Background: Cisplatin is an active drug in advanced gastric cancer and acts synergis-tically with etoposide and 5-fluorouracil (5-FU). These were the reasons for adding cisplatin (P) to the combination of folinic acid, etoposide, and 5-FU (ELF), which is one of the newer and active regimens for the treatment of advanced gastric cancer. Patients and Methods: 29 patients with advanced gastric cancer were treated with folinic acid (300 mg/m2), etoposide (100 mg/m2), 5-FU (500 mg/m2), and cisplatin (30 mg/m2) intravenously on days 1, 2, and 3. Cycles were repeated on days 22-28. Results: 2 (7%) complete and 9 (31%) partial remissions were achieved. The medium remission duration was 6 months and the median survival time was 7 months. The main toxicity of FLEP was severe myelosuppression of WHO grades 3 and 4 leucocytopenia in 38 and 21 % of the patients. Conclusions: FLEP is an active regimen for gastric cancer with respect to remission induction. However, because of the marked objective and subjective side effects, and a response rate which was not different from ELF alone, the further evaluation of this combination is not meaningful in this tumor.