A Prospective Randomized Study of Ramucirumab plus Pembrolizumab versus Standard of Care for Participants Previously Treated with Immunotherapy for Stage IV or Recurrent Non-Small Cell Lung Cancer.

Inclusion Criteria

- Participants must have histologically or cytologically confirmed non-small cell lung

cancer (NSCLC) which is stage IV or recurrent

- Participants must have received at least one line of anti-PD-1 or anti-PD-L1 therapy

for any stage of NSCLC. Anti-PD-1 or anti-PD-L1 may have been given alone or in

combination with other therapy

- Participants must have experienced disease progression (in the opinion of the treating

physician) more than (>) 84 days following initiation (cycle 1 day 1) of their most

recent anti-PD-1 or PD-L1 therapy

- Participants who received anti-PD-1 or anti-PD-L1 therapy for stage IV or recurrent

disease, must have had a best response on anti-PD-1 or anti-PD-L1 therapy of stable,

partial response or complete response (in the opinion of the treating physician)

- Participants who received neoadjuvant, adjuvant, and/or consolidation anti-PD-1 or

anti-PD-L1 therapy as their only line of anti-PD-1 or anti-PD-L1 therapy must have

experienced disease progression within (=<) 365 days from initiation (cycle 1 day 1)

of anti-PD-1 or PD-L1 therapy

- Participants must have received platinum-based chemotherapy and experienced disease

progression (in the opinion of the treating physician) during or after this regimen

- Participants with a known sensitizing mutation for which an Food and Drug

Administration (FDA)-approved targeted therapy for NSCLC exists (e.g., EGFR, ALK,

ROS1, BRAF, RET, NTRK, KRAS, HER2 and MET sensitizing mutations), must have previously

received at least one of the approved therapy(s). Prior targeted therapy for

participants with targetable alterations is allowed if all other eligibility criteria

are also met

- Participants must be >= 18 years old

- Participants must be able to safely receive the investigational drug combination and

the investigator's choice of standard of care regimens per the current FDA approved

package insert(s), treating investigator's discretion, and institutional guidelines

- Participants must have Zubrod performance status of 0-2

Exclusion Criteria

- Participants must not have received more than one line of anti-PD-1 or anti-PD-L1 for

stage IV or recurrent disease

- Participants must not be receiving or planning to receive another investigational

therapy during study participation