Question 10. 
 
A 58-year-old man presented with haemoptysis, weight loss and worsening breathlessness. 
He was a lifelong heavy smoker. His chest X-ray was abnormal. A CT scan of chest and 
abdomen demonstrated a large mass in the right lower lobe invading into the mediastinum 
and pericardium, extensive mediastinal lymphadenopathy, and bone metastasis (T4, N3, 
M1b). Bronchoscopy and biopsy confirmed a squamous cell carcinoma. Mutation analysis 
revealed that EGFR and K-ras

genes were both wild type. 

 
What is the most appropriate first-line therapy? 
 
A docetaxel 
B erlotinib 
C gefitinib 
D  gemcitabine and cisplatin 
E  pemetrexed and cisplatin