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It is undeniably a great challenge to adequately weigh the benefits and harms of tumor-specific therapy near the end of life and to find the right time for changing the objective of therapy to palliative care alone. In a curative situation, the “survival” benefit of the treatment outweighs its potential harm due to side effects. However, things are different when the possibility of cure is ruled out. Important prerequisites to avoid overly zealous care are adequate communication about the therapeutic options and consensus between the doctor and the patient with regard to the (realistic) therapeutic goal, a realistic estimated prognosis and early integration of palliative care.