There are clear challenges to robust prospective phase 3 trials establishing the utility of local therapies for oligometastatic cancer, not least of which is the sheer heterogeneity of the entity itself. This in-depth editorial outlines recognized challenges and offers up several potential solutions. First is increasing collaborative efforts across disciplines and institutions in trial design and enrollment to increase buy-in and ultimately capture as many different patients as possible. Second is being innovative in trial design such as prioritizing analysis of biologic and genetic predictors of outcomes and capitalizing on readily available tech to reduce the follow-up burden for enrollees. | Yan, Semin Radiat Oncol 2023
