Taken as a whole, clinical (i.e., association with myositis and myocarditis) and laboratory (i.e., frequent anti-titin positivity) similarities between ICI-induced and thymoma-associated autoimmunity, may led us to speculate that both this conditions (thymoma and ICI treatment) produce a common immunological dysregulation, which may deal with altered autoantigens presentation and antigen spreading at the neuromuscular junction [23]. The gene discussed is TTN; the disease is myositis disease.