Immune checkpoint inhibitor-associated myositis and myasthenia gravis overlap: Understanding the diversity in a case series

Evelyn Yi Ting Wong; Ming Hui Yong; Kok Pin Yong; Eng Huat Tan; Chee Keong Toh; Ravindran Kanesvaran; Angela Takano; Quan Sing Ng

doi:10.1111/ajco.13442

Immune checkpoint inhibitor-associated myositis and myasthenia gravis overlap: Understanding the diversity in a case series

Asia Pac J Clin Oncol. 2021 Oct;17(5):e262-e267. doi: 10.1111/ajco.13442. Epub 2020 Sep 27.

Authors

Evelyn Yi Ting Wong¹, Ming Hui Yong², Kok Pin Yong², Eng Huat Tan¹, Chee Keong Toh¹, Ravindran Kanesvaran¹, Angela Takano³, Quan Sing Ng¹

Affiliations

¹ Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
² Department of Neurology, National Neuroscience Institute - Singapore General Hospital Campus, Singapore.
³ Department of Anatomical Pathology, Singapore General Hospital, Singapore.

PMID: 32985078
DOI: 10.1111/ajco.13442

Abstract

Immune checkpoint inhibitors (ICI) have improved survival across tumor types however they cause immune-related toxicities through removal of the inhibition of auto-reactive T cells. In this case review, we present 4 patients with metastatic cancer who developed de-novo neuromuscular side effects of myositis with overlapping seropositive myasthenia gravis after ICI treatment. Declaration: This study was performed in accordance to the ethical standards set by the SingHealth Institutional Review Board, with consent taken from living patients and waiver of consent from deceased patients (CIRB Ref 2019/2485). Supporting data were collected from our institution's digital medical records system.

Publication types

Case Reports

MeSH terms

Antineoplastic Agents, Immunological* / adverse effects
Humans
Immune Checkpoint Inhibitors
Myasthenia Gravis* / chemically induced
Myositis* / chemically induced
Neoplasms* / drug therapy

Substances

Antineoplastic Agents, Immunological
Immune Checkpoint Inhibitors