MRI-Guided Laser Surgery and Doxorubicin Hydrochloride in Treating Patients with Recurrent Glioblastoma Multiforme

Inclusion Criteria

• ARMS B AND C: Histologically confirmed glioblastoma multiforme (GBM); rare GBM variants, secondary GBM, and suspected secondary GBM are allowed
• ARMS B AND C: Unequivocal evidence of tumor progression by MRI scan
• ARMS B AND C: There must be an interval of at least 12 weeks from the completion of radiotherapy to study registration except if there is unequivocal evidence for tumor recurrence per Response Assessment in Neuro-Oncology (RANO) criteria; when the interval is less than 12 weeks from the completion of radiotherapy, the use of positron emission tomography (PET) scan is allowed to differentiate between unequivocal evidence of tumor recurrence and pseudo progression
• ARMS B AND C:Candidate for MLA based on the size, location, and shape of the recurrent tumor as determined by the performing neurosurgeon
• ARMS B AND C: At least 18 years of age
• ARMS B AND C: Karnofsky performance status >= 60%
• ARMS B AND C: Scheduled for MLA
• ARMS B AND C: Normal left ventricular ejection fraction on multigated acquisition scan (MUGA) or echocardiogram within the past 1 year prior to registration for patients with history of congestive heart failure and/or coronary disease requiring medications other than aspirin, or known prior exposure to anthracycline chemotherapy
• ARMS B AND C: Absolute neutrophil count (ANC) >= 1500/mcl (filgrastim [G-CSF] is allowed) (must be within 7 days of MLA)
• ARMS B AND C: Platelets >= 100,000/mcl (must be within 7 days of MLA)
• ARMS B AND C: Hemoglobin >= 9 (packed red blood cells [pRBC] transfusion +/- erythropoiesis-stimulating agents [ESA] are allowed) (must be within 7 days of MLA)
• ARMS B AND C: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 3 x upper limit of normal (ULN) (must be within 7 days of MLA)
• ARMS B AND C: Alkaline phosphatase (ALP) =< 3 x ULN; if ALP is > 3 x ULN, gamma glutamyl transpeptidase (GGT) must be checked and be =< 3 x ULN (must be within 7 days of MLA)
• ARMS B AND C: Bilirubin =< 2 x ULN (must be within 7 days of MLA)
• ARMS B AND C: At the time of registration, patient must have recovered from the toxic effects of prior therapy to no more than grade 1 toxicity
• ARMS B AND C: At the time of registration, patient must be at least 2 weeks from prior vincristine, 3 weeks from prior procarbazine, and 4 weeks from other prior cytotoxic chemotherapy
• ARMS B AND C: Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately
• ARMS B AND C: Ability to understand and willingness to sign an Institutional Review Board (IRB) approved written informed consent document (or that of legally authorized representative, if applicable)

Exclusion Criteria

• ARMS B AND C: Prior treatment with doxorubicin and/or bevacizumab
• ARMS B AND C: Prior treatment with Gliadel wafer is allowed if it has been at least 3 months from placement
• ARMS B AND C: Previous treatment with complete cumulative doses of daunorubicin, idarubicin, and/or other anthracyclines and anthracenediones that is equivalent to a total dose of 240 mg/m^2 doxorubicin
• ARMS B AND C: More than 2 prior relapses
• ARMS B AND C: Currently receiving any other investigational agents that are intended as treatments of GBM
• ARMS B AND C: A history of allergic reactions attributed to compounds of similar chemical or biologic composition to doxorubicin or other agents used in the study
• ARMS B AND C: Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, recent heart attack within the previous 12 months or severe heart problems, or psychiatric illness/social situations that would limit compliance with study requirements
• ARMS B AND C: Pregnant and/or breastfeeding; premenopausal women must have a negative serum or urine pregnancy test within 14 days of study entry
• ARMS B AND C: Inability to undergo MRI due to personal and medical reasons
• ARMS B AND C: Known history of human immunodeficiency virus (HIV) or autoimmune diseases requiring immunosuppressant drugs