Reversible osimertinib‑associated heart failure mimicking cancer recurrence in <em>EGFR</em>‑mutated non‑small cell lung cancer after pneumonectomy: A case report

Yokoyama,Hirona; Hara,Nobuhito; Sasaki,Rika; Yoshii,Yumi; Ota,Masahide; Okazaki,Shunsuke; Nakagawa,Hitoshi; Kawaguchi,Takeshi; Hamaji,Masatsugu; Nitta,Yuji; Takeda,Maiko; Takeda,Masayuki

doi:10.3892/etm.2026.13293

November-2026 Volume 32 Issue 5

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November-2026 Volume 32 Issue 5

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Case Report Open Access

Reversible osimertinib‑associated heart failure mimicking cancer recurrence in EGFR‑mutated non‑small cell lung cancer after pneumonectomy: A case report

Authors:
- Hirona Yokoyama
- Nobuhito Hara
- Rika Sasaki
- Yumi Yoshii
- Masahide Ota
- Shunsuke Okazaki
- Hitoshi Nakagawa
- Takeshi Kawaguchi
- Masatsugu Hamaji
- Yuji Nitta
- Maiko Takeda
- Masayuki Takeda
View Affiliations / Copyright

Affiliations: Center for Postgraduate Training, Nara Medical University Hospital, Kashihara, Nara 634‑8521, Japan, Department of Cancer Genomics and Medical Oncology, Nara Medical University, Kashihara, Nara 634‑8521, Japan, Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara 634‑8521, Japan, Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Kashihara, Nara 634‑8521, Japan, Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara 634‑8521, Japan

Copyright: © Yokoyama et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 298
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Published online on: September 11, 2026

https://doi.org/10.3892/etm.2026.13293
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Abstract

Osimertinib is a third‑generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor widely used in patients with EGFR mutation‑positive non‑small cell lung cancer (NSCLC). Although generally well tolerated, clinically notable cardiovascular toxicities, including heart failure, have been recognized. The present study describes the case of a 77‑year‑old man who developed symptomatic heart failure 5 months after initiating osimertinib treatment for postoperative recurrence of NSCLC. The patient presented with dyspnea and right‑sided pleural effusion, which was initially suspected to represent tumor progression. However, the pleural effusion was transudative and echocardiography revealed a marked reduction in left ventricular ejection fraction from 69 to 27%. Discontinuation of osimertinib and treatment for heart failure resulted in resolution of the pleural effusion and recovery of cardiac function. The present case highlights the importance of differentiating heart failure‑related pleural effusion from tumor recurrence and indicates the need for careful monitoring of cardiac function during osimertinib therapy, particularly in patients with conditions that may compromise cardiopulmonary reserve, such as prior pneumonectomy or aortic stenosis.

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Reversible osimertinib‑associated heart failure mimicking cancer recurrence in EGFR‑mutated non‑small cell lung cancer after pneumonectomy: A case report

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