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Merestinib + cisplatin + gemcitabine is a combination regimen investigated primarily for advanced or metastatic biliary tract cancer. **Merestinib** is an oral small-molecule multikinase inhibitor with antiproliferative and antiangiogenic properties; it inhibits several receptor tyrosine kinases including MET, MST1R, AXL, ROS1, PDGFRA, FLT3, TEK, DDR1, DDR2, MERTK, TYRO3, and the TRK family (TRKA/B/C), as well as serine/threonine kinases MKNK1/2. **Cisplatin** is a platinum-based chemotherapeutic that crosslinks DNA to induce apoptosis, and **gemcitabine** is a nucleoside analog that inhibits DNA synthesis. The combination is being investigated as first-line therapy for patients with advanced or metastatic biliary tract adenocarcinoma. Clinical trials showed a tolerable safety profile but no significant improvement in progression-free survival compared to cisplatin/gemcitabine alone in unselected patients.
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