Anlotinib-induced sick sinus syndrome: Two case reports

Abstract

BACKGROUND

This manuscript describes the first known cases of sick sinus syndrome (SSS) associated with the use of anlotinib in non-small cell lung cancer patients, highlighting the need for increased vigilance and cardiac monitoring.

CASE SUMMARY

Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment, respectively, presenting with syncope and palpitations. Electrocardiogram confirmed SSS, and different treatment approaches were taken for each patient. One patient received a dual-chamber permanent pacemaker, while the other discontinued the medication and experienced symptom resolution.

CONCLUSION

Anlotinib can induce SSS, suggesting that cardiac monitoring is crucial during anlotinib treatment. Individualized management strategies are necessary for affected individuals.

Keywords: Lung cancer; Anlotinib; Sick sinus syndrome; Cardiac pacemaker; Adverse drug reaction; Case report

Core Tip: This case report presents the first known instances of sick sinus syndrome associated with the use of anlotinib in patients with non-small cell lung cancer, emphasizing the importance of cardiac monitoring during treatment. The report compares two different management approaches for anlotinib-induced sick sinus syndrome, one with a dual-chamber permanent pacemaker and the other with medication discontinuation, providing valuable insights for clinical practice.