Key result
Treatment with paclitaxel and bevacizumab successfully controlled pulmonary tumor thrombotic microangiopathy secondary to breast cancer, leading to a survival of 1 year and 8 months.
Why the study?
Pulmonary tumor thrombotic microangiopathy is a rapidly progressing, rare condition involving VEGF with no established treatment guidelines.
Does bevacizumab combined with chemotherapy and pulmonary hypertension targeted therapy improve outcomes in a patient with pulmonary tumor thrombotic microangiopathy caused by breast cancer?
Case Report (n=1)
No
Does bevacizumab combined with chemotherapy and pulmonary hypertension targeted therapy improve outcomes in a patient with pulmonary tumor thrombotic microangiopathy caused by breast cancer?
Bevacizumab, combined with chemotherapy and pulmonary hypertension targeted therapy, may improve the prognosis of rapidly progressive pulmonary tumor thrombotic microangiopathy secondary to breast cancer.
Raises suspicion for PH in symptomatic advanced breast cancer; hypothesis-generating for tumor-related mechanisms pending prospective studies.
A 47-year-old woman diagnosed with stage IV left-sided breast cancer (T3N3aM1; OSS, HEP, LYM) 6 months back presented with respiratory distress. On admission, she developed respiratory failure, requiring 4 L of oxygen support. Pulmonary embolism was ruled out because computed tomography revealed no obvious pulmonary artery thrombus. Transthoracic echocardiography revealed a significant enlargement of the right ventricle and atrium. Pulmonary hypertension was confirmed via right heart catheterization. Pulmonary artery wedge aspiration cytology revealed adenocarcinoma cells. Based on these findings, we diagnosed the patient with pulmonary tumor thrombotic microangiopathy (PTTM) caused by breast cancer. Immediate chemotherapy (paclitaxel and bevacizumab) for breast cancer and concurrent treatment for pulmonary hypertension and disseminated intravascular coagulation were initiated. We could successfully control her condition with paclitaxel and bevacizumab for a year, and the patient survived for 1 year and 8 months. PTTM is a rare disease characterized by pulmonary hypertension and hypoxemia arising due to tumor embolization of the peripheral pulmonary arteries. PTTM is a rapidly progressing condition with no established treatment guidelines; its pathogenesis involves vascular endothelial growth factor (VEGF). This report highlighted the potential of bevacizumab, known for its anti-VEGF effect, in improving the pathological condition of patients with PTTM caused by breast cancer.
No takes yet. Share an insight, caveat, or question.
Kimura et al. (2023) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) secondary to breast cancer (n=1). Paclitaxel and bevacizumab was evaluated on Survival and clinical improvement. Treatment with paclitaxel and bevacizumab successfully controlled pulmonary tumor thrombotic microangiopathy secondary to breast cancer, leading to a survival of 1 year and 8 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: