In light of the negative feedback regulation between PMEPA1-a and TGF-β signaling, and the gain of TGF-β signaling in hormone treatment resistance, our study highlighted the potential biomarker features of PMEPA1-a reflecting the TGF-β signaling status and successive castration resistance in prostate cancer patients. The gene discussed is TGFB1; the disease is Familial prostate cancer.