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Thank you for your coverage of the AANEM Annual Meeting. Please join us at the 2025 AANEM Annual Meeting, being held Oct.29-Nov. 1 in San Francisco, California. Journalists covering the annual meeting and posting stories on social media channels are encouraged to use the official meeting hashtag #AANEMinSanFran.
Please review the Abstract Embargo Policy. For questions regarding AANEM Annual Meeting policies, please email communications@aanem.org.

View the latest AANEM Achievement Award winners, the American Neuromuscular Foundation (ANF) Abstract Award winners, and the latest AANEM news articles on News Express.

Questions? Check out the frequently asked questions below or contact communications@aanem.org. 

Frequently Asked Questions

Q: When will be content of abstracts be viewable, as opposed to just the titles?
A: The abstract content will be available at the annual meeting during the Poster Hall hours. We do not provide abstract presenter information or slides ahead of time. All available information can be found in the AANEM Abstract Guide online when it becomes available.

Q: How do I reach out to abstract or session presenters for an interview?
A: We do not offer member contact information. To connect with abstract or session presenters, review the AANEM Annual Meeting Program when available. Find the topics of interest and connect with the presenter after their lecture or during their abstract poster session time. Currently there is no interview option for virtual attendees.

Q: When can I share information?
A: The embargo on the abstracts themselves is lifted when they have been published in Muscle & Nerve and online in the AANEM Abstract Guide. However, the additional information beyond what is in the abstract itself is still embargoed. 

AANEM requires information that goes beyond that which is contained within the abstract, e.g., the release of data not included in the abstract, discussion of the abstract done as part of a scientific presentation, etc. to be embargoed until the start of the annual meeting. Please see the Abstract Embargo Policy.

Q: Will the Abstract Award Reception feature the best posters? 
A: The Abstract Award Reception is a social hour in honor of the abstract award winners where all authors, including award winners, will be available to discuss research. 

Q: Original research is ONLY presented as posters, correct?
A: Yes - the research is presented in the Poster Hall via abstract posters.

Patient Safety: Immune Checkpoint Inhibitors Related Neuromuscular Adverse Effects

Sep 18, 2025, 14:17 by Maggie Schmidt (Admin)
From the Quality and Patient Safety Committee

A 68-year-old man with hypertension, type 2 diabetes and metastatic melanoma was started on combination therapy with ipilimumab and nivolumab. Three weeks later, he presented with generalized myalgias, difficulty rising from a chair, bilateral ptosis, and intermittent diplopia. Examination revealed proximal muscle weakness, fatigable ptosis, and mild extraocular movement limitation. Laboratory tests showed markedly elevated creatine kinase and troponin levels, and ECG reveals non-specific ST-T changes. Chest imaging showed pulmonary congestion, and echocardiography demonstrated left ventricular ejection fraction of 40%. 

Question: Which of the following is the most likely diagnosis?

A. Paraneoplastic Lambert-Eaton myasthenic syndrome
B. ICI-induced triple-M syndrome (myositis, myocarditis and myasthenia overlap syndrome)
C. Polymyositis
D. Myasthenia gravis

Explanation: 

The answer is B. Immune checkpoint inhibitors (ICIs), by augmenting T-cell responses against tumors, can inadvertently disrupt self-tolerance, leading to immune-related adverse events (irAEs), including a diverse array of neuromuscular syndromes. While overall incidence is low (~1-2%), these irAEs can lead to significant morbidity and mortality. Key syndromes include immune-mediated myopathies (ranging from mild myalgia to severe necrotizing myositis), myasthenia gravis (MG) (often presenting acutely and severely, sometimes with atypical antibody profiles), inflammatory neuropathies (including demyelinating polyradiculoneuropathy mimicking Guillain-Barré syndrome or chronic inflammatory demyelinating polyneuropathy) and cranial neuropathies. The underlying pathophysiology often involves T-cell infiltration and activation within target tissues (muscle, nerve, neuromuscular junction). A critical concern is the ICI-associated myositis, myocarditis, and MG (MMM) overlap syndrome, which carries a poor prognosis due to synergistic cardiorespiratory risks. Onset typically occurs early, often within 1-3 months of ICI initiation, particularly with combination therapy (e.g., anti-CTLA-4 plus anti-PD-1/PD-L1).

Diagnosis requires a high index of suspicion and multimodal assessment, including detailed neurological examination, serum CK and troponin levels, electromyography/nerve conduction studies (EMG/NCS), autoantibody testing (AChR, MuSK, anti-striated muscle antibodies), cardiac imaging (echocardiography, cardiac MRI), and potentially muscle/nerve biopsy revealing inflammatory infiltrates. Urgent discontinuation of ICI therapy and initiation of high-dose corticosteroids (e.g., prednisone 1-2 mg/kg/day or equivalent  intravenous methylprednisolone) are foundational management steps. Refractory or severe cases often necessitate additional immunotherapy, such as intravenous immunoglobulin (IVIg), plasma exchange (PLEX), mycophenolate mofetil, or rituximab, guided by the specific syndrome and clinical severity. Recent case reports have suggested potential benefit of using complement inhibition with eculizumab.


Authors: Nirav Sanghani, MD, DM; Michal Vytopil, MD

Sources:

  1. Dalakas, M.C., Neurological complications of immune checkpoint inhibitors: what happens when you 'take the brakes off' the immune system. Ther Adv Neurol Disord, 2018. 11: p. 1756286418799864.
  2. Carr, A.S., et al., Neurological complications of immune checkpoint inhibitors: a practical guide. Pract Neurol, 2025. 25(2): p. 116-126.
  3. Beecher, G., et al., Immune Checkpoint Inhibitor Myopathy: The Double-Edged Sword of Cancer Immunotherapy. Neurology, 2024. 103(11): p. e210031.
  4. O'Hare, M. and A.C. Guidon, Peripheral nervous system immune-related adverse events due to checkpoint inhibition. Nat Rev Neurol, 2024. 20(9): p. 509-525.
  5. Lipe, D.N., et al., Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome Associated with Immune Checkpoint Inhibitors: A Systematic Review. Diagnostics, 2024. 14(16): p. 1794.