Historically, patients with advanced gastric or gastro-esophageal junction (GEJ) cancer progressing on their first-line treatment had very limited effective treatment options. Recently, however, several life-prolonging therapies have emerged for these patients, representing an important paradigm shift. In fact, the introduction of ramucirumab-based treatment regimens in second and trifluridine/tipiracil in third line now facilitate a continuum of care for patients with advanced gastric/GEJ cancer. In this new edition of BJMO oncotalks, Dr Veerle Casneuf, gastro-enterologist at the OLZ Hospital Aast talks us through the current therapeutic landscape for advanced stomach cancer, sharing practical advice on how the treatment of these patients can be optimized.