Expression of EGF and EGFR was detected in about 62.1% and 51.5% gastric cancer tissues, respectively. Tumors with simultaneous expression of EGF, TGF-alpha, EGFR and p185c-erbB-2 were associated with a high BrdU labeling index, rapid tumor growth, and an unfavorable outcome. Teramoto et al. have shown a dose-dependent growth inhibition of an anti-EGFR monoclonal antibody (MoAb 528) on EGFR-overexpressing human gastric cancer cells, both in vitro and in vivo. We have recently demonstrated that cetuximab is cytotoxic to human gastric cancer cells, and cetuximab has a chemo-sensitizing effect for cisplatin and 5-FU in human gastric cancer cells (Yeh et al, unpublished observation). We hypothesize that the combination of cetuximab with P-HDFL will further improve the efficacy of the latter on advanced gastric cancer.