{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:41:04Z","timestamp":1776692464847,"version":"3.51.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Glucocorticoids (GCs) are often used to treat cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). The effects of GCs on the efficacy of CAR-T cell treatment in relapsed\/refractory multiple myeloma (RRMM) have not been fully established. We evaluated the impact of GCs on clinical outcomes of RRMM patients treated with CAR-T cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study involved RRMM patients treated with CAR-T cells at our center between June 2017 and December 2020. Patients were stratified into GC-used group (GC-group) and non-GC-used group (NGC-group). CRS or ICANS was graded on the basis of the American Society of Transplantation and Cellular Therapy consensus grading system. Response status was evaluated by the IMWG Uniform Response Criteria. The duration of response (DOR), progression-free survival (PFS), and overall survival (OS) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 71 patients were included in this study. In the NGC group (40 patients), 34 (85%) had responses to CAR-T cell therapy, including 16 (40%) stringent complete response (sCR), seven (17.5%) complete response (CR), five (12.5%) very good partial response (VGPR), and six (15%) partial response (PR). The overall response rate (ORR) and complete response rate (CRR) in the NGC group were 85% and 57.5%. In the GC group (31 patients), 29 (93.5%) had responses, including 11 (35.5%) sCR, nine (29%) CR, two (6.4%) VGPR, and seven (22.6%) PR. Differences in ORR and CRR between the two groups were insignificant. The dose, duration, and timing of GCs did not affect ORR and CRR. At a median follow-up of 28.2 months, the median PFS was 20.4 months (95% CI, 7.9 to 32.9) while the median OS was 36.6 months (95% CI, 25.9 to 47.2) for the GC group. The median PFS and OS for the NGC group were 13.7 months (95% CI, 8.8 to 18.6) and 27.5 months (95% CI, 14.1 to 41.0). There were no significant differences in either PFS or OS between the GC group and the NGC group. Differences in median DOR for the patients with CR or better in the GC group and NGC group were not significant (<jats:italic>p<\/jats:italic> = 0.17). Earlier, prolonged use and high dose of GCs were not associated with any effects on either PFS or OS. Additionally, GCs had no effects on CAR-T cell proliferation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Administration of GCs, dose, timing, and duration does not influence the clinical efficacy of CAR-T cells in RRMM in this study.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.943004","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T04:49:30Z","timestamp":1661230170000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of glucocorticoids on short-term and long-term outcomes in patients with relapsed\/refractory multiple myeloma treated with CAR-T therapy"],"prefix":"10.3389","volume":"13","author":[{"given":"Xue","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuekun","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hujun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunming","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiling","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenyu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kailin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00933-8","article-title":"Ciltacabtagene autoleucel, a b-cell maturation antigen-directed chimeric antigen receptor T-cell therapy in patients with relapsed or refractory multiple myeloma (Cartitude-1): A phase 1b\/2 open-label study","volume":"398","author":"Berdeja","year":"2021","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.77.8084","article-title":"T Cells genetically modified to express an anti-B-Cell maturation antigen chimeric antigen receptor cause remissions of poor-prognosis relapsed multiple myeloma","volume":"36","author":"Brudno","year":"2018","journal-title":"J Clin Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/ctm2.346","article-title":"A phase I study of anti-bcma car T cell therapy in Relapsed\/Refractory multiple myeloma and plasma cell leukemia","volume":"11","author":"Li","year":"2021","journal-title":"Clin Transl Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2024850","article-title":"Idecabtagene vicleucel in relapsed and refractory multiple myeloma","volume":"384","author":"Munshi","year":"2021","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1186\/s13045-020-01001-1","article-title":"Safety and clinical efficacy of bcma car-T-Cell therapy in multiple myeloma","volume":"13","author":"Roex","year":"2020","journal-title":"J Hematol Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008936","article-title":"A phase 1 study of a novel fully human bcma-targeting car (Ct103a) in patients with Relapsed\/Refractory multiple myeloma","volume":"137","author":"Wang","year":"2021","journal-title":"Blood"},{"key":"B7","doi-asserted-by":"publisher","first-page":"5192","DOI":"10.3390\/ijms21155192","article-title":"B-Cell maturation antigen (BCMA) as a target for new drug development in relapsed and\/or refractory multiple myeloma","volume":"21","author":"Abramson","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B8","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/nrclinonc.2017.148","article-title":"Chimeric antigen receptor T-cell therapy - assessment and management of toxicities","volume":"15","author":"Neelapu","year":"2018","journal-title":"Nat Rev Clin Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.annonc.2020.10.478","article-title":"Side-effect management of chimeric antigen receptor (Car) T-cell therapy","volume":"32","author":"Schubert","year":"2021","journal-title":"Ann Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-05-846428","article-title":"Improved cns exposure to tocilizumab after cerebrospinal fluid compared to intravenous administration in rhesus macaques","volume":"132","author":"Nellan","year":"2018","journal-title":"Blood"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-02-769208","article-title":"Intent-to-Treat leukemia remission by Cd19 car T cells of defined formulation and dose in children and young adults","volume":"129","author":"Gardner","year":"2017","journal-title":"Blood"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008865","article-title":"Prognostic impact of corticosteroids on efficacy of chimeric antigen receptor T-cell therapy in Large b-cell lymphoma","volume":"137","author":"Strati","year":"2021","journal-title":"Blood"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25108","article-title":"Potent anti-leukemia activities of humanized Cd19-targeted chimeric antigen receptor T (Car-T) cells in patients with Relapsed\/Refractory acute lymphoblastic leukemia","volume":"93","author":"Cao","year":"2018","journal-title":"Am J Hematol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(19)30115-2","article-title":"A combination of humanised anti-Cd19 and anti-bcma car T cells in patients with relapsed or refractory multiple myeloma: A single-arm, phase 2 trial","volume":"6","author":"Yan","year":"2019","journal-title":"Lancet Haematol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.758","article-title":"Astct consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells","volume":"25","author":"Lee","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30206-6","article-title":"International myeloma working group consensus criteria for response and minimal residual disease assessment in multiple myeloma","volume":"17","author":"Kumar","year":"2016","journal-title":"Lancet Oncol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/0022-1759(93)90273-a","article-title":"Purification of antibodies using protein l-binding framework structures in the light chain variable domain","volume":"164","author":"Nilson","year":"1993","journal-title":"J Immunol Methods"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5876-10-29","article-title":"Protein l: A novel reagent for the detection of chimeric antigen receptor (Car) expression by flow cytometry","volume":"10","author":"Zheng","year":"2012","journal-title":"J Transl Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707447","article-title":"Axicabtagene ciloleucel car T-cell therapy in refractory Large b-cell lymphoma","volume":"377","author":"Neelapu","year":"2017","journal-title":"N Engl J Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/s41408-020-0280-y","article-title":"Corticosteroids do not influence the efficacy and kinetics of car-T cells for b-cell acute lymphoblastic leukemia","volume":"10","author":"Liu","year":"2020","journal-title":"Blood Cancer J"},{"key":"B21","doi-asserted-by":"publisher","first-page":"224ra25","DOI":"10.1126\/scitranslmed.3008226","article-title":"Efficacy and toxicity management of 19-28z car T cell therapy in b cell acute lymphoblastic leukemia","volume":"6","author":"Davila","year":"2014","journal-title":"Sci Transl Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25951","article-title":"Commercial anti-Cd19 car T cell therapy for patients with Relapsed\/Refractory aggressive b cell lymphoma in a European center","volume":"95","author":"Sesques","year":"2020","journal-title":"Am J Hematol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02104","article-title":"Standard-of-Care axicabtagene ciloleucel for relapsed or refractory Large b-cell lymphoma: Results from the us lymphoma car T consortium","volume":"38","author":"Nastoupil","year":"2020","journal-title":"J Clin Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaa183","article-title":"Immune effector cell-associated neurotoxicity syndrome after chimeric antigen receptor T-cell therapy for lymphoma: Predictive biomarkers and clinical outcomes","volume":"23","author":"Holtzman","year":"2021","journal-title":"Neuro Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019001463","article-title":"Preemptive mitigation of Cd19 car T-cell cytokine release syndrome without attenuation of antileukemic efficacy","volume":"134","author":"Gardner","year":"2019","journal-title":"Blood"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17673","article-title":"Earlier corticosteroid use for adverse event management in patients receiving axicabtagene ciloleucel for Large b-cell lymphoma","volume":"195","author":"Topp","year":"2021","journal-title":"Br J Haematol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17527","article-title":"Prophylactic corticosteroid use in patients receiving axicabtagene ciloleucel for Large b-cell lymphoma","volume":"194","author":"Oluwole","year":"2021","journal-title":"Br J Haematol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.08023.x","article-title":"Impact of dexamethasone responsiveness on long term outcome in patients with newly diagnosed multiple myeloma","volume":"148","author":"Sinha","year":"2010","journal-title":"Br J Haematol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.943004\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T04:49:33Z","timestamp":1661230173000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.943004\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":28,"alternative-id":["10.3389\/fimmu.2022.943004"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2022.943004","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,23]]},"article-number":"943004"}}