Gafita A, Heck MM, Rauscher I, et al. - In this study, the prognostic value of early prostate-specific antigen (PSA) changes after ¹⁷⁷Lu-labeled prostate-specific membrane antigen (¹⁷⁷Lu-PSMA) radionuclide treatment in metastatic castration-resistant prostate cancer patients was investigated. Individuals were allocated to 3 groups on the basis of PSA variations: response (≥ 30% decline), progression (≥ 25% increase), and stable (< 30% decline and < 25% increase). Researchers distinguished 124 eligible patients with PSA values at 6 wk. At 6 weeks, PSA variations after ¹⁷⁷Lu-PSMA initiation are an early indicator of long-term clinical outcomes. After 6 wk of treatment, individuals with PSA progression could benefit from a very early decision to switch treatment. The data exhibited that PSA flare-up during 177Lu-PSMA treatment is very uncommon. Prospective studies are now required to confirm the data and potentially inform clinicians earlier on the efficacy of ¹⁷⁷Lu-PSMA.