{
  "abstract": "An older adult in his early 80s with locally advanced small cell lung carcinoma was treated with carboplatin, etoposide and atezolizumab. After two well-tolerated cycles, he developed acute ocular and neuromuscular symptoms. Investigations revealed features consistent with immune checkpoint inhibitor–related myasthenia gravis, myocarditis and myositis (triple M syndrome). The patient responded to high-dose corticosteroids and pyridostigmine but required prolonged rehabilitation. Notably, he demonstrated an excellent radiological response to systemic therapy. This case highlights the need for vigilance for severe neuromuscular and cardiac immune-related adverse events, the importance of prompt multidisciplinary management, and the clinical paradox of balancing cancer control with life-threatening toxicity.",
  "authors": [
    {
      "affiliations": [
        "Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "Jenna Williams"
    },
    {
      "affiliations": [
        "Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK",
        "Leeds Institute of Medical Research, University of Leeds, Leeds, UK"
      ],
      "name": "Carl Simela"
    },
    {
      "affiliations": [
        "Leeds Institute of Medical Research, University of Leeds, Leeds, UK",
        "York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK"
      ],
      "name": "Divyalakshmi Bhaskaran"
    }
  ],
  "title": "Triple M syndrome (myasthenia gravis, myocarditis and myositis) following atezolizumab in small cell lung carcinoma",
  "uid": "985aae22-3f34-5376-9fba-6b9c881e39b5"
}