不幸的是，并非所有转移性去势抵抗性前列腺癌 (mCRPC) 患者都能接受可用的延长生命的全身治疗，这强调了优化 mCRPC 治疗选择的必要性。需要更好的指南来确定前列腺癌的基因检测。在这本由两部分组成的基于专家意见的指南中，我们提供了关于利用种系和体细胞检测来检测 mCRPC 患者 HRR 改变的专家共识意见。本指南由 2023-2024 年召集的多学科专家小组制定，其中包括肿瘤内科、泌尿科、放射肿瘤科、病理学、医学基因组学和基础科学的代表。我们主张在所有前列腺患者中广泛采用种系检测癌症以及复发/转移性疾病患者的体细胞突变检测。在第一部分中，我们回顾如何进行基因组测试。我们还回顾了如何克服某些障碍，将遗传和生物标志物测试整合到临床实践中。© 2024。作者。

Unfortunately, not all metastatic castration resistant prostate cancer (mCRPC) patients receive available life-prolonging systemic therapies, emphasizing the need to optimize mCRPC treatment selections. Better guidelines are necessary to determine genetic testing in prostate cancer.In this two-part expert opinion-based guide, we provide an expert consensus opinion on the utilization of germline and somatic testing to detect HRR alterations in patients with mCRPC. This guide was developed by a multidisciplinary expert panel that convened in 2023-2024, including representatives from medical oncology, urology, radiation oncology, pathology, medical genomics, and basic science.We argue for the widespread adoption of germline testing in all patients with prostate cancer and for somatic mutations testing in patients at the time of recurrent/metastatic disease. In this first part, we review how genomic testing is performed. We also review how to overcome certain barriers to integrate genetic and biomarker testing into clinical practice.© 2024. The Author(s).