Prostate cancer affects one in every nine men in the USA and is the second 
leading cause of cancer-related death. The treatment landscape of advanced 
prostate cancer is changing rapidly. Multiple agents including abiraterone, 
enzalutamide, apalutamide, darolutamide, docetaxel, cabazitaxel, radium-223, and 
sipuleucel-T have been approved for advanced prostate cancer. Appropriate drug 
selection remains crucial in this evolving landscape to derive maximum benefit 
for the patients. We summarize clinical trials leading to recent drug approvals 
and discuss optimal treatment selection. We also review recent advances in 
genomics including its evolving role in prognosis, in elucidating mechanisms of 
treatment resistance, and in guiding treatment decisions.