A real-world evidence analysis reports that 177Lu-PSMA-617 is delivering efficacy and safety outcomes in routine metastatic castration-resistant prostate cancer care that closely track the VISION trial benchmark. In the French early-access program covering 3,709 patients, median progression-free survival was 7.6 months and disease control was reported in 82% of patients. The dataset supports continued broad clinical adoption of PSMA-targeted radioligand therapy outside trial settings, where practical endpoints—treatment persistence, safety management, and imaging-linked patient selection—tend to diverge from pivotal study populations. For biotech developers of PSMA agents and companion diagnostics, the study offers a concrete reference point for expected outcomes under standard-of-care workflows. Bottom line: the program reinforces that PSMA radioligand therapy is working at scale, not only in controlled trials.