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donafenib + lenvatinib + apatinib is a combination of three small-molecule multi-kinase inhibitors used in the treatment of hepatocellular carcinoma (HCC). This combination is specifically highlighted in clinical trial contexts (such as NCT05523609) where these agents serve as the targeted therapy component of a multimodal regimen including hepatic arterial infusion chemotherapy (HAIC) and PD-1 inhibitors (e.g., sintilimab, camrelizumab, or tislelizumab). Donafenib, a deuterated sorafenib derivative, targets Raf kinases and VEGFR; lenvatinib targets VEGFR1-3, FGFR1-4, PDGFRα, KIT, and RET; and apatinib (rivoceranib) is a highly selective inhibitor of VEGFR-2. Together, these agents provide comprehensive inhibition of angiogenesis and tumor cell signaling pathways to treat postoperative HCC with microvascular invasion (MVI).
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