A French early-access program tracking 3,709 patients with metastatic castration-resistant prostate cancer reported outcomes for 177Lu-PSMA-617 in routine care that closely match the VISION trial profile. In the program, median progression-free survival was 7.6 months and disease control was reported in 82% of patients. The findings add to the real-world effectiveness and safety conversation around PSMA radiopharmaceutical therapy, including how performance holds up outside tightly controlled trial settings. For biotech and clinical decision-makers, the scale of the cohort provides a stronger basis for adoption discussions as health systems assess utilization of radioligand therapies.