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Notably, he demonstrated an excellent radiological response to systemic therapy. This case highlights the need for vigilance for severe neuromuscular and cardiac immune-related adverse events, the importance of prompt multidisciplinary management, and the clinical paradox of balancing cancer control with life-threatening toxicity.<\/jats:p>","DOI":"10.1136\/bcr-2025-270266","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:05:18Z","timestamp":1772255118000},"page":"e270266","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Triple M syndrome (myasthenia gravis, myocarditis and myositis) following atezolizumab in small cell lung carcinoma"],"prefix":"10.1136","volume":"19","author":[{"given":"Jenna","family":"Williams","sequence":"first","affiliation":[{"name":"Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Simela","sequence":"additional","affiliation":[{"name":"Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"},{"name":"Leeds Institute of Medical Research, University of Leeds, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4262-5143","authenticated-orcid":false,"given":"Divyalakshmi","family":"Bhaskaran","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research, University of Leeds, Leeds, UK"},{"name":"York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022721050976000_19.2.e270266.1","doi-asserted-by":"crossref","first-page":"1126582","DOI":"10.3389\/fimmu.2023.1126582","article-title":"Progress in the clinical application of immune checkpoint inhibitors in small cell lung cancer","volume":"14","author":"He","year":"2023","journal-title":"Front Immunol"},{"key":"2026022721050976000_19.2.e270266.2","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2024.1398667","article-title":"Immune-related adverse events in small-cell lung cancer patients treated with immune checkpoint inhibitors: a comprehensive analysis from the FDA adverse event reporting system","volume":"15","author":"Bai","year":"2024","journal-title":"Front Pharmacol"},{"key":"2026022721050976000_19.2.e270266.3","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.013757","article-title":"Immune Checkpoint Inhibitor Myocarditis: Pathophysiological Characteristics, Diagnosis, and Treatment","volume":"9","author":"Palaskas","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2026022721050976000_19.2.e270266.4","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2021-002890","article-title":"Consensus disease definitions for neurologic immune-related adverse events of immune checkpoint inhibitors","volume":"9","author":"Guidon","year":"2021","journal-title":"J Immunother Cancer"},{"key":"2026022721050976000_19.2.e270266.5","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2025.1597259","article-title":"Management of immune-related myocarditis, myositis and myasthenia gravis (MMM) overlap syndrome: a single institution case series and literature review","volume":"16","author":"S\u00e1nchez-Camacho","year":"2025","journal-title":"Front Immunol"},{"key":"2026022721050976000_19.2.e270266.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.10.001"},{"key":"2026022721050976000_19.2.e270266.7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01440"},{"key":"2026022721050976000_19.2.e270266.8","doi-asserted-by":"crossref","unstructured":"Frey C , Etminan M . n.d. 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