Inclusion Criteria:

- Patient with histologically proven adenocarcinoma of stomach or the gastro-esophageal
junction

- Patient with distant metastases laparoscopically proven operative incurability of an
locally advanced gastric cancer or patient with a tumor recurrence after gastrectomy

- Patient with progressive disease under a palliative first-line chemotherapy or
progressive disease within 6 months after termination of a first-line chemotherapy,
defined as objective progression by imaging techniques according to WHO criteria

- Age 18 and 75 years

- Sufficient liver function, defined as serum-bilirubin <1,5 mg/dl (1,5 upper normal
limit), ALT und AST < 3x upper normal limit

- Sufficient renal function, defined as serum creatinine < 1,25 x upper normal limit or
creatinine clearance >60ml/min calculated according to Crockroft-Gault

- Contraction for patient with reproductive potential

- Karnofsky-Index >60%

- Measurable or evaluable tumor manifestation

Exclusion Criteria:

- Tumor progression later than 6 months after termination of first-line chemotherapy

- KI 50% or less

- Patient who have already received a second line chemotherapy for the metastatic
setting (adjuvant chemotherapy and one line of palliative chemotherapy os allowed,
biologic prior therapies are allowed)

- Prior or current second malignancy despite of basal carcinoma of the skin and
curatively treated carcinoma in situ of the cervix

- Uncontrolled infection

- CNS metastases

- Other severe medical illness

- Prior major surgery less than 2 weeks ago

- Parallel treatment with another experimental therapy

- Parallel treatment with another therapy aiming at tumor reduction

- Chronic diarrhea, subileus

- Chronic inflammatory bowel disease or intestinal obstruction

- Pretreatment with irinotecan