Purpose: To investigate the therapeutic potential of 213 Bilabeled multiple targeted a-radioimmunoconjugates for treating prostate cancer (CaP) micrometastases in mouse models. Experimental Design: PC-3 CaP cells were implanted s.c., in the prostate, and intratibially in NODSCID mice. The expression of multiple tumor^associated antigens on tumor xenografts and micrometastases was detected by immunohistochemistry.Targeting vectors were two monoclonal antibodies, and a plasminogen activator inhibitor type 2 that binds to cell surface urokinase plasminogen activator, labeled with 213 Bi using standard methodology. In vivo efficacy of multiple a conjugates (MTAT) at different activities was evaluated in these mouse models. Tumor growth was monitored during observations and local regional lymph node metastases were assessed at the end of experiments. Results: The take rate of PC-3 cells was 100% for each route of injection. The tumor-associated antigens (MUC1, urokinase plasminogen activator, and BLCA-38) were heterogeneously expressed on primary tumors and metastatic cancer clusters at transit. A single i.p. injection of MTAT (test) at high and low doses caused regression of the growth of primary tumors and prevented local lymph node metastases in a concentration-dependent fashion; it also caused cancer cells to undergo necrosis and apoptosis. Conclusions: Our results suggest that MTATcan impede primary PC-3 CaP growth at three different sites in vivo through induction of apoptosis, and can prevent the spread of cancer cells and target lymph node micrometastases in a concentration-dependent manner. MTAT, by targeting multiple antigens, can overcome heterogeneous antigen expression to kill small CaP cell clusters, thus providing a potent therapy for micrometastases.The incidence of prostate cancer (CaP) is increasing; the high mortality rate is associated with widespread metastatic disease. Despite surgery and radiation therapy that can treat localized disease and the possibility of early diagnosis through testing for serum prostate-specific antigen, up to 30% of treated CaP patients suffer relapse. Most of these show an initial response to androgen-ablation therapy because early CaP growth is androgen dependent but eventually progress to hormone refractory CaP; this no longer responds to androgen ablation.At that stage, there is no curative therapy for metastatic CaP and median survival is f1 year. Nonhormonal agents have been evaluated for patients with hormone refractory CaP but have had limited antitumor activity, an objective response rate of <20% and did not show survival benefit (1). Combined radiation therapy and chemotherapy (2) or radiation and bisphosphonates (3) have shown only limited success in controlling CaP progression. Furthermore, although recent phase II studies with docetaxel (taxotere) display important single agent (4) or combination activity (5) in patients with hormone refractory CaP, the increase in survival is only a median of f2 months in f40% of patients. As such, metastatic horm...