eligibility_summary
Adults >=18 with consent, ECOG 0-1, aggressive LBCL (DLBCL, PMBCL, transformed FL/MZL, HGBL, CNS allowed except primary), eligible for commercial anti-CD19 CAR-T as 2nd-4th line, biopsy, TMTV >80 mL on pre-CAR-T PET, CrCl >45 mL/min, AST/ALT <=3x ULN, bilirubin <=2 mg/dL, WOCBP: 2 contraception methods. Exclude: recent other cancers, uncontrolled infection, HIV/HBV/HCV, SaO2<92%, major cardiac disease/recent MI, severe allergy, strong CYP3A4/5 modulators, pregnancy, major comorbidity, legal restrictions.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Intervention: Golcadomide (BMS-986369, CC-99282), an oral CELMoD (cereblon E3-ligase–modulating immunomodulatory small molecule), dosed weekly for 6 months starting day +5 after anti-CD19 CAR T infusion. Mechanism: Binds cereblon (CRBN) to induce degradation of Ikaros/Aiolos (IKZF1/IKZF3). In tumor B cells this downregulates IRF4 and MYC, promoting apoptosis, in immune cells it enhances T-cell activation/proliferation and IL-2 production and increases NK-cell cytotoxicity, potentially sustaining/enhancing CAR T activity. Targets: CD19+ large B-cell lymphomas, T cells (including CAR T cells) and NK cells, CRBN–IKZF1/3 axis and downstream IRF4/MYC pathway.