(UroToday.com) There has been a rapid evolution in treatment options for patients with non-metastatic castration-resistant prostate cancer (nmCRPC) since the spring of 2018. Up until the presentation of SPARTAN and PROSPER trials, reporting on the use of apalutamide and enzalutamide in non-metastatic castration-resistant prostate cancer, at GU ASCO in February 2018, there were no specifically approved treatment options for these patients. These agents, as well as darolutamide, were subsequently approved on the basis of demonstrated improvements in metastasis-free survival. At ASCO 2020, updated results of the PROPSER, SPARTAN, and ARAMIS trials were presented demonstrating improvements in overall survival for patients with nmCRPC randomized to enzalutamide, apalutamide, or darolutamide and androgen deprivation therapy, as compared to ADT alone.