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Applied Sciences
Volume 15
Issue 22
10.3390/app152212113
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Integration of Radiotherapy and Immunotherapy in Urological Cancers: Hype or Hope?

by
Catalin Andrei Bulai
1,2,
Dragos Adrian Georgescu
1,2,*,
Razvan Dragos Multescu
1,2,*,
Adrian Militaru
1,2,
Ana Maria Andreea Punga
1,2,
Cristian Mares
1,2,
Ileana Adela Vacaroiu
1,3,
Daniela Roca
4 and
Bogdan Florin Geavlete
1,2
1
Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
2
Department of Urology, “Saint John” Emergency Clinical Hospital, 042122 Bucharest, Romania
3
Department of Nephrology, “Saint John” Emergency Clinical Hospital, 042122 Bucharest, Romania
4
Department of Oncology, “Saint John” Emergency Clinical Hospital, 042122 Bucharest, Romania
*
Authors to whom correspondence should be addressed.
Appl. Sci. 2025, 15(22), 12113; https://doi.org/10.3390/app152212113
Submission received: 6 October 2025 / Revised: 2 November 2025 / Accepted: 13 November 2025 / Published: 14 November 2025
(This article belongs to the Special Issue Novel Research on Radiotherapy and Oncology)
Versions Notes

Abstract

Background: The integration of radiotherapy (RT) and immunotherapy (IO) is transforming oncologic paradigms by combining local tumor control with systemic immune activation. In urological cancers—prostate, bladder, and renal cell carcinoma—this strategy is supported by growing biological rationale and promising early clinical results. Methods: This narrative review synthesizes preclinical and clinical evidence on RT–IO combinations in urological malignancies. A comprehensive literature search was performed in PubMed, Embase, and ClinicalTrials.gov, focusing on mechanistic insights, clinical trials, and translational challenges related to RT–IO synergy. Results: Early-phase studies in bladder and renal cell carcinoma demonstrate feasibility, immunogenic enhancement, and manageable toxicity when RT is combined with checkpoint inhibitors. Prostate cancer remains less immunoresponsive but may benefit from RT-induced immune priming, particularly in biomarker-enriched subgroups. Innovations in precision RT, biomarkers, artificial intelligence, and novel immunotherapeutics are shaping future applications. Conclusions: RT–IO combinations represent a promising yet complex frontier in urological oncology. Future success will rely on precision-guided patient selection, optimized trial design, and equitable global implementation to ensure durable clinical benefit.
Keywords: radiotherapy; immunotherapy; prostate cancer; bladder cancer; renal cell carcinoma; immune checkpoint inhibitors; abscopal effect; precision oncology radiotherapy; immunotherapy; prostate cancer; bladder cancer; renal cell carcinoma; immune checkpoint inhibitors; abscopal effect; precision oncology

Share and Cite

MDPI and ACS Style

Bulai, C.A.; Georgescu, D.A.; Multescu, R.D.; Militaru, A.; Punga, A.M.A.; Mares, C.; Vacaroiu, I.A.; Roca, D.; Geavlete, B.F. Integration of Radiotherapy and Immunotherapy in Urological Cancers: Hype or Hope? Appl. Sci. 2025, 15, 12113. https://doi.org/10.3390/app152212113

AMA Style

Bulai CA, Georgescu DA, Multescu RD, Militaru A, Punga AMA, Mares C, Vacaroiu IA, Roca D, Geavlete BF. Integration of Radiotherapy and Immunotherapy in Urological Cancers: Hype or Hope? Applied Sciences. 2025; 15(22):12113. https://doi.org/10.3390/app152212113

Chicago/Turabian Style

Bulai, Catalin Andrei, Dragos Adrian Georgescu, Razvan Dragos Multescu, Adrian Militaru, Ana Maria Andreea Punga, Cristian Mares, Ileana Adela Vacaroiu, Daniela Roca, and Bogdan Florin Geavlete. 2025. "Integration of Radiotherapy and Immunotherapy in Urological Cancers: Hype or Hope?" Applied Sciences 15, no. 22: 12113. https://doi.org/10.3390/app152212113

APA Style

Bulai, C. A., Georgescu, D. A., Multescu, R. D., Militaru, A., Punga, A. M. A., Mares, C., Vacaroiu, I. A., Roca, D., & Geavlete, B. F. (2025). Integration of Radiotherapy and Immunotherapy in Urological Cancers: Hype or Hope? Applied Sciences, 15(22), 12113. https://doi.org/10.3390/app152212113

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