after you agree to join the study, you will sign an informed consent form.

the study team will collect your medical history, perform physical examinations, and obtain baseline laboratory tests and imaging scans of the chest.

you will receive ustekinumab as two separate doses on the first day of treatment.

the first dose is a subcutaneous injection of 90 mg (provided in a pre‑filled pen).

the second dose is an intravenous infusion of 520 mg (provided as a concentrate for infusion).

both doses are given as a single administration before the start of the dual icb therapy.

following the anti‑p40 doses, you will begin receiving the dual icb regimen, which includes an anti‑pd‑1 antibody and an anti‑ctla‑4 antibody.

the specific dosing schedule for these agents is defined by the study protocol and will be administered by the clinical staff.

throughout the first 24 weeks, you will attend clinic visits at regular intervals (for example, weekly or every few weeks) to have your vital signs, blood work, and any symptoms evaluated.

the purpose of these visits is to detect any severe (grade ≥3) immune‑related adverse events, which are side effects caused by the immune‑modulating drugs.

chest ct scans will be performed at baseline, around week 12, and again at week 24 to assess how the tumor is responding to the treatment.

the scans are interpreted using standardized criteria (mrecist v1.1) to determine objective response.

after the initial 24‑week period, you will continue to be monitored until week 48.

additional clinic visits will focus on identifying any later‑occurring severe (grade ≥3) immune‑related adverse events and on recording disease progression or survival outcomes.

at the end of the study period (approximately week 48), a final set of assessments will be performed, including laboratory tests, imaging, and a review of any adverse events.

you will then discontinue the study medications and receive appropriate follow‑up care as directed by your treating physician.