新辅助疗法能够改善耐受性，减少肿瘤体积以便于手术，并评估后续治疗效果。因此，人们对将癌症治疗的益处扩展到新辅助治疗中，以减少复发并提高局部或局部晚期泌尿生殖系统（GU）癌症患者的生存率表示热情。这种方法在临床上非常相关，因为这些治疗主要针对未经治疗的患者，并能产生最佳的药物反应。此外，这些结果不受其他抗癌治疗的影响。尽管过去新辅助疗法一直是膀胱癌的标准治疗方法，但目前仅限于肾脏和前列腺癌（PCa）的临床试验；然而，变化即将来临。基于生物标志物分层的新辅助治疗试验将会引入精确的新辅助疗法，并结合适当的生存终点和全面的相关性和影像研究。本综述讨论了GU恶性肿瘤中的新辅助研究，以及它们如何指导未来的研究设计考虑。版权所有 © 2023 The Authors. Elsevier Inc.发表并保留所有权利。

Neoadjuvant therapies can improve tolerability, reduce tumor volume to facilitate surgery, and assess subsequent treatment response. Therefore, there is much enthusiasm for expanding the benefits of cancer therapies to the neoadjuvant setting to reduce recurrence and improve survival in patients with localized or locally advanced genitourinary (GU) cancer. This approach is clinically pertinent because these treatments are administered primarily to treatment-naive patients and can elicit the greatest drug response. In addition, the results are not impacted by other anticancer treatments. While neoadjuvant therapies have been the standard treatment for bladder cancer in the past, they are presently restricted to clinical trials for renal and prostate cancer (PCa); however, changes are imminent. Precision neoadjuvant therapies will be ushered in by biomarker-stratified neoadjuvant trials with appropriate survival endpoints and comprehensive correlative and imaging studies. This review discusses neoadjuvant studies in GU malignancies and how they inform future study design considerations.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.