TTFields and Pulsed Bevacizumab for Recurrent Glioblastoma

Inclusion Criteria:

• Histologically confirmed GBM, WHO grade IV. GBM variants and secondary GBM are allowedin any recurrence (including multiple) and have been treated with radiation andchemotherapy.
• Unequivocal evidence of tumor progression during prior bevacizumab treatment per RANOcriteria.
• Patient is a candidate for, and agrees to proceed with additional bevacizumabtreatment.
• Male or female at least 22 years of age or older.
• Karnofsky Performance Scale (KPS) ≥ 60%.
• Planned treatment with TTFields therapy.
• Women of childbearing potential must have a negative serum or urine pregnancy testwithin 14 days of treatment.
• Participants of childbearing/reproductive potential must use effective contraception.
• Participants must be able to understand and willing to comply with protocolrequirements as assessed by the investigator.
• Signed informed consent according to institutional guidelines prior to registration.

Exclusion Criteria:

• Inability to undergo brain MRI due to medical or personal reasons.
• Currently receiving investigational agents that are intended as treatments ofrecurrent GBM.
• Skull defect such as missing bone or bullet fragments.
• Uncontrolled intercurrent illness including, but not limited to symptomatic congestiveheart failure, unstable angina pectoris, heart attack within the previous 12 months,stroke (except for TIA) within the previous 6 months, or psychiatric illness/socialsituations that would limit compliance with study requirements.
• Intracranial hemorrhage except for tumor associated micro hemorrhage.
• Women who are pregnant or breastfeeding.
• Implanted pacemaker, programmable shunts, defibrillator, deep brain stimulator, vagusnerve stimulator, and other implanted electronic devices in the brain or the spinalcord.
• Tumor located entirely in the infratentorium.
• History of hypersensitivity to hydrogel.