{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T05:30:22Z","timestamp":1787376622234,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Combination immunotherapy (Ipi\/Nivo) was approved in Australia in 2019 for metastatic clear cell kidney cancer (mccRCC) patients with International Metastatic Database Consortium (IMDC) intermediate and poor\u2010risk. Although selected patients can safely delay treatment due to indolent disease, delaying treatment beyond 1 year in patients without other IMDC risk factors classifies them as favorable risk and prevents access to Ipi\/Nivo. This study investigated the impact of Ipi\/Nivo approval on timing of treatment initiation and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multicenter retrospective cohort study analyzing real\u2010world data from the Kidney canceR Australian registry and Biobank (KRAB) was used to identify patients &gt;\u00a018 years with mccRCC who received systemic therapy. Patient demographics, time to systemic therapy (TTST) from diagnosis of metastatic disease, and outcomes were compared for patients diagnosed with metastatic disease before and from January 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 494 patients met study criteria. The 256 patients diagnosed from 2019 had a significant decrease in both mean TTST (3.9 months from 15.3 months) and proportion with TTST \u2265\u00a01\u00a0year (8.2% from 27.7%). More patients met criteria for intermediate and poor\u2010risk disease from 2019 (61% from 49%). Of the 242 patients with de novo metastatic disease, the proportion with TTST\u00a0\u2265\u00a01\u00a0year decreased from 2019 (5.2% from 16.7%). Despite this, there was no significant difference in overall survival before and from 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prescribing restrictions for Ipi\/Nivo in Australia were associated with a substantial change in prescribing practice for patients with mccRCC, without any change in survival outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajco.70164","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T05:11:22Z","timestamp":1787375482000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Immunotherapy Prescribing Restrictions on Time to Systemic Therapy and Outcomes in Metastatic Clear Cell Renal Carcinoma in Australia"],"prefix":"10.1111","author":[{"given":"Evon","family":"Jude","sequence":"first","affiliation":[{"name":"Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Liow","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Cabrini Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun A.","family":"Azad","sequence":"additional","affiliation":[{"name":"Southeast Oncology  Melbourne Victoria Australia"},{"name":"St Vincent's Hospital Sydney, New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Crumbaker","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganes","family":"Pranavan","sequence":"additional","affiliation":[{"name":"Canberra Hospital  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hocking","sequence":"additional","affiliation":[{"name":"Lyell McEwin Hospital, South Australia  &gt;Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Roncolato","sequence":"additional","affiliation":[{"name":"Macarthur Cancer Therapy Centre Campbelltown Hospital, New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabel","family":"Smith","sequence":"additional","affiliation":[{"name":"ICON Cancer Centre, South Australia  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Wong","sequence":"additional","affiliation":[{"name":"Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelyn","family":"Anton","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Eastern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Johns","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Tran","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"},{"name":"St Vincent's Hospital Sydney, New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Weickhardt","sequence":"additional","affiliation":[{"name":"Austin Health  Melbourne Victoria Australia"},{"name":"Olivia Newton\u2010John Cancer Wellness and Research Centre  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"issue":"1","key":"e_1_2_7_2_1","first-page":"7","article-title":"Cancer Statistics, 2020","volume":"70","author":"Siegel R. 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