Genitourinary tumors consist of a large variety of malignancies located in the urinary and the reproductive systems, mainly including prostate cancer, bladder cancer, and renal tumors. Apart from surgeries, various systemic treatments have been used for the whole-course management of genitourinary tumors, including radiation therapy, chemotherapy, and hormonal therapy. However, the characteristics of progression, metastasis, and drug resistance deriving from tumors require and breed novel treatments. Furthermore, exploring biomarkers of genitourinary tumors at the early stage is also beneficial to strengthen the management of patients with tumors. Additionally, the diagnostic and prognostic value of the potential biomarkers for immunotherapy and combined therapy of genitourinary tumors are underexplored. On the basis of precision treatments, the advent of immune-based therapies, including immune checkpoint inhibitors (ICIs, antibodies targeting PD-L1 /PD-1 and CTLA-4 pathways), tumor vaccines, and other therapies, has extended the scope of treatment modalities. FDA has until now approved the clinical application of immune checkpoint inhibitors in a wide range of diseases including some types of genitourinary tumors, whereas not all patients with genitourinary tumors are suitable for immune-based therapies, therefore, the understanding of its underlying mechanism is key to develop effective treatments based on current ICI-based immunotherapy.

The identification of effective biomarkers has becoming a major focus in cancer research, mainly due to the necessity of selecting potentially responsive patients in order to improve their outcomes, as well as to reduce the toxicity and costs related to ineffective treatments. In genitourinary tumors, the lack of biomarkers does not allow for the development of personalized strategies for a single patient, thus representing a major goal in this field. This eBook includes the description of these emerging techniques and identify the most promising biomarkers in genitourinary tumors.

Tumor microenvironment (TME) is a bidirectional, dynamic and intricate network of interactions between tumor cells and mesenchymal tissue cells. Therefore, an in-depth study in TME is of great significance for clarifying tumor biology and molecular mechanisms during tumorigenesis and progression. The genitourinary tumors mainly include relatively high-incidence malignant prostate cancer, kidney cancer and bladder cancer, and relatively rare adrenocortical cancer, penile cancer, and so on. There are various complex intercellular communications in genitourinary tumor microenvironment. Many cells reprogram their metabolic pathways to adapt to an acidic hypoxic environment, providing energy support for growth and metastasis of genitourinary tumors. The heterogeneity of genitourinary TME makes tumor progression quite different between individuals. Therefore, it is necessary to analyze the interaction between tumor cells and stromal components, the key components that exert anti-tumor immunity (such as cytotoxic T lymphocytes, TAM, MDSC, etc.) and other genitourinary tumor microenvironment characterizations

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