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This investigational combination therapy consists of sintilimab, surufatinib, and temozolomide, currently being evaluated in a Phase II clinical trial for the treatment of advanced neuroendocrine carcinoma (NEC). Sintilimab is a fully human IgG4 monoclonal antibody that targets the programmed cell death protein 1 (PD-1) receptor, blocking its interaction with PD-L1 and PD-L2 to restore T-cell antitumor activity. Surufatinib is a small-molecule tyrosine kinase inhibitor that selectively inhibits VEGFR-1, -2, and -3, FGFR1, and CSF-1R, thereby inhibiting tumor angiogenesis and modulating the tumor immune microenvironment by reducing tumor-associated macrophages. Temozolomide is an oral alkylating agent that exerts its cytotoxic effect by methylating DNA, primarily at the O6 and N7 positions of guanine, leading to DNA damage and apoptosis. The combination aims to leverage the synergistic effects of immune checkpoint inhibition, anti-angiogenesis, and cytotoxic chemotherapy in patients who have progressed on first-line treatments.
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