Louise Emmett and colleagues1 investigated that the combination of enzalutamide and lutetium-177 [177Lu]Lu-prostate-specific membrane antigen (PSMA)-617 has anti-tumour activity and addressed a crucial gap in the therapeutic landscape for metastatic castration-resistant prostate cancer. The findings that this combination significantly improved prostate-specific antigen (PSA) progression-free survival and showed a favourable safety profile compared with enzalutamide alone are particularly noteworthy.