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This combination therapy is a four-drug regimen being investigated for the treatment of advanced or metastatic urothelial carcinoma (bladder cancer). It consists of **anlotinib**, a multi-targeted tyrosine kinase inhibitor (TKI) that inhibits angiogenesis by targeting VEGFR, FGFR, and PDGFR; **benmelstobart** (TQB2450), a humanized monoclonal antibody that blocks the Programmed cell death 1 ligand 1 (PD-L1) to restore anti-tumor immune responses; and the standard-of-care chemotherapy doublet **cisplatin** and **gemcitabine**. The rationale for this combination is to leverage the anti-angiogenic and immunomodulatory effects of anlotinib and the cytotoxic debulking of chemotherapy to enhance the efficacy of PD-L1 inhibition. The regimen is primarily developed by Chia Tai Tianqing (Sino Biopharmaceutical) and is being evaluated in clinical trials led by institutions such as the Sun Yat-sen University Cancer Center.
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