Nonetheless, the combination of ramucirumab, a recombinant human immunoglobulin G1 monoclonal antibody that binds to the extracellular binding domain of VEGFR-2, with paclitaxel is widely considered the optimal second line of treatment in metastatic GC.[32,33] The study result of gastric cancer indicate a lower efficacy of second-line paclitaxel + ramucirumab in the treatment of advanced GC in patients with lung metastases. This evidence concerns the gene KDR and gastric cancer.