Abstract
Cancer patients treated with immune checkpoint inhibitors (ICIs) are known to be at risk for developing immune-related adverse events (irAEs). Myositis, which is characterized by muscle weakness, elevated serum muscle enzyme levels, and inflammatory muscle biopsies, occurs in approximately 0.5% of those treated with ICIs. Those treated with multiple ICIs are at an especially increased risk of developing myositis. Unlike spontaneously occurring myositis patients, those with ICI-induced disease may have ptosis and oculomotor muscle weakness, instead of or in addition to a proximal pattern of muscle weakness. Muscle biopsies from these patients reveal abundant CD4+ and CD8+ T cells. Importantly, as many as 25% of these patients may have co-existing myasthenia gravis and/or myocarditis. Although optimal treatment strategies remain to be defined, corticosteroids with or without other immunomodulating therapies are often effective.
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Funding
 This work was supported by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health.
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Mammen, A.L. (2021). Myositis. In: Suarez-Almazor, M.E., Calabrese, L.H. (eds) Rheumatic Diseases and Syndromes Induced by Cancer Immunotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-56824-5_6
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DOI: https://doi.org/10.1007/978-3-030-56824-5_6
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