A trial to understand if surovatamig (AZD0486) is safe and helps in people with Relapsed or Refractory B-cell acute lymphoblastic leukemia (B-ALL)

Prior treatment

• History or presence of clinically relevant CNS pathology such as epilepsy, seizure, paresis, aphasia, stroke, severe brain injuries, dementia, Parkinson’s disease, cerebellar disease, organic brain syndrome, or psychosis; or prior Grade 4 neurotoxicity with CAR-T or TCE therapy.
• Unresolved AEs >/= Grade 2, from prior therapies
• Prior therapy with ADCs within 3 weeks, TCEs within 4 weeks, CAR T-cell therapy or autologous HSCT within 8 weeks or prior alloSCT within 12 weeks of start of therapy.
• GVHD requiring immunosuppressive therapy within 3 weeks prior to AZD0486 treatment.

Other illness

• Isolated extramedullary disease relapse.
• History of other malignancy (with certain exceptions).

Other

• Active CNS involvement by B-ALL, defined by presence of ALL blasts in CSF (CNS2 and CNS3 criteria).
• Testicular leukemia
• The above is a summary, other exclusion criteria details may apply.

• Age: 12 years and above
• Participants with CD19+ B-cell Acute Lymphoblastic Leukemia by local lab with Bone marrow infiltration with >/= 5% blasts
• Participants with CD19+ B-cell Acute Lymphoblastic Leukemia by local lab with Either relapsed or refractory after a minimum of 2 prior therapies or after 1 prior line of therapy if no SOC available option (Parts A-C) or after 1 prior line of therapy (Part D).
• Participants with CD19+ B-cell Acute Lymphoblastic Leukemia by local lab with Philadelphia positive participants are allowed in All Parts if intolerant or refractory to TKIs.
• Eastern Cooperative Oncology Group (ECOG) Performance Status less than or equal to 2 OR Lansky score more or equal to 50%.
• The above is a summary, other inclusion criteria details may apply