Purpose of review: Until 2015, androgen deprivation therapy (ADT) alone was the standard-of-care for metastatic hormone-naïve prostate cancer (mHNPC). In the last decade, important landmark therapeutic advances occurred in the management of these patients permitting improvement of their survival.
Recent findings: At least two prospective randomized trials proved upfront docetaxel (DOC) + ADT benefit consequently providing strong evidence for guidelines modifications. Second, similar benefit results were demonstrated when using upfront abiraterone acetate + ADT in mHNPC.
Summary: Both DOC-based chemotherapy and abiraterone acetate provide survival improvement when added to ADT in mHNPC. In the current article, we review the evidence behind this progress and discuss ongoing clinical controversies.