In this retrospective study, we evaluated the safety and efficacy of two different PSMA-RLT schemes (monotherapy of 177Lu-PSMA and 177Lu-PSMA in combination with 225Ac-PSMA) in 20 patients with early-stage metastatic prostate cancer patients, and generally prior to application of ADT, and/or even prior to hormonal therapy. The gene discussed is FOLH1; the disease is metastatic prostate carcinoma.