Table 5.

Cases of MG induced by combination of ICI therapy

Study	Publish year	Age	Gender	Immune checkpoint inhibitors (ICI)	Cancer type and stage	Anti-AChR Ab	Anti-MuSK/anti-striated muscle Ab	Previous history of MG	Time between initiation of treatment (Rx) and onset of symptoms	Initial symptoms	Severe respiratory failure requiring intubation	Initial treatment	MG-related outcome
Loochtan et al67	2015	70	M	Nivolumab+ipilimumab	Small cell lung cancer (SCLC) stage	Positive	Positive	No	16 days	Ptosis and diplopia	Yes	Prednisone and plasmapheresis	Comfort care
Chen et al52	2017	57	M	Nivolumab+ipilimumab	Non-small cell lung cancer (NSCLC)	Positive	Unknown	No	14 days	Drooping of eyelids, dropped head, limb weakness, unsteadiness in walking and mild dyspnoea	No	Prednisolone and pyridostigmine	Improved from MG but died from sepsis in the same hospitalisation
Werner et al68	2019	62	M	Nivolumab+ipilimumab	Melanoma (clark-level III)	Negative	Negative	No	28 days	Fatigue and ptosis of right eye	No	Pyridostigmine+high-dose glucocorticoids	Improved
Fazel et al54	2019	78	F	Nivolumab+ipilimumab	Metastatic melanoma	Unknown	Positive	No	5 days	Diplopia, proximal muscle weakness and myalgia	Yes (refused by the patient)	Methylprednisolone+ Intravenous immune globulin (IVIG)	Inpatient hospice
Leaver et al69	2020	55	M	Nivolumab+ipilimumab	Metastatic melanoma	Negative	Negative	No	28 days	Blurred vision, mild bilateral ptosis and fatigable left arm abduction	No	Prednisolone	Improved
Antonia et al55	2016			Durvaluma+tremelimumab	Advanced NSCLC	Unknown	Unknown	Unknown	14 days	Unknown	Unknown	Unknown	Died
Yousef et al36		65	F	Durvalumab+tremelimumab	Liomyosarcoma stage IV with lung metastasis	Positive	Positive	No	After the first dose	Back pain and stooped posture with difficulty lifting her head	No	Plasma exchange+ Intravenous immune globulin (IVIG) + prednisone	Improved

Ab, antibody; AChR, acetylcholine receptor; MG, myasthenia gravis; MuSK, muscle-specific kinase.