Vaccine Therapy and Poly-ICLC in Treating Younger Patients with Recurrent Low-Grade Gliomas that Cannot Be Removed by Surgery

Inclusion Criteria

• Unresectable low-grade gliomas that have received at least two chemotherapy/biologic regimens; radiation therapy counts as a biologic regimen; patients may not have received radiation therapy to the index lesion within 1 year of enrollment; patients may have tumor spread within the central nervous system (CNS); histologic confirmation of eligibility is required if tissue is available
• Human leukocyte antigen (HLA)-A2 positive based on flow cytometry
• Patients must be clinically stable and off or on low-dose (no more than 0.1 mg/kg/day, max 4 mg/day dexamethasone) corticosteroid for at least one week prior to study registration
• All patients must sign an Institutional Review Board (IRB)-approved informed consent document
• Patients must have a performance status of >= 70; (Karnofsky if > 16 years and Lansky if =< 16 years of age)
• Documented negative serum beta-human chorionic gonadotropin (HCG) for female patients who are post-menarchal; pregnant females will not be included in the study; males and females must agree to use effective birth control methods during the course of vaccination (from the first vaccine to two weeks after the last vaccine); should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately; breastfeeding should be discontinued if the mother is treated in this study
• Patients must be free of systemic infection requiring intravenous (IV) antibiotics at the time of registration; patients must be off IV antibiotics for at least 7 days prior to registration
• Absolute neutrophil count (ANC) > 1,000/ul
• Platelets > 100,000/ul (transfusion independent)
• Absolute lymphocyte count of >= 500/uL
• Hemoglobin > 8 g/dl (may be transfused)
• Bilirubin < 1.5 x institutional normal for age
• Serum glutamate pyruvate transaminase (SGPT) alanine aminotransferase (ALT) < 3 x institutional normal
• Serum creatinine based on age or creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 ml/min/ml/min/1.73 m^2
• Patients must have recovered from the toxic effects of prior therapy to grade 1 or better; patients must be at least 3 weeks form the last dose of standard cytotoxic chemotherapy or myelosuppressive biological therapy and at least 1 week from the last dose of non-myelosuppressive biologic therapy
• No overt cardiac, gastrointestinal, pulmonary or psychiatric disease

Exclusion Criteria

• Patients may not have received radiation to the index lesion within 1 year of enrollment
• Concurrent treatment or medications (must be off for at least 1 week) including: *Interferon (e.g. Intron-A) *Allergy desensitization injections *Growth factors (e.g. Procrit, Aranesp, Neulasta) *Interleukins (e.g. Proleukin) *Any investigational therapeutic medication
• Patients must not have a history of, or currently active autoimmune disorders requiring cytotoxic or immunosuppressive therapy, or autoimmune disorders with visceral involvement
• Use of immunosuppressives within four weeks prior to study entry or anticipated use of immunosuppressive agents; dexamethasone, or other corticosteroid medications, if used in the peri-operative period must be tapered to no more than 0.1 mg/kg/day, max 4 mg/day dexamethasone for at least one week before study registration; topical corticosteroids are acceptable
• Because patients with immune deficiency are not expected to respond to this therapy, human immunodeficiency virus (HIV)-positive patients are excluded from the study
• Patients must be registered prior to the start of treatment
• The date protocol therapy is projected to start must be no later than 7 days after the date of study registration