All patients with advanced prostate cancer ranging from high risk to metastatic disease should undergo germline testing.
Predictive biomarkers provide information that a specific treatment will help a particular patient: prostate cancer predictive biomarkers help identify patients with metastatic castration resistant prostate cancer who would benefit from specific therapies.
PARP inhibitors having been effective in treating patients with prostate cancer with homologous recombination repair deficiencies and metastatic disease.
BRCA1, BRCA,2, ATM, PALB, 2, and RAD 51 mutations predict sensitivity to PARP inhibitors in metastatic prostate cancer.
Checkpoint inhibitors have efficacy in patients with metastatic prostate cancer, that are microsatellite instability high (MSI-H), or who have mismatch repair deficiency.
PSMA positive prostate cancer can benefit from Lu-PSMA therapies.
AR-V 7 in circulating tumor cells in metastatic prostate cancer ia a negative prognostic factor, associated with worse outcomes, and a negative response to androgen receptor inhibitors, enzalutamide and abiraterone.