Evidence map›Paper›PMID 35878815›Full record

ArticleUrology2022

Oral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC).

Michaela A Dinan, Lauren E Wilson, Melissa A Greiner, Lisa P Spees, Jessica E Pritchard, Tian Zhang, Deborah Kaye, Daniel George, Charles D Scales, Chris D Baggett and 3 more

Open access · greenAbstract read
In one paragraph

Article in Urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 10% 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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Article
  6. 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

13 authors at 6 institutions in 1 country.

Michaela A DinanDepartment of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT; Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, CT. Electronic address: Michaela.dinan@yale.edu.
Lauren E WilsonDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Melissa A GreinerDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
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, UNC-CH, Chapel Hill, NC.
Jessica E PritchardDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Tian ZhangDuke Cancer Institute, Durham, NC; Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC.
Deborah KayeDepartment of Surgery (Urology), Duke University School of Medicine, Durham, NC.
Daniel GeorgeDuke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC.
Charles D ScalesDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC; Department of Surgery (Urology), Duke University School of Medicine, Durham, NC.
Chris D BaggettLineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, NC; Department of Epidemiology, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC.
Cary P GrossYale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, CT; Department of Medicine, Yale School of Medicine, New Haven, CT.
Michael S LeapmanYale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, CT; Department of Urology, Yale School of Medicine, New Haven, CT.
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, UNC-CH, Chapel Hill, NC.
Duke University · USYale Cancer Center · USUniversity of North Carolina at Chapel Hill · USDuke Cancer InstituteDuke Medical Center · USUNC Lineberger Comprehensive Cancer Center

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
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 TR001863NCCDPHP CDC HHS U58 DP003862NCI NIH HHS HHSN261201000034CNCI NIH HHS HHSN261201000035CNCI NIH HHS HHSN261201000035INCI NIH HHS HHSN261201000140CNCI NIH HHS R01 CA226842
6 · The paper itself

Abstract

objectiveTo examine real-world adherence to oral anticancer agents (OAAs) and its association with outcomes among Medicare beneficiaries with metastatic renal cell carcinoma (mRCC).

methodsSEER-Medicare retrospective cohort study of patients with metastatic renal cell carcinoma (mRCC) who received an OAA between 2007 and 2015. We examined A) adherence and B) overall and disease-specific 2-year survival landmarked at 3 months after OAA initiation. Adherence was assessed by calculating the proportion of days covered (PDC) within 3 months of OAA initiation, with adherent use being defined as PDC > 80%.

resultsA total of 905 patients met study criteria, of whom 445 patients (49.2%) were categorized as adherent to initial OAA treatment. Adjusting for clinical and demographic factors revealed decreased odds of adherence associated with living within an impoverished neighborhood (OR 0.49, CI 0.0.33 - 0.74) and out-of-pocket costs > $200 (OR 0.68, CI 0.47-.98). Adherence was associated with improved 2-year survival in univariate analysis (logrank test, P = .01) and a non-significant trend toward an association with decreased all-cause (HR 0.87, CI 0.72 - 1.05) and RCC-specific survival (HR 0.84, CI 0.69 - 1.03) in multivariable analysis.

conclusionLocal poverty levels and high out-of-pocket costs are associated with poor initial adherence to OAA therapy in Medicare beneficiaries with mRCC, which in turn, suggests a trend toward poor overall and disease-specific survival. Efforts to improve outcomes in the broader mRCC population should incorporate OAA adherence and economic factors.

Indexed as

Antineoplastic AgentsCarcinoma, Renal CellKidney NeoplasmsAgedHumansMedicareMedication AdherenceRetrospective StudiesUnited StatesAntineoplastic Agents

Identifiers

PMID35878815
PMCPMC9588695
OpenAlexW4286449073

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.