A Global Phase III Study of Rilvegostomig or Pembrolizumab Plus Chemotherapy for First-Line Treatment of Metastatic Squamous Non-small Cell Lung Cancer (NSCLC)

Inclusion Criteria:

• Histologically or cytologically documented squamous NSCLC.

• Stage IV mNSCLC (based on the American Joint Committee on Cancer Edition 8) notamenable to curative treatment.

• Absence of documented tumor genomic mutation results from tests conducted as part ofstandard local practice in any actionable driver oncogenes for which there arelocally approved targeted 1L therapies.

• Provision of acceptable tumor sample to confirm tumor PD-L1 expression TC ≥ 1%.

• At least one lesion not previously irradiated that qualifies as a RECIST 1.1 TL atbaseline and can be accurately measured at baseline as ≥ 10 mm in the longestdiameter (except lymph nodes, which must have short axis ≥ 15 mm) with CT or MRI andis suitable for accurate repeated measurements.

• Adequate organ and bone marrow function.

Exclusion Criteria:

• Presence of small cell and neuroendocrine histology components.

• Brain metastases unless asymptomatic, stable, and not requiring steroids oranticonvulsants for at least 7 days prior to randomization. A minimum of 2 weeksmust have elapsed between the end of local therapy (brain radiotherapy or surgery)and randomization. Participants must have recovered from the acute toxic effect ofradiotherapy (eg, dizziness and signs of increased intracranial pressure) or surgeryprior to randomization.

• Any prior systemic therapy received for advanced or mNSCLC.

• Any prior treatment with an anti-PD-1 or anti-PD-L1 agent.

• Any prior exposure to an anti-TIGIT therapy or any other anticancer therapytargeting immune-regulatory receptors or mechanisms.

• History of another primary malignancy except for malignancy treated with curativeintent with no known active disease ≥ 2 years before the first dose of studyintervention and of low potential risk for recurrence.

• Active or prior documented autoimmune or inflammatory disorders requiring chronictreatment with steroids or other immunosuppressive treatment.

• Active primary immunodeficiency/active infectious disease(s).

• Active tuberculosis infection.