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Tian En Fu (rmhTNF-NC) is a recombinant modified human tumor necrosis factor-alpha (TNF-alpha) developed by Shanghai Wellcares Biopharmaceutical. It is a Class 1 biological drug in China, engineered to have significantly higher anti-tumor activity and lower systemic toxicity compared to natural TNF. For the treatment of malignant pleural and peritoneal effusions, it is administered via intracavitary infusion in combination with cisplatin. The mechanism involves TNF-mediated direct cytotoxicity against tumor cells and vascular effects that reduce fluid accumulation, complemented by the DNA-damaging effects of cisplatin. While already approved in China for advanced non-small cell lung cancer (NSCLC) and non-Hodgkin's lymphoma, the combination with cisplatin for malignant effusions is currently under regulatory review following an NDA filing.
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