(UroToday.com) The treatment landscape in advanced prostate cancer has rapidly evolved. In the context of metastatic castration resistant prostate cancer (mCRPC), docetaxel was the first agent to demonstrate a survival benefit when combined with conventional androgen deprivation therapy (ADT). Following this, a number of other treatment approaches have been assessed and are now clinically used including androgen receptor targeting agents. Additionally, agents with demonstrated survival benefits later in the natural history of prostate cancer have been used earlier in the disease process, including both metastatic castration sensitive prostate cancer (mCSPC) and non-metastatic castration resistant prostate cancer (nmCRPC). The phase 3 TITAN and SPARTAN studies demonstrated improved outcomes with the addition of apalutamide to androgen deprivation therapy (ADT) for patients with mCSPC and nmCRPC, respectively.