Noel Clarke, MBBS, FRCS, ChM, The Christie NHS Foundation Trust, Manchester, UK, talks on the systemic treatment of patients with metastatic hormone-sensitive prostate cancer (HSPC). Prof. Clarke discusses the benefits of the addition of docetaxel to androgen deprivation therapy (ADT), and comments on the findings of the LATITUDE trial (NCT01715285) and the STAMPEDE trial (NCT00268476), both of which investigated the use of abiraterone. Prof. Clarke reports that in these trials disease burden did not have a significant impact on survival outcomes, which has subsequently been confirmed in trials with the alternative systemic therapies enzalutamide and apalutamide. Prof. Clarke also comments on the use of localized radiotherapy for patients with metastatic prostate cancer, reporting that post-hoc analysis of the STAMPEDE trial demonstrated that disease burden does impact outcomes with radiotherapy. This interview took place at the virtual European Association of Urology (EAU) Virtual Meeting 2021.