This study looks at new treatment options for people with stage IV or returning non-small cell lung cancer, a type of cancer that affects the lungs. It compares the effects of using two drugs, ramucirumab and pembrolizumab, against regular chemotherapy. Ramucirumab is a kind of special medicine called a monoclonal antibody that helps stop cancer from growing by preventing new blood vessels from forming. Pembrolizumab is another monoclonal antibody that helps the immune system fight cancer. The main goal is to see if these two drugs together help patients live longer than chemotherapy alone. Patients will be split into two groups: one will get the standard chemotherapy, and the other will receive the new drug combination through an IV (a needle in a vein).

• The study involves getting drugs either through an IV or as usual chemotherapy.
• Participants must be 18 or older and have previously received specific treatments.
• Those who join this study cannot partake in other experimental treatments during it.