Sacituzumab Tirumotecan (MK-2870) in Combination With Pembrolizumab Versus Pembrolizumab Alone in Metastatic Non-small Cell Lung Cancer (NSCLC) With Programmed Cell Death Ligand 1 (PD-L1) Tumor Proportion Score (TPS) ≥ 50% (MK-2870-007)

Required: EGFR wild-type

Confirmation that epidermal growth factor receptor- (EGFR-)...directed therapy is not indicated as primary therapy

Required: ALK wild-type

Confirmation that...anaplastic lymphoma kinase- (ALK-)...directed therapy is not indicated as primary therapy

Required: ROS1 wild-type

Confirmation that...proto-oncogene tyrosine-protein kinase ROS (ROS1-) directed therapy is not indicated as primary therapy

Required: PD-L1 (CD274) overexpression (TPS ≥ 50%)

tumor tissue that demonstrates programmed cell death ligand 1 (PD-L1) expression in ≥50% of tumor cells as assessed by an immunohistochemistry (IHC) central laboratory

Cannot have received: systemic anticancer therapy

Received prior systemic anticancer therapy for their metastatic NSCLC

Cannot have received: anti-PD-1 therapy

Exception: Prior treatment with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent in the neoadjuvant or adjuvant setting for nonmetastatic resectable NSCLC is allowed as long as therapy was completed at least 12 months before diagnosis of metastatic NSCLC.

Received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent, or with an agent directed to another stimulatory or coinhibitory T-cell receptor

Cannot have received: systemic anticancer therapy

Received prior systemic anticancer therapy including investigational agents within 4 weeks before randomization

Cannot have received: radiation therapy

Received radiation therapy to the lung that is >30 Gy within 6 months of start of study intervention

Cannot have received: radiation therapy

Received prior radiotherapy within 2 weeks of start of study intervention, or radiation-related toxicities, requiring corticosteroids