{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:45:26Z","timestamp":1791906326473,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Pulmonary papillomatosis is a rare but severe manifestation of recurrent respiratory papillomatosis (RRP). Efficacy data of systemic bevacizumab for pulmonary RRP are limited. This study's objective was to characterize disease response of pulmonary RRP to systemic bevacizumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was performed to identify patients with pulmonary RRP seen at three medical institutions. Clinical symptoms, CT findings, and disease response were compared before and after initiation of systemic bevacizumab therapy. Disease response was categorized as complete response, partial response, stabilization, or progression for each subsite involved by papilloma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 12 pulmonary RRP patients treated with systemic bevacizumab, 4 (33.3%) were male, and 11 (91.7%) were juvenile\u2010onset RRP patients. All presented with laryngeal, tracheal, and pulmonary RRP. The median (range) age at first bevacizumab infusion was 48.1 (19.5\u201370.2) years. Progression to pulmonary malignancy was identified in 3 (25.0%) patients, 2 before initiation of and 1 after complete cessation of bevacizumab therapy. Clinical symptoms such as dyspnea (75.0% vs. 25.0%; <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and dysphagia and\/or odynophagia (33.3 vs. 0.0%; <jats:italic>p<\/jats:italic>\u2009=\u20090.03) were significantly decreased following bevacizumab therapy. Compared with pre\u2010treatment baseline, 9 (75.0%) patients experienced a stable\u2010to\u2010partial response in the lungs to systemic bevacizumab, and 10 (83.3%) experienced partial\u2010to\u2010complete responses in the larynx and trachea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Systemic bevacizumab is effective in stabilizing progression in even the most severe cases of RRP, with both a dramatic reduction in laryngeal and tracheal disease as well as a stable\u2010to\u2010partial response of pulmonary involvement in a majority of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:577\u2013581, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30893","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T10:29:32Z","timestamp":1689848972000},"page":"577-581","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Efficacy of Systemic Bevacizumab for Recurrent Respiratory Papillomatosis with Pulmonary Involvement"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1004-7606","authenticated-orcid":false,"given":"Raymond J.","family":"So","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio C.","family":"Hidalgo Lopez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir A.","family":"Ballestas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor","family":"Steuer","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong M.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marin","family":"Abousaud","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabil F.","family":"Saba","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Tkaczuk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Emory University  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Highlands Oncology  Fayetteville Arkansas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanguy Y.","family":"Seiwert","sequence":"additional","affiliation":[{"name":"Department of Oncology Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"McClellan","sequence":"additional","affiliation":[{"name":"Recurrent Respiratory Papillomatosis Foundation  Lawrenceville New Jersey U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.","family":"Best","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31816a7135"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2012.03.006"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310200802"},{"issue":"3","key":"e_1_2_6_5_1","first-page":"40","article-title":"Ad hoc committee on service delivery in the schools. 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