Optimizing Prostate Cancer Management in Men Harboring High-Risk Genetic Variants

Prostate cancer is a major cause of mortality among men, with about 12.5% of those diagnosed ultimately dying from the disease. Because outcomes vary substantially between low-risk and high-risk cases, identifying men at heightened risk for disease progression and death is critical. Germline genetic mutations are increasingly recognized as significant contributors to aggressive and lethal prostate cancer. This article aims to provide a comprehensive overview of management strategies for prostate cancer in men who carry high-risk germline variants. We conducted a literature review to collect studies focusing on the clinical management of prostate cancer in individuals with high-risk germline genetic alterations. Numerous publications address treatment considerations for prostate cancer in this high-risk population; however, the overall strength and quality of evidence remain limited. This review synthesizes current knowledge and clinical considerations for managing prostate cancer in men with high-risk germline mutations. The scarcity of robust evidence highlights the urgent need for further studies and the establishment of standardized guidelines to support optimal clinical care in this patient group.