Yes, some patients with Stage 4 NSCLC can live longer than five years, but this depends on specific clinical and biological factors. Patients with actionable mutations (EGFR, ALK, ROS1, etc.) may experience prolonged control with targeted therapies. Individuals with favorable immune markers or strong responses to immunotherapy can also achieve longer-than-expected survival. In oligometastatic disease, combining systemic therapy with local treatments (SRS, radiation, selected surgery) may provide additional benefit in carefully chosen cases. However, outcomes vary widely based on metastatic burden, organs involved, performance status, and treatment tolerance. The most meaningful estimate comes from integrating your biomarker profile, imaging findings, and response trends with your oncology team.