(UroToday.com) The treatment landscape in advanced prostate cancer has rapidly evolved. In particular, agents with demonstrated survival benefits later in the natural history of prostate cancer have been used earlier in the disease process. In the context of metastatic castration-sensitive prostate cancer (mCSPC), docetaxel was the first agent to demonstrate a survival benefit when combined with conventional androgen deprivation therapy (ADT). Following this, a number of androgen receptor targeting agents have been assessed, beginning with abiraterone acetate. In TITAN, the addition of apalutamide to ADT has demonstrated improvement in long-term outcomes for patients with mCSPC.