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This investigational combination therapy is being evaluated as a first-line treatment for advanced large-cell neuroendocrine carcinoma (LCNEC) and extrapulmonary neuroendocrine carcinoma (EP-NEC). The regimen consists of benmelstobart, a humanized IgG1 monoclonal antibody targeting PD-L1; anlotinib, a multi-targeted small molecule tyrosine kinase inhibitor; and a chemotherapy backbone of etoposide plus a platinum agent (cisplatin or carboplatin). Benmelstobart functions as an immune checkpoint inhibitor by blocking the PD-1/PD-L1 pathway, while anlotinib inhibits angiogenesis and tumor proliferation by targeting VEGFR, FGFR, PDGFR, and c-Kit. The addition of cytotoxic chemotherapy (platinum and etoposide) provides a synergistic effect by inducing DNA damage and inhibiting topoisomerase II. This specific combination is currently being investigated in a Phase II clinical trial led by Tianjin Medical University Cancer Institute and Hospital.
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