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The third-generation thalidomide analogue for myeloma that has failed lenalidomide, and since 2020 the first new drug for Kaposi sarcoma in two decades.
Pomalidomide, the third-generation thalidomide analogue, binds cereblon to trigger degradation of IKZF1 and IKZF3, giving direct anti-myeloma, immunostimulatory and anti-angiogenic effects that persist after lenalidomide failure. MM-003 (2013) showed an overall survival benefit versus high-dose dexamethasone in refractory myeloma, and US and EU approval followed in 2013 after at least two therapies including lenalidomide and a proteasome inhibitor. It anchors triplets such as isatuximab-Pd (ICARIA), elotuzumab-Pd and daratumumab-Pd (APOLLO). In 2020 it was approved for Kaposi sarcoma, both AIDS-related after antiretroviral failure and HIV-negative, on a 71% response rate, the first new Kaposi drug in two decades. Neutropenia and thrombosis risk need monitoring. Pomalidomide is the immunomodulator that keeps working after lenalidomide stops.
Binds cereblon to induce degradation of IKZF1/3, with direct anti-myeloma, immunomodulatory and anti-angiogenic effects; active after lenalidomide failure. Connects to IKZF1 (Ikaros) and IKZF3 (Aiolos).
1.Pomalidomide binds IKZF1 (Ikaros) with one end and an E3 ubiquitin ligase with the other.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Pomalyst was selected for Medicare price negotiation in January 2025; the negotiated maximum fair price takes effect 1 January 2027. REMS-restricted dispensing.
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap) · CMS: Medicare Drug Price Negotiation Program. Not medical or financial advice; verify with your plan.
Sources: NICE TA427 · SMC advice: pomalidomide. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Date | Deal | Type | Upfront | Total | Source |
|---|---|---|---|---|---|
| 2019-01-03 | Celgene to Bristol Myers Squibb Revlimid, Pomalyst, bb2121 (Abecma), liso-cel (Breyanzi) and the Celgene pipeline | Acquisition | not disclosed | $74bn (plus a contingent value right) | source |
Multiple myeloma after at least 2 prior therapies including lenalidomide and bortezomib and disease progression on or within 60 days of completion of the last therapy
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
Multiple myeloma after at least 2 prior therapies including lenalidomide and bortezomib and disease progression on or within 60 days of completion of the last therapy
Confirmed: the accelerated approval of 2013 converted to traditional approval 2.2 years after it was granted.
Treatment of patients with AIDS-related Kaposi’s Sarcoma after failure of highly active antiretroviral therapy (HAART).
Accelerated approval on a surrogate endpoint; the confirmatory requirement was still open 6.3 years later, when the FDA's table was read.
Treatment of Kaposi’s Sarcoma in patients who are HIV-negative
Accelerated approval on a surrogate endpoint; the confirmatory requirement was still open 6.3 years later, when the FDA's table was read.
| Region | Year | Indication |
|---|---|---|
| US | 2013 | Multiple myeloma after ≥2 therapies including lenalidomide and a proteasome inhibitor |
| US | 2020 | Kaposi sarcoma (AIDS-related after ART failure; HIV-negative) |
| EU | 2013 | Relapsed/refractory multiple myeloma |
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Query for this drug: (TITLE:"Pomalidomide" OR ABSTRACT:"Pomalidomide" OR TITLE:"Pomalyst" OR ABSTRACT:"Pomalyst" OR TITLE:"Imnovid" OR ABSTRACT:"Imnovid") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Pomalidomide, not a curated reading list.
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