All Clinical Trials

The purpose is to determine if mycophenolate motfetil (MMF) combine with temozolomide (TMZ) can stop glioblatoma.

Mycophenolate Mofetil is an antimetabolite immunosuppressant and is FDA approved for the prophylaxis of organ rejection in recipients of allogeneic kidney, heart or liver transplant, and is used in combination with other immunosuppressants.

Group S (Pre-surgical): Window of Opportunity Study, pre-operative MMF and temozolomide (TMZ)

Participants with suspected newly diagnosed or recurrent glioblastoma who plan to have surgical resection are eligible. Study treatment must begin within 7 days after registration. Group S will open in Part 1 after one participant in Group 1 has successfully completed the first dose level DLT period and subsequent DSMB review. The MMF dose for Group S will be adjusted each time DSMB has approved a subsequent dose escalation. The MMF dose for Group S will always be 1 dose level below the current enrolling dose level (the last safe dose level as indicated by the DSMB) in Group 1. Participants will have 5 days of pre-operative MMF (BID) and TMZ (200 mg/m2 QD)

Group 1 (Adjuvant): Adjuvant therapy+ MMF (dose escalation)

Four to six weeks after the completion of chemoradiation, participants will be registered to the study. Study treatment must begin within 7 days after registration. On study, participants will receive maintenance TMZ and MMF. Each maintenance cycle is 28 days long.

TMZ will be taken orally once a day on Days 1-5, at a dose of 150 mg/m2, for up to 6 cycles. On Cycles 2-6, the TMZ dose may be increased to 200 mg/m2 in the absence of toxicity. Starting Cycle 1 Day 1, MMF will be taken orally twice daily for up to 6 cycles (each cycle is 28 days). The dose of MMF will depend on the dose level each participant is accrued to. See MMF Dose Level table in Section 4.2. The DLT period for Group 1 is the duration of Cycle 1 (28 days), and 7 days thereafter.

Group 2 (Chemoradiation): RT + MMF for MGMT unmethylated tumors (dose escalation)

About 4 weeks after surgical resection, participants confirmed to have unmethylated glioblastoma will be registered and treated with concurrent MMF and TMZ (75 mg/m2 daily) and 6 weeks of focal radiation therapy (60 Gy). Study treatment must begin within 7 days after registration. MMF will be taken twice daily for the entire 6 week period of focal radiation therapy. The dose of MMF will depend on the dose level each participant is accrued to.

After radiation therapy, participants will start adjuvant treatment with TMZ. TMZ will be taken orally once a day on Days 1-5, at a dose of 150 mg/m2, for up to 6 cycles. On Cycles 2-6, the TMZ dose may be increased to 200 mg/m2 in the absence of toxicity

The DLT period for Group 2 is the duration of radiation therapy (6 week period), and 7 days thereafter.

Group 3 (Expansion): MMF during RT and during adjuvant phase. Enrollment to begin only AFTER the completion of groups 1 and 2.

About 4 weeks after surgical resection, participants will be registered and treated with concurrent MMF and 6 weeks of focal radiation therapy (60Gy) and concurrent TMZ at a dose of 75 mg/m2 daily. Study treatment must begin within 7 days after registration. After completion of chemoradiation, participants will go on to have adjuvant TMZ (at a dose of 150 mg/m2 on days 1-5 of each cycle, may be up to 200 mg/m2 during cycles 2-6) with concurrent twice-daily MMF for a total of 6 planned cycles (each cycle is 28 days). The dose of MMF during radiation therapy and during adjuvant treatment will be the RP2D determined in dose escalation Groups 1 and 2.

Optune® Device (Tumor Treating Fields) Concurrent use of the Optune® device (TTFields) is permitted, but not required for participation on this study. It’s use will be according to standard of care.