Lung cancer (Amsterdam, Netherlands) · 2026
Cardiovascular adverse events in non-small cell lung cancer patients receiving osimertinib therapy: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Liu Wei-He, Cheng Yun-Jiu, Kang Jin, Chen Jian, An Zhen-Jie, Li Ting-Hui, Tan Ning, Zhong Wen-Zhao, Wu Yi-Long, Jiang Lei
Аннотация
BACKGROUND AND AIMS: The incidences and specific risk factors for cardiovascular adverse events (CVAEs) during osimertinib treatment remain uncertain.
METHODS: Studies in which participants with EGFR-mutated NSCLC who received osimertinib treatment with CVAEs were included. Treatment-emergent and treatment-related CVAEs were analysed separately. The primary outcomes were all grades and grades ≥ 3 QTc prolongation, left ventricular ejection fraction (LVEF)decrease, 3-point major adverse cardiovascular events (MACE), venous thromboembolism (VTE), and hypertension. The incidences of the CVAEs were calculated, along with subgroup, meta-regression and cumulative analysis.
RESULTS: A total of 10,316 patients from 61 studies were included. Hypertension was the most common treatment-emergent and treatment-related CVAE, for both all-grade and grade ≥ 3. In addition to QTc prolongation (6.88%[95% CI 5.24%-8.70%], there is also a common incidence of treatment-emergent LVEF decrease for all-grade (4.31% [95% CI 2.38%-6.69%]). Subgroup analyses showed higher incidences of treatment-emergent than treatment-related hypertension in anti-VEGF combination therapy (all grades: 45.46% vs. 26.11%). QTc prolongation (all grades and grades ≥ 3) and LVEF reduction (all grade) occurred more frequently with osimertinib plus platinum-pemetrexed than with other treatments, with incidence rates of 22.24%, 6.53%, and 15.82% respectively. Univariable meta-regression further indicated that the cardiovascular toxicity profile of osimertinib was related to treatment regimens, while independent of age, race and prior exposure to EGFR-TKIs. Cumulative analyses showed effect sizes plateaued for primary outcomes.
CONCLUSIONS: Hypertension is the most frequent treatment-emergent and treatment-related CVAE associated with osimertinib. Therapies combining anti-VEGF therapy present a particularly severe cardiac safety profile.
METHODS: Studies in which participants with EGFR-mutated NSCLC who received osimertinib treatment with CVAEs were included. Treatment-emergent and treatment-related CVAEs were analysed separately. The primary outcomes were all grades and grades ≥ 3 QTc prolongation, left ventricular ejection fraction (LVEF)decrease, 3-point major adverse cardiovascular events (MACE), venous thromboembolism (VTE), and hypertension. The incidences of the CVAEs were calculated, along with subgroup, meta-regression and cumulative analysis.
RESULTS: A total of 10,316 patients from 61 studies were included. Hypertension was the most common treatment-emergent and treatment-related CVAE, for both all-grade and grade ≥ 3. In addition to QTc prolongation (6.88%[95% CI 5.24%-8.70%], there is also a common incidence of treatment-emergent LVEF decrease for all-grade (4.31% [95% CI 2.38%-6.69%]). Subgroup analyses showed higher incidences of treatment-emergent than treatment-related hypertension in anti-VEGF combination therapy (all grades: 45.46% vs. 26.11%). QTc prolongation (all grades and grades ≥ 3) and LVEF reduction (all grade) occurred more frequently with osimertinib plus platinum-pemetrexed than with other treatments, with incidence rates of 22.24%, 6.53%, and 15.82% respectively. Univariable meta-regression further indicated that the cardiovascular toxicity profile of osimertinib was related to treatment regimens, while independent of age, race and prior exposure to EGFR-TKIs. Cumulative analyses showed effect sizes plateaued for primary outcomes.
CONCLUSIONS: Hypertension is the most frequent treatment-emergent and treatment-related CVAE associated with osimertinib. Therapies combining anti-VEGF therapy present a particularly severe cardiac safety profile.