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Vol.64 No.3 contents | Japanese/English |
 | Full Text of PDF (2525K) Article in Japanese |
- Case Report -
Two Cases of Takotsubo Cardiomyopathy During Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Treatment for Rare Non-small Cell Lung Cancer with Epidermal Growth Factor Receptor Mutation
Satoshi Tanaka1, Ryota Yagi2, Nobuaki Yoshimura1, Ryo Asakawa1, Satoshi Tobita1, Moto Yaga1, Kiyonobu Ueno11Department of Respiratory Medicine, 2Division of Cardiology, Osaka General Medical Center, Japan
Background. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are recognized as effective and well-tolerated drugs and are widely used clinically in patients with EGFR-positive non-small cell lung cancer. The main adverse events are diarrhea, hepatotoxicity, and skin rash. However, reports of cardiotoxicity are increasing. Case 1. A 77-year-old woman was diagnosed with left upper lobe lung adenocarcinoma cT4N2M1a (PLE, PUL) stage IVA with EGFR L858R mutation and human epidermal growth factor receptor 2 (HER2) mutation. She was started on first-line afatinib (20 mg/day). After 16 days, she presented to our emergency department with a chief complaint of dyspnea on exertion. Based on the suspicion of acute myocardial infarction, coronary angiography and left ventriculography were performed, and takotsubo cardiomyopathy was diagnosed. Case 2. An 82-year-old woman was diagnosed with right upper lobe lung adenocarcinoma cT4N2M0 stage IIIB with EGFR del19 mutation and L861Q mutation. She was started on first-line osimertinib (80 mg/day) and suddenly developed palpitations at night 4 days after the start of treatment. Based on the suspicion of acute myocardial infarction, coronary angiography and left ventriculography were performed, and takotsubo cardiomyopathy was diagnosed. Conclusion. EGFR-TKI-induced cardiotoxicity can also cause takotsubo cardiomyopathy. Although it is considered to be a relatively rare adverse event, it can be fatal and the possibility that takotsubo cardiomyopathy may develop during EGFR-TKI treatment should be noted.
key words: EGFR mutation, EGFR-TKI, Cardiotoxicity, Takotsubo cardiomyopathy
Received: January 12, 2024
Accepted: March 21, 2024
JJLC 64 (3): 200-205, 2024
