Table 2  Clinical relevance of metronomic chemotherapy in different disease settings.

Setting	Clinical relevance
Adjuvant maintenance	Survival benefit not significant; trend towards better survival in triple-negative node-positive patients 11 Data from three large phase III trials pending
Neoadjuvant	Modest activity in elderly and frail patients; comparable efficacy to preoperative endocrine therapy in patients with hormone receptor-positive tumors Conflicting results of conventional chemotherapy combined with metronomic chemotherapy (negative results of GeparQuattro and SWOG0012 trials, higher pCR-rates in the ABCSG-24 trial)
Adjuvant	Evidence not conclusive: older regimens (CMF) might be an interesting alternative for elderly, frail patients but metronomic capecitabine performs worse than standard chemotherapy and does not improve survival compared to no chemotherapy at all Combined metronomic/standard regimens perform worse than standard schedules