docetaxel + oxaliplatin + capecitabine + bevacizumab + trastuzumab

This is a multi-agent combination chemotherapy and targeted therapy regimen consisting of five drugs: - **Docetaxel** (a taxane-class cytotoxic agent that stabilizes microtubules, inhibiting cell division) - **Oxaliplatin** (a platinum-based cytotoxic agent that forms DNA crosslinks, leading to apoptosis) - **Capecitabine** (an oral prodrug converted to 5-fluorouracil, which inhibits thymidylate synthase and disrupts DNA synthesis) - **Bevacizumab** (a monoclonal antibody targeting vascular endothelial growth factor A [VEGF-A], inhibiting angiogenesis) - **Trastuzumab** (a monoclonal antibody targeting human epidermal growth factor receptor 2 [HER2], blocking HER2-mediated signaling) This combination brings together three chemotherapeutic agents with two targeted therapies. The triplet of docetaxel, oxaliplatin, and capecitabine has been studied in advanced gastric cancer as the "TEX" or "DOX" regimen[1][2][4][5][6][8]. Bevacizumab and trastuzumab are both used in HER2-positive cancers; their combination has shown activity in metastatic breast cancer[7] and was evaluated with docetaxel in HER2-positive locally recurrent/metastatic breast cancer[10]. The rationale for combining all five agents would be to maximize cytotoxicity while simultaneously inhibiting tumor angiogenesis and HER2-driven proliferation.