Recurrent Respiratory Papillomatosis (RRP) all you need to know - approaches from around the world

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In this episode of the podcast, host Natalie Watson explores the comprehensive management of Recurrent Respiratory Papillomatosis (RRP), bringing together three top experts: Dr Andile Sibiya from South Africa, Mr Adam Donne from the UK, and Prof Craig Derkay from the USA. The discussion covers various aspects of RRP, including differences in patient presentation and healthcare systems across the three countries, the impact of HPV vaccination, and evolving treatment modalities.

Dr. Sibiya discusses the challenges in South Africa, highlighting delays in diagnosis and access to specialized ENT services, particularly for pediatric patients. She emphasizes the need for centralizing care for younger children and the limitations posed by a tiered healthcare system. Sibiya also mentions the significant disease burden and the approach of using surgery as a primary treatment, with consideration for adjuvant therapies, despite limited access to certain treatments like Bevacizumab.

Adam Donne outlines the situation in the UK, where the National Health Service facilitates early referral for hoarseness, a red flag symptom. He notes the prevalence of RRP and the transition from primarily surgical treatments to incorporating adjuvant therapies such as the Quadrivalent vaccine, Cidofovir, and Bevacizumab. Donne underscores the importance of specialist centres and the evolving treatment landscape, reflecting a shift towards medical management.

Craig Derkay provides insights from the US, describing the typical presentation of RRP in children and adults and the role of tertiary care centres in managing the disease. He highlights the promising results of intravenous Bevacizumab in reducing the need for repeated surgeries and the psychological burden on patients. Derkay also discusses the potential of new DNA vaccines in phase three trials, which show promise in significantly reducing or even curing RRP.

The episode concludes with a consensus on the need for earlier adoption of adjuvant therapies to minimize long-term damage and improve patient outcomes, alongside excitement about future developments in vaccine research. The experts agree on the importance of a multidisciplinary approach, involving patients and families in treatment decisions and maintaining a focus on innovative solutions to improve the care and prognosis of RRP patients.

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Chapters

1. Recurrent Respiratory Papillomatosis (RRP) all you need to know - approaches from around the world (00:00:00)

2. Global Perspectives on Respiratory Papillomatosis (00:00:08)

3. Global Perspectives on Respiratory Papillomatosis Treatment (00:05:28)

4. Current Advances in RRP Treatment (00:10:47)

5. Surgical and Medical Approaches for RRP (00:29:02)

6. Adjuvant Therapy Management Approaches for RRP (00:45:21)

7. Advances in RRP Treatment Options (00:51:28)