Randomized

• Adagrasib 600 mg BID without regard to food, or
• Adagrasib 400 mg BID with food.

• Receipt of prior treatment with a platinum (cisplatin or carboplatin)-containing regimen and an immune checkpoint inhibitor (ie, anti- PD-1/ PD-L1 inhibitor) administered concurrently or sequentially.
• Presence of measurable disease per RECIST version 1.1.

• Prior treatment with an agent targeting KRAS G12C (eg, sotorasib).
• Any of the following cardiac abnormalities:
  a. Unstable angina pectoris or myocardial infarction within 6 months prior to randomization.
  b. Symptomatic or uncontrolled atrial fibrillation within 6 months prior to randomization.
  c. Congestive heart failure (CHF) ≥ New York Heart Association (NYHA) Class 3 within 6 months prior to randomization.
  d. Prolonged QTc interval > 470 milliseconds during screening period
  e. Family or medical history of congenital Long QT Syndrome.
• Patients are excluded if they have any of the following CNS lesions:
  a. Any untreated brain lesions > 2.0 cm in size
  b. Any brainstem lesions
  c. Ongoing use of systemic corticosteroids for control of symptoms of brain lesions at a total daily dose of > 10 mg of prednisone (or equivalent) prior to randomization.
  d. Poorly controlled (> 1/week) generalized or complex partial seizures, or manifest neurologic progression.