Atezolizumab and Pre-Surgical Brain Radiation Therapy for Glioblastoma Multiforme

Inclusion Criteria:

• Diagnosis of glioblastoma multiforme WHO Grade IV

• The patient is a surgical candidate, with the surgical intent for a > 80% resectionof the lesion

• Negative pregnancy test

• ECOG status <= 2

• Tumor volume <= 3.5 cm

• Adequate organ function

• Negative for infectious disease (human immunodeficiency virus, Hepatitis B Virus,Hepatitis C Virus, tubercolosis)

Exclusion Criteria:

• Presence of leptomeningeal disease, gliomatosis cerebri, multifocal disease,bilateral cerebral hemisphere involvement ("butterfly" gliomas)

• Patients at increased risk of neurologic decompensation

• Continued use of high dose intravenous or oral corticosteroids, or > 8milligrams perday of systemic dexamethasone

• Uncontrolled tumor-related pain

• Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrentdrainage procedures (once monthly or more frequently)

• Uncontrolled or symptomatic hypercalcemia

• History of autoimmune disease or immune deficiency

• History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitisobliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence ofactive pneumonitis

• Significant cardiovascular disease

• History of other malignancy within 1 year prior to screening

• Severe infection within 4 weeks prior to initiation of study treatment

• History of allogeneic stem cell or organ transplant

• Prior treatment with CD137 agonists or immune checkpoint blockade therapies

• Treatment with systemic immunostimulatory agents

• Treatment with systemic immunosuppressive medication