Gastric cancer is one of the most chemosensitve tumors of the gastrointestinal tract. Chemotherapy treatment in patients with metastatic disease has been shown to improve quality of life and prolong survival. There are a number of second-generation active regimens that give high response rates and are currently being assessed in phase III studies. Ultimately these regimens will find their role in the preoperative and adjuvant setting. At present, in patients with metastatic disease, there is a need to compare these regimens to single-agent schedules with less toxicity. Continued optimism is necessary in gastric cancer with new types of drugs, high-dose treatment and revisiting old drugs--all potential ways of increasing the cure rate in this disease.