78 Background: There is no prospective data to guide optimal selection of treatment for first line (1L) mCRPC after D and androgen deprivation therapy (ADT) is given in the hormone sensitive setting. We explored efficacy of 1L treatment in this group. Methods: Pts with mCRPC treated with D for hormone sensitive disease were identified from a prospectively maintained multi-site mCRPC database (ePAD) of patients treated in a community and academic setting in Australia. 1L treatment, clinicopathologic and outcome data were extracted. Results: We identified 93 pts, median age 65y (range 43–85), who received median 6 cycles of D-ADT and developed mCRPC between May 2013 and Jun 2019. 58% had Gleason ≥ 8, median PSA at diagnosis was 53 ng/mL (range 0.67–7086), 65% had de-novo metastatic disease. Median time to mCRPC was 14.8mo (range 1.3 to 56.9) with median time to 1L 16.3mo (range 2.1–57.2). Eighty-five patients (91%) received at least one further active treatment for mCRPC with outcomes below. Conclusions: Abiraterone, enzalutamide, and cabazitaxel all demonstrate activity for 1L mCRPC following progression on D-ADT. Compared to historical controls, PSA responses appear less than pre-docetaxel, but greater than the post-docetaxel setting.[Table: see text]