Steroid-resistant immune checkpoint inhibitor-associated myocarditis: a case report

Abstract Objective Steroid-resistant immune checkpoint inhibitor (ICI)-associated myocarditis (ICIAM) is rare, with no effective therapy. We present a case of successfully managed steroid-resistant ICIAM, demonstrating an effective treatment for this life-threatening complication. Case report A 77-year-old woman with intrahepatic cholangiocarcinoma developed myocardial injury after two doses of ICI treatment. There was a rebound in troponin T during corticosteroid therapy; consequently, the patient was treated with tofacitinib combined with mycophenolate mofetil as second-line immunosuppressive therapy. Outcomes improved and anti-tumor treatment was rechallenged. Conclusion The early administration of second-line immunosuppressive therapy is crucial for good outcomes with steroid-resistant ICIAM and the subsequent rechallenge of anti-tumor therapy.