• Shun Shinomiya, Kyoichi Kaira, Ou Yamaguchi, Keitaro Ishikawa, and Hiroshi Kagamu.
• Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama University Hospital, 1397-1 Yamane, Hidaka-City, Saitama, Japan.
• Medicine (Baltimore). 2020 Sep 25; 99 (39): e22301e22301.

RationaleCardiotoxicity related to osimertinib, including cardiac failure, QT prolongation, and atrial fibrillation, has been reported as an extremely rare incidence in patients with advanced non-small cell lung cancer (NSCLC). However, little is known about the occurrence of osimertinib-induced cardiomyopathy.Patient ConcernsA 76-year old woman was treated with afatinib (40 mg/day) as the 1st line treatment due to recurrence after surgical resection for pulmonary adenocarcinoma. However, she experienced recurrence with positive T790 M, and osimertinib (80 mg/day) was administered as the 2nd line therapy.DiagnosisFour months after osimertinib initiation, she complained of fever and progressive dyspnea, and a diagnostic endomyocardial biopsy confirmed non-specific cardiomyopathy, indicating osimertinib-induced cardiomyopathy.Interventions And OutcomesShe was treated with furosemide, carvedilol, and enalapril, and her cardiac function, her symptoms, and condition improved 3 weeks after the withdrawal of osimertinib.LessonsPhysicians should be alert of the cardiomyopathy-causing potential of osimertinib in advanced NSCLC patients.

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