Stage IV lung adenocarcinoma patients need to improve the genetic test, and according to the genetic test results, they are categorized into driver gene-positive targeted therapy, and non-driver gene-positive therapy, including systemic chemotherapy, immunotherapy and radiotherapy. 1. Driver gene positive treatment for stage IV lung adenocarcinoma: EGFR gene positive targeted drugs include gefitinib, erlotinib, erlotinib, ectinib, ositinib, etc.; ALK fusion-positive targeted drugs include alectinib, crizotinib, ceritinib, etc.; ROS1 positive targeted drugs include crizotinib. 2. Treatment of stage IV lung adenocarcinoma without driver gene positivity: first-line treatment includes Platinum-containing two-drug chemotherapy, such as pemetrexed/gemcitabine/paclitaxel liposome + carboplatin/cisplatin; Platinum-containing two-agent combination immunotherapy, e.g., pemetrexed + carboplatin/cisplatin + pabrolizumab/caririlizumab/sindilizumab; Immune monotherapy, such as pabolizumab, atelizumab single-agent immunotherapy. Note: Lung adenocarcinoma treatment needs to be individualized according to the patient’s physical condition score and age.