CASE REPORT article
Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1626318
ECMO combined with IABP for the treatment of fulminant myocarditis caused by the targeted drug entrectinib for lung adenocarcinoma: A case report
Provisionally accepted
- 1Department of Intensive Care Unit, Chest Hospital Affiliated to Tianjin University, Tianjin, China，, Tianjin, China
- 2Department of Cardiovascular Surgery, Chest Hospital Affiliated to Tianjin University, Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background:Entrectinib, a recently approved multikinase inhibitor indicated for advanced ROS1-positive non-small cell lung cancer (NSCLC), has demonstrated significant survival benefits in metastatic disease. However, it carries risks of severe cardiotoxicity. We report the successful management of entrectinib-induced fulminant myocarditis using integrated venoarterial extracorporeal membrane oxygenation (V-A ECMO) and intra-aortic balloon pump (IABP) circulatory support. Case summary:A 71-year-old male diagnosed with lung adenocarcinoma three years ago (ROS1-positive on genetic testing) initiated crizotinib therapy. One week prior to admission, surveillance chest computed tomography(CT) revealed disease progression with increased tumor burden, prompting transition to entrectinib. Seven days post-treatment initiation, he presented to our emergency department with acute-onset palpitations, dyspnea, dizziness, and nausea. Emergent coronary angiography excluded significant stenosis. The patient subsequently developed frequent ventricular premature complexes(VPCs), cardiogenic shock (serum lactate 2.6 mmol/L), and acute heart failure. Absent cardiac history and negative viral serology supported a diagnosis of drug-induced fulminant myocarditis. V-A ECMO with IABP support was emergently instituted. Remarkable recovery ensued: cardiac function normalized by day 3 (ECMO decannulation), followed by extubation and IABP removal on day 5.After 12 days of hospitalization, the patient was discharged. Ejection fraction (EF) recovered from 10% at admission to 61% at discharge. Follow-up demonstrates sustained cardiac function comparable to discharge status.Conclusion：Entrectinib demonstrates potential cardiotoxicity in lung adenocarcinoma therapy, necessitating prospective studies to quantify this risk. During treatment, multidisciplinary team (MDT) collaboration is essential for rigorous cardiac function surveillance. This case establishes V-A ECMO with IABP as an effective salvage therapy for drug-induced fulminant myocarditis.
Keywords: mechanical assistance, Entrectinib, Cardiogenic shock, Fulminant myocarditis, case report
Received: 10 May 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Qi, Ma and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhenhua Wu, Department of Intensive Care Unit, Chest Hospital Affiliated to Tianjin University, Tianjin, China，, Tianjin, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.