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Capecitabine + lenvatinib is an investigational combination therapy consisting of two small molecule drugs. Capecitabine is an oral prodrug of 5-fluorouracil (5-FU), a pyrimidine analog that inhibits DNA synthesis by interfering with thymidylate synthase, leading to antitumor effects. Lenvatinib is a multi-kinase inhibitor targeting vascular endothelial growth factor receptors (VEGFR1-3), fibroblast growth factor receptors (FGFR1-4), platelet-derived growth factor receptor alpha (PDGFRα), RET, and KIT, thereby inhibiting tumor angiogenesis and proliferation. This combination has been studied in phase I/II trials for advanced malignancies including rectal cancer and biliary tract cancer, often in conjunction with radiation or other agents[1][2][3][4]. The rationale for the combination lies in potential synergistic effects on tumor vasculature disruption and enhanced cytotoxicity.
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