{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:40:49Z","timestamp":1787506849212,"version":"build-2736575974"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,12]]},"DOI":"10.7759\/cureus.112508","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:39:21Z","timestamp":1783903161000},"source":"Crossref","is-referenced-by-count":1,"title":["Rapidly Progressive Triple M Overlap Syndrome After Immune Checkpoint Inhibitor Therapy"],"prefix":"10.7759","author":[{"given":"Seth","family":"Garrett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anam","family":"Ansari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sruthi","family":"Siddada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shobana","family":"Sankar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amita","family":"Bishnoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Meysami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sufiya","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aar4060","article-title":"Cancer immunotherapy using checkpoint blockade","volume":"359","author":"Ribas A","year":"2018","unstructured":"Ribas A, Wolchok JD. Cancer immunotherapy using checkpoint blockade. Science. 2018, 359:1350-5. 10.1126\/science.aar4060","journal-title":"Science"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2022-006500","article-title":"Chronic immune-related adverse events in patients with cancer receiving immune checkpoint inhibitors: a systematic review","volume":"11","author":"Barron CC","year":"2023","unstructured":"Barron CC, Stefanova I, Cha Y, Elsolh K, Zereshkian A, Gaafour N, McWhirter E. Chronic immune-related adverse events in patients with cancer receiving immune checkpoint inhibitors: a systematic review. J Immunother Cancer. 2023, 11:e006500. 10.1136\/jitc-2022-006500","journal-title":"J Immunother Cancer"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.2643","article-title":"Triple M overlap syndrome (TMOS): evaluating immune checkpoint inhibitor-related overlap syndrome of myocarditis, myositis, and myasthenia gravis using an international pharmacovigilance database","volume":"42","author":"Naqash AR","year":"2024","unstructured":"Naqash AR, Abushukair HM, Alghamdi E, et al.. Triple M overlap syndrome (TMOS): evaluating immune checkpoint inhibitor-related overlap syndrome of myocarditis, myositis, and myasthenia gravis using an international pharmacovigilance database. J Clin Oncol. 2024, 42:2643. 10.1200\/JCO.2024.42.16_suppl.2643","journal-title":"J Clin Oncol"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1130438","article-title":"Advances in immune checkpoint inhibitors induced-cardiotoxicity","volume":"14","author":"Li X","year":"2023","unstructured":"Li X, Peng W, Wu J, Yeung SJ, Yang R. Advances in immune checkpoint inhibitors induced-cardiotoxicity. Front Immunol. 2023, 14:1130438. 10.3389\/fimmu.2023.1130438","journal-title":"Front Immunol"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00369-1","article-title":"Neurological adverse events of immune checkpoint inhibitors and the development of paraneoplastic neurological syndromes","volume":"23","author":"Farina A","year":"2024","unstructured":"Farina A, Villagr\u00e1n-Garc\u00eda M, Vogrig A, et al.. Neurological adverse events of immune checkpoint inhibitors and the development of paraneoplastic neurological syndromes. Lancet Neurol. 2024, 23:81-94. 10.1016\/S1474-4422(23)00369-1","journal-title":"Lancet Neurol"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/art.41604","article-title":"Inflammatory myositis in cancer patients receiving immune checkpoint inhibitors","volume":"73","author":"Aldrich J","year":"2021","unstructured":"Aldrich J, Pundole X, Tummala S, et al.. Inflammatory myositis in cancer patients receiving immune checkpoint inhibitors. Arthritis Rheumatol. 2021, 73:866-74. 10.1002\/art.41604","journal-title":"Arthritis Rheumatol"},{"key":"ref7","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 R","year":"2021","unstructured":"Pathak R, Katel A, Massarelli E, Villaflor VM, Sun V, Salgia R. Immune checkpoint inhibitor-induced myocarditis with myositis\/myasthenia gravis overlap syndrome: a systematic review of cases. Oncologist. 2021, 26:1052-61. 10.1002\/onco.13931","journal-title":"Oncologist"},{"key":"ref8","unstructured":"National Comprehensive Cancer Network. Management of immune checkpoint inhibitors-related toxicities. NCCN Clinical Practice Guidelines in Oncology. (2025). Accessed. March 9, 2026: https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=3&amp;id=1548."},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000210031","article-title":"Immune checkpoint inhibitor myopathy. The double-edged sword of cancer immunotherapy","volume":"103","author":"Beecher G","year":"2024","unstructured":"Beecher G, Pinal-Fernandez I, Mammen AL, Liewluck T. Immune checkpoint inhibitor myopathy. The double-edged sword of cancer immunotherapy. Neurology. 2024, 103:e210031. 10.1212\/WNL.0000000000210031","journal-title":"Neurology"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000218081","article-title":"Comparative study of sporadic and immune checkpoint inhibitor-related forms of myasthenia gravis-myositis overlap syndrome","volume":"106","author":"Lauletta A","year":"2026","unstructured":"Lauletta A, Rossini E, Beretta F, et al.. Comparative study of sporadic and immune checkpoint inhibitor-related forms of myasthenia gravis-myositis overlap syndrome. Neurology. 2026, 106:e218081. 10.1212\/WNL.0000000000218081","journal-title":"Neurology"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2024.3065","article-title":"Immune checkpoint inhibitor-induced cardiotoxicity: a systematic review and meta-analysis","volume":"10","author":"Nielsen DL","year":"2024","unstructured":"Nielsen DL, Juhl CB, Nielsen OH, Chen IM, Herrmann J. Immune checkpoint inhibitor-induced cardiotoxicity: a systematic review and meta-analysis. JAMA Oncol. 2024, 10:1390-9. 10.1001\/jamaoncol.2024.3065","journal-title":"JAMA Oncol"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035716","article-title":"Lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma","volume":"384","author":"Motzer R","year":"2021","unstructured":"Motzer R, Alekseev B, Rha SY, et al.. Lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma. N Engl J Med. 2021, 384:1289-300. 10.1056\/NEJMoa2035716","journal-title":"N Engl J Med"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.8772-21","article-title":"Nivolumab-induced myositis and myocarditis with positive anti-titin antibody and anti-voltage-gated potassium channel Kv1.4 antibody","volume":"61","author":"Ono R","year":"2022","unstructured":"Ono R, Iwai Y, Yamazaki T, Takahashi H, Hori Y, Fukushima K, Saotome T. Nivolumab-induced myositis and myocarditis with positive anti-titin antibody and anti-voltage-gated potassium channel Kv1.4 antibody. Intern Med. 2022, 61:2973-9. 10.2169\/internalmedicine.8772-21","journal-title":"Intern Med"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.037","article-title":"Myocarditis in patients treated with immune checkpoint inhibitors","volume":"71","author":"Mahmood SS","year":"2018","unstructured":"Mahmood SS, Fradley MG, Cohen JV, et al.. Myocarditis in patients treated with immune checkpoint inhibitors. J Am Coll Cardiol. 2018, 71:1755-64. 10.1016\/j.jacc.2018.02.037","journal-title":"J Am Coll Cardiol"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1402225","article-title":"Inflammatory muscle diseases","volume":"372","author":"Dalakas MC","year":"2015","unstructured":"Dalakas MC. Inflammatory muscle diseases. N Engl J Med. 2015, 372:1734-47. 10.1056\/NEJMra1402225","journal-title":"N Engl J Med"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis. Executive summary","volume":"87","author":"Sanders DB","year":"2016","unstructured":"Sanders DB, Wolfe GI, Benatar M, et al.. International consensus guidance for management of myasthenia gravis. Executive summary. Neurology. 2016, 87:419-25. 10.1212\/WNL.0000000000002790","journal-title":"Neurology"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1901677","article-title":"Abatacept for severe immune checkpoint inhibitor-associated myocarditis","volume":"380","author":"Salem JE","year":"2019","unstructured":"Salem JE, Allenbach Y, Vozy A, Brechot N, Johnson DB, Moslehi JJ, Kerneis M. Abatacept for severe immune checkpoint inhibitor-associated myocarditis. N Engl J Med. 2019, 380:2377-9. 10.1056\/NEJMc1901677","journal-title":"N Engl J Med"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2022-004699","article-title":"Reversal of immune-checkpoint inhibitor fulminant myocarditis using personalized-dose-adjusted abatacept and ruxolitinib: proof of concept","volume":"10","author":"Nguyen LS","year":"2022","unstructured":"Nguyen LS, Bretagne M, Arrondeau J, et al.. Reversal of immune-checkpoint inhibitor fulminant myocarditis using personalized-dose-adjusted abatacept and ruxolitinib: proof of concept. J Immunother Cancer. 2022, 10:e004699. 10.1136\/jitc-2022-004699","journal-title":"J Immunother Cancer"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-22-1180","article-title":"Abatacept\/ruxolitinib and screening for concomitant respiratory muscle failure to mitigate fatality of immune-checkpoint inhibitor myocarditis","volume":"13","author":"Salem JE","year":"2023","unstructured":"Salem JE, Bretagne M, Abbar B, et al.. Abatacept\/ruxolitinib and screening for concomitant respiratory muscle failure to mitigate fatality of immune-checkpoint inhibitor myocarditis. Cancer Discov. 2023, 13:1100-15. 10.1158\/2159-8290.CD-22-1180","journal-title":"Cancer Discov"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2024.12.005","article-title":"Abatacept dose-finding phase II triaL for immune checkpoint inhibitors myocarditis (ACHLYS) trial design","volume":"118","author":"Salem JE","year":"2025","unstructured":"Salem JE, Ederhy S, Belin L, et al.. Abatacept dose-finding phase II triaL for immune checkpoint inhibitors myocarditis (ACHLYS) trial design. Arch Cardiovasc Dis. 2025, 118:106-15. 10.1016\/j.acvd.2024.12.005","journal-title":"Arch Cardiovasc Dis"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2025.10.018","article-title":"Diagnosis and management of cardiovascular adverse effects of targeted oncology therapies: Bruton\u2019s tyrosine kinase, immune checkpoint, and vascular endothelial growth factor inhibitors: 2025 ACC concise clinical guidance: a report of the American College of Cardiology Solution Set Oversight Committee","volume":"87","author":"Ganatra S","year":"2026","unstructured":"Ganatra S, Barac A, Armenian S, et al.. Diagnosis and management of cardiovascular adverse effects of targeted oncology therapies: Bruton\u2019s tyrosine kinase, immune checkpoint, and vascular endothelial growth factor inhibitors: 2025 ACC concise clinical guidance: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2026, 87:654-82. 10.1016\/j.jacc.2025.10.018","journal-title":"J Am Coll Cardiol"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13562","article-title":"Rituximab in myasthenia gravis: a \"to be or not to be\" inhibitor of T cell function","volume":"1413","author":"Marino M","year":"2018","unstructured":"Marino M, Bartoccioni E, Alboini PE, Evoli A. Rituximab in myasthenia gravis: a \"to be or not to be\" inhibitor of T cell function. Ann N Y Acad Sci. 2018, 1413:41-8. 10.1111\/nyas.13562","journal-title":"Ann N Y Acad Sci"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-026-04325-y","article-title":"Rituximab for severe immune checkpoint inhibitor-related adverse events: a multicenter case series","volume":"75","author":"Hermabessiere S","year":"2026","unstructured":"Hermabessiere S, Jauzelon B, Marmain S, et al.. Rituximab for severe immune checkpoint inhibitor-related adverse events: a multicenter case series. Cancer Immunol Immunother. 2026, 75:76. 10.1007\/s00262-026-04325-y","journal-title":"Cancer Immunol Immunother"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1097\/CAD.0000000000001727","article-title":"Nivolumab- and ipilimumab-induced myositis, myasthenia gravis, and myocarditis in a patient with metastatic melanoma","volume":"36","author":"Inan B","year":"2025","unstructured":"Inan B, Duzgun U, Ergul-Ulger Z, Bekircan-Kurt CE, Ceylan BN, Karadas O, Odabasi Z. Nivolumab- and ipilimumab-induced myositis, myasthenia gravis, and myocarditis in a patient with metastatic melanoma. Anticancer Drugs. 2025, 36:600-5. 10.1097\/CAD.0000000000001727","journal-title":"Anticancer Drugs"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2025.43.16_suppl.12118","article-title":"Immune profiling to identify predictive biomarkers and highlights the potential efficacy of IL-6R blockade in checkpoint inhibitor-related myocarditis","volume":"43","author":"Obeid M","year":"2025","unstructured":"Obeid M, Boughdad S, Daoudlarian D, et al.. Immune profiling to identify predictive biomarkers and highlights the potential efficacy of IL-6R blockade in checkpoint inhibitor-related myocarditis. J Clin Oncol. 2025, 43:12118. 10.1200\/JCO.2025.43.16_suppl.12118","journal-title":"J Clin Oncol"},{"key":"ref26","unstructured":"U.S. Food and Drug Administration. LENVIMA (lenvatinib) prescribing information. (2024). Accessed. June 10, 2026: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2021\/206947s020lbl.pdf."}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/496973-rapidly-progressive-triple-m-overlap-syndrome-after-immune-checkpoint-inhibitor-therapy","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:39:22Z","timestamp":1783903162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/496973-rapidly-progressive-triple-m-overlap-syndrome-after-immune-checkpoint-inhibitor-therapy"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,12]]},"references-count":26,"URL":"https:\/\/doi.org\/10.7759\/cureus.112508","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,12]]}}}