Site Editor
Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Thursday, February 1, 2024
According to findings presented in the journal Expert Opinion on Drug Safety, older patients who undergo treatment with osimertinib may be at increased risk for long QT syndrome, a serious cardiotoxicity that disrupts heart rhythm. Osimertinib is a third-generation epidermal growth factor receptor–tyrosine kinase inhibitor (EGFR-TKI).
“The distinct risk of long QT syndrome associated with the generation of EGFR-TKIs and patient demographic characteristics could help clinicians and oncologists choose appropriate treatment options and recognize the need for preventing and monitoring long QT syndrome after EGFR-TKI use, especially in high-risk groups,” concluded Chanhyun Park, PhD, MPharm, MEd, RPh, of The University of Texas at Austin, and colleagues.
The retrospective observational study included patients with advanced non–small cell lung cancer (NSCLC) who had been treated with either osimertinib (n = 1,614) or a first- or second-generation EGFR-TKI (n = 1,659) between 2007 and 2017. Compared with the first- or second-generation group, the osimertinib group had a higher incidence rate of long QT syndrome (2.62 vs 1.33 per 100 person-years). The elevated risk remained after adjustment for covariates (hazard ratio = 1.94, 95% confidence interval = 1.23–3.08). Within the osimertinib group, long QT syndrome risk was particularly high for female patients, White patients, and patients aged 75 or older.
Patient information was sourced Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2006 to 2019. Propensity scores of study cohorts were balanced via inverse probability of treatment weighting. Scores were estimated based on socioeconomic and clinical patient characteristics.
“Close monitoring for cardiac rhythm irregularities of high-risk patients following initiation of EGFR-TKI is recommended,” the study authors proposed.
Disclosure: The study authors reported no conflicts of interest.
JNCCN Spotlights
