Clinical Trial Finder

Inclusion Criteria:

• - Pathologic diagnosis of glioblastoma or grade IV glioma.

• - Tumor volume should be less than 60 cc (approximately 5cm maximum diameter).

• - Age > or = to 18.

• - KPS ≥70.

• - Granulocyte count >1.5 X 10 9/L.

• - Platelet count >99 X 10 9/L.

• - SGOT < 2.5X upper limit of normal (ULN) - Serum creatinine < 2X ULN.

• - Bilirubin < 2X ULN.

• - All patients must sign written informed consent.

Exclusion Criteria:

• - Any prior chemotherapy, radiotherapy and biologic therapy for glioma.

• - Any prior experimental therapy for glioma.

• - Multicentric glioma.

• - Other concurrent active malignancy (with the exception of cervical carcinoma in situ or basal cell ca of the skin).

• - Serious medical or psychiatric illness that would in the opinion of the investigator interfere with the prescribed treatment.

• - Pregnant or breast feeding women.

• - Refusal to use effective contraception.

• - Inadequately controlled hypertension (defined as systolic blood pressure >150 mmHg and/or diastolic blood pressure > 100 mmHg) - Prior history of hypertensive crisis or hypertensive encephalopathy.

• - New York Heart Association (NYHA) Grade II or greater congestive heart failure.

• - History of myocardial infarction or unstable angina within 12 months prior to Day 1.

• - History of stroke or transient ischemic attack.

• - Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to Day 1.

• - History of hemoptysis (≥ 1/2 teaspoon of bright red blood per episode) within 1 month prior to Day 1.

• - Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation) - Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 of treatment or anticipation of need for major surgical procedure during the course of the study.

• - Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day 1.

• - History of abdominal fistula or gastrointestinal perforation within 6 months prior to Day 1.

• - Serious, non-healing wound, active ulcer, or untreated bone fracture.

• - Proteinuria as demonstrated by a UPC ratio ≥ 1.0 at screening.

- Known hypersensitivity to any component of bevacizumab

Arms

Experimental: RT, with temozolomide and bevacizumab

This treatment regimen is novel in that it delivers the initial course of RT over 2 weeks instead of 6 weeks; also, the addition of bevacizumab during and after RT is a new approach.

Interventions

Other: - radiotherapy (RT) in combination with temozolomide and bevacizumab

Bevacizumab10 mg/kg IV once every two weeks on days 1 and 15 of every cycle (Cycle defined as 28 days). Temozolomide 75mg/m2 daily beginning on day 1 through completion of radiotherapy. Hypofractionated dose painting IMRT will start on day 1 and will be delivered on a Monday, Wednesday, Friday schedule for a total of 6 fractions. Post RT therapy: Bevacizumab 10mg/kg IV every two weeks. Temozolomide 150-200mg/m2 daily for 5 consecutive days will be given on 28 day cycles. Follow up: CBC weekly, comprehensive panel and urinalysis monthly, blood pressure every other week. Neurological/physical examination monthly. Gd-enhanced MRI with perfusion every 2 cycles. Neurocognitive testing (approximately 4months post RT, 1 year after diagnosis and then annually in long term survivors). Blood sample for correlative studies monthly.