Systemic bevacizumab for end-stage juvenile recurrent respiratory papillomas: A case report

Hamdi, Osama; Dome, Jeff; Zalzal, George H.; Preciado, Diego

doi:10.1016/j.ijporl.2019.109706

Cited by 14 publications

(29 citation statements)

References 13 publications

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“…The risk of side effects from a long‐term chemotherapeutic is a concern but not well understood. Hamdi and colleagues include a comprehensive list of potential adverse events with their case report 24 . Bevacizumab has been investigated more for the control of schwannoma growth in neurofibromatosis type 2 (NF2) than for JORRP.…”

Section: Discussionmentioning

confidence: 99%

“…In many cases with lung parenchymal involvement, complete clearance of pulmonary lesions was not seen after treatment with systemic bevacizumab, but the lesions stabilized, decreased on imaging, or became cavitated 4, 5, 19, 21–24 . In one case, there was complete resolution of papillomas, but empty vacuoles were seen in their place in the lung parenchyma (patient 20) 17 .…”

Section: Case Reviewmentioning

confidence: 99%

“…In one of the most recent reports, Hamdi and colleagues describe a case of an 8‐year‐old started at 10 mg/kg dosing every 3 weeks (patient 12) 24 . Details about the administration were also provided; the medication was diluted in 0.9% normal saline to a total volume of 100 mL administered intravenously over 90 minutes in the oncology clinic.…”

Section: Case Reviewmentioning

confidence: 99%

“…Subsequent doses can be administered over 60 or 30 minutes if no adverse events occur. Hamdi and colleagues also included their oncology department's detailed bevacizumab administration protocol as a supplement to their report 24 . Their patient had been maintained on treatment without side effects for 4.5 years at the time of publication 24 …”

Section: Case Reviewmentioning

confidence: 99%

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Systemic Bevacizumab (Avastin) for Juvenile‐Onset Recurrent Respiratory Papillomatosis: A Systematic Review

et al. 2020

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Objectives Juvenile onset recurrent respiratory papillomatosis (JORRP) can cause severe or disseminated disease. Surgical treatment may be inadequate. Systemic bevacizumab has shown initial success for severe JORRP. The objective of this systematic review was to assess usage, effectiveness, and safety of this treatment. Methods We searched PubMed, Embase, and Web of Science for studies of humans with JORRP treated with systemic bevacizumab. Two researchers independently reviewed the studies to determine inclusion and aggregate data on patient characteristics, dosing protocols, treatment response, adverse events, and level of evidence. Results Of 80 identified articles, 12 studies were included detailing 20 distinct cases. At a mean age of 12.8 years (range = 1–43 years) patients received initial dosing of 5 to 10 mg/kg of bevacizumab followed by ongoing doses at a mean 3‐week intervals (range = 2–5 weeks). All patients had clinically significant disease reduction with reduced need for surgery. Six patients (30%) had complete response in at least one involved anatomic site. Eleven (55%) required no surgery after initiating treatment. There was recurrence in all four patients whose treatment was stopped, but had rapid improvement with treatment resumption. Six (30%) experienced mild or moderate adverse events. Conclusions Marked improvement in severe JORRP has been reported from systemic bevacizumab. Treatment protocols vary, and treatment discontinuation was not feasible in any reported patient. Based on currently available data, systemic bevacizumab can be considered for severe JORRP as it appears to be well tolerated and effective. A clinical trial could enhance the understanding of its safety and efficacy for this indication. Laryngoscope, 131:1138–1146, 2021

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Section: Discussionmentioning

confidence: 99%

Section: Case Reviewmentioning

confidence: 99%

Section: Case Reviewmentioning

confidence: 99%

Section: Case Reviewmentioning

confidence: 99%

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Systemic Bevacizumab (Avastin) for Juvenile‐Onset Recurrent Respiratory Papillomatosis: A Systematic Review

et al. 2020

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“…There is only one case report with a long-term follow-up on systemic bevacizumab administration in a 12-year old male also leading to a reduced number of surgical interventions. 15 Of interest, pulmonary RRP manifestation is thought to be almost invariably fatal within 10 years. 16 Nevertheless, patients #1 and #4 have been suffering from pulmonary RRP manifestation for 8 and 12 years, respectively, but are still alive and continue to receive systematic bevacizumab treatment.…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Follow‐Up on Systemic Bevacizumab Treatment in Recurrent Respiratory Papillomatosis

et al. 2020

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Objectives/Hypothesis: Recurrent respiratory papillomatosis (RRP) is a primarily benign disease affecting the entire respiratory tract. Treatment is challenging and usually involves surgical interventions and adjuvant medications. Previously, promising results on systemic administration of bevacizumab have been reported. However, experience on long-term systemic use in patients with RRP is not yet available. Here, we present our long-term follow-up on RRP patients undergoing systemic bevacizumab treatment.Study Design: Case series.Methods: To describe experience on long-term systemic bevacizumab administration, we performed the underlying investigation. Clinical, radiological, and bronchoscopy data were collected.Results: To date, a total of n = 5 patients has been treated with systemic bevacizumab at Muenster University Hospital. With a median follow-up since first systemic bevacizumab administration of 95.5 months long-term follow-up is illustrated. Following bevacizumab treatment partial remission or very good partial remission were achieved in all patients. After papilloma recurrence/progression due to bevacizumab discontinuation, further response was documented in all patients in whom bevacizumab was started again. In one patient, bevacizumab was discontinued due to loss of efficacy. Lung cancer developed in one patient with pulmonary papillomatosis prior to bevacizumab administration whereas three patients suffered from malignant transformation during bevacizumab treatment. Systemic bevacizumab led to long-term reduction in surgical interventions in all patients. Except from mild proteinuria and hypertension in two patients therapy was well tolerated.Conclusions: Systemic bevacizumab represents a promising long-term treatment option for aggressive forms of papillomatosis. Rate of malignant transformation under bevacizumab treatment, optimal treatment schedule, and influence on survival should be further evaluated in clinical trials.

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Aggressive recurrent respiratory papillomatosis: A series of five consecutive patients successfully treated with adjuvant intravenous bevacizumab. A single Belgian academic center experience

et al. 2023

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Background Recurrent respiratory papillomatosis (RRP) is a currently incurable benign neoplasm caused by human papilloma virus (HPV) infection. It usually reduces voice, respiratory, and general quality of life, and is sometimes life‐threatening. Patients usually need repeated operations. The use of adjuvant bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor A, has been described in several case reports, with a good efficacy and safety profile. Methods We report the cases of five patients with aggressive RRP who were treated with adjuvant systemic bevacizumab in a single Belgian tertiary center. Results A complete response was achieved in four patients after a median of 4.5 months, and a partial response in one. In all cases, the number of surgeries was drastically reduced, and quality of life improved. Toxicity was easily managed. Conclusions Systemic bevacizumab seems to be an effective and safe adjuvant treatment for aggressive RRP.

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Systemic bevacizumab for end-stage juvenile recurrent respiratory papillomas: A case report

Cited by 14 publications

References 13 publications

Systemic Bevacizumab (Avastin) for Juvenile‐Onset Recurrent Respiratory Papillomatosis: A Systematic Review

Systemic Bevacizumab (Avastin) for Juvenile‐Onset Recurrent Respiratory Papillomatosis: A Systematic Review

Long‐Term Follow‐Up on Systemic Bevacizumab Treatment in Recurrent Respiratory Papillomatosis

Aggressive recurrent respiratory papillomatosis: A series of five consecutive patients successfully treated with adjuvant intravenous bevacizumab. A single Belgian academic center experience

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