POWER Study (Prospective Transbronchial Microwave + Robotic-Assisted Bronchoscopy)

INCLUSION CRITERIA:

   - Signed informed consent.

   - Subjects greater or equal to 22 years old.

   - Performance status 0-2 (Eastern Cooperative Oncology Group classification (ECOG).

   - Willing to fulfill all follow-up visit requirements.

   - Subjects with at least one oligometastatic lung tumor where the primary tumor is
   controlled (in the opinion of the investigator or treating oncologist).

   - Oligometastatic lung tumor(s) planned to be ablated in the outer two-thirds of the
   lung and not closer than 1cm to the pleura.

EXCLUSION CRITERIA:

   - Pregnant or breastfeeding.

   - Subjects with thoracic implantable devices, including pacemakers or other electronic
   implants.

   - Chronic, continuous ventilator support, which uses bi-level positive airway pressure
   (PAP) to improve lung function for severe conditions. (However, intermittent PAP, for
   non-pulmonary conditions, such as sleep apnea, is permitted).

   - Prior pneumonectomy.

   - Severe bronchiectasis (with FEV1 <30%) or disease deemed to be too severe in the
   opinion of the investigator.

   - Platelet count ≤ 50,000/mm3.

   - Subjects with uncorrectable coagulopathy at time of screening.

   - Subjects medically unable to stop anti-platelet agents (e.g., aspirin, clopidogrel,
   prasugrel, ticagrelor) at least 5 days prior to the procedure through 48-72 hours
   after the procedure.

   - Subjects medically unable to stop warfarin at least 3-5 days prior to the ablation
   procedure, or until INR < 1.5, through 48-72 hours after the procedure. On the day of
   the procedure, subjects with an INR > 1.5 cannot have the procedure completed that day
   but may be rescheduled or postponed.

   - Subjects medically unable to stop anticoagulants (e.g., rivaroxaban, apixaban,
   dabigatran, endoxaban) at least 3 days prior to the ablation procedure through 48-72
   hours after the procedure.

   - Expected survival less than 6 months in the opinion of the investigator and/or
   treating oncologist.

   - Subjects with known or suspected brain metastases.

   - Subject has had any radiation (i.e., SBRT or EBRT) to the intended ablation zone.

   - Endobronchial tumors proximal to and including the segmental airways.

   - Lung ablation, surgical resection therapy, radiotherapy, or any other treating
   procedure within 30 days prior to the planned study ablation procedure or those who
   plan to receive a lung ablation, surgical resection, or radiation therapy on the
   ablated lung side before completing the primary endpoint assessment (30 days
   post-ablation).

   - Systemic therapy (e.g., chemotherapy, targeted drug therapy, or immunotherapy) within
   14 days prior to the planned study ablation procedure or those who plan to receive
   systemic therapy before completing the primary endpoint assessment (30 days
   post-ablation).