Inclusion Criteria:
1. metastatic androgen pathway modulation resistant (mAPMR) prostate cancer refers to Prostate cancer with distant metastases and sustained castrate testosterone (\< 50 ng/dL or 1.7 nmol/L) during APM therapy, meeting ≥1 criterion:
* PSA nadir ≥1.0 ng/mL, absolute PSA rise ≥0.2 ng/mL confirmed ≥21 days apart;
* Radiographic progression: RECIST 1.1 soft tissue progression, or bone scan progression per PCWG4 2+2 rule (≥6 new bone lesions confirmed on single scan); PSMA-PET new metastatic lesions also qualify as progression.
2. Failure of, Refusal of, Absence of, or Refractoriness to Standard Therapy, or Disease Progression, or No Available Standard Therapy per Current Guidelines:
* Patients who have not received, refused, or progressed after receiving at least 1 but no more than 2 prior taxane-based therapies. The taxane regimen must have included exposure for at least 2 cycles. Patients who received only one taxane may be included if the investigator deems them unsuitable for a second taxane (e.g., due to frailty assessed by geriatric/comorbidity evaluation or intolerance).
* Patients who have progressed after receiving at least one novel androgen axis drug \[NAAD\] (e.g., abiraterone, enzalutamide).
3. Ability to understand and voluntarily sign a written informed consent form (ICF), and willingness and ability to comply with trial procedures including examinations and follow-up.
4. Age 18-90 years (inclusive).
5. Expected survival \> 6 months.
6. ECOG performance status ≤ 2.
7. Presence of high-uptake lesions confirmed by 68Ga-PSMA-11 PET/CT imaging (positive defined as lesion uptake \>1.5 times the liver background).
8. At least one measurable soft tissue lesion per RECIST version 1.1 criteria, OR at least one bone metastasis on bone scintigraphy, OR at least one PSMA-positive metastatic lesion on PSMA-PET/CT, all as defined by PCWG4.
9. Adequate organ function (No blood products, growth factors, or albumin administered within 14 days prior to baseline lab tests):
* Bone Marrow Function: Neutrophil count ≥ 1.5 × 10\^9/L, White blood cell count ≥ 3.0 × 10\^9/L, Platelet count ≥ 100 × 10\^9/L, Hemoglobin ≥ 10 g/dL (≥ 100 g/L).
* Liver Function: Albumin ≥ 30 g/L, Total bilirubin ≤ 1.5 × ULN, ALT or AST ≤ 3.0 × ULN (without liver metastases) or ≤ 5.0 × ULN (with liver metastases).
* Renal Function: Serum creatinine ≤ 1.5 × ULN.
10. Agreement to comply with prescribed radiation protection measures during the trial period.
Exclusion Criteria:
1. Inability to tolerate imaging procedures;
2. Patients who have received systemic anticancer therapy (e.g., chemotherapy, radiotherapy, immunotherapy; excluding endocrine therapy), investigational drugs, or device therapy within 4 weeks prior to dosing;
3. Patients who received radionuclide therapy (Strontium-89, Samarium-153, Rhenium-186, Rhenium-188, Radium-223, Lutetium-177) within 6 months, or any External Beam Radiation Therapy (EBRT) within 2 months prior to the first dose;
4. Patients with unresolved Grade 4 myelosuppression from prior anticancer therapy within 2 weeks, or Grade 3 myelosuppression requiring \>6 weeks for recovery;
5. Planned use of cytotoxic chemotherapy, antitumor immunotherapy, radioligand therapy, or similar agents during the study;
6. Use of blood products or albumin within 14 days before dosing to meet enrollment criteria;
7. Brain metastasis at screening, except:
* Asymptomatic cases confined to supratentorial/cerebellar regions (no midbrain/pons/medulla/spinal cord involvement) without corticosteroid therapy and with lesions ≤1.5 cm;
* Symptomatic cases with treated and radiologically stable lesions (\>4 weeks);
8. Other malignancies within 5 years (excluding cured localized cancers like basal/squamous cell skin carcinoma);
9. Superscan on bone scintigraphy;
10. Symptomatic or impending spinal cord compression;
11. Prior EBRT involving extensive bone marrow (\>25%);
12. Significant cardiac disease at screening, including:
* QTcF \>470 ms or long QT syndrome history;
* Myocardial infarction, angina, or CABG within 6 months deemed ineligible by investigators;
13. Any condition that, per investigator judgment, may compromise safety, data interpretation, or indicate high risk;
14. Uncontrolled bladder outlet obstruction, urinary incontinence, claustrophobia, or radiophobia at screening;
15. Positive for HCV-Ab, HIV, or syphilis antibodies at screening;
16. HBsAg-positive patients with active HBV replication (confirmed by HBVDNA per investigator assessment);
17. Known allergy to proteins/peptides, excipients, or structurally related compounds;
18. History of drug/alcohol abuse within 1 year or chronic substance abuse;
19. Failure to use effective contraception during the trial and for 6 months post-last dose;
20. Severe active infection prior to the first administration.
