This multicenter prospective study aimed to investigate the efficacy and safety of RAM plus DOC after combined chemoimmunotherapy….The ORR and DCR were 36.4% (95% CI: 22.4–52.2) and 72.7% (95% CI: 57.2–85.0). High VEGF-D groups had significantly shortened PFS and OS. The combination of high VEGF-A and low VEGF-D had a longer PFS than other groups.