Most interestingly, in addition to MMR gene alterations, other pathogenic or likely pathogenic somatic mutations in DDR pathway genes in our dMMR-PCa cases included mutations in TP53, PTEN, ATR, RAD50, PALB2, ATM, XRCC2, RAD54L, and ATRX. Furthermore, some genes were recurrently mutated, including those involved in the MAPK and PI3K signaling pathways. Here, ATR is linked to posterior cortical atrophy.