In a previous study, we used a modified FOLFOX regimen with the omission of bolus 5-FU with the aim to improve tolerability of such regimen in the elderly population, while preserving the outcome. This strategy was adopted based on the results of previous and ongoing studies of oxaliplatin/5-FU combination regimens. We attained an overall response rate of 34.9 %, which compared favorably with other phase II studies of FOLFOX chemotherapy, ranging from 32.2 % to 52.5 % (see Table 5). This overall response rate was noteworthy if we consider that all the patients had metastatic or recurrent gastric cancer compared with other studies in which a variable percentage (from 8 % to 35 %) of enrolled patients had locally advanced disease. We observed no grade 4 toxicity, whereas grade 1-3 gastrointestinal toxicities were reported in a moderate number of patients. The modified FOLFOX (m FOLFOX) regimen showed a 9.3% occurrence of grade 3 to 4 neutropenia, which is lower than reported in other studies.