奥西美替尼诱导的双心室心肌病伴心脏MRI异常:一例报告。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Karishma Patel, Kristie Y Hsu, Kevin Lou, Krishan Soni, Yoo Jin Lee, Claire K Mulvey, Alan H Baik
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引用次数: 1

摘要

背景:Osimertinib是一种第三代表皮生长因子受体(EGFR)抑制剂,由于其与前几代EGFR抑制剂相比具有良好的疗效和耐受性,目前是转移性EGFR突变的非小细胞肺癌(NSCLC)的一线治疗药物。然而,它可能会导致罕见但严重的心血管不良反应。病例介绍:我们报告了一例63岁的EGFR突变非小细胞肺癌患者,他接受奥西替尼治疗,在心包积液扩大的情况下发展为新发非缺血性心肌病,伴有双心室功能障碍和心力衰竭。我们首次证明了与奥西替尼相关心肌病相关的心脏MR成像结果,包括局灶性晚期钆增强和心肌水肿。患者的双心室功能在开始以目标为导向的心力衰竭药物治疗并服用奥西替尼后恢复正常。患者随后开始服用第二代表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)阿法替尼,没有心肌病复发。结论:该病例强调需要更好地了解奥西替尼诱导的心脏毒性,以及在癌症治疗中出现严重心脏毒性的患者中优化肿瘤治疗的策略。它进一步强调了对出现心脏毒性的癌症患者进行专业多学科护理以优化其肿瘤结果的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Osimertinib-induced biventricular cardiomyopathy with abnormal cardiac MRI findings: a case report.

Background: Osimertinib is a third-generation epidermal growth factor receptor (EGFR) inhibitor that is currently the first-line treatment for metastatic EGFR-mutated non-small-cell lung cancer (NSCLC) due to its favorable efficacy and tolerability profile compared to previous generations of EGFR inhibitors. However, it can cause uncommon, yet serious, cardiovascular adverse effects.

Case presentation: We present the case of a 63-year-old man with EGFR-mutated NSCLC treated with osimertinib who developed new-onset non-ischemic cardiomyopathy with biventricular dysfunction and heart failure in the context of an enlarging pericardial effusion. For the first time, we demonstrate cardiac MR imaging findings associated with osimertinib-associated cardiomyopathy, including focal late gadolinium enhancement and myocardial edema. The patient's biventricular function normalized after initiation of goal-directed medical therapy for heart failure and holding osimertinib. The patient was subsequently started on afatinib, a second-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), without recurrence of cardiomyopathy.

Conclusions: This case highlights the need to better understand osimertinib-induced cardiotoxicity and strategies to optimize oncologic care in patients who develop severe cardiac toxicities from cancer therapy. It further underlines the importance of specialized multidisciplinary care of cancer patients who develop cardiotoxicities to optimize their oncologic outcomes.

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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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