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Most modern medical centers worldwide now offer sentinel lymph node (SLN) biopsy for treating melanoma and breast cancer, yet debate continues regarding whether SLN biopsy should be routinely used in clinical practice. The authors assert that SLN biopsy is an accurate, safe and minimally invasive staging technique that is an extremely powerful prognostic tool, and should be considered a staging procedure, not a therapeutic one. This review provides a concise overview of the current literature on SLN biopsy and discusses the controversies associated with technical and patient management issues.
Some molecular targeted therapies can confer radiation response and minimize toxicity compared with chemoradiation regimens. Many of these molecular targeted drugs are being tested in clinical trials in combination with radiotherapy; however, for the optimal translation of these drugs in the clinical setting, their safety must be demonstrated in phase I clinical trials. The combination of new molecular targeted therapies and radiation might not necessarily be equivalent to the toxicity of the targeted drug plus the usual toxicity of radiation. Deutschet al. discuss the need for specific and long-term clinical evaluation and the necessity to reassess phase I strategies, toxicity endpoints, and trial concepts in order to fully optimize these regimens.