Bevacizumab, Temozolomide, and External Beam Radiation Therapy as First-Line Therapy in Treating Patients With Newly Diagnosed Glioblastoma Multiforme or Gliosarcoma

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring adult giant cell glioblastoma, adult gliosarcoma, adult glioblastoma Read More

Inclusion Criteria:

• Histologically confirmed intracranial glioblastoma multiforme (GBM) or gliosarcoma.
• Prior histologic diagnosis of low-grade glioma allowed provided it has been upgraded to GBM after repeat resection
• Has undergone surgery to collect tumor tissue 3-6 weeks ago
• Measurable or assessable disease is not required
• Karnofsky performance status 60-100%
• Life expectancy > 8 weeks
• White Blood Cell (WBC) ≥ 3,000/mm³
• Absolute Neutrophil Count (ANC) ≥ 1,500/mm³
• Platelet count ≥ 100,000/mm³
• Hemoglobin ≥ 10 g/dL (transfusion allowed)
• Serum Glutamate Oxaloacetate Transaminase (SGOT) < 2.5 times upper limit of normal (ULN)
• Bilirubin < 2.5 times ULN
• INR (international normalized ratio) ≤ 1.5 times ULN (except if on therapeutic anticoagulation therapy)
• aPTT (activated partial thromboplastin time) ≤ 1.5 times ULN (except if on therapeutic anticoagulation therapy)
• Creatinine < 1.5 mg/dL
• Urine protein:creatinine ratio < 1.0
• Negative pregnancy test
• Fertile patients must use effective contraception
• More than 28 days since prior major surgical procedures or open biopsy (other than craniotomy)
• More than 7 days since prior minor surgical procedures (e.g., placement of PortoCath (port-a-cath - a port placed under the subjects skin), stereotactic biopsy, fine-needle aspirations, or core biopsies)
• More than 4 weeks since prior and no concurrent participation in another experimental drug study.
• Prior or concurrent corticosteroids, anti-epileptic drugs, analgesics, or other drugs to treat symptoms or prevent complications are allowed
• Concurrent full-dose warfarin or its equivalent (i.e., unfractionated and/or low molecular weight heparin) allowed

Exclusion Criteria:

• unstable angina
• BP > 150/100 mm Hg
• New York Heart Association (NYHA) class II-IV congestive heart failure
• myocardial infarction within the past 6 months
• stroke within the past 6 months
• clinically significant peripheral vascular disease
• evidence of bleeding diathesis or coagulopathy
• intracerebral abscess within past 6 months
• abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
• serious, non-healing wound, ulcer, or bone fracture
• Any wound requiring surgical intervention (including scalp wounds requiring cranioplasty) allowed provided the wound is clean and without further infection post-surgical intervention
• significant traumatic injury within the past 28 days
• concurrent serious uncontrolled medical illness including, but not limited to, the following:
• Ongoing or active infection requiring IV antibiotics
• Psychiatric illness/social situation that would limit compliance with study requirements
• Disorders associated with significant immunocompromised state (e.g., HIV, systemic lupus erythematosus)
• other cancer within the past 3 years, except nonmelanoma skin cancer or carcinoma in situ of the cervix
• disease that would obscure toxicity or dangerously alter drug metabolism
• significant medical illness that, in the investigator's opinion, cannot be adequately controlled with appropriate therapy or would compromise the patient's ability to tolerate study therapy
• prior radiotherapy to the brain
• prior cytotoxic or non-cytotoxic drug therapy or experimental drug therapy for the brain tumor
• prior Gliadel wafers
• concurrent participation in any other clinical trial
• concurrent GM-CSF (granulocyte-macrophage colony-stimulating factor)
• concurrent stereotactic radiosurgery or brachytherapy
• concurrent major surgical procedure
• other concurrent anticancer therapy, including chemotherapy, hormonal therapy, radiotherapy, or immunotherapy