ReviewSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2023
Improved outcomes with early immunosuppression in patients with immune-checkpoint inhibitor induced myasthenia gravis, myocarditis and myositis: a case series.
Review in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- 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
- Triple-M syndrome after immune checkpoint inhibitors: a systematic review of cases-early recognition is critical to survival.Frontiers in neurology · 2026Pooled it
- Immune checkpoint inhibitor-induced myocarditis with myositis and/or myasthenia gravis overlap syndrome: A case series.Experimental and therapeutic medicine · 2026Article
- Triple M Syndrome Associated With Concurrent Durvalumab and Olaparib Therapy in Metastatic Cholangiocarcinoma: A Case Report.Case reports in oncological medicine · 2026Article
- Case Report and literature review: immune checkpoint inhibitor-associated myasthenia gravis and myocarditis.Frontiers in cardiovascular medicine · 2026Article
- Immune Checkpoint Inhibitor-Associated Myocarditis With Myositis/Myasthenia Gravis Overlap Syndrome: Two Case Reports Highlighting Early Onset, Diagnostic Uncertainty, and Management Considerations.Clinical case reports · 2026Article
- Pharmacovigilance Insights Into Immune Checkpoint Inhibitor-Induced Risk of Paraneoplastic Syndrome: A Large-Scale Real World Study.CNS neuroscience & therapeutics · 2026Article
- Neurological immune-related adverse events with checkpoint inhibitor therapy: challenges for the neurologist.Journal of neurology, neurosurgery, and psychiatry · 2025Review
- Clinicopathological profiling and prognosis of idiopathic inflammatory myopathy overlapping with myasthenia gravis: a retrospective cohort study.Journal of neurology · 2025Article
- Efgartigimod therapy for immune checkpoint inhibitor-associated myasthenia gravis with myositis: a case report.BMC neurology · 2025Article
- Immune checkpoint inhibitor-related myasthenia gravis, myocarditis and myositis: further insights.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Pembrolizumab-induced myocarditis, myositis, and myasthenia gravis overlap syndrome (IM3OS) treated with Efgartigimod: case report.Immunotherapy · 2025Article
- Immune checkpoint inhibitor-associated myocarditis: a historical and comprehensive review.American journal of physiology. Heart and circulatory physiology · 2025Review
- Features of myositis and myasthenia gravis in patients treated with immune checkpoint inhibitors: a multicentric, retrospective cohort study.The Lancet regional health. Europe · 2025Article
- Case Report: Fatal myocarditis and myasthenia gravis induced by immune checkpoint inhibitors: concurrent dual adverse events in an older adult.Frontiers in oncology · 2025Article
- Management of immune-related myocarditis, myositis and myasthenia gravis (MMM) overlap syndrome: a single institution case series and literature review.Frontiers in immunology · 2025Review
- Modeling immune checkpoint inhibitor associated myocarditisJournal of molecular and cellular cardiology plus · 2024Article
- Myasthenia gravis and myocarditis induced by chemoimmunotherapy in locally advanced gastric cancer: A case report.Experimental and therapeutic medicine · 2024Article
- Clinical Issue of Myasthenia Gravis Related to Immune Checkpoint Inhibitors.Current oncology reports · 2024Review
- Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome Associated with Immune Checkpoint Inhibitors: A Systematic Review.Diagnostics (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMyasthenia gravis (MG) is a rare but life-threatening complication of immune-checkpoint inhibitor (ICI) therapy and often co-presents with myositis and myocarditis. Previous case series of ICI-related MG have reported high mortality rates. We present a series of ten patients from a tertiary oncology centre outlining outcomes of an early multi-modal immunosuppression strategy.
methodsWe reviewed The Christie Hospital database of immunotherapy-related toxicity from 2017 to 2020. Symptom severity was assessed using the Myasthenia Gravis Foundation of America (MGFA) classification.
resultsTen patients with ICI-related MG were identified. All patients presented following 1 (n = 4) or 2 (n = 6) cycles of ICI. Symptom progression was rapid with a median of 3 days from onset of symptoms to admission. Concomitant myositis and myocarditis were observed in nine patients. AChR or MuSK autoantibodies were positive in six patients. All patients received urgent treatment with intravenous methylprednisolone (IVMP) and eight received intravenous immunoglobulin (IVIG). A single patient died from myasthenia-related symptoms; the remaining 9 patients were successfully discharged.
conclusionIn our cohort, we demonstrate good outcomes associated with early intensive immunosuppressive treatment with IVIG and IVMP. An agreed national treatment protocol or clinical discussion forum would be beneficial.
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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.