LBH589 and Bevacizumab in Patients With Recurrent High Grade Glioma

Inclusion Criteria

• Provide written informed consent prior to participation in the study and any related procedures being performed.
• Agreed to and signed an authorization for the release of their protected health information.
• Must be 18 years of age or older
• Karnofsky Performance Status 60 or greater
• Life expectancy of at least 8 weeks
• Histologic diagnosis of GBM, gliosarcoma, anaplastic astrocytoma (AA), anaplastic oligodendroglioma (AO), or anaplastic mixed oligoastrocytoma (AMO) (Patients are eligible if the original histology was lower-grade glioma)
• Unequivocal progression by magnetic resonance imaging (MRI) or computed tomography (CT) scan. A scan must be performed within 14 days prior to registration and on a steroid dose that has been stable for at least 5 days. (Patients with recurrence who undergo resection and are left without measurable or evaluable disease are eligible.)
• Patients must have failed prior radiation therapy and must have an interval of greater than or equal to 60 days from the completion of radiation therapy to study entry.
• Patients must have recovered from the toxic effects of prior therapy. Residual toxicity from any previous treatment must be Grade 1 or less.
• Sufficient time for recovery from prior therapy: 28 days from any investigational agent, 28 days from prior cytotoxic therapy(except 23 days from prior temozolomide, 14 days from vincristine, 42 days from nitrosoureas, 21 days from procarbazine administration), and 7 days for non-cytotoxic agents.
• Patients with prior therapy that included interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true progressive disease rather than radiation necrosis based upon positron emission tomography (PET), Thallium scanning, MR spectroscopy or surgical documentation of disease.
• Subjects who have undergone recent resection of recurrent or progressive tumor will be eligible as long as all of the following conditions apply: a) prior to initiating therapy, 4 weeks must have elapsed since surgery (Subjects must have recovered from surgical-related trauma. Wound healing needs to have occurred.) b) residual disease following resection of recurrent malignant glioma is not mandated for eligibility. To assess the extent of residual disease postoperatively, a MRI or CT should be done at least 4 weeks postoperatively and within 14 days prior to registration.
• Clinical laboratory tests within 14 days prior to enrollment meeting the criteria listed in the protocol
• Cardiology assessment: Baseline MUGA or Echocardiogram must demonstrate LVEF 50% or greater
• Electrocardiogram: A single screening ECG, taken within 14 days of registration, will be performed to assess study eligibility. Patients whose single QTc interval is ≤ 450 msec are eligible. Patients whose QTc interval is > 460 msec are ineligible. If the result is > 450 msec and ≤ 460 msec, two additional ECG readings are to be performed, each one separated by at least 5 minutes; in this case to be eligible, each individual QTc interval must be ≤ 460 msec and the average of the QTc intervals must be ≤ 450 msec.
• Patient is non-hypertensive or has well-controlled hypertension (systolic blood pressure of /= 140 mmHg and/or diastolic blood pressure >/= 90 mmHg) and/or prior history of hypertensive crisis or hypertensive encephalopathy
• Significant vascular disease within 6 months prior to Day 1
• History of stroke or transient ischemic attack within 6 months prior to Day 1
• Patients with unresolved diarrhea > CTCAE grade 1
• Patients with INR > 1.5
• Patients with major surgery or a significant traumatic injury within 28 days prior to Day 1
• Patients with any condition that impairs their ability to swallow and/or absorb pills
• Concomitant use of drugs with a risk of causing torsades de pointes
• Concomitant use of CYP3A4 inhibitors during the treatment phase of the study and within 72 hours prior to starting treatment
• Concomitant use of potent CYP3A4/5 inducer