PD-1 inhibitor + apatinib + bevacizumab

This is a combination therapy consisting of three agents: - A PD-1 inhibitor (immune checkpoint inhibitor targeting programmed cell death protein 1) - Apatinib (a small molecule tyrosine kinase inhibitor that selectively targets vascular endothelial growth factor receptor 2, VEGFR2) - Bevacizumab (a monoclonal antibody that binds to and neutralizes vascular endothelial growth factor A, VEGF-A) The rationale for this combination is to synergistically inhibit tumor angiogenesis and enhance antitumor immune responses. The PD-1 inhibitor blocks the interaction between PD-1 on T cells and its ligands, thereby reinvigorating T cell-mediated antitumor immunity. Apatinib inhibits VEGFR2 signaling, disrupting angiogenesis at the receptor level. Bevacizumab neutralizes circulating VEGF-A, further suppressing tumor blood vessel formation and modulating the tumor microenvironment to reduce immunosuppression. Clinical studies have shown that combining antiangiogenic agents like apatinib or bevacizumab with immune checkpoint inhibitors can improve response rates and survival in various cancers such as advanced gastric cancer, hepatocellular carcinoma, nasopharyngeal carcinoma, colorectal cancer, and others[6][8][9]. The triple combination aims to amplify these effects by targeting multiple points in the angiogenesis pathway while simultaneously activating immune responses.