Immune checkpoint inhibitors have transformed the management of patients with metastatic urothelial cancer, by leading to long-term response and prolongation of survival in a subset of patients. Unfortunately, only one in five patients with metastatic urothelial cancer responds to anti-programmed death ligand-1 ([AQ1]anti-PD-1) monotherapy. Preclinical and early clinical evidence indicates that radiotherapy not only acts locally, but also exerts systemic anti-tumour effects by modulating the immune system. It is hypothesised that combining checkpoint inhibitors with radiotherapy might enhance an anti-tumour immune response and increase response rates. So far, a handful of early phase clinical trials have been performed seeking to answer this question in urothelial cancer patients. The current review summarises the available preclinical and clinical evidence on radiotherapy/immunotherapy combinations in locally advanced and metastatic bladder cancer and suggests future avenues worthy of exploration.

免疫检查点抑制剂改变了转移性尿路上皮癌患者的管理方式，导致部分患者的长期反应和生存期延长。不幸的是，只有五分之一的转移性尿路上皮癌患者对抗程序性死亡配体-1（[AQ1]anti-PD-1）单药治疗有反应。临床前和早期临床证据表明，放疗不仅在局部起作用，而且通过调节免疫系统发挥全身抗肿瘤作用。假设将检查点抑制剂与放射疗法相结合可能会增强抗肿瘤免疫反应并提高反应率。到目前为止，已经进行了一些早期临床试验，试图在尿路上皮癌患者中回答这个问题。