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We present a rare case in which sequential administration of two PD\u22121 inhibitors (ICIs), Camrelizumab and Sintilimab, in combination with conventional chemotherapy led to ICI-related systemic sclerosis (ICI-SSc) with early-stage interstitial lung disease (ILD) and autoimmune thyroiditis (AIT). The clinical presentation also suggested a possible scleroderma overlap syndrome. The underlying pathology is likely linked to widespread immune activation following PD\u22121 pathway blockade. Early identification of ICI-SSc is crucial. Once the diagnosis is confirmed, the suspected drug should be discontinued immediately, and a personalized treatment plan should be initiated, ideally with consideration of the safety profile of steroid-based regimens. Furthermore, our findings raise important considerations regarding pharmacovigilance in the context of sequential ICIs use.<\/jats:p>","DOI":"10.3389\/fonc.2026.1776228","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:21:21Z","timestamp":1774243281000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["PD-1 inhibitor-induced systemic sclerosis with early interstitial lung disease and autoimmune thyroiditis in advanced gastric cancer: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Qi","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, China"]},{"name":"First Clinical Medical College, Nanjing University of Chinese Medicine","place":["Nanjing, 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