Ixazomib Plus Low-dose Lenalidomide Versus Ixazomib Alone for Maintenance Treatment of High Risk Multiple Myeloma

This study is comparing two maintenance therapy strategies for patients with high-risk multiple myeloma (a blood cancer) after they have finished initial treatment: ixazomib alone (an oral chemotherapy pill) versus ixazomib combined with low-dose lenalidomide. The goal is to delay or prevent the cancer from coming back in patients with specific high-risk genetic features. **You may be eligible if...** - You have confirmed multiple myeloma with high-risk genetic features (specific chromosomal changes like del17p, 1q21 amplification, or translocations t(4;14), t(14;16), or t(14;20)) - You have completed induction and consolidation therapy (including stem cell transplant if eligible) - You are willing to start maintenance therapy - You are between 18 and 80 years old with adequate organ function **You may NOT be eligible if...** - You have significant kidney, liver, or heart function problems (beyond what multiple myeloma has caused) - You are pregnant or breastfeeding - You are unable to follow the study protocol as judged by your doctor Talk to your doctor to see if this trial is right for you.