Clinically actionable findings in the tumor. (a, b) Integrated clinical analysis and interpretation of the patient’s tumor and normal exome revealed multiple somatic and germline events warranting further review (a). These included a homozygous PTEN deletion and a PIK3R1 nonsense mutation. Remaining alterations were scored by rules as being biologically relevant, being relevant specifically to prostate cancer biology, being in the pathway of a cancer gene, or being present in COSMIC. Germline clinical analysis also revealed a BRCA2 variant of uncertain significance. These events may be linked to clinical actions, which are listed here (b). mTOR, mammalian target of rapamycin; PARP, poly(ADP-ribose) polymerase; PI3K, phosphoinostide 3-kinase; PTEN, phosphatase and tensin homolog deleted on chromosome 10.