Would you recommend adding 4c of adjuvant nivolumab following SBRT to oligorecurrent NSCLC extrapolating from I-SABR results?

Extrapolating I-SABR results to oligo-recurrent NSCLC needs further investigation. Some preliminary prospective randomized studies have indicated that SBRT with concurrent IO may be beneficial for treatment-naive oligo-metastatic NSCLC or oligo-progressive disease after systemic therapy, including IO. These strategies need to be further optimized and validated.

Oligorecurrent NSCLC appropriately salvaged with SBRT may or may not need adjuvant systemic therapy. I would weigh several factors when discussing the need for systemic therapy with the medical oncology team: how long the patient has been off systemic therapy, their performance status/quality of life and goals of care, what subsequent lines of systemic therapy would be available for effective use, the extent of recurrence, etc. Again, I would not broadly offer the patient nivolumab extrapolating...