Anlotinib as a Tailored Treatment for Extensive-Stage Small Cell Lung Cancer with Stable Disease after Two Cycles of First Chemotherapy Plus Immunotherapy: A Retrospective Study

<b><i>Objective:</i></b> Optimize the treatment of extensive-stage small cell lung cancer (ES-SCLC). <b><i>Materials and Methods:</i></b> We collected data on patients with ES-SCLC who had stable disease (SD) after two cycles of first-line chemotherapy combined with immunotherapy (CIO) and subsequently received tailored treatment with anlotinib. The primary endpoints of the study were progression-free survival and overall survival (OS), while secondary endpoints included overall response rate (ORR), disease control rate (DCR), and adverse events (AEs). <b><i>Results:</i></b> A total of 45 patients were ultimately enrolled in the study. Preliminary analysis indicated that the integration of anlotinib provides promising efficacy for patients with ES-SCLC who had SD after two cycles of CIO. ORR and DCR were 26.67% and 62.22%, respectively, with median progression-free survival and median OS were 6.0 months and 10.0 months. Furthermore, subgroup analysis results showed that patients who experienced hypertension, proteinuria, and hand-foot syndrome during treatment had better efficacy. In addition, mechanistic analysis suggested that this regimen may activate the immune system by depleting immune suppression, thereby exerting a synergistic antitumor effect. Beyond the promising efficacy, the overall AEs of this regimen were manageable, indicating a potential positive outlook for this treatment model in this patient population. <b><i>Conclusion:</i></b> The adaptive treatment with anlotinib can significantly improve outcomes for these patients, with manageable toxicities, suggesting that this treatment model has the potential to become an important option for first-line therapy in ES-SCLC. However, its true clinical value requires further research for validation.