bevacizumab + toripalimab + gemcitabine

This is a combination regimen consisting of three drugs: - **Bevacizumab** is a recombinant humanized monoclonal antibody that targets vascular endothelial growth factor A (VEGF-A), inhibiting angiogenesis and thereby restricting tumor blood supply. - **Toripalimab** is a humanized monoclonal antibody targeting programmed cell death protein 1 (PD-1), functioning as an immune checkpoint inhibitor to enhance T-cell mediated antitumor immunity. - **Gemcitabine** is a nucleoside analog used as chemotherapy, which inhibits DNA synthesis and induces apoptosis in rapidly dividing cells. The combination of these agents leverages antiangiogenic therapy, immunotherapy, and cytotoxic chemotherapy. This regimen has been reported in case studies for metastatic gallbladder carcinoma with promising results, including partial response and prolonged progression-free survival. The rationale for this combination includes the potential synergistic effect of VEGF inhibition enhancing immune checkpoint blockade efficacy while gemcitabine provides direct cytotoxicity[6][9].