In univariable Cox regression, a higher number of previous chemotherapy lines (p = 0.006), the presence of liver metastases (p = 0.024), the presence of brain metastases (p < 0.001), a higher tumor load on baseline PSMA-PET (p < 0.001), a higher PSA level prior to the first RLT cycle (p = 0.001), a lower red blood cell count prior to RLT (p < 0.001), lower hemoglobin (p = 0.003), a higher NLR (p = 0.011), and a higher De Ritis ratio before the first RLT cycle (p < 0.001) were associated with shorter OS (Table 2). The gene discussed is KLK3; the disease is neoplasm.