用艾加莫德治疗的帕博利珠单抗诱导的心肌炎、肌炎和重症肌无力重叠综合征（IM3OS）：病例报告
Pembrolizumab-induced myocarditis, myositis, and myasthenia gravis overlap syndrome (IM3OS) treated with Efgartigimod: case report.
作者信息
Cobelas-Cartagena Stephanie S, Amigo-Otero Emilio, García-Samblas Victoria, Flores-Raposo Jesus, Rodrigo-Herrero Silvia, Bayo-Calero Juan
机构信息
Oncology Unit, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain.
Cardiology Unit, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain.
出版信息
Immunotherapy. 2025 Jun;17(8):561-566. doi: 10.1080/1750743X.2025.2517522. Epub 2025 Jun 13.
Abstract
The use of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of many malignancies. However, they may be associated with life-threatening immune-mediated adverse effects.In this article, we present the case of a patient diagnosed with stage IIB acral melanoma (pT4aN0M0) who started adjuvant treatment with pembrolizumab, after which he developed severe myocarditis with myositis and myasthenia gravis overlap syndrome (IM3OS) treated with Efgartigimod.The use of Efgartigimod resulted in a remarkable recovery, marking the first reported acute application of this agent for IM3OS and positive anti-acetylcholine receptor antibodies (anti-AChR).
摘要
免疫检查点抑制剂（ICIs）的使用彻底改变了许多恶性肿瘤的治疗方式。然而，它们可能会引发危及生命的免疫介导不良反应。在本文中，我们介绍了一名被诊断为IIB期肢端黑色素瘤（pT4aN0M0）的患者，该患者开始接受帕博利珠单抗辅助治疗，之后出现了严重心肌炎，并伴有肌炎和重症肌无力重叠综合征（IM3OS），随后接受了艾加莫德治疗。艾加莫德的使用带来了显著的康复效果，这标志着该药物首次被报道急性应用于IM3OS且抗乙酰胆碱受体抗体（抗AChR）呈阳性的情况。
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本文引用的文献
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Cureus. 2025 Jan 2;17(1):e76834. doi: 10.7759/cureus.76834. eCollection 2025 Jan.
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Post-hoc analyses from the ADAPT clinical study demonstrate aggregate sustained benefit of Efgartigimod in generalized myasthenia gravis.ADAPT 临床研究的事后分析显示，依库珠单抗在全身性重症肌无力中具有总体持续获益。
J Neurol Sci. 2024 Nov 15;466:123264. doi: 10.1016/j.jns.2024.123264. Epub 2024 Oct 4.
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