As prostate cancer progresses, tumors lose the androgen receptor (AR) on which initial treatment is based. Oftentimes, such patients also lose expression prostate-specific membrane antigen (PSMA), which is the target of approved agent Pluvicto (lutetium (177Lu) vipivotide tetraxetan; Novartis AG) as well as a number of experimental drugs. Such patients can no longer benefit from either androgen- or PSMA-directed therapy.