TABLE I.

Summary of Adjuvant Treatment for Patients With Recurrent Respiratory Papillomatosis Currently in Clinical Practice or Development.

Treatment	Pathway	Currently Used in Practice?	Currently in Prospective Clinical Trials?	Strengths	Weaknesses
Cidofovir	Viral DNA replication	Yes	No	Safe for repeat administration	Unclear clinical benefit, no induction of HPV immunity
Celecoxib	COX-2 inhibitor	No	No	Targets mitogenic signaling	No clinical benefit, no induction of HPV immunity
I-3-C	Viral DNA replication	Yes	No	Likely safe for long-term use	Unclear clinical benefit, no induction of HPV immunity
Bevacizumab	Angiogenesis and vessel stability	Yes	No	Can induce rapid regression of lesions	Nephrotoxicity when used systemically, no induction of HPV immunity
Gardasil	Induces humoral immunity	Yes	No	May increase intersurgery interval	Does not induce T cell immunity
Immune checkpoint blockade	Induces cellular immunity	Yes	Yes	May unleash existing anti-HPV immunity	Risk of immune-related adverse events
Therapeutic vaccines	Induces cellular immunity	No	Yes	May induce new anti-HPV immunity	Unknown

HPV = human papillomavirus; I-3-C = indole-3-carbinol; COX-2 = cyclooxygenase-2; T cell = T-lymphocyte.