Crizotinib for ROS1‐rearranged lung cancer and pulmonary tumor thrombotic microangiopathy under venoarterial extracorporeal membrane oxygenation. (21st February 2022)

• Record Type: Journal Article
• Authors: Aoyama, Daisetsu; Fukui, Shigefumi; Hirata, Haruhiko; Ohta‐Ogo, Keiko; Matama, Hideo; Tateishi, Emi; Nishii, Tatsuya; Asaumi, Yasuhide; Toyofuku, Mamoru; Ikeue, Tatsuyoshi; Ogo, Takeshi; Ishibashi‐Ueda, Hatsue; Yasuda, Satoshi
• Is Part Of: Pulmonary circulation. Volume 12:Number 1(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-02-21
• Subjects: crizotinib -- lung cancer -- pulmonary hypertension -- pulmonary tumor thrombotic microangiopathy -- venoarterial extracorporeal membrane oxygenation; Pulmonary circulation -- Periodicals; Pulmonary circulation; Electronic journals -- Sciences; Periodicals; 616.24005
• DOI: 10.1002/pul2.12047
• Languages: English
• ISSNs: 2045-8932

Abstract

Abstract: Pulmonary tumor thrombotic microangiopathy (PTTM) is a rapidly progressive subtype of pulmonary hypertension (PH) associated with impaired right ventricular adaptation and very poor prognosis in cancer, and its rapid progression makes antemortem diagnosis and treatment extremely difficult. We describe the case of a 35‐year‐old woman who developed severe PH with subsequent circulatory collapse. The patient was clinically diagnosed with PTTM induced by lung adenocarcinoma harboring the c‐ros oncogene 1 (ROS1) rearrangement within 1–2 weeks, while hemodynamics were stabilized by rescue venoarterial extracorporeal membrane oxygenation support. Crizotinib, an oral tyrosine kinase inhibitor targeting anaplastic lymphoma kinase, MET, and ROS1 kinase domains dramatically resolved PH, resulting in more than 3 years of survival. Targeted gene‐tailored therapy with mechanical support can improve survival in PTTM.