Abstract African Americans have the highest mortality rate and shortest survival of any racial/ethnic group in the US for most cancers. An estimated 29,570 cases of prostate cancer are expected to be diagnosed in AA men in 2020. The average annual incidence rate for African American men is 76% higher than the rate in Caucasian Americans. Prostate cancer is the second leading cause of cancer death in African American men, with an estimated 5,350 deaths expected in 2020, which is the highest of all ethnic groups (2.2X higher than Caucasian men). These disparities are appalling and demand immediate action. While the underlying causes are multifactorial, recent studies demonstrate that African American men are at higher risk of being diagnosed with prostate cancer, have higher Gleason grades, and increased risk of progression after radical prostatectomy (RP), even in equal access settings and after accounting for socioeconomic status. These data strongly argue that there is a significant underlying biological/genetic difference between African Americans and Caucasian American men with prostate cancer. Importantly, they highlight an unmet need in order to deliver personalized therapeutic options and ultimately, improve clinical outcomes. Unfortunately, most preclinical studies are performed in prostate cancer cell lines and patient-derived xenografts (PDXs) isolated from patients of Caucasian origin. At Baylor College of Medicine, we are leveraging the high numbers of minority cancer patients in our GU clinics, to generate and utilize innovative prostate cancer PDX and organoid models of diverse racial/ethnic minority origin, which will broaden our understanding of the molecular basis of the disease as well as expedite the drug discovery process. We will discuss preliminary findings from our ongoing studies in genomic and transcriptomic profiling of African American patients, progress in our development of novel prostate cancer models, and lastly, emerging therapeutic opportunities based on precision oncology. Citation Format: Salma Kaochar, Patricia Castro, Sandra Grimm, Darlene Skapura, Matthew Rodriguez, Maurice Dufilho, Cammy Mason, Maria Machado Heredia, Quentxia Wrighting, Jami Daly, Matthew Robertson, Nora Navone, Jacob Berchuck, Matthew Freeman, Zoltan Szallasi, Albert Dobi, Guiherme Godoy, Michael Scheurer, Heidi Dowst, Susan Hilsenbeck, Martha Mims, Anita Sabichi, Edward Yen, Cristian Coarfa, Michael Ittmann, Nicholas Mitsiades. Development of Novel Models and Identification of Therapeutic Vulnerabilities in Highly Aggressive Prostate Cancer In African American Men [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr IA15.