Non-infectious cystitis as a complication of toripalimab therapy in a patient with alpha-fetoprotein-producing gastric adenocarcinoma: a case study

Background

Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for gastric cancer, yet they can lead to rare immune-related adverse events (irAEs), including those affecting the urinary system. Non-bacterial cystitis is a particularly uncommon irAE, and its occurrence in patients with alpha-fetoprotein-producing gastric carcinoma (AFP-GC) is not well-documented.

Data Highlights

No numerical data or trial data provided in the source material.

Key Findings

• A 59-year-old male with AFP-GC developed non-bacterial cystitis and acute kidney injury after toripalimab and SOX chemotherapy.
• Symptoms included urinary tract irritation, gross hematuria, and stage II acute kidney injury.
• Cystoscopy revealed diffuse mucosal hemorrhage, and biopsy showed extensive lymphocyte infiltration and high PD-L1 expression.
• Full-dose methylprednisolone (200 mg/day) effectively alleviated symptoms and restored renal function.

Clinical Implications

Healthcare professionals should monitor for urinary-related irAEs in patients undergoing treatment with ICIs, particularly in rare subtypes like AFP-GC.

Conclusion

This case highlights non-bacterial cystitis as a potential complication of ICI therapy in gastric cancer patients.

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