The emerging role of oncolytic virotherapy in genitourinary malignancies

Genitourinary cancers represent a significant global health burden, accounting for millions of new cases annually and high mortality, particularly in advanced disease. Conventional therapies such as surgery, chemotherapy, radiotherapy, and immune checkpoint inhibitors have improved outcomes but are often limited by resistance, tumor immune evasion, and treatment-related toxicities. Oncolytic viruses, with their dual capacity to directly lyse tumor cells and stimulate systemic anti-tumor immunity, have emerged as a promising therapeutic platform in genitourinary oncology. This review provides a comprehensive analysis of the mechanistic underpinnings of oncolytic viruses' therapy, encompassing direct oncolysis, immunogenic cell death, modulation of the tumor microenvironment, and genetic engineering strategies. We highlight key viral platforms, landmark clinical advances, and future perspectives in personalized therapies, CRISPR-based genetic engineering, and biomarker-driven clinical translation. Taken together, the integration of oncolytic viruses into genitourinary cancer management represents a rapidly maturing field, with the potential to transform current therapeutic paradigms through tumor-selective viro-immunotherapy.