Phase II Study of Chemotherapy and Immunotherapy for Stage IV Non-Small Cell Lung Cancer

Inclusion Criteria

• Must have stage IV non-squamous non-small cell lung cancer confirmed by lab tests.
• Must have specific genetic mutations (EGFR mutation in exon 19 or 21) or be a never smoker without certain genetic changes. Never smokers must have smoked less than 100 cigarettes in their lifetime.
• Must have measurable cancer that can be tracked by scans.
• Patients with EGFR mutations must have tried certain targeted therapies before.
• Must not have had chemotherapy, anti-VEGF therapy, or immunotherapy before, except for specific cases with prior targeted therapies.
• Patients with treated, symptom-free brain metastases are eligible if they meet certain conditions.
• Must be over 18 years old and in good overall health (ECOG status 0 or 1).
• Must have normal organ and blood function as shown by specific tests.
• Must be able to provide a tumor sample for the study.
• Women of childbearing potential must use effective birth control during and after the study.
• Men with partners who can become pregnant must use effective birth control during and after the study.

Exclusion Criteria

• Currently receiving other investigational or cancer treatments.
• Recent severe gastrointestinal bleeding.
• Untreated brain metastases larger than 1 cm.
• Severe liver disease or certain heart conditions.
• Uncontrolled high blood pressure or recent severe vascular issues.
• Recent major surgery or serious wounds.
• History of smoking more than 100 cigarettes unless specific genetic mutations are present.
• Active autoimmune diseases requiring treatment in the past year.
• Recent significant bleeding or blood vessel issues.
• Pregnant or breastfeeding women.
• Known allergies to study drugs or related products.
• Previous organ transplants or certain other cancers unless in remission for at least 2 years.
• Uncontrolled pain or other serious health conditions that could interfere with the study.