Real-World Data on Osimertinib-Associated Cardiac Toxicity

Area of Science:

• Oncology
• Cardiology

Background:

• Lung cancer is a leading global cause of cancer death.
• Epidermal growth factor receptor (EGFR) mutations occur in 17-39% of non-small cell lung cancer (NSCLC).
• Osimertinib is a key EGFR tyrosine kinase inhibitor (EGFR-TKI) for EGFR-mutated NSCLC, but its cardiac risks are not fully understood.

Purpose of the Study:

• To investigate the incidence and characteristics of osimertinib-related cardiotoxicity in EGFR-mutated NSCLC patients.
• To identify risk factors and outcomes associated with osimertinib-induced cardiac adverse events.

Main Methods:

• Retrospective analysis of a multi-center registry data.
• Inclusion criteria: NSCLC patients with EGFR mutations receiving first-line osimertinib (Dec 2018 - Apr 2024).
• Cardiotoxicity defined as reduced ejection fraction (EF) and/or cardiac death.

Main Results:

• 17 patients evaluated; most had smoking history.
• Cardiac toxicity emerged 1-28 months post-initiation; 70.59% within 6 months.
• 14 patients showed EF recovery, but not to baseline; high prevalence of comorbidities (heart failure, hypertension).

Conclusions:

• Osimertinib-associated cardiotoxicity is a significant concern, particularly in patients with comorbidities.
• Close monitoring, early intervention, and personalized management are essential.
• Rechallenge may be possible for mild toxicity; severe/persistent cases warrant exclusion from osimertinib.