Immune Checkpoint Blockade for Genitourinary Malignancies and the Abscopal Response

In order to control the amplitude and duration of T-cell inflammatory response, our immune system has evolved a series of checks and balances commonly referred to as immune checkpoints. Unfortunately, cancer cells exploit such checkpoints to evade immune-mediated rejection. A recognition of the role of adaptive immune resistance in cancer growth and progression has led to the development of immune checkpoint inhibitors (ICIs) as cancer therapies. Within just a few years of introduction of ICIs into the clinic, these agents have become a pillar of standard treatment across a range of malignancies. Genitourinary cancers, particularly renal cancer and urothelial cancer, have figured prominently in the initial clinical development of ICIs. Here, we discuss the role of ICIs in the treatment of genitourinary malignancies and address the potential immunomodulatory role of local ablative therapies.