Predominantly squamous cell histology NSCLC; mixed cell types must be primarily (≥90%) adenocarcinoma cells. If small cell elements are present, the subject cannot be enrolled
Currently participating in interventional clinical research or treatment, or receiving other research drugs or using research equipment within 4 weeks before the first dose
Previously received the following therapies: anti-PD-1, anti-PD-L1, or anti-PD-L2 agents, or agents directed at another stimulatory or coinhibitory T-cell receptor (eg, CTLA-4, OX-40, CD137)
Received a traditional Chinese medicine with antitumor effect, or an immunomodulatory drug (thymosin, interferon, interleukin) within 2 weeks before the first dose, or received major surgery within 3 weeks before the first dose
Pulmonary radiation therapy of >30 Gy within 6 months prior to the first dose
Completed palliative radiotherapy within 7 days prior to the first dose
Clinically active diverticulitis, abdominal abscess, gastrointestinal obstruction, and peritoneal metastasis
Received a physical organ or blood system transplant
Clinically uncontrollable pleural effusion/peritoneal effusion
Known to have severe allergic reactions (grade ≥3) to the active ingredients of sintilimab, pemetrexed, cisplatin, carboplatin, and/or any excipients
Active autoimmune diseases requiring systemic treatment (eg, using a disease-modifying drug, corticosteroid, or immunosuppressant) within 2 years prior to the first dose. Alternative therapies (such as thyroxine, insulin, or physiological corticosteroids for adrenal or pituitary insufficiency) are not considered systemic treatments
Diagnosis of immunodeficiency, or receiving systemic steroid therapy or any other form of immunosuppressive therapy, within 7 days prior to the first dose of study treatment. Physiological doses of corticosteroids (≤10 mg/day of prednisone or equivalent) are permitted
Not fully recovered from the toxicity and/or complications caused by any intervention before starting treatment (ie, ≤ grade 1 or to baseline, excluding fatigue or alopecia)
Other malignant tumors within 5 years prior to the first dose, with the exception of radically treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin, and/or radically resected carcinoma in situ
Active central nervous system (CNS) metastasis and/or cancerous meningitis. Patients with asymptomatic brain metastases or stable symptoms after treatment of brain metastatic lesions may participate in the study as long as all of the following criteria are met: measurable disease outside the CNS; no meningeal, midbrain, pontine, medullary, or spinal metastases; clinically stable for at least 2 weeks; and discontinuation of hormonal therapy 14 days prior to the first dose of study treatment. Patients with known untreated, asymptomatic brain metastases can be enrolled, but regular imaging assessments of the brain must be performed
A history of noninfectious pneumonitis requiring corticosteroid therapy within 1 year prior to the first dose of study treatment or has current interstitial lung disease
Active infections that require systemic treatment
Unable or unwilling to receive folic acid or vitamin B₁₂ supplementation
Known cases of mental illness or substance abuse that may have an impact on compliance with the test requirements
Known HIV infection or untreated active hepatitis B or C
Vaccination of live vaccine within 30 days before the first dose (cycle 1, day 1)
- Inactivated virus vaccines for seasonal influenza are permitted; however, live attenuated influenza vaccines administered intranasally are not allowed

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