Hyun MH, et al. - Researchers sought to describe the significance of quantifying cell-free DNA (cfDNA) as a promising measure of the biological behavior/aggressiveness of tumors. Further, they investigated the clinical implications of assessment of metabolic tumor burden for recognizing patients who need more aggressive treatment in advanced non-small cell lung cancer (NSCLC). A precise assessment of metabolic tumor burden could be done via measuring metabolic tumor volume (MTV) and total lesion glycolysis (TLG) by positron emission tomography/computed tomography scan. One hundred one newly diagnosed advanced NSCLC (stage III-IV) patients with measurable baseline MTV, TLG, and cfDNA quantification were studied in the current prospective trial. Findings revealed a poor prognosis for patients with high metabolic tumor burden, irrespective of the biological behavior/aggressiveness of the tumor. However, a poor prognosis was also noted for patients with low metabolic tumor burden and high cfDNA levels. Taken together, baseline cfDNA levels are suggested to have a stronger prognostic value for recognizing patients with advanced NSCLC and personalizing their treatment approaches for better survival.