The evidence suggests that blocking PD-1/PD-L1 signaling may shift the systemic immune balance from the T cell-mediated immune response (cellular immune response) to the B-cell mediated immune response (humoral immune response) [33,36,37] which enhances pre-existing anti-AChR antibody, and may lead to the onset of MG as an irAE (Figure 5A). This evidence concerns the gene CD274 and myasthenia gravis.