gemcitabine + oxaliplatin + cadonilimab + regorafenib

This is a combination therapy consisting of gemcitabine (a nucleoside metabolic inhibitor), oxaliplatin (a platinum-based chemotherapy agent), cadonilimab (likely an immunotherapy agent), and regorafenib (a multikinase inhibitor). Gemcitabine works as a prodrug that is transformed into active metabolites that replace building blocks of nucleic acids during DNA elongation, arresting tumor growth and promoting apoptosis of malignant cells. Oxaliplatin is a platinum-based chemotherapy agent that forms crosslinks in DNA, preventing DNA replication and transcription. Regorafenib is a small molecule inhibitor of multiple kinases involved in oncogenesis, tumor angiogenesis, and maintenance of the tumor microenvironment. It blocks proteins that signal cancer cells to divide and proteins that signal the growth of new blood vessels that tumors need to grow. The combination of gemcitabine and oxaliplatin (GEMOX) has shown activity in various cancers including pancreatic cancer, ovarian cancer, and germ cell tumors.