 Standard chemotherapy for advanced gastric cancer AGC in the US is Cisplatin5-FU CF or docetaxelCF DCF, is in Europe epirubicinCF ECF or epirubicinoxaliplatin capecitabine EOX. Until 2006, there was no evidence of standard chemotherapy for AGC in Japan. In 2007, by the results of JCOG9912 trial 5-FU alone vs. CPT-11CDDP vs S-1 and SPIRITS trial S-1 alone vs. S-1CDDP, S-1CDDP is regarded as a new standard regimen in Japan. In 2008, by the results of TOP-002 trial s-1 alone vs. S-1CPT-11, S-1CPT-11 could not show the superiority to S-1 alone. One of the other phase III trials, JACCRO GC-03 trial S-1 alone vs. S-1docetaxel, NCT00287768 is now ongoing. However, the position of CPT-11 in the treatment of AGC will be regarded as a second-line. 