Mensah Samuel Akaakole, Ahmad Syed, Alruwaili Waleed, Raval Rutu, Gonuguntla Karthik, Patel Brijesh
Department of Medicine, West Virginia University, Morgantown, West Virginia, USA
Department of Medicine, West Virginia University, Morgantown, West Virginia, USA.
Eur J Hosp Pharm. 2025 Jan 31. doi: 10.1136/ejhpharm-2024-004319.
There have been cases of cardiotoxicity induced by osimertinib in patients with non-small-cell lung cancer (NSCLC). However, limited data exist for a comprehensive cardiotoxicity profile analysis for osimertinib use in NSCLC patients. The aim of this study was to report the entire profile of cardiotoxicities after the initiation of osimertinib in consecutive patients with epidermal growth factor receptor (EGFR) mutation at a single health system.
The data were retrospectively collected from electronic medical records for all patients who were started on osimertinib for NSCLC at West Virginia University Health System. Prevalence of heart failure (HF), atrial fibrillation, and prolonged QT before and after starting osimertinib were calculated.
This study had 116 participants and the median age was 72 years. The frequency of each new cardiotoxicity was between 6% and 9%, and the overall percentage of patients who had developed any of the four cardiotoxicities while on osimertinib was 19.9%. The median time of follow-up was 477 days and the median time on osimertinib for all patients was 390 days. The strongest risk factor in predicting a new onset cardiac event was hypertension with a hazard ratio (HR) of 6.35 (confidence interval (CI) 1.48 to 27.23, p=0.013) and HR 5.36 (CI 1.23 to 23.39, p=0.025) in univariate and multivariate analysis respectively.
Osimertinib appears to be associated with an increase in cardiac abnormalities. Given the association between this medication exposure and the observed cardiac toxicities, use of osimertinib may entail closer cardiac monitoring of electrocardiogram (ECG) and echocardiogram abnormalities.
在非小细胞肺癌（NSCLC）患者中，已有奥希替尼诱发心脏毒性的病例。然而，关于NSCLC患者使用奥希替尼的全面心脏毒性分析的数据有限。本研究的目的是报告在单一医疗系统中，连续的表皮生长因子受体（EGFR）突变患者开始使用奥希替尼后心脏毒性的全貌。
回顾性收集西弗吉尼亚大学医疗系统中所有开始使用奥希替尼治疗NSCLC患者的电子病历数据。计算开始使用奥希替尼前后心力衰竭（HF）、心房颤动和QT间期延长的发生率。
本研究有116名参与者，中位年龄为72岁。每种新的心脏毒性发生率在6%至9%之间，在使用奥希替尼期间出现这四种心脏毒性中任何一种的患者总比例为19.9%。中位随访时间为477天，所有患者使用奥希替尼的中位时间为390天。预测新发心脏事件的最强危险因素是高血压，单因素分析中风险比（HR）为6.35（置信区间（CI）1.48至27.23，p = 0.013），多因素分析中HR为5.36（CI 1.23至23.39，p = 0.025）。
奥希替尼似乎与心脏异常增加有关。鉴于这种药物暴露与观察到的心脏毒性之间的关联，使用奥希替尼可能需要更密切地监测心电图（ECG）和超声心动图异常。
