2024 Latin America Conference on Lung Cancer (LALCA) - Posters-PP01.51: Osimertinib Plus Chemotherapy : Cardiac Toxicity - Stop or Continue. Case Report and Review of Literature

PP01.51: Osimertinib Plus Chemotherapy : Cardiac Toxicity - Stop or Continue. Case Report and Review of Literature

Pdf Summary

This case report discusses a 63-year-old female with stage IV lung adenocarcinoma harboring an EGFR mutation, treated with Osimertinib and chemotherapy. Following treatment, the patient experienced significant cardiac toxicity, including tachyarrhythmia, acute coronary symptoms, and heart failure. Despite these severe adverse events, treatment with a reduced Osimertinib dose continued after cardiac stabilization, resulting in sustained clinical and radiological response.<br /><br />Osimertinib is a frontline therapy for non-small cell lung cancer (NSCLC) with EGFR mutations. Clinical trials FLAURA and AURA3 demonstrated its superiority in progression-free and overall survival over other EGFR-TKIs and chemotherapy. However, rare but severe cardiac toxicities are becoming apparent with increasing use. Osimertinib may lead to type 1 irreversible cardiac damage or type 2 reversible damage, including myocardial injury or ejection fraction reduction.<br /><br />The report highlights the importance of baseline and ongoing cardiac evaluations for patients on Osimertinib due to its cardiotoxic potential. A thorough cardiologic assessment is emphasized before initiating and during therapy to mitigate risks. This case illustrates the challenge of balancing effective cancer treatment with managing significant side effects, emphasizing individualized patient care and careful monitoring. <br /><br />The tables summarize cardiac adverse events from multiple Osimertinib trials, noting incidences of cardiac failures and changes in ejection fraction. Despite these rare risks, the benefits of Osimertinib in managing EGFR-mutated NSCLC warrant continued use with precautions. The literature calls for increased awareness and monitoring of cardiotoxicity in patients undergoing Osimertinib treatment, facilitating improved management of these adverse effects while maximizing therapeutic outcomes for NSCLC patients.

Asset Subtitle

Ludwing Bacon

Keywords

lung adenocarcinoma

EGFR mutation

Osimertinib

cardiac toxicity

non-small cell lung cancer

cardiac evaluation

cardiotoxicity

myocardial injury

ejection fraction

individualized patient care