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Compared with chemotherapy alone, PD-1 inhibitor plus chemotherapy significantly increased the risk of diarrhea (RR = 1.38, 95% CI, 1.13-1.68, P = 0.001; I 2 = 0%) and colitis (RR = 2.90, 95% CI, 1.02-8.21, P = 0.050; I 2 = 0%), PD-L1 inhibitor plus chemotherapy significantly increased the risk of nausea (RR = 1.17, 95% CI, 1.02-1.35, P = 0.020; I 2 = 0%), while CTLA-4 inhibitor plus chemotherapy significantly increased the risk of decreased appetite (RR = 1.49, 95% CI, 1.17-1.90, P = 0.001; I 2 = 0%), diarrhea (RR = 2.23, 95% CI, 1.90-