Germline testing should be considered for all patients with advanced prostate cancer, when possible, regardless of family or personal history of cancer. Several multigene panels evaluating cancer susceptibility genes are available. Germline mutations in genes involved in DNA damage repair (DDR) have been identified in 11.8% of men with metastatic prostate cancer, with the most commonly identified gene mutations being BRCA1/2, CHEK2, ATM, RAD51D, and PALB2.42   Germline testing may be used to counsel patients regarding their familial risk of associated malignancies. When possible, germline testing should include counseling by someone knowledgeable about the implications of testing. This may include a discussion of possible test results; implications for patients; discussion of the Genetic Information Nondiscrimination Act (GINA); possible impact of test results on life, disability, and long-term care insurance; and potential role of cascade testing of family members if a pathogenic or likely pathogenic mutation is identified. Post-test counseling with a genetic counselor is necessary for anyone who is found to have one of these mutations. The panel acknowledges that access to certified genetic counselors can may be limited, particularly in community urology settings. Telehealth genetic counseling or provider-led counseling may facilitate recommended testing.  Somatic testing can be performed to identify DNA MMR status, MSI, tumor mutational burden (TMB), PTEN loss and other potential mutations that may inform prognosis and direct potential targeted therapies. Additionally, mutations in HRR genes such as BRCA1-2, ATM, BARD1, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D, and RAD54L should be tested. These mutations may have implications in clinical trial eligibility or therapeutics selection (i.e., PARP inhibitors, immunotherapy, or possibly early use of cytotoxic chemotherapy).43, 44 More recently, ctDNA is being explored for its potential role in guiding therapy in advanced prostate cancer, but tissue biopsy remains preferable for somatic testing.45   Finally, the landscape of evidence detailing the interactions between mutations and treatment individualization continues to evolve, and the use of genetic testing may ultimately enable the treating clinician to offer a personalized approach to prostate cancer treatment.