Testing the Safety and Effectiveness of Radiation-based Treatment (Lutetium Lu 177 Dotatate) for Metastatic Prostate Cancer That Has Neuroendocrine Cells

This study tests lutetium-177 dotatate (a targeted radioactive treatment) in people with metastatic prostate cancer that has developed neuroendocrine features — a type of aggressive prostate cancer that doesn't respond well to hormonal therapy and has limited treatment options. **You may be eligible if...** - You are 18 or older - You have metastatic prostate cancer with neuroendocrine characteristics, confirmed by biopsy or molecular testing, or by specific lab findings - You are in reasonable physical health (ECOG 0–2) - Your blood counts, kidney, and liver function meet minimum thresholds - Prior chemotherapy for prostate cancer is allowed, as is having had no prior chemotherapy **You may NOT be eligible if...** - Your prostate cancer does not have neuroendocrine features - Your organ function is significantly impaired - You are pregnant or unwilling to use contraception - You have had certain specific prior treatments that would disqualify you per protocol criteria Talk to your doctor to see if this trial is right for you.