This study is for men aged 60 and older with prostate cancer that can't be cured and has spread beyond the prostate. The study compares two treatments: lutetium (177Lu) rhPSMA-10.1 and lutetium (177Lu) vipivotide tetraxetan (Pluvicto®). Both are radioactive drugs designed to target prostate cancer cells. You need to have a type of cancer that shows up on special scans called PET or CT, and have good organ function to join. Participants must also agree not to father children or donate sperm during the study and for 14 weeks after the last treatment.

• Study Length: Participation involves multiple visits for imaging and dosimetry.
• Risks: Possible side effects from radioactive treatments; not for those with certain allergies or metal implants.
• Commitment: Must not change cancer medications or have new cancer procedures during the study.

Before joining, participants need to sign a consent form. If allergic to these drugs, had recent radioactive treatments, or have mental health issues, you might not be eligible. If interested, discuss with your doctor to see if this study is right for you.