Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Sep;279(9):4229-4240.
doi: 10.1007/s00405-022-07388-6. Epub 2022 Apr 24.

Bevacizumab as treatment option for recurrent respiratory papillomatosis: a systematic review

Louis Pogoda  1 , Fuat Ziylan  1 , Diederik P J Smeeing  2 , Frederik G Dikkers  3 , Rico N P M Rinkel  4
Affiliations
Case Reports

Bevacizumab as treatment option for recurrent respiratory papillomatosis: a systematic review

Louis Pogoda et al. Eur Arch Otorhinolaryngol. 2022 Sep.

Abstract

Purpose: To this day, there is no cure for recurrent respiratory papillomatosis (RRP). Multiple surgical procedures are performed to achieve symptom relief and prevention of airway obstruction. A promising drug for RRP is the vascular endothelial growth factor (VEGF) binding antibody bevacizumab. This chemotherapeutic agent has an angiogenesis-inhibiting effect which inhibits tumor growth. The objective of this review was to investigate the efficacy of bevacizumab as treatment option for RRP, and to explore the difference of its effects between intralesional and systemic treatment.

Methods: A systematic search was conducted in Cochrane, PubMed, and Embase. Articles were included if bevacizumab treatment was given intralesionally and/or systemically. The methodological quality of the studies was assessed using the CAse REport (CARE) guidelines.

Results: Of 585 unique articles screened by title and abstract, 15 studies were included, yielding a total of 64 patients. In 95% of the patients treated with systemic bevacizumab, the post-bevacizumab surgical interval was considerably prolonged. More than half of them did not need any surgical intervention during mean follow-up of 21.6 months. Treatment with intralesional bevacizumab showed a lower efficacy: in 62% of the patients, the post-bevacizumab surgical interval (mean, 1.8 months follow-up) was extended when compared to the interval before the treatment.

Conclusion: Systemically and intralesionally administered bevacizumab are effective treatment options for severe RRP. A systemic administration might be the treatment of first choice. Further prospective research with long term follow-up is advocated to elucidate this important topic.

Keywords: Avastin®; Bevacizumab; Human papilloma virus; Larynx papillomatosis; Recurrent respiratory papillomatosis; Vascular endothelial growth factor.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of inclusion of relevant publications for use of systemic and intralesional bevacizumab in treatment of recurrent respiratory papillomatosis
See this image and copyright information in PMC

References

    1. Derkay CS, Bluher AE. Update on recurrent respiratory papillomatosis. Otolaryngol Clin N Am. 2019;52(4):669–679. doi: 10.1016/j.otc.2019.03.011. - DOI - PubMed
    1. Wilcox LJ, Hull BP, Baldassari CM, Derkay CS. Diagnosis and management of recurrent respiratory papillomatosis. Pediatr Infect Dis J. 2014;33(12):1283–1284. doi: 10.1097/INF.0000000000000551. - DOI - PubMed
    1. San-Giorgi MR, van den Heuvel ER, Tjon-Pian-Gi RE, et al. Age of onset of recurrent respiratory papillomatosis: a distribution analysis. Clin Otolaryngol. 2016;41(5):448–453. doi: 10.1111/coa.12565. - DOI - PubMed
    1. Buchinsky FJ, Valentino WL, Ruszkay N, et al. Age at diagnosis, but not HPV type, is strongly associated with clinical course in recurrent respiratory papillomatosis. PLoS ONE. 2019;14(6):e0216697. doi: 10.1371/journal.pone.0216697. - DOI - PMC - PubMed
    1. Ivancic R, Iqbal H, deSilva B, Pan Q, Matrka L. Current and future management of recurrent respiratory papillomatosis. Laryngosc Investig Otolaryngol. 2018;3(1):22–34. doi: 10.1002/lio2.132. - DOI - PMC - PubMed

MeSH terms

Substances

Supplementary concepts

LinkOut - more resources