Early detection of HPD in NSCLC by monitoring T cell dynamics showed a strong expansion of highly differentiated CD28-CD4+ T lymphocytes (CD4+ THD) between the first and second treatment cycles in HPD patients and a significant stratification among HPD patients, non-HDP patients, and effective patients (median 1.525, 1.000, and 0.9700, respectively, P = 0.0007). Here, CD28 is linked to non-small cell lung carcinoma.