@denis76 Very broadly, to quality for isotope therapy (Pluvicto in this instance), requires:
> a positive PSMA PET scan to confirm cancer cells have the PSMA target.
> Metastatic prostate cancer (usually hormone resistant PCa, but more recently hormone sensitive PCa also).
> Failed Other Treatments (Generally refers to patients who still have cancer after trying surgery and/or radiation, ADT, ARPI, and chemotherapy.)

That’s it. You need to ask why Pluvicto (Lutetium-177) hasn’t been offered to you.

Xofigo (Radium-223) is another isotope therapy, but it’s only for bone metastasis.

225 PSMA Actinium is another isotope therapy, but I don’t know if it’s FDA-Approved yet.
===========

I don’t know when the right time is to use PARP therapy - like lynparza (olaparib) or talzenna (talazoparib). But, if it were me I would ask for an explicit and precise answer to “When?”

Similar question regarding immunotherapies/checkpoint inhibitor therapies - Are you a candidate for those therapies?

You have many questions to ask - and many answers to get - before you need to resort to radical treatments.