By default, storing content in memory is the same as HttpRuntime.Cache (actually in the internal HttpRuntime.CacheInternal , which behaves similar to the public cache), but in ASP.NET 4.0 you can write your own provider to store the content, but you want to.
This is a good introduction to the implementation of the provider and its use in your application: http://dotnet.dzone.com/news/aspnet-output-cache-provider
stevemegson
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