Role of immunotherapy in oligometastatic nonsmall cell lung cancer

The approach to metastatic lung cancer has long been focused on palliation therapy and comfort care. Recently, significant subsets of patients who suffer from a limited form of the disease have shown curative outcomes. The oligometastatic disease theory was first introduced in 1995, and since has been applied to many solid tumours. In oligometastatic nonsmall cell lung cancer, current treatment strategies include surgery, radiation therapy and chemotherapy. There is evidence of astounding survival benefits in selected patients treated with immune checkpoint inhibitors. We present three cases with oligometastatic nonsmall cell lung cancer treated with pembrolizumab, an immune checkpoint inhibitor, and describe the outcomes. Immunotherapy with pembrolizumab appears to be an effective adjunctive treatment with low toxicity in oligometastatic nonsmall cell lung cancer.