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Surufatinib + gemcitabine + nab-paclitaxel is an investigational combination therapy primarily being studied for the treatment of pancreatic ductal adenocarcinoma (PDAC). The regimen combines surufatinib, a small-molecule tyrosine kinase inhibitor (TKI), with the standard-of-care chemotherapy doublet of gemcitabine and nab-paclitaxel (AG). Surufatinib provides a dual anti-tumor mechanism by selectively targeting vascular endothelial growth factor receptors (VEGFR-1, -2, and -3) and fibroblast growth factor receptor 1 (FGFR-1) to inhibit angiogenesis, while also inhibiting colony-stimulating factor 1 receptor (CSF-1R) to modulate the tumor immune microenvironment by reducing tumor-associated macrophages. Gemcitabine acts as a nucleoside analog that inhibits DNA synthesis, and nab-paclitaxel is an albumin-bound nanoparticle formulation of paclitaxel that disrupts microtubule dynamics. This triple combination is being evaluated in Phase II clinical trials as a first-line treatment for metastatic disease and as a neoadjuvant or peri-operative therapy for locally advanced and borderline resectable pancreatic cancer.
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