Systemic and Intralesional Bevacizumab in Juvenile Onset Recurrent Respiratory Papillomatosis: A Report of Two Cases

Goyal, Arun; Kapoor, Dipti; Saha, Richa

doi:10.1007/s12070-021-02814-3

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…Of the 17 RRP patients included in this study, all experienced a reduction in surgical frequency following induction of systemic bevacizumab, with the most notable improvements found in laryngeal and tracheal RRP. The present study contributes one of the largest cohorts of patients to the literature on bevicuzmab efficacy and corroborates existing case series that demonstrate the ability of bevacizumab to space surgical interventions 17–36 . As patients treated with systemic bevacizumab were likely to have failed disease control through surgical intervention alone, we emphasize that our cohort represents a subset of the RRP population with more severe disease presentations.…”

Section: Discussionsupporting

confidence: 79%

“…The present study contributes one of the largest cohorts of patients to the literature on bevicuzmab efficacy and corroborates existing case series that demonstrate the ability of bevacizumab to space surgical interventions. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] As patients treated with systemic bevacizumab were likely to have failed disease control through surgical intervention alone, we emphasize that our cohort represents a subset of the RRP population with more severe disease presentations. The majority of patients in our study had received more than 50 surgeries in their lifetime and had unsuccessfully trialed other adjuvant treatments before starting systemic bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

“…To this end, systemic bevacizumab is emerging as a promising adjuvant treatment modality capable of controlling even the most severe and recalcitrant of RRP presentations 17–37 . An anti‐VEGF agent commonly used in oncologic treatment, bevacizumab has been shown in several case reports to successfully prolong the time between surgical debridements—including for patients with pulmonary RRP, 34 which represents the rarest and most severe presentation of RRP.…”

Section: Introductionmentioning

confidence: 99%

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Systemic Bevacizumab for Recurrent Respiratory Papillomatosis: A Single Institution's Experience

So,

Rayle,

Joo

et al. 2024

The Laryngoscope

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ObjectivesMedical therapies to limit disease recurrence are critically needed for recurrent respiratory papillomatosis (RRP). Systemic bevacizumab is emerging as an exciting adjuvant therapy toward this end, but uptake has been poor due to the lack of experience and awareness of best prescribing practices. The objective of this study was to describe a single tertiary care academic medical center's experience using systemic bevacizumab for the treatment of RRP.MethodsA retrospective review was performed to identify patients with RRP on systemic bevacizumab. Demographic and clinical characteristics, findings on imaging reports, and disease response at all anatomic subsites involved in papilloma were documented.ResultsOf the 17 RRP patients on systemic bevacizumab, 9 (52.9%) were male, and 12 (70.6%) were diagnosed with juvenile‐onset RRP. The total lifetime number of surgeries was high, with more than half (n = 9; 52.9%) undergoing more than 50 surgeries. Following induction of systemic bevacizumab, a significant reduction in patients with laryngeal (n = 15; 94.1% vs. n = 7; 41.2%, p < 0.001) and tracheal (n = 11; 64.7% vs. n = 5; 29.4%, p = 0.04) RRP was noted. Surgical frequency was significantly lower following systemic bevacizumab (2.5 vs. 0.5 surgeries per year; p < 0.001). The most common complications were new‐onset hypertension (n = 4; 23.5%) and proteinuria (n = 5; 29.4%).ConclusionSystemic bevacizumab is effective in reducing the number of surgeries needed for RRP while exhibiting a relatively safe complication profile. Papillomas in the larynx and trachea are most responsive to systemic bevacizumab, while pulmonary RRP is most likely to exhibit a partial‐to‐stable response.Level of Evidence4 Laryngoscope, 2024

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Systemic Bevacizumab for Recurrent Respiratory Papillomatosis: A Single Institution's Experience

So,

Rayle,

Joo

et al. 2024

The Laryngoscope

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Adjuvant Intralesional Bevacizumab in Pediatric and Adult Populations With Recurrent Respiratory Papillomatosis: A Systematic Review

Gately,

Zhang,

Karle

et al. 2024

Ann Otol Rhinol Laryngol

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Objective: Recurrent respiratory papillomatosis (RRP) is a rare disease of the airway for which there is no known cure. Treatment involves the surgical removal or destruction of these lesions. There has been a long-standing debate over the effectiveness of the adjuvant intralesional injection of the immune modifying agent bevacizumab. This study is a systematic review investigating the effect of adjuvant intralesional bevacizumab on patients with laryngeal papillomatosis. The main objective was to assess functional outcomes and efficacy. Data Sources: Pubmed, Google Scholar, and Web of Science. Review Methods: Search words were “intralesional bevacizumab” AND “recurrent respiratory papillomatosis.” Sources were systematically identified using inclusion and exclusion criteria (ie, study publication must post-date 2000, must be peer-reviewed, investigate patients with RRP, apply bevacizumab intralesionally, not systemically). Findings were then collected and analyzed. Results: Ten studies were included for analysis. The majority of these studies found an increase in the surgical interval, voice outcomes, and a decrease in tumor burden in most patients. No studies reported side effects or lasting complications related to the bevacizumab injection. Conclusion: This systematic review provides further evidence for the safety of intralesional bevacizumab injections and their likely positive effect on disease control. Future research would benefit from the implementation of standardized documentation of RRP outcomes.

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Systemic Bevacizumab for Recurrent Respiratory Papillomatosis: A Scoping Review from 2009 to 2022

et al. 2022

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Background: Respiratory recurrent papillomatosis (RRP) is a fatal disease with no known cure. In severe RRP cases, systemic bevacizumab (SB) could be used as adjuvant therapy. Objective: This study aims to determine the extent and type of evidence in relation to the clinical outcomes of RRP after SB treatment. Methods: Participants with RRP of all genders are included in this scoping review. There were no exclusion criteria (country, language, or document type). The information sources included experimental, quasi-experimental, and analytical observational studies. Unpublished data will not be covered, but gray literature was covered. Screening, paper selection, and data extraction were all done by two independent reviewers. This procedure was performed blindly. Results: Of the 175 unique records found, 15 were eligible for inclusion. Fourteen studies were included after applying inclusion and exclusion criteria. Thirty-four patients in these studies came from the United States, India, Germany, Colombia, Argentina, Chile, and Spain. In total, 17 and 34 patients were below 18 years old and were adults respectively. The most commonly reported dose was 10 mg/kg, which was received by 25 (73.5%) patients. According to reports, 58.8% of patients completed the questionnaire. Twelve (35%) patients did not require a repeat surgery. The time interval between surgical procedures has increased for patients who require them. Conclusion: SB may be a promissory treatment and control option for RRP. More research is needed to evaluate the efficiency and adverse effects in various populations.

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Systemic and Intralesional Bevacizumab in Juvenile Onset Recurrent Respiratory Papillomatosis: A Report of Two Cases

Cited by 4 publications

References 9 publications

Systemic Bevacizumab for Recurrent Respiratory Papillomatosis: A Single Institution's Experience

Systemic Bevacizumab for Recurrent Respiratory Papillomatosis: A Single Institution's Experience

Adjuvant Intralesional Bevacizumab in Pediatric and Adult Populations With Recurrent Respiratory Papillomatosis: A Systematic Review

Systemic Bevacizumab for Recurrent Respiratory Papillomatosis: A Scoping Review from 2009 to 2022

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