Palma DA, Olson R, Harrow S, et al. - Since there is a lack of long-term randomized data that tested the oligometastatic paradigm which hypothesizes that long-term disease control or even cure may be achieved in patients with a limited number of metastases if all sites of disease can be ablated, therefore, researchers used a randomized phase II screening design and enrolled patients having a controlled primary malignancy and 1-5 metastatic lesions, with all metastases amenable to stereotactic ablative radiotherapy (SABR). Based on the number of metastases (1-3 v 4-5), stratification was done, and patients were randomly assigned in a 1:2 ratio between palliative standard-of-care (SOC) treatments (arm 1) and SOC plus SABR (arm 2). A 5-year overall survival (OS) rate of 17.7% vs 42.3% was observed in arm 1 vs arm 2, respectively. Findings of extended follow-up demonstrated that the effect of SABR on OS was larger in magnitude, as compared with that in the initial analysis, and was durable over time. No new safety signals were reported, and there was no detrimental influence of SABR on quality of life.