A network meta-analysis of endocrine adverse events induced by immune checkpoint inhibitors in colorectal cancer

Category	Detail
Condition	Colorectal cancer (CRC)
Key Mechanisms	Immune checkpoint inhibitors (ICIs) block inhibitory checkpoints, enhancing T cell activity against tumors.
Target Population	Patients with advanced colorectal cancer, particularly those with high microsatellite instability or mismatch repair deficiency (MSI-H/dMMR).
Care Setting	Oncology clinics managing advanced colorectal cancer.

ICI-based regimens are associated with a higher thyroid-related toxicity burden compared to conventional therapy.
Pembrolizumab and ICI+tyrosine kinase inhibitor (TKI) significantly increase the risk of hypothyroidism.
Hyperthyroidism risk is significantly higher with ICI+TKI and ICI plus chemotherapy plus an anti-angiogenic antibody.
Grade 1–2 adverse events are consistently increased across ICI-based treatments.
Endocrine adverse events often require long-term follow-up and management.

Proactive endocrine monitoring is recommended during the first few months of ICI therapy.

About 10% of patients receiving ICIs may develop some form of endocrine dysfunction.

Patients with advanced CRC receiving immune checkpoint inhibitors.

Endocrine adverse events can disrupt treatment continuity and impair quality of life.

Early recognition of endocrine irAEs is crucial.
Long-term follow-up is necessary for patients with irreversible endocrine dysfunction.

Clinical Scorecard: A network meta-analysis assessing endocrine side effects associated with immune checkpoint inhibitors in colorectal cancer