This contribution gives an overview of recent insights and emerging strategies for individualized therapeutic approaches based on genomic and cancer molecular profiles in patients with a morphological diagnosis of renal, bladder and prostate tumors. Significant advances have been made in molecular biology technologies, such as next-generation sequencing and whole-exome sequencing. The rise of such novel techniques has increased our knowledge on tumor cell biology and cancer development, thus allowing us to identify complex genomic abnormalities. These findings have paved the way to provide healthcare from an individual perspective. An emerging strategy to individualize therapeutic interventions is focused on stem cells. Because of their unique characteristics, they are among the most promising candidates as potential vectors carrying suicide genes into different types of cancer, including genitourinary tumors. Another emerging strategy could be based on prostate specific membrane antigen (PSMA), a unique membrane-bound glycoprotein, which is overexpressed manifold in prostate cancer. PSMA can serve as target for delivering therapeutic agents such as cytotoxins or radionuclides.