Super Selective Intra-arterial Repeated Infusion of Cetuximab (Erbitux) With Reirradiation for Treatment of Relapsed/Refractory GBM, AA, and AOA
Super Selective Intra-arterial Repeated Infusion of Cetuximab (Erbitux) With Reirradiation for Treatment of Relapsed/Refractory GBM, AA, and AOA
Primary brain tumors are typically treated by surgery, radiation therapy and chemotherapy,
 either individually or in combination. Present therapies are inadequate, as evidenced by the
 low 5-year survival rate for brain cancer patients, with median survival at approximately 12
 months. Glioma is the most common form of primary brain cancer, afflicting approximately
 7,000 patients in the United States each year. These highly malignant cancers remain a
 significant unmet clinical need in oncology. GBM often has a high expression of EFGR
 (Epidermal Growth Factor Receptor), which is associated with poor prognosis. Several methods
 of inhibiting this receptor have been tested, including monoclonal antibodies, vaccines, and
 tyrosine kinase inhibitors. The investigators hypothesize that in patients with recurring
 GBM, intracranial superselective intra-arterial infusion of Cetuximab (CTX), at a dose of
 250mg/m2 in conjunction with hypofractionated radiation, will be safe and efficacious and
 prevent tumor progression in patients with recurrent, residual GBM.
Inclusion Criteria:

 -  Male or female patients of ≥18 years of age

 -  Patients with a documented histologic diagnosis of relapsed or refractory glioblastoma
 multiforme (GBM), anaplastic astrocytoma (AA) or anaplastic oligoastrocytoma (AOA)

 -  Patients with pathology confirmed histologic EGFR overexpression

 -  Patients must have at least one confirmed and evaluable tumor site.∗

 *A confirmed tumor site is one in which is biopsy-proven

 -  Patients must have a Karnofsky performance status ≥60% and an expected survival of ≥
 three months.

 -  No chemotherapy for two weeks prior to treatment under this research protocol and no
 external beam radiation for eight weeks prior to treatment under this research
 protocol

 -  Patients must have adequate hematologic reserve with WBC≥3000/mm3, absolute
 neutrophils ≥1500/mm3 and platelets ≥100,000/ mm3. Patients who are on Coumadin must
 have a platelet count of ≥150,000/ mm3

 -  Pre-enrollment chemistry parameters must show: bilirubin<1.5X the institutional upper
 limit of normal (IUNL); AST or ALT<2.5X IUNL and creatinine<1.5X IUNL

 -  Pre-enrollment coagulation parameters (PT and PTT) must be ≤1.5X the IUNL

 -  Patients must agree to use a medically effective method of contraception during and
 for a period of three months after the treatment period. A pregnancy test will be
 performed on each premenopausal female of childbearing potential immediately prior to
 entry into the research study

 -  Patients must be able to understand and give written informed consent. Informed
 consent must be obtained at the time of patient screening

 Exclusion Criteria:

 -  Women who are pregnant or lactating.

 -  Women of childbearing potential and fertile men will be informed of the potential
 unknown risk of conception while participating in this research trial and will be
 advised that they must use effective contraception during and for a period of three
 months after the treatment period

 -  Patients with significant intercurrent medical or psychiatric conditions that would
 place them at increased risk or affect their ability to receive or comply with
 treatment or post-treatment clinical monitoring

 -  Patients with radiological evidence of leptomeningeal disease

 -  Patients with history of allergic reaction to CTX

 -  Patients who completed chemo/RT less than 6 months prior to enrollment

 -  Patients who have not failed standard Stupp protocol