If you cannot take targeted drugs for lung adenocarcinoma, you will have to undergo systemic chemotherapy. The first choice for lung adenocarcinoma is pemetrexed combined with platinum-based combination chemotherapy. If the patient’s health condition is poor and cannot tolerate the combination chemotherapy, he can also choose pemetrexed monotherapy. Bevacizumab combined with chemotherapy can also be combined with bevacizumab, a targeted anti-tumor angiogenesis drug. Bevacizumab combined with chemotherapy can improve the efficacy, and if the lesion is more limited to the lung, radiotherapy for lung tumor can also be considered. If chemotherapy fails, consider changing to another chemotherapy regimen to continue chemotherapy. If the lesions still progress after two chemotherapy regimens are used, you can try oral anlotinib or apatinib, two targeted drugs that can be taken without genetic testing.