<![CDATA[Patient Selection for Radiopharmaceuticals in Metastatic Castration-Resistant Prostate Cancer]]>

Advertisement Opinion|Videos|May 13, 2026 Patient Selection for Radiopharmaceuticals in Metastatic Castration-Resistant Prostate Cancer Author(s)Pedro C. Barata, MD, MSc, FACP , Johann de Bono, MD, PhD Dr. Pedro Barata and Dr. Johann De Bono discuss how patient selection and disease characteristics influence the use of radiopharmaceuticals in metastatic castration-resistant prostate cancer (mCRPC). Advertisement Episodes in this seriesEP. 1 Radiopharmaceutical Strategies in Metastatic Castration-Resistant Prostate CancerEP. 2 Combination Radiopharmaceutical Approaches in Metastatic Castration-Resistant Prostate CancerEP. 3 Alpha-Emitting Therapies in Metastatic Castration-Resistant Prostate CancerNow PlayingEP. 4 Patient Selection for Radiopharmaceuticals in Metastatic Castration-Resistant Prostate CancerEP. 5 Treatment Sequencing in Metastatic Castration-Resistant Prostate CancerEP. 6 Combination and Sequencing Strategies in Metastatic Castration-Resistant Prostate CancerEP. 7 Safety and Toxicity Management in Metastatic Castration-Resistant Prostate CancerEP. 8 Future Radiopharmaceutical Strategies in Metastatic Castration-Resistant Prostate CancerEP. 9 Personalized Treatment Decision-Making in Metastatic Castration-Resistant Prostate CancerEP. 10 Future Directions in Metastatic Castration-Resistant Prostate Cancer Dr. Pedro Barata and Dr. Johann De Bono discuss how patient selection and disease characteristics influence the use of radiopharmaceuticals in metastatic castration-resistant prostate cancer (mCRPC). Dr. De Bono reviews practical considerations for selecting between bone-targeting therapies such as radium Ra 223 dichloride and PSMA-targeted radioligand therapies, emphasizing the importance of disease burden, metastatic distribution, imaging characteristics, and tolerability. The faculty discuss how radium Ra 223 dichloride may remain particularly relevant for patients with bone-only or lower-volume bone metastases, while PSMA-targeted therapies offer broader tumor-directed approaches supported by PSMA PET imaging. Dr. De Bono also highlights the growing role of actinium-225–based therapies and ongoing clinical development in this space. In addition, the discussion explores challenges associated with PSMA-low or PSMA-negative disease, particularly liver metastases, and emerging strategies aimed at enhancing PSMA expression to potentially improve radiopharmaceutical targeting and therapeutic response in mCRPC. NewsletterStay up to date on the most recent and practice-changing oncology dataSubscribe Now! Advertisement Related ContentAdvertisementFuture Directions in Metastatic Castration-Resistant Prostate CancerByPedro C. Barata, MD, MSc, FACP ,Johann de Bono, MD, PhDMay 13th 2026Personalized Treatment Decision-Making in Metastatic Castration-Resistant Prostate CancerByPedro C. Barata, MD, MSc, FACP ,Johann de Bono, MD, PhDMay 13th 2026Future Radiopharmaceutical Strategies in Metastatic Castration-Resistant Prostate CancerByPedro C. Barata, MD, MSc, FACP ,Johann de Bono, MD, PhDMay 13th 2026Safety and Toxicity Management in Metastatic Castration-Resistant Prostate CancerByPedro C. Barata, MD, MSc, FACP ,Johann de Bono, MD, PhDMay 13th 2026Combination and Sequencing Strategies in Metastatic Castration-Resistant Prostate CancerByPedro C. 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