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Chronic erlotinib treatment, as reported by Mak et al., led to hypomagnesemia, triggering substance P receptor-mediated oxidative stress and resulting in cardiac dysfunction ( 3 Clinical manifestations of EGFR-TKIs-related cardiotoxicity Since the advent of EGFR-TKI drugs, their associated cardiovascular adverse events have been extensively documented, including prolonged QT intervals, HF, atrial fibrillation (AF), myocardial infarction (MI), pericardial effusion, hypertension, and cardiac valvular lesions (Figure 2) ( FIGURE 2 3.1 QT interval prolongation Extended QT intervals pose an elevated risk for severe arrhythmias, including torsade de pointes (TdP), a potentially fatal condition precipitating sudden cardiac death ( Within the realm of EGFR-TKIs, the third-generation variant, osimertinib, exhibited substantially higher rates of QT interval prolongation compared to other EGFR-TKIs (ROR = 49.19, 99% CI: 25.8893.47), other targeted NSCLC therapies (ROR = 6.13, 99% CI: 4.438.48), and the overall VigiBase database (ROR = 14.34, 99% CI: 10.7919.04, IC025 = 3.38)

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