Oligometastatic non-small cell lung cancer (omNSCLC) is increasingly recognized as a clinically actionable subset, characterized by a limited number of metastatic lesions and the potential to benefit from combined systemic and local treatments. Advances in systemic therapy, particularly immune checkpoint inhibitors (ICI) and molecular targeted agents, have led to prolonged disease control in selected patients. Prospective clinical trials have shown that incorporating local therapy into systemic treatment can improve progression-free and overall survival outcomes in carefully selected patients with metastatic disease. Radiotherapy has increasingly become the preferred modality for local consolidation, especially when surgical options are limited or impractical. Key factors influencing treatment selection include biomarker status, the number and distribution of metastases, and the response to the initial systemic therapy. The optimal timing and modality of local interventions remain under investigation. This review examines the evolving treatment strategies for omNSCLC, primarily from the perspective of systemic therapies. By contextualizing local treatment modalities within the framework of immunotherapy and targeted therapy, we reinterpret current evidence to clarify when and how local therapy contributes to long-term disease control.
Kawaguchi et al. (Fri,) studied this question.