence of putative HPD is a possible reason for the favorable outcomes in this patient population. The Oncologist 2021;9999:• • Implications for Practice: There is a significant underrepresentation of minority patients in randomized clinical trials, and this study demonstrates we can use real world data to investigate the impact of race and ethnicity on treatment response. In retrospective analysis of advanced non-small cell lung cancer patients treated with PD-1 or PD-L1 inhibitors, African American patients had significantly longer time-to-treatment discontinuation and longer overall survival. Analysis of realworld data can yield clinical insights and establish a more complete picture of medical interventions in routine clinical practice.

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We report on an experiment testing the effects of releasing all of the content in a Massive Open Online Course (MOOC) at launch versus in a staggered release. In 2013, HarvardX offered two "runs" of the HeroesX course: In the first, content was released weekly over four months; in the second, all content was released at once. We develop three operationalizations of "ontrackness" to measure how students participated in sync with the recommended syllabus. Ontrackness in both versions was low, though in the second, mean ontrackness was approximately one-half of levels in the first HeroesX. We find few differences in persistence, participation, and completion between the two runs. Controlling for a students' number of active weeks, we estimate modest positive effects of ontrackness on certification. The revealed preferences of students for flexibility and the minimal benefits of ontrackness suggest that releasing content all at once may be a viable strategy for MOOC designers.