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This is a combination therapy consisting of three anti-cancer agents: anlotinib, bevacizumab, and pyrotinib. Pyrotinib is an irreversible dual pan-ErbB receptor tyrosine kinase inhibitor that targets EGFR (HER1), HER2, and HER4. It works by binding competitively to the ATP binding domain of the EGFR family, inhibiting phosphorylation of tyrosine kinase and blocking downstream RAS/RAF/MEK/MAPK and PI3K/AKT signaling pathways, thereby inhibiting tumor cell growth. Pyrotinib was developed in China and received conditional approval there for use in combination with capecitabine for HER2-positive advanced or metastatic breast cancer in patients previously treated with anthracycline or taxane chemotherapy.
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