- *DLT visit will only be performed in phase I. In phase I, visit 2.3 is only performed additionally; if the start of cycle 3 is prolonged for more than 3 days after the DLT visit, all patients in phase II have visit 2.3
- **EoT: end of treatment is reached 3 days after last MFA intake (phase I and experimental arm of phase II) or on day 31 of the last TMZ cycle (standard arm of phase II)
- ***End of study and of follow-up in the entire trial will be reached when both of the following requirements are fulfilled: (1) at least 6 months after randomization of the last patient in phase II and (2) at least 3 days after definite termination of MFA intake in the last patient receiving MFA therapy (i.e., all patients have concluded study-related MFA intake for more than 3 days)
- 1Every 8 weeks: progression assessment, Karnofsky score and QoL, blood samples
- 2Na, K, creatinine, ASAT, ALAT, bilirubin
- 3Gadolinium-enhanced MRI obtained prior to inclusion/randomization can be used as baseline MRI if the interval between this MRI and the start of study therapy is shorter than 21 days. In patients who have undergone re-resection prior to randomization (only possible in phase II), the MRI used as baseline MRI has to be a postoperative MRI
- 4Relapse tumor resection 7–10 days after initiation of study therapy, tissue asservation should take place 2–4 h after the last intake of MFA/TMZ: (1) fresh frozen, (2) 4% PFA, and (3) FFPE tumor material for MFA/MFA metabolite level determination and for analysis of MFA-dependent tissue effects. The exact timepoint of the last MFA intake prior to resection and the exact timepoint of asservation of the tumor material have to be documented
- 5Timepoints (to be documented): (a) 2 h after first intake, (b) on the days between MFA start and resection daily blood sampling 2 h after morning application of MFA (optional), and (c) on the day of resection 5 blood samples at an interval of 2 h (0 h (prior to last preOP MFA dose) 2 h, 4 h, 6 h, 8 h later)
- 6Only at the first follow-up visit after discontinuation of MFA
- 7Only during ongoing MFA treatment + 3 days
- 8Only if clinically indicated