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Endostar + chemotherapy is a combination therapeutic regimen consisting of the recombinant human endostatin, Endostar, and a standard chemotherapy backbone (typically including methotrexate, cisplatin, doxorubicin, and ifosfamide). Developed by Shandong Simcere-Medgenn Bio-pharmaceutical, Endostar is a biologic anti-angiogenic agent produced in *Escherichia coli*. It features a modified N-terminal nine-amino acid sequence (MGGSHHHHH) that improves its stability and solubility compared to native endostatin. The regimen is primarily investigated for the treatment of osteosarcoma, where Endostar's inhibition of the vascular endothelial growth factor (VEGF) pathway and the Wnt/β-catenin signaling pathway complements the cytotoxic effects of chemotherapy. Endostar was previously approved in China in 2005 for non-small cell lung cancer.
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