rh-endostatin + carboplatin + pemetrexed

This combination therapy consists of recombinant human endostatin (rh-endostatin, also known as Endostar) combined with the chemotherapy agents carboplatin and pemetrexed. It's primarily used in the treatment of non-small cell lung cancer (NSCLC). ## Mechanism of Action The combination works through multiple mechanisms: 1. **Rh-endostatin (Endostar)** is an anti-angiogenic agent that directly targets new capillary endothelial cells around tumors. It's a C-terminal fragment type of XVIII collagen that inhibits neovascularization[1][3]. Rh-endostatin can remodel and normalize tumor blood vessels, which improves the hypoxic condition in tumors and increases the concentration of other drugs inside tumor tissues[2]. 2. **Pemetrexed** (Alimta) is a chemotherapy drug that destroys quickly dividing cells, such as cancer cells[5]. 3. **Carboplatin** is another chemotherapy drug that also targets rapidly dividing cells[5]. ## Clinical Evidence Studies have shown that adding rh-endostatin to chemotherapy regimens can improve outcomes in NSCLC patients: - Extended use of rh-endostatin (≥4 cycles) with platinum-based chemotherapy has been associated with significantly better progression-free survival (PFS) and overall survival (OS) in advanced NSCLC patients[3]. - When combined with pemetrexed/cisplatin, rh-endostatin showed a trend of improved PFS in maintenance therapy for NSCLC patients, though it did not significantly prolong PFS or OS in first-line treatment compared to pemetrexed/cisplatin alone[1]. - A phase II clinical study in extensive small cell lung cancer (SCLC) patients showed promising results with rh-endostatin plus chemotherapy (etoposide plus cisplatin), with median PFS and OS of 5 and 11.5 months, respectively[2]. ## Administration The treatment is typically administered as follows: - Pemetrexed is given as an intravenous drip over 10 minutes - Carboplatin is administered as an intravenous drip over 15 to 60 minutes - Rh-endostatin is given intravenously Treatment cycles usually last 3 weeks (21 days), and patients might receive 4 to 6 cycles over approximately 4 months[5]. To reduce side effects of pemetrexed, patients may also receive: - Folic acid tablets starting at least 5 days before treatment - Vitamin B12 injections - Steroid tablets[5] ## Safety Profile The combination therapy has shown acceptable toxicity profiles. Common side effects associated with rh-endostatin include fever, rash, dizziness, headache, diarrhea, fatigue, palpitation, and chest discomfort[1]. Studies have indicated that extended use of rh-endostatin (≥4 cycles) provides additional survival benefits with satisfactory toxicity profiles[3]. This combination represents an important treatment option for advanced NSCLC patients, particularly those without driver gene mutations who may benefit from the anti-angiogenic effects of rh-endostatin alongside traditional chemotherapy.

Brand names

Endostar

Other names

recombinant human endostatin, carboplatin, pemetrexed combination