Ogata T, Narita Y, Kumanishi R, et al. - Since use of several drugs in advanced gastric cancer (AGC) is limited due to insufficient oral intake, researchers here assessed the oral intake status of AGC patients during later-line chemotherapy. They retrospectively studied data of AGC patients with disease progression during first-line chemotherapy. “Insufficient oral intake” was described as needing daily intravenous fluids or hyperalimentation. In 589 enrolled patients, at disease progression during first-line, second-line, and third-line chemotherapy, sufficient oral intake was evident in 78.3% (461), 53.3% (314), and 30.4% (179) of patients, respectively. Poor Eastern Cooperative Oncology Group Performance Status, moderate or severe ascites, peritoneal metastasis, prior palliative surgery, and high neutrophil-to-lymphocyte ratio were the factors that correlated to deterioration in oral intake during second-line chemotherapy, whereas poorly differentiated pathology and high neutrophil-to-lymphocyte ratio correlated to deterioration in oral intake during third-line chemotherapy. Findings demonstrated later-line chemotherapy is inefficacious in improving oral intake in patients with AGC, therefore, there is a need for careful adaptation of regimens for patients at risk for impaired oral intake.