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In this Review, the authors discuss racial differences in the prevalence of genetic mutations in the main molecular drivers of prostate cancer and provide input regarding the role of genomics in racial disparities observed in prostate cancer outcomes.

Controversies over how, why and when pelvic lymph node dissection (PLND) should be performed persist. Available data suggest that a limited number of patients will experience a curative benefit from PLND, but it remains the most tried and tested diagnostic tool for staging. New techniques aim to improve noninvasive detection of diseased nodes.

Muscle-invasive bladder cancer (MIBC) remains a deadly disease, despite aggressive surgical and systemic chemotherapeutic treatments. New treatment modalities are needed. A novel intravesicle drug delivery device for neoadjuvant treatment of MIBC has been developed, and preliminary results on the efficacy and safety of this system are available.

Some chemotherapeutic agents can induce distinct mutational signatures in healthy cells in patients with cancer. The effect of such mutational signatures on spermatogenesis is not fully understood but is of great clinical importance for counselling patients diagnosed with cancer planning to start a family after treatment.

Prostate cancer recurrence is common after radical radiotherapy and the increasing use of novel, minimally invasive salvage treatments means that accurate detection and localization of radiorecurrent disease is vital in treatment planning and delivery. PET–CT is increasingly used to detect metastatic disease; however, data regarding its value for identifying and accurately characterizing intraprostatic recurrence need improvement.

In this Review, Joshi and colleagues describe the immune landscape of penile cancer, examine existing and novel immune-based therapeutic targets, and discuss the future directions of immune-based therapies in penile cancer based on preclinical and clinical studies.