A Study to Compare Sacituzumab Tirumotecan (MK-2870) Monotherapy Versus Treatment of Physician's Choice as Second-line Treatment for Participants With Recurrent or Metastatic Cervical Cancer (MK-2870-020/TroFuse-020/Gog-3101/ENGOT-cx20)

Inclusion Criteria:

• Has histologically-confirmed diagnosis of squamous cell carcinoma, adenosquamouscarcinoma, or adenocarcinoma of the cervix

• Must have recurrent or metastatic cervical cancer that has progressed on or aftertreatment with 1 prior line of systemic platinum doublet chemotherapy (with orwithout bevacizumab) AND must have received anti-PD-1/anti-PD-L1 therapy as part ofprior cervical cancer regimens

• Has measurable disease per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1, as assessed by the investigator. Lesions situated in a previously irradiatedarea are considered measurable if progression has been shown in such lesions

• Is assigned female sex at birth, at least 18 years of age at the time of providingthe informed consent

• Has ECOG performance status of 0 or 1 within 7 days before allocation for theSacituzumab Tirumotecan Run-in or within 7 days before randomization for the Phase 3portion

• Has provided tumor tissue (most recent sample is preferred) from a core orexcisional biopsy of a tumor lesion not previously irradiated

• HIV-infected participants must have well controlled human immunodeficiency virus (HIV) on antiretroviral therapy (ART)

• Participants who are hepatitis B surface antigen (HBsAg) positive are eligible ifthey have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks,and have undetectable HBV viral load prior to allocation (Sacituzumab TirumotecanRun-in) or randomization (Phase 3 portion)

• Participants with history of hepatitis C virus (HCV) infection are eligible if HCVviral load is undetectable at screening

• Has adequate organ function

Exclusion Criteria:

• Has Grade ≥2 peripheral neuropathy

• Has history of documented severe dry eye syndrome, severe Meibomian gland diseaseand/or blepharitis, or severe corneal disease that prevents/delays corneal healing

• Has active inflammatory bowel disease requiring immunosuppressive medication orprevious history of inflammatory bowel disease (eg, Crohn's disease, ulcerativecolitis, or chronic diarrhea)

• Has uncontrolled, significant cardiovascular disease or cerebrovascular disease.

• Received prior systemic anticancer therapy

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

• Received a live or live-attenuated vaccine within 30 days before the first dose ofstudy intervention. Administration of killed vaccines is allowed

• Has other histological subtypes of cervical cancer apart from squamous cellcarcinoma, adenocarcinoma, or adenosquamous carcinoma (eg, carcinosarcoma), or has adiagnosis of nonepithelial cancer (eg, sarcoma, neuroendocrine tumors) of thecervix.

• Known additional malignancy that is progressing or has required active treatmentwithin the past 3 years

• Known active central nervous system (CNS) metastases and/or carcinomatous meningitis

• Active infection requiring systemic therapy

• HIV-infected participants with a history of Kaposi's sarcoma and/or MulticentricCastleman's Disease

• Concurrent active Hepatitis B and active Hepatitis C virus infection

• Severe hypersensitivity (≥Grade 3) to sacituzumab tirumotecan or treatment ofphysician's choice (TPC) and/or any of their excipients, or other biologic therapy

• Participants who have not adequately recovered from major surgery or have ongoingsurgical complications

• Has a history of (noninfectious) pneumonitis/ILD that required steroids or hascurrent pneumonitis/ILD