# Androgen deprivation & AR pathway inhibitors

Source: https://onco.cc/technologies/androgen-deprivation/  
OnCo record `androgen-deprivation` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Androgen deprivation lowers testosterone or blocks its receptor, and has been the foundation of prostate cancer treatment since 1941 (Nobel Prize 1966).

## Summary

GnRH agonists/antagonists (leuprolide, relugolix) plus AR pathway inhibitors (abiraterone, enzalutamide, apalutamide, darolutamide) as triplet or doublet therapy in metastatic hormone-sensitive disease. Combined with PARP inhibitors in HRR-mutant, with capivasertib in PTEN-deficient (2026), and with 177Lu-PSMA in castration-resistant disease.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-04
- Principle: Suppress ligand or block AR; resistance via AR amplification, splice variants, and lineage plasticity.
- Since: 1941
- Strengths: Prolonged disease control
- Limitations: Metabolic and bone toxicity; castration resistance inevitable in metastatic disease

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Androgen_deprivation_therapy
- Wikipedia: https://en.wikipedia.org/wiki/Androgen_deprivation_therapy

## Connected records

- pairings: [AI pathology → androgen deprivation duration](https://onco.cc/pairings/ai-pathology-to-adt/), [PARP inhibitor + AR pathway inhibitor (prostate)](https://onco.cc/pairings/parp-plus-arpi/)
- cancers: [Biochemical recurrence of prostate cancer](https://onco.cc/cancers/prostate-bcr/), [Ductal adenocarcinoma of the prostate](https://onco.cc/cancers/prostate-ductal-adenocarcinoma/), [Localised prostate cancer, high and very high risk](https://onco.cc/cancers/prostate-high-risk/), [Localised prostate cancer, intermediate risk](https://onco.cc/cancers/prostate-intermediate-risk/), [Metastatic hormone-sensitive prostate cancer](https://onco.cc/cancers/prostate-mhspc/), [Neuroendocrine and small-cell prostate cancer](https://onco.cc/cancers/prostate-nepc/), [Non-metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-nmcrpc/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Salivary duct carcinoma](https://onco.cc/cancers/salivary-duct-carcinoma/), [Salivary gland cancers](https://onco.cc/cancers/salivary-gland/)
- fronts: [Hormonal Therapy](https://onco.cc/fronts/hormonal/)
- targets: [Androgen receptor](https://onco.cc/targets/androgen-receptor/)
- drugs: [Abiraterone acetate](https://onco.cc/drugs/abiraterone/), [Apalutamide](https://onco.cc/drugs/apalutamide/), [Bicalutamide](https://onco.cc/drugs/bicalutamide/), [Darolutamide](https://onco.cc/drugs/darolutamide/), [Degarelix](https://onco.cc/drugs/degarelix/), [Enzalutamide](https://onco.cc/drugs/enzalutamide/), [Flutamide](https://onco.cc/drugs/flutamide/), [Leuprolide (leuprorelin) and GnRH agonists](https://onco.cc/drugs/leuprolide/), [Nilutamide](https://onco.cc/drugs/nilutamide/), [Relugolix](https://onco.cc/drugs/relugolix/), [Triptorelin](https://onco.cc/drugs/triptorelin/)
- trials: [A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase III Study of Fuzuloparib Combined With Abiraterone Acetate and Prednisone (AA-P) Ver](https://onco.cc/trials/nct04691804/), [A Phase 1b/2a Study of Pocenbrodib as Monotherapy and in Combination With Darolutamide in Participants With mCRPC](https://onco.cc/trials/nct06785636/), [A Phase 3B Study to Evaluate Bone Mineral Density With Long-Term Use of Relugolix Combination Tablet in Women With Uterine Fibroids or Endometriosis](https://onco.cc/trials/nct05862272/), [A Study for Subjects With Prostate Cancer Who Previously Participated in an Enzalutamide Clinical Study](https://onco.cc/trials/nct02960022/), [A Study of Abiraterone Acetate Plus Prednisone With or Without Abemaciclib (LY2835219) in Participants With Prostate Cancer](https://onco.cc/trials/nct03706365/), [A Study of Adding Apalutamide to Radiotherapy and LHRH Agonist in High-Risk Patients With Hormone-Sensitive Prostate Cancer](https://onco.cc/trials/nct04557059/), [A Study of an Intermittent ADT Approach With Apalutamide Monotherapy in Participants With mCSPC](https://onco.cc/trials/nct05884398/), [A Study of Apalutamide (ARN-509) in Men With Non-Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct01946204/), [A Study of Apalutamide (JNJ-56021927, ARN-509) Plus Androgen Deprivation Therapy (ADT) Versus ADT in Participants With mHSPC](https://onco.cc/trials/nct02489318/), [A Study of Apalutamide Combined With GnRH Agonist in Participants With Androgen Receptor Positive Salivary Gland Carcinoma](https://onco.cc/trials/nct04325828/), [A Study of Apalutamide in Participants With High-Risk, Localized or Locally Advanced Prostate Cancer Who Are Candidates for Radical Prostatectomy](https://onco.cc/trials/nct03767244/), [A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for the Treatment of Participants With Deleterious Germline or Somatic Homologous Recombination Repair (HRR) Gene-MutatedProstatic Neoplasms (mCSPC)](https://onco.cc/trials/nct04497844/), [A Study of Tulmimetostat DZR123 (CPI-0209) in Patients With Advanced Solid Tumors and Lymphomas](https://onco.cc/trials/nct04104776/), [A Study to Compare Darolutamide Given With Androgen Deprivation Therapy (ADT) and Placebo Given With ADT in Men With Hormone Sensitive Prostate Cancer](https://onco.cc/trials/nct05794906/), [A Study to Learn How PF-06821497 (Mevrometostat) Works in Men With Metastatic Castration-resistant Prostate Cancer.](https://onco.cc/trials/nct06629779/), [A Study to Learn How Well a Combination of Darolutamide and Androgen Deprivation Therapy (ADT) Works as a Treatment Before Surgery for Men Who Have Hi](https://onco.cc/trials/nct07450599/), [A Study to Test Inavolisib Treatment in Participants With Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct07287150/), [Abiraterone, Enzalutamide, or Apalutamide in Castrate-sensitive Prostate Cancer.](https://onco.cc/trials/nct05422911/), [AFFIRM](https://onco.cc/trials/affirm/), [An Efficacy and Safety Study of Apalutamide (JNJ-56021927) in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone in Participants With Chemotherapy-naive Metastatic Castration-resistant Prostate Cancer (mCRPC)](https://onco.cc/trials/nct02257736/), [An Efficacy and Safety Study of Enzalutamide Plus Androgen Deprivation Therapy (ADT) Versus Placebo Plus ADT in Chinese Patients With Metastatic Hormo](https://onco.cc/trials/nct04076059/), [An Efficacy and Safety Study of JNJ-56021927 (Apalutamide) in High-risk Prostate Cancer Subjects Receiving Primary Radiation Therapy: ATLAS](https://onco.cc/trials/nct02531516/), [ARAMIS](https://onco.cc/trials/aramis/), [ARANOTE](https://onco.cc/trials/aranote/), [ARASENS](https://onco.cc/trials/arasens/), [ARCHES](https://onco.cc/trials/arches/), [ASCENDE-RT](https://onco.cc/trials/ascende-rt/), [CARD](https://onco.cc/trials/card/), [COU-AA-301](https://onco.cc/trials/cou-aa-301/), [COU-AA-302](https://onco.cc/trials/cou-aa-302/), [DART 01/05 GICOR](https://onco.cc/trials/dart-01-05-gicor/), [ELM-PC 4](https://onco.cc/trials/elm-pc-4-orteronel/), [EMBARK](https://onco.cc/trials/embark/), [ENZAMET](https://onco.cc/trials/enzamet/), [EORTC 22863](https://onco.cc/trials/eortc-22863/), [EORTC 22961](https://onco.cc/trials/eortc-22961/), [EORTC 22991](https://onco.cc/trials/eortc-22991/), [ERA 223](https://onco.cc/trials/era-223/), [Gedatolisib in Combination With Darolutamide in Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct06190899/), [GETUG-AFU 15](https://onco.cc/trials/getug-afu-15/), [GETUG-AFU 16](https://onco.cc/trials/getug-afu-16/), [GETUG-AFU 17](https://onco.cc/trials/getug-afu-17/), [HERO](https://onco.cc/trials/hero/), [KEYNOTE-991](https://onco.cc/trials/keynote-991/), [LATITUDE](https://onco.cc/trials/latitude/), [NRG Oncology RTOG 0521](https://onco.cc/trials/rtog-0521/), [PATCH (Prostate Adenocarcinoma Transcutaneous Hormone)](https://onco.cc/trials/patch-transdermal-oestradiol/), [PEACE-1](https://onco.cc/trials/peace-1/), [PEACE-3 (EORTC 1333)](https://onco.cc/trials/peace-3/), [Pharmacogenomics IND Commercial SNP Clinical Study - Abiraterone and Single Nucleotide Polymorphisms](https://onco.cc/trials/nct03348670/), [PREVAIL](https://onco.cc/trials/prevail/), [PROSPER](https://onco.cc/trials/prosper/), [RADICALS-HD](https://onco.cc/trials/radicals-hd/), [RTOG 92-02](https://onco.cc/trials/rtog-9202/), [RTOG 94-08](https://onco.cc/trials/rtog-9408/), [SPCG-7/SFUO-3](https://onco.cc/trials/spcg-7/), [STAMPEDE](https://onco.cc/trials/stampede/), [Study of Oral MRT-2359 With Apalutamide in Prostate Cancer](https://onco.cc/trials/nct07745361/), [Study of SX-682 Plus Enzalutamide in Men With ARPI-Resistant Metastatic Castration Resistant Prostate Cancer](https://onco.cc/trials/nct06228053/), [Study of Talazoparib With Enzalutamide in Men With DDR Gene Mutated mCSPC](https://onco.cc/trials/nct04821622/), [Study of XNW5004 Tablet in Combination With Enzalutamide in Subjects With Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct06702995/), [Study to Continue Treatment With Darolutamide in Patients Who Have Been Participating in Previous Darolutamide Studies Supported by Bayer](https://onco.cc/trials/nct04464226/), [SWOG 9346 (intermittent androgen deprivation)](https://onco.cc/trials/swog-9346/), [This Study Will Explore Whether a Combination of the Investigational Drug Mevrometostat (PF-06821497) and Enzalutamide Will Work Better Than Taking En](https://onco.cc/trials/nct07028853/), [TulmiSTAR-02: A Phase I/II Open-label Study of Tulmimetostat in Combination With Darolutamide vs. Darolutamide, and Tulmimetostat With Abiraterone in ](https://onco.cc/trials/nct07190300/), [ZEN003694 and Enzalutamide Versus Enzalutamide Monotherapy in Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct04986423/)
- terms: [Agonist and antagonist](https://onco.cc/terms/agonist-antagonist/), [Androgen deprivation therapy (ADT)](https://onco.cc/terms/adt/), [Hormone therapy](https://onco.cc/terms/hormone-therapy/), [STAMPEDE's arms, and what each one answered](https://onco.cc/terms/prostate-stampede-arms/), [What androgen deprivation costs: the side of hormone therapy the survival curves do not show](https://onco.cc/terms/prostate-adt-burden/), [What follows what in castration-resistant prostate cancer](https://onco.cc/terms/prostate-crpc-sequencing/)
- pathways: [Androgen receptor signalling](https://onco.cc/pathways/ar-signaling/), [Transcriptional machinery & addiction](https://onco.cc/pathways/transcription-addiction/)
- people: [Andrew J. Armstrong](https://onco.cc/people/andrew-armstrong/), [Anthony V. D'Amico](https://onco.cc/people/anthony-damico/), [Christopher J. Sweeney](https://onco.cc/people/christopher-sweeney/), [Johann de Bono](https://onco.cc/people/johann-de-bono/), [Maha Hussain](https://onco.cc/people/maha-hussain/), [Matthew R. Smith](https://onco.cc/people/matthew-smith/)
- ideas: [Cardiometabolic screening and treatment for survivors on long-term hormone therapy](https://onco.cc/ideas/idea-acc-cardiometabolic-clinic-hormone-therapy/), [Prescribe a quarter dose of abiraterone with breakfast](https://onco.cc/ideas/idea-cost-low-dose-abiraterone-food/), [Use food effects to cut the dose and cost of oral drugs that absorb better with meals](https://onco.cc/ideas/idea-tr1-food-effect-dose-reduction/)
- roadmaps: [Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test](https://onco.cc/roadmaps/hormonal-therapy-roadmap/), [Paths to cures: interception, eradication, control](https://onco.cc/roadmaps/cure-paths/)
- key papers: [STAMPEDE: adding abiraterone to hormone therapy at diagnosis of advanced prostate cancer](https://onco.cc/key-papers/paper-stampede-abiraterone-nejm-2017/)
- institutions: [University of Chicago Medicine Comprehensive Cancer Center](https://onco.cc/institutions/uchicago-cancer/)
- technologies: [Bone loss caused by cancer treatment, and what rebuilds it](https://onco.cc/technologies/cancer-treatment-bone-loss/), [Testosterone after cancer treatment in men](https://onco.cc/technologies/testosterone-after-cancer-treatment/)
- companies: [ANZUP Cancer Trials Group](https://onco.cc/companies/anzup/), [TROG Cancer Research](https://onco.cc/companies/trog/)

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