sintilimab + apatinib + capecitabine

Sintilimab + apatinib + capecitabine is an investigational combination regimen comprising three agents with distinct mechanisms of action, evaluated primarily as a first-line treatment for unresectable hepatocellular carcinoma (HCC). Sintilimab is a highly selective, fully human IgG4 monoclonal antibody targeting programmed cell death 1 (PD-1), functioning as an immune checkpoint inhibitor to enhance anti-tumor immune responses. Apatinib is a small molecule tyrosine kinase inhibitor that selectively inhibits vascular endothelial growth factor receptor 2 (VEGFR2), thereby blocking tumor angiogenesis. Capecitabine is an oral prodrug of 5-fluorouracil (5-FU) and acts as an antimetabolite chemotherapeutic agent interfering with DNA synthesis in rapidly dividing cells. The combination aims to synergistically improve anti-tumor efficacy by integrating immunotherapy, anti-angiogenic therapy, and cytotoxic chemotherapy. Clinical studies have demonstrated promising objective response rates and disease control rates in advanced HCC patients who had not received prior systemic therapy[1][2][6].