Previously untreated, stage IV, EGFR/ALK/ROS1 negative NSCLC patients (pts) were eligible….The primary end point ORR was significantly improved from 29.8% (95% CI [17.3-44.9] in Arm B to 52.2% (95% CI [40.0-67.1]) in Arm A (p=0.032). mDoR in Arm A vs Arm B was 21.4 vs 13.0 mo. Arm A continued to prolong PFS vs Arm B, and mPFS was 12.6 vs 5.7 mo (HR 0.38; 95% CI [0.22-0.66], p<0.01)....In this updated analysis, sintilimab plus anlotinib provided durable efficacy benefits over chemotherapy with a manageable safety profile in treatment naïve metastatic NSCLC.