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Pomalidomide + cyclophosphamide + prednisone is a combination regimen used primarily in the treatment of relapsed or refractory multiple myeloma. Pomalidomide is a third-generation immunomodulatory drug (IMiD) that exerts anti-myeloma effects through multiple mechanisms, including direct tumoricidal activity, inhibition of angiogenesis, and modulation of the immune microenvironment. Cyclophosphamide is an alkylating agent that interferes with DNA replication and transcription, leading to cell death. Prednisone is a synthetic glucocorticoid with anti-inflammatory and immunosuppressive properties that also induces apoptosis in certain hematologic malignancies. This combination has demonstrated efficacy in patients who have failed prior therapies such as lenalidomide and bortezomib, with overall response rates around 50% reported in clinical trials[1][2][7]. The regimen’s main toxicities include cytopenias (notably neutropenia), infections, thromboembolic events, and steroid-related side effects.
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