2025
Opioid 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, Rivera D, Liberatore M, 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. Cancer 2025, 131: e70027. PMID: 40977160, PMCID: PMC12451255, DOI: 10.1002/cncr.70027.Peer-Reviewed Original ResearchConceptsOpioid prescribingMetastatic cancerNo painHealth systemPain scoresWidespread policy changeOpioid-naive adultsNewly diagnosed cancerOpioid-related harmsOpioid prescribing trendsPain managementOpioid prescriptionsRetrospective studyAdult patientsClinical strataPrescribingPrescribing trendsSurgical patientsLogistic regressionOpioidPainPatientsCancerStewardship policiesPolicy changesBiomarker-Specific Survival and Medication Cost for Patients With Non–Small Cell Lung Cancer
Tan J, Yang S, Dinan M, Chiang A, Gross C, Wang S. Biomarker-Specific Survival and Medication Cost for Patients With Non–Small Cell Lung Cancer. JAMA Network Open 2025, 8: e2514519. PMID: 40493365, PMCID: PMC12152704, DOI: 10.1001/jamanetworkopen.2025.14519.Peer-Reviewed Original ResearchConceptsAdvanced non-small cell lung cancerNon-small cell lung cancerEGFR variationPD-L1ALK rearrangementCell lung cancerDriver alterationsMedical costsLung cancerCohort studyProgrammed cell death 1 ligand 1Cell death 1 ligand 1Biomarker statusMedian overall survivalRetrospective cohort studyLower medical costsOverall survivalTargeted therapyNon-smallPatient cohortMonthly medical costsFollow-upStudy cohortBiomarker testingAssociated with higher costsOff-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma
McManus H, Long J, Westvold S, Leapman M, Hurwitz M, Mitchell A, Pollack C, Gross C, Dinan M. Off-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma. Clinical Genitourinary Cancer 2025, 23: 102330. PMID: 40186898, PMCID: PMC12084128, DOI: 10.1016/j.clgc.2025.102330.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaImmune checkpoint inhibitorsFood and Drug AdministrationRenal cell carcinomaOff-labelCell carcinomaOlder patientsImmune checkpoint inhibitor useFood and Drug Administration approvalFirst-line immunotherapyMultivariate logistic regressionOff-label useCo-morbid conditionsCheckpoint inhibitorsFirst-lineCo-morbiditiesDrug AdministrationPatientsCo-morbidityPostapproval settingLogistic regressionCarcinomaDemographic characteristicsPostapprovalPostapproval period
2024
Area 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
Characteristics, 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 ResearchMeSH KeywordsBreast NeoplasmsDelivery of Health CareFemaleHumansPatient Acceptance of Health CareReceptor, ErbB-2Retrospective StudiesConceptsHER2-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 IVFactors 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 ResearchMeSH KeywordsAdultCarcinoma, Non-Small-Cell LungEthnicityHumansLung NeoplasmsMaleMolecular Diagnostic TechniquesRetrospective StudiesConceptsInitial 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 age
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 ResearchMeSH KeywordsAgedAntineoplastic AgentsCarcinoma, Renal CellHospital MortalityHumansKidney NeoplasmsMedicareRetrospective StudiesTerminal CareUnited StatesConceptsMetastatic 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 useConcurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis
Check D, Baggett C, Kim K, Merlin J, Oeffinger K, Winn A, Roberts M, Robinson T, Dinan M. Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis. Supportive Care In Cancer 2022, 30: 9781-9791. PMID: 36396793, DOI: 10.1007/s00520-022-07439-y.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnalgesics, OpioidBenzodiazepinesHumansMedicareNeoplasmsRetrospective StudiesUnited StatesConceptsConcurrent prescribingSedating medicationsPatient characteristicsMedication-related eventsRetrospective cohort studyNon-metastatic cancerPopulation-based assessmentCancer registry dataMental health conditionsSubstance use disordersPrivate insurance claimsConcurrent prescriptionsCohort studyHispanic patientsSymptom managementRelative riskRegistry dataGabapentinoidsOpioidsPrescribingUse disordersPatientsPoisson regressionPrior useMedicationsOral 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 ResearchMeSH KeywordsAgedAntineoplastic AgentsCarcinoma, Renal CellHumansKidney NeoplasmsMedicareMedication AdherenceRetrospective StudiesUnited StatesConceptsMetastatic 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 treatmentPatientsCarcinomaAdherenceSurvivalPatient- 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 ResearchMeSH KeywordsAgedAntineoplastic AgentsCarcinoma, Renal CellHumansKidney NeoplasmsMedicareRetrospective StudiesUnited StatesConceptsOral 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 characteristicsPatient, 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 ResearchMeSH KeywordsAgedCarcinoma, Renal CellHospitalsHumansKidney NeoplasmsMedicareRetrospective StudiesUnited StatesConceptsMetastatic 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 risk
2021
Adoption of New Risk Stratification Technologies Within US Hospital Referral Regions and Association With Prostate Cancer Management
Leapman MS, Wang R, Park HS, Yu JB, Sprenkle PC, Dinan MA, Ma X, Gross CP. Adoption of New Risk Stratification Technologies Within US Hospital Referral Regions and Association With Prostate Cancer Management. JAMA Network Open 2021, 4: e2128646. PMID: 34623406, PMCID: PMC8501394, DOI: 10.1001/jamanetworkopen.2021.28646.Peer-Reviewed Original ResearchConceptsProstate magnetic resonance imagingMagnetic resonance imagingHospital referral regionsProportion of patientsProstate cancerGenomic testingCohort studyReferral regionsRetrospective cohort studyProstate cancer carePatient-level analysisCommercial insurance claimsProstate cancer managementUS hospital referral regionsYears of ageProportion of menPatients 40Definitive treatmentCancer careTesting uptakeHRR levelMAIN OUTCOMECancer managementPatientsRegional uptakeProvider‐ 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 ResearchMeSH KeywordsAdministration, OralAgedAntineoplastic AgentsCarcinoma, Renal CellFemaleHumansKidney NeoplasmsMaleMedication AdherenceRetrospective StudiesConceptsMetastatic 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 agentsPatterns 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 modelPredictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims
Check DK, Baggett C, Kim K, Roberts AW, Roberts MC, Robinson T, Oeffinger KC, Dinan MA. Predictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims. Journal Of The National Cancer Institute 2021, 113: 1581-1589. PMID: 33881543, PMCID: PMC8562975, DOI: 10.1093/jnci/djab082.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidCancer SurvivorsHumansNeoplasmsNorth CarolinaOpioid-Related DisordersRetrospective StudiesUnited StatesConceptsChronic opioid useChronic opioid therapyOpioid useCancer survivorsOpioid therapyBaseline depressionLong-term pain managementSubstance useRetrospective cohort studyPopulation-based studyCancer registry dataLow-income survivorsCohort studyPatient characteristicsPain managementActive treatmentNonmetastatic cancerChronic useInsurance statusRelative riskRegistry dataOpioidsPoisson regressionYounger ageAge groupsTreatment at Integrated Centers Might Bridge the Academic-Community Survival Gap in Patients With Metastatic Non-Small Cell Carcinoma of the Lung
Ramalingam S, Dinan M, Crawford J. Treatment at Integrated Centers Might Bridge the Academic-Community Survival Gap in Patients With Metastatic Non-Small Cell Carcinoma of the Lung. Clinical Lung Cancer 2021, 22: e646-e653. PMID: 33582071, DOI: 10.1016/j.cllc.2020.12.013.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerMetastatic non-small cell lung cancerCommunity-based centersAcademic centersMetastatic non-small cell carcinomaNon-small cell carcinomaStudy periodPrimary end pointNational Cancer DatabaseCell lung cancerSquamous cell carcinomaCancer-related deathMost cancer-related deathsTreatment-related improvementOverall survivalSurvival gapSurvival disparitiesImproved survivalCell carcinomaLung cancerCancer DatabaseRetrospective analysisNew therapiesPatientsEnd point
2020
Rapid rise in the cost of targeted cancer therapies for Medicare patients with solid tumors from 2006 to 2015
Wilson LE, Greiner MA, Altomare I, Rotter J, Dinan MA. Rapid rise in the cost of targeted cancer therapies for Medicare patients with solid tumors from 2006 to 2015. Journal Of Geriatric Oncology 2020, 12: 375-380. PMID: 33250425, DOI: 10.1016/j.jgo.2020.11.007.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic AgentsBreast NeoplasmsFee-for-Service PlansHumansMaleMedicareRetrospective StudiesUnited StatesConceptsProstate cancerCancer costsLung cancerBreast cancerProportion of patientsSystemic anticancer therapyPart D enrollmentNew malignanciesPatients 65Systemic therapyMedicare 5Colorectal cancerInvasive lungMedicare patientsCohort analysisMedicare populationMedicare beneficiariesPatientsSolid tumorsTherapyCancerAnticancer therapyCancer therapyFinancial burdenLungAssociation of 21-Gene Assay (OncotypeDX) Testing and Receipt of Chemotherapy in the Medicare Breast Cancer Patient Population Following Initial Adoption
Dinan MA, Wilson LE, Reed SD, Griggs JJ, Norton EC. Association of 21-Gene Assay (OncotypeDX) Testing and Receipt of Chemotherapy in the Medicare Breast Cancer Patient Population Following Initial Adoption. Clinical Breast Cancer 2020, 20: 487-494.e1. PMID: 32653473, DOI: 10.1016/j.clbc.2020.05.010.Peer-Reviewed Original Research
2019
Low-Risk Thyroid Cancer in Elderly: Total Thyroidectomy/RAI Predominates but Lacks Survival Advantage
Zambeli-Ljepović A, Wang F, Dinan MA, Hyslop T, Roman SA, Sosa J, Scheri RP. Low-Risk Thyroid Cancer in Elderly: Total Thyroidectomy/RAI Predominates but Lacks Survival Advantage. Journal Of Surgical Research 2019, 243: 189-197. PMID: 31185435, PMCID: PMC6773493, DOI: 10.1016/j.jss.2019.05.029.Peer-Reviewed Original ResearchConceptsDisease-specific survivalPapillary thyroid cancerExtent of surgeryTotal thyroidectomyTumor sizeThyroid cancerLow-risk papillary thyroid cancerEnd Results-Medicare databaseLow-risk thyroid cancerOlder adultsNational treatment patternsRadioactive iodine administrationUnderwent total thyroidectomyLarger tumor sizeMultivariable logistic regressionQuality of lifeMost older adultsPostoperative RAIRAI administrationCompletion thyroidectomyExcellent prognosisOlder patientsExtensive surgeryFavorable prognosisMedian ageShared-patient physician networks and their impact on the uptake of genomic testing in breast cancer
Rotter J, Wilson L, Greiner MA, Pollack CE, Dinan M. Shared-patient physician networks and their impact on the uptake of genomic testing in breast cancer. Breast Cancer Research And Treatment 2019, 176: 445-451. PMID: 31028607, PMCID: PMC6556129, DOI: 10.1007/s10549-019-05248-2.Peer-Reviewed Original ResearchConceptsPatient-level analysisOncotype DXBreast cancerMedical oncologistsEarly-stage breast cancerGenomic testingPhysician networksODX testingMore patientsRetrospective studySEER-MedicareStudy criteriaSuboptimal treatmentCancer patientsMedian numberModifiable driversModifiable meansPatientsOncologistsLogistic mixed modelsEarly adoption periodWomenCancerPhysiciansGenomic assays
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