Figure 1.

Diagram of androgen production and subsequent signaling through the androgen receptor. Testosterone (T) is produced in the testes and adrenal glands. Testosterone is then converted to its most common and active metabolite, dihydrotestosterone (DHT) by 5α-reductase. Androgens, usually DHT, bind to the androgen receptor (AR), dissociating chaperone proteins, members of the heat shock protein family HSP27 and HSP70. Ligand-bound AR molecules homodimerize and translocate to the nucleus where they bind to androgen response elements (ARE), and act as transcription factors to signal downstream targets. Second-generation antiandrogens are illustrated at their points of pathway disruption; Abiraterone acetate prevents androgen biosynthesis, and Enzalutamide, Apalutamide and Darolutamide prevent AR translocation to the nucleus.