When chemotherapy is given with palliative intent, one should avoid treatment that is more troublesome to the patients than the disease itself. Palliative chemotherapy should be evidence-based in the same way as other treatment regimens. It is given in order to extend life, to prevent development of symptoms, and/or to relieve symptoms. The treatment intention has to be clarified to the patient as well as his or her significant others before chemotherapy is initiated. We recommend drawing up an oral or written agreement with the patient on the number of cycles, parameters for effect evaluation, and rules for when treatment should be stopped. It is important that non-effective chemotherapy is not given, even if it is without side effects, or even if the patient is eager to continue the treatment.