LAUSR

Simple Summary The treatment landscape for EGFR-mutated non-small-cell lung cancer (NSCLC) has significantly evolved with the introduction of EGFR tyrosine kinase inhibitors (EGFR-TKIs). However, acquired resistance to EGFR-TKIs remains inevitable, limiting long-term survival. Recent evidence suggests that local ablative therapy (LAT), such as stereotactic radiotherapy or surgery, may improve outcomes in patients with a limited number of metastatic lesions—collectively referred to as oligometastatic states. These include synchronous oligometastatic disease (present at diagnosis), oligo-residual disease (persistent lesions after initial EGFR-TKI therapy), and oligo-progressive disease (limited progressive disease during ongoing EGFR-TKI treatment). Integrating LAT with systemic therapy may delay resistance, prolong disease control, and potentially improve survival. However, optimal timing and patient selection for LAT remain uncertain, and standardized criteria for defining these “oligo” states are still lacking. This review summarizes the current clinical evidence, ongoing trials, and future perspectives for the role of LAT in the multidisciplinary management of EGFR-mutated NSCLC across different oligometastatic settings.