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A meta-analysis of dizziness as an adverse reaction in novel endocrine therapy for advanced prostate cancer

Wenbin Xue1, Pu Zhang1, Jing Quan2

  • 1Urology & Nephrology Center, Department of Urology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China.

BMC Cancer
|May 1, 2026
PubMed

Insights

Novel endocrine therapies, specifically androgen receptor pathway inhibitors (ARPIs), increase the risk of dizziness in advanced prostate cancer patients. While all-grade dizziness is more common, severe dizziness risk remains non-significant.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Advanced prostate cancer treatment often involves novel endocrine therapies.
  • Androgen receptor pathway inhibitors (ARPIs) are a key class of these therapies.
  • Dizziness is a potential side effect that requires systematic evaluation.

Purpose of the Study:

  • To systematically evaluate the incidence and risk of dizziness associated with ARPIs in advanced prostate cancer.
  • To compare dizziness risk between ARPI-based therapies and control treatments.
  • To analyze dizziness risk across different types of ARPIs.

Main Methods:

  • A meta-analysis of eligible randomized controlled trials (RCTs) was conducted.
  • Literature search included PubMed, Web of Science, and ClinicalTrials.gov.
  • Risk of bias was assessed using the Cochrane Risk of Bias (RoB 2) tool.

Main Results:

  • ARPI therapy significantly increased the risk of all-grade dizziness (RR = 1.60, 95% CI: 1.28-2.00).
  • The risk of grade ≥3 dizziness was not statistically significant (RR = 2.03, 95% CI: 0.56-7.29).
  • Subgroup analyses by ARPI type did not reveal significant differences in dizziness risk.

Conclusions:

  • Novel endocrine therapy with ARPIs is associated with an increased risk of all-grade dizziness in prostate cancer patients.
  • The risk of severe dizziness (grade ≥3) was not significantly elevated.
  • Clinicians should monitor for dizziness during ARPI treatment for optimal patient management.
Keywords:
DizzinessNovel endocrine therapyProstate cancer

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