2024
Cost trends of Metastatic Renal Cell Carcinoma Therapy: the impact of oral anticancer agents and immunotherapy
Forman R, Long J, Westvold S, Agnish K, McManus H, Leapman M, Hurwitz M, Spees L, Wheeler S, Gross C, Dinan M. Cost trends of Metastatic Renal Cell Carcinoma Therapy: the impact of oral anticancer agents and immunotherapy. JNCI Cancer Spectrum 2024, pkae067. PMID: 39133171, DOI: 10.1093/jncics/pkae067.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anticancer agentsOAA useAssociated with decreased adherenceRenal cell carcinomaAnticancer agentsDays of treatmentCombination therapyCell carcinomaStudy patientsInitial treatmentReal-world costsCombination groupImmunotherapyPatientsOOP costsTherapyTreatment typePercent daysPerspective of payersTreatmentClaims dataMedicare patientsAnalyzed differencesFee-for-service MedicareArea Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma
Rahman S, Long J, Westvold S, Leapman M, Spees L, Hurwitz M, McManus H, Gross C, Wheeler S, Dinan M. Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma. JAMA Network Open 2024, 7: e248747. PMID: 38687479, PMCID: PMC11061765, DOI: 10.1001/jamanetworkopen.2024.8747.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaArea-level measuresRenal cell carcinomaPatient-level factorsSystemic therapyEthnic disparitiesRelative risk ratiosSocially vulnerable areasCell carcinomaMeasures of social vulnerabilityMedicare beneficiariesCohort studyFee-for-service Medicare Parts AOdds ratioReceipt of systemic therapyLogistic regressionArea-level characteristicsAssociated with lack of treatmentNon-Hispanic blacksRetrospective cohort studyIndividual-level demographicsNon-Hispanic whitesAssociated with disparitiesUS Medicare beneficiariesMeasures of disadvantage
2023
Total and treatment-related costs of care associated with in patients with metastatic renal cell carcinoma receiving targeted or immune therapy.
Rahman S, Long J, Westvold S, Wheeler S, Spees L, Leapman M, Hurwitz M, McManus H, Gross C, Dinan M. Total and treatment-related costs of care associated with in patients with metastatic renal cell carcinoma receiving targeted or immune therapy. JCO Oncology Practice 2023, 19: 28-28. DOI: 10.1200/op.2023.19.11_suppl.28.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anticancer agentsInitial treatmentRetrospective cohort studyUse of immunotherapyYear of diagnosisRenal cell carcinomaDirect treatment costsMean Medicare paymentsMedicare paymentsMedicare Part DInitial therapyCohort studyMetastatic diagnosisCell carcinomaCombination therapyImmunotherapyMedicare beneficiariesPatientsAge 65Disease controlOlder ageStudy periodTherapyDiagnosisDisparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma
Chow R, Long J, Hassan S, Wheeler S, Spees L, Leapman M, Hurwitz M, McManus H, Gross C, Dinan M. Disparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma. JNCI Cancer Spectrum 2023, 7: pkad036. PMID: 37202354, PMCID: PMC10276895, DOI: 10.1093/jncics/pkad036.Peer-Reviewed Original ResearchConceptsOral anticancer agentsTherapy utilizationMedicare beneficiariesNon-Hispanic white raceMetastatic renal cell carcinomaNon-Hispanic black raceOlder US patientsUS Medicare beneficiariesRenal cell carcinomaLogistic regression modelsTherapy receiptMultivariable adjustmentSystemic therapyMale sexUS patientsCell carcinomaStudy criteriaBlack raceFemale sexPatient raceWhite raceImmunotherapyOutcomes persistSexPatientsEvolution of systemic therapy from 2015 to 2019 for older patients in the United States with metastatic renal cell carcinoma.
Chow R, Long J, Hassan S, Wheeler S, Spees L, Leapman M, Hurwitz M, McManus H, Gross C, Dinan M. Evolution of systemic therapy from 2015 to 2019 for older patients in the United States with metastatic renal cell carcinoma. Journal Of Clinical Oncology 2023, 41: 610-610. DOI: 10.1200/jco.2023.41.6_suppl.610.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaImmune checkpoint inhibitorsOral anti-cancer agentsNon-Hispanic white patientsSystemic therapyRenal cell carcinomaNHW patientsWhite patientsCell carcinomaMedicare beneficiariesService Medicare Parts ARetrospective cohort studyOverall treatment rateMedicare Part AIO therapyMRCC therapyAnti-cancer agentsCheckpoint inhibitorsCohort studyOlder patientsRandomized trialsSurvival improvementFirst therapyStudy criteriaTreatment receipt
2022
End-of-Life Care for Patients With Metastatic Renal Cell Carcinoma in the Era of Oral Anticancer Therapy
Dzimitrowicz H, Wilson L, Jackson B, Spees L, Baggett C, Greiner M, Kaye D, Zhang T, George D, Scales C, Pritchard J, Leapman M, Gross C, Dinan M, Wheeler S. End-of-Life Care for Patients With Metastatic Renal Cell Carcinoma in the Era of Oral Anticancer Therapy. JCO Oncology Practice 2022, 19: e213-e227. PMID: 36413741, PMCID: PMC9970274, DOI: 10.1200/op.22.00401.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsDays of lifeRenal cell carcinomaEOL careSystemic therapySEER-MedicareHospital deathCell carcinomaLife careIntensive care unit admissionCancer informationAggressive EOL careHigh-quality EOLOral anticancer therapySystemic therapy useCare unit admissionMultivariable logistic regressionQuality of endUnit admissionED visitsOlder patientsYounger patientsHospital admissionTherapy useOral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC)
Dinan MA, Wilson LE, Greiner MA, Spees LP, Pritchard JE, Zhang T, Kaye D, George D, Scales CD, Baggett CD, Gross CP, Leapman MS, Wheeler SB. Oral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC). Urology 2022, 168: 129-136. PMID: 35878815, PMCID: PMC9588695, DOI: 10.1016/j.urology.2022.07.012.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsRenal cell carcinomaCell carcinomaMedicare beneficiariesPocket costsOdds of adherenceRetrospective cohort studyDisease-specific survivalReal-world adherenceRCC-specific survivalProportion of daysNon-significant trendAdherent useOAA therapyCohort studyElderly patientsMultivariable analysisStudy criteriaUnivariate analysisOAA treatmentPatientsCarcinomaAdherenceSurvivalAssociation between cognitive impairment and oral anticancer agent use in older patients with metastatic renal cell carcinoma
Pritchard JE, Wilson LE, Miller SM, Greiner MA, Cohen HJ, Kaye DR, Zhang T, Dinan MA. Association between cognitive impairment and oral anticancer agent use in older patients with metastatic renal cell carcinoma. Journal Of The American Geriatrics Society 2022, 70: 2330-2343. PMID: 35499667, PMCID: PMC9378524, DOI: 10.1111/jgs.17826.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsRenal cell carcinomaMRCC diagnosisCognitive impairmentCell carcinomaFive-year survival rateSEER-Medicare patientsMedicare Part D coveragePart D coverageMild cognitive impairmentMRCC patientsMRCC treatmentEligible patientsOlder patientsTreatment initiationKidney cancerAgent useOAA treatmentPatientsStage IVSurvival rateNew casesDiagnosisD diagnosisPatient- And Provider-Level Predictors of Survival Among Patients With Metastatic Renal Cell Carcinoma Initiating Oral Anticancer Agents
Spees LP, Dinan MA, Jackson BE, Baggett CD, Wilson LE, Greiner MA, Kaye DR, Zhang T, George DJ, Scales CD, Pritchard JE, Leapman M, Gross CP, Wheeler SB. Patient- And Provider-Level Predictors of Survival Among Patients With Metastatic Renal Cell Carcinoma Initiating Oral Anticancer Agents. Clinical Genitourinary Cancer 2022, 20: e396-e405. PMID: 35595633, PMCID: PMC9529768, DOI: 10.1016/j.clgc.2022.04.010.Peer-Reviewed Original ResearchConceptsOral anticancer agentsCause mortalityReal-world populationHazard ratioComplex patientsMetastatic renal cell carcinoma patientsFDA approvalMetastatic renal cell carcinomaRenal cell carcinoma patientsProvider-level predictorsRetrospective cohort studyCell carcinoma patientsPatients' clinical characteristicsProvider-level factorsPivotal clinical trialsState Cancer RegistryRenal cell carcinomaCox hazard modelHigh-quality careAnticancer agentsProvider Enumeration SystemMRCC patientsClinical characteristicsCohort studyPatient characteristicsFactors associated with the quality of end-of-life care for patients with metastatic renal cell carcinoma.
Dzimitrowicz H, Wilson L, Jackson B, Spees L, Baggett C, Greiner M, Kaye D, Zhang T, George D, Scales C, Pritchard J, Leapman M, Gross C, Dinan M, Wheeler S. Factors associated with the quality of end-of-life care for patients with metastatic renal cell carcinoma. Journal Of Clinical Oncology 2022, 40: 300-300. DOI: 10.1200/jco.2022.40.6_suppl.300.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anti-cancer agentsRenal cell carcinomaSEER-MedicareDays of lifeSystemic therapyICU admissionCell carcinomaOdds ratioLife careSEER-Medicare cohortSystemic therapy useMultivariable logistic regressionUse of hospiceQuality of endHigh-quality endMRCC diagnosisAnti-cancer agentsMost patientsOlder patientsHospital admissionMedian ageTherapy useImmunotherapy treatmentRetrospective studyPatient, provider, and hospital factors associated with oral anti-neoplastic agent initiation and adherence in older patients with metastatic renal cell carcinoma
Kaye DR, Wilson LE, Greiner MA, Spees LP, Pritchard JE, Zhang T, Pollack CE, George D, Scales CD, Baggett CD, Gross CP, Leapman MS, Wheeler SB, Dinan MA. Patient, provider, and hospital factors associated with oral anti-neoplastic agent initiation and adherence in older patients with metastatic renal cell carcinoma. Journal Of Geriatric Oncology 2022, 13: 614-623. PMID: 35125336, PMCID: PMC9232903, DOI: 10.1016/j.jgo.2022.01.008.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaCancer-specific survivalMedical oncologistsRenal cell carcinomaHospital factorsHospital characteristicsOlder patientsCell carcinomaOAA treatmentDiagnosis of mRCCHigh-quality cancer careOlder adultsDecreased relative riskHigh-poverty zip codesYears of ageAnti-neoplastic agentsMRCC diagnosisSpecialty accessSurvival persistCause mortalityCancer providersPatient factorsMetastatic diagnosisCancer careRelative riskEvaluation of mild cognitive impairment and dementia in patients with metastatic renal cell carcinoma
Miller SM, Wilson LE, Greiner MA, Pritchard JE, Zhang T, Kaye DR, Cohen HJ, Becher RD, Maerz LL, Dinan MA. Evaluation of mild cognitive impairment and dementia in patients with metastatic renal cell carcinoma. Journal Of Geriatric Oncology 2022, 13: 635-643. PMID: 34996724, PMCID: PMC9232862, DOI: 10.1016/j.jgo.2021.12.012.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaNon-cancer controlsRenal cell carcinomaMRCC diagnosisMild cognitive impairmentCell carcinomaRisk factorsCognitive impairmentOlder adultsProportional hazards modelNew cancer treatmentsCohort entryOlder patientsSurgical therapyMAIN OUTCOMEExclusion criteriaAgent useDisease processHazards modelPatientsMedicare datasetCancer treatmentDiagnosisDementiaCarcinoma
2021
Vitamin D, Insulin-Like Growth Factor, and Cognitive Performance: Age and Sex Variations
Miller S, Wilson L, Greiner M, Pritchard J, Zhang T, Kaye D, Cohen H, Dinan M. Vitamin D, Insulin-Like Growth Factor, and Cognitive Performance: Age and Sex Variations. Innovation In Aging 2021, 5: 703-703. PMCID: PMC8969788, DOI: 10.1093/geroni/igab046.2613.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaRenal cell carcinomaProportional hazards regressionOral anticancer agentsMRCC diagnosisCell carcinomaHazards regressionRisk factorsCox proportional hazards regressionOlder adultsNon-cancer controlsMild cognitive impairmentCohort entryRenal dysfunctionOnly patientsSurgical therapyWhite patientsBlack patientsSEER-MedicareDementia onsetMAIN OUTCOMEExclusion criteriaHigh riskPatientsCognitive impairmentPatient- and provider-level predictors of mortality among patients with metastatic renal cell carcinoma receiving oral anticancer agents.
Spees L, Dinan M, Jackson B, Baggett C, Wilson L, Greiner M, Kaye D, Zhang T, George D, Scales C, Pritchard J, Leapman M, Gross C, Wheeler S. Patient- and provider-level predictors of mortality among patients with metastatic renal cell carcinoma receiving oral anticancer agents. Journal Of Clinical Oncology 2021, 39: 116-116. DOI: 10.1200/jco.2020.39.28_suppl.116.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anti-cancer agentsPatients' clinical characteristicsProvider-level factorsCause mortalityRenal cell carcinomaClinical characteristicsHazard ratioMetastatic diagnosisCell carcinomaState cancer registry dataCox proportional hazards modelProvider-level predictorsLower overall survivalOral anticancer agentsCancer registry dataReal-world populationProportional hazards modelSkilled nursing facilitiesProvider Enumeration SystemAnti-cancer agentsIndex dateOverall survivalPatient demographicsBlack patientsProvider- and patient-level predictors of oral anticancer agent initiation and adherence in patients with metastatic renal cell carcinoma.
Spees L, Wheeler S, Jackson B, Baggett C, Wilson L, Greiner M, Kaye D, Zhang T, George D, Scales C, Pritchard J, Leapman M, Gross C, Dinan M. Provider- and patient-level predictors of oral anticancer agent initiation and adherence in patients with metastatic renal cell carcinoma. Journal Of Clinical Oncology 2021, 39: 87-87. DOI: 10.1200/jco.2020.39.28_suppl.87.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaPatient-level factorsProvider-level factorsRenal cell carcinomaIndex dateRace/ethnicityInitial diagnosisCell carcinomaRisk ratioState cancer registry dataNumber of comorbiditiesMore comorbid conditionsPatient-level predictorsCancer registry dataProportion of daysProvider-level variablesPrescription drug filesMedian PDCMRCC diagnosisMRCC patientsPatient characteristicsPharmacy claimsComorbid conditionsMetastatic diagnosisMedical oncologyProvider‐ and patient‐level predictors of oral anticancer agent initiation and adherence in patients with metastatic renal cell carcinoma
Spees LP, Wheeler SB, Jackson BE, Baggett CD, Wilson LE, Greiner MA, Kaye DR, Zhang T, George D, Scales CD, Pritchard JE, Leapman M, Gross CP, Dinan MA. Provider‐ and patient‐level predictors of oral anticancer agent initiation and adherence in patients with metastatic renal cell carcinoma. Cancer Medicine 2021, 10: 6653-6665. PMID: 34480518, PMCID: PMC8495289, DOI: 10.1002/cam4.4201.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaPatient-level factorsRenal cell carcinomaCell carcinomaRisk ratioState cancer registry dataPatient-level predictorsPatient-level characteristicsCancer registry dataProvider Enumeration SystemMRCC diagnosisMedical oncologyInsurance typeMedicare patientsRegistry dataFemale providersPatientsMedian proportionPoisson regressionCare issuesPrivate insuranceMale providersAdherenceCarcinomaAnticancer agentsReal-World Utilization of Oral Anticancer Agents and Related Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States
Wilson LE, Spees L, Pritchard J, Greiner MA, Scales CD, Baggett CD, Kaye D, George DJ, Zhang T, Wheeler SB, Dinan MA. Real-World Utilization of Oral Anticancer Agents and Related Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States. Kidney Cancer 2021, 5: 115-127. PMID: 34632169, PMCID: PMC8474520, DOI: 10.3233/kca-210119.Peer-Reviewed Original ResearchOral anticancer agentsMetastatic RCCPatient characteristicsMetastatic renal cell carcinomaPocket costsFirst oral therapySEER-Medicare analysisRepresentative patient populationRenal cell carcinomaAnticancer agentsPrescription drug coverageRace/ethnicityMRCC diagnosisMost patientsOral therapyUnmarried patientsCell carcinomaPatient populationAdvanced ageInclusion criteriaPatientsDrug coverageAge 65Medicare Part D prescription drug coverageSocioeconomic disparitiesPatterns and Predictors of Oral Anticancer Agent Use in Diverse Patients With Metastatic Renal Cell Carcinoma
Wheeler SB, Spees LP, Jackson BE, Baggett CD, Wilson LE, Greiner MA, Kaye DR, Zhang T, George D, Scales CD, Pritchard JE, Dinan MA. Patterns and Predictors of Oral Anticancer Agent Use in Diverse Patients With Metastatic Renal Cell Carcinoma. JCO Oncology Practice 2021, 17: e1895-e1904. PMID: 34138665, PMCID: PMC8678030, DOI: 10.1200/op.20.01082.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsRenal cell carcinomaIndex dateCell carcinomaRisk ratioPatterns of usePatients age 80Patients age 18Population-based studyAdjusted risk differenceOral therapyPatient characteristicsContinuous enrollmentHigh frailtyAge 80Agent useRisk differencePatientsDiverse patientsComorbiditiesAge 18Regulatory approvalCarcinomaLog-Poisson modelOral anticancer agent (OAA) adherence and survival in elderly patients with metastatic renal cell carcinoma (mRCC).
Dinan M, Wilson L, Greiner M, Spees L, Pritchard J, Zhang T, Kaye D, George D, Scales C, Wheeler S. Oral anticancer agent (OAA) adherence and survival in elderly patients with metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2021, 39: 280-280. DOI: 10.1200/jco.2021.39.6_suppl.280.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anticancer agentsDisease-specific survivalRenal cell carcinomaCell carcinomaPatient populationSEER-Medicare patientsDisease-specific mortalityNumber of comorbiditiesOlder patient populationProgression-free survivalReal-world adherenceRandomized clinical trialsTreatment of patientsAnalysis of patientsProportion of daysRCC-specific mortalityMinimum effective doseSignificant reductionOAA therapyCause mortalityElderly patientsFavorable survivalMetastatic RCCMultivariable analysis
2020
Disparities in utilization of oral anticancer agents and related costs in elderly patients with metastatic renal cell carcinoma in the United States.
Wilson L, Spees L, Pritchard J, Greiner M, Scales C, Baggett C, Kaye D, George D, Zhang T, Wheeler S, Dinan M. Disparities in utilization of oral anticancer agents and related costs in elderly patients with metastatic renal cell carcinoma in the United States. Journal Of Clinical Oncology 2020, 38: 106-106. DOI: 10.1200/jco.2020.38.29_suppl.106.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anticancer agentsRenal cell carcinomaPatient characteristicsCell carcinomaManagement of mRCCSEER-Medicare patientsMultivariable-adjusted modelsMajority of patientsPatient-level characteristicsAnticancer agentsMedicare Part D benefitPart D benefitSurvival persistCertain comorbiditiesElderly patientsMultivariable adjustmentMarried patientsMetastatic diagnosisRace/ethnicity categoriesAdvanced ageInclusion criteriaHispanic ethnicityPatientsPocket spending