The Addition of Multisite SBRT to Ipilimumab and Nivolumab in First Line Metastatic NSCLC: The COSINR Trial

Checkmate 227 established ipilimumab and nivolumab (ipi/nivo) as a first line treatment option for stage IV non-small cell lung cancer (NSCLC), providing a median overall survival of 17.1 months. Stereotactic body radiotherapy (SBRT) provides high rates of metastasis control and may be additive to immunotherapy by providing direct cytoreduction and preventing early progression at existing sites of disease, leading to durable improved outcomes. We designed a phase I study to examine the safety and efficacy of SBRT and ipi/nivo in first line treatment of metastatic NSCLC.