amifostine + bevacizumab + capecitabine

This is a combination regimen consisting of three drugs—amifostine, bevacizumab, and capecitabine—used primarily in the context of preoperative radiochemotherapy for rectal cancer. - **Amifostine** is a cytoprotective agent that acts as a prodrug, converted in tissues to an active thiol metabolite which scavenges free radicals and protects normal tissues from the toxic effects of chemotherapy and radiation. - **Bevacizumab** is a recombinant humanized monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A), thereby inhibiting angiogenesis essential for tumor growth. - **Capecitabine** is an oral prodrug that is enzymatically converted to 5-fluorouracil (5-FU) in tumor tissue, where it inhibits thymidylate synthase and disrupts DNA synthesis, leading to antitumor activity[1][4]. This combination has been studied as part of preoperative therapy for locally advanced rectal cancer alongside hypofractionated radiotherapy. The regimen aims to enhance tumor response rates while providing cytoprotection against treatment-related toxicity[1].