Local Ablative Therapy in Oligometastatic NSCLC

Oligometastatic non-small cell lung cancer (NSCLC) has been recognized as a unique, yet common, clinical entity over the past 2-3 decades. Numerous retrospective series and early phase single arm trials have demonstrated the efficacy and safety of aggressive approaches in select patients. In addition, results from recent randomized trials have demonstrated potential benefits of radiation therapy and surgery as a form of local ablative therapy (LAT) in prolonging disease-free survival and overall survival. However, more questions remain given the limitation of existing clinical evidence and the lack of well validated biomarkers. Advances in late stage randomized trials with biological correlatives may further clarify the role of LAT to assist with clinical decision making in treating patients with oligometastatic NSCLC. In this review, we discuss the clinical and biologic data surrounding patient selection for LAT in oligometastatic NSCLC, as well as future directions in prospective and translational studies.