(UroToday.com) There has been a rapid change in the past few years for patients with advanced prostate cancer, including metastatic castration-resistant prostate cancer (mCRPC). It was in this disease space that change first began in earnest with the introduction of docetaxel on the basis of TAX-327. Subsequently, both abiraterone acetate (COU-301 and COU-302) and enzalutamide (AFFIRM and PREVAIL) demonstrated improvements in overall survival. Given the relative ease of oral administration and avoidance of some of the severe toxicity associated with the infusion of cytotoxic chemotherapy, these oral agents have become preferred treatment approaches for many clinicians and patients. However, over time, resistance to these advanced oral androgen-axis targeting agents develops. PTEN-loss is relatively common in advanced prostate cancer and is associated with worse prognosis as well as reduced benefit from androgen-axis targeting agents.