Although Ac-225-PSMA-617 has shown significant efficacy in the treatment of bone metastasis of prostate cancer (19), its multiple fibrogenic mechanisms suggest that dynamic monitoring of inflammatory factors (such as IL-6) and fibrosis markers (such as TGF-β) may be required to optimize the treatment strategy to balance the efficacy and the risk of myelotoxicity. This evidence concerns the gene TGFB1 and prostate cancer.