The emergence of an effective treatment for nonmetastatic castration-resistant prostate cancer (nmCRPC) is likely to have a paradigm-changing effect on the treatment of CRPC. In this informative talk with Eric Small, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, he discusses how he expects that the results of the SPARTAN trial (NCT01946204) of apalutamide will impact clinical practice in the US. Dr Small highlights the identification of patients at high-risk of progression, the benefits of early treatment and the effect of this treatment on later therapy. He also discusses the questions that are yet to be answered. This video was recorded at the 2018 Genitourinary Cancers Symposium, held in San Francisco, CA.