Phase II Imatinib + Hydroxyurea in Treatment of Patients With Recurrent/Progressive Grade II Low-Grade Glioma (LGG)

Inclusion Criteria:

* Patients with grade II LGG that is recurrent/progressive following prior surgical resection while on non-decreasing dose of corticosteroids
* \> 25percent enlargement of bidimensional measure/new lesions on sequential imaging new \&/or worsening neurologic deficits
* Patients with progressive/recurrent optic pathway tumors
* Patients have measurable disease on MRI/CT
* Interval of \> 4 wks between prior external beam radiation therapy (XRT)/chemo,\& enrollment on protocol unless there is unequivocal evidence of tumor progression \& patient has recovered from all expected toxicities associated with prior therapy. Patients treated w chemo agents such as VP-16 who would normally be retreated after shorter intervals may be treated at usual starting time even if \< 4 wks from last prior dose of chemo
* Patients not have had tumor biopsy \< 1 wk/surgical resection \< 2 wks prior to starting study drug
* Patients enrolling on arm B must be on \> 1 enzyme inducing anticonvulsants for \>2 wks prior to starting study drug
* Patients should be on non-increasing dose of steroids for \> 7 days prior to obtaining baseline Gd-MRI of brain
* Patients should be on non-increasing dose of steroids for \> 7 days prior to starting study drug
* Multifocal disease is eligible
* Age \> 18 yrs old
* Karnofsky Performance Status (KPS) of \> 60
* absolute neutrophil count (ANC) \> 1.5 x 10 9/L
* Hgb \> 9 g/dL
* Platelets \> 100 x 10 9/L
* K ≥ lower limit of normal (LLN)/correctable with supplements
* Ca ≥ LLN/correctable with supplements
* P ≥ LLN/correctable with supplements
* aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) \& Alanine transaminase (ALT)/ Serum Glutamic Pyruvate Transaminase (SGPT} \< 2.5 x ULN
* Serum bilirubin \< 1.5 x upper limit of normal (ULN)
* Serum creatinine \< 1.5 x ULN/measured 24hr Creatinine Clearance \> 50 mL/min/1.73m2
* Life expectancy ≥ 12wks
* Written informed consent obtained prior to screening procedures

Exclusion Criteria:

* Prior progressive disease/toxicity grade ≥ 3 with prior hydroxyurea therapy
* Prior treatment with imatinib/other platelet derived growth factor (PDGF)-directed therapy
* Excessive risk of bleeding as defined by stroke \< 6 months, history of central nervous system (CNS)/intraocular bleed, or septic endocarditis
* Evidence of intratumor hemorrhage on pretreatment diagnostic imaging, except for stable post-operative gr1 hemorrhage
* Pregnant/breast feeding, /adults of reproductive potential not employing effective method of birth control
* Concurrent severe and/or uncontrolled medical disease that could compromise participation in study
* Acute/chronic liver disease
* Confirmed diagnosis of HIV infection
* Impairment of GI function/GI disease that may significantly alter absorption of imatinib
* Patients taking Coumadin
* Patients have received investigational drugs \< 2wks prior to entry on study/have not recovered from toxic effects of such therapy
* Patients have received biologic, immunotherapeutic/cytostatic agents \< 1 wk prior to entry on study/have not recovered from toxic effects of such therapy
* Patient \> 5 yrs free of another primary malignancy except: if other primary malignancy is not currently clinically significant/requiring active intervention, or if other primary malignancy is basal cell skin cancer/ cervical carcinoma in situ. Existence of any other malignant disease is not allowed
* Patients have had any surgery other than resection of brain tumor \< 2 wks prior to entry on study/have not recovered from side effects of such therapy
* Patients unwilling to/unable to comply with protocol
* Active systemic bleeding, such as GI bleeding/gross hematuria
* Gr2 /\> peripheral edema/central/systemic fluid collections
* Patients who enroll on arm A must have not received any EIAC for \> 2 wks prior to starting study regimen
* Any of following exclusion criteria to MRI imaging:

  * Cardiac pacemaker
  * Ferromagnetic metal implants other than those approved as safe for use in magnetic resonance (MR) scanners
  * Claustrophobia
  * Obesity