EGFR Inhibition Using Weekly Erlotinib for Recurrent Malignant Gliomas

Inclusion Criteria:

* Histologically confirmed intracranial malignant glioma of the following types: Glioblastoma (GBM), Gliosarcoma (GS), Anaplastic astrocytoma (AA), Anaplastic oligodendroglioma (AO), Anaplastic oligoastrocytoma (AOA, also called anaplastic mixed gliomas or AMG), High grade glioma not otherwise specified (NOS).
* EGFRvIII mutation detected on pretreatment tissue from at least 1 prior surgery.
* At least 15 unstained slides or at least 1 tissue blocks must be collected from at least one prior surgery.
* Recovered from toxic effects of prior therapies.
* Able to undergo contrast enhanced MRI scans (or CT scans for patients unable to tolerate MRI).
* Shown unequivocal evidence for contrast enhancing tumor progression by MRI (or CT for patients who cannot tolerate MRI) in comparison to a prior scan.
* Age \> or = 18 years.
* Karnofsky Performance Status \> or = 60%.
* Life expectancy of \> 8 weeks.
* Normal organ and marrow function, adequate liver function and adequate renal function before starting therapy.
* Women of child-bearing potential and men must agree to use adequate contraception.
* Women of childbearing potential must have a negative pregnancy test documented within 7 days prior to treatment.
* Women must agree not to breast feed.
* Ability to understand and the willingness to sign a written informed consent document.
* Ability to swallow the tablets.

Cohort A (medical) specific inclusion criteria:

* Fulfill all of the general inclusion criteria.
* MRI/CT must demonstrate measurable enhancing tumor of at least 1cm2 in cross-sectional area to allow assessment of radiographic response, unless: measurable disease is not present because the patient underwent gross total resection as the most recent anti-tumor therapy.
* At least 3 months have elapsed between any prior brain radiotherapy and initiation of study therapy.
* MRI/CT must demonstrate measureable enhancing tumor at least 1cm by 1cm squared in cross-sectional area to allow assessment of radiographic response.
* Stable or decreasing dose of corticosteroids for a minimum of 5 days before the baseline MRI/CT.
* The baseline MRI/CT must be performed on the 14th day or less prior to initiation of study treatment.

Cohort B (surgical) specific inclusion criteria:

* Fulfill all of the general inclusion criteria.
* An MRI/CT scan showing progression is required.

Exclusion Criteria:

* Received prior treatment with convection enhanced delivery, other catheter based intratumoral treatment, or carmustine (BCNU)/Gliadel wafers.
* Prior therapy that included stereotactic radiosurgery during therapy for newly diagnosed or recurrent disease, or re-irradiation of any type, must have confirmation of true progressive disease rather than radiation necrosis based upon surgical documentation of recurrent/progressive disease.
* Prior treatment with an EGFR inhibitor.
* Received prior treatment with direct Vascular endothelial growth factor (VEGF)/Vascular Endothelial Growth Factor Receptors (VEGFR) inhibitors.
* Smoking or plan to smoke tobacco or marijuana during study therapy.
* Receiving any other investigational agents concurrently with study treatment.
* Taking Enzyme Inducing Anti-Epileptic Drug (EIAED). If previously on an EIAED, the patient must be off of it for at least two weeks prior to study treatment.
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to erlotinib.
* Uncontrolled intercurrent illness that would limit compliance with study requirements.
* Have HIV and are receiving combination antiretroviral therapy.
* Other active concurrent malignancy.