EGFR Inhibitor Therapy for Laryngeal Papillomatosis

Abstract

Objective: 1) Study efficacy of epidermal growth factor receptor (EGFR) inhibitor adjuvant therapies in recurrent respiratory papillomatosis by comparing surgical treatment intervals and modified Derkay score prior to and following initiation of medical therapy. 2) Understand factors which affect patient responses to EGFR inhibitor adjuvant therapy.

Method: We performed a retrospective case series of 4 pediatric patients with life threatening recurrent respiratory papillomatosis. Patient charts were reviewed to determine time between surgical procedures and Derkay severity score during operative procedures prior to and following initiation of EGFR inhibitors.

Results: Prior to therapy many of the patients’ median Derkay scores were worsening. Following initiation of EGFR inhibitor therapy, the median Derkay score decreased for all 4 patients. In one patient, in whom a limited response was observed, there was no significant change in the time interval between surgical procedures. In 2 patients there was a greater than 25% increase and in the remaining case the interval between procedures more than doubled the original time.

Conclusion: EGFR inhibitors appear to be a potential effective adjunct therapy for the treatment of recurrent respiratory papillomatosis. Beneficial results were observed in 3 patients as evidenced by Derkay score and interval between operative interventions. One patient exhibited no response to the EGFR inhibitors for reasons which are being investigated.