Is there a benefit to locally consolidative therapy for oligometastatic non-small cell lung cancer?

Metastatic non-small cell lung cancer (NSCLC) is known to have a particularly poor prognosis, with a median overall survival of 8 months and a 10% survival rate at 2 years (1). Historically, treatment for metastatic NSCLC has been palliative chemotherapy (2) which has been shown to modestly prolong 1-year survival in comparison with best supportive care (3). Nowadays, with the advent of more sensitive imaging modalities, improvement in the specificity of radiation therapy delivery, and targeted systemic therapies, many patients with limited metastatic disease are being detected and treated more aggressively, in the absence of randomized, prospective data to support these practices. In patients with metastatic lung cancer, where obstructive or functionally limiting manifestations of disease can reduce performance status and diminish quality of life, there may be a uniquely important role for early enactment of locally directed therapy.