Erlotinib-Induced Cardiomyopathy in a Patient with Metastatic Non-Small Cell Lung Cancer

Int Heart J. 2021 Sep 30;62(5):1171-1175. doi: 10.1536/ihj.21-130. Epub 2021 Sep 7.

Abstract

Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor, is a targeted drug used for the treatment of non-small cell lung cancer (NSCLC). Erlotinib is considered relatively safe and generally well-tolerated, with rarely reported cardiac side effects. Herein, we report a case of cardiomyopathy that developed during erlotinib treatment for NSCLC. Two months after erlotinib initiation, our 70 year-old female patient complained of progressive dyspnea, and a diagnostic endomyocardial biopsy confirmed non-specific cardiomyopathy, indicating erlotinib-induced cardiomyopathy. We believed that continued administration of erlotinib would exacerbate her heart failure, while treatment of the heart failure with intensive monitoring would allow the administration of erlotinib to be continued. This case report highlights the potential cardiotoxic effects of erlotinib and suggests the need for close clinical and echocardiographic follow-up of patients receiving erlotinib.

Keywords: CTRCD; Cardio-oncology; EGFR-TKI; Heart failure; Onco-cardiology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy / methods
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / secondary
  • Cardiomyopathies / chemically induced*
  • Cardiomyopathies / pathology
  • Cardiotoxicity / complications
  • Disease Progression
  • Dyspnea / diagnosis
  • Dyspnea / etiology
  • Erlotinib Hydrochloride / adverse effects
  • Erlotinib Hydrochloride / therapeutic use
  • Erlotinib Hydrochloride / toxicity*
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy
  • Heart Failure / etiology
  • Humans
  • Lung Neoplasms / pathology
  • Neoplasm Metastasis / pathology
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Protein Kinase Inhibitors / toxicity*

Substances

  • Protein Kinase Inhibitors
  • Erlotinib Hydrochloride