• Patients who agree to participate in the study and sign the informed consent form.

• Age ≥18 years, male.

• Histologically or cytologically confirmed prostate adenocarcinoma.

• Bone scan, CT, or MRI showing ≥4 bone metastases (with ≥1 outside the pelvis or spine) or visceral metastases.

• Newly diagnosed or recurrent disease after local therapy, with sensitivity to androgen deprivation therapy (ADT).

• Patients who have received ADT (medical or surgical castration) with or without first-generation antiandrogens for ≤3 months, without evidence of soft tissue disease progression (per RECIST 1.1) or clinically significant PSA progression (≥50% increase from nadir with serum testosterone at castrate levels).

• Planned treatment with docetaxel plus apalutamide and ADT, or apalutamide plus ADT.

• ECOG Performance Status (PS) score of 0-1.

• Adequate hematologic and organ function:

‣ \*\*Bone marrow function (without transfusion or growth factor support):\*\*

⁃ Absolute neutrophil count (ANC) ≥1.5 × 10⁹/L (1500/μL)

⁃ Hemoglobin ≥90 g/L (9.0 g/dL)

⁃ Platelet count ≥100 × 10⁹/L (100,000/μL)

⁃ \*\*Liver function:\*\*

⁃ Total bilirubin (TBIL) ≤1.5 × ULN

⁃ AST, ALT, and alkaline phosphatase (ALP) ≤2.5 × ULN

⁃ \*\*Renal function:\*\*

⁃ Serum creatinine ≤1.5 × ULN \*\*or\*\* calculated creatinine clearance ≥30 mL/min (Cockcroft-Gault formula)

⁃ \*\*Coagulation function (without anticoagulation therapy):\*\* INR ≤1.5

⁃ Patients of reproductive potential must use effective contraception during the study and for 6 months after the last dose.