Feasibility/Early Phase 1 iberdomide (CC-220) cereblon E3-ligase modulator primes T cells

This single-site feasibility study tests whether a 28-day “priming” cycle of iberdomide before leukapheresis can improve T-cell fitness and, downstream, CAR-T expansion kinetics in relapsed/refractory multiple myeloma patients already scheduled for standard-of-care CAR-T. Iberdomide is a cereblon E3-ligase modulator that promotes degradation of key lymphoid transcription factors such as Ikaros and Aiolos, with the potential to enhance immune-cell function. Participants take iberdomide 1.0 mg daily on days 1–21 of a 28-day cycle, then undergo leukapheresis and proceed to their planned commercial CAR-T therapy, with added immune profiling and monitoring of CAR-T expansion. Iberdomide itself is now FDA approved in combination with daratumumab and dexamethasone for previously treated multiple myeloma. Here, however, it is being used in a very different way: as a short “priming” treatment before leukapheresis, with the goal of improving the T cells collected to manufacture CAR-T. The study asks whether changing the quality of those starting T cells can improve subsequent CAR-T expansion and persistence without changing the CAR-T product itself.