Background: Prior trauma, including personal, pre-migration, or racial experiences common among Asian Americans, is linked to poorer adjustment to life stressors. This study examines how such trauma affects the well-being and adjustment of Asian American metastatic cancer patients. Given that cancer is the leading cause of mortality in this population, understanding how past trauma influences patient-reported outcomes (PROs)—mental health, physical symptoms, distress, quality of life—is critical. Method: Eligible participants were Chinese, Vietnamese, or Korean, fluent in English or a relevant Asian language; >18 years; diagnosed with metastatic solid cancer; and residing in the U.S. A survey included sociodemographic and cancer information, and PRO measures (GAD-7, PHQ-9, modified IES-6, NCCN thermometer, FACT-G7, MFSI-SF, PEG, SCI-02). A yes/no question with open response assessed past personal/sociopolitical trauma. Linear regressions assessed the relationship between past trauma and PROs; Little’s MCAR test was nonsignificant. Pairwise correlations guided covariates. Age, ethnicity, nativity, de novo status, time since diagnosis, treatment type, and comorbidities were not correlated with PROs. Results: Data from 63 patients (65% female; 87% foreign-born; 54% Chinese, 30% Vietnamese; 35% breast, 19% lung, 13% colorectal) who responded to the lifetime trauma question. Past trauma is significantly associated with depressive symptoms (r=0.32, p=.01), anxiety symptoms (r=0.38, p<.01), cancer-related posttraumatic stress (PTS; r=0.26, p=.04), overall distress (r=0.28, p=.03), and marginally with quality of life (QOL; r=-.27, p=.05). Controlling for sex, past trauma significantly predicted anxiety (b=4.41, p< .01) and depression (b=3.96, p=.01). However, past trauma did not significantly predict fatigue, pain, or sleep. Past trauma was marginally predictive of PTS (b=2.80, p=.06), distress (b=1.41, p=.05), and QOL (b=-3.00, p=.06). Open-ended responses clarify that those endorsing past trauma (30%) are referring to pre-migration trauma (e.g., war), discrimination, and immigration-related experiences. Conclusions: To our knowledge, this study is the first to examine past trauma among Asian Americans with metastatic cancer. Given the link between trauma and mental health outcomes, trauma-informed care may be beneficial. Future research should explore interactions among cultural factors, trauma, and mental health in diverse cancer subpopulations to improve PROs.