EGFR and heart failure: Osimertinib, a first-line treatment for EGFR-mutated NSCLC, often leads to adverse effects like rashes, diarrhea, and dry skin, with serious adverse effects in 22% of patients vs 25% of patients receiving other EGFR-TKIs, and interstitial lung disease in 2.2% vs 1.4%.14 Analyses do not link osimertinib to heart failure, yet reduced LVEF has been noted in patients with cardiac risk.20 Other studies18,20 suggest higher rates of cardiac toxic effects, potentially not dose dependent, than clinical trials report.