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surufatinib + etoposide + cisplatin + serplulimab is an investigational four-drug combination regimen being evaluated as a first-line treatment for advanced or metastatic extrapulmonary neuroendocrine carcinoma (NEC) and extensive-stage small cell lung cancer (ES-SCLC). The regimen combines surufatinib, an oral small-molecule tyrosine kinase inhibitor targeting VEGFR-1/2/3, FGFR-1, and CSF-1R; serplulimab, a humanized anti-PD-1 monoclonal antibody; and the standard etoposide/cisplatin (EP) chemotherapy backbone. By combining antiangiogenic, immunomodulatory, and cytotoxic mechanisms, this regimen aims to overcome tumor immune escape and enhance antitumor efficacy. In a Phase I/II trial (NCT05747729), the combination demonstrated encouraging clinical activity with a high objective response rate in patients with extrapulmonary NEC.
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