ATM and Familial prostate cancer: Specifically, men with metastatic prostate cancer are at higher risk of having germline mutations in these pathways, with up to 11.8% having pathogenic mutations compared to only 2.4% of all men with prostate cancer (including localized disease).12 Studies have shown between 15-23% of patients with mCRPC have somatic or germline mutations in HRR genes including BRCA2, BRCA1, ATM, and CDK12.