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 MedicareChanges in Facility Share of Medicaid-Insured Patients with Urologic Cancers Following Implementation of the Patient Protection and Affordable Care Act
Demkowicz P, Buck M, Nie J, Marks V, Wheeler S, Dinan M, Gross C, Leapman M. Changes in Facility Share of Medicaid-Insured Patients with Urologic Cancers Following Implementation of the Patient Protection and Affordable Care Act. Urology 2024 PMID: 38901803, DOI: 10.1016/j.urology.2024.06.003.Peer-Reviewed Original ResearchFacility-level changesAffordable Care ActNon-expansion statesUrological cancer patientsProportion of patientsExpansion statesBaseline proportion of patientsUrologic cancer careHigh-income zip codesCancer patientsFactors associated with changesPre-post designCancer care centerPost-ACA periodMedicaid expansion statesMultivariate logistic regressionMedicaid-insured patientsCancer careUrological cancersZip codesCare ActMedicaid patientsMedicaidLogistic regressionCare centerCharacterization of time toxicity in older patients with metastatic breast cancer
Atre S, Soulos P, Kuderer N, Gross C, Baum L, Dinan M, Lustberg M. Characterization of time toxicity in older patients with metastatic breast cancer. Breast Cancer Research And Treatment 2024, 1-10. PMID: 38816556, DOI: 10.1007/s10549-024-07379-7.Peer-Reviewed Original ResearchMetastatic breast cancerBone-modifying agentsComorbid medical conditionsOlder patientsBreast cancerRetrospective cohort studySEER-Medicare databaseTreatment typeCancer treatment modalityTreatment modalitiesSEER-MedicareCohort studyUnadjusted analysisPatientsAge-related impactCancer treatmentComorbiditiesDay patientsCancerRadiotherapyOlder ageMedical conditionsToxicityTreatmentSociodemographic factorsOpioid prescribing trends and pain scores among adult patients with cancer in a large health system.
Baum L, Soulos P, KC M, Jeffery M, Ruddy K, Lerro C, Lee H, Graham D, Liberatore M, Rivera D, Leapman M, Jairam V, Dinan M, Gross C, Park H. Opioid prescribing trends and pain scores among adult patients with cancer in a large health system. Journal Of Clinical Oncology 2024, 42: 11059-11059. DOI: 10.1200/jco.2024.42.16_suppl.11059.Peer-Reviewed Original ResearchDocumented painHealth systemOpioid prescribingOpioid prescriptionsOpioid prescribing trendsYale New Haven Health SystemPrescribing trendsMetastatic cancerDocumented pain scoresUS health systemOpioid usePain scoresAdult patientsCalculated predicted probabilitiesFlowsheet dataRetrospective cohort studyRelated harmSolid tumor malignanciesCohort studyCancer painPrescribingContext of cancer treatmentStudy criteriaPainSurgery cohortPersonalized risk assessment of new onset depression in long-term cancer survivors.
Taylor M, Westvold S, Long J, Hyslop T, Wang S, Cecchini M, Leapman M, Leeds I, Lustberg M, Spees L, Wheeler S, Gross C, Oeffinger K, Dinan M. Personalized risk assessment of new onset depression in long-term cancer survivors. Journal Of Clinical Oncology 2024, 42: e13798-e13798. DOI: 10.1200/jco.2024.42.16_suppl.e13798.Peer-Reviewed Original ResearchHistory of depressionIncidence of depressionCumulative incidence of depressionRisk of developing depressionLong-term survivorsPredictors of depressionCancer survivorsDisease specific factorsCumulative incidenceNon-HispanicHigher risk of developing depressionRectal cancerLong-term cancer survivorsBreast cancer survivorsCensus tract povertyColon cancerEpisodes of bipolar I disorderPrevalence of depressionMean survival time modelsDiagnosis of depressionReceipt of treatmentAssociated with prior historyHormone receptor statusPatients aged <Adjuvant endocrine therapyACO leakage among gynecologic cancer patients: Incidence, predictors, and impact on annual Medicare expenditure
Osazuwa-Peters O, Greiner M, Kaufman B, Zambrano Guevara L, Dinan M, Havrilesky L, Moss H. ACO leakage among gynecologic cancer patients: Incidence, predictors, and impact on annual Medicare expenditure. Gynecologic Oncology 2024, 187: 184-191. PMID: 38788516, DOI: 10.1016/j.ygyno.2024.05.020.Peer-Reviewed Original ResearchAccountable care organizationsGynecologic cancer patientsACO sizeYear of cancer diagnosisReceipt of healthcareLog-binomial regression modelsCancer patientsNon-ACO providersPatients seeking careAdjusted risk ratiosHealth care costsAnnual Medicare expendituresMedian household incomeAssociated with useCare organizationsOutpatient careMedicare expendituresCare costsHealthcare costsMedicare spendingCancer diagnosisOutpatient settingHousehold incomeRisk ratioMultivariable adjusted risk ratiosArea 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 periodTherapyDiagnosisMutation-specific costs of advanced non-small cell lung cancer treatment.
Tan J, Yang S, Dinan M, Chiang A, Gross C, Wang S. Mutation-specific costs of advanced non-small cell lung cancer treatment. JCO Oncology Practice 2023, 19: 14-14. DOI: 10.1200/op.2023.19.11_suppl.14.Peer-Reviewed Original ResearchAdvanced non-small cell lung cancerNon-small cell lung cancerMean medication costsActionable gene alterationsMedication costsFirst-year costsReference groupAdvanced non-small cell lung cancer (NSCLC) treatmentNon-small cell lung cancer (NSCLC) treatmentCell lung cancer treatmentGene alterationsBiomarker resultsFlatiron Health databasePD-L1 resultsTherapy prolongs survivalRetrospective cohort studyCell lung cancerBiomarker test resultsLung cancer treatmentCost-effectiveness analysisCohort studyNovel immunotherapiesOverall cohortProlong survivalTreatment optionsZillow MD: Do housing prices predict cancer survival?
Dinan M, Wheeler S. Zillow MD: Do housing prices predict cancer survival? JNCI Cancer Spectrum 2023, 7: pkad086. PMID: 37965909, PMCID: PMC10646759, DOI: 10.1093/jncics/pkad086.Peer-Reviewed Original ResearchCharacteristics, healthcare utilization, and outcomes of patients with HER2-low breast cancer
Check D, Jackson B, Reeder-Hayes K, Dinan M, Faherty E, Kwong J, Mehta S, Spees L, Wheeler S, Wilson L, Lam C. Characteristics, healthcare utilization, and outcomes of patients with HER2-low breast cancer. Breast Cancer Research And Treatment 2023, 203: 329-338. PMID: 37875669, DOI: 10.1007/s10549-023-07142-4.Peer-Reviewed Original ResearchConceptsHER2-low breast cancerBreast cancerHealthcare utilizationOutcomes of patientsRetrospective cohort studyStage IV diseaseStage IV patientsMetastatic breast cancerNew treatment guidelinesRate of hospitalizationBreast cancer patientsClinical characteristicsCohort studyHazard ratioIV patientsOverall cohortPositive diseaseTreatment guidelinesIHC 0Utilization outcomesTreatment optionsCancer patientsSurvival differencesPatientsStage IVTrends in new and persistent opioid use in older adults with and without cancer
Baum L, KC M, Soulos P, Jeffery M, Ruddy K, Lerro C, Lee H, Graham D, Rivera D, Leapman M, Jairam V, Dinan M, Gross C, Park H. Trends in new and persistent opioid use in older adults with and without cancer. Journal Of The National Cancer Institute 2023, 116: 316-323. PMID: 37802882, DOI: 10.1093/jnci/djad206.Peer-Reviewed Original ResearchAdditional opioid useNew opioid useOpioid useNon-metastatic cancerPersistent opioid useRetrospective cohort studySolid tumor malignanciesClinical strataEligible patientsNaïve patientsOpioid prescribingMetastatic patientsSurgery patientsCohort studySEER-MedicareMetastatic cancerPatientsTumor malignancyCancerOlder adultsSurgeryRandom sampleAdditional useChemotherapyPrescribingRelative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US
Kc M, Fan J, Hyslop T, Hassan S, Cecchini M, Wang S, Silber A, Leapman M, Leeds I, Wheeler S, Spees L, Gross C, Lustberg M, Greenup R, Justice A, Oeffinger K, Dinan M. Relative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US. JAMA Network Open 2023, 6: e2323115. PMID: 37436746, PMCID: PMC10339147, DOI: 10.1001/jamanetworkopen.2023.23115.Peer-Reviewed Original ResearchConceptsLong-term survivorsCancer-specific mortalityColorectal cancerCancer cohortReceptor statusInitial diagnosisGleason scoreProstate cancerBreast cancerLong-term adult survivorsMedian cancer-specific survivalEnd Results cancer registryProstate-specific antigen levelRectal cancer cohortCancer-specific survivalStage III diseaseYear of diagnosisProgesterone receptor statusEstrogen receptor statusProportion of deathsSurvival time ratioEarly-stage cancerNononcologic outcomesIndex cancerLocalized diseaseDemographic and clinical factors associated with cardiovascular events in elderly long-term survivors of breast cancer.
Westvold S, KC M, Fan J, Hyslop T, Spees L, Wang S, Silber A, Oeffinger K, Dinan M. Demographic and clinical factors associated with cardiovascular events in elderly long-term survivors of breast cancer. Journal Of Clinical Oncology 2023, 41: e24105-e24105. DOI: 10.1200/jco.2023.41.16_suppl.e24105.Peer-Reviewed Original ResearchLong-term breast cancer survivorsBreast cancer survivorsLong-term survivorsCardiovascular diseaseCancer survivorsHigh riskCancer stageRace/ethnicityClinical characteristicsDiagnosis yearBreast cancerEvidence of CVDNon-Hispanic black patientsNon-metastatic breast cancerLong-term cancer survivorsCox proportional hazards modelCurative-intent surgeryCVD hazard ratiosNon-oncologic outcomesCancer-specific survivalStage III diseaseInitial cancer diagnosisDiagnosis of CVDRace/ethnicity groupsChi-square testDisparities 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 persistSexPatientsClinician and Cancer Survivor Perspectives on Managing Chronic Pain after Cancer Treatment: A Qualitative Study (Sci216)
Check D, O'Regan A, Jones K, Fish L, Dinan M, Farley S, E. J, Makarushka C, Merlin J, Somers T, Oeffinger K. Clinician and Cancer Survivor Perspectives on Managing Chronic Pain after Cancer Treatment: A Qualitative Study (Sci216). Journal Of Pain And Symptom Management 2023, 65: e648. DOI: 10.1016/j.jpainsymman.2023.02.266.Peer-Reviewed Original ResearchChronic painPalliative care cliniciansCancer survivorsCare cliniciansCancer treatmentCancer survivorshipLong-term opioid therapyRoutine survivorship careCurative-intent treatmentActive cancer treatmentChronic pain managementImpact of painCancer survivors' perspectivesOpioid therapySurvivorship carePain managementActive treatmentMultimodal managementPain carePrimary careHigh prevalencePainCliniciansSurvivorsSurvivors' perspectivesFactors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer
Osazuwa-Peters O, Wilson L, Check D, Roberts M, Srinivasan S, Clark A, Crawford J, Chrischilles E, Carnahan R, Campbell W, Cowell L, Greenlee R, Abbott A, Mosa A, Mandhadi V, Stoddard A, Dinan M. Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer. Clinical Lung Cancer 2023, 24: 305-312. PMID: 37055337, DOI: 10.1016/j.cllc.2023.03.001.Peer-Reviewed Original ResearchConceptsInitial systemic treatmentSystemic treatmentMolecular testingComorbidity statusMetastatic non-small cell lung cancer patientsMetastatic non-small cell lung cancerTime-varying Cox regression modelsNon-small cell lung cancer patientsProportional hazardsNon-small cell lung cancerCell lung cancer patientsInitial systemic therapyMolecular testing ratesRetrospective cohort studyMajority of patientsCell lung cancerCox regression modelLung cancer patientsNon-Hispanic white individualsCox proportional hazardsYears of ageRace/ethnicityAdult patientsCohort studyPatient ageManaging Chronic Pain in Cancer Survivorship: Communication Challenges and Opportunities as Described by Cancer Survivors
O’Regan A, Fish L, Makarushka C, Somers T, Jones K, Merlin J, Dinan M, Oeffinger K, Check D. Managing Chronic Pain in Cancer Survivorship: Communication Challenges and Opportunities as Described by Cancer Survivors. American Journal Of Hospice And Palliative Medicine® 2023, 41: 78-86. PMID: 36927121, DOI: 10.1177/10499091231164634.Peer-Reviewed Original ResearchPain management experiencesCurative-intent treatmentChronic painCancer survivorsPain managementProvider-initiated communicationChronic pain managementHead/neckCancer survivors' experiencesDecision-making interventionSurvivorship careColorectal cancerClinical managementCancer survivorshipPainPain experienceStage ISurvivorsConvenience sampleSurvivors' experiencesTreatmentFunctional goalsCareThematic approachProvidersEvolution 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 receiptClinician Perspectives on Managing Chronic Pain After Curative-Intent Cancer Treatment
Check D, Jones K, Fish L, Dinan M, Dunbar T, Farley S, Ma J, Merlin J, O'Regan A, Oeffinger K. Clinician Perspectives on Managing Chronic Pain After Curative-Intent Cancer Treatment. JCO Oncology Practice 2023, 19: e484-e491. PMID: 36595729, PMCID: PMC10530392, DOI: 10.1200/op.22.00410.Peer-Reviewed Original ResearchConceptsChronic painCancer survivorsClinician experienceLong-term opioid therapyMultimodal pain careCurative-intent treatmentBehavioral health servicesAcademic medical centerOpioid therapyOpioid managementActive treatmentPain careHighlights unmetHigh prevalenceClinician's perspectiveMedical CenterMost cliniciansPainMultidisciplinary teamHealth servicesPsychosocial stressorsPain monitoringCliniciansCancer treatmentSurvivors