Consolidative Use of Radiotherapy to Block Oligoprogression in Patients With Metastatic Melanoma

Inclusion Criteria: * Age 18 or older * ECOG 0-2 * Willing and able to provide informed consent * Metastatic melanoma detected on imaging and clinically confirmed. * Treated with first line immunotherapy or BRAF inhibitors. * No upper limit to the number of total metastatic sites, but a maximum of ten progressive metastatic sites, inclusive of primary disease and metastatic lesions, all of which must be extra cranial. * Patients who had any prior radiation therapy near or overlapping with the oligoprogressive sites are allowed to enroll. * All sites of oligoprogression that can be safely treated with SBRT or hypofractionated radiotherapy. Exclusion Criteria: * \>10 extracranial sites of progressive disease. * Pregnancy. * Leptomeningeal disease. * Serious medical comorbidities precluding radiotherapy, such as ataxia-telangiectasia or scleroderma. * Prior radiotherapy near the oligoprogressive lesion precluding SBRT or hypofractionated radiotherapy due to exceeding OAR tolerance. * Any psychological, sociological or geographical issue potentially hampering compliance with the study. * Any other condition which in the judgment of the investigator would make the patient inappropriate for entry into this study.