Authors
Tomoya Sugimoto, Yoshihiro Noguchi, Rikuto Masuda, Sorami Tani, Tomohiko Harada, Yukio Toyama, Mitsuru Saguchi, Tomoaki Yoshimura
Published in
Current oncology (Toronto, Ont.). Volume 33. Issue 10. Sep 29, 2026. Epub Sep 29, 2026.
Abstract
Osimertinib is the standard of care for epidermal growth factor receptor mutation-positive non-small cell lung cancer, but heart failure hospitalization (HFH) remains a concern, and no practical tool exists to stratify HFH risk during therapy.
In this retrospective cohort study using a Japanese claims database, 5802 patients newly initiating osimertinib were followed for HFH during treatment. Baseline predictors assessed before the index date were selected by 10-fold cross-validated least absolute shrinkage and selection operator (LASSO) logistic regression and internally validated by bootstrapping (B = 500), repeating predictor selection in each resample. Cumulative incidence functions and Fine-Gray models treated death as a competing event; cause-specific Cox models served as sensitivity analyses.
HFH occurred in 169 patients (2.9%) during a median on-treatment follow-up of 9.3 months, with 268 competing deaths. LASSO retained seven predictors. The apparent concordance index (C-index) was 0.731 (95% confidence interval, 0.691-0.771) and the optimism-corrected C-index 0.718. Observed incidence increased 10.2-fold across predicted-risk deciles (1.03-10.50%). Fine-Gray and Cox estimates closely matched the logistic model.
Baseline cardiovascular vulnerability stratifies HFH risk during osimertinib therapy. The nomogram, not externally validated, is best used as a screening aid to identify patients who may benefit from intensified cardiovascular monitoring.
PMID:
42930153
Bibliographic data and abstract were imported from PubMed on 26 Oct 2026.
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