What is the clinical evidence from this study?

Study design: Case Report. Population: advanced non-small cell lung cancer (NSCLC) (n=1). Intervention: Osimertinib. Primary outcome: Development of cardiomyopathy.

September 24, 2020Open Access

Osimertinib induced cardiomyopathy

SSShun ShinomiyaSaiseikai Central Hospital KKKyoichi KairaSaitama International Medical Center OYOu YamaguchiSaitama International Medical Center

Key Result

A 76-year-old woman with advanced NSCLC developed biopsy-confirmed cardiomyopathy 4 months after starting osimertinib, which improved 3 weeks after drug withdrawal and medical therapy.

Study Design

Type

Case Report (n=1)

Structured PICO

Does osimertinib cause cardiomyopathy in patients with advanced non-small cell lung cancer?

Population

A 76-year-old woman with advanced non-small cell lung cancer who developed cardiomyopathy 4 months after initiating osimertinib therapy.

Exposure

Osimertinib 80 mg/day as 2nd line therapy, followed by withdrawal and initiation of furosemide, carvedilol, and enalapril upon diagnosis of cardiomyopathy.

Outcome

Development of osimertinib-induced cardiomyopathy (confirmed by endomyocardial biopsy) and clinical response to drug withdrawal and heart failure therapy.safety

Osimertinib can induce reversible cardiomyopathy in patients with advanced non-small cell lung cancer, requiring clinical vigilance and prompt management.

Abstract

RATIONALE: Cardiotoxicity related to osimertinib, including cardiac failure, QT prolongation, and atrial fibrillation, has been reported as an extremely rare incidence in patients with advanced non-small cell lung cancer (NSCLC). However, little is known about the occurrence of osimertinib-induced cardiomyopathy. PATIENT CONCERNS: A 76-year old woman was treated with afatinib (40 mg/day) as the 1st line treatment due to recurrence after surgical resection for pulmonary adenocarcinoma. However, she experienced recurrence with positive T790 M, and osimertinib (80 mg/day) was administered as the 2nd line therapy. DIAGNOSIS: Four months after osimertinib initiation, she complained of fever and progressive dyspnea, and a diagnostic endomyocardial biopsy confirmed non-specific cardiomyopathy, indicating osimertinib-induced cardiomyopathy. INTERVENTIONS AND OUTCOMES: She was treated with furosemide, carvedilol, and enalapril, and her cardiac function, her symptoms, and condition improved 3 weeks after the withdrawal of osimertinib. LESSONS: Physicians should be alert of the cardiomyopathy-causing potential of osimertinib in advanced NSCLC patients.

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