A Study of Oral Ixazomib Maintenance Therapy in Participants With Newly Diagnosed Multiple Myeloma (NDMM) Not Treated With Stem Cell Transplantation (SCT)

The drug being tested in this study is called ixazomib citrate. Ixazomib citrate is being
tested to slow PD and improve overall survival in people who have NDMM who have had a major
positive response to initial therapy and have not undergone SCT. This study will look at the
effect of ixazomib citrate has on the length of time that participants are free of PD and
their overall survival.

The study will enroll approximately 700 participants. Participants will be randomly assigned
(by chance, like flipping a coin) to one of the two treatment groups-which will remain
undisclosed to the participant and study doctor during the study (unless there is an urgent
medical need):

- Ixazomib citrate 3 mg

- Placebo (dummy inactive pill) - this is a capsule that looks like the study drug but has
no active ingredient

All participants will be asked to take one capsule on Days 1, 8 and 15 of each 28-day cycle,
for up to 26 cycles.

This multi-center trial will be conducted worldwide. The overall time to participate in this
study is approximately 76 to 104 months. Participants will make 28 visits to the clinic
during the treatment period and will continue to make follow-up visits every 4 weeks until
the next line of therapy begins. Participants will also be contacted by telephone every 12
weeks after last treatment visit for a follow-up assessment.

Inclusion Criteria:

1. Adult male or female participants 18 years or older with a confirmed diagnosis of
symptomatic NDMM according to standard criteria.

2. Completed 6 to 12 months (+- 2 weeks) of initial therapy, during which the participant
was treated to best response, defined as the best response maintained for 2 cycles
after the M-protein nadir is reached.

3. Documented major response (PR, VGPR, CR) according to the IMWG uniform response
criteria, version 2011, after this initial therapy.

4. Female participants who:

- Are postmenopausal for at least 1 year before the screening visit, OR

- Are surgically sterile, OR

- If they are of childbearing potential, agree to practice 2 effective methods of
contraception, at the same time, from the time of signing the informed consent
through 90 days after the last dose of study drug, OR

- Agree to practice true abstinence, when this is in line with the preferred and
usual lifestyle of the participant. (Periodic abstinence (eg, calendar,
ovulation, symptothermal, postovulation methods] and withdrawal are not
acceptable methods of contraception.)

Male participants, even if surgically sterilized (that is, status postvasectomy), who:

- Agree to practice effective barrier contraception during the entire study
Treatment period and through 90 days after the last dose of study drug, OR

- Agree to practice true abstinence, when this is in line with the preferred and
usual lifestyle of the participant. (Periodic abstinence [example, calendar,
ovulation, symptothermal, postovulation methods for the female partner] and
withdrawal are not acceptable methods of contraception.)

5. Voluntary written consent must be given before performance of any study-related
procedure not part of standard medical care, with the understanding that consent may
be withdrawn by the participant at any time without prejudice to future medical care.

6. Complete documentation of the details of the initial therapy before randomization
including cytogenetics and International Staging System (ISS) is available.

7. Eastern Cooperative Oncology Group Performance Status of 0 to 2.

8. Suitable venous access for the study-required blood sampling and consent for the
specific amounts that will be taken.

9. Is willing and able to adhere to the study visit schedule and other protocol
requirements including blood sampling and bone marrow aspiration.

10. Must meet the following clinical laboratory criteria at study entry:

- Absolute neutrophil count (ANC) greater than or equal to (>=) 1,000 per cubic
millimeter (/mm^3) without growth factor support and platelet count >=
75,000/mm^3. Platelet transfusions to help participants meet eligibility criteria
are not allowed within 3 days before randomization.

- Total bilirubin less than or equal to (<=) 1.5*the upper limit of the normal
range (ULN).

- Alanine aminotransferase and aspartate aminotransferase <= 3*ULN.

- Calculated creatinine clearance >= 30 milliliter per minute (mL/min) (using the
Cockcroft-Gault equation).

Exclusion Criteria:

1. Multiple myeloma that has relapsed after, or was not responsive to, initial therapy.

2. Prior SCT.

3. Radiotherapy within 14 days before randomization.

4. Diagnosed or treated for another malignancy within 5 years before randomization or
previous diagnosis with another malignancy. Participants with nonmelanoma skin cancer
or carcinoma in situ of any type are not excluded if they have undergone complete
resection.

5. Female participants who are lactating and breastfeeding or have a positive serum
pregnancy test during the Screening period.

6. Major surgery within 14 days before randomization.

7. Central nervous system involvement.

8. Infection requiring intravenous (IV) antibiotic therapy or other serious infection
within 14 days before randomization.

9. Diagnosis of Waldenstrom's macroglobulinemia, polyneuropathy, organomegaly,
endocrinopathy, monoclonal gammopathy, and skin changes syndrome (POEMS), plasma cell
leukemia, primary amyloidosis, myelodysplastic syndrome, or myeloproliferative
syndrome.

10. Evidence of current uncontrolled cardiovascular conditions, including uncontrolled
hypertension, uncontrolled cardiac arrhythmias, uncontrolled congestive heart failure,
unstable angina, or myocardial infarction within the past 6 months.

11. Systemic treatment with strong cytochrome P450 3A (CYP3A) inducers (rifampin,
rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital) or use of Ginkgo
biloba or St. John's wort within 14 days before randomization.

12. Ongoing or active infection, known human immunodeficiency virus (HIV) positive, active
hepatitis B or C infection.

13. Comorbid systemic illnesses or other severe concurrent disease that, in the judgment
of the investigator, would make the participant inappropriate for entry into this
study or interfere significantly with the proper assessment of safety and toxicity of
the prescribed regimens (example, PN that is Grade 1 with pain or Grade 2 or higher of
any cause).

14. Psychiatric illness or social situation that would limit compliance with study
requirements.

15. Known allergy to any of the study medications, their analogues, or excipients in the
various formulations of any agent.

16. Inability to swallow oral medication, inability or unwillingness to comply with the
drug administration requirements, or gastrointestinal (GI) procedure that could
interfere with the oral absorption or tolerance of treatment.

17. Treatment with any investigational products within 30 days before randomization.