A real-world comparison of two androgen receptor pathway inhibitors (ARPIs) for advanced prostate cancer showed a significant difference in overall survival (OS). The study included patients with castration-sensitive metastatic prostate cancer. In the ARASENS trial, the addition of darolutamide (DAR) to docetaxel (DOCT) achieved a survival rate of 62.7% versus 50.4% for DOCT plus placebo. DART treatment demonstrated a statistically significant benefit in progression-free survival (PFS). No difference in safety was observed between DART and DOCT plus placebo, both treatments had a similar incidence of adverse events. Addition of DAR did not increase toxicity or alter quality of life. Compared to other ARPIs (APAT, ENZAT, ABIT), DART treatment performed numerically better in APAT (HR=0.80; CI: 0.60–1.06) and ENZAT (HR=0.79; CI: 0.59–1.06).[1]