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. 2024 Dec;134(12):5041-5046.
doi: 10.1002/lary.31670. Epub 2024 Aug 3.

A Consensus Statement on the Administration of Systemic Bevacizumab in Patients with Recurrent Respiratory Papillomatosis

Simon R Best  1 , Jonathan M Bock  2 , Nicole B Fowler  3 , Eric H Raabe  4   5 , Adam M Klein  6 , Theodore W Laetsch  7 , Kim McClellan  3 , Rico N P M Rinkel  8 , Nabil F Saba  9 , Douglas R Sidell  10 , James B Tansey  3 , David E Tunkel  1 , Geoffrey D Young  3   11 , Karen B Zur  12
Affiliations

A Consensus Statement on the Administration of Systemic Bevacizumab in Patients with Recurrent Respiratory Papillomatosis

Simon R Best et al. Laryngoscope. 2024 Dec.

Abstract

Objective: To provide detailed guidance on the administration of systemic bevacizumab in patients with recurrent respiratory papillomatosis (RRP) based on a detailed review of the scientific literature and a consensus of experts with real-world clinical experience.

Methods: A bevacizumab consensus working group (N = 10) was composed of adult and pediatric otolaryngologists, adult and pediatric oncologists, and a representative from the RRP Foundation (RRPF), all with experience administering systemic bevacizumab in patients with RRP. After extensive review of the medical literature, a modified Delphi method-based survey series was utilized to establish consensus on the following key areas: clinical and patient characteristics ideal for treatment candidacy, patient perspective in treatment decisions, treatment access, initial dosing, monitoring, guidelines for tapering and discontinuation, and reintensifying therapy.

Results: Seventy-nine statements were identified across nine critical domains, and 45 reached consensus [clinical benefits of bevacizumab (3), patient and disease characteristics for treatment consideration (7), contraindications for treatment (3), shared decision-making (incorporating the patient perspective) (5), treatment access (3), initial dosing and administration (8), monitoring (7), tapering and discontinuation (6), and reintensification (3)].

Conclusion: This consensus statement provides the necessary guidance for clinicians to initiate systemic administration of bevacizumab and represents a potential paradigm shift toward nonsurgical treatment options for patients with RRP.

Level of evidence: 5 Laryngoscope, 134:5041-5046, 2024.

Keywords: Avastin; administration; consensus; systemic bevacizumab.

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References

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