Manjunath Y, et al. - Given the presence of circulating tumor cell (CTC) clusters (≥2 CTCs in aggregate) in the peripheral blood has predictive value in solid cancers, including non-small cell lung cancer (NSCLC), researchers focused on CTC clusters presence in NSCLC patients and in high-risk screening individuals with no or benign nodules in a screening low-dose computed tomography (LDCT). In this prospective pilot trial, healthy never-smoking subjects were included as controls. Experts identified CTC clusters in 12/29 (41.4%) of all NSCLC patients but these were absent in 31 high-risk screening individuals with Lung-RADS (lung imaging reporting and data system) 1 or Lung-RADS 2. In NSCLC patients (100%) and in 18/31 (58.1%) of high-risk screening subjects, single CTCs, since non-clustered, were detectable. In 20 healthy controls, no CTCs were found. In this study, the utility and specificity of CTC clusters as a liquid biomarker to further explore for screening by LDCT and risk stratification of NSCLC patients is shown.