Lung cancer remains the foremost cause of cancer-related mortality worldwide, with approximately 40% of adenocarcinoma cases lacking identifiable driver genes and effective targeted therapies. Consequently, chemotherapy, immune checkpoint inhibitors and their combination regimens constitute the primary therapeutic approaches. In recent years, immunotherapy has markedly enhanced patient survival rates and has been established as a standard first-line treatment.However, issues of primary resistance remain significant. Current research has increasingly focused on novel immune checkpoints and bispecific antibodies, which aim to reverse the immunosuppressive tumor microenvironment. Furthermore, the combination treatment strategy of immunotherapy plus anti-angiogenesis and antibody-drug conjugates has demonstrated superiority over traditional regimens. In the area of technological innovation, emerging biological treatment modalities, including personalized vaccines, oncolytic viruses and CAR-T cell therapy, have shown promising antitumor activity in advanced clinical trials. Future efforts should prioritize the elucidation of resistance mechanisms, the identification of biomarkers, and the implementation of multidisciplinary comprehensive management to further refine and optimize the therapeutic landscape.