Systemic Bevacizumab Therapy in Recurrent Respiratory Papillomatosis: First Preliminary Study From Azerbaijan

Area of Science:

• Otolaryngology
• Medical Oncology

Background:

• Recurrent respiratory papillomatosis (RRP) is a rare disease characterized by the growth of papillomas in the respiratory tract.
• RRP often requires multiple surgical interventions, leading to significant morbidity and healthcare costs.
• Current treatment options for severe or refractory RRP are limited, necessitating exploration of novel therapeutic strategies.

Purpose of the Study:

• To present the initial clinical experience with systemic bevacizumab for RRP treatment in Azerbaijan.
• To assess the efficacy of bevacizumab in reducing disease recurrence and surgical intervention frequency.
• To evaluate outcomes in both pediatric and adult RRP patients receiving bevacizumab therapy.

Main Methods:

• A retrospective case series involving five RRP patients (four pediatric, one adult) who received a single intravenous dose of bevacizumab (5-10 mg/kg).
• Patients had a history of multiple surgeries and were considered for adjuvant systemic therapy.
• Clinical and endoscopic follow-up was conducted to monitor remission duration and recurrence patterns.

Main Results:

• All five patients experienced extended remission periods after a single bevacizumab dose.
• Pediatric patients had remission durations of 8-24 months, with one child remaining recurrence-free for over two years.
• The adult patient with severe disease achieved a 6-month remission, the longest interval between surgeries in over a decade. No adverse events were reported.

Conclusions:

• Systemic bevacizumab may serve as a beneficial adjuvant therapy for severe RRP, potentially increasing disease-free intervals.
• While promising, these findings are hypothesis-generating and require validation through larger, prospective studies with control groups.
• This case series provides valuable real-world data from Azerbaijan, contributing to the growing evidence for anti-VEGF therapy in RRP management.