Evidence has been presented in the last seven years that has transformed the management of metastatic hormone-sensitive prostate cancer (mHSPC). The principles of management for about seven decades had fundamentally been around testosterone suppression. We now have clear data for the benefit of docetaxel (CHAARTED, STAMPEDE), abiraterone (LATITUDE, STAMPEDE), apalutamide (TITAN), and enzalutamide (ARCHES, ENZAMET).