Trials are underway to investigate the role of nonsteroidal antiandrogens in non-metastatic castration-resistant prostate cancer and Bertrand Tombal, MD, PhD, of Cliniques Saint-Luc University, Brussels, Belgium, summarizes the results from three important clinical trials at the European Society for Medical Oncology (ESMO) 2018 Congress, in Munich, Germany. Prof. Tombal presents fascinating data from the PROSPER (NCT02003924), SPARTAN (NCT01946204) and ARAMIS (NCT02200614) trials, exploring the impact of early enzalutamide, apalutamide and darolutamide treatment, respectively, in patients at high risk of developing metastases, and considers the implications associated with a potential approval in this setting.