Denosumab is a human monoclonal antibody that inhibits RANKL, a critical driver of osteoclast formation and survival, thus preventing osteoclast‐mediated bone destruction.40, 41 Denosumab has been shown to not only reduce skeletal complications in men with castrate‐resistant prostate cancer with bone metastases (mCRPC) with superior efficacy compared with either bisphosphonates or zoledronic acid,41, 42 but it has also been shown to delay the onset of bone metastases among men with castrate‐resistant, nonmetastatic disease.43 This evidence concerns the gene TNFSF11 and Familial prostate cancer.