Therefore, other biomarkers like FDG PET-CT or PD-1 or PD L-1 imaging in combination with TMB and laboratory parameters should be used in the future (as prognostic markers and also for therapy monitoring) to get a holistic approach of tumor biology including heterogeneity of the metastatic disease and in order to tailor therapy on a personalized basis. Here, PDCD1 is linked to metastatic neoplasm.