Treatment of hormone-naive metastatic prostate cancer

Purpose of review Until 2015, androgen deprivation therapy (ADT) alone was the standard-of-care for metastatic hormone-naive 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.