Immune Checkpoint Inhibitor and MR-guided SBRT for Limited Progressive Metastatic Carcinoma.

Exclusion Criteria

• •1. Any contraindication to having an MRI scan.
• •2. Chemotherapy, biologic agent, investigational therapy, or radiation therapy given within 14 days of study enrollment.
• •3. Symptomatic or uncontrolled brain metastasis requiring treatment.
• •4. The need for palliative radiation therapy to a non-target lesion prior to radiation therapy to one of 2 target lesion on this study.
• •5. Prior radiation therapy to any lesion that would receive radiation therapy on this protocol.
• •6. Prior radiation therapy to a lesion located within 4 cm of previously irradiated structures: spinal cord that previously received \>45 Gy; brachial plexus that previously received \>45 Gy; small/large intestine or stomach that previously received \>45 Gy; prior total lung V20 \>30%.
• •7. Prior radiation therapy that could lead to an unacceptably high risk of clinically significant normal tissue injury due to high cumulative normal tissue dose as determined by the investigator.
• •8. History of any primary malignancy with the exception of
• •1. Malignancy treated with curative intent and with no known active disease for at least 3 years before enrollment on this study.
• •2. Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease.
• •3. Adequately treated carcinoma in situ without evidence of disease (i.e. cervical carcinoma in situ; superficial bladder cancer).
• •9. Any unresolved toxicity (Common Terminology Criteria for Adverse Events version 5.0 \> grade 2) from previous anti-cancer therapy. Subjects with irreversible toxicity that is not reasonably expected to worsen by treatment on this study are permitted to enroll on this study.
• •10. Active or prior documented autoimmune disease within the past 2 years. Subjects with vitiligo, type I diabetes mellitus, Graves disease, or psoriasis not requiring systemic treatment (within the past 2 years) are not excluded.
• •11. Subjects requiring systemic corticosteroid (\>10 mg daily prednisone equivalent) or other immunosuppressive medication within 14 days of study enrollment.
• •12. Contraindication to IV contrast despite premedication for iodine allergy, which would limit the ability to assess radiographic response to study treatment.
• •13. Prior allogeneic organ transplantation.