title: Lung cancer at the intensive care unit: The era of targeted therapy.
abstract: Lung cancer is the most common solid tumor that requires admission to an intensive care unit (ICU). The overall perception about the value of ICU admission for lung cancer patients remains negative, given the poor overall prognosis of patients with advanced lung cancer. Recently developed highly effective targeted therapies for lung cancers with an oncogene driver have an expected rapid onset of action and a decreased risk of toxicity. Therefore, ICU care for lung cancer patients has to be reconsidered. We present an illustrative case of a young woman with stage IV ALK-translocated pulmonary adenocarcinoma. Her disease dramatically worsened while waiting for central confirmation of the ALK-translocation to start treatment in a clinical trial with ceritinib, a 2nd generation ALK tyrosine kinase inhibitor. She needed mechanical ventilation and veno-venous extracorporal membranous oxygenation, to have sufficient time to recover from overwhelming bilateral lung adenocarcinoma, while on treatment. She is now doing fine 1 year later.
authors.affiliation: Respiratory Oncology Unit, Dept. Respiratory Medicine, University Hospitals KU Leuven, Leuven, Belgium.
authors.forename: Valerie
authors.initials: V
authors.lastname: Adam
authors.affiliation: Respiratory Oncology Unit, Dept. Respiratory Medicine, University Hospitals KU Leuven, Leuven, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: Dooms
authors.affiliation: Respiratory Oncology Unit, Dept. Respiratory Medicine, University Hospitals KU Leuven, Leuven, Belgium. Electronic address: Johan.vansteenkiste@uzleuven.be.
authors.forename: Johan
authors.initials: J
authors.lastname: Vansteenkiste
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000628:therapy; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors
keywords: ALK gene rearrangement; Ceritinib; Clinical trials; Intensive care; Lung cancer; Targeted therapy