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Dr Neal Shore is joined by Dr Simon Chowdhury, Prof Matthew Smith and Prof Boris Hadaschik at the ASCO 2018 conference in Chicago. The discussion opens with comments on the day's poster sessions here at ASCO 2018, including genomic profiling of tumours from mCRPC patients, which gives promising findings. Following this there is a discussion about the P3 SPARTAN trial, investigating Association of metastasis-free survival (MFS) and overall survival (OS) in nonmetastatic castration-resistant prostate cancer (nmCRPC), led by Prof Smith. Prof Hadaschik comments on the Phase 2 randomised cross-over trial of abiraterone + prednisone (ABI+P) vs enzalutamide (ENZ) which give 2nd line therapy results. He believes the results point towards no large difference between the drugs, and at this point in time it should be down do a discussion with the clinician and patient. The panel discuss this further in the context of their own work. Dr Chowdhury comments on the Phase II randomised trial; Olaparib combined with abiraterone in patients with mCRPC, and describes why he believes some of the results were unexpected, and also discusses some of the toxicities. This leads on to Cora Sternberg's randomised phase 2 study investigating 3 dosing regimens of radium-223 dichloride (Ra-223) in bone metastatic castration-resistant prostate cancer (mCRPC) with comments from Prof Smith particularly highlighting the changes in toxicity as the dose increased. The discussion ends with a roundup of the Australian study with Lutetium and PSMA Gallium, Prof Hadaschik gives a detailed overview and opinion. This programme has been supported by an unrestricted educational grant from Janssen Pharmaceutica (A Johnson & Johnson Company).