A Study to Learn About the Effects of the Combination of Elranatamab, Daratumumab and Lenalidomide Compared With Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma Who Are Not Candidates for Transplant

Inclusion Criteria:

• Diagnosis of multiple myeloma (MM) as defined by IMWG criteria (Rajkumar et al.,

• Measurable disease based on IMWG criteria as defined by at least 1 of the following:

• Serum M-protein ≥0.5 g/dL (Part 1) and ≥1 g/dL (Part 2);

• Urinary M-protein excretion ≥200 mg/24 hours;

• Involved FLC ≥10 mg/dL (≥100 mg/L) AND abnormal serum immunoglobulin kappa tolambda FLC ratio (<0.26 or >1.65).

• Part 1: Participants with relapsed/refractory multiple myeloma (RRMM) who havereceived 1-2 prior lines of therapy including at least one immunomodulatory drug andone proteasome inhibitor: or participants with newly-diagnosed multiple myeloma (NDMM) that are transplant-ineligible as defined by age ≥65 years ortransplant-ineligible as defined by age <65 years with comorbidities impacting thepossibility of transplant.

• Part 2: participants with newly-diagnosed multiple myeloma that aretransplant-ineligible defined as:

• Participants not considered candidates for high-dose chemotherapy and ASCT dueto age or

• Participants with important comorbidities likely to have a negative impact ontolerability of high dose chemotherapy and ASCT.

• ECOG performance status ≤2.

• Not pregnant and willing to use contraception

• For participants with RRMM: Resolved acute effects of any prior therapy to baselineseverity or CTCAE Grade ≤1.

Exclusion Criteria:

• Smoldering Multiple Myeloma.

• Monoclonal gammopathy of undetermined significance.

• Waldenströms Macroglobulinemia

• Plasma cell leukemia.

• Active, uncontrolled bacterial, fungal, or viral infection, including (but notlimited to) COVID-19/SARS-CoV-2, HBV, HCV, and known HIV or AIDS-related illness.

• Any other active malignancy within 3 years prior to enrollment, except foradequately treated basal cell or squamous cell skin cancer, carcinoma in situ, orStage 0/1 with minimal risk of recurrence per investigator.

• For participants with RRMM: Previous treatment with a BCMA-directed therapy oranti-CD38-directed therapy within 6 months preceding the first dose of studyintervention in this study. Stem cell transplant ≤3 months prior to first dose ofstudy intervention or active GVHD.

• For participants with NDMM: Previous systemic treatment for MM except for a shortcourse of corticosteroids (ie, total of 160 mg dexamethasone or equivalent beforethe first dose of study intervention). A cumulative dose of systemic corticosteroidsequivalent to ≥20 mg of dexamethasone during screening.

• Live attenuated vaccine administered within 4 weeks of the first dose of studyintervention.

• Administration of investigational product (eg, drug or vaccine) concurrent withstudy intervention or within 30 days (or as determined by the local requirement)preceding the first dose of study intervention used in this study.