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| Name | Class |
|---|---|
| Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | OTHER |
| University of Virginia | OTHER |
| Virginia Commonwealth University | OTHER |
| Wake Forest University |
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Better treatments are needed for high-grade gliomas (HGG), and new ways of treating this disease should be tested. The investigators want to see if giving medicine before radiation works well. After radiation, MRI scans can be harder to understand because radiation changes how the brain looks on the scan. If new medicines are given before radiation, the scans are easier to read.
First, the investigators need to find out if giving chemotherapy early works using a drug we already know can treat gliomas. The investigators will start with temozolomide, which is the only chemotherapy approved by the FDA for HGG. If this approach is successful, the investigators can then test new drugs using this screening method.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| All Patients | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pre-radiation temozolomide. | Drug | Patients will receive 2 cycles of pre-radiation temozolomide (200mg/m^2). Cycles are 28-days in length. Participants will take temozolomide on days 1-5 of the 28-day cycle. |
| Measure | Description | Time Frame |
|---|---|---|
| Response Rate | Response rate using RANO criteria. | Post-operative MRI (day 0) until radiation simulation MRI (day 70). |
| Measure | Description | Time Frame |
|---|---|---|
| Secondary Outcome | To assess the safety and tolerability of pre-radiation temozolomide utilizing CTCAE version 5. | From start of pre-radiation chemotherapy (day 10) until 2 cycles of pre-radiation temozolomide are complete (day 70) |
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Inclusion Criteria:
Pathologic diagnosis of high-grade glioma
Residual measurable post-operative contrast enhancing tumor
Lack of urgency in requiring immediate radiation or chemotherapy (mass effect, mid-line shift, herniation, etc.)
Ability to provide informed consent
Willingness to comply with all study procedures and availability for the duration of the study
Male or female, aged 18-80.
Karnofsky Performance Status ³70%.
Patients must have the following organ and marrow functions:
Absolute neutrophil count ≥1,500/µL Platelets ≥100,000/µL Hemoglobin ≥ 9 g/dL Total bilirubin £ 1.5 × institutional upper limit of normal (ULN), (except for patients with known Gilbert's syndrome who must have normal direct bilirubin) AST (SGOT)/ALT (SGPT) £ 2.5 × ULN Creatinine £ 1.5 × ULN OR Creatinine clearance ≥ 60 mL/min/1.73m2 APTT/PTT ≤ 1.5 × ULN Sodium ≥ the institutional lower limit of normal
Ability to take oral medication and be willing to adhere to the pre-radiation temozolomide regimen
For females of reproductive potential: use of highly effective contraception for at least 1 week prior to screening and agreement to use such a method during study participation and for an additional 4 weeks after the end of pr-radiation temozolomide administration
For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner
Patients must have measurable disease as defined by RANO criteria.
Exclusion Criteria:
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| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| D001254 | Astrocytoma |
| D009837 | Oligodendroglioma |
| D005910 | Glioma |
| D001932 | Brain Neoplasms |
| ID | Term |
|---|---|
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
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| OTHER |
| Georgetown University | OTHER |
| Musella Foundation | UNKNOWN |
| Imaging Biometrics, LLC | INDUSTRY |
| West Virginia University | OTHER |
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| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |