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AR-V7 — SCE Medical Oncology MCQ

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HardUrological CancersAR-V7SCE Medical Oncology

A 58-year-old man with metastatic prostate cancer has circulating tumour cells tested for the AR-V7 splice variant. AR-V7 is detected. What is the clinical implication?

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Correct answer: CAR-V7 confers resistance to enzalutamide and abiraterone

AR-V7 is a constitutively active androgen receptor splice variant lacking the ligand-binding domain, rendering it insensitive to enzalutamide (AR antagonist) and abiraterone (CYP17 inhibitor). Antonarakis et al (NEJM 2014) showed that AR-V7-positive patients had no PSA response to enzalutamide/abiraterone but maintained taxane sensitivity. AR-V7 CTC testing is available clinically and may guide treatment sequencing in mCRPC, particularly regarding ARPI vs taxane choice after prior ARPI failure.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer