Immune checkpoint inhibitors in genitourinary malignancies

Area of Science:

• Genitourinary oncology
• Immunotherapy
• Cancer treatment

Background:

• Immune-mediated therapies have a long history in genitourinary (GU) cancers.
• Recent advancements include monoclonal antibody checkpoint inhibitors (CPIS), offering new treatment avenues.
• CPIS are becoming increasingly important in managing GU malignancies.

Purpose of the Study:

• To review the current evidence for checkpoint inhibitor (CPI) use in various GU cancers.
• To highlight ongoing clinical trials and future directions for CPI therapy.
• To discuss challenges associated with CPI implementation in GU oncology.

Main Methods:

• Literature review of current evidence on CPIs in GU malignancies.
• Summary of clinical trial data for CPIS in renal cell carcinoma, urothelial carcinoma, prostate cancer, testicular germ-cell tumours, and penile carcinoma.
• Identification of ongoing clinical trials and potential challenges.

Main Results:

• CPIS demonstrate significant benefit in renal cell carcinoma (RCC), establishing a new standard of care, particularly in combination with antiangiogenic therapies.
• CPIS are effective in second-line treatment for metastatic urothelial carcinoma, with ongoing trials exploring broader applications.
• Results for CPIS in prostate cancer and other GU malignancies have been less promising to date, though research continues.

Conclusions:

• Checkpoint inhibitors represent a significant advancement in GU cancer treatment, with established roles in RCC and urothelial carcinoma.
• Combinations of CPIS with antiangiogenic therapies are emerging as a new standard in RCC.
• Continued research and careful consideration of challenges are essential for optimizing CPI use across all GU cancer types.