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This combination therapy consists of the PD-L1 inhibitor envolimab, the VEGFR inhibitor fruquintinib, and the SOX chemotherapy regimen (oxaliplatin and tegafur). It is being investigated as a conversion therapy for patients with HER2-negative, unresectable locally advanced gastric cancer. Envolimab is a unique single-domain antibody (nanobody) targeting the PD-1/PD-L1 pathway, notable for its subcutaneous administration. Fruquintinib is a highly selective small-molecule inhibitor of vascular endothelial growth factor receptors (VEGFR) 1, 2, and 3, which inhibits tumor angiogenesis. The addition of these targeted agents to the standard SOX chemotherapy backbone aims to increase the rate of successful surgical resection (R0 resection) by enhancing anti-tumor activity through synergistic immune checkpoint blockade, anti-angiogenesis, and cytotoxic effects.
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