blue DNA helix blue DNA helix mobile

Step up to metastatic
prostate cancer
with HRR gene testing

Testing for HRR gene alterations is an important tool for identifying potential targeted treatment strategies for patients who have progressed to metastatic castration-resistant prostate cancer (mCRPC).1,2

Scroll down to learn why you should test for HRR gene alterations.

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) recommend testing all mPC patients for somatic and germline HRR gene alterations with a multigene test.3

When to test

Style
nccn-section

What is an HRR gene alteration?

Alterations can occur in genes involved in homologous recombination repair (HRR), which is a pathway involved in DNA repair. HRR gene mutations (HRRm) may encompass alterations in a number of genes, including:

ATM, ATR, BARD1, BRCA1, BRCA2, CDK12, CHEK2, FANCA, FANCL, MLH1, MRE11A, NBN, PALB2, RAD51C, and RAD51D.2,4

Style
Hrr-gene, subhead


blue DNA helix

blue DNA helix mobile

Why test for HRRm

HRR testing can be both prognostic and predictive.3,5

HRR testing can help:

Identify patients who may have a worse overall prognosis5–7

Who to test

Identify appropriate treatment options, including HRR-targeted therapies3

See available tests

Identify family members at increased risk of cancer3

How to test

Style
testing-cards, subhead
id
why-testing-for-hrrm
Style
therapies-section, subhead

Percentage of mPC patients with an HRR gene alteration

blue DNA helix

blue DNA helix mobile

Based on a comprehensive review of multiple studies and/or pooled datasets reporting the prevalence in mPC11–13:

blue circle

~ 25

of men with mPC have an HRR gene alteration

blue circle

> 50

of HRRm in mPC is not BRCA1or BRCA214

When to test

Style
percentage-section, subhead

mPC, metastatic prostate cancer; PARPi, poly (adenosine diphosphate-ribose) polymerase inhibitor.

Lord CJ, Ashworth A. The DNA damage response and cancer therapy. Nature 2012;481(7381):287-94.
Scott RJ, Mehta A, Macedo GS, Borisov PS, Kanesvaran R, El Metnawy W. Genetic testing for homologous recombination repair (HRR) in metastatic castration-resistant prostate cancer (mCRPC): challenges and solutions. Oncotarget 2021;12(16):1600-14.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Prostate Cancer V2.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed September 16, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
Catalano M, Generali D, Gatti M, et al. DNA repair deficiency as circulating biomarker in prostate cancer. Front Oncol 2023;13:1115241.
Lowrance W, Dreicer R, Jarrard DF, et al. Updates to advanced prostate cancer: AUA/SUO guideline (2023). J Urol 2023;209(6):1082-90.
Plym A, Dióssy M, Szallasi Z, et al. DNA repair pathways and their association with lethal prostate cancer in African American and European American men. JNCI Cancer Spectr 2021;6(1):pkab097.
Castro E, Romero-Laorden N, del Pozo A, et al. PROREPAIR-B: a prospective cohort study of the impact of germline DNA repair mutations on the outcomes of patients with metastatic castration-resistant prostate cancer. J Clin Oncol 2019;37(6):490-503.
Shore N, Oliver L, Shui I, et al. Systematic literature review of the epidemiology of advanced prostate cancer and associated homologous recombination repair gene alterations. J Urol 2021;205(4):977-86.
Leith A, Ribbands A, Kim J, et al. Real-world homologous recombination repair mutation testing in metastatic castration-resistant prostate cancer in the USA, Europe and Japan. Future Oncol 2022;10:2217.
Schostak M, Bradbury A, Briganti A, et al. Practical guidance on establishing a molecular testing pathway for alterations in homologous recombination repair genes in clinical practice for patients with metastatic prostate cancer. Eur Urol Oncol 2024;7(3):344-54.
Chung JH, Dewal N, Sokol E, et al. Prospective comprehensive genomic profiling of primary and metastatic prostate tumors. JCO Precis Oncol 2019;3:PO.18.00283.
Lang SH, Swift SL, White H, Misso K, Kleijnen J, Quek RGW. A systematic review of the prevalence of DNA damage response gene mutations in prostate cancer. Int J Oncol 2019;55(3):597-616.
Kim IE Jr, Kim S, Srivastava A, et al. Similar incidence of DNA damage response pathway alterations between clinically localized and metastatic prostate cancer. BMC Urol 2019;19(1):33.
Olmos D, Lorente D, Alameda D, et al. Treatment patterns and outcomes in metastatic castration-resistant prostate cancer patients with and without somatic or germline alterations in homologous recombination repair genes. Ann Oncol 2024;35(5):458-72.
Style
reference