In 2025, the 15th Shanghai Urologic Oncology Academic Conference was grandly held in Pudong, Shanghai. The meeting convened leading experts in urologic oncology from across China to discuss cutting-edge diagnostic and therapeutic strategies for genitourinary malignancies, including prostate cancer, renal cell carcinoma, and bladder cancer. During the conference, Professor Jingjing Wang, representing the field of medical oncology, delivered an outstanding presentation grounded in the latest evidence-based data, focusing on precision treatment strategies for metastatic castration-resistant prostate cancer (mCRPC), with particular emphasis on combination regimens involving PARP inhibitors. Based on Professor Wang’s presentation, this article systematically reviews the therapeutic challenges of mCRPC, genetic screening strategies, and the clinical benefits of emerging combination approaches, with the aim of providing practical insights for clinicians.