Prostate cancer is the second mortalitycause among males with cancer. Patients withmetastatic castration resistant prostate cancer (mCRPC)essentially die due to tumor progression in a castrationresistance situation.Docetaxel based chemotherapy was the first therapeuticstrategy that demonstrated a survival increase, inaddition to pain decrease, increase in tumor responsesand quality of life benefit, and it currently continuesbeing useful after the incorporation of new therapies forthe treatment of mCRPC. Cabazitaxel, a taxane withefficacy in docetaxel resistant tumors, was the seconddrug demonstrating increased survival in this scenario,and it is an additional alternative option effective inselected patients. Patients with aggressive variantsand those with DNA repair genes alterations maybenefit from platin-based therapies. In the absence ofvalidated biomarkers, we should base our decisions onclinical and patient`s preferences criteria.It is important to design a comprehensive therapeuticplan at an early stage including the treatments withdemonstrated efficacy on survival. For this, it is essentiala comprehensive and multidisciplinary evaluation ofthe patient at the start of therapy and during tumorevolution. This evaluation must be done with anadequate information process and shared decisiontogether with the patient.