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Genitourinary Malignancies

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The Basics of Cancer Immunotherapy

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Abstract

Genitourinary cancers accounted for one-fifth of new cancer cases in 2015, with an estimated 370,000 cases and 59,000 cancer-related deaths (Siegel et al., CA: A Cancer Journal for Clinicians 65:5–29, 2015). The most common genitourinary malignancy is prostate cancer, which is the most commonly diagnosed cancer in men and overall it accounts for almost one in five new cancer diagnoses (Siegel et al., CA: A Cancer Journal for Clinicians 67:7–30, 2017). Genitourinary cancers include prostate cancer, bladder cancer, renal cancer, and germ cell tumors. Aside from arising in the genitourinary organs and requiring a multidisciplinary approach to management, each cancer type is unique with regard to the biology and genetic makeup, risk factors, immunogenicity, and treatment options. Traditionally, bladder cancer and renal cell cancer have been found to be particularly sensitive to immunotherapy, although durable complete remissions occurred in a limited number of patients treated with historic first-line therapies such as interferon alfa 2b and interleukin-2. In the last couple of decades, the molecular characterization of the various mechanisms mediated by cancer cells to evade immune detection has sharpened the focus of cancer immunotherapy to develop targeted molecules capable of manipulating the tumor microenvironment in favor of an anti-tumor immune response. The increased immune specificity of these novel immune checkpoint inhibitors has resulted in better tolerability and a more favorable side-effect profile than that of high-dose interleukin 2, the first non-specific immune modulator approved for the treatment of metastatic renal cell carcinoma.

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Authors and Affiliations

  1. Mayo Clinic, Division of Medical Oncology, Rochester, MN, USA

    Roxana Dronca

  2. Clinical Pharmacology Fellow, Mayo Clinic, Rochester, MN, USA

    Anagha Bangalore Kumar

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  1. Roxana Dronca
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Editors and Affiliations

  1. Department of Urology, Department of Immunology, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA

    Haidong Dong

  2. Department of Oncology, Department of Medicine/Division of Hematology, Department of Immunology, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA

    Svetomir N. Markovic

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Dronca, R., Kumar, A.B. (2018). Genitourinary Malignancies. In: Dong, H., Markovic, S. (eds) The Basics of Cancer Immunotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-70622-1_5

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