Lutetium-177 PSMA-617 is FDA approved for treatment of patients with castrate resistant metastasized prostate cancer (CRPC) progressing after at least one second generation androgen receptor signaling inhibitor (ARSI) and 1 line of taxane based chemotherapy based on a 4-month median overall survival (OS) benefit demonstrated in the VISION randomized controlled trial (RCT) [1] (see Table 1). This evidence concerns the gene AR and prostate carcinoma.