William R. Shapiro, MD

The first descriptions of neurologic disorders in patients with cancer identified those who had peripheral neuropathy. Most neurologists thought these patients actually had a peripheral neuropathy secondary to the inanition associated with their cancer. Still other patients clearly had peripheral neurologic damage from chemotherapy (eg, vincristine).

Drs. Wen and Loeffler present a scholarly review of the management of brain metastases. They correctly note the high frequency of the brain as a site of metastasis and the fact that, overall, there are more metastatic than primary brain tumors.

A large number of oncogenes have been identified as aberrant in gliomas, but only the erbB oncogene (gene encoding the epidermal growth factor receptor [EGFR]) is amplified in an appreciable number. The loss or

Dr. Halperin evaluates progress in the treatment of adults with malignant glioma, with emphasis on older patients and those with a poor prognosis. He provides a good review of past clinical trials in this area, including, among others, trials conducted by the Brain Tumor Study Group (subsequently called the Brain Tumor Cooperative Group [BTCG]), with which we have been involved.