ruxolitinib + capecitabine + regorafenib

This is a combination regimen of three oral small molecule drugs: **ruxolitinib, capecitabine, and regorafenib**. - **Ruxolitinib** is a selective inhibitor of Janus kinase 1 (JAK1) and Janus kinase 2 (JAK2), originally developed for myeloproliferative neoplasms. It acts by inhibiting the JAK-STAT pathway, reducing inflammatory cytokine signaling which can modulate the tumor microenvironment[1][4][5]. - **Capecitabine** is an oral prodrug of 5-fluorouracil (5-FU), a pyrimidine antimetabolite that inhibits DNA synthesis by blocking thymidylate synthase, leading to cell death in rapidly dividing tumor cells[2][7]. - **Regorafenib** is an oral multi-kinase inhibitor that targets multiple protein kinases involved in tumor angiogenesis (e.g. VEGFR1–3, TIE2), oncogenesis (e.g. KIT, RET, BRAF), and modulation of the tumor microenvironment (e.g. PDGFR, FGFR)[1][3][4][6][7]. This triple drug regimen is not an approved fixed-dose combination but has been investigated (in subgroups or parallel studies) for **advanced/metastatic colorectal cancer** and **metastatic pancreatic cancer** resistant to prior treatments. The rationale behind combining these drugs is to target multiple relevant pathways in tumor biology (inflammation, DNA synthesis, angiogenesis) in highly refractory malignancies[1][2][4][5][7].