Practice changing data from the SARON study at #ESMO26 from @fifimcdrmh @royalmarsdenNHS 👏 Herculean effort, run over 10 years 🤔 Does adding radiotherapy to SACT in the immunotherapy era improve survival in synchronous oligometastatic NSCLC? What do we know already? ✅ LCT improves outcomes in pre-immuno era & with AGA+ NSCLC ❌ More recently, no survival benefit with niv/ipi regimens (LONESTAR) What does SARON add? ✅ Well designed, randomised, multicentre prospective study ✅ Comprehensive baseline assessments with PET and MRI ✅ Appropriate definition of OMD (1-5 sites) ✅ PFS benefit, and reduces progression at treated sites ❌ No OS benefit, and no reduction progression at new sites of disease ✅ No additional toxicity Thoughts: 🤔 Great academic 🇬🇧 study 👏 🤔 Addresses important & relevant question 🤔 Presumably parents have more metastases than we can detect, which then progress, losing OS benefit 🤔 Patients must be informed of lack of OS benefit if LCT being considered 🤔 Is LCT appropriate if OS not improved? (❗️LCT in AGA+ NSCLC, and LCT in metachronous OMD not answered here) #LCSM