Inclusion Criteria:

• Age ≥ 18 years.
• Clinical and radiographic evidence suggesting a diagnosis of a diffuse high grade glioma (HGG), or a prior diagnosis of a diffuse glioma.
• Planned subtotal resection due to tumor location, size, or other clinical indication deemed appropriate by the surgeon.
• Provide written informed consent for the current study and the Neuro-Oncology biorepository for archiving of ceerebal spinal fluid (CSF) and blood samples collected on this protocol. Willing to remain in the hospital at Mayo Clinic (Rochester, MN) for three days added to their standard post-operative stay to undergo longitudinal microdialysis.
• Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L without transfusion within 7 days preceding the lab assessment (obtained ≤ 14 days prior to registration).
• Platelet ≥ 100 x 10^9/L, without transfusion within 7 days preceding the lab assessment (obtained ≤ 14 days prior to registration)
• Hemoglobin ≥ 9 g/dL, without transfusion support within 7 days preceding the lab assessment (obtained ≤ 14 days prior to registration).
• Activated partial thromboplastin time/ partial thromboplastin time (aPTT/PTT) ≤ 1.5 x upper limit of normal (ULN) (obtained ≤ 14 days prior to registration).
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN (obtained ≤ 14 days prior to registration)
• Total serum bilirubin ≤ 1.5 x ULN (obtained ≤ 14 days prior to registration).
• The patient is clinically euthyroid.
• Serum creatinine ≤ 1.5 x ULN or creatinine clearance ≤ 60 mL/min/1.73 m^2 for patients with serum creatinine levels above 1.5 x ULN (obtained ≤ 14 days prior to registration).
• Negative serum or urine pregnancy test is required for female subjects of childbearing age.

Exclusion Criteria:

• Patients who are not appropriate surgical candidates due to current or past medical history or uncontrolled concurrent illness which limits safety of or compliance to study proceedings.
• Vulnerable populations: pregnant or nursing women, prisoners, mentally handicapped.
• Participants who are unable to swallow tablets or who are at risk for impaired absorption of oral medication.
  • NOTE: This includes but not limited to, refractory vomiting, gastric resection/bypass, and duodenal/jejunal resection.
• Patients with known hypersensitivity or allergy to DFMO or AMXT 1501.
• Contraindication to MRI or administration of gadolinium.

Eligibility last updated 3/21/23. Questions regarding updates should be directed to the study team contact.