When would you consider local ablative therapy (e.g. SBRT, surgery) for patients with oligometastatic non small cell lung cancer on immunotherapy?

Definitely would treat this exactly as I do for EGFR or ALK-targeted therapy. If the patient is doing well, and most sites of disease continue to be controlled but one is progressing I would consider local ablative therapy.

That being said, I just had a patient doing well with a CR on ipi-nivo for ...

I agree with Dr Carbone's approach. But his example where SBRT of an axillary node lead to peripheral neuropathy indicates that SBRT using high doses per fraction is not appropriate for all sites. At University of Colorado we do radiation therapy for oligoprogression on whatever systemic therapy, if...