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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We would like to thank Editage (www.editage.com) for English language editing.
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All authors contributed to the conception and design of the study. KF and TH wrote the first draft of the manuscript.
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T. Hase received personal fees and research funding from Chugai Pharmaceutical Co. outside the submitted work. All remaining authors have no conflicts of interest to declare.
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The patient gave written informed consent as a part of an observational study approved by the Ethics Review Committee of Nagoya University Graduate School of Medicine (No. 2018–0386).
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Futamura, K., Hase, T., Tanaka, A. et al. Lethal ventricular arrhythmia due to entrectinib-induced Brugada syndrome: a case report and literature review. Int Canc Conf J 12, 299–304 (2023). https://doi.org/10.1007/s13691-023-00620-y
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DOI: https://doi.org/10.1007/s13691-023-00620-y