Multiple Intracerebral Doses of Neural Stem Cell-Based Virotherapy (NSC-CRAd-S-pk7) for the Treatment of Recurrent High-Grade Gliomas

Inclusion Criteria:

• Patient must be age >= 18 years

• Patient has a Karnofsky performance status of >= 70%

• Patient has a life expectancy of >= 3 months

• When determining the maximum tolerated number of treatment cycles (MTC):patient has a histologically confirmed diagnosis of a grade 3 or 4 glioma (eg.,glioblastoma, grade 4 astrocytoma, grade 3 astrocytoma, grade 3oligodendroglioma). (This part of the study has been completed).

• When enrolling to Treatment Schedules 4 and 4a: patient has glioblastoma atfirst recurrence.

• Imaging studies show evidence of recurrent, supratentorial tumor(s).

• Patient's high-grade glioma has recurred or progressed after prior treatment withbrain radiation and temozolomide

• The patient must be in need of surgery for tumor resection

• Based on the neurosurgeon's judgment, there is no anticipated physical connectionbetween the post-resection tumor cavity and the cerebral ventricles

• Absolute neutrophil count (ANC) of >= 1000 cells/mm^3

• Platelet count >= 100,000 cells/mm^3

• Total bilirubin =< 2.0 mg/dl

• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =< 4 times the institutional upper limit of normal

• Serum creatinine =< the institutional upper limit of normal

• At least 2 weeks from taking the last dose of a targeted agent

• At least 4 weeks from the last dose of bevacizumab For temozolomide, an interval of 23 days is required from the last dose administered if the patient was recentlytreated with adjuvant temozolomide, consisting of temozolomide daily for 5 days,repeated every 28 days.

• At least 2 weeks from taking the last dose of a targeted agent.

• At least 4 weeks from the last dose of bevacizumab.

• All significant toxicities from previous anticancer therapy must have stabilized toa new baseline or resolved.

• All participants must have the ability to understand and the willingness to sign awritten informed consent.

• The effects of this treatment on a developing fetus are unknown. Therefore, femalepatients of childbearing potential and sexually-active male patients or who are ableto impregnate their partner, must agree to use an effective method of contraceptionwhile participating in this study. Patients of childbearing potential must have anegative pregnancy test =< 2 week prior to registration.

Exclusion Criteria:

• Patient has multi-focal disease.

• Patient is receiving radiation, chemotherapy, or another investigational agent.

• Patient has had prior therapy with neural stem cells.

• Patient has not recovered from any toxicity (> grade 1) of prior therapies, exceptalopecia.

• Patient is unable to undergo a brain MRI.

• Patient has chronic or active viral infections of the central nervous system (CNS).

• Patient has a coagulopathy or bleeding disorder.

• Patient has an uncontrolled illness including ongoing or active infection.

• Patient has another active malignancy.

• Patient is pregnant or breastfeeding.

• A patient has a serious medical or psychiatric illness that could, in theinvestigator's opinion, potentially interfere with the safety monitoringrequirements and completion of treatment according to this protocol.