Combination of CPT-11 and LoHP vs Combination of 5-FU, Leucovorin and LoHP as 1st Line Treatment in Gastric Patients

Inclusion Criteria: * Histologically confirmed locally advanced or metastatic gastric cancer. * Measurable or evaluable disease. * Measurable disease is defined as at least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques or 1 bidimensionally measurable lesion ≥ 20 X 10 mm. Lesions that are smaller or uni- or bidimensionally unmeasurable are considered as evaluable disease. * Previous adjuvant chemotherapy with Irinotecan, Oxaliplatin and/or 5-FU based regimen. Patients who relapse within the first 6 months after the completion of adjuvant treatment are not eligible for the study. * Karnofsky performance status \> 70%. * Age ≥18 years. * Adequate liver (Bilirubin ≤ 1.5 UNL, SGOT/SGPT ≤ 4 UNL, ALP ≤ 2.5 UNL), renal (Creatinine ≤ 1.5 UNL) and bone marrow (ANC ≥ 1,500/mm3, PLT ≥ 100,000/mm3) function. * Patients must be able to understand the nature of this study and give written informed consent. Exclusion Criteria: * Active infection * History of serious cardiac disease (unstable angina, congestive heart failure, myocardial infarction within the previous 6 months, ventricular arrhythmias) * Previous radiotherapy within the last 4 weeks or \> 25% of bone marrow. * Patients with CNS metastases * Patients with chronic diarrhea (at least for 3 months) or partial bowel obstruction. * Malnutrition or loss of \> 10% of body weight during the last month. * Peripheral neuropathy ≥ grade 2 * Second primary malignancy, except for non-melanoma skin cancer and in situ cervical cancer. * Psychiatric illness or social situation that would preclude study compliance. * Pregnant or lactating women.