Do you routinely treat oligoprogressive metastatic sites with SBRT in patients receiving systemic therapy and otherwise stable disease?

I am often referred patients who have oligoprogressive disease in the context of widely metastatic disease that is responding to systemic therapy, particularly targeted therapies. These patients have often been on these therapies for at least a year and generally have good performance status. The decision to consider SBRT must be made in a multidisciplinary fashion as the site where we decide to give SBRT can inform toxicity. Further, many patients with oligoprogressive disease are offered SBRT to sites of disease that are asymptomatic. After the above considerations, I do treat oligoprogressive disease with SBRT. The theoretical notion of ablating a clone of resistant disease to allow continued response to current systemic treatment makes ...

Would put the patients on trials first if there is one.

If not, I would be more inclined to treat OPD NSCLC vs. other histologies, given the lack of evidence beyond NSCLC. However, I have offered SBRT to patients with cancers other than NSLC after thorough discussions of potential side effects and benefits (or lack thereof).