The study conducted by Okunaka et al. [41] showed that the addition of ramucirumab (VEGF inhibitor) to trifluridine-tipiracil versus trifluridine-tipiracil monotherapy does not show a benefit for the PFS of patients with advanced gastric cancer (HR 0.66; 95% CI 0.43–1.03; p = 0.059). This evidence concerns the gene VEGFA and gastric cancer.