Concerning first-line treatment using mono-ICI therapy, Dall’Olio et al. recently reported an MTV ≥ 75 cm3 as a biomarker of poor prognosis in a cohort of 34 pembrolizumab-treated NSCLC patients with PD-L1 expression ≥50%, with an OS of 4.7 M (0.3–9.1), while median OS was not reached in patients with MTV < 75 m3 [22]. This evidence concerns the gene CD274 and non-small cell lung carcinoma.