PurposeAnlotinib　is　widely　used　in　the　treatment　of　lung　cancer.　However,　there　remains　a　lack　of　predictive　biomarkers　to　effectively　gauge　the　response　to　anlotinib　therapy.　We　conducted　a　retrospective　study　to　preliminarily　explore　potential　risk　factors　that　might　predict　outcomes　in　lung　cancer　patients　undergoing　anlotinib　treatment.　Patients　and　MethodsWe　retrospectively　analyzed　lung　cancer　patients　treated　with　anlotinib　at　our　hospital　between　1　June　2018　and　1　June　2021.　Data　were　gathered　from　electronic　medical　records.　Demographic　and　clinical　characteristics　of　patients,　progression-free　survival　(PFS),　and　overall　survival　(OS)　were　described.　Predictive　factors　related　to　treatment　efficacy　were　preliminarily　analyzed　using　Cox　regression　and　Kaplan-Meier　survival　analyses.　ResultsAfter　adjusting　for　potential　confounders,　clinical　stage　IV　(hazard　ratio　[HR]　=　2.52,　95%　confidence　interval　[CI],　1.09-5.82,　p　=　0.0311),　N-terminal　fragment　brain　natriuretic　peptides　(NT-pro-BNP)　＞　300　pg/mL　(HR　=　2.54,　95%　CI,　1.17-5.52,　p　=　0.0183),　and　neuron-specific　enolase　(NSE)　＞　16.3　ng/mL　(HR　=　1.70,　95%　CI,　1.03-2.81,　p　=　0.0389)　were　associated　with　shorter　OS,　whereas　age　(HR　=　0.96,　95%　CI,　0.94-0.99,　p　=　0.0055)　was　associated　with　a　longer　PFS　in　fully　adjusted　model.　Kaplan-Meier　analyses　of　cumulative　risk　factors　(clinical　stage　IV,　NT-pro-BNP　＞　300　pg/mL,　and　NSE　＞　16.3　ng/mL)　indicated　that　patients　with　a　greater　number　of　coexisting　risk　factors　had　significantly　shorter　OS　(p　＜　0.0001).　ConclusionClinical　stage　IV,　NT-pro-BNP　level,　and　NSE　level　were　identified　as　independent　prognostic　factors　for　lung　cancer　patients　undergoing　anlotinib　treatment.　Patients　with　multiple　high-risk　factors　may　derive　limited　benefit　from　anlotinib.