Key result
Among patients receiving oral targeted tyrosine kinase inhibitors in a community oncology setting, the incidence of QTc prolongation was 24%, though no patients discontinued therapy primarily due to this adverse event.
Why the study?
Limited data exist regarding QTc prolongation and associated risk factors among patients receiving oral targeted antineoplastic agents in the ambulatory oncology setting.
Does oral targeted tyrosine kinase inhibitor therapy cause QTc prolongation in ambulatory oncology patients?
Observational (n=49)
No
Does oral targeted tyrosine kinase inhibitor therapy cause QTc prolongation in ambulatory oncology patients?
In a real-world ambulatory oncology setting, QTc prolongation occurred in 24% of patients receiving oral TKIs, with concomitant loop diuretic use identified as a significant risk factor requiring closer monitoring.
QTc prolongation affected 24% of ambulatory TKI recipients without driving discontinuation; supports targeted monitoring with loop diuretics but leaves causal risk open.
Introduction: Thirty oral targeted antineoplastic agents are associated with prolongation of the QT interval. However, limited data exists regarding QTc prolongation and associated risk factors in the ambulatory oncology setting. Methods: This retrospective study was completed to describe QTc prolongation incidence among patients receiving oral targeted tyrosine kinase inhibitors (TKI) and identify potential risk factors in the ambulatory community-based oncology clinic. Results: Of the 341 patients identified as receiving oral TKI, 49 with a baseline and follow-up ECG were included. The incidence of QTc prolongation (QTc > 470 ms in males, QTc > 480 ms in females, or >20 ms increase in QTc from baseline) was 24%. Three patients developed significant QTc prolongation (QTc >500 ms or >60 ms increase in QTc from baseline). No patients discontinued therapy primarily due to QTc prolongation or experienced symptomatic torsades de pointes. Analysis of risk factors demonstrated that patients with QTc prolongation were more likely to receive concomitant therapy with a loop diuretic (41% vs 11%, respectively, p=0.029). Discussion: The frequency of QTc prolongation may be higher in the real-world setting than that observed in clinical trials; however, continuation of therapy may be possible. Patients receiving concomitant loop diuretics should be monitored more closely for QTc prolongation and electrolyte abnormalities.
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Reeves et al. (2023) conducted an observational in Cancer (receiving oral targeted tyrosine kinase inhibitors) (n=49). Oral targeted tyrosine kinase inhibitors (TKIs) was evaluated on Incidence of QTc prolongation (QTc > 470 ms in males, QTc > 480 ms in females, or >20 ms increase in QTc from baseline). Among patients receiving oral targeted tyrosine kinase inhibitors in a community oncology setting, the incidence of QTc prolongation was 24%, though no patients discontinued therapy primarily due to this adverse event.
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