Actinium-225 prostate-specific membrane antigen radioligand therapy ( 225 AcAc-PSMA RLT) is a promising salvage option for metastatic castration-resistant prostate cancer (mCRPC). This study aimed to identify predictive parameters for renal and hematological adverse events. Twenty-six patients undergoing 225 AcAc-PSMA-I each P ≤ 0.037) also contributed. In line, baseline Hb emerged as the strongest predictor of anemia-free survival ( P = 0.0007; osseous TV, P = 0.024). PET-derived renal SUV and osseous tumor volume are promising predictive markers for renal and hematological adverse events during 225 AcAc-PSMA-I&T RLT. These findings may support pretherapeutic risk stratification in this vulnerable patient population.
Widjaja et al. (2026) studied this question.