학술논문

Crizotinib for ROS1‐rearranged lung cancer and pulmonary tumor thrombotic microangiopathy under venoarterial extracorporeal membrane oxygenation
Document Type
article
Source
Pulmonary Circulation, Vol 12, Iss 1, Pp n/a-n/a (2022)
Subject
crizotinib
lung cancer
pulmonary hypertension
pulmonary tumor thrombotic microangiopathy
venoarterial extracorporeal membrane oxygenation
Diseases of the circulatory (Cardiovascular) system
RC666-701
Diseases of the respiratory system
RC705-779
Language
English
ISSN
2045-8940
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.