Lethal ventricular arrhythmia due to entrectinib-induced Brugada syndrome: a case report and literature review.

IF 0.5 Q4 ONCOLOGY International Cancer Conference Journal Pub Date : 2023-06-26 eCollection Date: 2023-10-01 DOI:10.1007/s13691-023-00620-y

Keisuke Futamura, Tetsunari Hase, Akihito Tanaka, Yoshinori Sakai, Shotaro Okachi, Hirofumi Shibata, Futoshi Ushijima, Takahiko Hashimoto, Kuniya Nakashima, Katsuki Ito, Takanori Yamamoto, Atsushi Numaguchi, Yasuya Inden, Makoto Ishii

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Abstract

Entrectinib, a multikinase inhibitor of ROS1 and tropomyosin receptor kinases, is recommended to treat ROS1-positive metastatic non-small cell lung cancer (NSCLC). In a previous study, entrectinib-related cardiotoxicity occurred in 2% of patients; however, lethal arrhythmias remain understudied. We encountered a case of fatal arrhythmia due to drug-induced Brugada syndrome caused by entrectinib. An 81-year-old Japanese male with lung adenocarcinoma harboring ROS1-fusion gene was treated with entrectinib. The patient developed lethal arrhythmias three days after drug initiation, including ventricular tachycardia with Brugada-like electrocardiogram changes. Echocardiography and coronary angiography revealed no evidence of acute coronary syndrome or myocarditis. Following the termination of entrectinib, the electrocardiogram abnormality improved within 12 days. Hence, paying special attention to and monitoring electrocardiogram changes is necessary. In addition, it is also necessary to consider early therapeutic interventions and discontinuation of the drug in cases of drug-induced Brugada syndrome.

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恩特替尼诱导的Brugada综合征引起的致命性室性心律失常：一例病例报告和文献综述。

Entrectinib是ROS1和原肌球蛋白受体激酶的多激酶抑制剂，推荐用于治疗ROS1阳性转移性癌症（NSCLC）。在之前的一项研究中，2%的患者出现了与恩替尼相关的心脏毒性；然而，致命性心律失常的研究仍然不足。我们遇到了一例因恩特替尼引起的药物诱导Brugada综合征导致的致命心律失常。一名携带ROS1融合基因的81岁日本男性肺腺癌患者接受恩曲替尼治疗。患者在用药三天后出现致命心律失常，包括室性心动过速伴Brugada样心电图改变。超声心动图和冠状动脉造影显示没有急性冠状动脉综合征或心肌炎的证据。恩曲替尼终止治疗后，心电图异常在12天内得到改善。因此，有必要特别注意和监测心电图的变化。此外，在药物诱导的Brugada综合征病例中，也有必要考虑早期治疗干预和停药。

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International Cancer Conference Journal ONCOLOGY-

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14.30%

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期刊介绍： This online-only journal publishes original case reports on all types of cancer. In particular, we welcome not only case reports of educational value in the diagnosis and treatment of cancers, but also reports on molecularly analyzed cancer cases, including gene mutations, gene fusions, gene expression, and changes in copy number, regardless of their known clinical significance. Assessing the molecular analysis of a tumor usually requires a “cancer conference” in which experts from various fields discuss it. Even if the authors and their respective “cancer conference” were unable to determine the clinical significance of molecular changes at the time of submission and publication, their data may provide evidence that will help the scientific community develop precision medicine solutions in the future. We welcome case reports with reviews of the literature on similar cases, as they are more useful and valuable to readers than are reports of rare cases. International Cancer Conference Journal is the official publication of the Japan Society of Clinical Oncology (JSCO). - Presents an online-only collection of original case reports on all types of cancer - In particular, welcomes molecularly analyzed cancer cases - The Official Publication of the Japan Society of Clinical Oncology (JSCO)