bevacizumab + capecitabine + cisplatin

**Bevacizumab + capecitabine + cisplatin** is an experimental combination chemotherapy regimen used primarily in clinical trials as a first-line therapy in patients with advanced or metastatic gastric (including gastroesophageal junction) adenocarcinoma. - **Bevacizumab** is a monoclonal antibody and angiogenesis inhibitor that binds vascular endothelial growth factor A (VEGF-A), preventing its interaction with VEGF receptors and thereby inhibiting tumor neovascularization[9][5][6]. - **Capecitabine** is an oral prodrug of 5-fluorouracil (5-FU), a pyrimidine antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis and function. - **Cisplatin** is a platinum-based chemotherapeutic that forms DNA crosslinks, inhibiting DNA replication and leading to apoptosis. This combination has been evaluated in randomized, double-blind phase III trials (e.g., AVATAR) in advanced gastric or gastroesophageal cancer, though it was not approved as a standard regimen since the addition of bevacizumab did not significantly improve overall or progression-free survival compared to capecitabine + cisplatin alone[5][2][7]. However, the regimen was generally well tolerated, and its mechanism of action combines anti-angiogenic effects (bevacizumab) with cytotoxic effects against rapidly dividing tumor cells (capecitabine and cisplatin).