
    low accrual
  
['glioblastoma multiforme', 'astrocytoma, grade iv']
['poly-iclc', 'temozolomide']

        Inclusion Criteria:

          -  Newly diagnosed histologically confirmed glioblastoma multiforme (WHO grade IV).
             Patients with secondary glioblastoma, in particular those who are IDH1 or IDH2 mutant,
             will not be excluded.

          -  Patients who had craniotomy with biopsy, subtotal resection, total gross resection, or
             re-resection will be permitted.

          -  Consented to genome sequencing and dbGaP-based data sharing and has provided or will
             provide germline (PBMC) and tumor DNA/RNA samples of adequate quality for sequencing.
             (Acquisition of specimens for sequencing and the sequencing itself may be done under
             this study or as part of routine care or another research project.)

          -  At least 18 years of age.

          -  Karnofsky performance status ≥ 60%

          -  Normal bone marrow and organ function as defined below:

               -  Absolute neutrophil count ≥ 1,500/mcL

               -  Platelets ≥ 100,000/mcL

               -  Total bilirubin ≤ 1.5 x IULN

               -  AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN

               -  Creatinine ≤ IULN OR creatinine clearance ≥ 60 mL/min/1.73 m2 for patients with
                  creatinine levels above institutional normal

          -  Systemic corticosteroid therapy is permitted provided dosing is no greater than 4 mg
             per day (dexamethasone or equivalent) on the day of vaccine administration

          -  Bevacizumab will be allowed if given for symptomatic control of vasogenic edema and to
             avoid high dose of corticosteroids

          -  Women of childbearing potential and men must agree to use adequate contraception
             (hormonal or barrier method of birth control, abstinence) prior to study entry and for
             the duration of study participation. Should a woman become pregnant or suspect she is
             pregnant while participating in this study, she must inform her treating physician
             immediately.

          -  Ability to understand and willingness to sign an IRB approved written informed consent
             document (or that of legally authorized representative, if applicable).

        Exclusion Criteria:

          -  As this is a safety and feasibility study, prior immunotherapy will be permitted.
             However, any prior immunotherapy must be discontinued at least 2 weeks before peptide
             vaccine administration. Non-immunologic therapy may be continued.

          -  Inadequate tissue acquisition to allow for neoantigen screening

          -  No candidate neoantigen identified during screening

          -  A history of other malignancy ≤ 3 years previous with the exception of non-melanoma
             skin cancer, any in situ cancer that has been successfully resected and cured, treated
             superficial bladder cancer, or any early-stage solid tumor that was successfully
             resected without need for adjuvant radiation or chemotherapy.

          -  Currently receiving any other investigational agents.

          -  Known allergy, or history of serious adverse reaction to, vaccines such as
             anaphylaxis, hives, or respiratory difficulty.

          -  A history of allergic reactions attributed to compounds of similar chemical or
             biologic composition to poly-ICLC or other agents used in the study.

          -  Uncontrolled intercurrent illness including, but not limited to, ongoing or active
             infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
             arrhythmia, or psychiatric illness/social situations that would limit compliance with
             study requirements.

          -  History of pre-existing immunodeficiency disorder including chronic infection (i.e.
             hepatitis B, hepatitis C, HIV), or autoimmune condition requiring immunosuppressive
             therapy. This includes inflammatory bowel disease, ulcerative colitis, Crohn's
             disease, systemic vasculitis, scleroderma, psoriasis, multiple sclerosis, hemolytic
             anemia, immune-mediated thrombocytopenia, rheumatoid arthritis, systemic lupus
             erythematosus, Sjogren's syndrome, sarcoidosis, or other rheumatologic disease or any
             other medical condition or use of medication which might make it difficult for the
             patient to complete the full course of treatments or to generate an immune response to
             vaccines.

          -  Presence of clinically significant increased intracranial pressure (e.g. impending
             herniation) or hemorrhage, uncontrolled seizures, or requirement for immediate
             palliative treatment.

          -  Pregnant and/or breastfeeding. Women of childbearing potential must have a negative
             pregnancy test within 7 days of first dose of vaccine.
      