The HERO trial led to the approval of relugolix, the first orally available form of LHRH manipulation for the treatment of prostate cancer.2 While the trial did show that relugolix was safe and highly effective in treating prostate cancer, some real-world and practical concerns were raised, particularly around compliance and financial implications, since prescription drug coverage can be less robust than primary insurance portions covering clinic visits and injection medications. This evidence concerns the gene GNRH1 and Familial prostate cancer.