Key Message

This review identified limited evidence regarding the clinical effectiveness of raltitrexed for patients who had previously experienced adverse events following treatment with fluoropyrimidines. These studies had several limitations, most notably lacking a separate control group; therefore, the effectiveness of raltitrexed in this population is uncertain.

Limited evidence was found about the safety of raltitrexed for patients who had previously experienced adverse events with fluoropyrimidine treatment. Reported adverse events included cardiac or vascular adverse events, anemia, and nausea and vomiting. No treatment-associated deaths were reported in the studies included in this review.

No studies were identified that compared the clinical effectiveness of raltitrexed to other therapies, placebo, or no treatment comparator groups for treatment of patients who had experienced adverse events from fluoropyrimidine therapy.

This review identified evidence for people who had previously experienced severe adverse events, primarily cardiotoxicity, following treatment with fluoropyrimidines. It is unclear if these findings are appliable to patients with a complete dihydropyrimidine dehydrogenase deficiency.

Key Message

Transanal total mesorectal excision may result in lower rates of conversion to open procedure and a better circumferential resection margin compared with laparoscopic total mesorectal excision in adults with rectal cancer.

Transanal total mesorectal excision may be comparable to laparoscopic total mesorectal excision for cancer recurrence, survival, death, and short-term safety outcomes in adults with rectal cancer.

Total mesorectal excision may be more cost-effective than laparoscopic and open total mesorectal excision in adults with rectal cancer, but this is uncertain.

Key Message

The review did not find any studies exclusively on the clinical effectiveness and safety of low-dose ipilimumab in combination with nivolumab for the treatment of advanced melanoma that met the criteria for this review.

The review found limited evidence, from 1 single-arm phase II trial of 70 adults and 1 retrospective cohort study of 9 adults, on the clinical benefits and safety of low-dose ipilimumab in combination with pembrolizumab (or nivolumab for an unspecified number of patients in the retrospective cohort study) for the treatment of advanced melanoma.

In the single-arm study, 20 of 70 enrolled patients (29%) achieved a confirmed response, including 5 complete (7.2%) and 15 partial responses (21.4%). In the retrospective cohort study, 3 of 9 patients (33%) achieved a partial response.

The review did not find any studies on the cost-effectiveness of low-dose ipilimumab in combination with nivolumab or pembrolizumab for the treatment of advanced melanoma that met our criteria for this review.

Key Message

Twenty evidence-based guidelines describing colonoscopic surveillance following colon cancer surgery were identified.