Biologics for the Treatment of Recurrent Respiratory Papillomatosis

Recurrent respiratory papillomatosis (RRP) is a neoplastic disorder that manifests as papillomatous growths in the upper aerodigestive tract. The symptom profile, socioeconomic implications, and standard treatment approaches have been outlined in recently published expert reviews.1 Briefly, RRP, similar to anogenital condyloma, is caused by a chronic infection with low-risk human papillomavirus (HPV) types 6 or 11. Many are exposed to HPV 6 and 11, but few patients develop chronic infection and papillomatous disease. The genetic or environmental risk factors that dictate the development of a chronic infection or clearance of the low-risk HPV virus are poorly understood.2 Diagnosis of papilloma by a trained pathologist is usually straightforward, and the recurrent nature and anatomic locations of disease point to the clinical diagnosis of RRP. Treatment of RRP has historically centered on maintenance surgical debulking of papillomatous disease aimed at providing the patient with a