Primary Tumor Resection With Sintilimab and Chemotherapy in Advanced NSCLC

* Preoperative evaluation must confirm resectability. Thoracoscopic minimally invasive surgery will be performed, with the surgical approach selected according to disease conditions, such as lobectomy, segmentectomy, wedge resection, or sleeve resection; ② Systematic mediastinal lymph node dissection or lymph node sampling (based on preoperative imaging and intraoperative evaluation) must be performed; ③ Postoperative recovery must be adequate (postoperative complications ≤ Clavien-Dindo grade II).

"1. Treatment phase:~ ① Sintilimab Dose: 200 mg, administered intravenously over 30 minutes or less;~ ② Pemetrexed Dose: 500 mg/m², administered intravenously over 10 minutes or less;~ ③ Carboplatin Dose: administered according to the area under the curve (AUC) of 5 mg/mL/min, with infusion time controlled within 15-60 minutes.~ The above regimen will be administered every 3 weeks after surgery for a total of 4 cycles.~2. Maintenance phase:~ * Sintilimab Dose: 200 mg, administered intravenously over 30 minutes or less; ② Pemetrexed Dose: 500 mg/m², administered intravenously over 10 minutes or less; The above regimen will be administered every 3 weeks. Maintenance with sintilimab will continue for up to 31 cycles, or the total duration of systemic therapy from randomization will not exceed 2 years, or until disease progression or the occurrence of unacceptable toxicity"