Nivolumab With DC Vaccines for Recurrent Brain Tumors

Inclusion Criteria:

* Age 18-80 years of age
* First or second recurrence of MG (WHO Grade III or IV glioma or astrocytoma) in surgically accessible areas with prior histologic diagnosis of MG
* Bevacizumab-naïve - no prior exposure to Bevacizumab
* Karnofsky Performance Status (KPS) of ≥ 70%
* Radiation Therapy (RT) with ≥ 45 Gray (Gy) tumor dose, completed ≥ 8 weeks prior to study entry
* Laboratory values must meet the following criteria:

  1. White Blood Count (WBC) ≥ 2000/microliters (uL)
  2. Neutrophils ≥ 1500/uL
  3. Platelets ≥ 100x103/uL
  4. Hemoglobin ≥ 9.0 g/dL
  5. Serum creatinine ≤ 1.5x the upper limit of normal (ULN) or creatinine clearance (CrCl)≥ 40 mL/min (using the Cockcroft-Gault formula) c. Female CrCl = (140 - age in years) x weight in kg x 0.85 /72 x serum creatinine in mg/dL d. Male CrCl = (140 - age in years) x weight in kg x 1.00/72 x serum creatinine in mg/dL
  6. Aspartate Aminotransferase (AST) ≤ 3x ULN
  7. Alanine Aminotransferase (ALT) ≤ 3x ULN
  8. Bilirubin≤ 1.5x ULN (except subjects with Gilbert Syndrome, who can have total bilirubin \< 3.0 mg/dL)
  9. Subjects must have resting baseline O2 saturation by pulse oximetry of ≥ 92% at rest.
* Patients of child bearing potential or with partners of child-bearing potential must practice recommended contraceptive methods to prevent pregnancy during treatment and for 5 months after the last dose of nivolumab for women, 7 months after the last dose of nivolumab for men, and for 6 months after the last dose of bevacizumab for subjects receiving bevacizumab.

Exclusion Criteria:

* Contrast-enhancing tumor component crossing the midline, multi-focal tumor, or tumor dissemination (subependymal or leptomeningeal)
* Clinically significant increased intracranial pressure (e.g., impending herniation), uncontrolled seizures, or requirement for immediate palliative treatment
* Pregnant or need to breast feed during the study period (Negative human chorionic gonadotropin (β-HCG) test required), or unable to maintain use of contraception while on study and for 31 weeks after the last dose of nivolumab
* Active infection requiring treatment or an unexplained febrile (\> 101.5o F) illness
* Known immunosuppressive disease, autoimmune disease or human immunodeficiency virus infection, Hepatitis B or Hepatitis C
* Known allergy or hypersensitivity to tetanus, or any other tetanus or diphtheria toxoid-containing vaccine, or any component of this vaccine (i.e., aluminum phosphate, formaldehyde)
* Known severe (Grade 3 or 4) infusion-related allergy or hypersensitivity to any monoclonal antibody
* Previous radiation therapy with anything other than standard radiation therapy (such as previous stereotactic radiosurgery) or previous treatment with an immune checkpoint inhibitor (i.e., nivolumab, pembrolizumab, ipilimumab)
* Unstable or severe intercurrent medical conditions such as severe heart (New York Association Class 3 or 4) or lung (FEV1 \< 50%) disease, uncontrolled diabetes mellitus
* Corticosteroid use \> 4 mg/day at time of consent
* Prior inguinal lymph node dissection.