Although several studies highlight the severity of MG as an irAE and the risks of the use of immune checkpoint inhibitors for the cancer patients with pre-existing MG or subclinical MG (asymptomatic anti-AChR Ab-seropositive cancer patients), the benefits and safety of immune checkpoint inhibitors in asymptomatic patients with pre-existing anti-AChR Abs, have not been studied [9,14,15,16,17]. Here, DDX41 is linked to myasthenia gravis.