The function of 3 angiogenesis-related mediators, such as VEGF-A, VEGF-D, and sVEGFR-2, as potential prognostic and predictive biomarkers in metastatic GC treated with second-line paclitaxel plus ramucirumab. We reported an association between higher baseline levels of VEGF-A and shorter OS. We also found an association between elevated sVEGFR-2 levels after 1 cycle and prolonged PFS and OS. Here, VEGFD is linked to gastric cancer.