To the best of our knowledge, regarding the application of 177Lu-PSMA RLT, no other cases, in addition to those mentioned above, have been reported, with the exception of one patient, described by Simsek et al., who was affected by a progressive metastatic testicular mixed germ cell tumor, who after 177Lu-PSMA RLT achieved a mixed therapy response based on the 68Ga-PSMA PET/CT imaging results but showed a concomitant increased level of alfa-feto protein [108] (Table 1). This evidence concerns the gene FOLH1 and testicular mixed germ cell tumor.