 Non-resectable gastric cancer is an incurable disease, with a median survival of 4 months if untreated. Systemic chemotherapy confers prolongation of survival and improvement of quality of life. Regimens containing cisplatin and 5-fluorouracil 5-FU are widely adopted in the world. The overall response rate and median overall survival of the P-HDFL regimen cisplatin and weekly 24-hour infusion of high-dose 5-FU and leucovorin for advanced gastric cancer are 60 45-76, 95 C.I. and 10 months, respectively. This regimen P-HDFL is very popular in Taiwan because of high objective response rates and low treatment-related toxicities. Adding a third active chemotherapeutic agent to cisplatin and 5-FU doublet does not seem to improve efficacy. Further, most of the patients with recurrent or metastatic gastric cancer are frequently associated with a poor general condition which prohibits intensive chemotherapy. Therefore, combination of P-HDFL with biologic agentssuch as everolimus, etc.is an attractive alternative. 