{"entity":{"id":"ar-v7-splice-variant","kind":"biomarker","name":"AR-V7 splice variant","aka":["AR-V7","AR-V7 positive","androgen receptor splice variant 7","AR-V7 CTC","nuclear AR-V7"],"tldr":"AR-V7 is a shortened androgen receptor that lacks the part hormone drugs bind, so it stays active without testosterone. Found in circulating tumour cells, it predicts poor response to abiraterone and enzalutamide, but no label uses it yet.","summary":"The AR-V7 transcript skips the ligand-binding domain and is detected by RT-PCR of circulating tumour cell RNA or by nuclear AR-V7 protein immunofluorescence in CTCs (the Oncotype DX AR-V7 Nucleus Detect assay, a laboratory-developed test). The prospective PROPHECY trial (NCT02269982) showed that AR-V7-positive men had shorter progression-free and overall survival on abiraterone or enzalutamide, while taxane response was preserved. No regulator has put AR-V7 in a label and no companion diagnostic exists; it is a guideline-discussed, not guideline-mandated, test.","asOf":"2026-09-23","links":[{"label":"PROPHECY (NCT02269982)","url":"https://clinicaltrials.gov/study/NCT02269982"}],"tags":["biomarker","prostate","no-approval"],"related":["psma-pet-expression","ar-amplification","ar-ligand-binding-domain-mutation"],"cancers":["prostate-mcrpc","prostate"],"sections":[],"technologies":[],"targets":[],"drugs":["abiraterone","enzalutamide"],"companies":[],"institutions":[],"pathways":[],"terms":["ar-v7"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-antonarakis-ar-v7-resistance-nejm-2014","paper-prophecy-arv7-validation-jco-2019","paper-scher-nuclear-arv7-taxane-vs-arsi-jama-oncol-2018"],"journals":[],"dependsOn":[],"notes":["Prevalence, from the two prospective series: AR-V7 messenger RNA was detectable in circulating tumour cells from 12 of 31 men starting enzalutamide, 39%, and 6 of 31 starting abiraterone, 19%, with no PSA response in any AR-V7-positive man in either group (Antonarakis 2014). PROPHECY validated the prognostic effect prospectively in 118 men on two assays that agreed on 82% of samples (Armstrong 2019).","The treatment-selection evidence: in a blinded three-centre series of 142 men, AR-V7-positive men had median overall survival of 14.3 months on a taxane against 7.3 months on a receptor signalling inhibitor, and AR-V7-negative men 19.8 against 12.8 months the other way, hazard ratio 1.67 (Scher 2018).","Mechanistically it belongs with the other four routes to androgen receptor reactivation, gene amplification, enhancer amplification, ligand-binding-domain mutation and receptor overexpression, and more than one is often present in the same man."],"target":"androgen-receptor","measurement":"sequencing-variant","scoringRule":{"text":"Detection of the AR-V7 transcript in circulating tumour cell RNA by RT-PCR, or nuclear-localised AR-V7 protein in circulating tumour cells by immunofluorescence; no label defines a threshold.","quote":"AR-V7 splice variant","source":"https://clinicaltrials.gov/study/NCT02269982","sourceLabel":"PROPHECY trial (NCT02269982): prospective validation of AR-V7 in metastatic castration-resistant prostate cancer"},"thresholds":[],"definedBy":{"label":"PROPHECY: AR-V7 in circulating tumour cells predicting resistance to abiraterone and enzalutamide (ClinicalTrials.gov NCT02269982)","url":"https://clinicaltrials.gov/study/NCT02269982"},"tests":[],"assays":[],"companionDiagnostics":[],"forPatient":"An AR-V7-positive result suggests that abiraterone and enzalutamide are less likely to work and that chemotherapy or a radioligand may be a better next step, but no approval depends on it and it is not routinely offered outside specialist centres. A negative result does not guarantee response."},"route":"/biomarkers/ar-v7-splice-variant/","neighbours":{"biomarker":[{"id":"ar-amplification","kind":"biomarker","name":"AR amplification (gene and upstream enhancer)","route":"/biomarkers/ar-amplification/"},{"id":"ar-ligand-binding-domain-mutation","kind":"biomarker","name":"AR ligand-binding-domain mutation (L702H, W742C, H875Y, T878A, F877L)","route":"/biomarkers/ar-ligand-binding-domain-mutation/"},{"id":"psma-pet-expression","kind":"biomarker","name":"PSMA expression by PET (PSMA-positive)","route":"/biomarkers/psma-pet-expression/"},{"id":"nepc-transformation","kind":"biomarker","name":"Treatment-emergent neuroendocrine transformation (recognising it)","route":"/biomarkers/nepc-transformation/"}],"cancer":[{"id":"prostate-mcrpc","kind":"cancer","name":"Metastatic castration-resistant prostate cancer","route":"/cancers/prostate-mcrpc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"drug":[{"id":"abiraterone","kind":"drug","name":"Abiraterone acetate","route":"/drugs/abiraterone/"},{"id":"enzalutamide","kind":"drug","name":"Enzalutamide","route":"/drugs/enzalutamide/"}],"term":[{"id":"ar-v7","kind":"term","name":"AR-V7 splice variant","route":"/terms/ar-v7/"}],"paper":[{"id":"paper-antonarakis-ar-v7-resistance-nejm-2014","kind":"paper","name":"AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer","route":"/key-papers/paper-antonarakis-ar-v7-resistance-nejm-2014/"},{"id":"paper-scher-nuclear-arv7-taxane-vs-arsi-jama-oncol-2018","kind":"paper","name":"Nuclear-localised androgen receptor splice variant 7 in circulating tumour cells as a predictive biomarker in castration-resistant prostate cancer","route":"/key-papers/paper-scher-nuclear-arv7-taxane-vs-arsi-jama-oncol-2018/"},{"id":"paper-prophecy-arv7-validation-jco-2019","kind":"paper","name":"PROPHECY: prospective multicentre validation of androgen receptor splice variant 7 and hormone therapy resistance in high-risk castration-resistant prostate cancer","route":"/key-papers/paper-prophecy-arv7-validation-jco-2019/"}],"target":[{"id":"androgen-receptor","kind":"target","name":"Androgen receptor","route":"/targets/androgen-receptor/"}]}}