In this retrospective study, we evaluated the activity and toxicity of the combination of 5-fluorouracil (5-FU), epirubicin and cisplatin (FEP) in previously untreated patients with metastatic gastric cancer. Sixty-five patients received 5-FU 300 mg/m² on days 1-5, epirubicin 50 mg/m² on day 1 and cisplatin 60 mg/m² on day 1, every 4 weeks. A median of 4 cycles was administered. There were 4 partial responses and 1 complete response (overall response rate 7.6%); 16 patients had stable disease. Median progression-free and overall survival rates were 3 months (95% CI 1.9-4) and 6 months (95% CI 4.2-7), respectively. The principal toxicity was myelosuppression. Grade 3-4 neutropenia occurred in 29.2%, anemia in 18.4%, and thrombocytopenia in 12.3% of patients. Non-hematological toxicity was mild and manageable. We concluded that FEP combination as used at the doses and schedules in this study has inferior activity against metastatic gastric cancer. [Turk J Cancer 2005;35(3):132-135].