Table 6. Recommendations for HRR testing in mCRPC.

• Obtain an appropriate and adequate tumor sample • Although fresh samples are recommended, FFPE tissue blocks stored in appropriate storage conditions as per CAP guidelines can be utilized for genetic testing • Comprehensive genomic profiling of mCRPC for HRR genes at presentation • NGS-based test to identify deleterious/suspected deleterious somatic mutations, and if identified, proceed for qualifying germline HRR mutations identification • Prioritize BRCA1/2 and ATM (somatic and or germline) testing in the HRR pathway • Reporting of germline results should follow ACMG guidelines and somatic results should follow A Joint Consensus Recommendation of the AMP, ASCO, and CAP • Incorporate pre-test and post-test genetic counseling

Abbreviations: ACMG: American College of Medical Genetics; AMP: Association for Molecular Pathology; ASCO: American Society of Clinical Oncology; ATM: ataxia-telangiectasia mutated; BRCA: breast cancer gene; CAP: College of American Pathologists; FFPE: formalin-fixed paraffin embedded; HRR: homologous recombination repair; NGS: next generation sequencing; mCPRC: metastatic castrate-resistant prostate cancer.