QT interval prolongation related to afatinib treatment in a patient with metastatic non-small-cell lung cancer

DEMİRCAN N. C., Akın Telli T., BAŞOĞLU TÜYLÜ T., Arıkan R., Kocakaya D., Şahin A. A., ...More

CURRENT PROBLEMS IN CANCER, vol.44, no.6, 2020 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 44 Issue: 6
  • Publication Date: 2020
  • Doi Number: 10.1016/j.currproblcancer.2020.100594
  • Journal Name: CURRENT PROBLEMS IN CANCER
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
  • Keywords: Afatinib, Epidermal growth factor receptor, Non-small-cell lung cancer, QT prolongation, Tyrosine kinase inhibitor, OPEN-LABEL, CARDIOTOXICITY, ADENOCARCINOMA, CHEMOTHERAPY
  • Marmara University Affiliated: Yes

Abstract

Afatinib improves survival in metastatic non-small-cell lung cancer driven by activating epidermal growth factor receptor mutations. QT interval prolongation is a possible side effect of tar geted anticancer drugs, but this has not been reported before with afatinib. We report a case of metastatic pulmonary adenocarcinoma with epidermal growth factor receptor exon 19 deletion who was treated with first-line afatinib. The patient was started on afatinib with a total dose of 40 mg/day and experienced grade 3 (> 500 ms) QT interval prolongation in the seventh week. Dose was interrupted and then reduced to 30 mg/day after the event repeated. QT prolongation occurred only once with the reduced dose and radiologic oligoprogression was detected. Local therapy was performed and afatinib was continued as 30 mg/day. To the best of our knowledge, this case marks the first QT interval prolongation associated with afatinib. It is prudent to perform a baseline cardiologic evaluation and electrocardiogram monitoring in non-small cell lung cancer patients treated with this drug. (c) 2020 Elsevier Inc. All rights reserved.