Abstract: We all know that molecular targeted therapy could significantly improve the survival and quality of life of the patients with advanced lung adenocarcinoma. Nevertheless, most patients with advanced lung adenocarcinoma still receive standard first-line chemotherapy treatment because of individual difference or economic factors, and their best therapeutic option is platinum-based chemotherapy. Moreover, the platinum-based chemotherapy is the standard second-line treatment after progression to an EGFR-inhibitor in EGFR-mutated patients currently. Several potential markers, such as excision repair cross-complementing 1 (ERCC1) and breast cancer susceptibility gene 1 (BRCA1) associated with resistance to platinum, class Ⅲbeta-tubulin (TUBB3) associated with resistance to paclitaxel, have been investigated to predict the outcome of platinum-based chemotherapy. Epidermal growth factor receptor (EGFR) could also provide predictive information to customized chemotherapy. This paper will draw a summary on the predictive factors and the molecular mechanism for customizing chemotherapy on advanced lung adenocarcinoma patients.