Grade 3-4 treatment-related adverse events occurred in 25.9% of patients, primarily hypertension (11.1%) and hand-foot syndrome (7.4%), with no fatal events.<h4>Conclusion</h4>This real-world case series suggests that sintilimab plus anlotinib offers promising efficacy and manageable toxicity as a later-line, chemotherapy-free regimen for advanced <i>KRAS</i>-mutant NSCLC. The gene discussed is KRAS; the disease is Hand-foot syndrome.