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. 2022 Dec;74(Suppl 3):5117-5121.
doi: 10.1007/s12070-021-02783-7. Epub 2021 Oct 8.

Experience with Systemic Bevacizumab in Advanced Juvenile Recurrent Respiratory Papillomatosis

Karan Aggarwal  1 , Rajeev Kumar  2 , Jyoti Kumari  3 , Arvind Kumar  3 , Kana Ram Jat  3 , S K Kabra  3 , Ashu Seith Bhalla  4 , Rakesh Kumar  2
Affiliations

Experience with Systemic Bevacizumab in Advanced Juvenile Recurrent Respiratory Papillomatosis

Karan Aggarwal et al. Indian J Otolaryngol Head Neck Surg. 2022 Dec.

Abstract

Vascular Endothelial Growth Factor has been demonstrated in squamous papillomas of Recurrent Respiratory Papillomatosis patients. This case series aimed at studying the feasibility and efficacy of systemic use of VEGF inhibitor Bevacizumab in advanced Juvenile Onset Recurrent Respiratory Papillomatosis (JORRP) patients. Three pediatric patients with advanced RRP were included in this study. A detailed bronchoscopic and radiological follow-up is presented. All patients responded well to the treatment. We conclude that systemic Bevacizumab can be tried as a feasible and rational adjuvant treatment in advanced JORRP patients.

Keywords: Larynx; Papillomatosis; Pediatric; Trachea.

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Conflict of interest statement

Conflict of interestThe authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Before and after Bevacizumab CT pictures of Case 1: A1- Before Bevacizumab: Multiple large cavities (red arrow) and nodules (yellow arrow). A2- Two years after starting Bevacizumab: The cavities have reduced in number and size, and the nodule has also cavitated (blue arrow) depicting response to therapy. B1- Before Bevacizumab: Bronchial soft tissue (red arrow) with mediastinal lymph nodes (yellow arrow). B2- Two years after starting bevacizumab: Reduced size of mediastinal lymphadenopathy (green arrow)
Fig. 2
Fig. 2
Before and after Bevacizumab Tracheo-bronchoscopy pictures of Case 1: a Bronchoscopic image of trachea before bevacizumab showing significantly large papillomas. b After 20 doses of bevacizumab, trachea showing significant reduction in papilloma size and number. c Bronchoscopic image of carina before bevacizumab showing significantly large papillomas. d After 20 doses of bevacizumab showing almost complete disappearance of the lesions from the carina
Fig. 3
Fig. 3
Before and after Bevacizumab CT Topograms of Case 2 a Before bevacizumab: Thick walled cavity with soft tissue component in right upper lobe with soft tissue componet (red arrow); multiple smaller cavities (blue arrow) b Six months after starting bevacizumab: Near complete resolution of the lesions
See this image and copyright information in PMC

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