What is the current status of recurrent respiratory papillomatosis (RRP) with regard to epidemiology, prevention, and treatment?
RRP continues to decline since the implementation of the human papilloma virus (HPV) vaccination, and advancements show promise in RRP medical management.
BACKGROUND: A rare benign neoplasm of the larynx affecting children and adults, RRP is caused by HPV infection. It presents as wart-like growths in the airway, is highly recurrent, and can significantly reduce quality of life. However, HPV research and vaccination, and an improved understanding of RRP, is changing the picture.
STUDY DESIGN: Retrospective review.
SETTING: Department of Otolaryngology–Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Va.
SYNOPSIS: In this retrospective review, researchers noted that the HPV vaccination has had a profound effect on the incidence of RRP and cited the findings of a five-year report using data from pediatric otolaryngologists in Australia, where the vaccination rate is high and RRP incidence was significantly decreased following vaccination implementation. They also pointed to recent case studies that suggest a potential role for the HPV-9 (Gardisil) vaccine as a therapy for RRP, and promising experimental trials using HPV DNA vaccines. Authors discussed the recent expansion in adjuvant medical treatment options for patients with severe RRP, including targeted therapies via immune modulation, which, with the advent of monoclonal antibodies, have become a mainstay of new drug development and application. One such treatment is bevacizumab, which, used intravenously, targets one of RRP’s pathologic pathways via vascular endothelial growth factor. The review also acknowledges the particular risk patients with RRP face during the COVID-19 pandemic due to their frequent need for operative interventions. Based on all current data examined, authors predicted a continued decrease in incidence of RRP and even a potential eradication of the disease.
CITATION: Benedict JJ, Derkay CS. Recurrent respiratory papillomatosis: A 2020 perspective [published online ahead of print March 13, 2021]. Laryngoscope Investig Otolaryngol. doi:10.1002/lio2.545.