Genitourinary (GU) cancers such as prostate, bladder, kidney, testis and penile cancers represent over 20% of all cancers and 10% of all cancer deaths. Many of these deaths occur in patients that present with advanced or metastatic disease and screening programs are ineffective or unavailable for many of these cancers. There is an urgent and unmet need for improved systemic therapies in GU cancers.
Hormonal therapies are becoming increasingly utilised for prostate cancer, targeted therapies are being refined to improve outcomes in renal cell carcinoma, molecular subgroups of urothelial cancer are being better defined to maximise chemotherapy benefits, and already very good outcomes in testis cancer are being optimised by ongoing clinical trials.
In all these cancers, the novel modality of checkpoint immunotherapy is being explored, at all stages of disease and in any a myriad of combinations and strategies. We’ll explore the refinements being tested using existing therapies and then review how immunotherapy is currently in use, in currents trials, and then imagine how GU cancer treatment might evolve in coming years.