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This combination therapy is an investigational chemo-immunotherapy regimen being evaluated for the first-line treatment of driver-negative non-squamous non-small cell lung cancer (NSCLC) presenting with malignant pleural effusion (MPE). The regimen integrates three distinct therapeutic modalities: **sintilimab**, a humanized IgG4 monoclonal antibody that targets the programmed cell death protein 1 (PD-1) receptor to enhance systemic anti-tumor immunity; **recombinant modified human tumor necrosis factor (rmhTNF)**, a cytokine therapy administered via pleural perfusion to induce local tumor cell apoptosis and stimulate an inflammatory response within the pleural cavity; and standard **chemotherapy**, typically a platinum-based doublet (such as pemetrexed and cisplatin). By combining local pleural treatment with systemic checkpoint inhibition and cytotoxic chemotherapy, the regimen aims to address both the primary tumor and the complications of pleural involvement.
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