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This is a combination regimen consisting of three agents: - **Nintedanib** is an oral small molecule tyrosine kinase inhibitor that targets multiple receptor tyrosine kinases including vascular endothelial growth factor receptors (VEGFR), fibroblast growth factor receptors (FGFR), and platelet-derived growth factor receptors (PDGFR). It inhibits angiogenesis and tumor cell proliferation. Nintedanib is primarily developed for use in idiopathic pulmonary fibrosis and certain cancers. - **Pegylated liposomal doxorubicin** (PLD) is a formulation of the anthracycline antibiotic doxorubicin encapsulated in pegylated liposomes to reduce cardiotoxicity while maintaining antitumor efficacy. Its mechanism involves intercalation into DNA and inhibition of topoisomerase II activity leading to DNA damage and apoptosis. The pegylation prolongs circulation time and alters tissue distribution[4][8]. - **Carboplatin** is a platinum-based chemotherapeutic agent that forms DNA crosslinks resulting in inhibition of DNA synthesis and function. The combination of PLD with carboplatin has demonstrated efficacy in recurrent ovarian cancer[1][2][6]. The addition of nintedanib introduces antiangiogenic effects to the cytotoxic backbone.
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