The first-line therapeutic recommendations for patients with lung adenocarcinoma without an EGFR-sensitizing mutation or ALK or ROS1 gene rearrangement with a good performance status are the following: (a) with high PD-L1 expression and non-contraindications, single-agent pembrolizumab is recommended; (b) with low PD-L1 expression, a variety of combination cytotoxic chemotherapies (platinum doublet with pemetrexed ± bacivuzumab or carboplatin/pemetreexed/pembrolizumab). The gene discussed is ROS1; the disease is lung adenocarcinoma.