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This possible detrimental effect of a delay in systemic treatment caused by initial resection is not supported by the survival benefit, as shown in the CAIRO studies.
The incidence of severe toxicities with CAPIRI-Bev was, also, comparable with those observed in the BICC-C and CAIRO studies (Fuchs et al, 2007; Koopman et al, 2007) for CAPIRI alone.
However, both FOCUS and CAIRO studies utilised treatment strategies without bevacizumab and cetuximab and thus support for sequential treatment might not apply for patients with access to these biological agents.
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The primary objective of the CAIRO study was to evaluate sequential versus combination chemotherapy.
The CAIRO study investigated the benefit of sequential versus combination therapy using capecitabine, oxaliplatin, and irinotecan.
Data were used from the phase III CAIRO study of the DCCG (Koopman et al, 2006, 2007a).
Data were obtained from the phase III CAIRO study of the Dutch Colorectal Cancer Group (DCCG) (Koopman et al, 2007a).
Of the 803 eligible patients with advanced CRC disease in the CAIRO study, 399 patients had stage IV disease at inclusion.
In 550 of 803 eligible patients in the CAIRO study, a resection of the primary tumour was performed and material for histological review of the primary tumour was available, and these 550 patients were included in this analysis.
We retrospectively investigated patient demographics, primary tumour characteristics and overall survival (OS) in 550 advanced CRC patients with metachronous vs synchronous metastases, who participated in the phase III CAIRO study.
Blood samples were obtained from patients enrolled in a multicenter phase III trial, the CAIRO study of the Dutch Colorectal Cancer Group (DCCG), of which the results have been published recently (Koopman et al, 2007).
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