Figure 4 illustrates that the ALT elevation had a higher incidence rate in the group using PD-1 or PD-L1 inhibitors than in the chemotherapy group (OR = 1.66, 95% CI: 1.12–2.45). Subgroup analysis indicated that the PD-1 inhibitors group had a higher risk of ALT elevation (OR = 1.63, 95% CI: 1.06–2.52). Figure S2 shows that adrenal insufficiency also showed a significantly higher risk in PD-1 or PD-L1 inhibitors group compared to the chemotherapy group (OR = 18.81, 95% CI: 3.42–103.40). The gene discussed is GPT; the disease is Adrenal insufficiency.