PARP1 and Familial prostate cancer: Also, Mutations in the BRCA2 gene have been associated with an increased risk of high-grade disease, progression of metastatic denervation-resistant disease, and a 50 to 60% cancer-specific 5-year survival rate.[40] Patients with metastatic destructive-resistant prostate cancer with germline BRCA mutations (versus no mutations) seem to respond well to first-line neoadjuvant hormonal ablative therapy (NHT).[41] In addition, the PARP inhibitor olaparib is effective in BRCA-associated cancers, especially prostate cancer.[42]