A dose escalation study of carboplatin in combination with 5FU and epirubicin in surgically incurable gastric cancer. Carboplatin was combined with a fixed dose epirubicin 35 mg/m2, leucovorin 250 mg/m2 and 5 FU 500 mg/m2 (CELF). The starting dose of carboplatin w as 100 mg/m2 which was escalated to 150 mg/m2. This CELF regimen was repeated every week, for a maximum of 14 cycles. Primary prophylaxis against leucopenia with filgastrim w as given. Twelve chemotherapy naive patients were enrolled, 9 w ith metastatic disease and 3 with locally advanced surgically irresectable disease. The major toxicities of the CELF regimen were uncomplicated leucopenia and thrombopenia. Nausea and mucositis were the most common nonhematological toxicities. The dose-limiting toxicity was grade 3 leucopenia, observed at a dose of 150 mg/m2/week. The objective response rate was 58% (95% CI 31%-85%). From the three patients with localized but surgically incurable disease two remain alive without disease progression and without sym ptoms after 6 and 9 years after chemotherapy without any other treatment.