Gefitinib induced severe but reversible heart failure with a reduced ejection fraction in an 84-year-old woman with EGFR-mutated lung adenocarcinoma, which was confirmed by recurrence on rechallenge.
Case Report (n=1)
No
Gefitinib can induce severe heart failure with reduced ejection fraction, highlighting the need for careful cardiac monitoring when switching EGFR tyrosine kinase inhibitors due to cumulative cardiotoxicity.
An 84-year-old woman with epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma developed sequential cardiotoxicity during treatment with two EGFR tyrosine kinase inhibitors. Osimertinib induced QT prolongation without systolic dysfunction, thus necessitating discontinuation. After switching to gefitinib, the patient developed heart failure with a reduced ejection fraction, which resolved after drug withdrawal, but recurred upon rechallenge. This case represents a rare instance of severe gefitinib-induced heart failure following electrical instability associated with osimertinib and highlights the need for careful cardiac monitoring and the awareness of cumulative cardiotoxicity when switching EGFR tyrosine kinase inhibitors, even to first-generation agents which are considered to be safe.
Ohtaka et al. (Thu,) conducted a case report in EGFR-mutated lung adenocarcinoma (n=1). Gefitinib was evaluated. Gefitinib induced severe but reversible heart failure with a reduced ejection fraction in an 84-year-old woman with EGFR-mutated lung adenocarcinoma, which was confirmed by recurrence on rechallenge.