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Anlotinib is a novel oral small molecule multi-target tyrosine kinase inhibitor developed independently in China. It targets several receptor tyrosine kinases involved in tumor angiogenesis and proliferation, including vascular endothelial growth factor receptors (VEGFR1/2/3), platelet-derived growth factor receptors (PDGFRα/β), fibroblast growth factor receptors (FGFR1–4), c-Kit, and Ret. By inhibiting these kinases and their downstream signaling pathways such as ERK and Akt, anlotinib suppresses tumor angiogenesis and cell proliferation. It has demonstrated efficacy in various solid tumors including non-small cell lung cancer (NSCLC), soft tissue sarcoma, renal cell carcinoma, medullary thyroid carcinoma, gastric cancer, esophageal squamous cell carcinoma, colorectal cancer (CRC), nasopharyngeal carcinoma, hepatocellular carcinoma, ovarian cancer and others. Anlotinib was first approved in China as a third-line treatment for advanced NSCLC after at least two prior systemic therapies and later for advanced soft tissue sarcoma after anthracycline-based chemotherapy.
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