Key result
Cardiac adverse events associated with EGFR tyrosine kinase inhibitors account for 3.7% of all adverse events in the FDA reporting system, including serious complications like cardiomyopathy and myocardial infarction.
While EGFR-TKIs have dramatically improved lung cancer prognosis, they are associated with a small but notable risk of cardiovascular complications such as heart failure and cardiomyopathy.
pidermal growth factor (EGF) receptor (EGFR), also known as ErbB1 or HER1, is a transmembrane receptor that exists on the surface of cells.The continuous activation of EGFR tyrosine kinase enzyme is essential for signal transduction for cell proliferation, cancer growth and disordered progression.In Japanese lung cancer patients, more than 80% of their lung cancers are classified as non-small cell lung cancer (NSCLC), and about 40% of them have mutations in EGFR.In the 21st century, EGFR tyrosine kinase inhibitors (EGFR-TKI) have been developed and currently 5 drugs are available in Japan.First-generation Gefitinib (Iressa, from 2002) and Erlotinib (Tarceva, from 2007) have reversible EGFR inhibition effects.Second-generation Afatinib (Giotrif, from 2014) and Dacomitinib (Vizimpro, from 2019) have irreversible EGFR inhibition effects.Third-generation Osimertinib (Tagrisso, from 2016) has an irreversible EGFR inhibition effect even on lung cancers with a T790M-resistant mutation.These molecularlytargeted therapies depending on molecular diagnosis have dramatically improved the prognosis of patients suffering from lung cancers with EGFR mutations.[1][2][3] Although the reported cases of cardiovascular complications of osimertinib are relatively higher than other EGFR-TKI (Table ), regarding overall EGFR-TKI, the cardiac adverse events actually made up the minority of all adverse events (315 of 8450 events; 3.7%) in the FDA adverse events reporting system.4) Article p.1171 Gefitinib (Iressa): The Japanese interview-form of gefitinib reports 16 (0.48%)cardiovascular events from 3322 cases, which include 5 heart failure (0.15%), 4 acute coronary syndrome (0.12%), 3 atrial fibrillation (0.09%), and 4 others (0.12%).Omori, et al. reported a case of gefitinib-induced cardiomyopathy.5) A 56-year-old female patient with NSCLC was treated with gefitinib for 7 months and her left ventricular ejection fraction (LVEF) decreased to 28%.Her coronary angiography showed no lesions.After gefitinib
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Kimura et al. (2021) conducted an editorial in Lung Cancer. EGFR Tyrosine Kinase Inhibitors was evaluated. Cardiac adverse events associated with EGFR tyrosine kinase inhibitors account for 3.7% of all adverse events in the FDA reporting system, including serious complications like cardiomyopathy and myocardial infarction.
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