Kim H, et al. - Researchers examined the cost-efficacy of adding stereotactic body radiation therapy (SBRT), routinely, to upfront therapy in stage IV non–small cell lung cancer (NSCLC) by mutational subgroup. They constructed a Markov state transition model to conduct a cost-effectiveness analysis comparing SBRT plus maintenance therapy with maintenance therapy alone for oligometastatic NSCLC. Analysis of three hypothetical cohorts was done: epidermal growth factor receptor or anaplastic lymphoma kinase mutation-positive, programmed death ligand-1 expressing, and mutation-negative group. They used mainly clinical trial data to obtain clinical parameters, and assessed 2018 Medicare reimbursement to obtain cost data. At a $100,000/quality-adjusted life years (QALYs) gained threshold, findings do not support the cost-efficacy of adding SBRT to maintenance therapy for oligometastatic NSCLC compared with maintenance therapy alone for mutation-positive groups. This was observed assuming the same survival for both treatments; for the epidermal growth factor receptor or anaplastic lymphoma kinase positive and programmed death ligand-1 positive cohorts, it resulted in an incremental cost-effectiveness ratio of $564,186 and $299,248 per QALY gained, respectively.