Safety and Tolerability of Fb-PMT in Recurrent Glioblastoma

Inclusion Criteria:

• Histologically proven intracranial glioblastoma, with first or second recurrence

• On stable or decreasing dose of steroids, if taken prior to screening

• Baseline MRI (with and without contrast) completed with 5 days of starting fb-PMT

• Prior completion of and recovery from the effects of standard of care forglioblastoma management with surgery/biopsy and radiotherapy

• Confirmation of true progressive disease for patients previously treated withinterstitial brachytherapy or stereotactic radio surgery

• Life expectancy of more than three months

• Karnofsky Performance Status of ≥ 70

• Hypertension must be well controlled (≤ 95th percentile) on stable doses ofmedication

• Adequate bone marrow and organ function, confirmed by laboratory testing atscreening

• Patient or caregiver must be able to store drug under refrigerated conditions,prepare and administer daily subcutaneous injections on a set schedule, and recordinformation in a daily treatment diary

• Women of childbearing potential must agree to ongoing pregnancy testing and to usemedically acceptable contraception for the duration of the study and for 2 monthsafter their last dose of study drug

• Males must agree to use medically acceptable contraception and refrain from donatingsperm for the duration of the study and for 2 months after their last dose of studydrug

Exclusion Criteria:

• Significant medical illness that is uncontrolled, may obscure toxicity, maydangerously alter drug metabolism, or may compromise ability for study participation

• History of any other cancer (except non-melanoma skin cancer or carcinoma in-situ ofthe cervix), unless in complete remission and off all therapy for that disease forat least 3 months prior to first dose of study drug

• Use of bevacizumab or any other experimental drug or therapy within 28 days of studytreatment

• Prior therapy with fb-PMT or related drugs

• Currently pregnant or breastfeeding

• Active infection or serious intercurrent medical illness

• Surgery of any type within the preceding 28 days that has not fully healed

• A serious or non-healing wound, ulcer, or bone fracture

• A known bleeding diathesis or coagulopathy, or a history of bleeding diathesiswithin 28 days of study treatment

• A known thrombophilic condition (i.e., protein S, protein C, or antithrombin IIIdeficiency, Factor V Leiden, Factor II G20210A mutation, homocysteinemia orantiphospholipid antibody syndrome). Testing is not required in patients withoutthrombophilic history.

• Evidence of new central nervous system hemorrhage on baseline MRI obtained within 14days prior to study enrollment

• Clinically significant cardiovascular event such as uncontrolled or symptomaticarrhythmias, congestive heart failure, or myocardial infarction within 6 months ofscreening.

• New York Heart Association classification of heart disease greater than Class 2

• QTc interval > 450 msec in males or > 470 msec in females at screening

• Use of concomitant medications that prolong the QT/QTc interval or risk inducingTorsades de Pointes

• Use of any concomitant OATP1B1, OATP1B3, or BSEP inhibitors within 14 days or fivehalf-lives (whichever is longer) before starting study drug treatment

• Abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within 6months prior to study enrollment

• A significant vascular disease (e.g., aortic aneurysm requiring surgical repair,deep venous or arterial thrombosis) within the last 6 months prior to studyenrollment

• History of stroke, myocardial infarction, transient ischemic attack (TIA), severe orunstable angina, peripheral vascular disease, or grade II or greater congestiveheart failure within the past 6 months

• History of Torsades de Pointes or risk factors for Torsades de Pointes (e.g., heartfailure, hypokalemia, family history of Long QT Syndrome)