45 patients (pts), 26 male & 19 female with gastric AC, with non-resectable adenocarcinoma were treated with E (50 mg/m2) and C (60 mg/m2) given every 3 weeks, with a continuous ambulatory infusion of F (200 mg/m2 per day). A cohort of 19 pts presenting from April 1993 to Sept 1994 were added to 26 previously reported cases. ECOG score 0-1, median age 61 (29-81), 258 cycles were given (1–12, median 6). All pts had a degree of alopecia no greater than Grade III. A single case of grade IV toxicity was seen (diarrhea). Grade III toxicity was seen as follows: vomiting 2 pts, diarrhea 2 pts, stomatitis 2 pts, infection 5 pts. Nine pts had mild foot & mouth syndrome. Five pts were not evaluable for response (3 early deaths and 2 stopped early due to toxicity). Of 40 evaluable pts, reassessed at 9 weeks, 57% responded- 2 (5%) CR, 21 (52%) PR, 13 stable disease & 4 progressed. Median survival was 9 months (1.4- 41+). We conclude that ECF has a high response rate in non-resectable gastric AC. Response rates in this cohort were similar to our previous report. A randomised phase III trial of ECF versus FAMTX, is open for accrual to assess the true value of this innovative regimen. 45 patients (pts), 26 male & 19 female with gastric AC, with non-resectable adenocarcinoma were treated with E (50 mg/m2) and C (60 mg/m2) given every 3 weeks, with a continuous ambulatory infusion of F (200 mg/m2 per day). A cohort of 19 pts presenting from April 1993 to Sept 1994 were added to 26 previously reported cases. ECOG score 0-1, median age 61 (29-81), 258 cycles were given (1–12, median 6). All pts had a degree of alopecia no greater than Grade III. A single case of grade IV toxicity was seen (diarrhea). Grade III toxicity was seen as follows: vomiting 2 pts, diarrhea 2 pts, stomatitis 2 pts, infection 5 pts. Nine pts had mild foot & mouth syndrome. Five pts were not evaluable for response (3 early deaths and 2 stopped early due to toxicity). Of 40 evaluable pts, reassessed at 9 weeks, 57% responded- 2 (5%) CR, 21 (52%) PR, 13 stable disease & 4 progressed. Median survival was 9 months (1.4- 41+). We conclude that ECF has a high response rate in non-resectable gastric AC. Response rates in this cohort were similar to our previous report. A randomised phase III trial of ECF versus FAMTX, is open for accrual to assess the true value of this innovative regimen.