Rana McKay, MD, University of California San Diego, San Diego, CA, discusses the prognostic significance of homologous recombination repair pathway alterations in metastatic hormone-sensitive prostate cancer (mHSPC) at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2021. Dr McKay outlines a single-center retrospective analysis of mHSPC patients who underwent next generation sequencing (NGS) between 2015 and 2020. The primary objective of this analysis was to assess the time from mHSPC diagnosis to onset of castration resistance in patients with either somatic or germline homologous recombination repair alterations, compared to those lacking gene alterations. Dr McKay discusses similarities in baseline characteristics between groups as well as the importance of these findings for future therapeutic strategies. The key conclusion presented by Dr McKay highlights that presence of homologous recombination gene alterations resulted in a shorter time to castration resistance. This interview took place during the 2021 Genitourinary Cancers Symposium.