At what point during first-line treatment with mono-immunotherapy for oligometastatic NSCLC is the ideal time to consider consolidative radiation/SBRT to the primary and oligometastatic sites?

What I do in general first and foremost is judge whether or not it’s appropriate to offer consolidation: reasonable indications thus far have been: oligometastatic disease status at presentation, oligoprogressive disease after therapy, limited # of sites to irradiate, safe to deliver SBRT in the anatomical area with reasonable volume of RT. With at least the PDL-1 or PD1 inhibitors, safety profile with concurrent RT (so far) has been favorable. In that case, if the IO is working, with the understanding that these drugs linger a while in the system and are important to the patients, we would continue the immunotherapy while we SBRT these limited sites and limited volume (within reason of course). In other words, we would not delay or omit th...

Agree with Dr Lee above. I see no reason why one cannot extrapolate from the Gomez data, which gave 3 months of targeted therapy (or 4 cycles platinum doublet chemo), assessed response, and treated non-progressors to the primary and oligomets