A trial to learn how well AZD0120 works and about its safety in adults with transplant eligible newly diagnosed multiple myeloma.

Prior treatment

• Participant has a known active, or prior history of central nervous system involvement or exhibits clinical signs of meningeal involvement of MM.
• Participant has significant neurological or psychiatriccondition within 6 months before signing ICF.
• Prior treatment with CAR-T and/or CAR-natural killer cell therapies directed at any target for any indications and any therapy that is targeted to BCMA and CD19.
• Participant received any prior T-cell engager therapy directed at any target.

Other illness

• Participant has primary amyloidosis, active plasma cell leukaemia at time of screening, Waldenstrom macroglobulinemia or POEMS syndrome.
• Participant has any other significant medical condition which, in the opinion of the investigator, places the participant at an unacceptable risk for treatment-related complications, could interfere with the successful or safe delivery of therapy, or could interfere with evaluation of study intervention or interpretation of participant safety or study results.

Other

• Participants who required the introduction of an additional agent due to inadequate response.

• Participant must be at least 18 years, at the time of signing the ICF.
• ECOG performance status score of 0 or 1.
• Participant must be eligible for treatment with high-dose melphalan (200 mg/m²) followed by ASCT.
• Participant must have adequate organ and bone marrow function (as detailed in CSP Table 9).
• Participant must have documented measurable disease at diagnosis, as defined by any of the following: (a) Serum M-protein level ≥ 1.0 g/dL (b) Urine M-protein level ≥ 200 mg/24 hour (c) Serum Ig FLC ≥ 10 mg/dL (100 mg/L) and abnormal serum Ig kappa lambda FLC ratio.
• Participant must have documented diagnosis of NDMM, per IMWG diagnostic criteria, and must have completed 4 to 6 cycles of approved induction therapy (anti-CD38+VRd, DVTd, DRd or VRd) prior to randomisation.
• Participant must have at least SD or better per IMWG 2016 after completion of induction, and prior to randomisation.