ArticleBMC cancer2025
Efficacy of PD-(L)1 inhibitors plus anlotinib in the second-line treatment of extensive-stage small cell lung cancer.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Real-World Safety of Immune Checkpoint Inhibitors in Small Cell Lung Cancer: A Systematic Review of Comparative Cohort Studies.Current oncology reports · 2026Pooled it
- Tislelizumab plus chemotherapy followed by anlotinib maintenance therapy in a patient with extensive-stage small cell lung cancer and intracranial recurrence after palliative whole-brain radiotherapy: a case report and literature review.Frontiers in immunology · 2026Review
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12 authors.
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Abstract
backgroundThe efficacy of second-line therapy for extensive-stage small cell lung cancer (ES-SCLC) is still limited, with the PFS of 2-3 months. Given the synergistic effect of PD-(L)1 inhibitors and anti-angiogenic agents, their combination represents a novel and promising strategy to reprogram the protumoral microenvironment and improve patient outcome. However, the efficacy of PD-(L)1 inhibitors plus anlotinib as the second-line treatment of ES-SCLC is undetermined in the real world.
methodsWe retrospectively analyzed 389 ES-SCLC patients from 3 cancer centers. All the patients received one of the following second-line schemes: PD-(L)1 inhibitors plus anlotinib (I + A), PD-(L)1 inhibitors plus chemotherapy (I + C), or chemotherapy alone (C). The efficacy, including the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety were compared among the three groups. We also analyzed the impact of first-line immune checkpoint inhibitors (ICIs) on the efficacy of second-line I + A.
resultsThe baseline clinical characteristics among three groups were largely balanced. I + A treatment demonstrated significantly higher ORR (30.2%) and DCR (82.6%) compared with I + C (ORR = 17.6%, DCR = 68.8%) and C (ORR = 18.0%, DCR = 53.9%). Furthermore, I + A group showed the longest mPFS (7.2 months) and mOS (33.5 months), compared to I + C (mPFS = 4.6 months, mOS = 19.0 months, both P < 0.001) and C (mPFS = 3.4 months, P < 0.01; mOS = 18.3 months, P = 0.083). The benefit of I + A treatment persists independent of the administration of first-line ICIs. A stratified analysis revealed that female patients and those with oligometastasis (≤ 3 metastatic sites) benefit more from I + A treatment than male patients and those with polymetastasis. In terms of safety, I + A group displayed the lowest incidence of ≥ grade 3 myelosuppression compared to the I + C and C groups (3.5% vs. 11.2% vs. 16.3%, P < 0.01). However, I + A treatment was associated with a higher prevalence of immune-related pneumonia (2.3% vs. 0% vs. 0%, P < 0.05) and hemoptysis (1.4% vs. 0% vs. 0.6%, P < 0.05) compared to I + C and C treatment.
conclusionsPD-(L)1 inhibitors and anlotinib has promising efficacy and manageable toxicity as the second-line therapy of ES-SCLC.
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