Current status, prospects, and challenges of cell therapy for urological tumors

Cell therapy has reshaped the treatment landscape for some hematological malignancies, but its role in urological tumors remains limited and uneven. Early studies in bladder cancer, renal cell carcinoma and prostate cancer suggest that cell therapy can redirect recognition of tumor-associated antigens, enhance cytotoxic effector function and reactivate endogenous antitumor immunity. However, current cell therapies have not yet achieved satisfactory durable responses in most patients. Durable remission depends on more than target recognition: tumor cells must express accessible antigens, and infused cells must enter lesions and maintain their activity within them. More importantly, immune activation must be strong enough to control tumors but sufficiently restrained to avoid systemic toxicity. Therefore, this review evaluates the factors influencing cell therapy from the perspectives of target selection, tumor accessibility, cellular persistence and activation control. It also compares different cell-therapy platforms in light of current clinical evidence and discusses the mechanisms that limit therapeutic efficacy. Finally, it proposes translational priorities and remaining challenges for the further development of cell therapy in urological tumors.