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[Immunotherapy for urological cancers in 2025]

Anikó Maráz1, Klára Koroncziová1, Tímea Rozsvai1

  • 1Szent-Györgyi Albert Klinikai Központ, Szegedi Tudományegyetem, Onkoterápiás Klinika, Szeged, Hungary. dr.aniko.maraz@gmail.com.

Magyar Onkologia
|December 12, 2025
PubMed
Abstract

Insights

Immunotherapy is now standard for urothelial carcinoma and renal cell carcinoma, with new combinations showing promise. For prostate and testicular cancers, immunotherapy is still experimental but evolving with new strategies.

Area of Science:

  • Urology
  • Oncology
  • Immunology

Background:

  • Immunotherapy (IO) has revolutionized cancer treatment.
  • Its application in urological cancers is rapidly evolving.
  • Recent advancements focus on combination strategies and guideline updates.

Purpose of the Study:

  • To review the development of immunotherapy for urothelial carcinoma (UC), renal cell carcinoma (RCC), prostate cancer (PCa), and testicular germ cell tumors (TGCT).
  • To highlight the latest studies, combination strategies, and 2025 guideline recommendations.
  • To assess the current and future role of immunotherapy in urological malignancies.

Main Methods:

  • Comprehensive review of randomized phase II-III studies published in 2024-2025.
  • Analysis of international treatment guidelines.
  • Evaluation of biomarker-guided approaches in immunotherapy.

Main Results:

  • In UC, enfortumab vedotin plus pembrolizumab is a new first-line standard; maintenance and adjuvant IOs are strengthened.
  • In RCC, IO-TKI and IO-IO combinations offer survival benefits, but sequential IO-after-IO is questionable.
  • In PCa, IO efficacy is mainly in MSI-H/dMMR subgroups. In TGCT, cisplatin remains standard, with IOs under investigation.

Conclusions:

  • Immunotherapy is the therapeutic foundation for UC and RCC in both metastatic and curative settings by 2025.
  • For PCa and TGCT, immunotherapy options are largely experimental but progressing with novel combinations and biomarkers.

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