We reported the cases of two patients affected by metastatic gastric cancer exposed to second line therapy with ramucirumab plus paclitaxel after progression. Both obtained a fast marker reduction with a very favourable toxicity profile. In the first case, a woman affected by peritoneal carcinomatosis, the disease had been stable for 8 months despite of the chemotherapy suspension after 3 cycles; whereas in the second case, a highly symptomatic man with a heavy tumor load (gastric tumor and multiple bone, node and peritoneal metastases) obtained an immediate clinical benefit even if of relatively short duration with a good tolerability.