A Personalized Vaccine (TTRNA-DCs & TTRNA-xALT) for the Treatment of Adult Patients with Recurrent/Progressive WHO Grade 2 or 3 Oligodendroglioma, ADAGiO Trial

Inclusion Criteria

• Male or female, aged 18 years and above
• Confirmed with recurrent/progressive IDH-mutant 1p/19q co-deleted oligodendroglioma World Health Organization (WHO) grade 2 or WHO grade 3, more than 12 weeks from completion of radiation
• Karnofsky Performance Status ≥ 60
• Must be a candidate for surgery/biopsy * Or tumor tissue obtained clinically, has been previously stored in a biorepository suitable for tumor ribonucleic acid (RNA) extraction and amplification and sample is made available to the principal investigator (PI)
• Absolute neutrophil count (ANC) ≥ 1,000/mcL
• Platelets ≥ 100,000/mcL
• Hemoglobin ≥ 9 g/dL (can be transfused)
• Serum creatinine ≤ 1.5 x institutional upper limit of normal (IULN) OR Creatinine clearance by Cockcroft-Gault ≥ 60 mL/min for patients with serum creatinine > 1.5 x IULN
• Serum total bilirubin ≤ 1.5 x IULN OR direct bilirubin ≤ IULN for patients with total bilirubin > 1.5 x IULN
• Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x IULN
• For females of childbearing potential, negative serum pregnancy test at enrollment
• For women of childbearing potential (WOCBP) must be willing to use acceptable contraceptive methods to avoid pregnancy throughout the study and for at least 24 weeks after the last dose of study drug or For males with female partners of childbearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) throughout the study and should avoid conceiving children for 24 weeks following the last dose of study drug

Exclusion Criteria

• Disease progression during treatment with an anti-IDH-1 or anti IDH-2
• Prior invasive malignancy (except for non-melanomatous skin cancer) unless disease free for >= 3 years
• Metastases detected below the tentorium or beyond the cranial vault and leptomeningeal involvement
• Multifocal disease
• Corticosteroids equivalent to ≥ 4mg dexamethasone daily
• HIV, hepatitis B, or hepatitis C seropositive
• Known active infection or immunosuppressive disease
• Autoimmune disease requiring medical management with immunosuppressant
• Pregnancy or lactation, due to possible adverse effects on the developing fetus or infant
• Treatment with another investigational drug or other intervention within 30 days prior to projected first dose of study treatment (Priming phase with TTRNA-DC)
• Severe, active co-morbidity, defined as follows: * Unstable angina and/or congestive heart failure requiring hospitalization. * Transmural myocardial infarction within the last 6 months. * Acute bacterial or fungal infection requiring intravenous antibiotics at time of enrollment. * Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy. * Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects. * Acquired Immune Deficiency Syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive. * Major medical illnesses or psychiatric impairments that, in the investigator's opinion, will prevent administration or completion of protocol therapy