Abstract: Objective To evaluate the efficacy and toxicity of celecoxib(CXB) combined with pemetrexed(PEM) plus carboplatin(CBP) as a first-line therapy for advanced pulmonary adenocarcinoma. Methods Forty-three eligible patients were randomly assigned into two groups. In Group A, 22 patients were treated with CXB combined with PEM plus CBP regimen; in Group B, 21 patients were treated with PEM plus CBP alone. PEM and CBP were repeated every 3 wk, whereas CXB was continued with no interruption until the progression of disease or serious adverse events occurred. The efficacy was evaluated every 2 cycles and adverse reactions were observed every day. Results There was no significant difference in the remission rate (RR) or disease control rate (DCR) between Group A and Group B (40.90% vs. 38.10%, 86.37% vs. 85.72%, P=0.863). The median progression free survival time(mPFS) and the median overall survival time (mOS) in Group A were higher than those in Group B(6.97 m vs. 6.37 m, 14.8 m vs. 11.3 m), but there was no statistically significant difference (P= 0.294, P=0.436). The one-year OS rate in Group A was two times higher than that in Group B, with no statistically significance unexpectedly(21.10% vs. 10.00%, P=0.339). Improved quality of life (QOL) in Group A was significantly higher than that in Group B(77.27% vs. 42.86%，P=0.031), while toxicity rates were similar (P>0.05). Conclusion Although CXB combined with PEM plus CBP as a first-line therapy for advanced pulmonary adenocarcinoma couldn't improve the DCR, it could significantly improve the QOL without any increase of toxicity incidence. Therefore, the therapy is valuable to some degree in the clinical application and further study is needed.