Since 2018, apalutamide, darolutamide, and enzalutamide have been approved for 
the treatment of men with non-metastatic castration-resistant prostate cancer 
(M0CRPC). These approvals were based on the results of three separate 
randomized, placebo-controlled, phase III trials: SPARTAN (apalutamide), ARAMIS 
(darolutamide) and PROSPER (enzalutamide). These trials included men with M0CRPC 
and a short PSA doubling time (≤10 months). Results demonstrated a longer 
metastasis-free survival with these agents when used in conjunction with 
androgen deprivation therapy (ADT), compared to ADT alone. Updated results of 
these trials presented in the 2020 annual meeting of American Society of 
Oncology (ASCO) showed significantly improved overall survival with these 
agents. Based on these results, apalutamide, darolutamide, and enzalutamide can 
now be considered the standard of care treatment options for the treatment of 
men with M0CRPC.