# Androgen receptor pathway inhibitor (ARPI)

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

## TL;DR

The newer prostate cancer hormone pills (abiraterone, enzalutamide, apalutamide, darolutamide) that block the androgen receptor or the last steps of androgen production, used on top of standard testosterone suppression.

## Summary

Abiraterone blocks CYP17 androgen synthesis (given with prednisone); enzalutamide, apalutamide and darolutamide are potent AR antagonists. Adding an ARPI to ADT extends survival in metastatic hormone-sensitive disease (LATITUDE, ARCHES, TITAN, ARASENS), in non-metastatic castration-resistant disease and in castration-resistant disease before or after docetaxel. Resistance arises via AR amplification, ligand-binding domain mutations, the AR-V7 splice variant and lineage plasticity to neuroendocrine disease; switching ARPIs after failure gives little benefit, so PSMA radioligands, PARP inhibitors and chemotherapy follow. Older antiandrogens (bicalutamide) are weaker first-generation drugs.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: ARPI; ARPIs; ARSI; androgen receptor signalling inhibitor; androgen receptor pathway inhibitor; novel hormonal agent; NHA; next-generation antiandrogen; second-generation antiandrogen; AR antagonist; AR inhibitor; antiandrogen; anti-androgen; AR-V7; AR-targeted; AR antagonists

## Sources

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

## Connected records

- terms: [Androgen deprivation therapy (ADT)](https://onco.cc/terms/adt/), [Castration-resistant prostate cancer (CRPC)](https://onco.cc/terms/castration-resistance/), [mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer)](https://onco.cc/terms/mcrpc-mhspc/), [Prostate cancer drugs in England: what NICE recommends, and what it refuses](https://onco.cc/terms/prostate-uk-drug-approvals/), [STAMPEDE's arms, and what each one answered](https://onco.cc/terms/prostate-stampede-arms/), [What follows what in castration-resistant prostate cancer](https://onco.cc/terms/prostate-crpc-sequencing/)
- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/)
- 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/), [Bicalutamide](https://onco.cc/drugs/bicalutamide/), [Enzalutamide](https://onco.cc/drugs/enzalutamide/), [Galeterone](https://onco.cc/drugs/galeterone/), [Orteronel](https://onco.cc/drugs/orteronel/)
- trials: [AFFIRM](https://onco.cc/trials/affirm/), [ARMOR3-SV](https://onco.cc/trials/armor3-sv/), [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/), [ELM-PC 4](https://onco.cc/trials/elm-pc-4-orteronel/), [IMbassador250](https://onco.cc/trials/imbassador250/), [KEYNOTE-641](https://onco.cc/trials/keynote-641/), [KEYNOTE-991](https://onco.cc/trials/keynote-991/), [LATITUDE](https://onco.cc/trials/latitude/), [PEACE-3 (EORTC 1333)](https://onco.cc/trials/peace-3/), [PREVAIL](https://onco.cc/trials/prevail/)

---
JSON: https://onco.cc/api/v1/entities/arpi.json