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We report a case of an 80\u2010year\u2010old female with metastatic cholangiocarcinoma, presenting with progressive asthenia, ptosis and dysphagia, following completion of six cycles of combination chemotherapy and immunotherapy, durvalumab. Her symptoms emerged 2 weeks after the commencement of maintenance therapy with immune checkpoint inhibitor, durvalumab, and poly(ADP\u2010ribose) polymerase inhibitor, olaparib. Biochemical investigations were suspicious for myocarditis, myositis and type 2 respiratory failure due to myasthenic crisis. Clinical findings supported the diagnosis of triple M syndrome, and she was treated with high\u2010dose steroids, intravenous immunoglobulin and supported with non\u2010invasive ventilation. The patient initially improved; however, her admission was complicated by a fatal retroperitoneal haemorrhage. Our case highlights the need to consider serious immune\u2010related adverse events and escalate prompt management for overlap syndromes in the context of immunotherapy and poly(ADP\u2010ribose) polymerase inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT06441747<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crom\/1318038","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:24:41Z","timestamp":1782127481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Triple M Syndrome Associated With Concurrent Durvalumab and Olaparib Therapy in Metastatic Cholangiocarcinoma: A Case 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