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Successful Management of Osimertinib-Induced Heart Failure

Atsuko Fukuo1, Teruhiko Imamura1, Hiroshi Onoda1

  • 1The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan.

Medicina (Kaunas, Lithuania)
|February 25, 2022
PubMed

Insights

Osimertinib, an EGFR inhibitor, can rarely cause heart failure in non-small cell lung cancer patients. Temporal cessation of osimertinib and aggressive heart failure treatment, including ivabradine, may be effective.

Area of Science:

  • Onco-cardiology
  • Pharmacology
  • Cardiology

Background:

  • Cancer therapeutics-related cardiac dysfunction is a significant concern in onco-cardiology.
  • Osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, is used for EGFR mutation-positive advanced non-small cell lung cancer.
  • Few studies have documented heart failure associated with osimertinib use.

Observation:

  • A 74-year-old woman developed advanced heart failure with reduced ejection fraction after receiving osimertinib.
  • The patient's condition was managed by temporarily discontinuing osimertinib.
  • Treatment also included neurohormonal blocker therapy and heart rate modulation with ivabradine.

Findings:

  • Osimertinib can induce advanced heart failure with reduced ejection fraction.
  • Temporal termination of osimertinib was a key part of the treatment strategy.
  • Combination therapy including neurohormonal blockers and ivabradine showed promise.

Implications:

  • While rare, osimertinib-induced heart failure necessitates vigilant cardiac monitoring in non-small cell lung cancer patients.
  • Early recognition and intervention, including drug cessation and aggressive medical management, are crucial.
  • This case highlights a potential therapeutic approach for managing this specific adverse event.
Keywords:
cancerheart failureonco-cardiology

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