Inclusion Criteria:

          -  Written informed consent and HIPAA authorization for release of personal health
             information.

        NOTE: HIPAA authorization may be included in the informed consent or obtained separately.

          -  Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2.

          -  Histological or cytological confirmed locally advanced or metastatic EGA. Known HER2
             status prior to treatment initiation required.

          -  Measurable disease according to RECIST v1.1.

          -  No prior lines of systemic therapy for advanced disease.

          -  Participants who had received neoadjuvant or adjuvant therapy or definitive
             chemoradiation will be allowed to participate if recurrence occurred 6 months or
             longer from the completion of all prior treatments.

          -  Demonstrate adequate organ function as defined below; all screening labs to be
             obtained within 14 days prior to registration

               -  Absolute Neutrophil Count (ANC) ≥1,500 /μl without the use of hematopoietic
                  growth factors

               -  Hemoglobin (Hgb) ≥8 g/dL (blood transfusions are permitted for participants with
                  hemoglobin levels below 8 g/dL)

               -  Platelets ≥100,000 /μl

               -  Serum creatinine ≤1.5 X upper limit of normal (ULN) OR Measured or calculated
                  creatinine clearance (GFR can also be used in place of creatinine or CrCl). CrCl
                  calculation using the Cockcroft-Gault formula. ≥50 mL/min for participants with
                  creatinine levels > 1.5 X institutional ULN

               -  Bilirubin within normal range for the institution (biliary drainage is allowed
                  for biliary obstruction)

               -  Aspartate aminotransferase (AST) ≤ 2.5 X ULN OR ≤ 5 X ULN for subjects with liver
                  metastases

               -  Alanine aminotransferase (ALT) ≤ 2.5 X ULN OR ≤ 5 X ULN for subjects with liver
                  metastases

               -  Albumin >3.0 g/dL

               -  International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5 X ULN unless
                  subject is receiving anticoagulant therapy as long as PT or PTT is within
                  therapeutic range of intended use of anticoagulants

               -  Activated Partial Thromboplastin Time (aPTT) ≤1.5 X ULN unless subject is
                  receiving anticoagulant therapy as long as PT or PTT is within therapeutic range
                  of intended use of anticoagulants

          -  Women of childbearing potential should have a negative urine or serum pregnancy test
             within 14 days of study registration. NOTE: Women are considered of child bearing
             potential unless they are surgically sterile (have undergone a hysterectomy, bilateral
             tubal ligation, or bilateral oophorectomy) or they are naturally postmenopausal for at
             least 12 consecutive months

          -  Women of childbearing potential and males must be willing to abstain from heterosexual
             activity or to use a form of effective method of contraception from the time of
             informed consent until 30 days after treatment discontinuation.

          -  As determined by the enrolling physician or protocol designee, ability of the subject
             to understand and comply with study procedures for the entire length of the study.

        Exclusion Criteria:

          -  Known hypersensitivity to 5-FU, oxaliplatin or other platinum agents, or any of the
             components of nal-IRI and other liposomal products.

          -  Known dihydropyrimidine dehydrogenase (DPD) deficiency (testing not required prior to
             enrollment).

          -  Other active malignancy requiring treatment within the last 2 years. Exceptions
             include subjects with non-melanoma skin cancer, non-invasive/in situ cancer or
             low-risk prostate cancer requiring hormonal therapy only.

          -  Current therapy with other investigational agents or participation in another clinical
             study.

          -  Major surgery within 28 days or minor surgery within 14 days of the start of the study
             treatment, except for tumor biopsy or placement of central infusion device (port
             placement).

          -  Radiotherapy less than 7 days prior to the start of the study treatment

          -  Psychological, familial, or sociological condition potentially hampering compliance
             with the study protocol and follow-up schedule.

          -  Active infection requiring systemic therapy.

          -  Pregnant or breastfeeding.

          -  Known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
             Participants with previously treated brain metastases may participate provided they
             are stable (without evidence of progression by imaging for at least four weeks prior
             to the first dose of trial treatment and any neurologic symptoms have returned to
             baseline), have no evidence of new or enlarging brain metastases, and are not using
             steroids for at least 7 days prior to trial treatment. This exception does not include
             carcinomatous meningitis, which is excluded regardless of clinical stability.

          -  Severe arterial thromboembolic events (myocardial infarction, unstable angina
             pectoris, stroke) less than 6 months before inclusion.

          -  NYHA Class III or IV congestive heart failure, ventricular arrhythmias or uncontrolled
             blood pressure.

          -  Known history of Human Immunodeficiency Virus (HIV).