***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: Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more PURPOSE Sunitinib has shown antitumor activity with a manageable safety profile as metastatic renal cell carcinoma ( RCC ) treatment , when given by the st and ard intermittent schedule as well as a continuous daily dosing ( CDD ) schedule . A trial was conducted to compare the schedules . PATIENTS AND METHODS Patients with treatment-naive , clear cell advanced RCC were r and omly assigned 1:1 to receive sunitinib 50 mg/d for 4 weeks followed by 2 weeks off treatment ( schedule 4/2 ; n = 146 ) or 37.5 mg/d on the CDD schedule ( n = 146 ) for up to 2 years . The primary end point was time to tumor progression . RESULTS Median time to tumor progression was 9.9 months for schedule 4/2 and 7.1 months for the CDD schedule ( hazard ratio , 0.77 ; 95 % CI , 0.57 to 1.04 ; P = .090 ) . No significant difference was observed in overall survival ( 23.1 v 23.5 months ; P = .615 ) , commonly reported adverse events , or patient-reported kidney cancer symptoms . Schedule 4/2 was statistically superior to CDD in time to deterioration , a composite end point of death , progression , and disease-related symptoms ( P = .034 ) . CONCLUSION ; There was no benefit in efficacy or safety for continuous dosing of sunitinib compared with the approved 50 mg/d dose on schedule 4/2 . Given the numerically longer time to tumor progression with the approved 50 mg/d dose on schedule 4/2 , adherence to this dose and schedule remains the treatment goal for patients with advanced RCC BACKGROUND The phase III COMPARZ study showed noninferior efficacy of pazopanib versus sunitinib in advanced renal cell carcinoma . In this COMPARZ post hoc analysis we characterized pazopanib responders , patient subgroups with better outcomes , and the effect of dose modification on efficacy and safety . PATIENTS AND METHODS Patients were r and omized to pazopanib 800 mg/d ( n = 557 ) or sunitinib 50 mg/d , 4 weeks on/2 weeks off ( n = 553 ) . Secondary end points included time to complete response (CR)/partial response ( PR ) ; the proportion of patients with CR/PR ≥10  months and progression-free survival ( PFS ) ≥10 months ; efficacy in patients with baseline metastasis ; and logistic regression analyses of patient characteristics associated with CR/PR ≥10 months . Median PFS , objective response rate ( ORR ) , and safety were evaluated in patients with or without dose reductions or interruptions lasting ≥7 days . RESULTS Median time to response was numerically shorter for patients treated with pazopanib versus sunitinib ( 11.9 vs. 17.4 weeks ) . Similar percentages of pazopanib and sunitinib patients had CR/PR ≥10 months ( 14 % and 13 % , respectively ) , and PFS ≥10 months ( 31 % and 34 % , respectively ) . For patients without versus with adverse event (AE)-related dose reductions , median PFS , median overall survival , and ORR were 7.3 versus 12.5 months , 21.7 versus 36.8 months , and 22 % versus 42 % ( all P < .0001 ) for pazopanib , and 5.5 versus 13.8 months , 18.1 versus 38.0 months , and 16 % versus 34 % ( all P < .0001 ) for sunitinib ; results were similar for dose interruptions . CONCLUSION Dose modifications when required because of AEs were associated with improved efficacy , suggesting that AEs might be used as a surrogate marker of adequate dosing for individual patients 
    Output:
    
Moreover , the 2/1 schedule was beneficial for reducing the incidence of several AEs .
Conclusively , our meta- analysis suggests that the 2/1 schedule holds promise as an alternative means of reducing AEs and maintaining patient quality of life .