Reoccurrence of takotsubo cardiomyopathy induced by osimertinib: A case report

Fukuda, Yuko; Kawa, Yoshitaka; Nonaka, Akiko; Shiotani, Hideyuki

doi:10.1002/ccr3.6279

Cited by 4 publications

(2 citation statements)

References 10 publications

(28 reference statements)

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“…There are currently no established guidelines regarding treatment modification in the setting of osimertinib-induced cardiomyopathy, although cases of osimertinib re-challenge and/or dose reduction have also been reported [ 5 , 6 , 12 , 13 ]. We reasoned that osimertinib-induced cardiomyopathy might involve an off-target that was non-overlapping with earlier generation EGFR TKIs and therefore favored EGFR TKI substitution as a strategy to prevent re-emergence of adverse cardiac side-effects.…”

Section: Discussionmentioning

confidence: 99%

Osimertinib-induced biventricular cardiomyopathy with abnormal cardiac MRI findings: a case report

Patel,

Hsu,

Lou

et al. 2023

Cardio-Oncology

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Background Osimertinib is a third-generation epidermal growth factor receptor (EGFR) inhibitor that is currently the first-line treatment for metastatic EGFR-mutated non-small-cell lung cancer (NSCLC) due to its favorable efficacy and tolerability profile compared to previous generations of EGFR inhibitors. However, it can cause uncommon, yet serious, cardiovascular adverse effects. Case Presentation We present the case of a 63-year-old man with EGFR-mutated NSCLC treated with osimertinib who developed new-onset non-ischemic cardiomyopathy with biventricular dysfunction and heart failure in the context of an enlarging pericardial effusion. For the first time, we demonstrate cardiac MR imaging findings associated with osimertinib-associated cardiomyopathy, including focal late gadolinium enhancement and myocardial edema. The patient’s biventricular function normalized after initiation of goal-directed medical therapy for heart failure and holding osimertinib. The patient was subsequently started on afatinib, a second-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), without recurrence of cardiomyopathy. Conclusions This case highlights the need to better understand osimertinib-induced cardiotoxicity and strategies to optimize oncologic care in patients who develop severe cardiac toxicities from cancer therapy. It further underlines the importance of specialized multidisciplinary care of cancer patients who develop cardiotoxicities to optimize their oncologic outcomes.

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