There has been significant progress in recent years in the treatment of patients with metastatic castration-sensitive prostate cancer (mCSPC). While for patients with less extensive or less aggressive disease, a combination of androgen deprivation (ADT) and hormonal agents aimed at inhibiting androgen receptor signaling (ARTA) is recommended, for patients in good overall condition with high-volume disease and especially synchronous metastases, the new standard of treatment is intensified initial therapy using a triplet of ADT+ARTA+docetaxel.