{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:27:31Z","timestamp":1787509651066,"version":"build-2736575974"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Myocarditis associated with immune checkpoint inhibitors is a rare but potentially fatal immune-related adverse event. Esophageal cancer patients with myasthenia gravis, who are recommended to receive radiotherapy combined with immunotherapy, are at risk for ICI-related myocarditis. We report a 69-year-old male esophageal cancer patient with myasthenia gravis who was diagnosed with immune checkpoint inhibitor related myocarditis after receiving radiotherapy combined with immunotherapy. The patient\u2019s laboratory test results showed elevated troponin and N-terminal pro-B-type natriuretic peptide. Electrocardiography revealed arrhythmia and complete left bundle branch block. Despite treatment with methylprednisolone, the patient\u2019s condition was severe, and clinical and auxiliary examination symptoms continued to deteriorate, leading to his unfortunate demise. In this case, the adverse event of myocarditis induced by radiotherapy combined with immunotherapy in oncology patients with myasthenia gravis is an area that requires further investigation. Clinicians must carefully weigh the potential benefits and risks when considering this combined treatment approach and closely monitor patients for adverse events.<\/jats:p>","DOI":"10.3389\/fonc.2025.1652084","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T05:24:04Z","timestamp":1767331444000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Immune checkpoint inhibitor-associated myocarditis in an esophageal cancer patient with myasthenia gravis following combined radiotherapy and immunotherapy"],"prefix":"10.3389","volume":"15","author":[{"given":"Xue","family":"Ren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Defu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14161794","article-title":"Myocarditis, myositis, and myasthenia gravis overlap syndrome associated with immune checkpoint inhibitors: a systematic review","volume":"14","author":"Lipe","year":"2024","journal-title":"Diagn (Basel)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1038\/s41698-021-00223-x","article-title":"Real-world data analyses unveiled the immune-related adverse effects of immune checkpoint inhibitors across cancer types","volume":"5","author":"Wang","year":"2021","journal-title":"NPJ Precis Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13931","article-title":"Immune checkpoint inhibitor-induced myocarditis with myositis\/myasthenia gravis overlap syndrome: a systematic review of cases","volume":"26","author":"Pathak","year":"2021","journal-title":"Oncologist"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.6439","article-title":"Association of radiation therapy with risk of adverse events in patients receiving immunotherapy: a pooled analysis of trials in the US Food and Drug Administration database","volume":"8","author":"Anscher","year":"2022","journal-title":"JAMA Oncol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e2242","DOI":"10.1002\/brb3.2242","article-title":"A systematic review of myasthenia gravis complicated with myocarditis","volume":"11","author":"Cheng","year":"2021","journal-title":"Brain Behav"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13468","article-title":"Immunotherapy choice and maintenance for generalized myasthenia gravis in China","volume":"26","author":"Zhang","year":"2020","journal-title":"CNS Neurosci Ther"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30608-9","article-title":"Cardiovascular toxicities associated with immune checkpoint inhibitors: an observational, retrospective, pharmacovigilance study","volume":"19","author":"Salem","year":"2018","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.0362","article-title":"Myositis and neuromuscular side-effects induced by immune checkpoint inhibitors","volume":"5","author":"Moreira","year":"2019","journal-title":"JAMA Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.03.005","article-title":"Immune checkpoint inhibitor-associated myasthenia gravis, myositis, and myocarditis overlap syndrome","volume":"46","author":"Lipe","year":"2021","journal-title":"Am J Emerg Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s40674-023-00212-0","article-title":"Treatment of myositis associated with immune checkpoint inhibitors","volume":"9","author":"Matas-Garc\u00eda","year":"2023","journal-title":"Curr Treat Options Rheumatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-024-02574-4","article-title":"Endomyocardial biopsy in patients with myocarditis-still justified in the CMR era? A single-centre experience","author":"Seuthe","year":"2024","journal-title":"Clin Res Cardiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1186\/s12967-024-05751-1","article-title":"Efficacy and safety of immunosuppressants and monoclonal antibodies in adults with myasthenia gravis: a systematic review and network meta-analysis","volume":"22","author":"Gu","year":"2024","journal-title":"J Transl Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf315","article-title":"Myasthenia gravis and adverse events from immune checkpoint inhibitors: an international pharmacovigilance study","volume":"42","author":"Sobrino","year":"2024","journal-title":"Eur Heart J"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.746853","article-title":"Biological bases of immune-related adverse events and potential crosslinks with immunogenic effects of radiation","volume":"12","author":"Bardoscia","year":"2021","journal-title":"Front Pharmacol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2020.109821","article-title":"Cancer immunotherapy: Pros, cons and beyond","volume":"124","author":"Tan","year":"2020","journal-title":"BioMed Pharmacother"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1101\/2024.06.02.24308336","article-title":"Predictors and risk score for immune checkpoint-inhibitor-associated myocarditis severity","author":"Power","year":"2024","journal-title":"medRxiv"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2015.02.007","article-title":"Discovery of new biomarkers of idiopathic inflammatory myopathy","volume":"444","author":"Lu","year":"2015","journal-title":"Clin Chim Acta"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1652084\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T05:24:05Z","timestamp":1767331445000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1652084\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,2]]},"references-count":17,"alternative-id":["10.3389\/fonc.2025.1652084"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1652084","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,2]]},"article-number":"1652084"}}