Compared to the multiple tissue and blood-based biomarkers that have been under investigation so far such as tumor PD-L1 expression, neutrophil to lymphocyte ratio, absolute lymphocyte count, level of lactate dehydrogenase, S100B or density of tumor infiltrating lymphocytes15,41–43, the imaging derived biomarkers investigated in this study have the practical advantage that they occur in routine clinical practice and do not require any additional examinations or blood sampling. This evidence concerns the gene CD274 and neoplasm.