High incidence and reversible bradycardia events following alectinib initiation
Abstract Background With the widespread use of alectinib in patients with anaplastic lymphoma kinase (ALK)‐positive non‐small‐cell lung cancer (NSCLC), its cardiotoxicity has gradually emerged, including new‐onset sinus bradycardia (SB). However, the incidence, timing, severity, and risk factors of...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.14769 |
| _version_ | 1828034248223752192 |
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| author | Dongqi Yuan Fuyi Zhu Ran Zuo Yu Wang Gengwei Huo Jinfang Cui Ping Yue Peng Chen |
| author_facet | Dongqi Yuan Fuyi Zhu Ran Zuo Yu Wang Gengwei Huo Jinfang Cui Ping Yue Peng Chen |
| author_sort | Dongqi Yuan |
| collection | DOAJ |
| description | Abstract Background With the widespread use of alectinib in patients with anaplastic lymphoma kinase (ALK)‐positive non‐small‐cell lung cancer (NSCLC), its cardiotoxicity has gradually emerged, including new‐onset sinus bradycardia (SB). However, the incidence, timing, severity, and risk factors of alectinib‐induced bradycardia remain unknown. Methods From January 2020 to June 2022, 93 patients with ALK‐positive NSCLC treated with alectinib were enrolled in this retrospective analysis. These patients had heart rate (HR) recorded before and after alectinib administration. By reviewing electronic medical records and follow‐up, the HR changes of patients during medication were recorded. The potential risk factors associated with alectinib‐induced SB were explored. Results According to an HR cut‐off of 60 beats per minute (bpm), 47 patients (50.54%) experienced at least one recorded bradycardia. The mean HR of total participants before alectinib administration was 78.32 (standard deviation [SD], 9.48) and after was 64.88 (SD, 12.21). The median maximum change in HR (range) for all patients was 11 (−55, +4) bpm. For the bradycardia subgroup, the HR of most patients (76.60%) hovered around 50–60 bpm, and 61.70% of SB occurred within 3 months after alectinib administration. Multivariate analysis indicated that baseline HR (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.79–0.93, p < 0.001) and history of hypertension (OR 13.71, 95% CI 2.49–76.38, p = 0.003) were independent risk factors for alectinib‐related bradycardia. Conclusions Alectinib‐induced bradycardia had a high incidence, appeared relatively early, and was reversible by dose reduction or withdrawal. |
| first_indexed | 2024-04-10T15:29:49Z |
| format | Article |
| id | doaj.art-13f58bd10bd34960875d290106708de6 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-10T15:29:49Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-13f58bd10bd34960875d290106708de62023-02-14T02:01:34ZengWileyThoracic Cancer1759-77061759-77142023-02-0114547948810.1111/1759-7714.14769High incidence and reversible bradycardia events following alectinib initiationDongqi Yuan0Fuyi Zhu1Ran Zuo2Yu Wang3Gengwei Huo4Jinfang Cui5Ping Yue6Peng Chen7Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaAbstract Background With the widespread use of alectinib in patients with anaplastic lymphoma kinase (ALK)‐positive non‐small‐cell lung cancer (NSCLC), its cardiotoxicity has gradually emerged, including new‐onset sinus bradycardia (SB). However, the incidence, timing, severity, and risk factors of alectinib‐induced bradycardia remain unknown. Methods From January 2020 to June 2022, 93 patients with ALK‐positive NSCLC treated with alectinib were enrolled in this retrospective analysis. These patients had heart rate (HR) recorded before and after alectinib administration. By reviewing electronic medical records and follow‐up, the HR changes of patients during medication were recorded. The potential risk factors associated with alectinib‐induced SB were explored. Results According to an HR cut‐off of 60 beats per minute (bpm), 47 patients (50.54%) experienced at least one recorded bradycardia. The mean HR of total participants before alectinib administration was 78.32 (standard deviation [SD], 9.48) and after was 64.88 (SD, 12.21). The median maximum change in HR (range) for all patients was 11 (−55, +4) bpm. For the bradycardia subgroup, the HR of most patients (76.60%) hovered around 50–60 bpm, and 61.70% of SB occurred within 3 months after alectinib administration. Multivariate analysis indicated that baseline HR (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.79–0.93, p < 0.001) and history of hypertension (OR 13.71, 95% CI 2.49–76.38, p = 0.003) were independent risk factors for alectinib‐related bradycardia. Conclusions Alectinib‐induced bradycardia had a high incidence, appeared relatively early, and was reversible by dose reduction or withdrawal.https://doi.org/10.1111/1759-7714.14769anaplastic lymphoma kinasealectinibbradycardianon‐small‐cell lung cancer |
| spellingShingle | Dongqi Yuan Fuyi Zhu Ran Zuo Yu Wang Gengwei Huo Jinfang Cui Ping Yue Peng Chen High incidence and reversible bradycardia events following alectinib initiation Thoracic Cancer anaplastic lymphoma kinase alectinib bradycardia non‐small‐cell lung cancer |
| title | High incidence and reversible bradycardia events following alectinib initiation |
| title_full | High incidence and reversible bradycardia events following alectinib initiation |
| title_fullStr | High incidence and reversible bradycardia events following alectinib initiation |
| title_full_unstemmed | High incidence and reversible bradycardia events following alectinib initiation |
| title_short | High incidence and reversible bradycardia events following alectinib initiation |
| title_sort | high incidence and reversible bradycardia events following alectinib initiation |
| topic | anaplastic lymphoma kinase alectinib bradycardia non‐small‐cell lung cancer |
| url | https://doi.org/10.1111/1759-7714.14769 |
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