It has been suggested that the combination of etoposide, leucovorin and 5-fluorouracil (ELF) is very active in the treatment of advanced gastric cancer in elderly patients. The aim of this study was to confirm the efficacy and to investigate the toxicity of the ELF-regimen in patients of all ages. Thirty patients with advanced gastric adenocarcinoma were treated with leucovorin (300 mg/m2), etoposide (100 mg/m2) and 5-FU (500 mg/m2) for 3 consecutive days every 4 weeks in a phase II study. Reevaluation of measurable disease was done after 3 cycles. A partial response was shown in 8 (27%) patients. An improvement of the Karnofsky Performance Status was observed in 10 (33%) patients. The mean survival amounted to 8 months (range 2-24). Toxicity was mild. No grade 4 toxicity nor chemotherapy-related mortality were observed. It is concluded from this phase II study that the ELF-regimen is an active palliative treatment for advanced gastric cancer, with mild toxicity.