Good. I switched from Revlimid to Pomalyst and was on it for over a year. It did a good job cleaning the abnormal MM plasma cells from by body and bone marrow. I got off of revlimid due to severe rashes. Pomalyst is in the same family class as Revlimid but was developed to have less side effects and is generally considered about 10 times more potent on a cellular and molecular level than Revlimid (lenalidomide), (and roughly 100 times more potent than original thalidomide.). The capsules come in 4 standard dosage strengths: 1 mg, 2 mg, 3 mg, and 4 mg. I started at 4mg and tapered down to 2mg and I got off it because it causes fatigue like Revlimid and my blood work was clean.

Revlimid and Pomalyst are very similar drugs and act on the cancer the same way. My oncologist has a good analogy. He said the drug does not kill the weeds in the garden. It poisons the soil it grows in. So it will cause non cancerous cells to die. Especially WBC. And RBC, neutrophils. I also had a drop in my immunoglobulins.
So your immune system will be compromised. I started at 4mg for about 4 months. Then 3mg for 6 months. Then 2mg for 8 months. The idea is to still get a good response with as little drug as possible.
I responded very well. It was supposed to be bridge therapy before Car-T but it dropped my numbers so well I stayed on it for 18 months. After that, I relapsed. Mine was combined with Empliciti and a huge dose of Dex. On my third Empliciti/Dex infusion I had a terrible allergic reaction to the Dex and actually hallucinated for 2 days. No more Dex for me.
Pomalyst can be rough. Diarrhea, some pretty bad Edema (swelling) in the feet, fluid in the lungs (probably upper respiratory infection), 1 case of covid and a few other flu infections.

There is a brand new treatment/drug called Zenbexus (Iberdomide) which is a CELMod that acts in a similar manner as Revlimid/Pomalyst as it bonds to cereblon and squeezes them into death. It also boosts the immune system, increases T cells and activates them in the killing process. The clinical trial showed very high response rates and and amazing 41% MRD- response. Using MRD testing significantly shortened the time for FDA approval. It is also a 21 day on, 7 day off pill.

I do not know where it falls in the line of treatments. Right now it is approved for use after just 1 refractory event.

Another bullet in the gun to keep fighting back.

Thanks for the share. I appreciate you.