Drs. Posadas and Ambinder reflect on the first AUA guideline update for salvage therapy in prostate cancer in over a decade. Dr. Marc Dall'Era spotlights the results from a phase 2 trial on neoadjuvant niraparib for DDR-deficient localized PCa. A recent study evaluated the impact of early withdrawal of upfront ARSIs on clinical outcomes in patients with mCSPC. Most patients in EMBARK recovered testosterone after treatment break, regardless of therapy or age. Patients with ARPI-treated mCSPC and BRCA1/2 alterations experienced higher rates of disease progression. Focal therapy may be feasible in select men with GG4 prostate cancer, showing similar success rates to GG2/GG3 disease. Research sheds light on the patient-reported outcomes from a 3-year focal therapy program for localized PCa using HIFU. Hemi-gland cryoablation and HIFU provided acceptable and eminent functional outcomes in patients over a 5-year follow-up. The combination of ADT and radiotherapy can provide quick benefits in patients with intermediate- or high-risk localized PCa. Dr. Yerram elucidates the evolving landscape of focal therapy for prostate cancer, emphasizing its ease of adoption. Dr. Yerram describes his post-HIFU surveillance protocol: regular PSA checks, MRI, and biopsies at defined intervals. Dr. Yerram explains the use of HIFU and cryotherapy as primary focal therapy modalities, emphasizing a few treatment options. Dr. Yerram explains how advances in focal therapy technologies over the past decade have driven increased use and acceptance. Dr. Hong reviews relevant key findings from clinical trials for oligometastatic disease. Dr. Hong reviews the criteria used to determine which patients may benefit from MDT. Dr. Chu highlights how PSMA PET is transforming perioperative prostate cancer care, including improving surgical precision. Dr. Tagawa compares the use of PSMA-targeted antibodies to other treatment approaches such as radioligand therapy. Apalutamide can boost rPFS and OS in patients with mHSPC when diagnosed via conventional imaging. Dr. Kishan reviews current evidence supporting the use of PSMA RLT in patients with oligometastatic disease. 177Lu vipivotide tetraxetan is the only PSMA-targeted agent to significantly improve rPFS with a tolerable safety profile.