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A three‑drug cancer regimen combining the anti‑VEGF monoclonal antibody bevacizumab, the mTOR inhibitor everolimus, and the pan‑histone deacetylase (HDAC) inhibitor panobinostat. Mechanistically, bevacizumab neutralizes VEGF‑A to inhibit angiogenesis; everolimus inhibits mTORC1 signaling to reduce tumor cell growth, proliferation, and angiogenesis; and panobinostat inhibits HDACs, affecting transcription, inducing apoptosis, and modulating hypoxia/angiogenesis pathways including HIF‑1α and VEGF signaling. A dedicated phase I study in advanced solid tumors found that the triplet at the lowest proposed doses did not have acceptable safety/tolerability, and no recommended phase II dose was established; overlapping toxicities included fatigue, thrombocytopenia, mucositis, hypertension, bleeding, and others.
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