Abstract
Purpose
We evaluated the prevalence of homologous recombination deficiencies (HRD) to determine the efficacy of different techniques and clinical characteristics of patients.
Methods
This retrospective study included patients with metastatic prostate cancer who underwent molecular testing at our hospital between 2016 and 2022. We used tumor tissue, ctDNA, and lymphocytes for somatic or germline testing. We analyzed the clinical characteristics and survival outcomes.
Results
144 patients were tested (113 somatic, 21 germline, and 10 both). Technical issues prevented the analysis of 23 prostatic samples (18.7%). 12 (8.3%) patients had HRD. BRCA2 was the most frequent mutation (66.7%). Patients with HRD were younger (57.5 years). Patients with BRCA mutations had poorer survival (31.9 vs 56.3 months, p = 0.048).
Conclusion
In our institution, 8.3% of the patients had HRD. Tumor tissue analysis failed in 18.7% of tests. ctDNA analysis is an alternative detection method. BRCA mutations are correlated with poor prognosis.

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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors would like to thank M Llobet and O Ramirez for their contribution to data collection.
Funding
The authors did not receive any funding from the study.
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Javier Gavira: Conceptualization, methodology, software, data curation, writing-original draft, writing-review and edition, project administration. Jose Carlos Tapia: Investigation, data curation, writing-original draft and writing—review and edition. Alejandra Romano: Investigation, data curation, writing-review and edition. Georgia Anguera: Investigation, data curation, and writing-review and edition. María Aguado: Investigation, data curation, writing—review and edition. Aida Piedra: Investigation, data curation, writing—review and edition. Freya Bosma: Investigation, data curation, writing—review and edition. Sofía Sánchez: Investigation, data curation, writing—review and edition. Cristina Martin: Investigation, and writing—review and edition. Ferrán Algaba: Methodology, Investigation, and writing—review and edition. Yolanda Arce: Methodology, Investigation, and writing—review and edition. Teresa Ramón y Cajal: Conceptualization, methodology, investigation, data curation, and writing—original draft and reviews. Pablo Maroto: Conceptualization, methodology, data curation, writing-original draft, writing—review and edition, and project administration.
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JG: Speakers’ bureau: Astellas, LEO Pharma. Travel, Accommodation, Expenses: Ipsen, BMS, Novartis, Roche and MSD. JCT: Travel, Accommodations, Expenses: Merck, Pfizer, Roche, MSD and Lily/Genentech. GA participated as Collaborator Investigator in clinical trials using PARPi. Speakers’ Bureau: Astellas Pharma, Ipsen, Bristol Myers Squibb, Merck/Pfizer, Leo pharma. Travel, Accommodations, Expenses: Merck, Ipsen, Bristol Myers Squibb. CM participated as Collaborator Investigator in clinical trials using PARPi. PM: participated as Principal Investigator in clinical trials related to the use of PARPi. Consulting or Advisory Role: Astellas Pharma, Ipsen, BMS, Merck/Pfizer, Bayer, Janssen. Travel, Accommodation, Expenses: Merck/Pfizer, Bayer. The rest of the authors declare no competing financial interest in relation to the work.
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Gavira, J., Tapia, J.C., Romano, A. et al. Challenges of diagnosing homologous recombination deficiencies in metastatic prostate cancer: a six-year experience from a single institution. Clin Transl Oncol 26, 2749–2753 (2024). https://doi.org/10.1007/s12094-024-03483-8
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DOI: https://doi.org/10.1007/s12094-024-03483-8