Key result
Long-term erlotinib therapy is linked to severe dilated cardiomyopathy with LVEF dropping to ~25%.
Why the study?
Very few cardiac adverse effects of erlotinib maintenance treatment in advanced NSCLC have been observed and reported, highlighting a need to understand potential cardiotoxicity.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Erlotinib may cause late-onset dilated cardiomyopathy; extends known EGFR TKI cardiotoxicity and leaves open need for surveillance studies.
Erlotinib maintenance treatment improves progression-free survival compared with observation after first-line chemotherapy in unselected advanced non-small cell lung cancer (NSCLC). Very few cardiac adverse effects have been observed in phase III studies on tyrosine kinase inhibitors (TKI). We report the case of a 71-year-old woman with metastatic NSCLC treated with cisplatin/pemetrexed and then erlotinib maintenance therapy. After 26 months of TKI therapy, she developed dilated cardiomyopathy. Despite symptomatic treatment, left ventricular ejection fraction decreased to 25%. Ischemic heart disease was excluded by coronary angiography and cardiac magnetic resonance imaging, and no other cause was found. Erlotinib was stopped, and cardiac resynchronization therapy by pacemaker was initiated. This case report highlights the possible cardiotoxic effects of long-term erlotinib and suggests the need for close clinical and echocardiographic follow-up of patients receiving long-term TKI therapy.
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Pinquie et al. (2016) conducted a case report in Metastatic non-small cell lung cancer (NSCLC) (n=1). Erlotinib was evaluated on Development of dilated cardiomyopathy (Left ventricular ejection fraction). A 71-year-old woman with metastatic non-small cell lung cancer developed dilated cardiomyopathy and a reduction in left ventricular ejection fraction to 25% after 26 months of erlotinib therapy.
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