Real-world evaluation of [ 177 Lu]Lu-PSMA-617 RLT in post-taxane mCRPC: feasibility and safety of individualized treatment in a challenging cohort.

Median administered activity was 7.1 GBq per cycle (range 2.7-11.6 GBq) and cumulative activity 22.3 GBq (range 2.7-77.8 GBq), while patients received a median of 3 cycles within a 6-week interval.

PSA declined after the first cycle in 63.9% of patients; PSA reduction ≥ 50% occurred in 51.5%.

Shortened PSA‑PFS was associated with visceral metastasis (p = 0.001) and ALP ≥ 220 U/L (p = 0.004).

Shortened OS was associated with visceral metastasis (p = 0.009), ALP ≥ 220 U/L (p = 0.001), age ≤ 65 years (p = 0.034), hemoglobin < 9 g/dL (p = 0.006), and early biochemical progressive disease after 1-2 courses (p < 0.001).