68Ga-PSMA-11 PET-directed Radioligand Therapy in Metastatic Hepatocellular Carcinoma (HCC)

Inclusion Criteria: * Participants must have histologically, cytologically or radiographically confirmed hepatocellular carcinoma by LI-RADS30 with metastatic and/or unresectable disease. * Participants must have received one prior line of systemic therapy for the treatment of metastatic and/or unresectable HCC including anti-PD-L1 therapy. Participants will be enrolled at the time of progression on first-line therapy for metastatic and/or unresectable disease. * Age \>18 years. Because no dosing or adverse event data are currently available on the use of 177Lu-PSMA-617 (Lu-177 vipivotide tetraxetan) in participants \<18 years of age, children are excluded from this study. * ECOG performance status 0 or 1. * Participants must have normal organ and marrow function as defined below: Absolute Neutrophil Count ≥ 1,500/mcL. Hemoglobin \> 9 g/dL. Platelet count ≥ 75,000/mcL. Serum creatinine ≤ 1.5 x institutional upper limit of normal or CrCl ≥60 mL/min using the Cockroft-Gault formula for participants with creatinine levels \>1.5 ULN. Child-Pugh class A or B7. * At least one target lesion measurable by RECIST 1.1 criteria. * PSMA-PET demonstrating PSMA PET positive lesion (higher uptake in the tumor compared with background liver uptake). * Participants must have the ability to understand and the willingness to sign a written informed consent document. * Participants of childbearing age are using an appropriate method of contraception. Exclusion Criteria: * Participants rece…