***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: PURPOSE Open-label , phase III trial evaluating whether sunitinib was superior or equivalent to sorafenib in hepatocellular cancer . PATIENTS AND METHODS Patients were stratified and r and omly assigned to receive sunitinib 37.5 mg once per day or sorafenib 400 mg twice per day . Primary end point was overall survival ( OS ) . RESULTS Early trial termination occurred for futility and safety reasons . A total of 1,074 patients were r and omly assigned to the study ( sunitinib arm , n = 530 ; sorafenib arm , n = 544 ) . For sunitinib and sorafenib , respectively , median OS was 7.9 versus 10.2 months ( hazard ratio [ HR ] , 1.30 ; one-sided P = .9990 ; two-sided P = .0014 ) ; median progression-free survival ( PFS ; 3.6 v 3.0 months ; HR , 1.13 ; one-sided P = .8785 ; two-sided P = .2286 ) and time to progression ( TTP ; 4.1 v 3.8 months ; HR , 1.13 ; one-sided P = .8312 ; two-sided P = .3082 ) were comparable . Median OS was similar among Asian ( 7.7 v 8.8 months ; HR , 1.21 ; one-sided P = .9829 ) and hepatitis B-infected patients ( 7.6 v 8.0 months ; HR , 1.10 ; one-sided P = .8286 ) , but was shorter with sunitinib in hepatitis C-infected patients ( 9.2 v 17.6 months ; HR , 1.52 ; one-sided P = .9835 ) . Sunitinib was associated with more frequent and severe adverse events ( AEs ) than sorafenib . Common grade 3/4 AEs were thrombocytopenia ( 29.7 % ) and neutropenia ( 25.7 % ) for sunitinib ; h and -foot syndrome ( 21.2 % ) for sorafenib . Discontinuations owing to AEs were similar ( sunitinib , 13.3 % ; sorafenib , 12.7 % ) . CONCLUSION OS with sunitinib was not superior or equivalent but was significantly inferior to sorafenib . OS was comparable in Asian and hepatitis B-infected patients . OS was superior in hepatitis C-infected patients who received sorafenib . Sunitinib-treated patients reported more frequent and severe toxicity Objective : A phase II study was performed to evaluate the efficacy and tolerability of bevacizumab and erlotinib in advanced hepatocellular carcinoma ( HCC ) patients , and to investigate clinical and molecular predictors of outcome . Methods : 59 patients with advanced HCC received 10 mg/kg i.v . of bevacizumab every 14 days and 150 mg p.o . of erlotinib daily . The primary endpoint was progression-free survival ( PFS ) at 16 weeks . Clinical characteristics and plasma biomarkers expression levels were analyzed . Results : PFS at 16 weeks was 64 % ( 95 % CI 51–76 ) : 14 patients achieved partial response ( 24 % ) , 33 had stable disease ( 56 % ) , 6 progressed ( 10 % ) , and 6 were not evaluable ( 10 % ) . Median overall survival was 13.7 months ( 95 % CI 9.6–19.7 ) , and median PFS was 7.2 months ( 95 % CI 5.6–8.3 ) . Grade 3–4 adverse events included fatigue ( 30 % ) , diarrhea ( 17 % ) , hypertension ( 14 % ) , elevated transaminases ( 12 % ) , and gastrointestinal hemorrhage ( 10 % ) . High plasma angiopoietin-2 , epidermal growth factor receptor , and endothelin-1 , and lack of acneiform rash were associated with poor outcome . Conclusions : The combination of bevacizumab with erlotinib achieved encouraging results in patients with advanced HCC . Current correlatives may help to guide future HCC studies Summary Purpose The only drug that improves survival in hepatocellular carcinoma is sorafenib . FOLFOX-4 regimen is safe and widely used in patients with colorectal cancer , yielding interesting results with little toxicity . We conducted a retrospective study to evaluate the safety and the effectiveness of FOLFOX-4 in cirrhotic or liver transplanted patients with hepatocellular carcinoma ineligible for sorafenib . Methods Thirty seven patients were enrolled in the study . The medical record of either cirrhotic patients or liver transplanted patients with advanced hepatocellular carcinoma receiving FOLFOX-4 regimen between November 1999 and March 2006 were retrospectively analyzed . Patients received oxaliplatin 85 mg/m2 as a 2-hour infusion on day one , and leucovorin 200 mg/m2 as a 2-hour infusion followed by bolus 5-fluorouracil 400 mg/m2 and a 48-hours infusion of 5-fluorouracil 2400 mg/m2 . Treatment was repeated every 2 weeks until disease progression or unacceptable adverse effects occurred . Results Patients had a Child-Pugh class A ( n = 16 ) , class B cirrhosis ( n = 10 ) or a liver transplant ( n = 11 ) and received 2 to 37 cycles of chemotherapy ( total of 310 cycles ) . Two ( 5.4 % ) cirrhotic patients developed neutropenic sepsis and one ( 2.7 % ) toxic death occurred . At first assessment , five patients from Child-Pugh class A ( 33 % ) and two from Child-Pugh class B group ( 20 % ) achieved a radiological response and /or alpha foeto-protein decrease , and no patient achieved a complete response . Conclusions In conclusion , with a manageable toxicity profile in cirrhotic Child-Pugh class A-B or liver transplanted patients , the FOLFOX-4 regimen appears to be a feasible treatment option for patients with advanced hepatocellular carcinoma unfit for sorafenib . These data need to be confirmed in a prospect i ve study Purpose We design ed a phase II trial of the combination with oxaliplatin and doxorubicin for patients with unresectable HCC to evaluate the overall response rate ( ORR ) and the toxicity . Methods Forty patients with inoperable , systemic chemotherapy naive HCC were enrolled . Finally , 32 patients received oxaliplatin ( 130 mg/m2 ) and doxorubicin ( 60 mg/m2 ) every 3 weeks . Results Eighty-two treatment cycles were administered ( median 2 cycles , range 1–6 ) . There was no treatment-related mortality . The ORR was 15.6 % ( 95 % CI , 3.3–28.7 ) with five partial responses . The median overall survival and median overall progression free survival were 31 weeks ( 95 % CI , 22–40 weeks ) and 12 weeks ( 95 % CI , 5 - 19 weeks ) . Nausea and peripheral neuropathy were most frequent non-hematologic toxicities ( nausea , n = 15 ; peripheral neuropathy , n = 10 ) . The most frequent grade 3–4 hematologic adverse event was neutropenia ( 14 of 82 cycles ) including three cases of febrile neutropenia . Conclusions The combination of oxaliplatin and doxorubicin showed modest activity and a tolerable toxicity profile in advanced HCC patients Evaluation of new drug combinations is needed to improve patients ' prognosis in advanced hepatocellular carcinoma ( HCC ) . The purpose of this study was to evaluate the safety and efficacy of the capecitabine – oxaliplatine combination ( XELOX ) in HCC patients . First-line chemotherapy with XELOX regimen consisting of a 3-week cycle of intravenous oxaliplatin ( 130 mg m−2 ) on Day 1 , and oral capecitabine twice daily from Days 1–14 ( 1000 mg m−2 ) was administered in patients with measurable , unresectable HCC . Fifty patients ( male , 88 % ; median age , 68 years ) received a total of 295 cycles ( median , 6 ) of treatment . Disease control ( three partial responses , 29 stable diseases ) rate was 72 % ( 95 % CI 57–83 % ) . Median overall and median progression-free ( PFS ) survival was 9.3 months and 4.1 months , respectively . Progression-free survival rates at 6 and 12 months were 38 % ( 95 % CI 26–52 % ) and 14 % ( 95 % CI 7–26 % ) , respectively . Main grade 3–4 drug-related toxicities included diarrhoea ( 16 % ) , elevation of aminotransferases and /or bilirubin ( 16 % ) , thrombocytopenia ( 12 % ) , and neurotoxicity ( 6 % ) . Capecitabine plus oxaliplatin regimen showed modest anti-tumour activity with tolerable toxicities in patients with advanced HCC . However , the manageable toxicity profile and the encouraging disease control rate deserve further attention for this convenient , outpatient-based chemotherapy regimen PURPOSE Hepatocellular carcinoma ( HCC ) is a vascular tumor with poor prognosis . Given the reported activity of gemcitabine and oxaliplatin ( GEMOX ) in HCC and the potential benefits of targeting the vascular endothelial growth factor pathway with bevacizumab ( B ) , a phase II study of GEMOX-B was undertaken to define efficacy and toxicity profiles in HCC patients . PATIENTS AND METHODS Eligible patients had pathologically proven measurable unresectable or metastatic HCC . For cycle 1 ( 14 days ) , bevacizumab 10 mg/kg was administered alone intravenously on day 1 . For cycle 2 and beyond ( 28 days/cycle ) , bevacizumab 10 mg/kg was administered on days 1 and 15 , gemcitabine 1,000 mg/m2 was administered as a dose rate infusion at 10 mg/m2/min followed by oxaliplatin at 85 mg/m2 on days 2 and 16 . RESULTS Thirty-three patients were enrolled and 30 patients were assessable for  efficacy  . The objective response rate was 20 % , and 27 % of patients had stable disease . Median overall survival was 9.6 months ( 95 % CI , 8.0 months to not available ) and median progression-free survival ( PFS ) was 5.3 months ( 95 % CI , 3.7 to 8.7 months ) ; the PFS rate at 3 and 6 months was 70 % ( 95 % CI , 54 % to 85 % ) and 48 % ( 95 % CI , 31 % to 65 % ) , respectively . The most common treatment-related grade 3 to 4 toxicities included leukopenia/neutropenia , transient elevation of aminotransferases , hypertension , and fatigue . CONCLUSION GEMOX-B could be safely administered with close monitoring and had moderate antitumor activity for patients with advanced HCC . The high 6-month PFS rate is encouraging , and this regimen is worthy of further investigation BACKGROUND Sorafenib has shown survival benefits in patients with advanced hepatocellular carcinoma ( HCC ) and Child-Pugh ( CP ) class A liver function . There are few prospect i ve data on sorafenib in patients with HCC and CP class B. PATIENTS AND METHODS A consecutive prospect i ve series of 300 patients with CP class A or B HCC were enrolled in a dual-phase trial to determine survival and safety data according to liver function ( class A or B ) in patients receiving oral sorafenib 800 mg daily . [ Results of this study were presented in part at the ASCO 2012 Gastrointestinal Cancers Symposium , 19 - 21 January 2012 . J Clin Oncol 2012 ; 30 ( Suppl 4 ) : abstract 306 . ] RESULTS Overall progression-free survival ( PFS ) , time to progression ( TTP ) and overall survival ( OS ) were 3.9 , 4.1 and 9.1 months , respectively . For patients with CP class A versus B status , PFS was 4.3 versus 2.1 months , TTP was 4.2 versus 3.8 months and OS was 10.0 versus 3 . 8 months . Extrahepatic spread was associated with worse outcomes but taken together with CP class , liver function played a greater role in reducing survival . Adverse events for the two CP groups were similar . CONCLUSION Although patients with HCC and CP class B liver function have poorer outcomes than those with CP class A function , data suggest that patients with CP class B liver function can tolerate treatment and may still benefit from sorafenib New systemic therapies are needed to improve the prognosis of patients with advanced‐stage hepatocellular carcinoma ( HCC ) . In a Phase II trial involving previously untreated patients with advanced HCC , the more favorable schedule from a previous pilot study was evaluated Purpose : Sorafenib impro 
    Output:
    
OXA-based chemotherapy is effective in advanced HCC and represents a viable option in these patients .