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**Anlotinib + topotecan** is an investigational combination therapy consisting of two small-molecule drugs used primarily in clinical settings for the treatment of small cell lung cancer (SCLC), especially as second-line or later therapy. **Anlotinib** is a novel multi-targeted tyrosine kinase inhibitor that predominantly targets angiogenesis and tumor proliferation pathways, including the vascular endothelial growth factor receptor (VEGFR), fibroblast growth factor receptor (FGFR), and platelet-derived growth factor receptor (PDGFR). **Topotecan** is a topoisomerase I inhibitor that prevents DNA replication in tumor cells, ultimately leading to cell death. The combination seeks to leverage anlotinib’s capacity to normalize tumor vasculature and modulate the tumor microenvironment—potentially improving drug delivery and reducing immunosuppression—alongside the cytotoxic effects of topotecan. This combination has shown antitumor activity and manageable toxicity profiles in clinical research for patients with relapsed SCLC, although comparative studies more frequently evaluate each agent separately. As of 2025, this combination is not an approved therapy and is mainly being evaluated in the context of clinical trials or off-label use.
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