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Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities

  • Authors:
    • Yanmei Peng
    • Dong Li
    • Jason A. Wampfler
    • Yung-Hung Luo
    • Ashok V. Kumar
    • Zhong Gu
    • Nikhila Kosuru
    • Nathan Y. Yu
    • Zhichao Wang
    • Konstantinos Leventakos
    • Vinicius Ernani
    • Ping Yang
  • View Affiliations / Copyright

    Affiliations: Department of Oncology, Fangshan Hospital Beijing University of Chinese Medicine, Beijing 102400, P.R. China, Department of Cardiology, Dongfang Hospital, The Second Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100078, P.R. China, Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan, R.O.C., Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, AZ 85259, USA, Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ 85259, USA, Division of Pulmonary and Critical Care Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China, Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA, Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ 85054, USA
    Copyright: © Peng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 25
    |
    Published online on: December 18, 2024
       https://doi.org/10.3892/or.2024.8858
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Abstract

Targeted drugs have revolutionized the treatment of advanced non‑small cell lung cancer (NSCLC). However, the understanding of how cardiac comorbidity and toxicity affect the clinical outcomes of patients following targeted therapy remains limited. In a 14‑year cohort, cardiac comorbidities and toxicities among patients with stage‑IV NSCLC treated with targeted therapy were identified. The cardiotoxicities were compared in three patient groups: Cardiac, other and no comorbidities. Survival analysis employed Cox Proportional Hazard Models. In the prospectively followed 3,767 patients with stage‑IV NSCLC, 701 received targeted therapy; of which 133 (19.0%) had cardiac comorbidity, 504 (71.9%) had other comorbidities and 64 (9.1%) had none. In total, 15 patients (2.1%) developed cardiotoxicity after taking drugs targeting epidermal growth factor receptor, anaplastic lymphoma kinase (ALK), c‑ros oncogene 1 (ROS1) or vascular endothelial growth factor/receptor (VEGF)/VEGFR, and all 15 had comorbidities: 10 cardiac and 5 other comorbidities. Cardiac comorbidity was associated with a 7.5‑fold higher risk of targeted therapy‑related cardiotoxicity than other comorbidities (7.5 vs. 1.0%; P<0.001). Patients with or without cardiotoxicity had a median survival time of 4.7 or 1.9 years, respectively, and patients with cardiotoxicity had a lower risk of death (hazard ratio, 0.45; 95% confidence interval, 0.25‑0.81) than those without (P=0.003), when adjusting for comorbidities. In the 164 patients that received osimertinib, 32 (19.5%) had cardiac comorbidity and a 1.7‑fold higher risk of death than the 121 (73.8%) patients with other comorbidities. In the 74 patients treated with ALK/ROS1 inhibitors, cardiotoxicity was 14 times more common in patients with heart disease (30.0%) than those without (2.1%) (P=0.001). Cardiotoxicity was uncommon in patients with targeted drug‑treated stage‑IV NSCLC but was more prevalent in those with cardiac comorbidity and appeared to be a protector for longer survival. However, in osimertinib‑treated patients, cardiac comorbidity increased mortality.
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Copy and paste a formatted citation
Spandidos Publications style
Peng Y, Li D, Wampfler JA, Luo Y, Kumar AV, Gu Z, Kosuru N, Yu NY, Wang Z, Leventakos K, Leventakos K, et al: Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities. Oncol Rep 53: 25, 2025.
APA
Peng, Y., Li, D., Wampfler, J.A., Luo, Y., Kumar, A.V., Gu, Z. ... Yang, P. (2025). Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities. Oncology Reports, 53, 25. https://doi.org/10.3892/or.2024.8858
MLA
Peng, Y., Li, D., Wampfler, J. A., Luo, Y., Kumar, A. V., Gu, Z., Kosuru, N., Yu, N. Y., Wang, Z., Leventakos, K., Ernani, V., Yang, P."Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities". Oncology Reports 53.2 (2025): 25.
Chicago
Peng, Y., Li, D., Wampfler, J. A., Luo, Y., Kumar, A. V., Gu, Z., Kosuru, N., Yu, N. Y., Wang, Z., Leventakos, K., Ernani, V., Yang, P."Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities". Oncology Reports 53, no. 2 (2025): 25. https://doi.org/10.3892/or.2024.8858
Copy and paste a formatted citation
x
Spandidos Publications style
Peng Y, Li D, Wampfler JA, Luo Y, Kumar AV, Gu Z, Kosuru N, Yu NY, Wang Z, Leventakos K, Leventakos K, et al: Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities. Oncol Rep 53: 25, 2025.
APA
Peng, Y., Li, D., Wampfler, J.A., Luo, Y., Kumar, A.V., Gu, Z. ... Yang, P. (2025). Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities. Oncology Reports, 53, 25. https://doi.org/10.3892/or.2024.8858
MLA
Peng, Y., Li, D., Wampfler, J. A., Luo, Y., Kumar, A. V., Gu, Z., Kosuru, N., Yu, N. Y., Wang, Z., Leventakos, K., Ernani, V., Yang, P."Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities". Oncology Reports 53.2 (2025): 25.
Chicago
Peng, Y., Li, D., Wampfler, J. A., Luo, Y., Kumar, A. V., Gu, Z., Kosuru, N., Yu, N. Y., Wang, Z., Leventakos, K., Ernani, V., Yang, P."Targeted therapy‑associated cardiotoxicity in patients with stage‑IV lung cancer with or without cardiac comorbidities". Oncology Reports 53, no. 2 (2025): 25. https://doi.org/10.3892/or.2024.8858
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