bevacizumab + indoximod + temozolomide

This is a combination therapy consisting of three agents: - **Bevacizumab** is a recombinant humanized monoclonal antibody that inhibits angiogenesis by binding to and neutralizing vascular endothelial growth factor A (VEGF-A), thereby preventing the formation of new blood vessels necessary for tumor growth[6][7][8]. - **Indoximod** is an orally administered small molecule immunomodulator that acts as an inhibitor of the indoleamine 2,3-dioxygenase (IDO) pathway. By blocking IDO-mediated tryptophan catabolism, it helps restore T-cell function and enhances antitumor immune responses. - **Temozolomide** is an oral alkylating agent that induces DNA damage in tumor cells, leading to apoptosis. It also has antiangiogenic effects by downregulating factors such as HIF-1α and cMyc[2]. The combination aims to target glioblastoma or other malignant gliomas through multiple mechanisms—antiangiogenesis (bevacizumab), immune modulation (indoximod), and direct cytotoxicity plus additional antiangiogenic effects (temozolomide). Bevacizumab plus temozolomide combinations have been studied in clinical trials for glioblastoma, showing improved progression-free survival but with increased risk of adverse events[3][4][5]. The addition of indoximod seeks to further enhance antitumor immunity.