Dr. Ivan de Kouchkovsky explains how radioligand therapy delivers targeted radiation to prostate cancer cells using a radioactive isotope attached to a molecule that binds to PSMA, a protein commonly expressed in these tumors. He reviews key clinical trials showing how the therapy improves survival and quality of life for men with metastatic castration-resistant prostate cancer, both after and before chemotherapy. The FDA now approves this approach for patients who have progressed on hormone therapy, even if they haven't yet received chemotherapy. De Kouchkovsky also highlights efforts to enhance effectiveness by combining therapies, increasing radiation dose, and targeting resistant or PSMA-negative cells. Diagnostic imaging plays a critical role in selecting patients most likely to benefit from treatment. Recorded on 05/02/2025. (#40810)