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This is a **combination regimen comprising four drugs**: - **Disitamab vedotin**: a HER2-targeted antibody-drug conjugate (ADC), composed of a monoclonal antibody against HER2 conjugated to monomethyl auristatin E (MMAE), a cytotoxic payload via a cleavable linker. It acts by binding HER2-expressing tumor cells, facilitating internalization, and releasing MMAE to disrupt microtubules, leading to cell death. - **Toripalimab**: a humanized monoclonal antibody targeting PD-1 (Programmed cell death protein 1) receptor, functioning as a checkpoint inhibitor to enhance antitumor immunity. - **Capecitabine**: an oral small-molecule prodrug of 5-fluorouracil (5-FU), inhibiting thymidylate synthase and thereby DNA synthesis. - **Oxaliplatin**: a platinum-based small-molecule chemotherapy agent, cross-linking DNA and disrupting its synthesis and function. The combination is being developed primarily for **HER2-positive locally advanced or metastatic urothelial carcinoma (la/mUC)**, with promising results seen in progression-free and overall survival when disitamab vedotin and toripalimab are paired[1][2][5]. The addition of capecitabine and oxaliplatin would constitute a multi-agent chemotherapy plus immunotherapy and targeted therapy regimen.
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