A multicenter randomized Phase 2 DURABLE trial reported improved outcomes for extensive-stage small-cell lung cancer with a maintenance regimen combining durvalumab and anlotinib versus durvalumab alone. The study also assessed biomarker profiles linked to treatment response. The trial’s design evaluated efficacy signals for the dual maintenance approach as part of a strategy to extend benefit after initial therapy in a disease subtype with limited durable options. Details included the comparative framing against durvalumab monotherapy. The development adds a potential evidence base for maintenance optimization in ES-SCLC, where subsequent trials may determine whether the combination can move toward broader guideline consideration.