Our research sought to evaluate circulating tumor cells (CTCs) as an adjunct predictive tool, while uncovering the transcriptomic shifts within the tumor microenvironment that facilitate cellular shedding.<h4>Methods</h4>A prospective cohort of 39 patients with NSCLC received neoadjuvant programmed cell death protein 1 (PD-1) inhibitors combined with platinum-doublet chemotherapy. Here, PDCD1 is linked to non-small cell lung carcinoma.