HSD3B1 and neoplasm: In contrast, upfront treatment with direct AR blockade in addition to ADT in the ENZAMET trial reversed the adverse association of the 1245C HSD3B1 variant and was associated with improved OS in men with low-volume mHSPC, consistent with an enhanced effect of this variant on tumor steroids and AR signaling in low-volume cancers (Sharifi et al. 2024).