Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide [1]. Over 70% of patients with advanced PCa develop bone metastases, which are a major contributor to morbidity and reduced quality of life[2,3]. Skeletal-related events (SREs), including pathological fractures, spinal cord compression, the need for bone radiotherapy or surgery, and cancer-induced bone pain, are common complications of bone metastases and have been linked to worse survival outcomes[4]. Oste…