Table 2 Panel consensus recommendations.

From: Germline and somatic testing for homologous repair deficiency in patients with prostate cancer (part 1 of 2)

1. All patients with prostate cancer should receive germline testing when possible until more comprehensive data is available to better stratify testing recommendations

2. Patients should be informed prior to testing that many types of tumor testing may reveal germline findings, and that confirmatory germline testing may be recommended if such results are identified.

3. Germline testing should not be replaced solely by somatic only testing, as this may lead to missed germline alterations in up to 20% of patients

4. A negative initial tumor test, particularly using HSPC tissue, does not rule out a pathogenic germline alteration nor a new mCRPC somatic event. Repeat testing is obviously indicated if the initial sample is insufficient, but even if sufficient, there is evidence that late mCRPC events such as those that are BRCA2 or MSI-H can be missed in the original metastatic hormone sensitive tissue but developed in the mCRPC setting. Germline and repeat somatic testing may be recommended in such cases.

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