Their relationship to PC screening and management has garnered recent interest.3 Previous reports suggest that PVs in BRCA1/2 confer increased risk for PC associated with poor survival and younger age at diagnosis; HOXB13 PVs also are associated with a young age at diagnosis.4,5 Men at increased risk for aggressive or earlier-onset disease may choose more aggressive screening or earlier intervention.6 Men with HRD or MMR-deficient metastatic prostate tumors may also benefit from targeted therapeutics, such as pembrolizumab, platinum therapies, or PARP inhibitors.7–9. This evidence concerns the gene MRC1 and pachyonychia congenita.