Key result
Osimertinib triggers reversible severe LVEF reduction from ~69% to 27% in post-pneumonectomy heart failure.
Why the study?
Clinically notable cardiovascular toxicities, including heart failure, have been recognized with osimertinib treatment in EGFR-mutated NSCLC, requiring differentiation from tumor progression.
Case Report (n=1)
No
Osimertinib can induce severe but reversible heart failure that may masquerade as malignant pleural effusion, emphasizing the critical need for cardiac monitoring in patients with compromised cardiopulmonary reserve such as those post-pneumonectomy.
Reversible osimertinib cardiotoxicity warrants LVEF surveillance in post-pneumonectomy patients; extends case reports but leaves open incidence and monitoring needs.
mutation-positive non-small cell lung cancer (NSCLC). Although generally well tolerated, clinically notable cardiovascular toxicities, including heart failure, have been recognized. The present study describes the case of a 77-year-old man who developed symptomatic heart failure 5 months after initiating osimertinib treatment for postoperative recurrence of NSCLC. The patient presented with dyspnea and right-sided pleural effusion, which was initially suspected to represent tumor progression. However, the pleural effusion was transudative and echocardiography revealed a marked reduction in left ventricular ejection fraction from 69 to 27%. Discontinuation of osimertinib and treatment for heart failure resulted in resolution of the pleural effusion and recovery of cardiac function. The present case highlights the importance of differentiating heart failure-related pleural effusion from tumor recurrence and indicates the need for careful monitoring of cardiac function during osimertinib therapy, particularly in patients with conditions that may compromise cardiopulmonary reserve, such as prior pneumonectomy or aortic stenosis.
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Yokoyama et al. (2026) conducted a case report in EGFR-mutated non-small cell lung cancer with heart failure (n=1). Osimertinib was evaluated on Development of symptomatic heart failure (LVEF reduction). Osimertinib treatment in a 77-year-old man post-pneumonectomy resulted in a reversible reduction in left ventricular ejection fraction from 69% to 27% and a transudative pleural effusion.
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