Retrospective or single-arm prospective studies have shown that local consolidative therapy (LCT) can extend progression-free survival (PFS) in patients with oligometastatic disease. An overall survival (OS) benefit in patients with non-small-cell lung cancer (NSCLC) has now been demonstrated in a prospective randomized phase II trial.

Patients with advanced-stage NSCLC and ≤3 metastatic lesions without progression ≥3 months after front-line systemic therapy received standard maintenance therapy or observation with (n = 25) or without (n = 24) LCT (with surgery and/or radiotherapy).

At a median of 38.8 months, LCT was associated with an OS benefit: median 41.2 months versus 17.0 months (P = 0.017). Previously published results of this trial indicated a statistically significant PFS benefit with LCT that has now been confirmed: 14.2 months versus 4.4 months (P = 0.022).

OS durations after disease progression were longer in the LCT arm than in the control arm: median 37.6 months versus 9.4 months (P = 0.034). Salvage therapy for these patients involved additional systemic agents and/or LCT to all progressing sites. Patients who received LCT-based salvage therapy (41%) had longer OS durations than those who received other salvage therapies: median not reached (NR; 95% CI 11.5 months–NR) versus 16.4 months (95% CI 8.7–40.9 months; P = 0.01). The previously reported incidence of grade ≥3 toxicities was 20% in the LCT arm versus 8% in the control arm; no additional events were described.

Together with the recently published results of the SABR-COMET trial, this study contributes to the growing evidence of a curative role of local ablative therapies in patients with oligometastatic cancer.