A preoperative hemoglobin level of less than 10 g/dL correlated with “significantly inferior” overall survival (OS) among patients with resectable non–small cell lung cancer (NSCLC) who were diagnosed with neoadjuvant chemoimmunotherapy-induced anemia, according to results from a recent study.
Jessica Hwang, MD, of The Ohio State University Wexner Medical Center, and colleagues conducted the study and published their findings as an abstract during the National Comprehensive Cancer Network (NCCN) 2026 Annual Conference.
The investigators highlighted that although neoadjuvant chemoimmunotherapy (chemo-IO) is a “standard of care” for patients with resectable NSCLC, “real-world data on treatment outcomes and laboratory biomarkers predictive of prognosis remain limited.”
To expand on the limited research on predictive biomarkers for survival in resectable NSCLC care, Dr. Hwang and her colleagues evaluated “the characteristics, clinical outcomes, and hematologic biomarkers” associated with OS among patients with the disease who received treatment with neoadjuvant chemo-IO.
A retrospective analysis was conducted, examining patients with resectable stage IIA-IIIC NSCLC “who received neoadjuvant chemo-IO at The Ohio State University and National Cheng Kung University Hospital” between 2020 and 2025. The chemo-IO they received included “platinum doublet chemotherapy with an anti-PD-1 or anti-PD-L1 antibody.”
A total of 79 patients were included in the retrospective analysis. The investigators highlighted that the cohort had a median age of 65 years at diagnosis and that the “racial distribution was White (53.2%), Asian (36.7%), and other (10.2%).” Most patients had a histologic diagnosis of adenocarcinoma (48.1%); other histologic diagnoses included squamous cell carcinoma (32.9%) and poorly differentiated carcinoma (8.9%).
The investigators also described the different immunotherapy regimens that were administered, with most patients receiving nivolumab (67.1%). Other immunotherapies included pembrolizumab (26.6%) and durvalumab (6.3%). In addition, the “baseline mean hemoglobin (Hgb) was 13.0 g/dL,” which decreased to 11.7 g/dL after administration of neoadjuvant chemo-IO before surgery was performed; a total of 10 patients (12.7%) had Hgb levels of less than 10 g/dL before surgery.
The results revealed that “patients with preoperative Hgb < 10 g/dL demonstrated significantly decreased OS compared with those with Hgb ≥ 10 g/dL (p = 0.004).” The investigators highlighted that “baseline Hgb or changes in Hgb during treatment were not significantly associated with survival outcomes.”
In reflecting on the findings, the investigators concluded that the results “highlight the need for further evaluation of perioperative optimization strategies, appropriate timing of surgery in this population, and validation in larger cohorts.”