With respect to germline mutations in DDR genes, a recent study found the incidence of inherited DNA repair gene alterations in metastatic prostate cancer to be significantly higher (11.8%) than in men with localized prostate cancer (4.6%) and in the general population (2.7%) [44] Specifically, mutations in BRCA2 (5.3%), CHEK2 (1.9%), ATM (1.6%), BRCA1 (0.9%), PALB2 (0.4%), RAD51D (0.4%), were significantly enriched in patients with metastatic prostate cancer compared to the general population. This evidence concerns the gene ATM and metastatic prostate carcinoma.