16 April 2026
: Case report 
Efgartigimod as Rescue Therapy for PD-1 Inhibitor–Associated Myasthenia Gravis, Myocarditis, and Myositis (MMM) Syndrome: A 2-Case Report and Literature Review
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Unexpected drug reaction, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Zi-Han Liu ABCDEF 1,2, Li-Min Duan ABCDEF 2, Xiang-Zhi Fang ABCDEF 2, Wen Jiang BCDF 2, Sheng-Wen Sun ABCE 2, You Shang
AF 1,2*, Chao-Lin Huang A 1, Yin Yuan AG 1,2
DOI: 10.12659/AJCR.951872
Am J Case Rep 2026; 27:e951872
Table 2 Basic information of 75 patients with immune-related MMM syndrome.
| Parameter | Classification | Value |
|---|---|---|
| Age | Years | 68.88±12.43 |
| Sex | Male | 50 (66.67%) |
| Female | 25 (33.33%) | |
| Malignancy | Melanoma | 29 (38.67%) |
| Urological cancer | 15 (20.00%) | |
| Lung cancer | 11 (14.67%) | |
| Gastrointestinal tumors | 8 (10.67%) | |
| Thymoma | 6 (8.00%) | |
| Other | 6 (8.00%) | |
| History of autoimmune disease | Yes | 3 (4.00%) |
| No | 32 (42.67%) | |
| Not reported | 40 (53.33%) | |
| Thymectomy | Yes | 7 (9.33%) |
| ICI therapy | Monotherapy (PD-1/PD-L1 or CTLA-4 or LAG-3 inhibitor) | 58 (77.33%) |
| Combination | 17 (22.67%) | |
| Cumulative number of cycles | 1 | 44 (58.67%) |
| 2 | 23 (30.67%) | |
| 3 or more | 5 (6.67%) | |
| Not reported | 3 (4.00%) | |
| Symptoms onset time (weeks) | 0–2 | 8 (10.67%) |
| 2–4 | 34 (45.33%) | |
| ≥4 | 17 (22.67%) | |
| Not reported | 16 (21.33%) | |
| Concomitant anti-tumor therapy | Chemotherapy | 18 (52.94%) |
| Radiotherapy | 9 (26.47%) | |
| Tyrosine kinase inhibitor | 4 (11.76%) | |
| Vascular endothelial growth factor inhibitor | 3 (8.82%) | |
| MMM – myasthenia gravis, myocarditis, and myositis; ICI – immune checkpoint inhibitors; CTLA-4 – cytotoxic T-lymphocyte-associated protein 4; LAG-3 – lymphocyte activation gene-3; PD-1 – programmed cell death protein 1; PD-L1 – programmed death ligand 1. | ||