Biomarkers
Prostate cancer biomarker testing has expanded dramatically. For metastatic or advanced disease, germline and tumor testing identify HRR-deficient tumors eligible for PARP inhibitors and inform treatment sequencing.
These are typically tested on every new diagnosis, or required before systemic therapy decisions, under current U.S. clinical guidelines.
What it is: Histologic grade of prostate cancer from biopsy, scored 6-10 (lower = less aggressive).
Why test: Primary staging and risk-stratification marker — drives surveillance vs active treatment decisions in localized disease.
What it is: Blood-based protein marker.
Why test: Used for screening, staging, monitoring response to therapy, and detecting recurrence.
Tested depending on cancer stage, subtype, family history, or as part of broader NGS (next-generation sequencing) panels.
What it is: Inherited or tumor mutations in homologous recombination repair genes.
Why test: Opens eligibility for PARP inhibitors in metastatic castration-resistant prostate cancer. Guidelines now recommend germline testing for all metastatic prostate cancer patients.
What it is: Expanded panel including ATM, BARD1, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, RAD51B, RAD51C, RAD51D, RAD54L beyond BRCA.
Why test: Broader HRR-deficiency identification. Some drugs approved specifically for HRR-mutated disease beyond BRCA.
What it is: Less common in prostate but occasionally MSI-H.
Why test: Opens immunotherapy eligibility.
What it is: Protein expression assessed by PET imaging (PSMA-PET scan) rather than tissue testing.
Why test: PSMA imaging informs staging, surveillance, and eligibility for PSMA-targeted therapy (Pluvicto).
See which FDA-approved drugs match each biomarker profile above.
Prostate Cancer clinical trials →Active recruiting trials, many biomarker-matched.
Biomarkers explained: full guide →Deeper background on how biomarker testing works.
Germline genetic testing →Different from tumor testing; addresses inherited cancer risk and family implications.
Genetic testing cost →What germline and tumor molecular tests cost, and how insurance covers each.
BRCA test cost →What patients pay in practice for BRCA1/2 testing and ACA preventive coverage rules.