HRR genes

HRR gene mutations can play a role in your metastatic prostate cancer

Metastatic prostate cancer is cancer that’s spread from the prostate gland to other parts of the body, such as the bones or lymph nodes.

Inside your cells, there are genes called HRR (homologous recombination repair) genes. These genes help repair damage to DNA. Some examples of HRR genes include BRCA1, BRCA2, ATM, CHEK2, PALB2, and others. Sometimes, these HRR genes have changes called mutations.

If you have mutations in HRR genes, not all DNA repair proteins may work properly. This may increase your chances of developing certain types of cancer, including prostate cancer. It may also contribute to prostate cancer progression.

A biomarker (short for biological marker) is found in the blood or tissue and is a sign of what may be happening to your cells. An HRR gene mutation test is one of the biomarker tests that can be done in patients with prostate cancer.

HRR testing

Testing for HRR gene mutations can inform treatment options

There are 2 types of HRR gene mutations that can be found in patients with prostate cancer:

Acquired (or somatic), which can happen at any point in a person’s life

Inherited (or germline), which can be passed down from family members

Your doctor can perform different tests to look for HRR gene mutations:

Biomarker
test

Genetic
test

What sample?

Blood or tissue from a solid tumor (biopsy)

What it looks for

Mutations found in cancer cells

What it tells us

How your tumor behaves and what treatments may work

What sample?

Blood, saliva, or cheek swab

What it looks for

Mutations you were born with

What it tells us

If cancer risk runs in families and which treatments can be used

  • A multigene panel is a type of biomarker test that can detect multiple inherited and/or acquired gene mutations, including HRR gene mutations, at once

Speak to your prostate cancer care team about using a multigene panel

Testing for HRR gene mutations early is vital

  • Gives you and your doctor more information about your prostate cancer and prognosis (the course the disease might take)
  • Helps identify treatment options now and informs future decisions
  • Reveals whether family members might have a higher chance of developing certain cancers

According to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), all adults diagnosed with metastatic prostate cancer should undergo biomarker and genetic testing that may identify HRR mutations.1

NCCN = National Comprehensive Cancer Network® (NCCN®).

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Doctor's appointments are a group effort

And your voice matters. Help your loved one prepare for HRR gene mutation testing by asking:

  • How will the test be done?
  • Are you doing a multi-panel test to find both acquired and inherited gene mutations?
  • When and how do we get the test results?

Start the testing conversation with your doctor

Download discussion guide

What to expect

What happens during testing

Your healthcare team may order a test based on several factors. They include your medical history or prior treatments, your disease stage (such as metastatic prostate cancer), clinical guidelines, and the need for current or future treatment decisions.

Before testing

  • If you’ve been referred to a new doctor or clinic, be sure your care team has access to your medical records so they can select the right test(s) for you

Day of test

  • No special preparation is usually needed
  • A blood, saliva, or cheek swab sample may be collected, or a tumor sample† from a past biopsy may be used
  • The sample is sent to a lab for analysis
  • Your care team should coordinate coverage and next steps

†Although tumor-based testing can identify both inherited and acquired mutations, it can’t tell which type of mutation they are from.

After testing

  • The results are shared with your care team
  • Timing for results varies and your healthcare team may start discussing a care plan before results are in
  • A member of your care team explains the results with you
  • The results will help guide the treatment options
  • If testing finds gene mutations are inherited, your doctor may recommend talking to a genetic counselor
  • If your disease progresses, ask about retesting, as it can impact your treatment plan
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What you can do:

Organize

  • Track appointment dates
  • Keep past test results and notes in one place

Take notes

  • You may want to bring something to take notes with at the appointment
  • If possible, ask the doctor and your loved one if it’s OK to record the conversation on your phone, so you can listen to the results after the visit

Share/Ask

  • Follow up about test results and ensure they are shared with the whole care team

Understanding results

If you test positive for HRR gene mutations, the results can help inform your care team on how to best manage your cancer and choose treatment options.

Interpreting results

No mutation found (negative for mutations)

  • No HRR gene changes were detected with the test used
  • This result can help your care team rule out treatment options
  • Future testing may be needed if cancer changes over time

Mutation found (positive for mutations)

  • Depending on the type of test, you may or may not be able to know whether it was an inherited or acquired mutation. Thus, additional testing may be recommended
  • If mutations are inherited, it’s important to discuss the family risk and additional next steps
  • Mutations can help guide treatment discussions now or in the future

Uncertain (significance not understood)

  • Not all changes are understood
  • A gene change was found, but its meaning isn’t clear yet
  • Results may not point to a clear next step—your care team may monitor or do a follow-up test

When results are in

Talk about how your disease will be monitored and whether repeat testing may be needed if it progresses

Ask if the results change your current care plan

Document the results. Keep a copy of your notes for future discussions

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Self-care is vital

Your well-being must be part of the care plan. Studies show healthy caregivers give better support. Prevent burnout: stay active, lessen stress when you can, and keep on top of your own health. Read more about caregiver self-care.

Patient and caregiver resources

Tools to support conversations, decisions, and follow-ups

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Helping you support their care

This downloadable guide offers tips to prepare for doctor’s visits and get answers to important questions. It supports informed and confident care decisions.

Patient advocacy groups

If you’re living with metastatic prostate cancer, you don’t have to face it alone. Many trusted advocacy and support groups can help. Reaching out can connect you with people who understand what you’re going through.

Reference: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Prostate Cancer V5.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed February 25, 2026. 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.