Bedoya Armando, Glisinski Kristen, Clarke Jeffrey, Lind Richard N, Buckley Charles Edward, Shofer Scott
Department of Pulmonary, Allergy, and Critical Care Medicine, Duke University, Durham, NC, USA.
Department of Hematology-Oncology, Duke University, Durham, NC, USA.
Am J Case Rep. 2017 Jul 31;18:842-846. doi: 10.12659/ajcr.904416.
BACKGROUND Recurrent respiratory papillomatosis (RRP), caused by human papillomavirus (HPV), is the most common benign neoplasm of the larynx and central airways. RRP has a significant impact on quality life and high annual costs to healthcare. Currently, there is no cure for RRP, leading to repeated debulking operations for symptomatic palliation. Various local adjuvant therapies have also been studied with mixed efficacy. HPV oncogene products increase expression of vascular endothelial growth factor (VEGF) providing a potential target for treatment of RRP. Bevacizumab, a recombinant monoclonal antibody that inhibits VEGF, has shown efficacy in patients with localized disease. CASE REPORT We present two cases of extensive airway and parenchymal RRP successfully managed with systemically administered bevacizumab, a recombinant monoclonal antibody that inhibits VEGF. CONCLUSIONS Bevacizumab has shown efficacy in patients with localized disease, but here we illustrate the potential of bevacizumab for patients with extensive parenchymal burden as well as provide a brief review of the literature.
背景 复发性呼吸道乳头状瘤病（RRP）由人乳头瘤病毒（HPV）引起，是喉和中央气道最常见的良性肿瘤。RRP对生活质量有重大影响，且医疗保健年度成本高昂。目前，RRP无法治愈，导致需反复进行减瘤手术以缓解症状。也对各种局部辅助治疗进行了研究，但其疗效不一。HPV癌基因产物会增加血管内皮生长因子（VEGF）的表达，这为RRP的治疗提供了一个潜在靶点。贝伐单抗是一种抑制VEGF的重组单克隆抗体，已在局限性疾病患者中显示出疗效。病例报告 我们报告了两例广泛累及气道和实质的RRP患者，通过系统性给予贝伐单抗（一种抑制VEGF的重组单克隆抗体）成功得到治疗。结论 贝伐单抗已在局限性疾病患者中显示出疗效，但在此我们阐述了贝伐单抗对实质受累广泛患者的治疗潜力，并对相关文献进行简要综述。
