Ramucirumab (Cyramza), Nal-IRI (ONIVYDE) and Trifluridine/Tipiracil (Lonsurf) in Second Line Metastatic Gastric Cancer .

This study tests a three-drug combination — ramucirumab, nal-IRI, and trifluridine/tipiracil — as a second-line treatment for people with metastatic stomach cancer (or cancer of the stomach-esophagus junction) that has progressed after one prior treatment. **You may be eligible if...** - You are between 20 and 80 years old - You have confirmed metastatic stomach cancer or gastric junction cancer - Your cancer has progressed after only one prior line of chemotherapy - Your general health score (ECOG) is 0 or 1 - Your blood counts, kidney, and liver function meet the required levels - If your cancer is HER2-positive, you have previously received Herceptin (trastuzumab) **You may NOT be eligible if...** - You cannot swallow oral medications - You have a known allergy to irinotecan, fluoropyrimidine, or ramucirumab - You have had surgery in the past 4 weeks - You have significant diarrhea or fluid in the abdomen - You are pregnant or planning to become pregnant Talk to your doctor to see if this trial is right for you.