Recurrent respiratory papillomatosis (RRP) has long been managed with repeated surgical debulking, sometimes requiring dozens of procedures over a lifetime. In this episode of BackTable, Dr. Aaron Friedman and guest host Dr. Stephen Schoeff discuss a major shift in care: immune-directed therapy targeting HPV 6 and 11.

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SYNPOSIS

Dr. Friedman reviews the recent FDA approval of the Precigen product PAPZIMEOS (August 2025), a therapeutic vaccine designed to stimulate HPV-specific T-cell responses. Clinical trial data show that about half of treated adults required no additional surgeries over the following year, with many responders maintaining durable benefit for years. The conversation also covers traditional management strategies, adjuvant therapies like bevacizumab, HPV vaccination, and the evolving algorithm for adult RRP care.

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TIMESTAMPS

00:00 - Introduction
02:13 - RRP Patient Types and Symptoms
05:06 - Adult vs Juvenile Transmission
10:46 - When to Escalate Treatment
15:40 - Immunotherapy
18:55 - Trial Enrollment, Results and Dosing Rules
26:17 - Durable Long Term Response
30:47 - Who Should Get Treated
32:34 - Logistics And Public Perception
37:50 - Future Research And Prevention

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Recurrent Respiratory Papillomatosis Foundation Position Statement on the Management of Adults With RRP
https://pubmed.ncbi.nlm.nih.gov/41543033/

Dr. Stephen Schoeff
https://healthy.kaiserpermanente.org/washington/clinicians/stephen-schoeff-6848607

Dr. Aaron Friedman
https://www.uchealth.com/en/provider-profiles/friedman-aaron-d-1609057587