recombinant human endostatin + temozolomide + irinotecan

This is a **combination regimen** consisting of **recombinant human endostatin (rh-endostatin)**, **temozolomide**, and **irinotecan**, used in investigational settings for treating advanced or refractory cancers. **Recombinant human endostatin** is a recombinant form of an endogenous anti-angiogenic protein, inhibiting tumor growth by blocking angiogenesis primarily through VEGF pathway antagonism and additional effects on ERK, p38 MAPK, focal adhesion kinase, and matrix metalloproteinases[3][5]. **Temozolomide** is an oral alkylating agent that methylates DNA, leading to tumor cell death, while **irinotecan** is a topoisomerase I inhibitor that induces DNA damage by preventing DNA strand relegation during replication[6]. The combination of temozolomide and irinotecan has demonstrated synergistic antitumor activity, especially in relapsed pediatric and sarcomatous malignancies, with temozolomide-induced DNA methylation potentiating the cytotoxicity of irinotecan[6][2][4][8]. Recombinant human endostatin has shown efficacy in combination with chemotherapy, particularly in non-small cell lung cancer (approved in China)[5][7], and is being further investigated in other malignancies.