When might local therapy be a good choice for someone with metastatic lung cancer?

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I've mentioned in posts in the past about the settings in which local therapy might be appropriate for someone even when we know the cancer is advanced/metastatic.  Here's a brief video that discusses some of these issues, including a situation in which the local treatment isn't specifically aimed at addressing a symptom, as is the usual reason for treating with local therapy for metastatic cancer, but is rather what I'd consider the "Get the Lead Runner" strategy:

[powerpress]

I'm interested in your thoughts.

ERCC1 in Advanced Lung Cancer

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As I described in my prior post, the marker ERCC1 (excision-repair cross complementing group 1) is a prognostic variable that is associated with a more favorable survival in patients who aren't treated with chemo after surgery for early stage NSCLC. But this marker also appears to be predictive of resistance to cisplatin and a worse survival in patients treated with platinum-based chemo after surgery.

Survival and Quality of Life (QoL) in Advanced Lung Cancer: A Devil's Bargain?

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A member recently asked me whether treatment in the second-line or later setting for advanced lung cancer would potentially improve survival at a cost of quality of life, or whether patients can benefit not only in terms of how long they live but also how they live during that time. Since advanced lung cancer, both NSCLC and SCLC, aren't generally able to be approached with curative intent, it's important for the treatment not to be worse than the disease. Ideally, patients will even feel better with treatment, rather than have to choose between quality of life (QoL) and quantity of life.