RRP AWARENESS DAY 2026​

The Next Era in RRP The Next Era in RRP The Next Era in RRP

BRIEF HISTORY OF RECURRENT 
RESPIRATORY PAPILLOMATOSIS (RRP) 

Sir Morrell Mackenzie was the first to recognize papillomas as a lesion of the laryngo-pharyngeal system in children in the late 1800s. It is now apparent that these benign tumours may occur at other parts of the upper gastrointestinal and respiratory tracts, and in all age groups. This era included early, limited surgical efforts.1

RRP HISTORY

In the 1940s, Chevalier Jackson (1865–1958) first coined the term “juvenile laryngeal papillomatosis”  highlighting the distinction from adult forms, though treatment remained primarily surgical.1

Introduction of laser technology allowed for more precise ablation in the operating room, though recurrences remained frequent.4-6

RRP HISTORY

Researchers identified HPV types 6 and 11 as the primary causes of recurrent respiratory papillomatosis (RRP) in the early 1980s.2 Studies throughout the 1990s and 2000s, such as the 2004 longitudinal study by Wiatrak et al., further established the link between HPV 6 and 11 and the severity of RRP.3

Off-label Experimental Era: 
Due to the high recurrence rate of surgery, various non-approved adjuvant treatments were used to try to reduce recurrence.

In the early 1990s scientists developed the first HPV vaccine and it was approved by the FDA in the US in 2006, first for girls, then in 2009 for boys. By the end of 2010s, more than 100 countries incorporated HPV vaccination into their recommended vaccine schedules.7

Next Era: The next era is defined by the FDA approval of the first therapy for the treatment of adults with RRP and the first therapy to address the root cause of RRP.8

 CREDITS
1 Goon P, Sonnex C, Jani P, Stanley M, Sudhoff H. Recurrent respiratory papillomatosis: an overview of current thinking and treatment. Eur Arch Otorhinolaryngol. 2008 Feb;265(2):147-51. doi: 10.1007/s00405-007-0546-z. Epub 2007 Nov 29. PMID: 18046565; PMCID: PMC2217621. ; 2Gissmann L, Wolnik L, Ikenberg H, Koldovsky U, Schnürch HG, zur Hausen H. Human papillomavirus types 6 and 11 DNA sequences in genital and laryngeal papillomas and in some cervical cancers. Proc Natl Acad Sci U S A. 1983 Jan;80(2):560-3. doi: 10.1073/pnas.80.2.560. PMID: 6300854; PMCID: PMC393419. ; 3 Wiatrak BJ, Wiatrak DW, Broker TR, Lewis L. Recurrent respiratory papillomatosis: a longitudinal study comparing severity associated with human papilloma viral types 6 and 11 and other risk factors in a large pediatric population. Laryngoscope. 2004 Nov;114(11 Pt 2 Suppl 104):1-23. doi: 10.1097/01.mlg.000148224.83491.0f. PMID: 15514560. ; 4Strong MS, Jako GJ. Laser surgery in the larynx: early clinical experience with continuous CO2 laser. Annals of Otology, Rhinology & Laryngology. 1972;81(6):791–798. PMID: 4636137. DOI: 10.1177/000348947208100606. ; 5Healy GB, et al. Laryngeal papilloma: results of treatment with the CO2 laser and podophyllum. Ann Otol Rhinol Laryngol. 1982;91:425–430. ; 6Dedo HH, Jackler RK. Laryngeal papilloma: results of treatment with the CO2 laser and podophyllum. Ann Otol Rhinol Laryngol. 1982 Jul-Aug;91(4 Pt 1):425-30. doi: 10.1177/000348948209100421. PMID: 7114726. ; 7History of HPV Vaccination: https://sjr-redesign.stjude.org/content/dam/research-redesign/centers-initiatives/hpv-cancer-prevention-program/hpv-advocacy-campaign/history-hpv-vaccination.pdf ; 8FDA Approves First Immunotherapy for Recurrent Respiratory Papillomatosis. August 14, 2025. https://www.fda.gov/news-events/press-announcements/fda-approves-first-immunotherapy-recurrent-respiratory-papillomatosis.

RRP can be juvenile onset or adult onset. ​

More aggressive disease has been linked to earlier age of onset. ​

The vast majority of burden is on the adult population, with around 95% of unique patients over the age of 18. 

27,000
Estimated number of adults with RRP in the United States.
170,000+
Estimated number of adults with RRP outside of the US.

RRP is a serious and debilitating chronic viral condition driven by HPV 6/11 viral infection. ​

COMMON SYMPTOMS

RRP is characterized by papilloma growths in the respiratory tract that can result in severe voice disturbance, compromised airway, and recurrent post-obstructive pneumonias. Although rare, RRP has the potential for transformation to malignant cancer and can be fatal.

RRP Community Stories

For this year’s RRP Awareness Day, we invited individuals living with RRP, caregivers, family members, advocates, supporters, and healthcare providers to reflect on their experiences with RRP and asked them these questions:

  • What do you wish you family and friends understood about your experience with RRP?
  • What do you wish your healthcare team knew about your journey?
  • What is the hardest moment you’ve faced in your role as a caregiver?

  • What has it been like watching your child go through repeated surgical interventions?


The responses are honest, powerful, and deeply personal, offering a window into the daily realities, challenges, and resilience that define this journey. This is what the community shared.

For a limited time, we invite you to add your voice, share your experience, and help raise awareness for everyone impacted by RRP.

Listening to the voice of the patient

The following charts are drawn from a 60-minute electronic survey conducted in June 2025 among 52 adults living with RRP in the United States. The survey was designed to capture the full scope of the RRP patient experience — from surgical burden and treatment history to quality of life (QoL), mental health, and socioeconomic impact. Together, these findings offer a data-driven look at how RRP shapes daily life for adult patients across the US.1

1Bourque, M. et al.2025. Listening To The Voice Of The Patient: Insights From A Survey On The Burden Of Recurrent Respiratory Papillomatosis In The United States. Study presented at ISPOR EU 2025: November 9 – 12, Glasgow, Scotland, UK. This study was sponsored by Precigen. View full data: https://precigen.com/posters/ispor2025_vop.pdf

Historically, RRP has been treated with repeated surgeries to treat and manage RRP symptoms. ​

Additionally, several non-FDA approved adjuvant therapies were tried over the years to manage or alleviate symptoms.

Additionally, several non-FDA approved adjuvant therapies were tried over the years to manage or alleviate symptoms.

"Surgery was the old way of treating laryngeal papilloma. The next era is HPV-specific immunotherapy. Surgery never could address the underlying problem, and that's exactly what HPV-specific immunotherapy is designed to do."

DR. SIMON R. BEST

Associate Professor of Otolaryngology–Head and Neck Surgery at Johns Hopkins University School of Medicine

What you’ve explored here — the history of RRP, its causes and symptoms, the weight of the data, and the voices of patients, caregivers, family, and healthcare providers — is only part of the story.