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This is a combination of four anti–PD-1 monoclonal antibodies: camrelizumab, sintilimab, tislelizumab, and toripalimab. Each agent is a humanized IgG4 monoclonal antibody that targets the programmed cell death protein 1 (PD‑1) receptor on T cells. By blocking PD‑1 interaction with its ligands PD-L1 and PD-L2, these drugs release the brakes on immune responses against tumor cells, enhancing T-cell–mediated antitumor activity. All four agents are approved in China for various cancers including non-small cell lung cancer and nasopharyngeal carcinoma; they have demonstrated similar efficacy profiles in clinical trials as monotherapies or in combination with chemotherapy[2][8]. There is no evidence or clinical precedent for combining all four agents together as a single regimen; typically, each is used individually or with chemotherapy.
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