Recently, the American Society of Clinical Oncology (ASCO) released an update to its guidelines for the systemic treatment of advanced non-small cell lung cancer (Stage IV NSCLC); this update is more than 6 years after the last update (2009) and emphasizes the importance of targeted therapy and palliative care in the treatment of advanced NSCLC compared to traditional platinum-based chemotherapy regimens. 1. There is no cure for patients with stage IV non-small cell lung cancer. 2. The decision to treat patients with chemotherapy should not be based on age alone. First-line therapy 1. For patients without EGFR-sensitive mutations or ALK gene rearrangements in mesenchymal lymphoma kinase, but with a Performance Status1 (PS) of grade 0-1 (or some grade 2): a combination chemotherapy regimen of cytotoxic agents, with preference for platinum-based agents, combined with early palliative2 and symptomatic treatment is recommended. Treatment varies based on the histologic characteristics of the tumor (e.g., phospho- and non-phospho-cellular carcinoma). (I, A) 2. The addition of bevacizumab to the carboplatin + paclitaxel regimen is recommended in the absence of contraindications to treatment. (II, A) 3. In patients with PS grade 2: combination or single chemotherapy or palliative therapy alone may be used. (Chemotherapy III, B; palliative I, B) 4. For patients with EGFR- sensitive mutations: Afatinib, erlotinib or gefitinib are recommended; (I, A) 5. For patients with ALK gene rearrangements: crizotinib is recommended; (II, B) 6. 6. For patients with ROS1 gene rearrangement: crizotinib is recommended; (Informal Consensus, III, C). 7. First-line therapy should be discontinued in patients with progressive disease or disease that does not improve significantly after 4 rounds of chemotherapy. 8. For patients whose disease status is controlled or improved after 4 rounds of pemetrexed-containing chemotherapy: pemetrexed maintenance may be continued; if the initial chemotherapy regimen does not contain pemetrexed, consider switching chemotherapy regimens (switch) or suspending chemotherapy until disease progression; (Add pemetrexed: II, B) Second-line therapy 1. cell carcinoma (NSCC) patients: docetaxel, erlotinib, gefitinib, or pemetrexed may be considered; (I, A) 2, for patients with squamous cell carcinoma: docetaxel, erlotinib, and gefitinib are acceptable; (I, A) 3, for patients with EGFR-sensitive mutations but with first-line EGFR tyrosine kinase inhibitors ( tyrosine kinase inhibitor (TKI) therapy: the use of cytotoxic drugs in combination with chemotherapy regimens is recommended for patients with NSCC. (Informal Consensus, I, B) 4. For patients with EGFR-sensitive mutations that are effectively treated with EGFR-TKIs initially but not controlled later: consider changing chemotherapy regimens or switching to another EGFR-TKI (Informal Consensus, III, C) 5. For patients with ALK gene rearrangements that are not controlled with first-line crizotinib: consider chemotherapy or ceritinib. (Chemotherapy I, A; ceritinib II, B) Third-line therapy 1. Patients with PS grade 0-3 who have not been treated with erlotinib or gefitinib: consider erlotinib. 2. Data are incomplete for conventional third-line cytotoxic drug therapy.