Mibefradil Dihydrochloride and Temozolomide in Treating Patients With Recurrent Glioma

OBJECTIVES: Primary * Determine the maximum-tolerated dose (MTD) of mibefradil dihydrochloride administered prior to five days of temozolomide (TMZ) at 150-200 mg/m² in subjects with progressive or recurrent high-grade glioma. Secondary * Assess the safety of mibefradil dihydrochloride administered prior to five days of TMZ at 150-200 mg/m² when the mibefradil dihydrochloride dose is escalated from a starting dose of 100 mg/day, given four times a day for seven consecutive days. * Determine the pharmacokinetic profile of mibefradil. * Determine the steady state levels of mibefradil dihydrochloride on the last day of dosing. * Assess the severity and frequency of adverse events for tested mibefradil dihydrochloride dose levels including cumulative toxicity and/or tolerance to adverse effects. * Estimate the number and type of radiographic responses to treatment with mibefradil dihydrochloride and temozolomide. * Assess the potential effect of mibefradil dihydrochloride on tumor metabolism as determined by Fluorothymidine Positron Emission Tomography (FLT PET) scans with the radiotracer \[18F\]-3'-fluoro-3'-deoxy-L-thymidine (dose-expansion cohort only). OUTLINE: This is a dose-escalation study of mibefradil dihydrochloride followed by a dose-expansion study. Patients receive mibefradil dihydrochloride orally (PO) 4 times a day on days 1-7 (days 1-8 on first course) and temozolomide PO on days 8-12 (days 9-13 on first course). Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Blood samples are collected during the first course for pharmacokinetic studies. Patients in the dose-expansion cohort undergo \[18F\]-3'-fluoro-3'-deoxy-L-thymidine (FLT)-positron emission tomography (PET) at baseline and on day 7 of the first course of therapy. After completion of study therapy, patients are followed up every 2 months.