In a patient with metastatic colorectal cancer to the lung and liver, is there a role for liver directed therapy if the lung is not amenable to local therapy?

A 60yo otherwise healthy patient is presented at tumor board who has a history of early stage colon cancer resected 5 years ago and now developed 2 oligometastases in the liver and lung amenable to local therapy. What would be your recommendation?

• Partial hepatectomy and lobectomy only
• Radiation to both liver and lung only
• Local therapy (surgery or radiation) and systemic therapy
• Upfront systemic therapy and consolidative local therapy if good response
• Systemic therapy only
• Other