Valproic Acid in Childhood Progressive Brain Tumors

Patients with progressive or recurrent pediatric brain tumors are administered valproic
acid, an HDAC inhibitor, along with standard of care therapy (radiation and temozolomide)
for induction therapy. Thereafter, patients will be able to continue on valproic acid and
temozolomide therapy as long as the combination is well tolerated and the tumor is not
progressing.

Inclusion Criteria:

- Subject, parent, or guardian willing and able to give informed consent

- Recurrent or progressive pediatric brain tumor, with MRI evidence of disease

- Age at first diagnosis of brain tumor 1-21 years old

- Lansky or Karnofsky performance score of at least 50 at diagnosis

Exclusion Criteria:

- Pregnancy

- Prior intolerance to valproic acid

- History of use of temozolomide

- Use of enzyme inducing anticonvulsant medications (see appendix B)

- Known urea cycle disorder (e.g. ornithine transcarbamylase deficiency)