한빛사논문
- 조회46
Minjung Bak MD a,∗, Hyukjin Park MD b,∗, Se-Hoon Lee MD c, Nuri Lee MD b, Myung-Ju Ahn MD c, Jin Seok Ahn MD c, Hyun Ae Jung MD c, Sehhoon Park MD c, Jinhyun Cho MD d, Jihoon Kim MD a, Sung-Ji Park MD a, Sung-A Chang MD a, Sang-Chol Lee MD a, Seung Woo Park MD a, Eun Kyoung Kim MD a
aDivision of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
bDepartment of Cardiology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
cDivision of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
dDivision of Hematology and Oncology, Department of Medicine, Inha University Hospital, Inchon, Republic of Korea
Corresponding author: Eun Kyoung Kim, MD, PhD
Abstract
Introduction: While osimertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor, as the first-line therapy for metastatic non-small cell lung cancer (NSCLC) has shown significant survival benefits, concerns have arisen regarding its potential cardiotoxicity, particularly in real-world clinical settings. We aimed to investigate the incidence, risk factors, and reversibility of osimertinib-related cardiotoxicity.
Methods: We analyzed 1,126 NSCLC patients treated with osimertinib from May 2016 to April 2023 in two cancer centers. Osimertinib-related cardiotoxicity was defined as a composite of osimertinib-related cardiac dysfunction (ORCD), newly developed arrhythmia, and cardiac death. Total follow-up duration was 20.6 (10.8-35.2) months.
Results: The osimertinib was administered for a median of 12.4 months. The incidence of osimertinib-related cardiotoxicity was 4.7%. Advanced age (adjusted hazard ratio with 95% confidence interval; 1.07 [1.04-1.09], P < 0.001), a history of heart failure (HF; 3.35 [1.67-9.64], P = 0.025), atrial fibrillation (AF; 3.42 [1.27-9.22], P = 0.015), and baseline low left ventricle strain (0.87 [0.79-0.96], P = 0.005) were independently associated with development of cardiotoxicity. The recovery rate of ORCD was 82.4%, which did not differ between patients who discontinued medication and those who did not.
Conclusion: In real-world practice, the incidence of osimertinib-related cardiotoxicity was 4.7%, including 3.4% for ORCD requiring cardiologic intervention, which is higher than previously reported. Given the long-term medication of osimertinib and increased mortality associated with cardiotoxicity, vigilant monitoring is crucial, especially in patients with advanced age, history of HF, AF, or decreased baseline LV strain.
논문정보
- Research article
- 2024년 10월 (BRIC 등록일 2024-10-30)
- 국내 연구진
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