Inclusion Criteria:

• 1. Must have one of the following histologically and/or biochemically confirmed genitourinary malignancies:
• 1. Cohort A: Non-small cell cancer
• 2. Cohort B: Small cell cancer
• 2. Provision of signed and dated informed consent form.
• 3. Stated willingness to comply with all study procedures and availability for the duration of the study.
• 4. Age ≥18 years at time of consent.
• 5. Currently on systemic therapy and a candidate to continue their current line of systemic therapy with no more than a planned 30-day break to allow for local ablative therapy.
• 6. ≥ 1 line of systemic therapy for metastatic disease with ≥ 3 months of clinical benefit on most recent line of systemic therapy prior to the development of new metastatic lesions. \[Clinical benefit: Treating provider assessment that majority of the tumor burden is stable on current systemic treatment and not requiring an immediate change in systemic treatment\]
• 7. ≤ 5 progressing or new metastatic lesions.
• 8. All progressing or new metastatic lesions can be safely treated with locally ablative therapies at discretion of treating radiation oncologist and/ interventional radiologist.

Exclusion Criteria:

• 1. Medical comorbidities precluding locally ablative therapies.
• 2. History of treatment related toxicities that limit or prohibit application of locally ablative therapies.
• 3. Progressing intracranial lesions.