1. Histologically confirmed metastatic, or recurrent AGC
2. Previous use of fluoropyrimidine as palliative chemotherapy. Concurrent use of
platinum is permitted. Patient with recurred disease within 6 months after the end of
adjuvant therapy can participate to this trial.
3. Documented HER2 expression status.
4. Radiologically proven progression of disease.
5. Age > 20 years
6. ECOG PS 0 - 2
7. Life expectancy more than 3 months
8. Adequate organ function for treatment including liver, kidney and bone marrow
(absolute neutrophil count (ANC) ≥ 1,500/ul, platelets ≥ 100,000/ul, AST/ALT ≤ 2.5 x
ULN, ≤ 5.0 x ULN if liver involvement, Total serum bilirubin ≤ 2.0 mg/dL)
9. Written informed consent
1. Prior administration of taxane or anthracycline as palliative chemotherapy. If those
agents were used as adjuvant or neoadjuvant aim, at least 6 months should be passed.
2. Uncontrolled medical comorbidities Congestive heart failure (NYHA class III or IV)
Recent (within 6 months) unstable angina or myocardial infarct Clinically significant
cardiac arrhythmia LVEF < 45% Liver cirrhosis (Child-Pugh class B or C) Interstitial
pneumonia Psychiatric illness/social situations that would limit compliance with
3. Active CNS metastasis not controllable with radiation or steroid
4. Concurrent administration of systemic chemotherapy or radiotherapy. Palliative
radiotherapy for pain control more than 2 weeks ago is acceptable.
5. Pregnant or lactating women.
6. Peripheral neuropathy G3~4.
7. Metachronous malignancy other than adequately treated CIN of uterine cervix, basal
cell or squamous cell carcinoma of the skin.