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Case Reports: Adverse drug reactions and complications
Severe cardiotoxicity induced by osimertinib in a patient with EGFR-mutated adenocarcinoma of the lung
  1. Takaaki Tanaka1,
  2. Soma Nii2,
  3. Hidenaru Yamaoka3 and
  4. Nobukazu Fujimoto1
  1. 1Medical Oncology, Okayama Rosai Hospital, Okayama, Japan
  2. 2Internal Medicine, Okayama Rosai Hospital, Okayama, Japan
  3. 3Cardiovascular Medicine, Okayama Rosai Hospital, Okayama, Japan
  1. Correspondence to Dr Nobukazu Fujimoto; nobufujimot{at}gmail.com

Abstract

A man in his 70s was detected an infiltrative shadow on the right lung. A bronchoscopy confirmed the diagnosis of adenocarcinoma of the lung, classified as cT2bN2M0 stage IIIA, with a deletion mutation in EGFR exon 19. Weekly carboplatin plus paclitaxel was administered in combination with thoracic radiotherapy, followed by maintenance therapy with durvalumab for 1 year. Four months later, he was diagnosed with a recurrence of adenocarcinoma in the lung. He started treatment with osimertinib. Six months after initiating osimertinib, a chest CT revealed bilateral pleural effusion and expansion of the inferior vena cava. Eleven months later, he entered our emergency department with progressive dyspnoea. A chest CT showed bilateral massive pleural effusion and cardiac enlargement. He was diagnosed with osimertinib-induced cardiac failure. Osimertinib was discontinued, and echocardiology demonstrated a gradual improvement in cardiac function. It is necessary to take care of osimertinib-related cardiotoxicity.

  • Cancer - see Oncology
  • Cancer intervention
  • Chemotherapy
  • Lung cancer (oncology)

https://doi.org/10.1136/bcr-2023-255245

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    Footnotes

    • Contributors TT, SN and HY contributed to conception and design, acquisition of data or analysis, interpretation of data and drafting the article. NF contributed to drafting the article and gave a final approval of the version published.

    • Funding This study was supported by grants-in-aid from the Ministry of Health, Labor, and Welfare, Japan (210901-01).

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests NF received honoraria from AstraZeneca.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.