A life-threatening acute immune-related myasthenia gravis and myocarditis during adjuvant therapy responding promptly to Abatacept

Immune checkpoint inhibitors (ICIs) have revolutionized the therapeutic landscape of most of malignancies. Their use in the treatment of melanoma is nowadays highly consolidated in both adjuvant and metastatic setting, providing a substantial gain of the overall survival rate [1]. The ICI-related adverse events (irAEs) may be challenging for clinicians, particularly for those who do not respond to steroids. The best sequencing after steroids is well established for some toxicities, such as colitis, but for rare irAEs the optimal sequential treatment steps is a matter of debate [1].