{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T06:17:59Z","timestamp":1778221079714,"version":"3.51.4"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small cell lung cancer (SCLC) is characterised by aggressive biological behaviour and a high propensity for early brain metastasis. Although whole-brain radiotherapy (WBRT) is a standard treatment modality, early intracranial relapse after WBRT remains prevalent and is associated with an exceedingly poor prognosis due to the paucity of effective salvage options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a 50-year-old male patient diagnosed with extensive-stage SCLC with brain and pancreatic metastases. The patient received first-line etoposide plus cisplatin(EP) chemotherapy and WBRT with simultaneous integrated boost, but experienced early intracranial and systemic progression approximately 7 months post-WBRT. Second-line immunotherapy-based treatment also failed to control disease progression. Consequently, the patient was administered oral anlotinib (12\u202fmg, days 1\u201314) in combination with temozolomide (200\u202fmg, days 1\u20135) as salvage therapy. The combination achieved durable intracranial disease control, significant systemic tumour regression, and deep tumour marker remission, with a progression-free survival of approximately 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of anlotinib and temozolomide has been shown to demonstrate promising efficacy as a salvage treatment for patients with early recurrent brain metastases after WBRT in extensive-stage SCLC. This regimen represents a viable therapeutic option with a manageable safety profile and warrants further prospective evaluation in larger clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1824583","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:51:08Z","timestamp":1778219468000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anlotinib combined with temozolomide for brain metastases in small cell lung cancer with early recurrence after whole-brain radiotherapy: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Bolun","family":"Jiang","sequence":"first","affiliation":[{"name":"The First Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojie","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Town Hospital, Affiliated Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qilin","family":"Liu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Fifth People's Hospital of Dalian","place":["Dalian, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"The First Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"885","DOI":"10.32604\/or.2024.051586","article-title":"Evaluating the efficacy and safety of Anlotinib in conjunction with stereotactic radiosurgery for small cell lung cancer patients with brain metastases","volume":"33","author":"Wang","year":"2025","journal-title":"Oncol Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s11060-023-04512-2","article-title":"Treatment and survival of patients with small cell lung cancer and brain metastasis","volume":"165","author":"Chiang","year":"2023","journal-title":"J Neuro-Oncol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0167-8140(97)00149-7","article-title":"Brain-only metastases of small cell lung cancer; efficacy of whole brain radiotherapy. 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A retrospective study of real-world data using landmark analyses","volume":"13","author":"Hoelzl","year":"2024","journal-title":"Cancer Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1093\/neuonc\/noad015","article-title":"Is there a future for maintenance temozolomide chemotherapy in PCNSL?","volume":"25","author":"Bromberg","year":"2023","journal-title":"Neuro-Oncology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"108539","DOI":"10.1016\/j.lungcan.2025.108539","article-title":"Outcome of temozolomide in relapsed small cell lung cancer: a retrospective single center analysis","volume":"203","author":"Dhaeyer","year":"2025","journal-title":"Lung Cancer"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2967","DOI":"10.1038\/s41591-024-03132-1","article-title":"Benmelstobart, anlotinib and chemotherapy in extensive-stage small-cell lung cancer: a randomized phase 3 trial","volume":"30","author":"Cheng","year":"2024","journal-title":"Nat Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"5372","DOI":"10.1002\/cam4.5360","article-title":"Efficacy and safety of anlotinib combined with PD-1\/PD-L1 inhibitors as second-line and subsequent therapy in advanced small-cell lung cancer","volume":"12","author":"Yu","year":"2023","journal-title":"Cancer Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"4114","DOI":"10.1007\/s00330-020-07514-0","article-title":"Immune checkpoint inhibitor therapy may increase the incidence of treatment-related necrosis after stereotactic radiosurgery for brain metastases: a systematic review and meta-analysis","volume":"31","author":"Kim","year":"2021","journal-title":"Eur Radiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1177\/03008916221082704","article-title":"The efficacy and safety of anlotinib for subsequent line treatment of small cell lung cancer: a systematic review and meta-analysis","volume":"109","author":"Xu","year":"2023","journal-title":"Tumori"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s11060-017-2510-0","article-title":"Outcome and prognostic factors in patients with brain metastases from small-cell lung cancer treated with whole brain radiotherapy","volume":"134","author":"Bernhardt","year":"2017","journal-title":"J Neuro-Oncol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1038\/s41419-020-02749-7","article-title":"Anlotinib suppresses tumor progression via blocking the VEGFR2\/PI3K\/AKT cascade in intrahepatic cholangiocarcinoma","volume":"11","author":"Song","year":"2020","journal-title":"Cell Death Dis"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"4937","DOI":"10.2147\/CMAR.S252181","article-title":"Anlotinib suppresses colorectal Cancer proliferation and angiogenesis via inhibition of AKT\/ERK signaling Cascade","volume":"12","author":"Yang","year":"2020","journal-title":"Cancer Manag Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2401618","DOI":"10.1080\/07853890.2024.2401618","article-title":"A phase II study of anlotinib plus whole brain radiation therapy for patients with NSCLC with multiple brain metastases","volume":"56","author":"Gu","year":"2024","journal-title":"Ann Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1007\/s12094-024-03390-y","article-title":"Comparison of the efficacy and safety of anlotinib monotherapy or anlotinib plus immune checkpoint inhibitor for advanced small cell lung cancer with brain metastases","volume":"26","author":"Xu","year":"2024","journal-title":"Clin Transl Oncol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e70449","DOI":"10.1002\/cam4.70449","article-title":"The efficacy and safety of albumin-bound paclitaxel combined with Anlotinib and PD-1\/L1 inhibitors for treating patients with extensive-stage small cell lung Cancer and brain metastasis: a retrospective cohort study","volume":"13","author":"Li","year":"2024","journal-title":"Cancer Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1824583\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:51:09Z","timestamp":1778219469000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1824583\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":21,"alternative-id":["10.3389\/fmed.2026.1824583"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1824583","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"article-number":"1824583"}}