The treatment of genitourinary malignancies has dramatically evolved over recent years. Renal cell carcinoma, urothelial carcinoma of the bladder, and prostate adenocarcinoma are the most commonly encountered genitourinary malignancies and represent a heterogeneous population of cancers, in both histology and approach to treatment. However, all three cancers have undergone paradigm shifts in their respective therapeutic landscapes due to a greater understanding of their underlying molecular mechanisms and oncogenic drivers. The advance that has gained the most recent traction has been the advent of immunotherapies, particularly immune checkpoint inhibitors. Immunotherapy has increased overall survival and even provided durable responses in the metastatic setting in some patients. The early success of immune checkpoint inhibitors has led to further drug development with the emergence of novel agents which modulate the immune system within the tumor microenvironment. Notwithstanding immunotherapy, investigators are also developing novel agents tailored to a variety of targets including small-molecule tyrosine kinase inhibitors, mTOR inhibitors, and novel fusion proteins to name a few. Erdafitinib has become the first targeted therapy approved for metastatic bladder cancer. Moreover, the combination therapy of immune checkpoint inhibitors with targeted agents such as pembrolizumab or avelumab with axitinib has demonstrated both safety and efficacy and just received FDA approval for their use. We are in an era of rapid progression in drug development with multiple exciting trials and ongoing pre-clinical studies. We highlight many of the promising new emerging therapies that will likely continue to improve outcomes in patients with genitourinary malignancies.

中文翻译：

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泌尿生殖系统癌症的新兴治疗剂。

近年来，泌尿生殖系统恶性肿瘤的治疗取得了巨大进展。肾细胞癌、膀胱尿路上皮癌和前列腺腺癌是最常见的泌尿生殖系统恶性肿瘤，并且在组织学和治疗方法上代表了异质性癌症群体。然而，由于对三种癌症的潜在分子机制和致癌驱动因素有了更深入的了解，这三种癌症在各自的治疗领域都经历了范式转变。最近获得关注的进展是免疫疗法的出现，特别是免疫检查点抑制剂。免疫疗法提高了总体生存率，甚至在某些患者的转移环境中提供了持久的反应。免疫检查点抑制剂的早期成功带动了药物的进一步开发，调节肿瘤微环境中免疫系统的新型药物的出现。除了免疫疗法之外，研究人员还在开发针对各种靶点的新型药物，包括小分子酪氨酸激酶抑制剂、mTOR 抑制剂和新型融合蛋白等。Erdafitinib已成为第一个被批准用于转移性膀胱癌的靶向治疗药物。此外，免疫检查点抑制剂与靶向药物（例如pembrolizumab或avelumab与axitinib）的联合治疗已证明安全性和有效性，并刚刚获得FDA批准使用。我们正处于药物开发快速发展的时代，有多项令人兴奋的试验和正在进行的临床前研究。我们重点介绍许多有前景的新兴疗法，这些疗法可能会继续改善泌尿生殖系统恶性肿瘤患者的预后。