Open AccessCrizotinib for ROS1‐rearranged lung cancer and pulmonary tumor thrombotic microangiopathy under venoarterial extracorporeal membrane oxygenation
Author(s) -
Aoyama Daisetsu,
Fukui Shigefumi,
Hirata Haruhiko,
OhtaOgo Keiko,
Matama Hideo,
Tateishi Emi,
Nishii Tatsuya,
Asaumi Yasuhide,
Toyofuku Mamoru,
Ikeue Tatsuyoshi,
Ogo Takeshi,
IshibashiUeda Hatsue,
Yasuda Satoshi
Publication year - 2022
Publication title -
pulmonary circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.791
H-Index - 40
ISSN - 2045-8940
DOI - 10.1002/pul2.12047
Subject(s) - crizotinib , thrombotic microangiopathy , extracorporeal membrane oxygenation , medicine , ros1 , anaplastic lymphoma kinase , cancer , lung cancer , adenocarcinoma , lung , cancer research , pathology , cardiology , disease , malignant pleural effusion
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.