The first-line treatment of advanced non-small cell lung cancer first needs to clarify the pathological tissue type, and different follow-up standardized testing and treatment choices for different pathological types: 1. Squamous carcinoma: Data from Europe and the United States show that because the EGFR mutation rate is very low (about 3%, multiplied by 70% efficiency, the actual first-line squamous carcinoma population benefiting from it is only about 2%), so there is no need to do EGFR mutation testing. Directly choose chemotherapy (class 1: efficacy: OR 25-35%; MST8-10M; 1-year survival rate 30-40%) or NP+/-cetuximab (class 2b: NP+C225 regimen MST 11.3M (12 months for adenocarcinoma, 10.2 months for squamous cancer)); Note: I attended a meeting on targeted lung cancer therapy in early June, at which Prof. Wu Yilong mentioned that the proportion of EGFR mutation in Chinese patients with squamous lung cancer was higher than that in European and American populations (about 10%). Therefore, it is better to give each patient a chance to be tested once for Chinese squamous lung cancer patients, but these are subject to the standardization of testing methods, reliability and reasonable testing costs. 2.Non-squamous cancer: For non-squamous cancer, we also need to test EGFR mutations, mainly at Exon18, 19 and 21 loci (some data show that exon 19 mutations are more effective than exon 21). If (1) EGFR mutation, direct selection of Iressa or Tarceta with >70% efficiency; PFS > 9 months, mOS > 2 years; if (2) EGFR wild, chemotherapy, first-line pemetrexed combined with platinum (category 1: adenocarcinoma MST = 12.6 months, non-squamous cancer 11.8 months) is preferred, followed by other new generation platinum-containing two-drug combination regimens (category 1) +/- Bevacizumab (category 2a: no history of coughing up blood, Tax+CBP+Avastin regimen MST up to 12.5 months), or NP+/- Cetuximab (category 2b). From the guidelines we can see that for advanced lung cancer, we have a clear pathological diagnosis first, followed by EGFR mutation or not. Therefore EGFR testing should be promoted to first-line therapy as a routine test. To add, 1. the EGFR mutation rate in Asian population is 35%, and the overall efficiency of EGFR-TKI is 27%. EGFR mutation in NSCLC is more than 70%! 2. The EGFR mutation rate in European and American races is about 10%-16% (mainly occurs in non-squamous cancer), 37.7% in never smokers (5.8% in those who still smoke), 20% in women (8% in men). The effectiveness rate can also reach 70.6% (including CR12.2%, PR58.4%).