surufatinib + envafolimab + tegafur-gimeracil-oteracil

Surufatinib + envafolimab + tegafur-gimeracil-oteracil is a multi-modal combination therapy regimen currently under investigation for the treatment of advanced or metastatic pancreatic cancer. This regimen integrates three distinct therapeutic approaches: **surufatinib**, a small molecule tyrosine kinase inhibitor that targets vascular endothelial growth factor receptors (VEGFR 1, 2, and 3), fibroblast growth factor receptor 1 (FGFR1), and colony-stimulating factor 1 receptor (CSF-1R); **envafolimab**, a unique subcutaneous single-domain antibody (nanobody) targeting programmed cell death-ligand 1 (PD-L1); and **S-1**, an oral fluoropyrimidine combination consisting of tegafur (a 5-FU prodrug), gimeracil (a DPD inhibitor), and oteracil (an OPRT inhibitor). The rationale behind this combination is to synergistically inhibit tumor angiogenesis, modulate the immunosuppressive tumor microenvironment by reducing myeloid-derived suppressor cells (via CSF-1R inhibition), and provide direct cytotoxic effects through DNA synthesis inhibition. It is primarily being evaluated in investigator-initiated trials, such as those led by Fujian Provincial Hospital, to improve clinical outcomes in patients with pancreatic ductal adenocarcinoma who have limited treatment options.

Other names

surufatinib + envafolimab + S-1