Recurrent respiratory papillomatosis treated with combined erlotinib and celecoxib: A retrospective study

Recurrent respiratory papillomatosis is a rare benign airway disease caused by human papillomavirus, typically types 6 and 11. Management is often difficult due to high recurrence rates and lack of effective pharmacologic options. Recent studies suggest that EGFR and COX-2 pathways play a role in the pathogenesis of human papillomavirus-related lesions.

We present an observational retrospective study of three patients with PCR confirmed human papillomavirus DNA associated to recurrent respiratory papillomatosis treated with erlotinib and celecoxib at a tertiary hospital between 2017 and 2024. Inclusion criteria were histological diagnosis, prior failure to conventional therapies, and complete clinical follow-up.

Two patients exhibited sustained improvement in symptoms and lesion burden, with no significant adverse events. In one case, treatment was well tolerated over six years. A third patient discontinued therapy due to disease progression, treated with immunotherapy afterwards.

Combined EGFR and COX-2 inhibition may be a promising treatment strategy for recurrent respiratory papillomatosis refractory to standard therapy. These preliminary observations support further prospective investigation in selected patients.