To evaluate the comparative risk of endocrine adverse events associated with immune checkpoint inhibitor (ICI) therapy in colorectal cancer (CRC) patients.
Approach:
Study Design: Conducted a network meta-analysis of randomized controlled trials (RCTs) in CRC published up to the date of the study.
Key Findings:
ICI-based regimens were associated with a higher thyroid-related toxicity burden compared to conventional therapy.
Pembrolizumab and ICI+tyrosine kinase inhibitor (TKI) significantly increased the risk of hypothyroidism.
Hyperthyroidism risk was significantly higher with ICI+TKI and ICI plus chemotherapy plus an anti-angiogenic antibody.
Grade 1–2 adverse events were consistently increased across ICI-based treatments.
Effect estimates for thyroiditis, diabetes mellitus, adrenal insufficiency, and grade 3–4 adverse events were imprecise, but ICI+TKI tended to rank higher for thyroiditis and diabetes.
Interpretation:
Limitations:
Effect estimates for rarer endpoints and severe toxicity were imprecise with wide 95% CIs.
Most available safety data are derived from other malignancies, limiting specific conclusions for CRC.
Conclusion:
The study emphasizes the importance of monitoring endocrine adverse events in patients receiving ICI therapy for CRC.
