ibrutinib + nab-paclitaxel + gemcitabine

A combination regimen of **ibrutinib** (a Bruton's tyrosine kinase inhibitor), **nab-paclitaxel** (albumin-bound paclitaxel, a microtubule inhibitor), and **gemcitabine** (a nucleoside analog antimetabolite), evaluated primarily in metastatic pancreatic ductal adenocarcinoma (PDAC). Ibrutinib inhibits Bruton's tyrosine kinase, modulating B-cell receptor signaling, mast cell degranulation, and tumor microenvironment; nab-paclitaxel interferes with microtubule function; gemcitabine incorporates into DNA to inhibit DNA synthesis. The combination was investigated in multiple clinical trials (e.g., the randomized, phase 3 RESOLVE trial) for first-line treatment of metastatic PDAC but did not demonstrate improved progression-free or overall survival versus standard therapy[1][2][3][4][5][6][7].