Real-world genetic testing patterns in metastatic castration-resistant prostate cancer.

To assess the patterns of genetic testing for homologous recombination repair mutations in patients with metastatic castration-resistant prostate cancer (mCRPC) pre-PARP inhibitors approval. mCRPC patients were selected in an oncology electronic medical records database. Patterns and predictors of testing for , , ,  and gene alterations were assessed. Of 5213 mCRPC patients, 674 (13%) had a documented genetic test. The number of tested patients increased from 1 in 2013 to 313 in 2018 (out of 3161 and 3010 clinically active patients, respectively). Receiving care in an academic oncology center (versus a community-based center) strongly predicted genetic testing (hazard ratio = 2.41). The use of and access to genetic testing pre-PARP inhibitor approval was suboptimal.