Over the past decade, there has been a paradigm shift in the management of patients with metastatic cancer. This change has been driven by advances in systemic therapies and the expanded use of local ablative therapies. Consequently, a growing number of clinical trials are now exploring the potential of locally ablative therapies for patients with limited metastatic disease, termed oligometastatic disease (OMD) or localized progression of a handful of metastatic lesions in the context of controlled widespread disease, oligoprogressive disease (OPD).

In real-world clinical practice, OMD is an umbrella term to describe a “spectrum of disease” encompassing a highly heterogeneous population of patients with varying prognoses. The term is often used loosely to encompass a wide range of disease entities. It is important to note that OMD and OPD not only differ in tumor burden but also imply distinct therapeutic intents. OPD can occur in patients with OMD or widespread (poly)metastatic disease.

Metastasis-directed therapy (MDT) utilizing local ablative treatment has emerged as a viable alternative to traditional surgical approaches in various metastatic states.1 This development has been spurred by the increasing recognition of the oligometastatic state in certain cancer types, leading to a surge in clinical trials investigating the use of locally administered therapies for affected patients. While the results of these trials have largely been positive, some have yielded mixed outcomes.