# Intralesional bevacizumab as an adjuvant approach to recurrent respiratory papillomatosis: A prospective study on different treatment protocols

## TL;DR

This study compares two bevacizumab treatment protocols for managing recurrent respiratory papillomatosis and finds both effective with no major differences in outcomes.

## Contribution

The study evaluates and compares two intralesional bevacizumab protocols for RRP, providing insights into their efficacy and safety.

## Key findings

- Both bevacizumab protocols reduced disease burden and improved voice outcomes in RRP patients.
- No statistically significant differences were found between the two treatment regimens in disease control.
- Higher intralesional doses of bevacizumab were safe and well tolerated in adult patients.

## Abstract

Adjuvant intralesional administration of bevacizumab has shown promising effects in the management of recurrent respiratory papillomatosis (RRP). However, the optimal therapeutic parameters remain undefined. This prospective study aimed to compare the efficacy of two distinct intralesional bevacizumab administration protocols following surgical resection of RRP.

Between 15/09/2023 and 31/12/2024, adult patients with RRP were enrolled in a prospective research study. Participants were allocated to one of two bevacizumab administration protocols, delivered intralesional during direct microlaryngoscopy and CO₂ laser excision. Disease severity was assessed using the Derkay, Dikkers and Numerical scoring systems, as well as the Voice Handicap Index (VHI), at baseline and at 8-week intervals.

Both treatment regimens were associated with reduction in disease burden and improved voice outcomes. No statistically significant differences in disease control were observed between the two administration protocols.

This study indicates that both dosing regimens of bevacizumab were effective as an adjunctive therapy of recurrent respiratory papillomatosis. The higher intralesional doses of bevacizumab are relatively safe and well tolerated in adult patients with laryngeal RRP. Further studies with extended follow-up are warranted to define long-term efficacy and optimal dosing strategies.