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**Recombinant tumor necrosis factor alpha-thymosin alpha 1 fusion protein** is a genetically engineered 185-amino-acid fusion protein comprising human tumor necrosis factor alpha and a C-terminal thymosin alpha 1 sequence. Marketed in Russia as **Refnot**, it was developed as an antineoplastic and immunomodulatory cytokine therapy intended to retain TNF-alpha-mediated tumor cytotoxicity while reducing systemic toxicity and adding thymosin alpha 1-associated immune stimulation. Its proposed antitumor actions include TNF receptor-mediated tumor-cell apoptosis or cytostasis, vascular injury and reduced tumor angiogenesis, and stimulation of innate and adaptive antitumor immunity. It is supplied as a lyophilisate for preparation of a subcutaneous injection and has been authorized in Russia for breast cancer in combination with chemotherapy and as an immunomodulator in disseminated melanoma. ([cancer.gov](https://www.cancer.gov/publications/dictionaries/cancer-drug/def/recombinant-tumor-necrosis-factor-alpha-thymosin-alpha-1-fusion-protein))
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