 3. Three or less metastatic lesions not sites. each lesion including a satellite nodule will individually be counted as one, and intrathoracic lymph node involvement defined here as hilar, mediastinal, or supraclavicular nodes, N1-N3 will collectively be counted as one. In addition, patients can receive treatment to CNS lesions or other symptomatic lesions requiring urgent local therapy prior to randomization, but these lesions will be counted towards the total number after chemotherapy, and patients will only be eligible if there are remaining sites amenable to local therapy after up-front systemic therapy. 