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ORIGINAL RESEARCH article

Front. Oncol.

Sec. Cancer Immunity and Immunotherapy

Clinical Features and HLA Typing of Immune Checkpoint Inhibitor-associated Myasthenia gravis, Myocarditis and Myositis

Provisionally accepted
  • 1People’s Hospital of Shijiazhuang, hebei, China
  • 2School of Basic Medicine, North China University of Science and Technology, Tangshan, China

The final, formatted version of the article will be published soon.

Immune checkpoint inhibitors (ICI) have significantly improved the therapeutic outcomes for various malignant tumors, but they may also trigger severe immune-related adverse events (irAEs), such as myositis, myocarditis and myasthenia gravis (MG). The mechanisms underlying these adverse reactions remain unclear and may be related to an individual's genetic background. Human Leucocyte Antigen (HLA) genes play a crucial role in immune regulation, and their polymorphism is closely related to the occurrence of various autoimmune diseases. To clarify whether irAEs is associated with specific HLA typing, we analyzed 23 patients diagnosed with myositis, myocarditis and/or MG after receiving ICI therapy, and conducted HLA high-resolution typing detection using the PCR-SBT method. Among the 14 patients with MG combined with myositis and myocarditis, the frequencies of HLA-DQB1*03:03 and HLA-C*01:02 loci were higher than those in the normal population. In 9 patients with myositis and myocarditis, the frequency of HLA-B*52:01 locus was higher than that in the normal population. Our research findings reveal that patients carrying autoimmune susceptibility genes have a higher risk of developing irAEs when treated with ICI, specific HLA alleles may be associated with the risk of ICI-related MG/myositis/myocarditis, but further large-scale, multi-center validation is needed.

Keywords: immune checkpoint inhibitors, Immune-related adverse events, HLA, Myasthenia Gravis, Myocarditis, Myositis

Received: 13 Jun 2025; Accepted: 04 Nov 2025.

Copyright: © 2025 Lin, Liu, Jin and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Guoyan Qi, qiguoyan@hebmu.edu.cn

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