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 costsScreening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer
Huang S, Westvold S, Soulos P, Fan J, Winer E, Zhan H, Lustberg M, Lewin J, Robinson T, Dinan M. Screening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer. JAMA Network Open 2025, 8: e255322. PMID: 40232715, PMCID: PMC12000969, DOI: 10.1001/jamanetworkopen.2025.5322.Peer-Reviewed Original ResearchConceptsBreast cancer-specific mortalityBreast cancer mortalityBreast cancer diagnosisCancer-specific mortalityCancer mortalityCancer diagnosisScreening mammographyHazard of breast cancer-specific deathFee-for-service Medicare Parts AAssociated with reduced breast cancer mortalityLower breast cancer mortalityHazard of breast cancer-specific mortalityBreast cancerImprove breast cancer outcomesScreen-detected breast cancerCohort studyBreast cancer-specific deathStudy of older womenBreast cancer outcomesFee-for-serviceDetection of breast cancerMedicare Part ALater-stage diseaseCox proportional hazards modelsAssociated with early stagesOff-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 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 IVDisparities 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 persistSexPatients
2022
Genetic testing in privately insured women with surgically treated breast cancer
Dinan M, Pitafi S, Greenup R, Long J, Gross C. Genetic testing in privately insured women with surgically treated breast cancer. Breast Cancer Research And Treatment 2022, 198: 177-181. PMID: 36542252, DOI: 10.1007/s10549-022-06829-4.Peer-Reviewed Original ResearchConceptsBreast cancerGenetic testingRoutine breast cancer careBRCA1/BRCA2 genetic testingHormone receptor statusBreast cancer careInvasive breast cancerBRCA2 genetic testingReceptor statusWomen 50Cancer careAge 45Family historyOlder womenInsurer databaseYoung womenCancerWomenCoverage policiesUnclear implicationsPatientsSurgeryPurposeRatesYearsPrevalence
2021
Analysis of Sociodemographic, Clinical, and Genomic Factors Associated With Breast Cancer Mortality in the Linked Surveillance, Epidemiology, and End Results and Medicare Database
Robinson TJ, Wilson LE, Marcom PK, Troester M, Lynch CF, Hernandez BY, Parrilla E, Brauer HA, Dinan MA. Analysis of Sociodemographic, Clinical, and Genomic Factors Associated With Breast Cancer Mortality in the Linked Surveillance, Epidemiology, and End Results and Medicare Database. JAMA Network Open 2021, 4: e2131020. PMID: 34714340, PMCID: PMC8556625, DOI: 10.1001/jamanetworkopen.2021.31020.Peer-Reviewed Original ResearchConceptsResidual tissue repositoryBreast cancer outcomesSEER-Medicare dataCancer outcomesCox proportional hazards regression modelHealth servicesEstrogen receptor-positive invasive breast cancerSymptomatic detectionBreast cancer-specific survivalPopulation-based cohort studyEstrogen receptor-positive tumorsProportional hazards regression modelsExploratory genomic analysisSEER-Medicare cohortCancer-specific survivalSocioeconomic statusHigh-grade diseaseInvasive breast cancerReceptor-positive tumorsSubset of womenBreast cancer mortalityAdvanced disease stageHazards regression modelsClaims-based algorithmGrowth factor β activationProvider‐ 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 agentsChallenges in Predicting Future Costs for Metastatic Breast Cancer
Dinan MA, Greenup RA. Challenges in Predicting Future Costs for Metastatic Breast Cancer. JNCI Cancer Spectrum 2021, 5: pkab064. PMID: 34409256, PMCID: PMC8364672, DOI: 10.1093/jncics/pkab064.Peer-Reviewed Original ResearchReporting of Study Participant Demographic Characteristics and Demographic Representation in Premarketing and Postmarketing Studies of Novel Cancer Therapeutics
Varma T, Wallach JD, Miller JE, Schnabel D, Skydel JJ, Zhang AD, Dinan MA, Ross JS, Gross CP. Reporting of Study Participant Demographic Characteristics and Demographic Representation in Premarketing and Postmarketing Studies of Novel Cancer Therapeutics. JAMA Network Open 2021, 4: e217063. PMID: 33877309, PMCID: PMC8058642, DOI: 10.1001/jamanetworkopen.2021.7063.Peer-Reviewed Original ResearchConceptsNovel cancer therapeuticsPostmarketing studyBlack patientsCancer therapeuticsDemographic dataOlder adultsUS cancer populationUS Cancer StatisticsCross-sectional studyRace/ethnicityParticipants' demographic characteristicsPercentage of trialsPatient sexCancer populationClinical studiesCancer statisticsMAIN OUTCOMEDrug AdministrationFDA approvalStudy participantsCancer typesDemographic characteristicsDemographic informationStudy samplePatientsTreatment 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
Association 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
Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer.
Moss HA, Havrilesky LJ, Wang FF, Georgieva MV, Hendrix LH, Dinan MA. Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer. JCO Oncology Practice 2019, 15: e1018-e1027. PMID: 31613721, PMCID: PMC10445789, DOI: 10.1200/jop.19.00026.Peer-Reviewed Original ResearchConceptsAdvanced ovarian cancerOvarian cancerAlternative payment modelsNeoadjuvant chemotherapy patientsEmergency department visitsSEER-Medicare dataMean total costOutpatient emergency department visitsPayment modelsHealth care servicesCost-efficient careAvoidable spendingNeoadjuvant chemotherapyReal-world practiceDepartment visitsChemotherapy patientsCancer careMedicare beneficiariesHospitalizationCare servicesPatientsService MedicareChemotherapySurgeryPotential cost savingsExtent of surgery for low-risk thyroid cancer in the elderly: Equipoise in survival but not in short-term outcomes
Zambeli-Ljepović A, Wang F, Dinan MA, Hyslop T, Stang MT, Roman SA, Sosa JA, Scheri RP. Extent of surgery for low-risk thyroid cancer in the elderly: Equipoise in survival but not in short-term outcomes. Surgery 2019, 166: 895-900. PMID: 31288935, PMCID: PMC6802283, DOI: 10.1016/j.surg.2019.05.035.Peer-Reviewed Original ResearchConceptsPapillary thyroid cancerLow-risk papillary thyroid cancerEmergency department visitsShort-term outcomesTotal thyroidectomyThyroid cancerFemale patientsBlack patientsEnd Results-Medicare databaseMore emergency department visitsLow-risk thyroid cancerExtent of thyroidectomyExtent of surgeryMultivariable logistic regressionUnderwent lobectomyUnplanned readmissionOlder patientsAvoidable complicationsMean ageMorbidity increasesThyroidectomyPatientsReadmissionComplicationsLobectomyLow-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 assaysChemotherapy Costs and 21-Gene Recurrence Score Genomic Testing Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005 to 2011.
Dinan MA, Wilson LE, Reed SD. Chemotherapy Costs and 21-Gene Recurrence Score Genomic Testing Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005 to 2011. Journal Of The National Comprehensive Cancer Network 2019, 17: 245-254. PMID: 30865923, DOI: 10.6004/jnccn.2018.7097.Peer-Reviewed Original ResearchConceptsLow-risk diseaseHigh-risk patientsHigh-risk diseaseRS testingMedicare beneficiariesPrimary analysisEstrogen receptor-positive breast cancerReceptor-positive breast cancerLower chemotherapy useIntermediate-risk diseaseIntermediate-risk patientsRetrospective cohort studyGenomic testingSEER-Medicare dataChemotherapy useCohort studyMultivariable analysisBreast cancerChemotherapy costsLow overall useMAIN OUTCOMEMedicare populationPatientsHigher overall costsDisease
2018
Survival Comparison in Patients with Stage IV Lung Cancer in Academic versus Community Centers in the United States
Ramalingam S, Dinan MA, Crawford J. Survival Comparison in Patients with Stage IV Lung Cancer in Academic versus Community Centers in the United States. Journal Of Thoracic Oncology 2018, 13: 1842-1850. PMID: 30312680, DOI: 10.1016/j.jtho.2018.09.007.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdenocarcinoma of LungAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Large CellCarcinoma, Non-Small-Cell LungCarcinoma, Squamous CellCommunity Health CentersFemaleFollow-Up StudiesHumansLung NeoplasmsMaleMiddle AgedNeoplasm StagingRetrospective StudiesSurvival RateUnited StatesConceptsCommunity-based centersNational Cancer DatabaseSquamous cell carcinomaAcademic centersMetastatic NSCLCCell carcinomaLung cancerCancer DatabaseStage IV lung cancerSquamous cell lung cancerStage IV NSCLCPercentage of patientsYear of diagnosisCell lung cancerVariety of chemotherapyMultivariable regression modelsPrimary outcomeHistologic typeMultivariable analysisSignificant relative increasePrimary payerSurvival differencesSurvival comparisonsMultivariable modelTreatment strategies
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