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This is a combination regimen consisting of three agents: - Albumin-bound paclitaxel (nab-paclitaxel), a microtubule inhibitor formulated with albumin to enhance delivery and reduce toxicity compared to conventional paclitaxel. - S-1, an oral fluoropyrimidine derivative combining tegafur (a prodrug of 5-fluorouracil) with two modulators (gimeracil and oteracil) to improve efficacy and reduce gastrointestinal toxicity. - Anlotinib, a small molecule multi-targeted tyrosine kinase inhibitor that primarily inhibits vascular endothelial growth factor receptors (VEGFRs), fibroblast growth factor receptors (FGFRs), platelet-derived growth factor receptor alpha/beta (PDGFRα/β), and c-Kit. The combination is under investigation as a second-line treatment for advanced biliary tract cancer[9]. Each component has demonstrated antitumor activity through distinct mechanisms—microtubule inhibition, DNA synthesis inhibition, and antiangiogenesis. The rationale for the combination is to provide synergistic antitumor effects by targeting tumor cell proliferation directly while also inhibiting angiogenesis.
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