A recent case-only study comprising 2770 aggressive and 2775 nonaggressive PrCa cases reported statistically significant evidence for substantially increased risk of aggressive disease among germline BRCA2 and PALB2 mutation carriers, with ATM also nominally associated [284], corresponding with observations of high combined germline and somatic mutation frequencies for these genes among mCRPC patients [292]. This evidence concerns the gene BRCA2 and pure red-cell aplasia.