The Horizon Two: HR NDMM (MMRC-100) study is for patients with newly diagnosed multiple myeloma, a type of blood cancer. This study tests new treatments in a flexible way to find the best options. Participants must be at least 18 years old and have high-risk myeloma, which means a greater chance of the disease getting worse. They need to be in good health otherwise and cannot have more than two cycles of previous treatment. The study will last for 5 years, including treatment and follow-up.

• Participants are randomly assigned to different treatment groups and may receive innovative therapies.
• Participants must visit the study center regularly for treatment and check-ups.
• It's important to be willing to follow the study's instructions and use birth control if needed.

Before joining, participants need to sign a consent form, showing they understand and agree to the study. Some people cannot join, like those with certain health problems or who are pregnant. This study helps researchers learn more about treating high-risk myeloma effectively.