Genetics in prostate cancer: implications for clinical practice.

PURPOSE OF REVIEW Recent advances in our understanding of prostate cancer genetics have transformed the field. However, challenges in implementation and clinical application remain. The aim of this review is to discuss recent noteworthy publications in prostate cancer germline testing, genetically informed treatment, and polygenetic risk. RECENT FINDINGS The recent U.S. Food and Drug Administration approval of two poly adenosine diphosphate-ribose inhibitors (olaparib and rucaparib) for the treatment of men with metastatic castration-resistant prostate cancer with mutations in DNA damage repair genes and updates to the National Cancer Center Network testing guidelines that expand the eligibility criteria for germline and somatic genetic testing in men with prostate cancer provide an opportunity for a larger portion of the prostate cancer population to access genetic testing and targeted therapies. Due to this, clinicians have needed to rapidly adapt their clinical workflows. Further, the field has renewed efforts to evaluate polygenetic risk profiles to better understand the complex genetic landscape beyond single genes. SUMMARY This review highlights advances in the understanding of prostate cancer genetics, and areas that remain less well defined. Collaboration between multidisciplinary team members is necessary to move this field forward and provide quality, optimal care.