SynthesisNature medicine2023
Thymus alterations and susceptibility to immune checkpoint inhibitor myocarditis.
Synthesis in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 54 papers.
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.
The trial behind it
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
54 citing papers in PubMed, 67 citations in OpenAlex.
- Cardiac biomarkers in patients with renal cell carcinoma treated with immune checkpoint inhibitors.The oncologist · 2026Trial
- Global epidemiology of myocarditis: disparities in age, sex and geography.Nature reviews. Cardiology · 2026Review
- Immune checkpoint inhibitor-associated myocarditis: clinical and mechanistic insights.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026Review
- Thymic function as a central determinant of immune competence and clinical outcomes.Seminars in immunopathology · 2026Review
- Beyond β-Adrenergic Receptor Brake: Compartment-Selective GRK2 Programs from Heart Failure to Cardio-Oncology.Kinases and phosphatases · 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
- Inhibition of the programmed death protein 1 immune checkpoint and the development of heart failure in the presence of prior cardiac ischaemia.Cardiovascular research · 2026Article
- Review
- VigiBase: Resource Profile Update with a Summary of Global Patterns and Trends in Adverse Event Reports for Medicines and Vaccines.Drug safety · 2026Review
- Prospective serial cardiovascular magnetic resonance imaging of immune checkpoint inhibitor myocarditis correlates with cardiovascular outcomes.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2026Article
- Immune checkpoint inhibitor-related myocarditis in patients with thymic epithelial tumors: a retrospective cohort analysis.Cancer immunology, immunotherapy : CII · 2026Article
- Article
- CXCR6Circulation · 2026Article
- Immune checkpoint inhibitor myocarditis-a score to tell you more.European heart journal · 2026Article
- Immune checkpoint inhibitor-associated myocarditis: a novel risk score.European heart journal · 2026Article
- Immunotherapy Safety in Thymic Epithelial Tumors: Disproportionality Analysis of the Food and Drug Administration Adverse Event Reporting System.JMIR cancer · 2026Article
- Immune-related adverse events in patients with preexisting myasthenia gravis and thymoma following immune checkpoint inhibitor treatment: a retrospective, observational study.Frontiers in immunology · 2026Observational
- Immune checkpoint inhibitor-induced cardiotoxicity: from immune mechanisms to clinical surveillance and targeted therapies.Frontiers in cardiovascular medicine · 2026Review
- Understanding immune checkpoint inhibitors-related myocarditis: Mechanisms and targeted therapeutic pathways.Theranostics · 2026Review
- Validation of a novel semi-automated ECG quantification tool, applied to a cardio-oncology : Semi-automated ECG Tool applied to cardio-oncology.Cardio-oncology (London, England) · 2025Article
Corrections and comments
- Erratum issued
- Erratum issued
Authors and funding
35 authors at 20 institutions in 14 countries.
Funding
Abstract
Immune checkpoint inhibitors (ICI) have transformed the therapeutic landscape in oncology. However, ICI can induce uncommon life-threatening autoimmune T-cell-mediated myotoxicities, including myocarditis and myositis. The thymus plays a critical role in T cell maturation. Here we demonstrate that thymic alterations are associated with increased incidence and severity of ICI myotoxicities. First, using the international pharmacovigilance database VigiBase, the Assistance Publique Hôpitaux de Paris-Sorbonne University data warehouse (Paris, France) and a meta-analysis of clinical trials, we show that ICI treatment of thymic epithelial tumors (TET, and particularly thymoma) was more frequently associated with ICI myotoxicities than other ICI-treated cancers. Second, in an international ICI myocarditis registry, we established that myocarditis occurred earlier after ICI initiation in patients with TET (including active or prior history of TET) compared to other cancers and was more severe in terms of life-threatening arrythmias and concurrent myositis, leading to respiratory muscle failure and death. Lastly, we show that presence of anti-acetylcholine-receptor antibodies (a biological proxy of thymic-associated autoimmunity) was more prevalent in patients with ICI myocarditis than in ICI-treated control patients. Altogether, our results highlight that thymic alterations are associated with incidence and seriousness of ICI myotoxicities. Clinico-radio-biological workup evaluating the thymus may help in predicting ICI myotoxicities.
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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.