A Fatal Case of Immune Checkpoint Inhibitor-Mediated Myasthenia Gravis, Myositis, and Cardiomyopathy Overlap Syndrome in Urothelial Carcinoma

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2024-07-23 DOI:10.1002/cnr2.2140

Matthew T. Newman, Mihir Bikhchandani

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Abstract

Background

Immune checkpoint inhibitors (ICIs) have led to improved outcomes for many cancer types. However, their use can also precipitate immune-related adverse events (irAEs) that can affect any organ system. While irAEs are often mild, they rarely affect multiple organ systems concurrently and can be fatal.

Case

We report a fatal case of myasthenia gravis, myositis, and cardiotoxicity overlap syndrome precipitated by the ICI pembrolizumab along with a brief review of available literature.

Conclusion

Early recognition of high grade irAEs and prompt intervention is essential. Despite the poor prognosis of these overlap syndromes, current recommendations offer little guidance for severe cases and warrant a call for increased awareness and expansion of available therapeutics.

Abstract Image

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免疫检查点抑制剂介导的尿道癌肌萎缩症、肌炎和心肌病重叠综合征致命病例

背景：免疫检查点抑制剂（ICIs）改善了许多癌症类型的治疗效果。然而，使用这些药物也可能引发免疫相关不良事件（irAEs），这些不良事件可能影响任何器官系统。虽然irAEs通常较轻，但它们很少会同时影响多个器官系统，而且可能是致命的：我们报告了一例由 ICI pembrolizumab 引发的肌无力、肌炎和心脏毒性重叠综合征的致命病例，并对现有文献进行了简要回顾：结论：早期识别高级别虹膜急性放射损伤并及时干预至关重要。尽管这些重叠综合征的预后较差，但目前的建议对严重病例几乎没有提供指导，因此需要提高人们的认识并扩大可用的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer reports Medicine-Oncology

CiteScore

2.70

自引率

5.90%

发文量

160

审稿时长

17 weeks