Efficacy of cidofovir versus bevacizumab in recurrent respiratory papillomatosis: A randomized, double-blind, placebo-controlled pilot study

Ablanedo-Terrazas, Yuria; Estrada-Camacho, Oscar; Barrera, Claudia Alvarado-de la; Ramírez-García, Arturo; Tona-Acedo, Gabriel; Bross-Soriano, Daniel; Schimelmitz-Idi, José

doi:10.1016/j.otorri.2020.12.001

Cited by 7 publications

(1 citation statement)

References 30 publications

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“…24 Subsequently, in one of his multiple studies, Zeitels et al demonstrated safety and efficacy of sublesional bevacizumab injections in patients with laryngeal papillomas after performing 100 laryngeal injections in 43 patients, with more than half of the injections performed concomitantly with the use of KTP laser. 25 The following reports had both positive 26,27 and equivocal 28 improvement with intralesional injections. A transition to parenteral use in subsequent case reports and series, including our own, has shown promise in reducing the procedural burden for patients and the potential consequences of repetitive ablative instrumentation of the vocal folds.…”

Section: Discussionmentioning

confidence: 86%

Long‐Term Follow‐up of Parenteral Bevacizumab In Patients with Recurrent Respiratory Papillomatosis

et al. 2023

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ObjectiveThe clinical course of recurrent respiratory papillomatosis (RRP) varies from spontaneous remission to severe airway obstruction with wide variability in recurrence. Standard treatment involves debulking to improve voice and/or breathing. Non‐surgical therapies are emerging in hopes of non‐operative disease control. This retrospective review analyzes long‐term safety, efficacy, and durability of clinical control in the largest reported series of parenteral bevacizumab in adults with RRP.MethodsTwenty‐three patients with known RRP who have been receiving off‐label systemic bevacizumab were included. Dosage, infusion interval, number of cycles, debulking requirements, subjective outcomes, adverse events, and reasons for treatment termination were investigated.ResultsPatients have been followed for an average of 791.43 (21–1468) days. The most common starting dosing regimen was 15 mg/kg at 3 weeks in 11 followed by 10 mg/kg at 6 weeks intervals in 6 individuals. Long‐term maintenance dosage varied with the least intensive regimen being 10 mg/kg at 14‐week intervals. Subjective improvement of voice and/or breathing was reported in 18/23 subjects. The median time for patients that needed a procedure after treatment was 634 days. Procedures after infusions decreased from 3.08 ± 2.48 procedures in the year prior to 0.52 ± 1.12 during systemic Bevacizumab, and to 0.86 ± 2.05 after stopping bevacizumab. Therapy termination occurred in 8 subjects where only 3 were due to adverse events.ConclusionParenteral bevacizumab remains a well‐tolerated treatment for patients with recalcitrant RRP. There appears to be a durable reduction in the frequency of debulking surgery requirements although on a maintenance regimen. Laryngoscope, 133:2725–2733, 2023

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