Key result
Entrectinib is linked to fulminant myocarditis and cardiogenic shock, reversible with steroids and mechanical support.
Why the study?
Entrectinib, a tyrosine kinase inhibitor used for lung adenocarcinoma, has rare cardiac side effects including myocarditis that are not well characterized.
Does entrectinib cause fulminant myocarditis in patients with lung adenocarcinoma?
Case Report (n=1)
Does entrectinib cause fulminant myocarditis in patients with lung adenocarcinoma?
Entrectinib, an ROS1 inhibitor used for lung adenocarcinoma, can cause severe cardiac side effects including fulminant myocarditis and cardiogenic shock.
May warrant myocarditis vigilance during entrectinib use; single case leaves open causality and class-effect risk for ROS1 inhibitors.
Background: fusion-positive cancers. Tyrosine kinase inhibitors have markedly improved outcomes for advanced cancers previously with poor prognosis. Entrectinib is an example of an ROS1 inhibitor that can be used for lung adenocarcinoma. There are numerous adverse effects with rare cardiac side effects reported, such as heart failure and myocarditis. Case summary: A 27-year-old male being treated for lung adenocarcinoma who presented new congestive heart failure 2 weeks after starting Entrectinib. He developed refractory ventricular tachycardia, cardiogenic shock with an endomyocardial biopsy that showed active lymphohistiocytic myocarditis. With antiarrhythmic therapy, heavy sedation, mechanical circulatory support, and high-dose steroids, the patient had complete resolution of symptoms and return to baseline status. Discussion: This is a rare case with a severe complication after starting Entrectinib for lung adenocarcinoma. In the literature, this is the first case of its kind presenting with myocarditis and severe heart failure after treatment with Entrectinib. This case highlights not only using cardiac imaging, and biopsy to help guide the diagnosis, but also describe the appropriate management.
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Rundhawa et al. (2024) conducted a case report in Lung adenocarcinoma (n=1). Entrectinib was evaluated on Development of fulminant myocarditis. Entrectinib therapy for lung adenocarcinoma was associated with fulminant myocarditis and cardiogenic shock in 1 patient after 2 weeks, resolving with mechanical support and steroids.
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