Reoccurrence of takotsubo cardiomyopathy induced by osimertinib: A case report

Abstract

A patient with lung cancer was administrated osimertinib. She developed symptomatic heart failure due to Takotsubo cardiomyopathy (TC). As her condition improved after discontinuing osimertinib, TC was thought to be caused by osimertinib. Reoccurrence of TC was seen after readministrating half dose of osimertinib.

Osimertinib-induced biventricular cardiomyopathy with abnormal cardiac MRI findings: a case report

“…There are currently no established guidelines regarding treatment modification in the setting of osimertinib-induced cardiomyopathy, although cases of osimertinib re-challenge and/or dose reduction have also been reported [ 5 , 6 , 12 , 13 ]. We reasoned that osimertinib-induced cardiomyopathy might involve an off-target that was non-overlapping with earlier generation EGFR TKIs and therefore favored EGFR TKI substitution as a strategy to prevent re-emergence of adverse cardiac side-effects.…”

Onset of takotsubo syndrome induced by osimertinib in a patient with lung adenocarcinoma

“…According to the U.S. Food and Drug Administration Adverse Events Reporting System, a pharmacovigilance database, the reporting odds ratios for cardiac failure, atrial fibrillation, and QT prolongation were significantly higher with osimertinib than with other EGFR-TKIs, such as afatinib, erlotinib, and gefitinib [ 3 ]. However, no cases of osimertinib-associated TTS have been reported until 2022 [ 4 , 11 ].…”

“…Fukuda et al were the first to report a case of osimertinib-induced TTS in an 81-year-old female with recurrent NSCLC after undergoing a right upper-middle lobectomy. The patient developed acute cardiac failure due to TTS within a month of starting osimertinib treatment [ 4 ]. TTS recurred even when a reduced dose of osimertinib was administered.…”

“…Takotsubo syndrome (TTS), also known as broken heart syndrome, is a transient left ventricular dysfunction typically triggered by physical or emotional stress. Osimertinib-induced TTS is extremely rare, and only one case has been reported in a patient with recurrent NSCLC with a history of thoracic surgery for primary lung cancer [ 4 ].…”

Osimertinib-Associated Cardiomyopathy In Patients With Non-Small Cell Lung Cancer

“…Two had Takotsubo syndrome, which has been associated with malignancy and osimertinib. 3 Nine (52.9%) had NYHA functional class III symptoms at diagnosis; all 9 required hospitalization. Fourteen patients (82.4%) were referred to a cardiologist because of the reduction in LVEF.…”