Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Muenster, Muenster, Germany.
Department of Otolaryngology/Head and Neck Cancer, University Hospital Muenster, Muenster, Germany.
Laryngoscope. 2021 Jun;131(6):E1926-E1933. doi: 10.1002/lary.29351. Epub 2020 Dec 31.
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.
Case series.
To describe experience on long-term systemic bevacizumab administration, we performed the underlying investigation. Clinical, radiological, and bronchoscopy data were collected.
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.
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.
4 Laryngoscope, 131:E1926-E1933, 2021.
目的/假设：复发性呼吸道乳头瘤病（RRP）是一种主要影响整个呼吸道的良性疾病。治疗具有挑战性，通常涉及手术干预和辅助药物治疗。此前，已有关于贝伐单抗全身给药的有希望的结果报告。然而，RRP 患者长期使用贝伐单抗的经验尚不可用。在这里，我们介绍了我们对接受贝伐单抗全身治疗的 RRP 患者的长期随访结果。
病例系列。
为了描述长期接受贝伐单抗全身治疗的经验，我们进行了基础研究。收集了临床、放射学和支气管镜数据。
迄今为止，已有 5 名患者在明斯特大学医院接受了贝伐单抗的全身治疗。自首次全身贝伐单抗给药以来，中位随访时间为 95.5 个月，在此期间进行了长期随访。在所有患者中，贝伐单抗治疗后均达到部分缓解或很好的部分缓解。在因贝伐单抗停药导致乳头瘤复发/进展后，在所有重新开始贝伐单抗治疗的患者中均记录到进一步的缓解。在一名患者中，由于疗效丧失而停止使用贝伐单抗。在开始贝伐单抗治疗之前，一名患有肺乳头瘤病的患者已患有肺癌，而在贝伐单抗治疗期间，有 3 名患者发生恶性转化。在所有患者中，全身贝伐单抗治疗可长期减少手术干预。除了两名患者出现轻度蛋白尿和高血压外，治疗耐受性良好。
全身贝伐单抗是一种有前途的治疗侵袭性乳头瘤病的长期治疗选择。贝伐单抗治疗下的恶性转化率、最佳治疗方案以及对生存的影响应在临床试验中进一步评估。
4 级喉镜，131：E1926-E1933，2021 年。
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