How does the presence of PSMA negative lesions in a patient with mCRPC affect your decision to treat with Lutetium (177Lu) vipivotide tetraxetan?

The tl;dr answer:
If the patient met VISION criteria for exclusion based on PSMA-negative disease burden, then yes, I would most likely not recommend Pluvicto and would prefer alternative systemic options. Consider cabazitaxel if the patient has already seen docetaxel. Also, ensure the patient has b...