Anlotinib Plus Etoposide and Carboplatin as First-line Treatment for Extensive-stage Small Cell Lung Cancer

Inclusion Criteria:

1. According to the 8th edition of the AJCC/UICC TNM staging system for NSCLC, patientswith extensive stage SCLC confirmed by histology or cytology and are confirmed to haveat least one measurable lesion according to RECIST 1.1.
2. Without active brain metastasis
3. Previously treated with ICIs with progressive disease.
4. Age ≥18 years and ≤75 years;
5. ECOG PS score: 0 to 1
6. The main organs function is normal, that is, the following criteria met: goodhematopoietic function, defined as absolute neutrophil count ≥1.5×109 /L, plateletcount≥100 ×109 /L, hemoglobin ≥90g/L [no blood transfusion or no erythropoietin (EPO)dependence within 7 days before enrollment]; biochemical test results should meet thefollowing criteria: BIL < 1.25 times the upper limit of normal value (ULN); ALT andAST < 2.5 × ULN; in case of liver metastases, ALT and AST < 5 × ULN; Cr ≤1.5×ULN orcreatinine clearance (CCr) ≥60ml/min; Coagulation function is good, INR and PT ≤1.5times ULN; if the subject is receiving anticoagulant treatment, PT should be withinthe prescribed range of use of anticoagulant drugs;
7. Women of child-bearing age should agree to take contraceptive measures (such asintrauterine devices, contraceptives or condoms) during the study and within 6 monthsafter the study; non-breast-feeding patients whose serum or urinary pregnancy testshould be negative; male patients should agree to take contraceptive measures duringthe study and within 6 months after the study.
8. Patients are voluntarily enrolled into the study, sign the informed consent form andhave good compliance.

Exclusion Criteria:

1. Subjects with active CNS metastases are excluded.
2. Non-small cell lung cancer.
3. With obvious hemorrhage symptom
4. Patients with many factors affecting oral medication, such as dysphagia,gastrointestinal resection, chronic diarrhea and intestinal obstruction.
5. Combined with other tumors at the time of initial diagnosis.
6. Patients who have previously participated in other clinical trials and have not yetterminated the trial.
7. Patients who have acute infection that difficult to control.