CELL INTELLIGENCE · 肿瘤细胞治疗研究

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抗生素使用对接受 CAR-T 治疗的复发/难治性多发性骨髓瘤患者结局的影响

英文原题：The impact of antibiotic use on outcomes of relapsed/refractory multiple myeloma patients treated with CAR-T therapy.

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The impact of antibiotic use on outcomes of relapsed/refractory multiple myeloma patients treated with CAR-T therapy.

PubMed 2025/04/17（内容时间） Front Immunol Q1 · IF 7（JCR 2025）

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技术：CAR-T多发性骨髓瘤地区：中国
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研究概要

我们的结果表明，ATB 对 CAR-T 细胞治疗的治疗结局具有不利影响。

中文摘要

背景

近年来，嵌合抗原受体（CAR）T细胞疗法在复发/难治性多发性骨髓瘤（R/R MM）中取得了显著疗效。然而，抗生素（ATB）使用对接受CAR-T 治疗的R/R MM患者的影响尚不明确。本研究旨在分析ATB对接受CAR-T 细胞治疗的R/R MM患者临床结局的影响。

方法

本回顾性研究纳入中国两家医院2018年1月至2023年12月接受CAR-T 细胞治疗的199例R/R MM患者。根据治疗前4周内是否使用ATB，将患者分为ATB组和未使用ATB组。主要分析两组患者CAR-T 细胞治疗的疗效、生存结局及细胞毒性。

结果

ATB组（90例）的总缓解率（ORR）为70%，与未使用ATB组（109例）的81.7%相比差异未达统计学显著性（P=0.054）。ATB组完全缓解率（CRR）为40%，显著低于未使用ATB组的57.8%（P=0.012）。ATB组中位无进展生存期（PFS）为6.7个月，中位总生存期（OS）为21.9个月；未使用ATB组分别为13.9个月和36.1个月。两组PFS（P=0.007）和OS（P=0.004）存在显著差异。然而，多变量分析显示，ATB使用并未降低CRR（比值比[OR]，0.947；95%置信区间[CI]，0.251–3.565；P=0.936）。此外，ATB给药未影响接受CAR-T 治疗的R/R MM患者的PFS（风险比[HR]，0.634；95% CI，0.28–1.436；P=0.275）或OS（HR，2.259；95% CI，0.755–6.762；P=0.145）。两组患者细胞因子释放综合征（CRS）和免疫效应细胞相关神经毒性综合征（ICANS）的发生率也相近。

结论

研究结果提示ATB可能对CAR-T 细胞治疗结局产生不利影响，但ATB使用与CRS或ICANS发生率无关。

展开英文摘要原文
BACKGROUND

In recent years, chimeric antigen receptor (CAR)-T cell therapy has achieved tremendous efficacy in relapsed/refractory multiple myeloma (R/R MM). However, the impact of antibiotic (ATB) use on R/R MM patients treated with CAR-T is still not known. The aim of our study was to analyse the influence of ATB on the clinical outcomes of R/R MM patients treated with CAR-T cells.

METHODS

In this retrospective study, 199 patients with R/R MM who received CAR-T cells between January 2018 and December 2023 were evaluated from two hospitals in China. They were stratified into ATB-group and No ATB-group according to whether ATB was administered in the 4 weeks before therapy. We mainly analyzed the efficacy, survival outcomes and cytotoxicity of CAR-T cell therapy in two groups of patients. RESULT: In the ATB group (90 patients), the overall response rate (ORR) was 70% comparable to the No ATB group (109 patients: ORR, 81.7%; P = 0.054). The complete response rate (CRR) was 40%, which was significantly lower compared with No ATB group (CRR, 57.8%; P = 0.012). The median progression-free survival (PFS) was 6.7 months while the median overall survival (OS) was 21.9 months for the ATB group. The median PFS and OS for the No ATB group were 13.9 months and 36.1 months. There were significant differences in PFS ( P = 0.007) and OS ( P = 0.004) between the evaluated groups. Nonetheless, multivariate analysis found ATB use did not reduce the CRR (odds ratio [OR], 0.947; 95% confidence interval [CI], 0.251 to 3.565, P = 0.936). Besides, administration of ATB did not affect the PFS (hazard ratio [HR], 0.634; 95% CI, 0.28 to 1.436, P = 0.275) and OS (HR, 2.259; 95% CI, 0.755 to 6.762, P = 0.145) in R/R MM patients treated with CAR-T cells. Additionally, both groups of patients had similar incidences of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).

CONCLUSION

Our results point to a detrimental effect of ATB on treatment outcomes to CAR-T cell therapy. However, the use of ATB is not associated with the incidence of CRS or ICANS.

论文信息

作者
Yin L、Lv B、Ge J、Qi Y、Xia J、Ma S、Wang Y、Liu Y
单位
Blood Diseases Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.China
期刊
Frontiers in immunology2025
原文标识
PubMed 40313953　·　DOI 10.3389/fimmu.2025.1566016

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