Phase 1 pomalidomide (IMiD cereblon modulator) to boost CD19 CAR‑T persistence

This single-center, single-arm Phase 1 pilot at University of Michigan Rogel Cancer Center evaluates whether short-course pomalidomide given after CD19-directed CAR‑T can safely improve CAR‑T expansion/persistence and clinical control in relapsed/refractory CD19+ B‑cell leukemias and lymphomas. Pomalidomide (Bristol Myers Squibb; marketed as Pomalyst/Imnovid) is an immunomodulatory drug that binds cereblon (CRBN) to drive degradation of transcription factors (notably Ikaros/Aiolos), enhancing T‑cell and NK‑cell function and altering cytokine signaling—mechanistically aligned with “tuning” the post–CAR‑T immune milieu. Patients receive oral pomalidomide once daily for 10 doses, with intensive blood sampling to track cellular kinetics and immune correlates alongside safety and preliminary efficacy readouts. The key scientific angle is using a well-known myeloma immunomodulator as a post-infusion “maintenance/augmentation” strategy for CAR‑T, where relapses are often linked to insufficient CAR‑T persistence or antigen escape. Today’s care after CD19 CAR‑T failure is limited and typically involves salvage chemo/immunochemotherapy, bispecific antibodies in some settings, clinical trials, and for select patients allogeneic transplant—so a simple oral, time-limited add-on could be commercially meaningful if it meaningfully extends CAR‑T durability.