Combination immunotherapy in genitourinary malignancies.

PURPOSE OF REVIEW: Combination immunotherapy has already shown promise in several tumor types, such as melanoma and nonsmall cell lung cancer, and studies are ongoing to evaluate this approach in other malignancies. Trials such as these will only continue to expand as additional immune therapies are shown to have efficacy as single agents in cancer. The purpose of this review is to outline the current landscape of immunotherapy in genitourinary cancer, and to highlight ongoing and pending combination immunotherapy trials in bladder, kidney, and prostate cancers.

RECENT FINDINGS: Immunotherapy agents have long been a part of the treatment armamentarium for patients with bladder, kidney, and prostate cancers, contributing to responses with variable toxicities.In the last year, checkpoint blockade immunotherapy has been Food and Drug Administration approved for renal and bladder cancer, whereas novel vaccines continue to be tested in prostate cancer. The efficacy coupled with mostly mild toxicity of modern immunotherapy make these agents perfect vehicles for combination, sequence, or priming studies to maximize benefit. Published and recently presented combination immunotherapy studies in genitourinary malignancies are summarized.

SUMMARY: Immune therapy strategies are integral to the treatment of bladder, kidney, and prostate cancers. Though the current experience with combination immunotherapy in these cancers is limited, ongoing and maturing studies of combination immunotherapy discussed herein may lead to improved outcomes for patients and change in standard of care. What is learned from correlative data on tumor microenvironment and systemic immune response before, during and following immunotherapy will be integral to the future design of combination immunotherapy trials.