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Published on: March 8, 2012
Epidermal growth factor receptor inhibitor therapy for recurrent respiratory papillomatosis
Matthew M Moldan1, Bruce C Bostrom2, Robert J Tibesar3
1Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA.
Abstract:
The epidermal growth factor pathway has been implicated in various tumors, including human papillomavirus (HPV) lesions such as recurrent respiratory papillomatosis (RRP). Due to the presence of epidermal growth factor receptors in RRP, epidermal growth factor receptor (EGFR) inhibitors have been utilized as adjuvant therapy. This case series examines the response to EGFR inhibitors in RRP. Four patients with life-threatening RRP were treated with EGFR inhibitors. Operative frequency and anatomical Derkay scores were calculated prior to, and following EGFR inhibitor treatment via retrospective chart review. The anatomical Derkay score decreased for all four patients after initiation of EGFR inhibitor therapy. In one patient, the operative frequency increased after switching to an intravenous inhibitor after loss of control with an oral inhibitor. In the other patients there was a greater than 20% decrease in operative frequency in one and a more than doubling in the time between procedures in two. This study suggests that EGFR inhibitors are a potential adjuvant therapy in RRP and deserve further study in a larger number of patients.
Insights
Epidermal growth factor receptor (EGFR) inhibitors show promise as an adjuvant therapy for recurrent respiratory papillomatosis (RRP). This case series indicates reduced symptom severity and fewer surgeries in RRP patients treated with EGFR inhibitors.
Area of Science:
- Oncology
- Otolaryngology
- Virology
Background:
- The epidermal growth factor pathway is implicated in various tumors and human papillomavirus (HPV) lesions.
- Recurrent respiratory papillomatosis (RRP) exhibits epidermal growth factor receptors, leading to the use of EGFR inhibitors as adjuvant therapy.
Purpose of the Study:
- This case series examines the efficacy of EGFR inhibitors in managing life-threatening RRP.
- To evaluate the impact of EGFR inhibitors on operative frequency and symptom severity in RRP patients.
Main Methods:
- Retrospective chart review of four RRP patients treated with EGFR inhibitors.
- Calculation of operative frequency and anatomical Derkay scores before and after EGFR inhibitor therapy.
Main Results:
- All four patients demonstrated a decrease in anatomical Derkay scores post-treatment.
- One patient experienced increased operative frequency after switching to intravenous inhibitors.
- Two patients showed a significant reduction in operative frequency, with one doubling the time between procedures.
Conclusions:
- EGFR inhibitors represent a potential adjuvant therapy for RRP.
- Further investigation with larger patient cohorts is warranted to confirm these findings.
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