Low PSMA SUV Boost (LPS-Boost): Intensified 177Lu-PSMA-617 Treatment for Patients With Metastatic Castrate-Resistant Prostate Cancer With Low PSMA Expressing Disease

This study is testing whether giving a higher, more intensive dose of a radioactive drug called lutetium-177 PSMA-617 can improve outcomes for men with metastatic castrate-resistant prostate cancer (mCRPC) whose tumors show relatively low uptake of the PSMA tracer on a specialized PET scan. Standard lutetium-PSMA therapy tends to be less effective when tumors absorb less of the radioactive drug. **You may be eligible if...** - You are a man aged 18 or older with confirmed prostate cancer that has spread and is no longer responding to hormone therapy - Your PSMA PET scan shows cancer spread but with a lower than average whole-body tumor signal (SUVmean below 10) - You have previously received at least one androgen receptor pathway inhibitor (such as enzalutamide or abiraterone) - Your cancer continues to progress despite treatment - Your blood counts and organ function meet the required levels **You may NOT be eligible if...** - You have previously received lutetium-PSMA therapy or other radioactive treatments (e.g., radium-223) - You have recent (within 30 days) systemic cancer treatment - You have symptomatic spinal cord compression - You have uncontrolled heart failure or significant co-existing medical conditions Talk to your doctor to see if this trial is right for you.