免疫治疗（IO）的发现和应用在晚期泌尿系统癌症管理方面引起了真正的革命。最近发现免疫治疗的治疗效益不仅仅局限于弥散性疾病患者，而且在局限性和局部进展的泌尿系统肿瘤中的特定患者中也同样有效。 KEYNOTE-057展示了帕姆单抗治疗对于对卡介苗不敏感的高危非肌层浸润性膀胱癌的疗效，最终获得了美国食品和药物管理局的批准。此外，当前的3期试验（Checkmate274）证实了在根治性膀胱切除术后，与安慰剂相比，辅助奈伐单抗给予的病无生存益处。此外，最近备受关注的KEYNOTE 564试验证明了辅助应用帕姆单抗对于高风险局限性/局部进展的肾癌患者具有无复发生存益处。 在具有侵袭性表型的局限性泌尿系统癌症的管理中，IO的应用和整合正在成为新兴的治疗范式。临床肿瘤学家和科学家应该熟悉这些试验和适应症，因为它们有可能在未来的几个月和几年中极大地改变我们的治疗策略。

A true revolution in the management of advanced genitourinary cancers has occurred with the discovery and adoption of immunotherapy (IO). The therapeutic benefits of IO were recently observed not to be solely confined to patients with disseminated disease but also in select patients with localized and locally advanced genitourinary neoplasms.KEYNOTE-057 demonstrated the benefit of pembrolizumab monotherapy for treating high-risk nonmuscle invasive bladder cancer unresponsive to bacillus Calmette-Guérin (BCG), resulting in recent US Food and Drug Administration approval. Furthermore, a current phase 3 trial (Checkmate274) demonstrated a disease-free survival benefit with the administration of adjuvant nivolumab vs placebo in muscle-invasive urothelial carcinoma after radical cystectomy. In addition, the recent highly publicized phase 3 KEYNOTE 564 trial demonstrated a recurrence-free survival benefit of adjuvant pembrolizumab in patients with high-risk localized/locally advanced kidney cancer.The adoption and integration of IO in the management of localized genitourinary cancers exhibiting aggressive phenotypes are becoming an emerging therapeutic paradigm. Clinical oncologists and scientists should become familiar with these trials and indications because they are likely to dramatically change our treatment strategies in the months and years to come.