Aflibercept, Radiation Therapy, and Temozolomide in Treating Patients With Newly Diagnosed or Recurrent Glioblastoma Multiforme, Gliosarcoma, or Other Malignant Glioma

Criteria:

* Creatinine \< = 1.5 mg/dL or creatinine clearance = \> 60 mL/min
* At least 28 days since prior major surgery or open biopsy
* INR \< = 1.5
* Not pregnant or nursing
* Negative pregnancy test
* Karnofsky performance status 60-100%
* SGOT and SGPT \< 2 times upper limit of normal (ULN)
* Bilirubin \< 2 times ULN
* Life expectancy = \> 12 weeks
* WBC = \> 3,000/μL
* ANC= \> 1,500/mm³
* Platelet count = \> 100,000/mm³
* Hemoglobin = \> 10 g/dL (transfusion allowed)
* At least 21 days since prior radiotherapy (groups 2 and 3)
* No prior Gliadel® wafers
* No concurrent major surgery
* Fertile patients must use effective contraception prior to, during, and for at least 6 months after completion of study treatment
* At least 28 days since prior significant traumatic injury No evidence of bleeding diathesis or coagulopathy
* No serious or nonhealing wound, ulcer, or bone fracture
* No history of other cancer (except nonmelanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off of all therapy for that disease for a minimum of 3 years
* No history of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess gastrointestinal bleeding or diverticulitis within the past 6 months
* No prior cranial radiotherapy (group 1 only)
* No prior aflibercept
* No prior treatment for brain tumors, except concurrent radiotherapy and temozolomide or 2 or fewer 28-day courses of adjuvant temozolomide (groups 2 and 3)
* No prior or concurrent cytotoxic drug therapy, non-cytotoxic drug therapy, or experimental drug therapy for brain tumors (group 1 only)
* No concurrent major surgery
* No known hypersensitivity to CHO cell products or other recombinant human antibodies
* No history of hypersensitivity to a recombinant protein whereby reaction occurs during or immediately after infusion
* No history of allergic reactions attributed to compounds of similar chemical or biological composition to other study agents
* No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness or social situation that would limit compliance with study requirements
* No clinically significant cardiovascular disease within the past 6 months, including any of the following:

History of ischemic or hemorrhagic stroke

* Myocardial infarction, coronary artery bypass graft, or unstable angina
* New York Heart Association class III-IV congestive heart failure, serious cardiac arrhythmia requiring medication, or unstable angina pectoris
* Clinically significant peripheral vascular disease
* Pulmonary embolism, deep vein thrombosis, or other thromboembolic event
* No disease that will obscure toxicity or dangerously alter drug metabolism
* Recovered from all prior therapy
* More than 28 days since prior and no concurrent investigational agents
* More than 7 days since prior core biopsy
* At least 23 days since prior temozolomide (groups 2 and 3)
* No concurrent combination antiretroviral therapy for HIV-positive patients
* No concurrent full-dose anticoagulants (e.g., warfarin or low molecular-weight heparin)
* Prophylactic doses allowed
* No concurrent routine prophylactic use of filgrastim (G-CSF)
* No other concurrent anticancer therapy (including chemotherapy, radiotherapy, hormonal treatment, or immunotherapy)
* Concurrent enzyme-inducing antiepileptic drugs (EIAED) or non-EIAED allowed
* Urine protein:creatinine ratio \< = 1 or 24-hour urine protein \< = 500 mg
* No significant medical illnesses that in the investigator's opinion cannot be adequately controlled with appropriate therapy or would compromise the patient's ability to tolerate therapy