***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: The frequent need to obtain an estimate of renal function in cancer patients , not least for targeting carboplatin dose , has led to a number of approaches to estimate glomerular filtration rate ( GFR ) . This study aim ed to develop a simple and reliable method to estimate GFR using readily-available patient characteristics . Data from 62 patients with estimates of 51Cr-EDTA clearance were analysed to determine the most appropriate formula relating this method of measuring GFR to patient characteristics . The population pharmacokinetics of 51Cr-EDTA were analysed using NONMEM to evaluate the influence of each covariate . The formulae derived were then vali date d using a further 38 patients and compared with those obtained using existing formulae  51Cr-EDTA clearance ( GFR ) was positively related to Dubois surface area , negatively related to age , and inversely related to serum creatinine ( SCr ) . Females had lower 51Cr-EDTA clearance than males . The enzymatic method of SCr assay gave more reliable results than the Jaffe colorimetric method . A measure of creatine kinase significantly improved the estimation of GFR . The new formula produced estimates of GFR which were less biased ( Mean Prediction Error = –3 % ) and more precise ( Mean Absolute Prediction Error = 12 % ) than Cockcroft and Gault ( –8 % and 16 % ) or Jelliffe ( –15 % and 19 % ) estimates . The formulae developed here can be used to provide reliable estimates of GFR , particularly in regard to targeted dosing of carboplatin . © 2001 Cancer Research BACKGROUND Assessment of the change in tumour burden is an important feature of the clinical evaluation of cancer therapeutics : both tumour shrinkage ( objective response ) and disease progression are useful endpoints in clinical trials . Since RECIST was published in 2000 , many investigators , cooperative groups , industry and government authorities have adopted these criteria in the assessment of treatment outcomes . However , a number of questions and issues have arisen which have led to the development of a revised RECIST guideline ( version 1.1 ) . Evidence for changes , summarised in separate papers in this special issue , has come from assessment of a large data warehouse ( > 6500 patients ) , simulation studies and literature review s. HIGHLIGHTS OF REVISED RECIST 1.1 : Major changes include : Number of lesions to be assessed : based on evidence from numerous trial data bases merged into a data warehouse for analysis purpose s , the number of lesions required to assess tumour burden for response determination has been reduced from a maximum of 10 to a maximum of five total ( and from five to two per organ , maximum ) . Assessment of pathological lymph nodes is now incorporated : nodes with a short axis of 15 mm are considered measurable and assessable as target lesions . The short axis measurement should be included in the sum of lesions in calculation of tumour response . Nodes that shrink to < 10 mm short axis are considered normal . Confirmation of response is required for trials with response primary endpoint but is no longer required in r and omised studies since the control arm serves as appropriate means of interpretation of data . Disease progression is clarified in several aspects : in addition to the previous definition of progression in target disease of 20 % increase in sum , a 5 mm absolute increase is now required as well to guard against over calling PD when the total sum is very small . Furthermore , there is guidance offered on what constitutes ' unequivocal progression ' of non-measurable/non-target disease , a source of confusion in the original RECIST guideline . Finally , a section on detection of new lesions , including the interpretation of FDG-PET scan assessment is included . Imaging guidance : the revised RECIST includes a new imaging appendix with up date d recommendations on the optimal anatomical assessment of lesions . FUTURE WORK A key question considered by the RECIST Working Group in developing RECIST 1.1 was whether it was appropriate to move from anatomic unidimensional assessment of tumour burden to either volumetric anatomical assessment or to functional assessment with PET or MRI . It was concluded that , at present , there is not sufficient st and ardisation or evidence to ab and on anatomical assessment of tumour burden . The only exception to this is in the use of FDG-PET imaging as an adjunct to determination of progression . As is detailed in the final paper in this special issue , the use of these promising newer approaches requires appropriate clinical validation studies BACKGROUND To compare the efficacy and toxicity of paclitaxel-carboplatin ( TAX-CBP ) and paclitaxel-cisplatin ( TAX-DDP ) chemotherapy protocol s for advanced non-small cell lung cancer . METHODS One hundred and twenty-six patients with non-small cell lung cancer were r and omized into TAX-DDP and TAX-CBP groups . TAX-CBP group : TAX 175 mg/m² and CBP 350 mg/m² , d1 iv ; TAX-DDP group : TAX 175 mg/m² and DDP 100 mg/m² d1 iv . The therapy was repeated every 28 days . The response rate was assessed after three treatments . RESULTS TAX-CBP group : response rate ( RR ) was 36 % ( 22/61 ) , 1-year survival rate was 34.1 % . TAX-DDP group : RR was 33.9 % (21/62),1-year survival rate was 33.1 % . There was no significant difference of RR and 1-year survival rate between TAX-CBP and TAX-DDP group ( P>0.05 ) . The median survival time  of TAX-CBP group ( 11.2 months ) was significant higher than that of TAX-DDP group ( 9 months ) ( P<0.05 ) . The major toxicity associated with paclitaxel  included alpecia , myelosuppression , gastrointestinal reaction and myalgia or arthralgia . The thrombocytopenia  in TAX-CBP group was more severe than that in TAX-DDP group ( P<0.05 ) . The Gastrointestinal and myalgia or arthralgia  in TAX-DDP group were more severe than those in TAX-CBP group ( P<0.05 ) . CONCLUSIONS TAX-CBP and TAX-DDP chemotherapy may be used as first choice protocol in the chemotherapy of non-small cell lung cancer In controlled clinical trials there are usually several prognostic factors known or thought to influence the patient 's ability to respond to treatment . Therefore , the method of sequential treatment assignment needs to be design ed so that treatment balance is simultaneously achieved across all such patients factor . Traditional methods of restricted r and omization such as " permuted blocks within strata " prove inadequate once the number of strata , or combinations of factor levels , approaches the sample size . A new general procedure for treatment assignment is described which concentrates on minimizing imbalance in the distributions of treatment numbers within the levels of each individual prognostic factor . The improved treatment balance obtained by this approach is explored using simulation for a simple model of a clinical trial . Further discussion centers on the selection , predictability and practicability of such a procedure Background : Bevacizumab , the anti-vascular endothelial growth factor agent , provides clinical benefit when combined with platinum-based chemotherapy in first-line advanced non-small-cell lung cancer . We report the final overall survival ( OS ) analysis from the phase III AVAiL trial . Patients and methods : Patients ( n = 1043 ) received cisplatin 80 mg/m2 and gemcitabine 1250 mg/m2 for up to six cycles plus bevacizumab 7.5 mg/kg ( n = 345 ) , bevacizumab 15 mg/kg ( n = 351 ) or placebo ( n = 347 ) every 3 weeks until progression . Primary end point was progression-free survival ( PFS ) ; OS was a secondary end point . Results : Significant PFS prolongation  with bevacizumab compared with placebo was maintained with longer follow-up { hazard ratio ( HR ) [ 95 % confidence interval ( CI ) ] 0.75 ( 0.64–0.87 ) , P = 0.0003 and 0.85 ( 0.73–1.00 ) , P = 0.0456 } for the 7.5 and 15 mg/kg groups , respectively . Median OS was > 13 months in all treatment groups ; nevertheless , OS was not significantly increased with bevacizumab [ HR ( 95 % CI ) 0.93 ( 0.78–1.11 ) , P = 0.420 and 1.03 ( 0.86–1.23 ) , P = 0.761 ] for the 7.5 and 15 mg/kg groups , respectively , versus placebo . Most patients ( ∼62 % ) received multiple lines of post study treatment . Up date d safety results are consistent with those previously reported . Conclusions : Final analysis of AVAiL confirms the  efficacy of bevacizumab when combined with cisplatin – gemcitabine . The PFS benefit did not translate into a significant OS benefit , possibly due to high use of efficacious second-line therapies BACKGROUND Bevacizumab , a monoclonal antibody against vascular endothelial growth factor , has been shown to benefit patients with a variety of cancers . METHODS Between July 2001 and April 2004 , the Eastern Cooperative Oncology Group ( ECOG ) conducted a r and omized study in which 878 patients with recurrent or advanced non-small-cell lung cancer ( stage IIIB or IV ) were assigned to chemotherapy with paclitaxel and carboplatin alone ( 444 ) or paclitaxel and carboplatin plus bevacizumab ( 434 ) . Chemotherapy was administered every 3 weeks for six cycles , and bevacizumab was administered every 3 weeks until disease progression was evident or toxic effects were intolerable . Patients with squamous-cell tumors , brain metastases , clinical ly significant hemoptysis , or inadequate organ function or performance status ( ECOG performance status , > 1 ) were excluded . The primary end point was overall survival . RESULTS The median survival was 12.3 months in the group assigned to chemotherapy plus bevacizumab , as compared with 10.3 months in the chemotherapy-alone group ( hazard ratio for death , 0.79 ; P=0.003 ) . The median progression-free survival in the two groups was 6.2 and 4.5 months , respectively ( hazard ratio for disease progression , 0.66 ; P<0.001 ) , with corresponding response rates of 35 % and 15 % ( P<0.001 ) . Rates of clinical ly significant bleeding were 4.4 % and 0.7 % , respectively ( P<0.001 ) . There were 15 treatment-related deaths in the chemotherapy-plus-bevacizumab group , including 5 from pulmonary hemorrhage . CONCLUSIONS The addition of bevacizumab to paclitaxel plus carboplatin in the treatment of selected patients with non-small-cell lung cancer has a significant survival benefit with the risk of increased treatment-related deaths . ( Clinical Trials.gov number , NCT00021060 . BACKGROUND In advanced not selected NSCLC chemotherapy achieved an advantage of approximately 1 - 2 months on median survival versus best supportive care . Chemotherapy seems to improve symptoms control , even if r and omised studies with quality of life as first endpoint are lacking and often chemotherapy toxicity compromises the frail cost/benefit ratio . The aim of the present study is to evaluate the impact on QoL , substituting cisplatin , a pivot drug in NSCLC therapy , with carboplatin , an analogue with an improved toxicity profile . The combination of cisplatin with Mitomycin and Vinblastine was one of the most frequently used in the palliative setting at the time of design of our study . METHODS Patients were r and omized to receive MVP regimen ( Mitomycin-C 8 mg/m2 d1 , Vinblastine 4 mg/m2 d 1 - 8 , Cisplatin 100 mg/m2 d1 ) or MVC regimen ( Mitomycin-C 8 mg/m2 d1 , Vinblastine 4 mg/m2 d 1 - 8 , Carboplatin 300 mg/m2 d1 ) every 3 weeks . The QoL was evaluated by the Spitzer QL-Index and by the EORTC QLQ-C30+LC 13 question naires before chemotherapy , after one cycle , after three cycles , and then every 6 weeks in the first 6 months and every 3 months thenafter . RESULTS From September 1994 to July 1997 , 153 consecutive patients were r and omized to MVP ( 75 patients ) or MVC arm ( 78 patients ) . Despite difficulties in carrying out and analysing QoL items in such patients , the global QoL evaluated by the Spitzer 's question naire suggested an advantage for MVC regimen ( P=0.05 ) and a significant difference was observed in global health subdomain ( P=0.04 ) . The disease-related symptoms improved with time , and the benefits lasted for the entire treatment period . When evaluated with the EORTC question naire there was significantly less nausea and vomiting ( P=0.0001 ) , appetite loss ( P=0.01 ) , insomnia ( P=0.03 ) , constipation ( P=0.01 ) and peripheral neuropathy ( P=0.01 ) in favour of MVC , and a trend for less hair loss ( P=0.05 ) . The advantage lasted for all the duration of chemotherapy . 
    Output:
    
The initial treatment of people with advanced NSCLC is palliative , and carboplatin can be a treatment option .
It has a similar effect on survival but a different toxicity profile when compared with cisplatin .