{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:13:30Z","timestamp":1788311610475,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100014188","name":"National Research Foundation of Korea grant funded by the Korea government","doi-asserted-by":"publisher","award":["RS-2025-00554796"],"award-info":[{"award-number":["RS-2025-00554796"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Bio & Medical Technology Development Program of the National Research Foundation of Korea, funded by the Ministry of Science and ICT","doi-asserted-by":"publisher","award":["RS-2025-02263016"],"award-info":[{"award-number":["RS-2025-02263016"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Future Medicine 2030 Project of Samsung Medical Center","award":["SMO126004"],"award-info":[{"award-number":["SMO126004"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuromuscular Diseases"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myasthenia gravis (MG) is commonly associated with thymic tumors and may be triggered or worsened by immune checkpoint inhibitors (ICIs). Although pembrolizumab (PEM) has shown efficacy in relapsed\/refractory thymic tumors, its relationship with MG in thymic tumor patients is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients with thymic tumors treated with PEM at a tertiary center (2016\u20132021) to assess the prevalence, timing, and clinical features of new-onset or exacerbated MG, along with immune-related adverse events (irAEs). Outcomes were compared with 714 thymic tumor patients not treated with ICIs (1993\u20132021), stratified by tumor type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 60 PEM-treated patients (mean age 50.4 years; 33% female), six (10%) developed new-onset (3\/60) or relapsed (3\/60) generalized MG which worsened after PEM administration. MG occurred in 42% of thymoma (5\/12) versus 2% of thymic carcinoma patients (1\/43; p = 0.001). All MG cases had other irAEs, most frequently myositis (n = 5) and myocarditis\/cardiomyopathy (n = 3). Despite improvement of MG with immunotherapy, three patients died from tumor progression or irAEs. Compared with non-PEM-treated thymoma patients, MG incidence was numerically higher but not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PEM-treated thymic tumor patients may develop or experience worsening MG, typically with severe symptoms and concurrent irAEs that affect prognosis. While a direct causal link between PEM and MG remains uncertain, careful monitoring is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/22143602261486591","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:20:59Z","timestamp":1788308459000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pembrolizumab-associated myasthenia gravis in thymic tumors: A single-center case series and comparative analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5578-7571","authenticated-orcid":false,"given":"Soonwook","family":"Kwon","sequence":"first","affiliation":[{"name":"Inha University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Ryun","family":"Park","sequence":"additional","affiliation":[{"name":"Dongguk University Ilsan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunjin","family":"Ju","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Seoul Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Hak","family":"Chung","sequence":"additional","affiliation":[{"name":"Korea University Guro Hospital"},{"name":"Korea University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Kyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Samsung Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se-Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Samsung Medical Center"},{"name":"Sungkyunkwan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Hong","family":"Min","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University"},{"name":"Samsung Medical 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