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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 2 - Laryngology/Broncho-Esophagology

Update on Gardasil Vaccination in Recurrent Respiratory Papillomatosis Patients Age 45 or Older

Sunday, September 29, 2024
9:42 AM – 9:48 AM EDT
Location: MBCC, 224
Disclosure(s):
Ryan J. Ivancic, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Molly O. Meeker, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brad W. DeSilva, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Laura Matrka, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Gardasil human papillomavirus (HPV) vaccination has been effective as both primary prevention and an adjuvant therapy for recurrent respiratory papillomatosis (RRP). We present an update to our previous research reporting a significant increase in the intersurgical interval (ISI) after adjuvant Gardasil vaccination. Our objectives were: 1) to assess durability of Gardasil as an adjuvant in RRP with longer-term follow up and a larger cohort, and 2) to compare the effect of adjuvant Gardasil, cidofovir, and bevacizumab on recurrence rates of RRP in patients over 45 years old.

Methods: We conducted a retrospective chart review of adult patients over 45 years old diagnosed with RRP from 2008-2022. Patients were considered vaccinated if they received at least 2 Gardasil doses.

Results: There were 49 total patients: 14 vaccinated and 35 unvaccinated. Of them, 12 vaccinated and 13 unvaccinated patients received adjuvant therapy during the treatment period. There was a significant increase in the ISI for the vaccinated group from 126 to 304 days (p < 0.01), with 100.1 ± 47.3 months follow-up. Our previous study, performed at 49.7 ± 30.3 months follow-up, found an ISI of 494 days in the vaccinated group. There was no significant increase in ISI in the vaccinated or unvaccinated groups post-cidofovir/bevacizumab (p = 0.2 and p = 0.24, respectively).

Conclusions: Adjuvant Gardasil use in RRP patients over 45 years old significantly reduces the ISI compared to other standard adjuvant therapies in our cohort. However, the magnitude of this effect appears to wane with time, with the ISI downtrending from 494 days to 304 days. While still significant, it may suggest a waning effect of Gardasil on disease recurrence and raises the question of whether a booster Gardasil dose might maintain its therapeutic effect.

    Co-Author(s)

  • Ryan J. Ivancic, MD

    Resident physician
    Ohio State University Hospital Program
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Presenting Author(s)

  • Molly O. Meeker, BS

    Medical Student
    The Ohio State University College of Medicine
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Brad W. DeSilva, MD

    Clinical Professor - Department of Otolaryngology - Head and Neck Surgery
    The Ohio State University Wexner Medical Center
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • LM

    Laura Matrka, MD

    Professor, Department of Otolaryngology - Head and Neck Surgery
    The Ohio State University
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.