SynthesisThe oncologist2021
Immune Checkpoint Inhibitor-Induced Myocarditis with Myositis/Myasthenia Gravis Overlap Syndrome: A Systematic Review of Cases.
Synthesis in The oncologist, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 148 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
148 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Cardiovascular Immune-Related Adverse Events of Immune Checkpoint Inhibitors: A Systematic Review and Meta-Summary of Case Reports.Cancer reports (Hoboken, N.J.) · 2026Pooled it
- Successful rescue therapy with eculizumab for probable tislelizumab-related MMM overlap syndrome with dual positivity for anti-acetylcholine receptor and anti-titin antibodies: a case report and literature review.Frontiers in immunology · 2026Pooled it
- Immune checkpoint inhibitor-related myositis, myocarditis, and myasthenia gravis overlap syndrome: a systematic review and pooled analysis of individual cases.Frontiers in immunology · 2026Pooled it
- Exploring the role of immune checkpoint inhibitors in the etiology of myasthenia gravis and Lambert-Eaton myasthenic syndrome: A systematic review.Frontiers in neurology · 2022Pooled it
- Incidence and Distinct Features of Immune Checkpoint Inhibitor-Related Myositis From Idiopathic Inflammatory Myositis: A Single-Center Experience With Systematic Literature Review and Meta-Analysis.Frontiers in immunology · 2021Pooled it
- Immune checkpoint inhibitor-induced myocarditis with myositis and/or myasthenia gravis overlap syndrome: A case series.Experimental and therapeutic medicine · 2026Article
- Immune checkpoint blockade reshapes drug-associated toxicity: a pharmacovigilance atlas of drug-ICI interactions.medRxiv : the preprint server for health sciences · 2026Article
- Systemic Melanoma Therapy in Patients with Pre-Existing Heart Failure: An HF-Centered Decision Framework and Critical Narrative Review.Journal of clinical medicine · 2026Review
- Review
- Immune Checkpoint Inhibitor-Related Myositis and Associated Triad Overlap Syndrome.Arthritis care & research · 2026Article
- Immune checkpoint inhibitors in thymic epithelial tumors: current evidence, immune-related toxicity, and perioperative considerations-a narrative review.Journal of thoracic disease · 2026Review
- Triple M Overlap Syndrome After Immune Checkpoint Inhibitors: A Case Series of a High-Mortality Phenotype.JACC. Case reports · 2026Article
- Reversible complete atrioventricular block in immune checkpoint inhibitor-associated triple-M overlap syndrome: a case report.European heart journal. Case reports · 2026Article
- Immune checkpoint inhibitors-related Overlap Syndrome: can a second course of intravenous immunoglobulin help?Acta neurologica Belgica · 2026Article
- Single-Dose Nivolumab as a Trigger of Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome With Late Cardiac Death Despite Initial Recovery: A Case Report.The American journal of case reports · 2026Article
- Article
- Neoadjuvant BO-112 and Hypofractionated Radiation Therapy with or without Nivolumab in Soft-Tissue Sarcoma: Preclinical and Phase I Results.Cancer discovery · 2026Article
- Rapidly Progressive Triple M Overlap Syndrome After Immune Checkpoint Inhibitor Therapy.Cureus · 2026Article
- Severe Immune-Related Neurological Adverse Events Associated With Immune Checkpoint Inhibitor Treatment: A Retrospective Single-Center Study.European journal of neurology · 2026Article
- Article
88 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe development of immune checkpoint inhibitors (ICIs) represents a paradigm shift in the treatment of cancers. Despite showing remarkable efficacy, these agents can be associated with life-threatening immune-related adverse events. In recent years, several cases of myocarditis with myositis and/or myasthenia gravis overlap syndrome (IM3OS) have been reported. However, given the rarity, the clinical features and outcomes of these cases remain poorly understood. We, therefore, attempted to systematically review and summarize all cases of IM3OS reported in the literature. MATERIALS AND
methodsStudies reporting IM3OS were identified in Embase and MEDLINE. Only case reports and case series published in journals or presented at conferences were included. We conducted a systematic review according to the PRISMA Harms guidelines.
resultsA total of 60 cases were eligible. The patients' median age was 71 years, and the majority (67%) were males; melanoma was the most common indication for ICIs (38%). The most-reported symptoms were fatigue (80%) and muscle weakness (78%). The median number of doses to the development of IM3OS was one. The average creatine kinase level was 9,645 IU/L. Cardiac arrhythmias occurred in 67% of patients, and 18% had depressed ejection fraction. Initial treatment consisted of immunosuppression with high-dose steroids and supportive therapies. Sixty percent of the patients died in hospital because of acute complications.
conclusionIM3OS can be associated with significant mortality and morbidity. Prospective studies are needed to understand the optimal approach to diagnose and manage these patients and to develop biomarkers to predict the occurrence and severity of this rare but serious condition. IMPLICATIONS FOR PRACTICE: Clinicians should suspect coexisting myositis and/or myasthenia gravis in all patients with immune checkpoint inhibitor-induced myocarditis, given their propensity to occur together. Early recognition and prompt treatment with the help of a multidisciplinary team might help improve the outcomes of this life-threatening condition.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.