(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 SPARTAN trial were presented demonstrating improvements in overall survival for patients with nmCRPC randomized to apalutamide and androgen deprivation therapy, as compared to ADT alone. At the time of primary analysis in2018, analysis of health-related quality of life data demonstrated that the use of apalutamide in nmCRPC was associated with the preservation of health-related quality of life.