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Chapter 480developed and expanded in an effort to improve the still dismal perspectives of patients suffering from metastatic esophagogastric cancer.In conclusion this phase 2 trial has demonstrated that folic acid and vitamin B12 supplementation does not improve the RR, PFS or OS of cisplatin and gemcitabine in patients with AEGC. We here show that the combination of gemcitabine/cisplatin is a reasonable alternative treatment schedule for patients with AEGC in case of dysphagia or preexistent neuropathy.Conflict of InterestThe authors declare that they have no conflict of interest.Financial supportAmgen and Lilly provided financial support for this study.