Metronomic chemotherapy (MCT) and drug repurposing represent a paradigm shift in oncology, offering improved cancer management with reduced toxicity and enhanced patient outcomes. MCT involves low-dose, continuous chemotherapy administration, which minimizes side effects and improves disease control. Drug repurposing utilizes existing drugs for cancer treatment, leveraging pre-existing safety data to accelerate clinical implementation. Together, these approaches form "metronomics," a novel therapeutic strategy that combines the benefits of both methods, including reduced toxicity, oral administration, improved quality of life, and cost-effectiveness. Clinical studies have shown that MCT is well-tolerated and effective, particularly in low- and middle-income countries. MCT works through multiple mechanisms, including anti-angiogenic effects, immune modulation, and tumor dormancy induction. It also reduces therapeutic resistance by targeting the tumor microenvironment and stroma. MCT has shown promise in various cancers, including breast cancer, where it has been used in combination with targeted therapies and immunotherapy. In HER2-positive breast cancer, MCT has demonstrated efficacy when combined with anti-HER2 agents. Additionally, MCT has been effective in treating triple-negative breast cancer, which lacks targeted therapies. The integration of MCT with other treatments is leading to a transformation in cancer care, offering new options for managing cancer as a chronic condition. Despite its potential, further clinical trials are needed to fully establish MCT's role in comprehensive cancer management.Metronomic chemotherapy (MCT) and drug repurposing represent a paradigm shift in oncology, offering improved cancer management with reduced toxicity and enhanced patient outcomes. MCT involves low-dose, continuous chemotherapy administration, which minimizes side effects and improves disease control. Drug repurposing utilizes existing drugs for cancer treatment, leveraging pre-existing safety data to accelerate clinical implementation. Together, these approaches form "metronomics," a novel therapeutic strategy that combines the benefits of both methods, including reduced toxicity, oral administration, improved quality of life, and cost-effectiveness. Clinical studies have shown that MCT is well-tolerated and effective, particularly in low- and middle-income countries. MCT works through multiple mechanisms, including anti-angiogenic effects, immune modulation, and tumor dormancy induction. It also reduces therapeutic resistance by targeting the tumor microenvironment and stroma. MCT has shown promise in various cancers, including breast cancer, where it has been used in combination with targeted therapies and immunotherapy. In HER2-positive breast cancer, MCT has demonstrated efficacy when combined with anti-HER2 agents. Additionally, MCT has been effective in treating triple-negative breast cancer, which lacks targeted therapies. The integration of MCT with other treatments is leading to a transformation in cancer care, offering new options for managing cancer as a chronic condition. Despite its potential, further clinical trials are needed to fully establish MCT's role in comprehensive cancer management.