Abstract: Objective To investigate the efficacy and safety of rh-endostatin （endostar） combined with docetaxel，platinates and fluoropyrimidines as first-line chemotherapy for advanced gastric cancer. Methods Twenty-five patients with advanced gastric cancer were enrolled into this study from Jan. 2011 to Jun. 2013. Seventeen patients received docetaxel， oxalipatin and flourouracil （DOF） regimen： docetaxel 40mg/m2 iv， d1；oxaliplatin 85mg/m2 iv，d2；flourouracil 400mg/m2 iv， 600mg/m2 continuous iv 22h d2-d3, with 2 weeks as a cycle. Eight patients received docetaxel， cisplatin and capecitabine （DCX） regimen： docetaxel 40mg/m2 iv， d1；cisplatin 25mg/m2 iv， d2-d3；capetitabine 1000mg/m2 bid po， d1-d8, with 2 weeks as a cycle. Endostar was administered 15mg/d iv, d1-d10. The response rate was evaluated according to RECIST1.1 criteria，and the toxicities were evaluated according to NCI CTC 3.0 standard. Progression-free survival （PFS） and overall survival （OS） were also observed. ResultsAmong the 24 evaluable cases， PR was observed in 10 patients， SD in 6 patients， and PD in 8 patients. The response rate was 41.7%， and the disease control rate was 66.7%. Digestive reaction and myelosuppression were the most common toxicities. Neutropenia（6 cases） was the most frequent grade 3-4 toxicity. One patient experienced cardiac toxicity. The median follow-up was 14.6 months, the median PFS was 8.0 months，and the median OS was 11.0 months. Conclusion Endostar combined with docetaxel，platinates and fluoropyrimidines is an effective and safe regimen as first-line chemotherapy for advanced gastric cancer. It is worthy of further large scale clinical trial.