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Intralesional cidofovir for recurrent laryngeal papillomas: preliminary report
W R Wilson1, R Hashemiyoon, A Hawrych
1Division of Otolaryngology-Head and Neck Surgery, George Washington University Medical Center, Washington, DC 20037, USA. surwrw@gwumc.edu
Abstract:
This is a preliminary report of an ongoing study to test the efficacy of intralesional injections of the antiviral drug cidofovir in adults with recurrent laryngeal papillomas in whom multiple other treatments have previously failed. This study has been designed to include 10 to 20 patients, a number sufficient to either prove or disprove the safety and efficacy of this agent. This report conveys information on the first three patients enrolled in the trial. Each patient received an overall dose of 5 to 10 ml of cidofovir, at a concentration of 4.17 mg/ml, intralesionally at 2- to 4-week intervals. The approximate volume injected into each wart was 0.2 to 0.5 ml. Biopsies of the lesion sites were obtained at the initiation and completion of therapy. No other treatment was given. Resolution of lesions was monitored by videolaryngoscopy and still photography 1 to 2 weeks after each treatment. In time, the lesions resolved in all three patients, although all three later experienced a minor recurrence. We conclude that intralesional cidofovir appears to be a promising new treatment for controlling--and perhaps at higher dosages curing--refractory laryngeal papillomas, while causing little or no injury to laryngeal structures.
Insights
Intralesional cidofovir shows promise for treating recurrent laryngeal papillomas in adults. This antiviral drug effectively resolved lesions in initial patients, though recurrences were noted.
Area of Science:
- Otolaryngology
- Virology
- Oncology
Background:
- Recurrent laryngeal papillomas (RLPs) are challenging to treat, often requiring multiple interventions.
- Existing therapies for RLPs have limitations in efficacy and safety.
- Antiviral agents are being explored for managing papilloma virus-related conditions.
Observation:
- A preliminary study investigated intralesional cidofovir for refractory RLPs in adult patients.
- Three patients received intralesional cidofovir injections at intervals of 2-4 weeks.
- Lesion resolution was monitored via videolaryngoscopy and photography.
Findings:
- Complete resolution of laryngeal papilloma lesions was observed in all three initial patients.
- Minor recurrences of lesions occurred in all patients post-treatment.
- Histopathological analysis of biopsies was performed at baseline and post-therapy.
Implications:
- Intralesional cidofovir presents a potential new therapeutic option for managing difficult-to-treat laryngeal papillomas.
- Further research with larger patient cohorts is warranted to establish optimal dosing and long-term efficacy.
- Cidofovir demonstrates a favorable safety profile with minimal laryngeal tissue damage.