{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T19:40:31Z","timestamp":1786390831214,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pembrolizumab, an anti\u2010PD\u20101 immune checkpoint inhibitor, has transformed the treatment of multiple solid tumors. However, it can rarely cause immune\u2010related myositis, which may involve limb, bulbar, and respiratory muscles, posing a risk of severe morbidity and mortality. Early recognition and management are essential. We report two cases of pembrolizumab\u2010induced myositis diagnosed and treated at our institution. A literature search of MEDLINE\/PubMed was conducted to identify English\u2010language case reports, focusing on clinical presentation, diagnostics, management, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases<\/jats:title>\n                    <jats:p>The first case involved a 74\u2010year\u2010old woman with advanced lung adenocarcinoma who developed grade 4 myositis affecting limb and phonatory muscles; intravenous methylprednisolone combined with IVIG led to full recovery. The second case involved a 78\u2010year\u2010old woman with advanced endometrial carcinoma who developed grade 3 limb\u2010girdle myositis, successfully treated with oral prednisone. Literature review (11 case reports) indicated that most patients were older males with lung cancer, presenting with proximal muscle weakness and elevated CK. Bulbar or ocular involvement was linked to a higher risk of myocarditis and respiratory complications. Early corticosteroid therapy, with IVIG for severe cases, was consistently effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pembrolizumab\u2010induced myositis is a rare but potentially life\u2010threatening adverse event. Recognition of characteristic clinical features, prompt immunosuppressive therapy, and multidisciplinary care are critical for favorable outcomes. Additional studies are needed to establish standardized diagnostic criteria and optimal treatment protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70534","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:51:11Z","timestamp":1782287471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pembrolizumab\u2010Induced Myositis: Diagnostic and Therapeutic Challenges From Two Case Reports and a Narrative Review"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8475-719X","authenticated-orcid":false,"given":"Francesca","family":"Rifaldi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"},{"name":"Department of Oncology, Comprehensive Cancer Center IRCCS Policlinico San Matteo Foundation  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8928-785X","authenticated-orcid":false,"given":"Niccol\u00f2 Leandro","family":"Alessio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"},{"name":"Department of Oncology, Comprehensive Cancer Center IRCCS Policlinico San Matteo Foundation  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1139-5873","authenticated-orcid":false,"given":"Francesca","family":"Caspani","sequence":"additional","affiliation":[{"name":"Department of Oncology Sant' Anna Hospita, ASST Lariana  San Fermo della Battaglia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bolzacchini","sequence":"additional","affiliation":[{"name":"Oncology Unit ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Oncology Sant' Anna Hospita, ASST Lariana  San Fermo della Battaglia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Pedrazzoli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"},{"name":"Department of Oncology, Comprehensive Cancer Center IRCCS Policlinico San Matteo Foundation  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606774"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102586"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21093054"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.2217\/lmt\u20102018\u20100017"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.9153"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2022-251966"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.1222-22"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw655"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574886314666190528121039"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND-200504"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-019-1416-1"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41604"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.803410"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aar4060"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12865\u2010024\u201000599\u2010y"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609214"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2019.102455"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26640"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00002.2019"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12050987"},{"key":"e_1_2_13_22_1","first-page":"1145","article-title":"A Controlled Trial of Intravenous Immunoglobulin in the Treatment of Chronic Inflammatory Demyelinating Polyneuropathy","volume":"329","author":"Dalakas M. 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