{"entity":{"id":"arpi","kind":"term","name":"Androgen receptor pathway inhibitor (ARPI)","aka":["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"],"tldr":"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.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Antiandrogen","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Antiandrogen"}],"tags":[],"related":["adt","castration-resistance"],"cancers":["prostate"],"sections":["hormonal"],"technologies":[],"targets":["androgen-receptor"],"drugs":["abiraterone","enzalutamide","bicalutamide"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["latitude"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Treatment jargon"},"route":"/terms/arpi/","neighbours":{"term":[{"id":"adt","kind":"term","name":"Androgen deprivation therapy (ADT)","route":"/terms/adt/"},{"id":"castration-resistance","kind":"term","name":"Castration-resistant prostate cancer (CRPC)","route":"/terms/castration-resistance/"},{"id":"mcrpc-mhspc","kind":"term","name":"mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer)","route":"/terms/mcrpc-mhspc/"},{"id":"prostate-uk-drug-approvals","kind":"term","name":"Prostate cancer drugs in England: what NICE recommends, and what it refuses","route":"/terms/prostate-uk-drug-approvals/"},{"id":"prostate-stampede-arms","kind":"term","name":"STAMPEDE's arms, and what each one answered","route":"/terms/prostate-stampede-arms/"},{"id":"prostate-crpc-sequencing","kind":"term","name":"What follows what in castration-resistant prostate cancer","route":"/terms/prostate-crpc-sequencing/"}],"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"hormonal","kind":"section","name":"Hormonal Therapy","route":"/fronts/hormonal/"}],"target":[{"id":"androgen-receptor","kind":"target","name":"Androgen receptor","route":"/targets/androgen-receptor/"}],"drug":[{"id":"abiraterone","kind":"drug","name":"Abiraterone acetate","route":"/drugs/abiraterone/"},{"id":"bicalutamide","kind":"drug","name":"Bicalutamide","route":"/drugs/bicalutamide/"},{"id":"enzalutamide","kind":"drug","name":"Enzalutamide","route":"/drugs/enzalutamide/"},{"id":"galeterone","kind":"drug","name":"Galeterone","route":"/drugs/galeterone/"},{"id":"orteronel","kind":"drug","name":"Orteronel","route":"/drugs/orteronel/"}],"trial":[{"id":"affirm","kind":"trial","name":"AFFIRM","route":"/trials/affirm/"},{"id":"armor3-sv","kind":"trial","name":"ARMOR3-SV","route":"/trials/armor3-sv/"},{"id":"card","kind":"trial","name":"CARD","route":"/trials/card/"},{"id":"cou-aa-301","kind":"trial","name":"COU-AA-301","route":"/trials/cou-aa-301/"},{"id":"cou-aa-302","kind":"trial","name":"COU-AA-302","route":"/trials/cou-aa-302/"},{"id":"elm-pc-4-orteronel","kind":"trial","name":"ELM-PC 4","route":"/trials/elm-pc-4-orteronel/"},{"id":"imbassador250","kind":"trial","name":"IMbassador250","route":"/trials/imbassador250/"},{"id":"keynote-641","kind":"trial","name":"KEYNOTE-641","route":"/trials/keynote-641/"},{"id":"keynote-991","kind":"trial","name":"KEYNOTE-991","route":"/trials/keynote-991/"},{"id":"latitude","kind":"trial","name":"LATITUDE","route":"/trials/latitude/"},{"id":"peace-3","kind":"trial","name":"PEACE-3 (EORTC 1333)","route":"/trials/peace-3/"},{"id":"prevail","kind":"trial","name":"PREVAIL","route":"/trials/prevail/"}]}}