Recurrent respiratory papillomatosis treated with combined erlotinib and celecoxib: A retrospective study

Abstract

Introduction

Recurrent respiratory papillomatosis is a rare benign airway disease caused by human papillomavirus, typically types 6 and 11. Management is often difficult due to high recurrence rates and lack of effective pharmacologic options. Recent studies suggest that EGFR and COX-2 pathways play a role in the pathogenesis of human papillomavirus-related lesions.

Patients and methods

We present an observational retrospective study of three patients with PCR confirmed human papillomavirus DNA associated to recurrent respiratory papillomatosis treated with erlotinib and celecoxib at a tertiary hospital between 2017 and 2024. Inclusion criteria were histological diagnosis, prior failure to conventional therapies, and complete clinical follow-up.

Results

Two patients exhibited sustained improvement in symptoms and lesion burden, with no significant adverse events. In one case, treatment was well tolerated over six years. A third patient discontinued therapy due to disease progression, treated with immunotherapy afterwards.

Conclusion

Combined EGFR and COX-2 inhibition may be a promising treatment strategy for recurrent respiratory papillomatosis refractory to standard therapy. These preliminary observations support further prospective investigation in selected patients.