Rather than blaming progression after ablative radiotherapy on radiation-induced seeding, this editorial argues for a more nuanced dynamic model. Drawing on recent data, they describe a bidirectional effect of ablative radiation—simultaneously inhibiting metastatic seeding from treated lesions while unmasking previously dormant distant clones. Many prospective trials of ablative radiation for oligomets restricted patients to a single course, notably discordant with real-world practice where serial treatment is common. They argue it is only partial treatment that may leave untreated clones capable of continued seeding, making a case for comprehensive ablation of all visible disease when feasible, particularly in patients with intermediate metastatic burden. | Pitroda & Weichselbaum, JAMA Oncol 2026
