(UroToday.com) Treatment paradigms for patients with metastatic hormone-sensitive prostate cancer (mHSPC) have changed dramatically in the past 4 years. Before 2016, there were no agents with a demonstrated overall survival benefit in this disease space. As a result, for nearly 20 years, there was no appreciable improvement in survival for men diagnosed with mHSPC. However, since 2016, phase III randomized controlled trials have demonstrated a survival benefit for the use of docetaxel (CHAARTED and STAMPEDE), abiraterone acetate (LATITUDE and STAMPEDE), enzalutamide (ENZAMET), and apalutamide (TITAN).