Acetazolamide Sodium and Temozolomide in Treating Adult Patients with Newly Diagnosed MGMT Promoter-Methylated IDH Wildtype Glioblastoma

Inclusion Criteria

• Histologically proven, newly diagnosed IDH wildtype GBM that has a methylated MGMT promoter as assessed by the standardized institutional analysis
• Patients are eligible if they had a prior low grade astrocytoma that was not previously treated, and there is subsequent histological evidence of a diagnosis of grade III or IV astrocytoma
• Patients are eligible if they are going to receive TMZ as part of the standard adjuvant treatment regimen following concomitant TMZ/radiation therapy (RT)
• Patients must have a Karnofsky performance >= 60%
• Absolute neutrophil count (ANC) >= 1.5 x 10^9/ L
• Platelets >= 100 x 10^9 / L
• Hemoglobin >= 8.0 g / dL
• Creatinine level within normal institutional limit, or creatinine clearance >= 60 mL/min/1.73 m^2 for patients with creatinine level above institutional normal
• Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) < 2.5 X institutional upper limit of normal
• Total bilirubin =< 1.5 x upper limit of normal (ULN)
• International normalized ratio (INR) within 1.5 times ULN (or if receiving anticoagulant therapy an INR of =< 3.0 is allowed with concomitant increase in prothrombin time (PT) or an activated partial thromboplastin time (aPTT) =< 2.5 x control)
• Women of childbearing potential must have a negative pregnancy test within 30 days of registration
• Patients must have the ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

• Prior invasive malignancy that is not low-grade glioma (except non-melanomatous skin cancer or carcinoma in situ of the cervix) unless the patient has been disease free and off therapy for that disease for a minimum of 3 years
• Active systemic infection requiring treatment, including any human immunodeficiency virus (HIV) infection or toxoplasmosis
• Other severe acute or chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration (e.g. acidosis, adrenocortical insufficiency, cirrhosis)
• Systemic corticosteroid therapy, > 8 mg of dexamethasone daily (or equivalent) at study enrollment
• Pregnant women are excluded from this study, where pregnancy is confirmed by a positive serum beta-human chorionic gonadotropin (hCG) laboratory test; breast-feeding should be discontinued
• Hypersensitivity to acetazolamide or sulfonamides