Can a novel drug combo outperform standard chemo for lung cancer?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Voluntarily sign the informed consent form and comply with the protocol requirements; 2. Age ≥ 18 years; 3. Expected survival time ≥ 3 months; 4. Patients with locally advanced non-squamous non-small cell lung cancer; 5. Agree to provide tumor tissue samples obtained at or after diagnosis of locally advanced or metastatic cancer; 6. Must have at least one measurable lesion as defined by RECIST v1.1; 7. ECOG performance status score of 0 or 1; 8. Toxicities from prior anti-tumor therapy have recovered to ≤ Grade 1 as defined by NCI-CTCAE v6.0; 9. No severe cardiac dysfunction, with left ventricular ejection fraction ≥ 50%; 10. Organ function levels must meet the required criteria; 11. Urinary protein ≤ 2+ or \< 1000 mg/24h; 12. For premenopausal women of childbearing potential, a pregnancy test must be performed within 7 days before starting treatment; serum pregnancy test must rule out pregnancy; patients must be non-lactating and must use highly effective contraceptive measures throughout the treatment period and for 7 months after the last dose. For male participants whose partners are women of childbearing potential, adequate barrier contraceptive measures must be used throughout the treatment period and for 7 months after the end of treatment. Exclusion Criteria: 1. Presence of small cell lung cancer, neuroendocrine carcinoma, sarcomatoid carcinoma components, or squamous carcinoma components exceeding 10%; 2. Evidence suggesting the presence of EGFR-sensitive mutations, etc.; 3. Patients who have received prior systemic therapy; 4. Prior receipt of therapies targeting the mechanism of tumor immunity; 5. Prior receipt of antibody-drug conjugates (ADCs) using topoisomerase I inhibitors as the toxin, etc.; 6. Trial participants who have received prior systemic anti-angiogenic therapy; 7. Receipt of radical radiotherapy, major surgery, or large-field radiotherapy within 4 weeks before study randomization; 8. History of severe cardiac or cerebrovascular disease; 9. Receiving long-term systemic corticosteroid therapy (e.g., \>10 mg/day prednisone) prior to the first dose; 10. Active autoimmune diseases and inflammatory diseases; 11. Unstable thrombotic events requiring therapeutic intervention within 6 months before screening; 12. Prolonged QT interval, complete left bundle branch block, etc.; 13. Diagnosis of active malignancy within 3 years before study randomization; 14. Hypertension poorly controlled by two antihypertensive medications; 15. Patients with poorly controlled blood glucose; 16. History of ILD requiring steroid therapy, current ILD, or ≥ grade 2 radiation pneumonitis, etc.; 17. Concurrent pulmonary diseases resulting in clinically severe impairment of respiratory function; 18. Patients with active central nervous system metastases; 19. Occurrence of severe infection within 4 weeks before study randomization; 20. Presence of large serous cavity effusions, or symptomatic serous cavity effusions, etc.; 21. Imaging findings suggesting tumor invasion or encasement of abdominal, thoracic, or other regions; 22. Presence of serious non-healing wounds, ulcers, or fractures within 4 weeks before signing informed consent; 23. Trial participants with clinically significant bleeding or obvious bleeding tendency within 4 weeks before signing informed consent; 24. Patients with a history of inflammatory bowel disease, extensive bowel resection, immune-mediated enteritis, intestinal obstruction, or chronic diarrhea, etc.; 25. History of allergy to recombinant humanized antibodies or allergy to the investigational drug, etc.; 26. History of autologous or allogeneic stem cell transplantation; 27. Positive for human immunodeficiency virus antibody, active hepatitis B virus infection, or hepatitis C virus infection; 28. History of severe neurological or psychiatric disorders; 29. Receipt of other unapproved investigational drugs or treatments within 4 weeks before study randomization; 30. Trial participants who plan to receive or have received live vaccines within 28 days before study randomization; 31. Other conditions that, in the investigator's opinion, make the patient unsuitable for participation in this clinical trial due to complications or other circumstances.