Inclusion Criteria:

- Male or female patients 21 years of age or older at the time written informed consent
is obtained.

- Patients with histologically confirmed adenocarcinoma of the stomach,
gastro-oesophageal junction or distal oesophagus with inoperable locally-advanced
metastatic disease.

- Patients with tumours with immunohistochemical evidence of expression of HER-1 (at
level of + or ++ or +++) and HER-2 (at level of + or ++ or +++) using standard
criteria OR tumours with gene-amplification of HER-2 by standard FISH.

- Patient has received 1 or more prior chemotherapy for the treatment of adenocarcinoma
of the stomach, gastro-oesophageal junction or distal oesophagus with metastatic
disease.

- Patients with prior partial gastrectomy if they can take oral medications, and can
undergo gastroendoscopic biopsies and meet all other inclusion/exclusion criteria.

- Patients with measurable and non-measurable disease per modified RECIST guidelines.
All scans and x-rays used to document measurable or non-measurable disease must be
done within a 28-day period prior to enrollment.

- Patient with Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
(within 14 days prior to enrolment).

- Patient with adequate organ and haematological function as evidenced by the following
laboratory studies within 14 days prior to enrollment:

- Haematological function, as follows:

- Absolute neutrophil count (ANC) ≥ 1.5 x 109/L

- Platelet count ≥ 75 x 109/L

- Haemoglobin ≥ 9 g/dL

- Coagulation functions, as follows:

- Partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) ≤
1.5 x upper limits of normal (ULN) per institutional laboratory normal range

- International normalized ratio (INR) ≤ 1.5

- Renal functions, as follows:

- Serum creatinine ≤ 1.5 x ULN

- Urea ≤ 1.5 x ULN

- Hepatic function, as follows:

- Total bilirubin ≤ 1.5 x ULN

- Serum glutamic oxaloacetic transaminase (SGOT)/aspartate transaminase (AST) and serum
glutamic pyruvic transaminase (SGPT)/ alanine transaminase (ALT) ≤ 2.5 x ULN (≤ 5 x
ULN if liver metastases are present)*.

- Except where due to direct disease involvement of the liver at the discretion of
the investigator.

Exclusion Criteria:

- Patients unable to swallow oral medications

- Patients with persistent gastric outlet obstruction, complete dysphagia or feeding
jejunostomy.

- Patients who underwent radiotherapy to the gastric remnant ≤ 14 days prior to
enrolment. Patients must have recovered from all radiotherapy-related toxicities.

- Patients with total gastrectomy.

- Patients who have uncontrolled, clinically significant symptomatic cardiovascular
diseases within 6 months prior to enrolment, including myocardial infarction,
unstable angina, grade 2 or greater peripheral vascular disease, cerebrovascular
accident, transient ischemic attack, congestive heart failure or arrhythmias not
controlled by outpatient medication.

- Patients with ongoing or clinically significant active infection as judged by the
Investigator.

- Pregnant (i.e., positive beta-human chorionic gonadotropin test) or is breast-feeding
women.