In NSCLC, Complete Blood Count a Promising Prognostic Biomarker

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A new complete blood count-based score predicted worse outcomes in patients with non-small cell lung cancer treated with immune checkpoint inhibitors.

Complete blood cell (CBC) values hold promise as a cost-effective prognostic biomarker in non-small cell lung cancer (NSCLC), according to findings presented at the 2025 ASCO Annual Meeting.

Lung cancer remains the leading cause of cancer-related mortality worldwide, claiming approximately 1.8 million lives each year. Of these cases, roughly 85% are classified as NSCLC.

The advent of immune checkpoint inhibitors (ICIs) has reshaped the treatment landscape for advanced NSCLC, yielding significant improvements over traditional second‑line chemotherapeutic options. Despite these advances, robust, easily accessible prognostic markers remain an unmet clinical need.

Researchers analyzed medical records to evaluate the prognostic value of routine CBC components in patients with advanced NSCLC receiving ICI therapy. Researchers at Barretos Cancer Hospital conducted a retrospective study that included 105 patients. The cohort was predominantly male (58%) and comprised primarily of stage IV disease (61%), with adenocarcinoma as the most common histology (57%). Most patients (62.9%) had PD‑L1–positive disease, and approximately four in five received anti–PD‑1 therapy. Only 11% of patients had never smoked.

Researchers introduced a novel Score 1 variable, calculated as the product of red cell distribution width (RDW) and erythrocyte count. Using SPSS software, the researchers assessed this parameter and its association with clinical outcomes after three cycles of ICI therapy.

The study found a significant correlation between elevated Score 1 levels (greater than 5.4) and adverse clinical outcomes. Patients with a Score 1 exceeding this threshold had significantly reduced overall survival (P=0.042) and progression‑free survival (P=0.049).

The researchers concluded that their findings underscore the need for effective NSCLC treatment with ICIs.

“The potential of CBC values as cost-effective prognostic biomarkers is promising, offering a valuable tool to refine treatment strategies and improve patient outcomes,” wrote study author Katiane Tostes and colleagues.