A Clinical Trial of Four Medicines (Elranatamab Plus Carfilzomib and Dexamethasone or Maplirpacept) in People With Relapsed Refractory Multiple Myeloma

Inclusion Criteria:

• Prior diagnosis of multiple myeloma as defined by IMWG criteria.

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

• Serum M-protein ≥0.5 g/dL.

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

• Serum immunoglobulin FLC ≥10 mg/dL (≥100 mg/L) AND abnormal serumimmunoglobulin kappa to lambda FLC ratio (<0.26 or >1.65).

• Part 1: Received at least 1 but not more than 3 prior lines of therapy for multiplemyeloma (induction therapy followed by stem cell transplant andconsolidation/maintenance therapy will be considered as 1 line of therapy).

• Part 2: Received at least 3 prior lines of therapy for multiple myeloma who arerefractory to at least one IMiD, one PI and one anti-CD38 antibody.

• ECOG performance status 0-1.

• Resolved acute effects of any prior therapy to baseline severity or CTCAE Grade ≤1.

• Not pregnant or breastfeeding and willing to use contraception.

Exclusion Criteria:

• Plasma cell leukemia, Smouldering MM, Waldenströms macroglobulinemia, Amyloidosis,POEMS Syndrome, Primary refractory MM

• Impaired cardiovascular function or clinically significant cardiovascular diseases.

• Participants with any active, uncontrolled bacterial, fungal, or viral infection.

• Stem cell transplant within 12 weeks prior to enrollment, or active graft versushost disease.

• Any other active malignancy within 3 years prior to enrollment, except foradequately treated basal cell or squamous cell skin cancer, or carcinoma in situ.

• Part 1: Previous treatment with a BCMA-directed therapy.

• Part 2: Previous treatment with any anti-BCMA directed therapy, with the exceptionof CAR-T. Previous treatment with a CD47-SIRP alpha-directed therapy.

• Part 1: Prior treatment with carfilzomib

• Live attenuated vaccine within 4 weeks of the first dose of study intervention.

• Administration with an investigational product (e.g. drug or vaccine) concurrentwith study intervention or within 30 days preceding the first dose of studyintervention used in this study.

• Any of the following within 3 months of enrollment: erosive esophagitis, treatmentresistant peptic ulcer, infectious or inflammatory bowel disease, pulmonary embolismor uncontrolled thromboembolic event.

• Intolerance to or participants who have had a severe (Grade ≥3) allergic oranaphylactic reaction to antibodies or therapeutic proteins