Multiple cardiotoxicities during osimertinib therapy.

Area of Science:

• Oncology
• Cardiology
• Pharmacology

Background:

• Osimertinib is a tyrosine-kinase inhibitor for metastatic non-small cell lung cancer with EGFR mutations.
• Patients on osimertinib face an increased risk of cardiac toxicity.
• This case highlights multiple cardiotoxicities observed during osimertinib therapy.

Purpose of the Study:

• To report a case of a patient experiencing multiple cardiotoxicities during osimertinib treatment.
• To emphasize the importance of cardiac monitoring in patients receiving osimertinib.
• To discuss strategies for mitigating cardiac risks associated with osimertinib therapy.

Main Methods:

• A 72-year-old male patient with lung adenocarcinoma received osimertinib.
• The patient developed QTc prolongation, atrial fibrillation, and heart failure during treatment.
• Cardiac assessments included electrocardiography and echocardiography.

Main Results:

• The patient experienced QTc prolongation at 15 months of osimertinib therapy.
• Subsequently, he developed rate-controlled atrial fibrillation and severely impaired left ventricular systolic function (LVEF: 30%).
• Management involved discontinuing rosuvastatin, initiating antiarrhythmics and heart failure medications, while continuing osimertinib.

Conclusions:

• Osimertinib therapy requires careful cardiac monitoring.
• Baseline cardiac risk stratification and assessment of concomitant medications are recommended.
• Regular electrocardiography and echocardiography surveillance may reduce the risk of cardiac toxicity.