CRCardiovascular Reviews3083-48802981-8109Bio-Byword Scientific Publishing Pty. Ltd.10.26689/cr.v2i4.9357ArticleAnalysis of a Case of Immune-Related Myocarditis Combined with Myasthenia Gravis and Liver Injury Induced by Tislelizumab https://artdesignp.com/journal/CR/2/4/10.26689/cr.v2i4.9357XuHongyan,HanRubing,ZhaoYunjie,ZhengMeicun,ZhangXia2025242025-01-13Immune checkpoint inhibitors (ICIs) have demonstrated significant advantages and potential in tumor immunotherapy, but immune-related adverse events (irAEs) are becoming increasingly important safety issues. This article analyzes and discusses a case of a patient with esophageal cancer who developed bilateral lower limb weakness, bilateral ptosis, loss of appetite, nausea, and vomiting after four cycles of treatment with tislelizumab. The patient was considered to have immune-related myocarditis, myasthenia gravis, and liver injury involving multiple organs caused by tislelizumab treatment. As multi-organ damage caused by tislelizumab is rarely reported domestically and internationally, this article will analyze and discuss domestic and foreign literature, hoping to provide some help to clinicians who subsequently use tislelizumab.

Du S, McCall N, Park K, et al., 2018, Blockade of Tumor-Expressed PD-1 Promotes Lung Cancer Growth. Oncoimmunology, 2018, 7(4): e1408747.

Liu Y, Liu Q, Huang L, et al., 2022, Programmed Death Receptor 1 Inhibitor: Tislelizumab. Journal of Clinical Medication, 20(1): 37–42.

Abushalha K, Abulaimoun S, Silberstein PT, 2020, So Slow, So Fast, a Case of Nivolumab-Induced Hypothyroidism With Subsequent Rhabdomyolysis. Immunotherapy, 12(9): 625–628.

Huang X, Tian T, Zhang Y, et al., 2021, Age-Associated Changes in Adverse Events Arising From Anti-PD-(L)1 Therapy. Frontier of Oncology, 11: 619385.

Zhang X, Wu T, Cai X, et al., 2022, Neoadjuvant Immunotherapy for MSI-H/dMMR Locally Advanced Colorectal Cancer: New Strategies and Unveiled Opportunities. Frontier of Immunology, 13: 795972.

Franke AJ, Skelton WP, Starr JS, et al., 2019, Immunotherapy for Colorectal Cancer: A Review of Current and Novel Therapeutic Approaches. Journal of National Cancer Institution, 111(11): 1131–1141.

Hornbech K, Ravn J, Steinbrüchel DA, 2011, Outcome After Pulmonary Metastasectomy: Analysis of 5 Years Consecutive Surgical Resections 2002–2006. Journal of Thoracic Oncology, 6(10): 1733–1740.

Tomlinson JS, Jarnagin WR, DeMatteo RP, et al., 2007, Actual 10-Year Survival After Resection of Colorectal Liver Metastases Defines Cure. Journal of Clinical Oncology, 25(29): 4575–4580.

Overman MJ, McDermott R, Leach JL, et al., 2017, Nivolumab in Patients With Metastatic DNA Mismatch Repair-Deficient or Microsatellite Instability-High Colorectal Cancer (CheckMate 142): An Open-Label, Multicentre, Phase 2 Study. Lancet of Oncology, 18(9): 1182–1191.

Le DT, Uram JN, Wang H, et al., 2015, PD-1 Blockade in Tumors With Mismatch-Repair Deficiency. National English Journal of Medicine, 372(26): 2509–2520.

Marabelle A, Le DT, Ascierto PA, et al., 2020, Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study. Journal of Clinical Oncology, 38(1): 1–10.

Liu J, Zhang Y, Wang Y, et al., 2021, Progress in the Diagnosis and Treatment of Immune Checkpoint Inhibitor-Related Myocarditis. Clinical Medical Research and Practice, 6(6): 193–195.

Desai J, Deva S, Lee JS, et al., 2020, Phase IA/IB Study of Single Agent Tislelizumab, an Investigational Anti-PD-1 Antibody, in Solid Tumors. Journal of Immunotherapy & Cancer, 8: e000453.

Shen L, Wu YL, Yuan Y, et al., 2020, 552p Safety and Efficacy of Long-Term Exposure (LTE) to Tislelizumab in Chinese Patients With Advanced Solid Tumour. Annals of Oncology, 31: S478–S47.

Deng C, Yang M, Jiang H, et al., 2021, Immune-Related Multiple Organs Injuries Following ICIT Treatment With Tislelizumab in an Advanced Non-Small Cell Lung Cancer Patient: A Case Report. Frontier of Oncology, 11: 664809.

Yao S, Li X, Nong J, et al., 2020, Immune Checkpoint Inhibitor-Related Myasthenia Gravis: From Diagnosis to Treatment. Chinese Journal of Lung Cancer, 23(8): 685–688.