***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Targeting the vascular endothelial growth factor or the epidermal growth factor receptor ( EGFR ) has shown efficacy in advanced colorectal cancer ( ACC ) , but no data are available on the combination of these strategies with chemotherapy in the first-line treatment . The CAIRO2 study evaluates the effect of adding cetuximab , a chimeric mAb against EGFR , to capecitabine , oxaliplatin and bevacizumab in the first-line treatment of ACC . PATIENTS AND METHODS In all , 755 patients were r and omly assigned between treatment with capecitabine , oxaliplatin and bevacizumab with or without cetuximab . The primary end point is progression-free survival . We here present the toxicity results in the first 400 patients that entered the study . RESULTS The incidence of overall grade 3 - 4 toxicity was significantly higher in arm B compared with arm A ( 81 % versus 72 % , P = 0.03 ) . This difference is fully attributed to cetuximab-related skin toxicity . The addition of cetuximab did not result in an increase of gastrointestinal toxicity or treatment-related mortality . CONCLUSIONS The addition of cetuximab to capecitabine , oxaliplatin and bevacizumab in the first-line treatment of ACC appears to be safe and feasible . No excessive or unexpected toxicity in the cetuximab-containing treatment arm was observed AIM To investigate the efficacy and safety of cape-citabine plus irinotecan + /- bevacizumab in advanced or metastatic colorectal cancer patients . METHODS Forty six patients with previously untreated , locally-advanced or metastatic colorectal cancer ( mCRC ) were recruited between 2001 - 2006 in a prospect i ve open-label phase II trial , in German community-based outpatient clinics . Patients received a st and ard capecitabine plus irinotecan ( CAPIRI ) or CAPIRI plus bevacizumab ( CAPIRI-BEV ) regimen every 3 wk . Dose reductions were m and atory from the first cycle in cases of > grade 2 toxicity . The treatment choice of bevacizumab was at the discretion of the physician . The primary endpoints were response and toxicity and secondary endpoints included progression-free survival and overall survival . RESULTS In the CAPIRI group vs the CAPRI-Bev group there were more female than male patients ( 47 % vs 24 % ) , and more patients had colon as the primary tumor site ( 58.8 % vs 48.2 % ) with fewer patients having sigmoid colon as primary tumor site ( 5.9 % vs 20.7 % ) . Grade 3/4 toxicity was higher with CAPIRI than CAPIRI-Bev : 82 % vs 58.6 % . Partial response rates were 29.4 % and 34.5 % , and tumor control rates were 70.6 % and 75.9 % , respectively . No complete responses were observed . The median progression-free survival was 11.4 mo and 12.8 mo for CAPIRI and CAPIRI-Bev , respectively . The median overall survival for CAPIRI was 15 mo ( 458 d ) and for CAPIRI-Bev 24 mo ( 733 d ) . These differences were not statistically different . In the CAPIRI-Bev , group , two patients underwent a full secondary tumor resection after treatment , whereas in the CAPIRI group no cases underwent this procedure . CONCLUSION Both regimens were well tolerated and offered effective tumor growth control in this outpatient setting . Severe gastrointestinal toxicities and thromboembolic events were rare and if observed were never fatal PURPOSE BAY 43 - 9006 ( sorafenib ) is an inhibitor of Raf kinase , the vascular endothelial growth factor ( VEGF ) receptor-2 , and angiogenesis in tumor xenografts . The current study investigated the incidence , severity , and mechanism of  blood pressure ( BP ) elevation in patients treated with BAY 43 - 9006 .  PATIENTS AND METHODS Twenty patients received BAY 43 - 9006 400 mg orally twice daily . BP and heart rate were measured at baseline and then every 3 weeks for 18 weeks . VEGF , catecholamines , endothelin I , urotensin II , renin , and aldosterone were measured at baseline and after 3 weeks of therapy . We assessed vascular stiffness at baseline , after 3 to 6 weeks of therapy , and again after 9 to 10 months of therapy . RESULTS Fifteen ( 75 % ) of 20 patients experienced an increase of > or = 10 mmHg in systolic BP ( SBP ) , and 12 ( 60 % ) of 20 patients experienced an increase of > or = 20 mmHg in SBP compared with their baseline value , with a mean change of 20.6 mmHg ( P < .0001 ) after 3 weeks of therapy . There were no statistically significant changes in humoral factors , although there was a statistically significant inverse relationship between decreases in catecholamines and increases in SBP , suggesting a secondary response to BP elevation . Measures of vascular stiffness increased significantly during the period of observation . CONCLUSION Treatment with BAY 43 - 9006 is associated with a significant and sustained increase in BP . The lack of significant change in circulating factors suggests that these humoral factors had little role in the increase in BP Rationale The management of patients with metastatic colorectal cancer ( CRC ) has changed dramatically over the past 5 years . The availability of new chemotherapy agents , eg , irinotecan , oxaliplatin , capecitabine , has altered the approach to these patients , and the introduction of the antibodies bevacizumab and cetuximab has created third and fourth options for many of these patients . These developments and the exposure of patients to multiple lines of only chemotherapy has dramatically improved the median survival for patients with advanced CRC.1 The potential impact of the biologic agents used in combination with chemotherapy could be even more dramatic , although the optimal timing and sequencing of the chemotherapy and biologic-agent therapy is unknown , and our current diagnostic tests make us so far unable to target patients with the “ optimal ” first-line regimen . This may be increasingly important because of the emerging evidence that certain patients with advanced CRC ( eg , those with isolated hepatic metastases ) could be cured when a surgical approach is used in conjunction with the “ optimal ” chemotherapy.2 As the current therapies now line up , it appears that oxaliplatin or irinotecan can be combined with infusional 5-fluorouracil ( 5-FU ) and leucovorin ( FOLFOX or FOLFIRI , respectively ) with relatively similar survival outcomes in the first-line setting 3,4 ; the decision of which to use is a function of comorbidities , anticipated toxicity , and the possibility of previous exposure to oxaliplatin in the adjuvant setting 
    Output:
    
These results show that the benefits of the treatment with bevacizumab outweigh the toxicity that may occur : enough to justify its use in advanced colorectal cancer