According to the meta-analysis by Barroso-Sousa et al., patients with combination ICI therapy (i.e., CTLA-4 and PD-1/PDL-1 inhibitors) were more likely to develop immune-related thyroiditis, and patients who were treated with PD-1 inhibitors had a higher risk of developing hypothyroidism compared to the patients using a CTLA-4 inhibitor, and they also had a higher risk of developing hyperthyroidism compared to the patients on PD-L1 inhibitors [7]. This evidence concerns the gene CTLA4 and hypothyroidism.