• EGFR基因突变在美国非小细胞肺癌腺癌中观察到约15％，与吸烟无关。存在多种EGFR突变型，其中最常见的是外显子19缺失和外显子21的点突变L858R。 • Osimertinib是一种口服酪氨酸激酶抑制剂，用于携带外显子19缺失和外显子21 L858R突变的转移性非小细胞肺癌的初始治疗。常见副作用包括痤疮样皮疹，腹泻和甲沟炎。Osimertinib还与心肌病（约1.4％-2.4％）和QT间期延长（2.7％）相关。 • 根据我们的经验，osimertinib引起的心肌病可以通过停用osimertinib和启动指南指导下的治疗来管理。考虑到osimertinib通常是最佳可用疗法，再次尝试osimertinib通常对益处大于风险。该案例证明安全地再次使用osimertinib。 © 2023美国心脏病学会基金会通过Elsevier出版

•Mutations in the EGFR gene are observed in about 15% of NSCLC adenocarcinomas in the United States and are not associated with smoking. There are numerous EGFR mutations, with the most common being exon 19 deletions and the point mutation L858R in exon 21.•Osimertinib, an oral TKI, is used as the initial therapy for metastatic NSCLC harboring exon 19 deletion and exon 21 L858R mutation. Common side effects include acneiform rash, diarrhea, and paronychia. Osimertinib has also been associated with cardiomyopathy (∼1.4%-2.4%) and prolongation of the QT interval (2.7%).•In our experience, osimertinib-induced cardiomyopathy can be managed with the cessation of osimertinib and the initiation of guideline-directed therapy. Given that osimertinib is often the best available therapy, rechallenging with osimertinib often favors benefit over risk. Safe rechallenge with osimertinib is demonstrated in this case.© 2023 Published by Elsevier on behalf of the American College of Cardiology Foundation.