treatment of patients with advanced gastric carcinoma with the combination of etoposide plus oral tegafur modulated by uracil and leucovorin a phase ii study of the oncopaz cooperative group background both the biochemical modulation and the continuous administration of 5fluorouracil 5fu have achieved promising results in patients with gastric carcinoma conversely several studies on gastric carcinoma have demonstrated that the combination of etoposide vp16 leucovorin lv and 5fu elf is efficacious and moderately toxic uft is a combination of uracil and tegafur ftorafur in a 41 molar ratio it can be administered orally for several weeks thus stimulating the effects of a continuous infusion of 5fu its combination with lv increased the efficacy of uft we conducted a phase ii study on patients with gastric carcinoma using the combination vp16lvuft this combination is administered mainly orally po and could yield a good response rate and low toxicitymethods fortysix patients with bidimensionally measurable disease were entered into the study patients received vp16 100 mgm2 iv on day 1 and 200 mg m2 po on days 2 and 3 lv 500 mgm2 administered intravenously iv on day 1 followed by po lv 15 mg every twelve hours on days 2 to 14 patients also received uft po 390 mgm2day on days 1 to 14 treatment was repeated every 28 days for a minimum of 3 courses per patient all courses were given on an outpatient basisresults four patients 9 had a complete response and 12 a partial response 26 for an overall response rate of 35 95 confidence interval 2251 the median duration of response was 10 months the median overall survival was 9 months the main side effects were gastrointestinal grade 3 to 4 toxicity was encountered as follows diarrhea in 17 of the patients nauseavomiting in 11 anemia in 13 mucositis and leukopenia in 4 each and thrombocytopenia in 2 one patient died of sepsis and neutropeniaconclusions vp16lvuft has an activity comparable to that of other schemes and a low incidence of side effects furthermore since it is administered mainly orally hospitalization is avoided which makes this scheme suitable for patients with advanced gastric carcinoma