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<p>Recurrent Respiratory Papillomatosis (RRP) is a rare disease primarily caused by specific serotypes of human papillomavirus (HPV), with an estimated prevalence of 2 cases per 100,000 adults. Characterized by papillomatous lesions mainly affecting the larynx, its clinical spectrum can range from mild symptoms to severe complications, including malignant transformation in 2–4% of cases. Currently, there is no definitive cure; treatment primarily consists of surgery to relieve symptoms and prevent airway obstruction. However, the recurrent nature of RRP often necessitates multiple surgical interventions, increasing the risk of morbidity. Recent developments in biological therapies, particularly antiangiogenic agents like bevacizumab, have shown promising results, offering alternative or adjunct treatment options. This report presents the case of a 91-year-old patient with sinonasal papillomatosis caused by HPV type 6, successfully treated with bevacizumab. The patient, with no history of autoimmune diseases, presented with an exophytic nasal lesion and was diagnosed with papilloma with severe dysplasia. Following immunological assessment, he was treated with intravenous immunoglobulin due to a functional antibody deficiency, which resulted in a reduction in recurrent infections. Due to the unavailability of interferon, treatment with bevacizumab was initiated at a dose of 500&#xa0;mg every four weeks, achieving significant improvements in the lesions without adverse effects. Bevacizumab, which inhibits the vascular endothelial growth factor (VEGF) pathway, has demonstrated the ability to extend disease-free periods and reduce the need for further surgeries in severe cases. However, questions remain regarding the optimal duration of therapy and the risk of relapse after discontinuation. This case highlights the importance of a multidisciplinary approach and underscores the need for further research to establish standardized treatment protocols. Advances in biological therapies offer hope for improving the quality of life in patients affected by RRP.</p>

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Bevacizumab in the Treatment of Recurrent Respiratory Papillomatosis: A Case of Isolated Nasal Involvement

  • 期刊论文

  • 发表日期：

    2025年7月26日

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  • Julián Martínez-Calvo,
  • Óscar Correa-Jiménez,
  • Alberto Alfaro-Murillo

摘要

Recurrent Respiratory Papillomatosis (RRP) is a rare disease primarily caused by specific serotypes of human papillomavirus (HPV), with an estimated prevalence of 2 cases per 100,000 adults. Characterized by papillomatous lesions mainly affecting the larynx, its clinical spectrum can range from mild symptoms to severe complications, including malignant transformation in 2–4% of cases. Currently, there is no definitive cure; treatment primarily consists of surgery to relieve symptoms and prevent airway obstruction. However, the recurrent nature of RRP often necessitates multiple surgical interventions, increasing the risk of morbidity. Recent developments in biological therapies, particularly antiangiogenic agents like bevacizumab, have shown promising results, offering alternative or adjunct treatment options. This report presents the case of a 91-year-old patient with sinonasal papillomatosis caused by HPV type 6, successfully treated with bevacizumab. The patient, with no history of autoimmune diseases, presented with an exophytic nasal lesion and was diagnosed with papilloma with severe dysplasia. Following immunological assessment, he was treated with intravenous immunoglobulin due to a functional antibody deficiency, which resulted in a reduction in recurrent infections. Due to the unavailability of interferon, treatment with bevacizumab was initiated at a dose of 500 mg every four weeks, achieving significant improvements in the lesions without adverse effects. Bevacizumab, which inhibits the vascular endothelial growth factor (VEGF) pathway, has demonstrated the ability to extend disease-free periods and reduce the need for further surgeries in severe cases. However, questions remain regarding the optimal duration of therapy and the risk of relapse after discontinuation. This case highlights the importance of a multidisciplinary approach and underscores the need for further research to establish standardized treatment protocols. Advances in biological therapies offer hope for improving the quality of life in patients affected by RRP.