For instance, previous studies have shown that alterations in tumor suppressor genes, including RB1, PTEN, and TP53, could be associated with more aggressive disease features and worse survival outcomes, and the presence of these genetic susceptible alterations may warrant more frequent monitoring with imaging studies rather than surveillance of serum prostate-specific antigen levels.2,33,34,35,36,37 Furthermore, ongoing trials are investigating additional susceptible alteration–targeting agents in an earlier disease setting. This evidence concerns the gene PTEN and neoplasm.