Evidence map›Paper›PMID 35595633›Full record

ArticleClinical genitourinary cancer2022

Patient- And Provider-Level Predictors of Survival Among Patients With Metastatic Renal Cell Carcinoma Initiating Oral Anticancer Agents.

Lisa P Spees, Michaela A Dinan, Bradford E Jackson, Christopher D Baggett, Lauren E Wilson, Melissa A Greiner, Deborah R Kaye, Tian Zhang, Daniel J George, Charles D Scales and 4 more

Open access · greenAbstract read
In one paragraph

Article in Clinical genitourinary cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 1 country.

Lisa P SpeesDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC; Lineberger Comprehensive Cancer Center (LCCC), UNC-CH, Chapel Hill, NC, USA. Electronic address: lspees21@unc.edu.
Michaela A DinanCancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Medicine, Yale School of Public Health, New Haven, CT, USA.
Bradford E JacksonLineberger Comprehensive Cancer Center (LCCC), UNC-CH, Chapel Hill, NC, USA.
Christopher D BaggettLineberger Comprehensive Cancer Center (LCCC), UNC-CH, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA.
Lauren E WilsonDepartment of Population Health Sciences, Duke University School of Medicine (DUSM), Durham, NC, USA.
Melissa A GreinerDepartment of Population Health Sciences, Duke University School of Medicine (DUSM), Durham, NC, USA.
Deborah R KayeDuke Cancer Institute (DCI) Center for Prostate and Urologic Cancers, Durham, NC, USA; Department of Surgery (Urology), DUSM, Durham, NC, USA.
Tian ZhangDepartment of Medicine, DUSM, Durham, NC, USA; Department of Surgery (Urology), DUSM, Durham, NC, USA.
Daniel J GeorgeDuke Cancer Institute (DCI) Center for Prostate and Urologic Cancers, Durham, NC, USA; Department of Medicine, DUSM, Durham, NC, USA.
Charles D ScalesDepartment of Population Health Sciences, Duke University School of Medicine (DUSM), Durham, NC, USA; Department of Surgery (Urology), DUSM, Durham, NC, USA.
Jessica E PritchardDepartment of Population Health Sciences, Duke University School of Medicine (DUSM), Durham, NC, USA.
Michael LeapmanCancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, CT, USA; Department of Urology, Yale School of Medicine, New Haven, CT, USA.
Cary P GrossCancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, CT, USA; Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
Stephanie B WheelerDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC; Lineberger Comprehensive Cancer Center (LCCC), UNC-CH, Chapel Hill, NC, USA; Duke Cancer Institute (DCI), DUSM, Durham, NC, USA.
Duke University · USUniversity of North Carolina Health Care · USYale Cancer Center · USDuke Medical Center · USNorth Carolina School of Science and Mathematics · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
North Carolina Translational & Clinical Sciences Institute (NC TraCS)UL1TR001111 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, CAREY, TIMOTHY S · 2013 to 2017
$43.9M
Investigation of the bidirectional relationship between kidney cancer treatment and dementiaR01CA226842 · NCI · YALE UNIVERSITY · PI DINAN, MICHAELA ANN · 2019 to 2023
$2.2M
NCATS NIH HHS UL1 TR001111NCATS NIH HHS UL1 TR001863NCI NIH HHS R01 CA226842
6 · The paper itself

Abstract

purposeIn an era of rapid expansion of FDA approvals for oral anticancer agents (OAAs), it is important to understand the factors associated with survival among real-world populations, which include groups not well-represented in pivotal clinical trials of OAAs, such as the elderly, racial minorities, and medically complex patients. Our objective was to evaluate patient- and provider-level characteristics' associations with mortality among a multi-payer cohort of metastatic renal cell carcinoma (mRCC) patients who initiated OAAs.

methodsThis retrospective cohort study was conducted using data from the North Carolina state cancer registry linked to multi-payer claims data for the years 2004 to 2015. Provider data were obtained from North Carolina Health Professions Data System and the National Plan & Provider Enumeration System. Included patients were individuals with mRCC who initiated an OAA and survived ≥90 days after beginning treatment. We estimated hazard ratios (HR) and corresponding 95% confidence limits (CL) using Cox hazard models for associations between patient demographics, patient clinical characteristics, provider-level factors, and 2-year all-cause mortality.

resultsThe cohort included 207 patients with mRCC who received OAAs. In multivariable models, clinical variables such as frailty (HR: 1.36, 95% CL: 1.11-1.67) and de novo metastatic diagnosis (HR: 2.63, 95%CL: 1.67-4.16) were associated with higher all-cause mortality. Additionally, patients solely on Medicare had higher adjusted all-cause mortality compared with patients with any private insurance (HR: 2.35, 95% CL: 1.32-4.18). No provider-level covariates investigated were associated with all-cause mortality.

conclusionsWithin a real-world population of mRCC patients taking OAAs, survival differed based on patient characteristics. In an era of rapid expansion of FDA approvals for OAAs, these real-world data underscore the continued importance of access to high-quality care, particularly for medically complex patients with limited resources.

Indexed as

Antineoplastic AgentsCarcinoma, Renal CellKidney NeoplasmsAgedHumansMedicareRetrospective StudiesUnited StatesAntineoplastic AgentsInsuranceMetastaticOral anti-cancer agentsRenal cell carcinomaSurvival

Identifiers

PMID35595633
PMCPMC9529768
OpenAlexW4224326361

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.