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This is a four-drug combination regimen consisting of bevacizumab, capecitabine, imatinib, and oxaliplatin. It has been investigated primarily as a first-line treatment for metastatic colorectal cancer. The rationale for this combination is to simultaneously inhibit vascular endothelial growth factor (VEGF) and platelet-derived growth factor receptor beta (PDGFR-β) signaling pathways—using bevacizumab and imatinib respectively—to promote vascular normalization in tumors, potentially enhancing the delivery and efficacy of cytotoxic chemotherapy agents such as capecitabine (an oral prodrug of 5-fluorouracil) and oxaliplatin (a platinum-based DNA crosslinker). Clinical studies have shown that this regimen is tolerable with promising efficacy; common toxicities include sensory neuropathy and diarrhea[1][2][4].
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