COSINR
nivolumab plus ipilimumab plus stereotactic body radiotherapy in stage IV non-small cell lung cancer
COSINR examines the safety of giving stereotactic body radiotherapy concurrently or sequentially with nivolumab–ipilimumab in stage IV NSCLC. Commentary comes from X posts and threaded exchanges. Debate centers on whether radiation adds systemic benefit, when concurrent SBRT–immunotherapy is appropriate, and the contested clinical relevance of proposed dormancy escape. The sources place COSINR presentation findings at ASTRO 2020 and COSINR trial results at WCLC2023.
- NCT03223155 ↗
- v1.0.0 · edition 1
- updated Oct 30, 2026
- Standard
12 findings, and what sits behind each
01. Radiation's added systemic contribution remains an explicit question despite strong enthusiasm
9 statements · 9 passages · 4 sources · 7 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Secondary endpoints, Safety and tolerability, Design and conduct.
02. Favorable concurrent-treatment reports use distinct endpoints and incomplete presentation summaries
8 statements · 8 passages · 7 sources · 5 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Safety and tolerability, The comparison, Secondary endpoints, Design and conduct.
03. Avoiding systemic-treatment delay is a conditional argument, not an unconditional preference for concurrency
9 statements · 8 passages · 1 sources · 5 named voices
Counterview: recorded · Limitations recorded: 5. Feeds the Medical Affairs question.
Draws on: The comparison, Safety and tolerability, Design and conduct.
04. Misreading COSINR as oligometastatic consolidation changes the clinical question
12 statements · 9 passages · 3 sources · 6 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Population and setting, Design and conduct.
05. The AREG interpretation concerns possible dormancy escape, not a demonstrated increase in metastatic spread
16 statements · 16 passages · 3 sources · 4 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Secondary endpoints.
06. Human validation, causal discrimination and real-world importance remain contested
21 statements · 24 passages · 2 sources · 8 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Secondary endpoints.
07. Partial-coverage concerns include a negative association and an explicit self-correction
14 statements · 11 passages · 4 sources · 3 named voices
Counterview: recorded · Limitations recorded: 4. Feeds the Medical Affairs question.
Draws on: Population and setting.
08. More ablative radiation has a systemic-treatment trade-off, not just a local-control rationale
8 statements · 8 passages · 3 sources · 5 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Safety and tolerability.
09. Evidence-generation concerns combine statistical power, accrual competition and disputed modality bias
15 statements · 16 passages · 2 sources · 7 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Design and conduct.
10. The rationale extends beyond abscopal effects, while timing and measurement remain unsettled
17 statements · 15 passages · 2 sources · 8 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
11. YTHDF2 adds a resistance hypothesis, not a clinically validated intervention or sequencing biomarker
8 statements · 7 passages · 2 sources · 1 named voices
Counterview: none recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Secondary endpoints.
12. Patient-facing communication is a consequential controversy alongside the science
16 statements · 15 passages · 3 sources · 10 named voices
Counterview: recorded · Limitations recorded: 4. Feeds the Medical Affairs question.
Draws on: Secondary endpoints.
Counts overlap, since one statement can back several findings. They show what the report kept, not how many clinicians agree. The full report includes the interpretations and source links.
Select a finding to see what the full report holds for it: how many verified HCP statements and of what kind, the passages behind them, the sources and voices, and the counterview and limits it records. Select a part of the trial to see which findings draw on it.
- Finding 1 of 12
Radiation's added systemic contribution remains an explicit question despite strong enthusiasm
- statements
- 9
- passages
- 9
- sources
- 4
- named voices
- 7
What the statements areViews 6Questions and uncertainty 2Clinical experience 0Comparisons 0Restated results and context 1How passages are usedSupporting a statement 9Giving context 0Recorded with the finding- Counterview: recorded
- Limitations: 3
- Feeds the Medical Affairs question
- 3 posts and articles
- 1 registry
Draws on: Secondary endpoints, Safety and tolerability, Design and conduct.
In the full report: the interpretation in full, all 9 statements cited to source and date, and the 4 sources linked where public.
Thicker lines mean more shared statements. A finding without a line goes beyond the registered design. Counts overlap, since one statement can back several findings, and they show what the report kept, not how many clinicians agree.
The full COSINR report gives each finding its interpretation, the attributed views behind it, counterviews, limits and the verified HCP statements, each linked to the original. Get a complete report free to see what you get.
What evidence would isolate SBRT's incremental benefit and validate actionable dose, timing or biomarker choices without overstating systemic harm?
Raised by the leading finding. The report shows what clinicians said and the sources behind it; it does not settle the question.
By the numbers
free- 28HCP commentary sources screened
- 23sources cited by verified HCP statements
- 41named in screened sources
- 39voices cited in the report
- 37cited voices matched to verified clinician profiles
Also in the sources: 2 organizational or shared accounts, not counted as people.
- 235verified statements, each linked to its source
- 181of them from speakers with a confirmed clinical role
- 12findings
Screened sources were retrieved for this trial. Cited sources back at least one verified statement and include primary sources used for context. No count estimates how many clinicians hold a view. Size (Standard) is set by the 235 verified statements. Statements from sponsors, hosts and organisations are labelled and count apart from identified clinicians. A confirmed clinical role is one verified by the NPI registry or by the person's own institution's staff page; a role a source only states is not counted.
What's inside
free| Section | Items | Access |
|---|---|---|
| Findings with interpretation, counterviews and limits | 12 | Titles free |
| Detailed analysis | 13 sections | Paid |
| Verified statements with short source quotes and links | 235 | Paid |
| Trial aspects mapped | 14 | Free |
| Sources with links | 23 | Counts free |
| Speaker attribution for cited voices | 39 | Paid |
Trial aspects
13 discussed · 1 no commentary · 0 incomplete| Aspect | Statements | Sources |
|---|---|---|
| Primary endpoint: Number of serious adverse eventsno commentary found | 0 | 0 |
| Secondary endpoints | 6 | 6 |
| Population and setting | 8 | 2 |
| The comparison | 14 | 8 |
| Safety and tolerability | 8 | 6 |
| Design and conduct | 22 | 6 |
| Clinical enthusiasm, chemotherapy-free appeal and radiation's incremental value | 13 | 7 |
| Dose, target selection and continuity of systemic treatment | 23 | 6 |
| Human timing evidence, tissue biology and translational measurements | 11 | 5 |
| AREG, dormancy escape and the meaning of post-SBRT progression | 29 | 3 |
| Causal validation, failure-pattern analysis and clinical meaningfulness | 56 | 1 |
| Partial SBRT, treated-lesion control and complete consolidation | 22 | 5 |
| YTHDF2-associated dendritic-cell resistance and experimental targeting | 6 | 1 |
| Local-therapy analogues, scientific framing and patient counseling | 31 | 2 |
An aspect marked incomplete is a question the public commentary did not let us answer. We show it rather than hide it.
Sources
free| Channel | Screened | Cited | |
|---|---|---|---|
| X threads | 28 | 21 | |
| Primary sources, cited for context, not screened | |||
| Publications | not screened | 1 | |
| Registry | not screened | 1 | |
max 8 / quarter
- Screened window
- Feb 13, 2018 → Nov 28, 2025
- Cited window
- Jun 14, 2018 → Nov 28, 2025
- Retrieved
- Oct 30, 2026
The trial
from ClinicalTrials.gov- Title
- A Randomized Phase I Trial to Evaluate Concurrent Or Sequential Ipilimumab, Nivolumab, and Stereotactic Body Radiotherapy in Patients With Stage IV Non-Small Cell Lung Cancer (COSINR Study)
- Registry
- NCT03223155
- Study IDs
- IRB17-0547
- Sponsor
- University of Chicago
- Design
- Phase 1 · Interventional, randomized, parallel
- Status
- Active, not recruiting
- Enrollment
- 78 actual
- Registered
- 2017-07-21
- Start
- 2017-09-07 actual
- Primary completion
- 2026-12 estimated
- Primary endpoint
- Number of serious adverse events
- Interventions
- 3 registered
Scope and limits
freeThis report does not judge efficacy, estimate HCP prevalence or consensus or give treatment advice.
- Discussion that does not name the trial may be missing from this edition.
- Some passages in the sources used in this report were not fully assessed for clinician views, so a view there may be missing from this edition.
- 118 statements in the sources reviewed for this edition are about other patients or topics, or only mention the trial, and are not counted.
- Further source limits: discussion that describes the trial without naming it may be incomplete; some discussion that describes the trial without naming it may be missing; sources about other trials are not included.
- The sources reviewed for this edition do not represent all HCPs or all public discussion; repeated posts and reposts are not independent clinical opinions.
- Some discussion passages and treatment-development suggestions were not fully assessed, and unnamed references or alternative transcriptions may be missing. Absence of a view here does not establish that no such view exists or that every proposed approach has been characterized.
- A complete protocol and the complete main clinical-results publication are not available. Presentation summaries and participant recalculations should not substitute for a full endpoint-level assessment.
- The registry condition labels describe small cell lung cancer, while the trial title, methods statement and commentary specify stage IV NSCLC. The report follows the latter clinical setting.
- Clinical associations involving AREG or YTHDF2 do not establish causation, predictive utility, a sequencing rule or benefit from a targeted intervention.
- Some numerical presentation summaries omit denominators, timepoints or group assignments; values from different presentations are not interchangeable.
- Some speakers' identities or clinical roles are not established in the sources used in this report; each statement is attributed only as far as its source shows.
- A speaker's favorable appraisal accompanies a post sharing COSINR results. Another speaker's AREG explanations concern the group's own research, including COSINR analyses. These should not be read as independent external reception.
- A speaker's involvement is described by the source as working for The University, the trial's sponsor; this description is not independent verification of employment or a reason to weight the view as external consensus.
- Surgical, bladder-RT and other-trial examples are used only where they qualify the connected treatment or evidence question; they are not COSINR treatment arms or outcomes. The pulmonary-vessel-ligation comparison is a reported study observation posted in 2019 about lung-cancer resection.
- Concerns about patient fear, specialty bias and media effects are attributed opinions or anticipated risks, not independently measured findings.
How reports are built and checked: Methods.
Editions and corrections
freeShow the correction
None of these corrections changed a finding.
- Oct 30, 2026Corrected to match the delivered report: the sample findings; the report description.
Last checked for new commentary Oct 30, 2026. A new or changed finding gets a new version number; added evidence alone is a smaller update.
Cite this report
Erudio Health. COSINR (NCT03223155): HCP commentary report. Edition 1, v1.0.0. Accepted Oct 30, 2026. https://www.erudio.com/reports/cosinr-nct03223155
For your AI agent
Paste this into ChatGPT, Claude, Microsoft Copilot or your own agent. It previews this report through the free Erudio MCP server, tells you whether it answers your question, and orders it if you ask. Some agents ask you to confirm pasted instructions before acting; that is expected.
Help me decide whether to buy the Erudio report "COSINR" (NCT03223155), and buy it for me if I ask. Erudio reports cover what clinicians say in public about one clinical trial, with every verified statement linked to its source.
1. Use the free Erudio MCP server at https://mcp.erudio.com/free; it needs no sign-in. Nothing needs installing: if it is not connected in this app and you can make HTTP requests, call it directly with JSON-RPC POSTs to that URL (initialize, then tools/call), sending "Accept: application/json, text/event-stream". Call get_report_card with slug "cosinr-03223155". If you cannot make requests, read https://www.erudio.com/reports/cosinr-nct03223155.md instead.
2. In a few lines, tell me what the report covers: its findings, its verified statements and sources, its evidence window, what it leaves out, and the price of each product (offer). Then ask what I need it for, and say plainly whether this report answers it.
3. If I want it, ask for my work email and the product: the current edition, or 3, 6 or 12 months of weekly updates. Call create_order with report "NCT03223155", that product and email, then show me the quote and the checkout_url to pay by card. If you have a payment client for HTTP 402 payments and I agree, you can pay the pay_url instead. Nothing is charged until one is paid.
4. Once it is paid, call get_order with the status_url: it returns my license key. Then use the Erudio MCP server at https://mcp.erudio.com/mcp with the header "Authorization: Bearer <key>". Call read_report with report_id erudio-nct03223155 and sections ["all"], and summarize the findings for me with their sources. The full report is large (about 500 KB): save the response to a file and work from it rather than printing it. If you cannot, read sections ["narratives"] first, the executive summary and analysis.
When you tell me what clinicians said, give each view as theirs, with its source. Counts are the sources the report kept, not the share of clinicians who agree. Reports are not medical advice.
Keep the key private to my organization.Or read the record directly: JSON, Markdown or MCP
curl https://www.erudio.com/reports/cosinr-nct03223155.json
curl https://www.erudio.com/reports/cosinr-nct03223155.md
# MCP, no sign-in (https://mcp.erudio.com/free)
get_report_card({ "slug": "cosinr-03223155" })release bb6847f2c5df1439c53118ac716f766994a58469289db6d1759b1065d9f00425