Anlotinib plus envafolimab as neoadjuvant therapy in a patient with chemotherapy-refractory advanced endometrial cancer: A case report

We report a case of a 51-y-old female presenting with synchronous double primary malignancies: advanced endometrial cancer and early-stage lung cancer. One year a post-chemotherapy withdrawal due to toxicity, she developed severe urinary retention and poor performance status caused by pelvic tumor progression. Considered ineligible for standard chemoradiotherapy, she received anlotinib (a novel multi-target TKI) combined with envafolimab (a subcutaneous PD-L1 antibody). This regimen resulted in rapid symptom resolution and significant tumor regression, successfully converting the patient to surgical candidacy. She subsequently underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy, achieving an R0 resection. The lung lesion was treated with stereotactic body radiation therapy. She remains disease-free at follow-up. The combination of anlotinib and envafolimab shows promise as an effective conversion therapy for endometrial cancer, particularly in patients with advanced stage, poor performance status, or intolerance to intensive treatments.