For NSCLC patients who are polymetastatic who then become and remain oligometastatic, is there a role for local ablative RT to the primary and metastatic sites?

I think it's an evolving area. I've had several patients with metastatic NSCLC where all their disease except for a couple of spots resolved on subsequent pet scans, for example. The med oncs ask if we could treat those, and I generally will on the theory that these sites might have a different biol...

Remember that the @Dr. First Last trial from MDACC (Gomez et al., PMID 31067138) enrolled patients with 3 or fewer lesions AFTER 3 months of first line systemic therapy - so someone could have 10 disease sites, and if 7 resolved on first line systemic they could still be included - relevant especial...

Agree with above points. As @Dr. First Last eluded to, I think Gomez is certainly relevant here as these patients were enrolled post-first line systemic therapy. However, only 36% had better than stable disease response (9 patients in both arms) thus, I think only a handful of patients would qualify...