Trial Comparing Systemic Therapy Alone and With Local Ablative Treatment for Stage IV NSCL Cancer Patients

Inclusion criteria

Patients fulfilling all of the following inclusion criteria at screening may be enrolled in the trial. • The inclusion criteria are irrespective from the tumor burden at the time of primary diagnosis before initiation of first line systemic therapy. Treatment of brain metastases upfront or after an induction phase of standard systemic therapy is done according to the standard practice of the treating center. • Adults (18 years or older) • Tissue confirmed, pre-treatment clinical stage IV NSCLC • ECOG performance status ≤ 1 • Patients responding after 3 cycles (4th bridging cycle up until randomization is allowed) or 3 months of first line SoC systemic therapy with PR or SD in restaging imaging, and presenting with (induced) oligometastatic or oligopersistent NSCLC defined as a maximum of 5 residual extracranial, distant metastases • Patients may have up to 5 cranial metastases in addition to the oligoresidual extracranial metastases as long as they are amenable for radiotherapy or surgery. • The primary tumor and all oligopersistent metastases must be amenable for radical LAT (surgery or radiotherapy) • Patients of reproductive age agree to use double contraception during the study • Patient is able to understand trial procedures and is able/willing to adhere to trial procedures as confirmed by signature