{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T11:30:38Z","timestamp":1794051038960,"version":"4.8.0"},"reference-count":55,"publisher":"Wiley","issue":"S4","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>With regulatory approval of HPV\u2010specific immunotherapy for recurrent respiratory papillomatosis (RRP) and growing experience with systemic bevacizumab, a management algorithm incorporating these medical treatments is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Methods<\/jats:title>\n                    <jats:p>RRP Foundation (RRPF) Key Opinion Leaders offer a proposed management algorithm for adults with RRP considering published literature and commercial drug availability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Preventative\n                      <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\n                      vaccination should be considered for all patients. Determination of\n                      <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\n                      type and pulmonary imaging are important for contemporary\n                      <jats:styled-content style=\"fixed-case\">RRP<\/jats:styled-content>\n                      patient care and assist in decision making. Risks and benefits of papilloma debulking as needed versus medical management of\n                      <jats:styled-content style=\"fixed-case\">RRP<\/jats:styled-content>\n                      must be deliberated on a patient case\u2010by\u2010case basis.\n                      <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\n                      \u2010specific immunotherapy that induces an\n                      <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\n                      \u2010specific T cell response to target the underlying\n                      <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\n                      infection that is the cause of\n                      <jats:styled-content style=\"fixed-case\">RRP<\/jats:styled-content>\n                      is safe, offers the possibility of durable disease control following a short treatment course and is the recommended first\u2010line medical treatment for patients who wish to avoid the risks of repeat procedural management. Papilloma disease control with systemic bevacizumab, which carries defined risks and must be continued for clinical benefit is the recommended second\u2010line medical treatment for patients who do not achieve a complete response with immunotherapy and wish to continue medical management. For patients who elect to be treated with debulking procedures as needed, use of locally\u2010administered adjuvant should be considered.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This proposed management algorithm from the RRPF serves as a contemporary resource and information guide for adult patients with RRP and their physicians considering treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>5<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70379","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:30:15Z","timestamp":1768566615000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Recurrent Respiratory Papillomatosis Foundation Position Statement on the Management of Adults With\n                    <scp>RRP<\/scp>"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8699-033X","authenticated-orcid":false,"given":"Simon R.","family":"Best","sequence":"first","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2014Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5615-3442","authenticated-orcid":false,"given":"Aaron D.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2014Head and Neck Surgery University of Cincinnati Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-1086","authenticated-orcid":false,"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5146-6319","authenticated-orcid":false,"given":"Robert T.","family":"Sataloff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Drexel University College of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-5202","authenticated-orcid":false,"given":"Laura A.","family":"Matrka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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