PRIMARY OBJECTIVE:~I. Determine the feasibility of serial cerebrospinal fluid (CSF) assessments to evaluate the pharmacodynamic impact of agents targeting radiation-induced biology administered following completion of brain radiation.~SECONDARY OBJECTIVE:~I. Assess the safety of study drug(s) as quantified by dose-limiting toxicities.~CORRELATIVE RESEARCH OBJECTIVES:~I. Investigate the relationship of the global CSF metabolome with magnetic resonance spectroscopy metabolite profile.~II. Investigate the relationship between brain radiation dose/volume and metabolic alterations in CSF.~III. Investigate the impact of metabolic therapy on early cognitive effects of radiotherapy in patients with brain tumors.~IV. Utilize paired blood samples to investigate association between the CSF and systemic metabolome.~V. Utilize paired stool samples to investigate association between the blood and CSF metabolome with the gastrointestinal microbiome.~OUTLINE: Patients are assigned to 1 of 2 cohorts.~COHORT I (EARLY POST-RADIATION): Patients within Cohort I are assigned to 1 of 2 arms.~ARM A: Patients receive standard of care therapy.~ARM B: Patients receive standard of care therapy and receive AEO orally (PO) two times daily (BID) for 1 month on study.~COHORT II (DELAYED POST-RADIATION): Patients within Cohort II are assigned to 1 of 2 arms.~ARM A: Patients receive standard of care therapy.~ARM B: Patients receive standard of care therapy and receive AEO PO BID for 3 months on study.~Patients in all cohorts and arms also undergo magnetic resonance spectroscopy (MRS) imaging, collection of cerebrospinal fluid (CSF), and collection of blood on study.
This phase I trial studies the impact of taking drugs (agents) that target altered brain metabolism following standard of care brain radiotherapy. Radiotherapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. However, radiotherapy can also cause harmful effects to normal brain functioning. One drug, called anhydrous enol-oxaloacetate (AEO), has previously been studied in ischemic stroke, Alzheimer's disease, Parkinson's disease, and glioma. Drugs such as AEO may help preserve or restore healthy brain function after brain radiotherapy compared to the standard practice which consists of no drugs.