Systemic bevacizumab for recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis (RRP) is a benign tumor of the respiratory tract associated with human papillomavirus 6 and 11. Patients undergo multiple surgical debridements for management of growing papilloma. Adjuvant treatment options for RRP in children are often ineffective and do not decrease the need for repeated surgical debridement. We report on three patients with severe disease refractory to surgery who were treated with 10 mg/kg systemic bevacizumab every 4 weeks. All patients had improvement in voice and reduced need for surgical debridement. Interval between bevacizumab doses was gradually increased to every 8-12 weeks. Adverse events included mild proteinuria and self-resolving epistaxis.